Blood Products Advisory Committee Meeting April 26, 2007 Ben Marchlewicz, Ph.D. PRISM R&D, Program Manager
Abbott’s approach to Chagas Testing PRISM Chagas Description of the assay Performance Chagas Confirmatory Description of the assay Performance
Abbott’s Strategy in Blood Screening for Chagas Disease Develop a recombinant antigen based assay for antibodies to T. cruzi on the PRISM platform Well-characterized antigens Presenting multiple epitopes Non-biohazardous Develop a recombinant antigen based Confirmatory assay for resolution of PRISM Repeat Reactive specimens.
PRISM Chagas Assay
PRISM Chagas Screening Assay Design Configuration Dual rAg Coated P, Single mAb Conjugate, Two–Step Assay
Multi-epitope rAg Amino acidsMol. Wt. (Kda) TcF858.3 FP FP FP Multi-epitope Recombinant Antigens used in PRISM Chagas Assay
Specificity StudyTotal Repeatedly Reactive Confirmed Positive Resolved Specificity In-House Feasibility Testing 7, % Field Study4, % Total11, % Random Donors
Specificity StudyTotal Specificity Leishmania visceral (sourced from India) 30100% Leishmania cutaneous (sourced from India) 11100% Malaria10100% Cross Reactivity with other Parasitic Infections
PRISM Chagas Assay Sensitivity Chagas Positive Specimens (confirmed by RIPA) RIPA Positive RIPA Negative PRISM Positive PRISM Negative00 Sensitivity 100% Sensitivity
Chagas Confirmatory Assay
Design of Chagas Confirmatory Immunostrip Anti-hIgG (Sample Addition CTL) hIgG-H CTL hIgG-L CTL (Cut-off) 4 rAgs for anti-T. cruzi detection TcF FP3 FP6 FP10 ID# Test BandsOn-board CTL bands
Visual Reading of Test Bands IntensityScore Absent - Faint or < on-board hIgG-L CTL +/- = on-board hIgG-L CTL 1+ Between on-board hIgG-L CTL and hIgG-H CTL 2+ = on-board hIgG-H CTL 3+ > on-board hIgG-H CTL 4+
Sensitivity RIPA Positive RIPA Negative Immunoblot Chagas Confirmatory Positive 410*0 Immunoblot Chagas Confirmatory Negative % Sensitivity * Also reactive in PRISM Assay & 2 reference ELISA’s
Country of Origin# of Samples Argentina 41 Bolivia53 Brazil176 Chile5 Colombia1 Ecuador1 El Salvador12 Honduras4 Mexico33 Nicaragua17 Surinam1 USA4 Venezuela21 Unknown41 Chagas Specimens Panel n = 410 (All are confirmed RIPA positive)
Specificity RIPA Positive PRISM Chagas Assay Non-reactive Immunoblot Chagas Confirmatory Positive 1*0 Immunoblot Chagas Confirmatory Negative % Resolved Specificity Unscreened Random Blood Donors * Also reactive in PRISM Assay & 2 reference ELISA’s
Specificity RIPA Positive PRISM Chagas Assay Non-reactive Immunoblot Chagas Confirmatory Positive 2*0 Immunoblot Chagas Confirmatory Negative % Resolved Specificity Unrelated Medical Conditions * Also reactive in PRISM Assay & 2 reference ELISA’s
Specificity StudyTotal Specificity Leishmania visceral (sourced from India) 30100% Leishmania cutaneous (sourced from India) 11100% Malaria10100% Cross Reactivity with other Parasitic Infections
Summary A fully automated blood screening assay for antibodies to T. Cruzi, on the PRISM system, is under development; Along with an Immunoblot Confirmatory assay, that can be performed on site, to confirm Repeat Reactive specimens to aid in donor management.