701
|
Luo S, Zhang P, Liu B, Yang C, Liang C, Wang Q, Zhang L, Tang X, Li J, Hou S, Zeng J, Fu Y, Allain JP, Li T, Zhang Y, Li C. Prime-boost vaccination of mice and rhesus macaques with two novel adenovirus vectored COVID-19 vaccine candidates. Emerg Microbes Infect 2021; 10:1002-1015. [PMID: 33993845 PMCID: PMC8172228 DOI: 10.1080/22221751.2021.1931466] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
ABSTRACTCOVID-19 vaccines are being developed urgently worldwide. Here, we constructed two adenovirus vectored COVID-19 vaccine candidates of Sad23L-nCoV-S and Ad49L-nCoV-S carrying the full-length gene of SARS-CoV-2 spike protein. The immunogenicity of two vaccines was individually evaluated in mice. Specific immune responses were observed by priming in a dose-dependent manner, and stronger responses were obtained by boosting. Furthermore, five rhesus macaques were primed with 5 × 109 PFU Sad23L-nCoV-S, followed by boosting with 5 × 109 PFU Ad49L-nCoV-S at 4-week interval. Both mice and macaques well tolerated the vaccine inoculations without detectable clinical or pathologic changes. In macaques, prime-boost regimen induced high titers of 103.16 anti-S, 102.75 anti-RBD binding antibody and 102.38 pseudovirus neutralizing antibody (pNAb) at 2 months, while pNAb decreased gradually to 101.45 at 7 months post-priming. Robust T-cell response of IFN-γ (712.6 SFCs/106 cells), IL-2 (334 SFCs/106 cells) and intracellular IFN-γ in CD4+/CD8+ T cell (0.39%/0.55%) to S peptides were detected in vaccinated macaques. It was concluded that prime-boost immunization with Sad23L-nCoV-S and Ad49L-nCoV-S can safely elicit strong immunity in animals in preparation of clinical phase 1/2 trials.
Collapse
Affiliation(s)
- Shengxue Luo
- Department of Pediatrics, Shenzhen Hospital, Southern Medical University, Shenzhen, People's Republic of China.,Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China.,Guangzhou Bai Rui Kang (BRK) Biological Science and Technology Limited Company, People's Republic of China
| | - Panli Zhang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China.,Guangzhou Bai Rui Kang (BRK) Biological Science and Technology Limited Company, People's Republic of China
| | - Bochao Liu
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China.,Guangzhou Bai Rui Kang (BRK) Biological Science and Technology Limited Company, People's Republic of China
| | - Chan Yang
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, People's Republic of China
| | - Chaolan Liang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China.,Guangzhou Bai Rui Kang (BRK) Biological Science and Technology Limited Company, People's Republic of China
| | - Qi Wang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China.,Guangzhou Bai Rui Kang (BRK) Biological Science and Technology Limited Company, People's Republic of China
| | - Ling Zhang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China
| | - Xi Tang
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China.,Department of Infection, The First People's Hospital of Foshan, Foshan, People's Republic of China
| | - Jinfeng Li
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China.,Shenzhen Key Laboratory of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, People's Republic of China
| | - Shuiping Hou
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China.,Guangzhou Center for Disease Control and Prevention, Guangzhou, People's Republic of China
| | - Jinfeng Zeng
- Shenzhen Blood Center, Shenzhen, People's Republic of China
| | - Yongshui Fu
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China.,Guangzhou Blood Center, Guangzhou, People's Republic of China
| | - Jean-Pierre Allain
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China.,Emeritus Professor, University of Cambridge, Cambridge, UK
| | - Tingting Li
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China
| | - Yuming Zhang
- Department of Pediatrics, Shenzhen Hospital, Southern Medical University, Shenzhen, People's Republic of China
| | - Chengyao Li
- Department of Transfusion Medicine, School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China
| |
Collapse
|
702
|
Norouzi M, Norouzi S, Ruggiero A, Khan MS, Myers S, Kavanagh K, Vemuri R. Type-2 Diabetes as a Risk Factor for Severe COVID-19 Infection. Microorganisms 2021; 9:1211. [PMID: 34205044 PMCID: PMC8229474 DOI: 10.3390/microorganisms9061211] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/22/2021] [Accepted: 05/31/2021] [Indexed: 01/08/2023] Open
Abstract
The current outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), termed coronavirus disease 2019 (COVID-19), has generated a notable challenge for diabetic patients. Overall, people with diabetes have a higher risk of developing different infectious diseases and demonstrate increased mortality. Type 2 diabetes mellitus (T2DM) is a significant risk factor for COVID-19 progression and its severity, poor prognosis, and increased mortality. How diabetes contributes to COVID-19 severity is unclear; however, it may be correlated with the effects of hyperglycemia on systemic inflammatory responses and immune system dysfunction. Using the envelope spike glycoprotein SARS-CoV-2, COVID-19 binds to angiotensin-converting enzyme 2 (ACE2) receptors, a key protein expressed in metabolic organs and tissues such as pancreatic islets. Therefore, it has been suggested that diabetic patients are more susceptible to severe SARS-CoV-2 infections, as glucose metabolism impairments complicate the pathophysiology of COVID-19 disease in these patients. In this review, we provide insight into the COVID-19 disease complications relevant to diabetes and try to focus on the present data and growing concepts surrounding SARS-CoV-2 infections in T2DM patients.
Collapse
Affiliation(s)
- Mahnaz Norouzi
- Department of Genetics, Faculty of Sciences, Shahid Chamran University of Ahvaz, Ahvaz 61355, Iran;
| | - Shaghayegh Norouzi
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, Melbourne, VIC 3083, Australia
| | - Alistaire Ruggiero
- Department of Pathology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA; (A.R.); (K.K.)
| | - Mohammad S. Khan
- Center for Precision Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA;
| | - Stephen Myers
- College of Health and Medicine, School of Health Sciences, University of Tasmania, Hobart, TAS 7005, Australia;
| | - Kylie Kavanagh
- Department of Pathology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA; (A.R.); (K.K.)
- College of Health and Medicine, School of Health Sciences, University of Tasmania, Hobart, TAS 7005, Australia;
| | - Ravichandra Vemuri
- Department of Pathology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA; (A.R.); (K.K.)
| |
Collapse
|
703
|
Damodharan K, Arumugam GS, Ganesan S, Doble M, Thennarasu S. A comprehensive overview of vaccines developed for pandemic viral pathogens over the past two decades including those in clinical trials for the current novel SARS-CoV-2. RSC Adv 2021; 11:20006-20035. [PMID: 35479882 PMCID: PMC9033969 DOI: 10.1039/d0ra09668g] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/14/2021] [Indexed: 12/12/2022] Open
Abstract
The unprecedented coronavirus disease 2019 (COVID-19) is triggered by a novel strain of coronavirus namely, Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2). Researchers are working around the clock to control this pandemic and consequent waves of viral reproduction, through repurposing existing drugs as well as designing new vaccines. Several countries have hastened vaccine design and clinical trials to quickly address this outbreak. Currently, more than 250 aspirants against SARS-CoV-2 are in progress, including mRNA-replicating or non-replicating viral vectored-, DNA-, autologous dendritic cell-based-, and inactivated virus-vaccines. Vaccines work by prompting effector mechanisms such as cells/molecules, which target quickly replicating pathogens and neutralize their toxic constituents. Vaccine-stimulated immune effectors include adjuvant, affinity, avidity, affinity maturation, antibodies, antigen-presenting cells, B lymphocytes, carrier protein, CD4+ T-helper cells. In this review, we describe updated information on the various vaccines available over the last two decades, along with recent progress in the ongoing battle developing 63 diverse vaccines against SARS-CoV-2. The inspiration of our effort is to convey the current investigation focus on registered clinical trials (as of January 08, 2021) that satisfy the safety and efficacy criteria of international wide vaccine development.
Collapse
Affiliation(s)
- Kannan Damodharan
- Department of Organic and Bioorganic Chemistry, CSIR-Central Leather Research Institute (CLRI) Chennai 600020 India
- Bioengineering and Drug Design Lab, Department of Biotechnology, Indian Institute of Technology Madras (IITM) Chennai 600032 India
| | | | - Suresh Ganesan
- Bioengineering and Drug Design Lab, Department of Biotechnology, Indian Institute of Technology Madras (IITM) Chennai 600032 India
| | - Mukesh Doble
- Bioengineering and Drug Design Lab, Department of Biotechnology, Indian Institute of Technology Madras (IITM) Chennai 600032 India
| | - Sathiah Thennarasu
- Department of Organic and Bioorganic Chemistry, CSIR-Central Leather Research Institute (CLRI) Chennai 600020 India
| |
Collapse
|
704
|
Feraoun Y, Maisonnasse P, Le Grand R, Beignon AS. [COVID-19: Warp Speed vaccines]. Med Sci (Paris) 2021; 37:759-772. [PMID: 34080537 DOI: 10.1051/medsci/2021094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
A vaccine is required to effectively control the COVID-19 pandemic in the mid and long term. The development of vaccines against SARS-CoV-2 was initiated as soon as the genetic sequence of the virus was published, and has evolved at an unprecedented speed, with a first clinical trial launched in March 2020. One year later, more than a dozen of vaccines based on different concepts, with some having been evaluated only in clinical trials so far, are authorized under emergency procedures. Here, we review these vaccines, compare their properties and discuss the challenges they face, including the emergence of viral variants of concern.
Collapse
Affiliation(s)
- Yanis Feraoun
- Immunologie des maladies virales, auto-immunes, hématologiques et bactériennes (IMVA-HB), Département IDMIT (Infectious Disease Models and Innovative Therapies), UMR 1184, Université Paris-Saclay, Unité Inserm 1184, CEA, 18 route du Panorama, 92265 Fontenay-aux-Roses, France
| | - Pauline Maisonnasse
- Immunologie des maladies virales, auto-immunes, hématologiques et bactériennes (IMVA-HB), Département IDMIT (Infectious Disease Models and Innovative Therapies), UMR 1184, Université Paris-Saclay, Unité Inserm 1184, CEA, 18 route du Panorama, 92265 Fontenay-aux-Roses, France
| | - Roger Le Grand
- Immunologie des maladies virales, auto-immunes, hématologiques et bactériennes (IMVA-HB), Département IDMIT (Infectious Disease Models and Innovative Therapies), UMR 1184, Université Paris-Saclay, Unité Inserm 1184, CEA, 18 route du Panorama, 92265 Fontenay-aux-Roses, France
| | - Anne-Sophie Beignon
- Immunologie des maladies virales, auto-immunes, hématologiques et bactériennes (IMVA-HB), Département IDMIT (Infectious Disease Models and Innovative Therapies), UMR 1184, Université Paris-Saclay, Unité Inserm 1184, CEA, 18 route du Panorama, 92265 Fontenay-aux-Roses, France
| |
Collapse
|
705
|
Comparison and Analysis of Neutralizing Antibody Levels in Serum after Inoculating with SARS-CoV-2, MERS-CoV, or SARS-CoV Vaccines in Humans. Vaccines (Basel) 2021; 9:vaccines9060588. [PMID: 34199384 PMCID: PMC8229804 DOI: 10.3390/vaccines9060588] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/24/2021] [Accepted: 05/28/2021] [Indexed: 11/20/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Middle East respiratory syndrome coronavirus (MERS-CoV), and severe acute respiratory syndrome coronavirus (SARS-CoV) pose a great threat to humanity. Every pandemic involving these coronaviruses has seriously affected human health and economic development. Currently, there are no approved therapeutic drugs against their infections. Therefore, the development of vaccines is particularly important to combat these coronaviruses. In this review, we summarized and analyzed the progress of vaccines against SARS-CoV, MERS-CoV, and SARS-CoV-2, including inactivated vaccines, live attenuated vaccines, subunit vaccines, nucleic acid vaccines, and viral vector vaccines. In addition, we compared the levels of neutralizing antibodies in the serum of patients with these three kinds of coronaviruses at different stages, and their ability and effects against SARS-CoV-2, MERS-CoV, and SARS-CoV. This review provides useful information for vaccine evaluation and analysis.
Collapse
|
706
|
Sandor AM, Sturdivant MS, Ting JPY. Influenza Virus and SARS-CoV-2 Vaccines. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2021; 206:2509-2520. [PMID: 34021048 PMCID: PMC8722349 DOI: 10.4049/jimmunol.2001287] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/29/2021] [Indexed: 12/13/2022]
Abstract
Seasonal influenza and the current COVID-19 pandemic represent looming global health challenges. Efficacious and safe vaccines remain the frontline tools for mitigating both influenza virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced diseases. This review will discuss the existing strategies for influenza vaccines and how these strategies have informed SARS-CoV-2 vaccines. It will also discuss new vaccine platforms and potential challenges for both viruses.
Collapse
Affiliation(s)
- Adam M Sandor
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC; and
| | - Michael S Sturdivant
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Biological and Biomedical Sciences Program, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jenny P Y Ting
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC;
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| |
Collapse
|
707
|
Zella D, Giovanetti M, Cella E, Borsetti A, Ciotti M, Ceccarelli G, D’Ettorre G, Pezzuto A, Tambone V, Campanozzi L, Magheri M, Unali F, Bianchi M, Benedetti F, Pascarella S, Angeletti S, Ciccozzi M. The importance of genomic analysis in cracking the coronavirus pandemic. Expert Rev Mol Diagn 2021; 21:547-562. [PMID: 33849359 PMCID: PMC8095159 DOI: 10.1080/14737159.2021.1917998] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/13/2021] [Indexed: 12/11/2022]
Abstract
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has pushed the scientific community to undertake intense research efforts. Understanding SARS-CoV-2 biology is necessary to discover therapeutic or preventive strategies capable of containing the pandemic. Knowledge of the structural characteristics of the virus genome and proteins is essential to find targets for therapies and immunological interventions.Areas covered: This review covers different areas of expertise, genomic analysis of circulating strains, structural biology, viral mutations, molecular diagnostics, disease, and vaccines. In particular, the review is focused on the molecular approaches and modern clinical strategies used in these fields.Expert opinion: Molecular approaches to SARS-CoV-2 pandemic have been critical to shorten time for new diagnostic, therapeutic and prevention strategies. In this perspective, the entire scientific community is moving in the same direction. Vaccines, together with the development of new drugs to treat the disease, represent the most important strategy to protect human from viral disease and prevent further spread. In this regard, new molecular technologies have been successfully implemented. The use of a novel strategy of communication is suggested for a better diffusion to the broader public of new data and results.
Collapse
Affiliation(s)
- Davide Zella
- Institute of Human Virology, Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore, USA
- , Member of the Global Virus Network, Baltimore, USA
| | - Marta Giovanetti
- Flavivirus Laboratory, Oswaldo Cruz Institute Oswaldo Cruz Foundation, Rio De Janeiro, Brazil
| | - Eleonora Cella
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida, USA
| | - Alessandra Borsetti
- Department of infectious diseases, National HIV/AIDS Research Center Istituto Superiore Di Sanità, Rome, Italy
| | - Marco Ciotti
- Virology Unit, Laboratory of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, Rome, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Gabriella D’Ettorre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Aldo Pezzuto
- Cardiovascular-Respiratory Science Department, Sant’ Andrea Hospital-Sapienza University, Rome, Italy
| | - Vittoradolfo Tambone
- Institute of Philosophy of Scientific and Technological Practice, Campus Bio-Medico University, Rome, Italy
| | - Laura Campanozzi
- Institute of Philosophy of Scientific and Technological Practice, Campus Bio-Medico University, Rome, Italy
| | - Marco Magheri
- Communication Division, University Campus Bio-Medico of Rome, Rome, Italy
| | - Francesco Unali
- Communication Division, University Campus Bio-Medico of Rome, Rome, Italy
| | - Martina Bianchi
- Department of Biochemical Sciences “A. Rossi Fanelli”, University of Rome “La Sapienza”, Rome, Italy
| | - Francesca Benedetti
- Institute of Human Virology, Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore, USA
| | - Stefano Pascarella
- Department of Biochemical Sciences “A. Rossi Fanelli”, University of Rome “La Sapienza”, Rome, Italy
| | - Silvia Angeletti
- Unit of Clinical Laboratory Science, University Campus Bio-Medico of Rome, Rome, Italy
| | - Massimo Ciccozzi
- Unit of Medical Statistics and Molecular Epidemiology, University Campus Bio-Medico of Rome, Rome, Italy
| |
Collapse
|
708
|
Angeli F, Spanevello A, Reboldi G, Visca D, Verdecchia P. SARS-CoV-2 vaccines: Lights and shadows. Eur J Intern Med 2021; 88:1-8. [PMID: 33966930 PMCID: PMC8084611 DOI: 10.1016/j.ejim.2021.04.019] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/27/2022]
Abstract
Vaccines to prevent acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection elicit an immune neutralizing response. Some concerns have been raised regarding the safety of SARS-CoV-2 vaccines, largely based on case-reports of serious thromboembolic events after vaccination. Some mechanisms have been suggested which might explain the adverse cardiovascular reactions to SARS-CoV-2 vaccines. Different vaccine platforms are currently available which include live attenuated vaccines, inactivated vaccines, recombinant protein vaccines, vector vaccines, DNA vaccines and RNA vaccines. Vaccines increase the endogenous synthesis of SARS-CoV-2 Spike proteins from a variety of cells. Once synthetized, the Spike proteins assembled in the cytoplasma migrate to the cell surface and protrude with a native-like conformation. These proteins are recognized by the immune system which rapidly develops an immune response. Such response appears to be quite vigorous in the presence of DNA vaccines which encode viral vectors, as well as in subjects who are immunized because of previous exposure to SARS-CoV-2. The resulting pathological features may resemble those of active coronavirus disease. The free-floating Spike proteins synthetized by cells targeted by vaccine and destroyed by the immune response circulate in the blood and systematically interact with angiotensin converting enzyme 2 (ACE2) receptors expressed by a variety of cells including platelets, thereby promoting ACE2 internalization and degradation. These reactions may ultimately lead to platelet aggregation, thrombosis and inflammation mediated by several mechanisms including platelet ACE2 receptors. Whereas Phase III vaccine trials generally excluded participants with previous immunization, vaccination of huge populations in the real life will inevitably include individuals with preexisting immunity. This might lead to excessively enhanced inflammatory and thrombotic reactions in occasional subjects. Further research is urgently needed in this area.
Collapse
Affiliation(s)
- Fabio Angeli
- Department of Medicine and Surgery, University of Insubria, Varese and Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institute, IRCCS Tradate, Varese, Italy.
| | - Antonio Spanevello
- Department of Medicine and Surgery, University of Insubria, Varese and Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institute, IRCCS Tradate, Varese, Italy
| | - Gianpaolo Reboldi
- Department of Medicine, and Centro di Ricerca Clinica e Traslazionale (CERICLET), University of Perugia, Perugia, Italy
| | - Dina Visca
- Department of Medicine and Surgery, University of Insubria, Varese and Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institute, IRCCS Tradate, Varese, Italy
| | - Paolo Verdecchia
- Fondazione Umbra Cuore e Ipertensione-ONLUS and Division of Cardiology, Hospital S. Maria della Misericordia, Perugia, Italy
| |
Collapse
|
709
|
Liao SH, Hung CC, Chen CN, Yen JY, Hsu CY, Yen AMF, Chen CL. Assessing efficacy of antiviral therapy for COVID-19 patients: A case study on remdesivir with bayesian synthesis design and multistate analysis. J Formos Med Assoc 2021; 120 Suppl 1:S77-S85. [PMID: 34074579 PMCID: PMC8096194 DOI: 10.1016/j.jfma.2021.04.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/18/2021] [Accepted: 04/21/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/PURPOSE A synthesis design and multistate analysis is required for assessing the clinical efficacy of antiviral therapy on dynamics of multistate disease progression and in reducing the mortality and enhancing the recovery of patients with COVID-19. A case study on remdesivir was illustrated for the clinical application of such a novel design and analysis. METHODS A Bayesian synthesis design was applied to integrating the empirical evidence on the one-arm compassion study and the two-arm ACTT-1 trial for COVID-19 patients treated with remdesivir. A multistate model was developed to model the dynamics of hospitalized COVID-19 patients from three transient states of low, medium-, and high-risk until the two outcomes of recovery and death. The outcome measures for clinical efficacy comprised high-risk state, death, and discharge. RESULTS The efficacy of remdesivir in reducing the risk of death and enhancing the odds of recovery were estimated as 31% (95% CI, 18-44%) and 10% (95% CI, 1-18%), respectively. Remdesivir therapy for patients with low-risk state showed the efficacy in reducing subsequent progression to high-risk state and death by 26% (relative rate (RR), 0.74; 95% CI, 0.55-0.93) and 62% (RR, 0.38; 95% CI, 0.29-0.48), respectively. Less but still statistically significant efficacy in mortality reduction was noted for the medium- and high-risk patients. Remdesivir treated patients had a significantly shorter period of hospitalization (9.9 days) compared with standard care group (12.9 days). CONCLUSION The clinical efficacy of remdesvir therapy in reducing mortality and accelerating discharge has been proved by the Bayesian synthesis design and multistate analysis.
Collapse
Affiliation(s)
- Sih-Han Liao
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Section of Gastroenterology, Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chien-Ching Hung
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chiung-Nien Chen
- Center for Functional Image and Interventional Therapy, National Taiwan University, Taipei, Taiwan; Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Jui-Yi Yen
- Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chen-Yang Hsu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Dachung Hospital, Miaoli, Taiwan
| | - Amy Ming-Fang Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chi-Ling Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|
710
|
Nielsen SS, Vibholm LK, Monrad I, Olesen R, Frattari GS, Pahus MH, Højen JF, Gunst JD, Erikstrup C, Holleufer A, Hartmann R, Østergaard L, Søgaard OS, Schleimann MH, Tolstrup M. SARS-CoV-2 elicits robust adaptive immune responses regardless of disease severity. EBioMedicine 2021; 68:103410. [PMID: 34098342 PMCID: PMC8176920 DOI: 10.1016/j.ebiom.2021.103410] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The SARS-CoV-2 pandemic currently prevails worldwide. To understand the immunological signature of SARS-CoV-2 infections and aid the search and evaluation of new treatment modalities and vaccines, comprehensive characterization of adaptive immune responses towards SARS-CoV-2 is needed. METHODS We included 203 recovered SARS-CoV-2 infected patients in Denmark between April 3rd and July 9th 2020, at least 14 days after COVID-19 symptom recovery. The participants had experienced a range of disease severities from asymptomatic to severe. We collected plasma, serum and PBMC's for analysis of SARS-CoV-2 specific antibody response by Meso Scale analysis including other coronavirus strains, ACE2 competition, IgA ELISA, pseudovirus neutralization capacity, and dextramer flow cytometry analysis of CD8+ T cells. The immunological outcomes were compared amongst severity groups within the cohort, and 10 pre-pandemic SARS-CoV-2 negative controls. FINDINGS We report broad serological profiles within the cohort, detecting antibody binding to other human coronaviruses. 202(>99%) participants had SARS-CoV-2 specific antibodies, with SARS-CoV-2 neutralization and spike-ACE2 receptor interaction blocking observed in 193(95%) individuals. A significant positive correlation (r=0.7804) between spike-ACE2 blocking antibody titers and neutralization potency was observed. Further, SARS-CoV-2 specific CD8+ T-cell responses were clear and quantifiable in 95 of 106(90%) HLA-A2+ individuals. INTERPRETATION The viral surface spike protein was identified as the dominant target for both neutralizing antibodies and CD8+ T-cell responses. Overall, the majority of patients had robust adaptive immune responses, regardless of their disease severity. FUNDING This study was supported by the Danish Ministry for Research and Education (grant# 0238-00001B) and The Danish Innovation Fund (grant# 0208-00018B).
Collapse
Affiliation(s)
- Stine Sf Nielsen
- Department of Infectious Diseases, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| | - Line K Vibholm
- Department of Infectious Diseases, Aarhus University Hospital, Denmark
| | - Ida Monrad
- Department of Infectious Diseases, Aarhus University Hospital, Denmark
| | - Rikke Olesen
- Department of Infectious Diseases, Aarhus University Hospital, Denmark
| | | | - Marie H Pahus
- Department of Clinical Medicine, Aarhus University, Denmark
| | - Jesper F Højen
- Department of Infectious Diseases, Aarhus University Hospital, Denmark
| | - Jesper D Gunst
- Department of Infectious Diseases, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| | | | - Andreas Holleufer
- Department of Molecular Biology and Genetics, Aarhus University, Denmark
| | - Rune Hartmann
- Department of Molecular Biology and Genetics, Aarhus University, Denmark
| | - Lars Østergaard
- Department of Infectious Diseases, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| | - Ole S Søgaard
- Department of Infectious Diseases, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| | | | - Martin Tolstrup
- Department of Infectious Diseases, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| |
Collapse
|
711
|
Cromer D, Juno JA, Khoury D, Reynaldi A, Wheatley AK, Kent SJ, Davenport MP. Prospects for durable immune control of SARS-CoV-2 and prevention of reinfection. Nat Rev Immunol 2021; 21:395-404. [PMID: 33927374 PMCID: PMC8082486 DOI: 10.1038/s41577-021-00550-x] [Citation(s) in RCA: 181] [Impact Index Per Article: 60.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2021] [Indexed: 12/16/2022]
Abstract
Immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is central to long-term control of the current pandemic. Despite our rapidly advancing knowledge of immune memory to SARS-CoV-2, understanding how these responses translate into protection against reinfection at both the individual and population levels remains a major challenge. An ideal outcome following infection or after vaccination would be a highly protective and durable immunity that allows for the establishment of high levels of population immunity. However, current studies suggest a decay of neutralizing antibody responses in convalescent patients, and documented cases of SARS-CoV-2 reinfection are increasing. Understanding the dynamics of memory responses to SARS-CoV-2 and the mechanisms of immune control are crucial for the rational design and deployment of vaccines and for understanding the possible future trajectories of the pandemic. Here, we summarize our current understanding of immune responses to and immune control of SARS-CoV-2 and the implications for prevention of reinfection.
Collapse
Affiliation(s)
- Deborah Cromer
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Jennifer A Juno
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - David Khoury
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Arnold Reynaldi
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Adam K Wheatley
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Stephen J Kent
- Department of Microbiology and Immunology, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.
| | | |
Collapse
|
712
|
Welsh J. Coronavirus Variants-Will New mRNA Vaccines Meet the Challenge? ENGINEERING (BEIJING, CHINA) 2021; 7:712-714. [PMID: 33898075 PMCID: PMC8053359 DOI: 10.1016/j.eng.2021.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
|
713
|
Rana MM. Polymer-based nano-therapies to combat COVID-19 related respiratory injury: progress, prospects, and challenges. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2021; 32:1219-1249. [PMID: 33787467 PMCID: PMC8054481 DOI: 10.1080/09205063.2021.1909412] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/13/2021] [Accepted: 03/17/2021] [Indexed: 12/13/2022]
Abstract
The recent coronavirus disease-2019 (COVID-19) outbreak has increased at an alarming rate, representing a substantial cause of mortality worldwide. Respiratory injuries are major COVID-19 related complications, leading to poor lung circulation, tissue scarring, and airway obstruction. Despite an in-depth investigation of respiratory injury's molecular pathogenesis, effective treatments have yet to be developed. Moreover, early detection of viral infection is required to halt the disease-related long-term complications, including respiratory injuries. The currently employed detection technique (quantitative real-time polymerase chain reaction or qRT-PCR) failed to meet this need at some point because it is costly, time-consuming, and requires higher expertise and technical skills. Polymer-based nanobiosensing techniques can be employed to overcome these limitations. Polymeric nanomaterials have the potential for clinical applications due to their versatile features like low cytotoxicity, biodegradability, bioavailability, biocompatibility, and specific delivery at the targeted site of action. In recent years, innovative polymeric nanomedicine approaches have been developed to deliver therapeutic agents and support tissue growth for the inflamed organs, including the lung. This review highlights the most recent advances of polymer-based nanomedicine approaches in infectious disease diagnosis and treatments. This paper also focuses on the potential of novel nanomedicine techniques that may prove to be therapeutically efficient in fighting against COVID-19 related respiratory injuries.
Collapse
Affiliation(s)
- Md Mohosin Rana
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
714
|
|
715
|
Ye Q, Lu S, Corbett KD. Structural basis for SARS-CoV-2 Nucleocapsid protein recognition by single-domain antibodies. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2021:2021.06.01.446591. [PMID: 34100017 PMCID: PMC8183014 DOI: 10.1101/2021.06.01.446591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic, caused by the coronavirus SARS-CoV-2, is the most severe public health event of the twenty-first century. While effective vaccines against SARS-CoV-2 have been developed, there remains an urgent need for diagnostics to quickly and accurately detect infections. Antigen tests, particularly those that detect the abundant SARS-CoV-2 Nucleocapsid protein, are a proven method for detecting active SARS-CoV-2 infections. Here we report high-resolution crystal structures of three llama-derived single-domain antibodies that bind the SARS-CoV-2 Nucleocapsid protein with high affinity. Each antibody recognizes a specific folded domain of the protein, with two antibodies recognizing the N-terminal RNA binding domain and one recognizing the C-terminal dimerization domain. The two antibodies that recognize the RNA binding domain affect both RNA binding affinity and RNA-mediated phase separation of the Nucleocapsid protein. All three antibodies recognize highly-conserved surfaces on the Nucleocapsid protein, suggesting that they could be used to develop affordable diagnostic tests to detect all circulating SARS-CoV-2 variants.
Collapse
Affiliation(s)
- Qiaozhen Ye
- Department of Cellular & Molecular Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA
| | - Shan Lu
- Department of Cellular & Molecular Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA
| | - Kevin D. Corbett
- Department of Cellular & Molecular Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA
- Department of Chemistry and Biochemistry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA
| |
Collapse
|
716
|
Beeraka NM, Tulimilli SV, Karnik M, Sadhu SP, Pragada RR, Aliev G, Madhunapantula SV. The Current Status and Challenges in the Development of Vaccines and Drugs against Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2). BIOMED RESEARCH INTERNATIONAL 2021; 2021:8160860. [PMID: 34159203 PMCID: PMC8168478 DOI: 10.1155/2021/8160860] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 04/16/2021] [Accepted: 05/19/2021] [Indexed: 02/07/2023]
Abstract
Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection causes coronavirus disease-19 (COVID-19), which is characterized by clinical manifestations such as pneumonia, lymphopenia, severe acute respiratory distress, and cytokine storm. S glycoprotein of SARS-CoV-2 binds to angiotensin-converting enzyme II (ACE-II) to enter into the lungs through membrane proteases consequently inflicting the extensive viral load through rapid replication mechanisms. Despite several research efforts, challenges in COVID-19 management still persist at various levels that include (a) availability of a low cost and rapid self-screening test, (b) lack of an effective vaccine which works against multiple variants of SARS-CoV-2, and (c) lack of a potent drug that can reduce the complications of COVID-19. The development of vaccines against SARS-CoV-2 is a complicated process due to the emergence of mutant variants with greater virulence and their ability to invoke intricate lung pathophysiology. Moreover, the lack of a thorough understanding about the virus transmission mechanisms and complete pathogenesis of SARS-CoV-2 is making it hard for medical scientists to develop a better strategy to prevent the spread of the virus and design a clinically viable vaccine to protect individuals from being infected. A recent report has tested the hypothesis of T cell immunity and found effective when compared to the antibody response in agammaglobulinemic patients. Understanding SARS-CoV-2-induced changes such as "Th-2 immunopathological variations, mononuclear cell & eosinophil infiltration of the lung and antibody-dependent enhancement (ADE)" in COVID-19 patients provides key insights to develop potential therapeutic interventions for immediate clinical management. Therefore, in this review, we have described the details of rapid detection methods of SARS-CoV-2 using molecular and serological tests and addressed different therapeutic modalities used for the treatment of COVID-19 patients. In addition, the current challenges against the development of vaccines for SARS-CoV-2 are also briefly described in this article.
Collapse
Affiliation(s)
- Narasimha M. Beeraka
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR), Department of Biochemistry, JSS Academy of Higher Education & Research (JSS AHER), Mysore, 570015 Karnataka, India
- Sechenov First Moscow State Medical University (Sechenov University), St. Trubetskaya, 8, Bld. 2, Moscow 119991, Russia
| | - SubbaRao V. Tulimilli
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR), Department of Biochemistry, JSS Academy of Higher Education & Research (JSS AHER), Mysore, 570015 Karnataka, India
| | - Medha Karnik
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR), Department of Biochemistry, JSS Academy of Higher Education & Research (JSS AHER), Mysore, 570015 Karnataka, India
| | - Surya P. Sadhu
- AU College of Pharmaceutical Sciences, Andhra University, Visakhapatnam, 530003 Andhra Pradesh, India
| | - Rajeswara Rao Pragada
- AU College of Pharmaceutical Sciences, Andhra University, Visakhapatnam, 530003 Andhra Pradesh, India
| | - Gjumrakch Aliev
- Sechenov First Moscow State Medical University (Sechenov University), St. Trubetskaya, 8, Bld. 2, Moscow 119991, Russia
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka, Moscow Region 142432, Russia
- Research Institute of Human Morphology, 3Tsyurupy Street, Moscow 117418, Russia
- GALLY International Research Institute, 7733 Louis Pasteur Drive, #330, San Antonio, TX 78229, USA
| | - SubbaRao V. Madhunapantula
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR), Department of Biochemistry, JSS Academy of Higher Education & Research (JSS AHER), Mysore, 570015 Karnataka, India
- Special Interest Group in Cancer Biology and Cancer Stem Cells (SIG-CBCSC), JSS Medical College, JSS Academy of Higher Education & Research (JSS AHER), Mysore, 570015 Karnataka, India
| |
Collapse
|
717
|
Bourdette D, Killestein J. Quelling Public Fears About Guillain-Barré Syndrome and COVID-19 Vaccination. Neurology 2021; 96:1021-1022. [PMID: 33824170 DOI: 10.1212/wnl.0000000000011882] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 11/15/2022] Open
Affiliation(s)
- Dennis Bourdette
- From the Department of Neurology (D.B.), Oregon Health & Science University, Portland; and Amsterdam UMC (J.K.), Vrije Universiteit Amsterdam, Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, the Netherlands
| | - Joep Killestein
- From the Department of Neurology (D.B.), Oregon Health & Science University, Portland; and Amsterdam UMC (J.K.), Vrije Universiteit Amsterdam, Department of Neurology, MS Center Amsterdam, Amsterdam Neuroscience, the Netherlands.
| |
Collapse
|
718
|
Márquez Loza AM, Holroyd KB, Johnson SA, Pilgrim DM, Amato AA. Guillain-Barré Syndrome in the Placebo and Active Arms of a COVID-19 Vaccine Clinical Trial: Temporal Associations Do Not Imply Causality. Neurology 2021; 96:1052-1054. [PMID: 33824169 DOI: 10.1212/wnl.0000000000011881] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/11/2021] [Indexed: 01/06/2023] Open
Affiliation(s)
| | - Kathryn B Holroyd
- From the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Stephen A Johnson
- From the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - David M Pilgrim
- From the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Anthony A Amato
- From the Department of Neurology, Brigham and Women's Hospital, Boston, MA.
| |
Collapse
|
719
|
Ikegame S, Siddiquey MNA, Hung CT, Haas G, Brambilla L, Oguntuyo KY, Kowdle S, Vilardo AE, Edelstein A, Perandones C, Kamil JP, Lee B. Neutralizing activity of Sputnik V vaccine sera against SARS-CoV-2 variants. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.03.31.21254660. [PMID: 33821288 PMCID: PMC8020991 DOI: 10.1101/2021.03.31.21254660] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The novel pandemic betacoronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has infected at least 120 million people since its identification as the cause of a December 2019 viral pneumonia outbreak in Wuhan, China. Despite the unprecedented pace of vaccine development, with six vaccines already in use worldwide, the emergence of SARS-CoV-2 'variants of concern' (VOC) across diverse geographic locales suggests herd immunity may fail to eliminate the virus. All three officially designated VOC carry Spike (S) polymorphisms thought to enable escape from neutralizing antibodies elicited during initial waves of the pandemic. Here, we characterize the biological consequences of the ensemble of S mutations present in VOC lineages B.1.1.7 (501Y.V1) and B.1.351 (501Y.V2). Using a replication-competent EGFP-reporter vesicular stomatitis virus (VSV) system, rcVSV-CoV2-S, which encodes S from SARS coronavirus 2 in place of VSV-G, and coupled with a clonal HEK-293T ACE2 TMPRSS2 cell line optimized for highly efficient S-mediated infection, we determined that only 1 out of 12 serum samples from a cohort of recipients of the Gamaleya Sputnik V Ad26 / Ad5 vaccine showed effective neutralization (IC90) of rcVSV-CoV2-S: B.1.351 at full serum strength. The same set of sera efficiently neutralized S from B.1.1.7 and showed only moderately reduced activity against S carrying the E484K substitution alone. Taken together, our data suggest that control of some emergent SARS-CoV-2 variants may benefit from updated vaccines.
Collapse
Affiliation(s)
- Satoshi Ikegame
- Department of Microbiology at the Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Mohammed N. A. Siddiquey
- Department of Microbiology and Immunology, Louisiana State University Health Shreveport, Shreveport, LA 71103, USA
| | - Chuan-Tien Hung
- Department of Microbiology at the Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Griffin Haas
- Department of Microbiology at the Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Luca Brambilla
- Department of Microbiology at the Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Kasopefoluwa Y. Oguntuyo
- Department of Microbiology at the Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Shreyas Kowdle
- Department of Microbiology at the Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ariel Esteban Vilardo
- National Administration of Laboratories and Health Institutes of Argentina (ANLIS) Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | - Alexis Edelstein
- National Administration of Laboratories and Health Institutes of Argentina (ANLIS) Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | - Claudia Perandones
- National Administration of Laboratories and Health Institutes of Argentina (ANLIS) Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | - Jeremy P. Kamil
- Department of Microbiology and Immunology, Louisiana State University Health Shreveport, Shreveport, LA 71103, USA
| | - Benhur Lee
- Department of Microbiology at the Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| |
Collapse
|
720
|
Montastruc JL, Lafaurie M, de Canecaude C, Montastruc F, Bagheri H, Durrieu G, Sommet A. COVID-19 vaccines: A perspective from social pharmacology. Therapie 2021; 76:311-315. [PMID: 34119317 PMCID: PMC8161798 DOI: 10.1016/j.therap.2021.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/04/2021] [Indexed: 12/03/2022]
Abstract
Social pharmacology is a branch of clinical pharmacology, which depicts relationships between society and drugs and in particular factors, reasons, social consequences of drug use as well as representations of drugs in the society. Recent development and marketing of coronavirus disease 2019 (COVID-19) vaccines raises a number of questions of social pharmacology: are vaccines drugs like any other? What is their perception at the individual, population and societal levels? How do individuals perceive the risks and benefits of these vaccines? What is the perception at the societal level? What is the individual and societal acceptability of these vaccines during a pandemic? All these questions are discussed in the light of recent data. A number of proposals, both at the individual and at the collective or population level, are formulated to help solve these problems of social pharmacology.
Collapse
Affiliation(s)
- Jean-Louis Montastruc
- Service de pharmacologie médicale et clinique, centre de pharmacovigilance, de pharmacoépidémiologie et d'informations sur le médicament, CIC INSERM 1436, centre hospitalier universitaire, faculté de médecine, 31000 Toulouse, France.
| | - Margaux Lafaurie
- Service de pharmacologie médicale et clinique, centre de pharmacovigilance, de pharmacoépidémiologie et d'informations sur le médicament, CIC INSERM 1436, centre hospitalier universitaire, faculté de médecine, 31000 Toulouse, France
| | - Claire de Canecaude
- Service de pharmacologie médicale et clinique, centre de pharmacovigilance, de pharmacoépidémiologie et d'informations sur le médicament, CIC INSERM 1436, centre hospitalier universitaire, faculté de médecine, 31000 Toulouse, France
| | - François Montastruc
- Service de pharmacologie médicale et clinique, centre de pharmacovigilance, de pharmacoépidémiologie et d'informations sur le médicament, CIC INSERM 1436, centre hospitalier universitaire, faculté de médecine, 31000 Toulouse, France
| | - Haleh Bagheri
- Service de pharmacologie médicale et clinique, centre de pharmacovigilance, de pharmacoépidémiologie et d'informations sur le médicament, CIC INSERM 1436, centre hospitalier universitaire, faculté de médecine, 31000 Toulouse, France
| | - Geneviève Durrieu
- Service de pharmacologie médicale et clinique, centre de pharmacovigilance, de pharmacoépidémiologie et d'informations sur le médicament, CIC INSERM 1436, centre hospitalier universitaire, faculté de médecine, 31000 Toulouse, France
| | - Agnès Sommet
- Service de pharmacologie médicale et clinique, centre de pharmacovigilance, de pharmacoépidémiologie et d'informations sur le médicament, CIC INSERM 1436, centre hospitalier universitaire, faculté de médecine, 31000 Toulouse, France
| |
Collapse
|
721
|
Scialo F, Vitale M, Daniele A, Nigro E, Perrotta F, Gelzo M, Iadevaia C, Cerqua FS, Costigliola A, Allocca V, Amato F, Pastore L, Castaldo G, Bianco A. SARS-CoV-2: One Year in the Pandemic. What Have We Learned, the New Vaccine Era and the Threat of SARS-CoV-2 Variants. Biomedicines 2021; 9:611. [PMID: 34072088 PMCID: PMC8226851 DOI: 10.3390/biomedicines9060611] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/11/2021] [Accepted: 05/20/2021] [Indexed: 02/07/2023] Open
Abstract
Since the beginning of 2020, the new pandemic caused by SARS-CoV-2 and named coronavirus disease 19 (COVID 19) has changed our socio-economic life. In just a few months, SARS-CoV-2 was able to spread worldwide at an unprecedented speed, causing hundreds of thousands of deaths, especially among the weakest part of the population. Indeed, especially at the beginning of this pandemic, many reports highlighted how people, suffering from other pathologies, such as hypertension, cardiovascular diseases, and diabetes, are more at risk of severe outcomes if infected. Although this pandemic has put the entire academic world to the test, it has also been a year of intense research and many important contributions have advanced our understanding of SARS-CoV-2 origin, its molecular structure and its mechanism of infection. Unfortunately, despite this great effort, we are still a long way from fully understanding how SARS-CoV-2 dysregulates organismal physiology and whether the current vaccines will be able to protect us from possible future pandemics. Here, we discuss the knowledge we have gained during this year and which questions future research should address.
Collapse
Affiliation(s)
- Filippo Scialo
- Dipartimento di Scienze Mediche Traslazionali, University of Campania “L. Vanvitelli”, 80131 Naples, Italy;
- CEINGE, Biotecnologie Avanzate, 80131 Naples, Italy; (M.V.); (A.D.); (E.N.); (M.G.); (F.A.); (G.C.)
| | - Maria Vitale
- CEINGE, Biotecnologie Avanzate, 80131 Naples, Italy; (M.V.); (A.D.); (E.N.); (M.G.); (F.A.); (G.C.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80131 Naples, Italy
| | - Aurora Daniele
- CEINGE, Biotecnologie Avanzate, 80131 Naples, Italy; (M.V.); (A.D.); (E.N.); (M.G.); (F.A.); (G.C.)
- Dipartimento di Scienze e Tecnologie Ambientali Biologiche Farmaceutiche, University of Campania “L. Vanvitelli”, 80131 Naples, Italy
| | - Ersilia Nigro
- CEINGE, Biotecnologie Avanzate, 80131 Naples, Italy; (M.V.); (A.D.); (E.N.); (M.G.); (F.A.); (G.C.)
- Dipartimento di Scienze e Tecnologie Ambientali Biologiche Farmaceutiche, University of Campania “L. Vanvitelli”, 80131 Naples, Italy
| | - Fabio Perrotta
- U.O.C Pneumologia Azienda Ospedaliera Sant’Anna e San Sebastiano, 81100 Caserta, Italy;
| | - Monica Gelzo
- CEINGE, Biotecnologie Avanzate, 80131 Naples, Italy; (M.V.); (A.D.); (E.N.); (M.G.); (F.A.); (G.C.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80131 Naples, Italy
| | - Carlo Iadevaia
- Pneumology Vanvitelly-COVID Unit A.O. dei Colli Hospital Monaldi, 80131 Naples, Italy; (C.I.); (F.S.C.); (A.C.); (V.A.)
| | - Francesco Saverio Cerqua
- Pneumology Vanvitelly-COVID Unit A.O. dei Colli Hospital Monaldi, 80131 Naples, Italy; (C.I.); (F.S.C.); (A.C.); (V.A.)
| | - Adriano Costigliola
- Pneumology Vanvitelly-COVID Unit A.O. dei Colli Hospital Monaldi, 80131 Naples, Italy; (C.I.); (F.S.C.); (A.C.); (V.A.)
| | - Valentino Allocca
- Pneumology Vanvitelly-COVID Unit A.O. dei Colli Hospital Monaldi, 80131 Naples, Italy; (C.I.); (F.S.C.); (A.C.); (V.A.)
| | - Felice Amato
- CEINGE, Biotecnologie Avanzate, 80131 Naples, Italy; (M.V.); (A.D.); (E.N.); (M.G.); (F.A.); (G.C.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80131 Naples, Italy
| | - Lucio Pastore
- CEINGE, Biotecnologie Avanzate, 80131 Naples, Italy; (M.V.); (A.D.); (E.N.); (M.G.); (F.A.); (G.C.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80131 Naples, Italy
| | - Giuseppe Castaldo
- CEINGE, Biotecnologie Avanzate, 80131 Naples, Italy; (M.V.); (A.D.); (E.N.); (M.G.); (F.A.); (G.C.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80131 Naples, Italy
| | - Andrea Bianco
- Dipartimento di Scienze Mediche Traslazionali, University of Campania “L. Vanvitelli”, 80131 Naples, Italy;
- Pneumology Vanvitelly-COVID Unit A.O. dei Colli Hospital Monaldi, 80131 Naples, Italy; (C.I.); (F.S.C.); (A.C.); (V.A.)
| |
Collapse
|
722
|
Moore JE, Millar BC. Improving COVID-19 vaccine-related health literacy and vaccine uptake in patients: Comparison on the readability of patient information leaflets of approved COVID-19 vaccines. J Clin Pharm Ther 2021; 46:1498-1500. [PMID: 34046929 PMCID: PMC8242599 DOI: 10.1111/jcpt.13453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 12/18/2022]
Abstract
What is known and objective Preparation of patient‐facing materials of a complex topic, such as describing new vaccines for COVID‐19, is difficult to accomplish. This study examined the readability of patient information leaflets accompanying approved COVID‐19 vaccines. Comment Readability of patient‐facing literature by the medicines regulator in the United States and the United Kingdom describing the recently US (FDA) and UK (MHRA) COVID‐19 approved vaccines (Pfizer/BioNTech, AstraZeneca, Moderna) was assessed employing 10 metrics. Analyses showed that showed that this material had a Flesch Ease of Reading score of 53.5 and 54, respectively and a Flesch‐Kincaid reading age of between 7th and 8th Grade (12–13 year olds) and between 8th and 9th Grade (13–14 year olds), respectively. When compared to a recent study on COVID‐19 information on healthcare websites, the vaccine literature readability was favourable. What is new & conclusion Adoption of readability calculators and scrutiny of materials of their readability will help authors develop materials with improved understanding for COVID‐19 vaccine recipients, carers and family, potentially leading to improved health literacy and vaccine uptake.
Collapse
Affiliation(s)
- John E Moore
- Laboratory for Disinfection and Pathogen Elimination Studies, Northern Ireland Public Health Laboratory, Nightingale (Belfast City) Hospital, Belfast, UK.,School of Medicine, Dentistry and Biomedical Sciences, The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, UK
| | - Beverley C Millar
- Laboratory for Disinfection and Pathogen Elimination Studies, Northern Ireland Public Health Laboratory, Nightingale (Belfast City) Hospital, Belfast, UK.,School of Medicine, Dentistry and Biomedical Sciences, The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, UK
| |
Collapse
|
723
|
Thrombotic Thrombocytopenia after COVID-19 Vaccination: In Search of the Underlying Mechanism. Vaccines (Basel) 2021; 9:vaccines9060559. [PMID: 34071883 PMCID: PMC8227748 DOI: 10.3390/vaccines9060559] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/13/2021] [Accepted: 05/21/2021] [Indexed: 02/06/2023] Open
Abstract
The rollout of COVID-19 vaccines brings hope for successful pandemic mitigation and getting the transmission of SARS-CoV-2 under control. The vaccines authorized in Europe displayed a good safety profile in the clinical trials. However, during their post-authorization use, unusual thrombotic events associated with thrombocytopenia have rarely been reported for vector vaccines. This led to the temporary suspension of the AZD1222 vaccine (Oxford/AstraZeneca) in various European countries and the Ad26.COV2 vaccine (Janssen/Johnson&Johnson) in the United States, with regulatory bodies launching investigations into potential causal associations. The thromboembolic reactions were also rarely reported after mRNA vaccines. The exact cause of these adverse effects remains to be elucidated. The present paper outlines the hypotheses on the mechanisms behind the very rare thrombotic thrombocytopenia reported after the COVID-19 vaccination, along with currently existing evidence and future research prospects. The following are discussed: (i) the role of antibodies against platelet factor 4 (PF4), (ii) the direct interaction between adenoviral vector and platelets, (iii) the cross-reactivity of antibodies against SARS-CoV-2 spike protein with PF4, (iv) cross-reactivity of anti-adenovirus antibodies and PF4, (v) interaction between spike protein and platelets, (vi) the platelet expression of spike protein and subsequent immune response, and (vii) the platelet expression of other adenoviral proteins and subsequent reactions. It is also plausible that thrombotic thrombocytopenia after the COVID-19 vaccine is multifactorial. The elucidation of the causes of these adverse events is pivotal in taking precautionary measures and managing vaccine hesitancy. It needs to be stressed, however, that the reported cases are currently sporadic and that the benefits of COVID-19 vaccines vastly outweigh their potential risks.
Collapse
|
724
|
Schiappacasse GV. Ethical Considerations in Chemotherapy and Vaccines in Cancer Patients in Times of the COVID-19 Pandemic. Curr Oncol 2021; 28:2007-2013. [PMID: 34073214 PMCID: PMC8161828 DOI: 10.3390/curroncol28030186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 situation is a worldwide health emergency with strong implications in clinical oncology. In this viewpoint, we address two crucial dilemmas from the ethical dimension: (1) Is it ethical to postpone or suspend cancer treatments which offer a statistically significant benefit in quality of life and survival in cancer patients during this time of pandemic?; (2) Should we vaccinate cancer patients against COVID-19 if scientific studies have not included this subgroup of patients? Regarding the first question, the best available evidence applied to the ethical principles of Beauchamp and Childress shows that treatments (such as chemotherapy) with clinical benefit are fair and beneficial. Indeed, the suspension or delay of such treatments should be considered malefic. Regarding the second question, applying the doctrine of double-effect, we show that the potential beneficial effect of vaccines in the population with cancer (or those one that has had cancer) is much higher than the potential adverse effects of these vaccines. In addition, there is no better and less harmful known solution.
Collapse
Affiliation(s)
- Guido V. Schiappacasse
- Oncology Department, Clinical Hospital of Viña del Mar, Limache Street 1741, Viña del Mar 2520000, Chile; ; Tel.: +56-959021201
- Oncology Department, Bupa Reñaca Clinic, Anabaena Street 336, Viña del Mar 2520000, Chile
| |
Collapse
|
725
|
|
726
|
Nappi F, Iervolino A, Avtaar Singh SS. Thromboembolic Complications of SARS-CoV-2 and Metabolic Derangements: Suggestions from Clinical Practice Evidence to Causative Agents. Metabolites 2021; 11:341. [PMID: 34070672 PMCID: PMC8229698 DOI: 10.3390/metabo11060341] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/18/2021] [Accepted: 05/22/2021] [Indexed: 01/08/2023] Open
Abstract
Severe Acute Respiratory Syndrome (SARS) Coronavirus (CoV)-2 is a recently identified positive sense single-strand RNA (ssRNA) β-coronavirus. The viral spike proteins infect human hosts by binding to the cellular receptor angiotensin-converting enzyme 2 (ACE2). The infection causes a systemic illness involving cell metabolism. This widespread involvement is implicated in the pathophysiology of the illness which ranges from mild to severe, requiring multi organ support, ranging from oxygen supplementation to full cardiovascular and respiratory support. Patients with multiple co-existing comorbidities are also at a higher risk. The aim of this review is to explore the exact mechanisms by which COVID-19 affects patients systemically with a primary focus on the bleeding and thrombotic complications linked with the disease. Issues surrounding the thrombotic complications following administration of the ChAdOx1 nCoV-19 (Astra-Zeneca-Oxford) vaccine have also been illustrated. Risk stratification and treatment options in these patients should be tailored according to clinical severity with input from a multidisciplinary team.
Collapse
Affiliation(s)
- Francesco Nappi
- Centre Cardiologique du Nord de Saint-Denis, Department of Cardiac Surgery, 93200 Saint-Denis, France
| | - Adelaide Iervolino
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCSS, 00168 Rome, Italy;
| | - Sanjeet Singh Avtaar Singh
- Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Agamemnon St, Clydebank G81 4DY, UK;
| |
Collapse
|
727
|
Alderson J, Batchelor V, O’Hanlon M, Cifuentes L, Richter FC, Kopycinski J. Overview of approved and upcoming vaccines for SARS-CoV-2: a living review. OXFORD OPEN IMMUNOLOGY 2021; 2:iqab010. [PMID: 34522886 PMCID: PMC8194545 DOI: 10.1093/oxfimm/iqab010] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/21/2021] [Indexed: 12/11/2022] Open
Abstract
The rapid design and implementation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines is testament to a successfully coordinated global research effort. While employing a variety of different technologies, some of which have been used for the first time, all approved vaccines demonstrate high levels of efficacy with excellent safety profiles. Despite this, there remains an urgent global demand for coronavirus disease 2019 vaccines that require further candidates to pass phase 3 clinical trials. In the expectation of SARS-CoV-2 becoming endemic, researchers are looking to adjust the vaccine constructs to tackle emerging variants. In this review, we outline different platforms used for approved vaccines and summarize latest research data with regards to immunogenicity, dosing regimens and efficiency against emerging variants.
Collapse
Affiliation(s)
- Jennifer Alderson
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Headington, OX3 7FY Oxford, UK
| | - Vicky Batchelor
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Headington, OX3 7FY Oxford, UK
| | - Miriam O’Hanlon
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Headington, OX3 7FY Oxford, UK
| | - Liliana Cifuentes
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Headington, OX3 7FY Oxford, UK
| | - Felix Clemens Richter
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kennedy Institute of Rheumatology, University of Oxford, Roosevelt Drive, Headington, OX3 7FY Oxford, UK
| | - Jakub Kopycinski
- Nuffield Department of Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Headington, OX3 7FZ Oxford, UK
| | | |
Collapse
|
728
|
Costanzo M, De Giglio MAR, Roviello GN. Anti-Coronavirus Vaccines: Past Investigations on SARS-CoV-1 and MERS-CoV, the Approved Vaccines from BioNTech/Pfizer, Moderna, Oxford/AstraZeneca and others under Development Against SARS-CoV-2 Infection. Curr Med Chem 2021; 29:4-18. [PMID: 34355678 DOI: 10.2174/0929867328666210521164809] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 11/22/2022]
Abstract
The aim of this review article is to summarize the knowledge available to date on prophylaxis achievements to fight against Coronavirus. This work will give an overview of what is reported in the most recent literature on vaccines (under investigation or already developed like BNT162b2, mRNA-1273, and ChAdOx1-S) effective against the most pathogenic Coronaviruses (SARS-CoV-1, MERS-CoV-1, and SARS-CoV-2), with of course particular attention paid to those under development or already in use to combat the current COVID-19 (COronaVIrus Disease 19) pandemic. Our main objective is to make a contribution to the comprehension, additionally at a molecular level, of what is currently ready for anti-SARS-CoV-2 prophylactic intervention, as well as to provide the reader with an overall picture of the most innovative approaches for the development of vaccines that could be of general utility in the fight against the most pathogenic Coronaviruses.
Collapse
Affiliation(s)
- Michele Costanzo
- Department of Molecular Medicine and Medical Biotechnology, School of Medicine, University of Naples 'Federico II', Via S. Pansini 5, I-80131 Naples, Italy
| | | | - Giovanni N Roviello
- Istituto di Biostrutture e Bioimmagini IBB - CNR, Via Mezzocannone 16; I-80134 Naples, Italy
| |
Collapse
|
729
|
Nanishi E, Borriello F, O'Meara TR, McGrath ME, Saito Y, Haupt RE, Seo HS, van Haren SD, Brook B, Chen J, Diray-Arce J, Doss-Gollin S, Leon MD, Chew K, Menon M, Song K, Xu AZ, Caradonna TM, Feldman J, Hauser BM, Schmidt AG, Sherman AC, Baden LR, Ernst RK, Dillen C, Weston SM, Johnson RM, Hammond HL, Mayer R, Burke A, Bottazzi ME, Hotez PJ, Strych U, Chang A, Yu J, Barouch DH, Dhe-Paganon S, Zanoni I, Ozonoff A, Frieman MB, Levy O, Dowling DJ. Alum:CpG adjuvant enables SARS-CoV-2 RBD-induced protection in aged mice and synergistic activation of human elder type 1 immunity. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2021. [PMID: 34031655 DOI: 10.1101/2021.05.20.444848] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Global deployment of vaccines that can provide protection across several age groups is still urgently needed to end the COVID-19 pandemic especially for low- and middle-income countries. While vaccines against SARS-CoV-2 based on mRNA and adenoviral-vector technologies have been rapidly developed, additional practical and scalable SARS-CoV-2 vaccines are needed to meet global demand. In this context, protein subunit vaccines formulated with appropriate adjuvants represent a promising approach to address this urgent need. Receptor-binding domain (RBD) is a key target of neutralizing antibodies (Abs) but is poorly immunogenic. We therefore compared pattern recognition receptor (PRR) agonists, including those activating STING, TLR3, TLR4 and TLR9, alone or formulated with aluminum hydroxide (AH), and benchmarked them to AS01B and AS03-like emulsion-based adjuvants for their potential to enhance RBD immunogenicity in young and aged mice. We found that the AH and CpG adjuvant formulation (AH:CpG) demonstrated the highest enhancement of anti-RBD neutralizing Ab titers in both age groups (∼80-fold over AH), and protected aged mice from the SARS-CoV-2 challenge. Notably, AH:CpG-adjuvanted RBD vaccine elicited neutralizing Abs against both wild-type SARS-CoV-2 and B.1.351 variant at serum concentrations comparable to those induced by the authorized mRNA BNT162b2 vaccine. AH:CpG induced similar cytokine and chemokine gene enrichment patterns in the draining lymph nodes of both young adult and aged mice and synergistically enhanced cytokine and chemokine production in human young adult and elderly mononuclear cells. These data support further development of AH:CpG-adjuvanted RBD as an affordable vaccine that may be effective across multiple age groups. One Sentence Summary Alum and CpG enhance SARS-CoV-2 RBD protective immunity, variant neutralization in aged mice and Th1-polarizing cytokine production by human elder leukocytes.
Collapse
|
730
|
Park JH, Lee HK. Delivery Routes for COVID-19 Vaccines. Vaccines (Basel) 2021; 9:524. [PMID: 34069359 PMCID: PMC8158705 DOI: 10.3390/vaccines9050524] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/12/2021] [Accepted: 05/17/2021] [Indexed: 12/14/2022] Open
Abstract
The novel coronavirus, SARS-CoV-2, which causes COVID-19, has resulted in a pandemic with millions of deaths. To eradicate SARS-CoV-2 and prevent further infections, many vaccine candidates have been developed. These vaccines include not only traditional subunit vaccines and attenuated or inactivated viral vaccines but also nucleic acid and viral vector vaccines. In contrast to the diversity in the platform technology, the delivery of vaccines is limited to intramuscular vaccination. Although intramuscular vaccination is safe and effective, mucosal vaccination could improve the local immune responses that block the spread of pathogens. However, a lack of understanding of mucosal immunity combined with the urgent need for a COVID-19 vaccine has resulted in only intramuscular vaccinations. In this review, we summarize the history of vaccines, current progress in COVID-19 vaccine technology, and the status of intranasal COVID-19 vaccines. Future research should determine the most effective route for vaccine delivery based on the platform and determine the mechanisms that underlie the efficacy of different delivery routes.
Collapse
Affiliation(s)
| | - Heung Kyu Lee
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, Korea;
| |
Collapse
|
731
|
Smith TE, Kister I. Infection Mitigation Strategies for Multiple Sclerosis Patients on Oral and Monoclonal Disease-Modifying Therapies. Curr Neurol Neurosci Rep 2021; 21:36. [PMID: 34009478 PMCID: PMC8132488 DOI: 10.1007/s11910-021-01117-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW The newer, higher-efficacy disease-modifying therapies (DMTs) for multiple sclerosis (MS)-orals and monoclonals-have more profound immunomodulatory and immunosuppressive properties than the older, injectable therapies and require risk mitigation strategies to reduce the risk of serious infections. This review will provide a systematic framework for infectious risk mitigation strategies relevant to these therapies. RECENT FINDINGS We classify risk mitigation strategies according to the following framework: (1) screening and patient selection, (2) vaccinations, (3) antibiotic prophylaxis, (4) laboratory and MRI monitoring, (5) adjusting dose and frequency of DMT, and (6) behavioral modifications to limit the risk of infection. We systematically apply this framework to the infections for which risk mitigations are available: hepatitis B, herpetic infections, progressive multifocal leukoencephalopathy, and tuberculosis. We also discuss up-to-date recommendations regarding COVID-19 vaccinations for patients on DMTs. We offer a practical, comprehensive, DMT-specific framework of derisking strategies designed to minimize the risk of infections associated with the newer MS therapies.
Collapse
Affiliation(s)
- Tyler Ellis Smith
- Department of Neurology, NYU-Multiple Sclerosis Care Center, NYU School of Medicine, New York, NY, USA.
- , New York, NY, USA.
| | - Ilya Kister
- Department of Neurology, NYU-Multiple Sclerosis Care Center, NYU School of Medicine, New York, NY, USA
| |
Collapse
|
732
|
Pucci F, Rooman M. Prediction and Evolution of the Molecular Fitness of SARS-CoV-2 Variants: Introducing SpikePro. Viruses 2021; 13:935. [PMID: 34070055 PMCID: PMC8158131 DOI: 10.3390/v13050935] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 12/18/2022] Open
Abstract
The understanding of the molecular mechanisms driving the fitness of the SARS-CoV-2 virus and its mutational evolution is still a critical issue. We built a simplified computational model, called SpikePro, to predict the SARS-CoV-2 fitness from the amino acid sequence and structure of the spike protein. It contains three contributions: the inter-human transmissibility of the virus predicted from the stability of the spike protein, the infectivity computed in terms of the affinity of the spike protein for the ACE2 receptor, and the ability of the virus to escape from the human immune response based on the binding affinity of the spike protein for a set of neutralizing antibodies. Our model reproduces well the available experimental, epidemiological and clinical data on the impact of variants on the biophysical characteristics of the virus. For example, it is able to identify circulating viral strains that, by increasing their fitness, recently became dominant at the population level. SpikePro is a useful, freely available instrument which predicts rapidly and with good accuracy the dangerousness of new viral strains. It can be integrated and play a fundamental role in the genomic surveillance programs of the SARS-CoV-2 virus that, despite all the efforts, remain time-consuming and expensive.
Collapse
Affiliation(s)
- Fabrizio Pucci
- Computational Biology and Bioinformatics, Université Libre de Bruxelles, 1050 Brussels, Belgium;
- Interuniversity Institute of Bioinformatics in Brussels, 1050 Brussels, Belgium
| | - Marianne Rooman
- Computational Biology and Bioinformatics, Université Libre de Bruxelles, 1050 Brussels, Belgium;
- Interuniversity Institute of Bioinformatics in Brussels, 1050 Brussels, Belgium
| |
Collapse
|
733
|
Mao Q, Xu M, He Q, Li C, Meng S, Wang Y, Cui B, Liang Z, Wang J. COVID-19 vaccines: progress and understanding on quality control and evaluation. Signal Transduct Target Ther 2021; 6:199. [PMID: 34006829 PMCID: PMC8129697 DOI: 10.1038/s41392-021-00621-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/19/2021] [Accepted: 04/26/2021] [Indexed: 11/09/2022] Open
Abstract
The outbreak of COVID-19 has posed a huge threat to global health and economy. Countermeasures have revolutionized norms for working, socializing, learning, and travel. Importantly, vaccines have been considered as most effective tools to combat with COVID-19. As of the beginning of 2021, >200 COVID-19 vaccine candidates, covering nearly all existing technologies and platforms, are being research and development (R&D) by multiple manufacturers worldwide. This has posed a huge obstacle to the quality control and evaluation of those candidate vaccines, especially in China, where five vaccine platforms are deployed in parallel. To accelerate the R&D progress of COVID-19 vaccines, the guidances on R&D of COVID-19 vaccine have been issued by National Regulatory Authorities or organizations worldwide. The Center for Drug Evaluation and national quality control laboratory in China have played a leading role in launching the research on quality control and evaluation in collaboration with relevant laboratories involved in the vaccine R&D, which greatly supported the progression of vaccines R&D, and accelerated the approval for emergency use and conditional marketing of currently vaccine candidates. In this paper, the progress and experience gained in quality control and evaluation of COVID-19 vaccines developed in China are summarized, which might provide references for the R&D of current and next generation of COVID-19 vaccines worldwide.
Collapse
Affiliation(s)
- Qunying Mao
- National Institutes for Food and Drug Control, Beijing, China
| | - Miao Xu
- National Institutes for Food and Drug Control, Beijing, China
| | - Qian He
- National Institutes for Food and Drug Control, Beijing, China
| | - Changgui Li
- National Institutes for Food and Drug Control, Beijing, China
| | - Shufang Meng
- National Institutes for Food and Drug Control, Beijing, China
| | - Yiping Wang
- National Institutes for Food and Drug Control, Beijing, China
| | - Bopei Cui
- National Institutes for Food and Drug Control, Beijing, China
| | - Zhenglun Liang
- National Institutes for Food and Drug Control, Beijing, China.
| | - Junzhi Wang
- National Institutes for Food and Drug Control, Beijing, China.
| |
Collapse
|
734
|
Pucci F, Rooman M. Prediction and Evolution of the Molecular Fitness of SARS-CoV-2 Variants: Introducing SpikePro. Viruses 2021; 13:v13050935. [PMID: 34070055 DOI: 10.1101/2021.04.11.439322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 05/25/2023] Open
Abstract
The understanding of the molecular mechanisms driving the fitness of the SARS-CoV-2 virus and its mutational evolution is still a critical issue. We built a simplified computational model, called SpikePro, to predict the SARS-CoV-2 fitness from the amino acid sequence and structure of the spike protein. It contains three contributions: the inter-human transmissibility of the virus predicted from the stability of the spike protein, the infectivity computed in terms of the affinity of the spike protein for the ACE2 receptor, and the ability of the virus to escape from the human immune response based on the binding affinity of the spike protein for a set of neutralizing antibodies. Our model reproduces well the available experimental, epidemiological and clinical data on the impact of variants on the biophysical characteristics of the virus. For example, it is able to identify circulating viral strains that, by increasing their fitness, recently became dominant at the population level. SpikePro is a useful, freely available instrument which predicts rapidly and with good accuracy the dangerousness of new viral strains. It can be integrated and play a fundamental role in the genomic surveillance programs of the SARS-CoV-2 virus that, despite all the efforts, remain time-consuming and expensive.
Collapse
Affiliation(s)
- Fabrizio Pucci
- Computational Biology and Bioinformatics, Université Libre de Bruxelles, 1050 Brussels, Belgium
- Interuniversity Institute of Bioinformatics in Brussels, 1050 Brussels, Belgium
| | - Marianne Rooman
- Computational Biology and Bioinformatics, Université Libre de Bruxelles, 1050 Brussels, Belgium
- Interuniversity Institute of Bioinformatics in Brussels, 1050 Brussels, Belgium
| |
Collapse
|
735
|
Sheikh AB, Pal S, Javed N, Shekhar R. COVID-19 Vaccination in Developing Nations: Challenges and Opportunities for Innovation. Infect Dis Rep 2021; 13:429-436. [PMID: 34069242 PMCID: PMC8162348 DOI: 10.3390/idr13020041] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/08/2021] [Accepted: 05/12/2021] [Indexed: 12/14/2022] Open
Abstract
Vaccines offer a hope toward ending the global pandemic caused by SARS-CoV2. Mass vaccination of the global population offers hope to curb the spread. Developing nations, however, face monumental challenges in procurement, allocation, distribution and uptake of vaccines. Inequities in vaccine supply are already evident with resource-rich nations having secured a large chunk of the available vaccine doses for 2021. Once supplies are made available, vaccines will have to be distributed and administered to entire populations—with considerations for individual risk level, remote geography, cultural and socio-economic factors. This would require logistical and trained personnel support that can be hard to come by for resource-poor nations. Several vaccines also require ultra-cold temperatures for storage and transport and therefore the need for specialized equipment and reliable power supply which may also not be readily available. Lastly, attention will need to be paid to ensuring adequate uptake of vaccines since vaccine hesitancy has already been reported for COVID vaccines. However, existing strengths of local and regional communities can be leveraged to provide innovative solutions and mitigate some of the challenges. Regional and international cooperation can also play a big role in ensuring equity in vaccine access and vaccination.
Collapse
Affiliation(s)
- Abu Baker Sheikh
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA
- Correspondence:
| | - Suman Pal
- Department of Internal Medicine, Division of Hospital Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA; (S.P.); (R.S.)
| | - Nismat Javed
- Shifa College of Medicine, Shifa Tameer-e-Millat University, Islamabad 44000, Pakistan;
| | - Rahul Shekhar
- Department of Internal Medicine, Division of Hospital Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA; (S.P.); (R.S.)
| |
Collapse
|
736
|
McDonald I, Murray SM, Reynolds CJ, Altmann DM, Boyton RJ. Comparative systematic review and meta-analysis of reactogenicity, immunogenicity and efficacy of vaccines against SARS-CoV-2. NPJ Vaccines 2021; 6:74. [PMID: 33986272 PMCID: PMC8116645 DOI: 10.1038/s41541-021-00336-1] [Citation(s) in RCA: 166] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/15/2021] [Indexed: 02/03/2023] Open
Abstract
As SARS-CoV-2 vaccines are deployed worldwide, a comparative evaluation is important to underpin decision-making. We here report a systematic literature review and meta-analysis of Phase I/II/III human trials and non-human primates (NHP) studies, comparing reactogenicity, immunogenicity and efficacy across different vaccine platforms for comparative evaluation (updated to March 22, 2021). Twenty-three NHP and 32 human studies are included. Vaccines result in mostly mild, self-limiting adverse events. Highest spike neutralizing antibody (nAb) responses are identified for the mRNA-1273-SARS-CoV and adjuvanted NVX-CoV2373-SARS-CoV-2 vaccines. ChAdOx-SARS-CoV-2 produces the highest T cell ELISpot responses. Pre-existing nAb against vaccine viral vector are identified following AdH-5-SARS-CoV-2 vaccination, halving immunogenicity. The mRNA vaccines depend on boosting to achieve optimal immunogenicity especially in the elderly. BNT162b2, and mRNA-1273 achieve >94%, rAd26/5 > 91% and ChAdOx-SARS-CoV-2 > 66.7% efficacy. Across different vaccine platforms there are trade-offs between antibody binding, functional nAb titers, T cell frequency, reactogenicity and efficacy. Emergence of variants makes rapid mass rollout of high efficacy vaccines essential to reduce any selective advantage.
Collapse
Affiliation(s)
- Ian McDonald
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Sam M Murray
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Catherine J Reynolds
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Daniel M Altmann
- Department of Immunology and Inflammation, Faculty of Medicine, Imperial College London, London, UK.
| | - Rosemary J Boyton
- Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK.
- Lung Division, Royal Brompton and Harefield Hospitals, London, UK.
| |
Collapse
|
737
|
Hildreth JEK, Alcendor DJ. Targeting COVID-19 Vaccine Hesitancy in Minority Populations in the US: Implications for Herd Immunity. Vaccines (Basel) 2021; 9:489. [PMID: 34064726 PMCID: PMC8151325 DOI: 10.3390/vaccines9050489] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 02/08/2023] Open
Abstract
There has been a continuous underrepresentation of minorities in healthcare research and vaccine trials, along with long-standing systemic racism and discrimination that have been fueling the distrust of the healthcare system among these communities for decades. The history and legacy of racial injustices and negative experiences within a culturally insensitive healthcare system have greatly contributed to vaccine hesitancy among ethnic minorities. COVID-19 vaccine hesitancy will impact vaccine uptake in the US, subsequently hindering the establishment of herd immunity (75-85% of the population vaccinated) to mitigate SARS-CoV-2 infection and transmission. Information targeting underserved racial/ethnic minorities in the US in a culturally competent manner has been lacking. This information is crucial for educating these communities about COVID-19 vaccines and their distribution as well as dispelling misinformation regarding vaccine trials, safety, and efficacy. This lack of education has greatly contributed to COVID-19 vaccine hesitancy and will increase disparities in vaccine uptake. Moreover, timely vaccinations are also essential to curtailing virus transmission and the emergence of SARS-CoV-2 variants that may evade the immune response produced by the three existing COVID-19 vaccines.
Collapse
Affiliation(s)
- James E. K. Hildreth
- Center for AIDS Health Disparities Research, Department of Microbiology and Immunology, School of Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Nashville, TN 37208-3599, USA;
- Department of Internal Medicine, School of Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Nashville, TN 37208-3599, USA
- Center for AIDS Health Disparities Research, Department of Microbiology, Immunology, and Physiology, School of Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| | - Donald J. Alcendor
- Center for AIDS Health Disparities Research, Department of Microbiology and Immunology, School of Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Nashville, TN 37208-3599, USA;
- Center for AIDS Health Disparities Research, Department of Microbiology, Immunology, and Physiology, School of Medicine, Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Nashville, TN 37208, USA
| |
Collapse
|
738
|
Zhan W, Muhuri M, Tai PWL, Gao G. Vectored Immunotherapeutics for Infectious Diseases: Can rAAVs Be The Game Changers for Fighting Transmissible Pathogens? Front Immunol 2021; 12:673699. [PMID: 34046041 PMCID: PMC8144494 DOI: 10.3389/fimmu.2021.673699] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 04/23/2021] [Indexed: 01/08/2023] Open
Abstract
Conventional vaccinations and immunotherapies have encountered major roadblocks in preventing infectious diseases like HIV, influenza, and malaria. These challenges are due to the high genomic variation and immunomodulatory mechanisms inherent to these diseases. Passive transfer of broadly neutralizing antibodies may offer partial protection, but these treatments require repeated dosing. Some recombinant viral vectors, such as those based on lentiviruses and adeno-associated viruses (AAVs), can confer long-term transgene expression in the host after a single dose. Particularly, recombinant (r)AAVs have emerged as favorable vectors, given their high in vivo transduction efficiency, proven clinical efficacy, and low immunogenicity profiles. Hence, rAAVs are being explored to deliver recombinant antibodies to confer immunity against infections or to diminish the severity of disease. When used as a vaccination vector for the delivery of antigens, rAAVs enable de novo synthesis of foreign proteins with the conformation and topology that resemble those of natural pathogens. However, technical hurdles like pre-existing immunity to the rAAV capsid and production of anti-drug antibodies can reduce the efficacy of rAAV-vectored immunotherapies. This review summarizes rAAV-based prophylactic and therapeutic strategies developed against infectious diseases that are currently being tested in pre-clinical and clinical studies. Technical challenges and potential solutions will also be discussed.
Collapse
Affiliation(s)
- Wei Zhan
- Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, MA, United States
- VIDE Program, University of Massachusetts Medical School, Worcester, MA, United States
| | - Manish Muhuri
- Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, MA, United States
- VIDE Program, University of Massachusetts Medical School, Worcester, MA, United States
- Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, MA, United States
| | - Phillip W. L. Tai
- Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, MA, United States
- VIDE Program, University of Massachusetts Medical School, Worcester, MA, United States
- Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, MA, United States
| | - Guangping Gao
- Horae Gene Therapy Center, University of Massachusetts Medical School, Worcester, MA, United States
- VIDE Program, University of Massachusetts Medical School, Worcester, MA, United States
- Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, MA, United States
- Li Weibo Institute for Rare Diseases Research, University of Massachusetts Medical School, Worcester, MA, United States
| |
Collapse
|
739
|
Dickey TH, Tang WK, Butler B, Ouahes T, Orr-Gonzalez S, Salinas ND, Lambert LE, Tolia NH. Design of the SARS-CoV-2 RBD vaccine antigen improves neutralizing antibody response. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2021. [PMID: 34013270 DOI: 10.1101/2021.05.09.443238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The receptor binding domain (RBD) of the SARS-CoV-2 spike protein is the primary target of neutralizing antibodies and is a component of almost all vaccine candidates. Here, RBD immunogens were created with stabilizing amino acid changes that improve the neutralizing antibody response, as well as characteristics for production, storage, and distribution. A computational design and in vitro screening platform identified three improved immunogens, each with approximately nine amino acid changes relative to the native RBD sequence and four key changes conserved between immunogens. The changes are adaptable to all vaccine platforms, are compatible with established changes in SARS-CoV-2 vaccines, and are compatible with mutations in emerging variants of concern. The immunogens elicit higher levels of neutralizing antibodies than native RBD, focus the immune response to structured neutralizing epitopes, and have increased production yields and thermostability. Incorporating these variant-independent amino acid changes in next-generation vaccines may enhance the neutralizing antibody response and lead to pan-SARS-CoV-2 protection.
Collapse
|
740
|
Efficacy and Safety of COVID-19 Vaccines: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Vaccines (Basel) 2021; 9:vaccines9050467. [PMID: 34066475 PMCID: PMC8148145 DOI: 10.3390/vaccines9050467] [Citation(s) in RCA: 189] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 01/12/2023] Open
Abstract
The current study systematically reviewed, summarized and meta-analyzed the clinical features of the vaccines in clinical trials to provide a better estimate of their efficacy, side effects and immunogenicity. All relevant publications were systematically searched and collected from major databases up to 12 March 2021. A total of 25 RCTs (123 datasets), 58,889 cases that received the COVID-19 vaccine and 46,638 controls who received placebo were included in the meta-analysis. In total, mRNA-based and adenovirus-vectored COVID-19 vaccines had 94.6% (95% CI 0.936-0.954) and 80.2% (95% CI 0.56-0.93) efficacy in phase II/III RCTs, respectively. Efficacy of the adenovirus-vectored vaccine after the first (97.6%; 95% CI 0.939-0.997) and second (98.2%; 95% CI 0.980-0.984) doses was the highest against receptor-binding domain (RBD) antigen after 3 weeks of injections. The mRNA-based vaccines had the highest level of side effects reported except for diarrhea and arthralgia. Aluminum-adjuvanted vaccines had the lowest systemic and local side effects between vaccines' adjuvant or without adjuvant, except for injection site redness. The adenovirus-vectored and mRNA-based vaccines for COVID-19 showed the highest efficacy after first and second doses, respectively. The mRNA-based vaccines had higher side effects. Remarkably few experienced extreme adverse effects and all stimulated robust immune responses.
Collapse
|
741
|
Quer G, Gadaleta M, Radin JM, Andersen KG, Baca-Motes K, Ramos E, Topol EJ, Steinhubl SR. The Physiologic Response to COVID-19 Vaccination. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021. [PMID: 33972954 DOI: 10.1101/2021.05.03.21256482] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Two mRNA vaccines and one adenovirus-based vaccine against SARS CoV-2 are currently being distributed at scale in the United States. Objective evidence of a specific individual's physiologic response to that vaccine are not routinely tracked but may offer insights into the acute immune response and personal and/or vaccine characteristics associated with that. We explored this possibility using a smartphone app-based research platform developed early in the pandemic that enabled volunteers (38,911 individuals between 25 March 2020 and 4 April 2021) to share their smartwatch and activity tracker data, as well as self-report, when appropriate, any symptoms, COVID-19 test results and vaccination dates and type. Of 4,110 individuals who reported at least one mRNA vaccination dose, 3,312 provided adequate resting heart rate data from the peri-vaccine period for analysis. We found changes in resting heart rate with respect to an individual baseline increased the days after vaccination, peaked on day 2, and returned to normal on day 6, with a much stronger effect after second dose with respect to first dose (average changes 1.6 versus 0.5 beats per minute). The changes were more pronounced for individuals who received the Moderna vaccine (on both doses), those who previously tested positive to COVID-19 (on dose 1), and for individuals aged <40 years, after adjusting for possible confounding factors. Taking advantage of continuous passive data from personal sensors could potentially enable the identification of a digital fingerprint of inflammation, which might prove useful as a surrogate for vaccine-induced immune response.
Collapse
|
742
|
Baldo A, Leunda A, Willemarck N, Pauwels K. Environmental Risk Assessment of Recombinant Viral Vector Vaccines against SARS-Cov-2. Vaccines (Basel) 2021; 9:453. [PMID: 34063733 PMCID: PMC8147846 DOI: 10.3390/vaccines9050453] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/23/2021] [Accepted: 05/01/2021] [Indexed: 12/19/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the coronavirus disease 2019 (COVID-19) pandemic. Over the past months, considerable efforts have been put into developing effective and safe drugs and vaccines against SARS-CoV-2. Various platforms are being used for the development of COVID-19 vaccine candidates: recombinant viral vectors, protein-based vaccines, nucleic acid-based vaccines, and inactivated/attenuated virus. Recombinant viral vector vaccine candidates represent a significant part of those vaccine candidates in clinical development, with two already authorised for use in the European Union and one currently under rolling review by the European Medicines Agency (EMA). Since recombinant viral vector vaccine candidates are considered as genetically modified organisms (GMOs), their regulatory oversight includes besides an assessment of their quality, safety and efficacy, also an environmental risk assessment (ERA). The present article highlights the main characteristics of recombinant viral vector vaccine (candidates) against SARS-CoV-2 in the pipeline and discusses their features from an environmental risk point of view.
Collapse
Affiliation(s)
- Aline Baldo
- Sciensano, Service Biosafety and Biotechnology, Rue Juliette Wytsmanstraat 14, B-1050 Brussels, Belgium; (A.L.); (N.W.); (K.P.)
| | | | | | | |
Collapse
|
743
|
Anastassopoulou C, Manoussopoulos Y, Lampropoulou V, Tsakris A. Glimpses into evolutionary trajectories of SARS-CoV-2: emerging variants and potential immune evasion routes. Future Microbiol 2021; 16:455-459. [PMID: 33960807 PMCID: PMC8111931 DOI: 10.2217/fmb-2020-0300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/24/2021] [Indexed: 11/30/2022] Open
Abstract
Tweetable abstract An opinion on the coronaviruses' evolution paradoxes, the continuing adaptation of the SARS-CoV-2 in humans following the zoonotic transmission, and clues into escape routes from host immune responses.
Collapse
Affiliation(s)
- Cleo Anastassopoulou
- Department of Microbiology, Medical School, National
& Kapodistrian University of Athens, Athens, Greece
| | - Yiannis Manoussopoulos
- Department of Microbiology, Medical School, National
& Kapodistrian University of Athens, Athens, Greece
- Laboratory of Virology, Plant Protection Division of
Patras, ELGO-Demeter, Patras, Greece
| | - Vicky Lampropoulou
- Laboratory of Immunobiology, Center for Clinical,
Experimental Surgery & Translational Research, Biomedical Research
Foundation of The Academy of Athens, Athens, Greece
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National
& Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
744
|
Chahroudi A, Permar S. Will We Have the Tools to Address a Reemergent Zika Virus Epidemic? Ann Intern Med 2021; 174:708-709. [PMID: 33587689 DOI: 10.7326/m21-0397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Ann Chahroudi
- Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Sallie Permar
- NewYork Presbyterian/Weill Cornell Medical School, New York, New York
| |
Collapse
|
745
|
Paoletti G, Racca F, Piona A, Melone G, Merigo M, Puggioni F, Ferri S, Azzolini E, Lagioia M, Lamacchia D, Cataldo G, Cecconi M, Canonica GW, Heffler E. Successful SARS-CoV-2 vaccine allergy risk-management: The experience of a large Italian University Hospital. World Allergy Organ J 2021; 14:100541. [PMID: 33850601 PMCID: PMC8030995 DOI: 10.1016/j.waojou.2021.100541] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/29/2021] [Accepted: 04/01/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccines have been approved recently, and public concern regarding the risk of anaphylactic reactions arose after a few cases during the first days of mass vaccination. Polyethylene glycol (PEG) has been suggested as the most probable culprit agent for allergic reactions. OBJECTIVE We describe the allergy work-up protocol implemented for the vaccination campaign in our Center, aiming to allow the greatest number of people to be vaccinated safely. METHODS The protocol included the self-report of a history of suspected drug or vaccine allergies, and subsequent teleconsultation and allergometric tests for PEG and Polysorbate 80 (PS80). A desensitizing protocol of vaccine administration was applied to patients sensitized only to PS80, and to those with a suspect allergic reaction after the first vaccine dose. RESULTS 10.2% (414 out of 4042) of the entire vaccine population have been screened: only one patient resulted allergic to PEG and therefore excluded from the vaccination. Another patient was sensitized to PS80 only and safely vaccinated applying the desensitizing protocol. Seven subjects without a previous history of allergic disease experienced suspect hypersensitivity reactions to the first administered dose: one of them resulted allergic to PEG and was excluded from the second dose, while the others safely completed the vaccination with the desensitizing protocol. CONCLUSION A careful allergological risk-assessment protocol significantly reduces the number of patients who would have avoided SARS-CoV-2 vaccination for their allergies and to effectively identify and manage those rare patients with sensitization to PEGs and/or PS80.
Collapse
Affiliation(s)
- Giovanni Paoletti
- Personalized Medicine, Asthma and Allergy – IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy
- Department of Biomedical Sciences – Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, MI, Italy
| | - Francesca Racca
- Personalized Medicine, Asthma and Allergy – IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy
| | - Alessandra Piona
- Allergy Service – Humanitas San Pio X Hospital, Via Francesco Nava 31, 20159, Milano, Italy
| | - Giulio Melone
- Personalized Medicine, Asthma and Allergy – IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy
| | - Morena Merigo
- Personalized Medicine, Asthma and Allergy – IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy
| | - Francesca Puggioni
- Personalized Medicine, Asthma and Allergy – IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy
- Department of Biomedical Sciences – Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, MI, Italy
| | - Sebastian Ferri
- Personalized Medicine, Asthma and Allergy – IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy
- Department of Biomedical Sciences – Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, MI, Italy
| | - Elena Azzolini
- Clinical Quality Department - IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy
| | - Michele Lagioia
- Clinical Quality Department - IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy
| | - Donatella Lamacchia
- Personalized Medicine, Asthma and Allergy – IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy
| | - Giuseppe Cataldo
- Personalized Medicine, Asthma and Allergy – IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy
| | - Maurizio Cecconi
- Department of Biomedical Sciences – Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, MI, Italy
- Department of Anesthesiology and Intensive Care - IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy
| | - Giorgio Walter Canonica
- Personalized Medicine, Asthma and Allergy – IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy
- Department of Biomedical Sciences – Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, MI, Italy
| | - Enrico Heffler
- Personalized Medicine, Asthma and Allergy – IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, MI, Italy
- Department of Biomedical Sciences – Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, MI, Italy
| |
Collapse
|
746
|
Ngo BT, Marik P, Kory P, Shapiro L, Thomadsen R, Iglesias J, Ditmore S, Rendell M, Varon J, Dubé M, Nanda N, In G, Arkfeld D, Chaudhary P, Campese VM, Hanna DL, Sawcer DE, Ehresmann G, Peng D, Smogorewski M, Armstrong A, Dasgupta R, Sattler F, Brennan-Rieder D, Mussini C, Mitja O, Soriano V, Peschanski N, Hayem G, Confalonieri M, Piccirillo MC, Lobo-Ferreira A, Bello Rivero I, Turkia M, Vingevoll EH, Griffin D, Hung IF. The time to offer treatments for COVID-19. Expert Opin Investig Drugs 2021; 30:505-518. [PMID: 33721548 PMCID: PMC8074648 DOI: 10.1080/13543784.2021.1901883] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/08/2021] [Indexed: 12/23/2022]
Abstract
Background: COVID-19 has several overlapping phases. Treatments to date have focused on the late stage of disease in hospital. Yet, the pandemic is by propagated by the viral phase in out-patients. The current public health strategy relies solely on vaccines to prevent disease.Methods: We searched the major national registries, pubmed.org, and the preprint servers for all ongoing, completed and published trial results.Results: As of 2/15/2021, we found 111 publications reporting findings on 14 classes of agents, and 9 vaccines. There were 62 randomized controlled studies, the rest retrospective observational analyses. Only 21 publications dealt with outpatient care. Remdesivir and high titer convalescent plasma have emergency use authorization for hospitalized patients in the U.S.A. There is also support for glucocorticoid treatment of the COVID-19 respiratory distress syndrome. Monoclonal antibodies are authorized for outpatients, but supply is inadequate to treat all at time of diagnosis. Favipiravir, ivermectin, and interferons are approved in certain countries.Expert Opinion: Vaccines and antibodies are highly antigen specific, and new SARS-Cov-2 variants are appearing. We call on public health authorities to authorize treatments with known low-risk and possible benefit for outpatients in parallel with universal vaccination.
Collapse
Affiliation(s)
- Binh T. Ngo
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
- The Rose Salter Medical Research Foundation, Newport Coast, USA
| | - Paul Marik
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
| | - Pierre Kory
- Pulmonary and Critical Care Medicine, Aurora St. Luke’s Medical Center, Milwaukee, USA
| | - Leland Shapiro
- Department of Internal Medicine, Rocky Mountain Regional Veterans Affairs Medical Center in Aurora, CO and University of Colorado Anschutz Medical Campus in Aurora, CO Supported by the Emily Foundation, Boston, USA
| | | | - Jose Iglesias
- Department of Internal Medicine, Jersey Shore University Medical Center, Hackensack Meridian School of Medicine at Seton Hall, Neptune, USA
| | | | - Marc Rendell
- The Rose Salter Medical Research Foundation, Newport Coast, USA
| | - Joseph Varon
- United Memorial Medical Center, University of Texas School of Medicine, Houston, USA
| | - Michael Dubé
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
| | - Neha Nanda
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
| | - Gino In
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
| | - Daniel Arkfeld
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
| | - Preet Chaudhary
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
| | - Vito M. Campese
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
| | - Diana L. Hanna
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
| | - David E. Sawcer
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
| | - Glenn Ehresmann
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
| | - David Peng
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
| | - Miroslaw Smogorewski
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
| | - April Armstrong
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
| | - Rajkumar Dasgupta
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
| | - Fred Sattler
- Department of Internal Medicine, Eastern Virginia Medical School, Pulmonary and Critical Care Medicine, Norfolk, USA
| | | | - Cristina Mussini
- Department of Infectious Disease, University of Modena and Reggio Emilia, Modena, Italy
| | - Oriol Mitja
- Department of Internal Medicine, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
| | - Vicente Soriano
- Director, Centro Medico, UNIR Health Sciences School & Medical Center, Madrid, Spain
| | - Nicolas Peschanski
- Department of Emergency Medicine, UniversityHospital of Rennes, Rennes, France
| | - Gilles Hayem
- Department of Rheumatology, Hôpital Paris Saint-Joseph, Paris, France
| | - Marco Confalonieri
- Department of Respiratory Diseases, Azienda Ospedaliero-Universitaria Di Trieste, Trieste, Italia
| | | | - Antonio Lobo-Ferreira
- Unidade De Investigação Cardiovascular (Unic), Faculdade De Medicina, Da Universidade Do Porto, Centro Hospitalar Universitário De São João, Porto, and Hospital Rainha Santa Isabel, Marco De Canaveses, Portugal
| | - Iraldo Bello Rivero
- Department of Clinical Investigations, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | | | | | - Daniel Griffin
- Department of Internal Medicine, Rocky Mountain Regional Veterans Affairs Medical Center in Aurora, CO and University of Colorado Anschutz Medical Campus in Aurora, CO Supported by the Emily Foundation, Boston, USA
- Department of Internal Medicine and Department of Biochemistry and Molecular Biophysics, ProHEALTH, an OPTUM Company, Columbia University, College of Physicians and Surgeons, USA
| | - Ivan Fn Hung
- Department of Internal Medicine, Rocky Mountain Regional Veterans Affairs Medical Center in Aurora, CO and University of Colorado Anschutz Medical Campus in Aurora, CO Supported by the Emily Foundation, Boston, USA
| |
Collapse
|
747
|
Iovino L, Thur LA, Gnjatic S, Chapuis A, Milano F, Hill JA. Shared inflammatory pathways and therapeutic strategies in COVID-19 and cancer immunotherapy. J Immunother Cancer 2021; 9:e002392. [PMID: 33986127 PMCID: PMC8126446 DOI: 10.1136/jitc-2021-002392] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 01/28/2023] Open
Abstract
COVID-19, the syndrome caused by the infection with SARS-CoV-2 coronavirus, is characterized, in its severe form, by interstitial diffuse pneumonitis and acute respiratory distress syndrome (ARDS). ARDS and systemic manifestations of COVID-19 are mainly due to an exaggerated immune response triggered by the viral infection. Cytokine release syndrome (CRS), an inflammatory syndrome characterized by elevated levels of circulating cytokines, and endothelial dysfunction are systemic manifestations of COVID-19. CRS is also an adverse event of immunotherapy (IMTX), the treatment of diseases using drugs, cells, and antibodies to stimulate or suppress the immune system. Graft-versus-host disease complications after an allogeneic stem cell transplant, toxicity after the infusion of chimeric antigen receptor-T cell therapy and monoclonal antibodies can all lead to CRS. It is hypothesized that anti-inflammatory drugs used for treatment of CRS in IMTX may be useful in reducing the mortality in COVID-19, whereas IMTX itself may help in ameliorating effects of SARS-CoV-2 infection. In this paper, we focused on the potential shared mechanisms and differences between COVID-19 and IMTX-related toxicities. We performed a systematic review of the clinical trials testing anti-inflammatory therapies and of the data published from prospective trials. Preliminary evidence suggests there might be a benefit in targeting the cytokines involved in the pathogenesis of COVID-19, especially by inhibiting the interleukin-6 pathway. Many other approaches based on novel drugs and cell therapies are currently under investigation and may lead to a reduction in hospitalization and mortality due to COVID-19.
Collapse
Affiliation(s)
- Lorenzo Iovino
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Laurel A Thur
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Sacha Gnjatic
- Medicine-Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Aude Chapuis
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Filippo Milano
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Joshua A Hill
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| |
Collapse
|
748
|
Abstract
As COVID vaccines roll out, internists and other health care providers are being turned to as trusted sources of information for patients and communities. Here, experts from NIAID outline the current state of knowledge regarding such vaccines. They contrast vaccine platforms, summarize clinical trial data regarding efficacy and safety, and comment on key questions including the ability of current vaccines to protect against infection and to decrease the prevalence of virus in the community.
Collapse
Affiliation(s)
- Mark Connors
- the Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland (M.C., H.C.L., A.S.F.)
| | - Barney S Graham
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland (B.S.G.)
| | - H Clifford Lane
- the Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland (M.C., H.C.L., A.S.F.)
| | - Anthony S Fauci
- the Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland (M.C., H.C.L., A.S.F.)
| |
Collapse
|
749
|
Strzelczyk A, Knake S, Holtkamp M, Schulze-Bonhage A, Lemke J, von Spiczak S, Berkenfeld R, Rosenow F, Brandt C, Schmitt FC. Impfung zur Vorbeugung der COVID-19-Erkrankung sowie Impfpriorisierung bei Epilepsie. ZEITSCHRIFT FÜR EPILEPTOLOGIE 2021. [PMCID: PMC7848875 DOI: 10.1007/s10309-021-00404-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
ZusammenfassungDer Vorstand der Deutschen Gesellschaft für Epileptologie und die Kommission „Epilepsie und Synkopen“ der Deutschen Gesellschaft für Neurologie haben die aktuelle Datenlage zur Impfung zur Vorbeugung der Corona-Virus-Krankheit 2019 (COVID-19) sowie zur Impfpriorisierung bei Menschen mit Epilepsie gesichtet, diese zusammengefasst und geben die unten genannten Empfehlungen ab.
Collapse
|
750
|
Hotez PJ, Nuzhath T, Callaghan T, Colwell B. COVID-19 vaccine decisions: considering the choices and opportunities. Microbes Infect 2021; 23:104811. [PMID: 33744495 PMCID: PMC7968147 DOI: 10.1016/j.micinf.2021.104811] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 12/17/2022]
Abstract
In the coming months, most American adults will have the opportunity to receive at least one of up to five different COVID-19 vaccines produced by Operation Warp Speed and released through emergency use authorization by the U.S. Food and Drug Administration (FDA). A similar group of vaccines will also be released in Europe by the European Medicines Agency (EMA) and in the United Kingdom by the Medicines & Healthcare products Regulatory Agency (MHRA). Those living outside of North America and Europe may not have access to those particular vaccines, but they will benefit from receiving vaccines produced in Brazil, China, India, or Russia. These vaccines and some of their major features based on clinical trials and testing are listed in Table 1 [1-25]. As vaccine scientists and policy experts working in the area of coronavirus disease 2019 (COVID-19), we are frequently asked about potential choices regarding the available vaccines, both in the U.S. and globally. Provided here is a summary and informal decision-making tool kit for considering the different vaccine options at this time.
Collapse
Affiliation(s)
- Peter J Hotez
- Texas Children's Hospital Center for Vaccine Development and Center for Medical Ethics and Health Policy, Departments of Pediatrics and Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Hagler Institute for Advanced Study at Texas A&M University, College Station, TX, USA; Scowcroft Institute of International Affairs, Bush School of Policy and Government, Texas A&M University, College Station, TX, USA; Department of Biology, Baylor University, Waco, TX, USA; James A Baker III Institute of Public Policy, Rice University Houston, Texas, USA.
| | - Tasmiah Nuzhath
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station, TX, USA
| | - Timothy Callaghan
- Department of Health Policy and Management, Texas A&M School of Public Health, College Station, TX, USA
| | - Brian Colwell
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station, TX, USA
| |
Collapse
|