51
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Hudock TA, Foreman TW, Bandyopadhyay N, Gautam US, Veatch AV, LoBato DN, Gentry KM, Golden NA, Cavigli A, Mueller M, Hwang SA, Hunter RL, Alvarez X, Lackner AA, Bader JS, Mehra S, Kaushal D. Hypoxia Sensing and Persistence Genes Are Expressed during the Intragranulomatous Survival of Mycobacterium tuberculosis. Am J Respir Cell Mol Biol 2017; 56:637-647. [PMID: 28135421 DOI: 10.1165/rcmb.2016-0239oc] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Although it is accepted that the environment within the granuloma profoundly affects Mycobacterium tuberculosis (Mtb) and infection outcome, our ability to understand Mtb gene expression in these niches has been limited. We determined intragranulomatous gene expression in human-like lung lesions derived from nonhuman primates with both active tuberculosis (ATB) and latent TB infection (LTBI). We employed a non-laser-based approach to microdissect individual lung lesions and interrogate the global transcriptome of Mtb within granulomas. Mtb genes expressed in classical granulomas with central, caseous necrosis, as well as within the caseum itself, were identified and compared with other Mtb lesions in animals with ATB (n = 7) or LTBI (n = 7). Results were validated using both an oligonucleotide approach and RT-PCR on macaque samples and by using human TB samples. We detected approximately 2,900 and 1,850 statistically significant genes in ATB and LTBI lesions, respectively (linear models for microarray analysis, Bonferroni corrected, P < 0.05). Of these genes, the expression of approximately 1,300 (ATB) and 900 (LTBI) was positively induced. We identified the induction of key regulons and compared our results to genes previously determined to be required for Mtb growth. Our results indicate pathways that Mtb uses to ensure its survival in a highly stressful environment in vivo. A large number of genes is commonly expressed in granulomas with ATB and LTBI. In addition, the enhanced expression of the dormancy survival regulon was a key feature of lesions in animals with LTBI, stressing its importance in the persistence of Mtb during the chronic phase of infection.
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Affiliation(s)
- Teresa A Hudock
- 1 Tulane National Primate Research Center, Covington, Louisiana.,2 Tulane University Health Sciences, New Orleans, Louisiana; and
| | - Taylor W Foreman
- 1 Tulane National Primate Research Center, Covington, Louisiana.,2 Tulane University Health Sciences, New Orleans, Louisiana; and
| | - Nirmalya Bandyopadhyay
- 3 Whitaker Biomedical Engineering Institute, Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Uma S Gautam
- 1 Tulane National Primate Research Center, Covington, Louisiana
| | - Ashley V Veatch
- 1 Tulane National Primate Research Center, Covington, Louisiana.,2 Tulane University Health Sciences, New Orleans, Louisiana; and
| | - Denae N LoBato
- 1 Tulane National Primate Research Center, Covington, Louisiana
| | - Kaylee M Gentry
- 1 Tulane National Primate Research Center, Covington, Louisiana
| | - Nadia A Golden
- 1 Tulane National Primate Research Center, Covington, Louisiana
| | - Amy Cavigli
- 1 Tulane National Primate Research Center, Covington, Louisiana
| | | | - Shen-An Hwang
- 4 Department of Pathology and Laboratory Medicine, University of Texas Health Science Center, Houston, Texas
| | - Robert L Hunter
- 4 Department of Pathology and Laboratory Medicine, University of Texas Health Science Center, Houston, Texas
| | - Xavier Alvarez
- 1 Tulane National Primate Research Center, Covington, Louisiana
| | - Andrew A Lackner
- 1 Tulane National Primate Research Center, Covington, Louisiana.,2 Tulane University Health Sciences, New Orleans, Louisiana; and
| | - Joel S Bader
- 3 Whitaker Biomedical Engineering Institute, Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Smriti Mehra
- 5 Department of Pathobiological Sciences, Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana
| | - Deepak Kaushal
- 1 Tulane National Primate Research Center, Covington, Louisiana.,2 Tulane University Health Sciences, New Orleans, Louisiana; and
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52
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van Zyl-Smit RN, Esmail A, Bateman ME, Dawson R, Goldin J, van Rikxoort E, Douoguih M, Pau MG, Sadoff JC, McClain JB, Snowden MA, Benko J, Hokey DA, Rutkowski KT, Graves A, Shepherd B, Ishmukhamedov S, Kagina BMN, Abel B, Hanekom WA, Scriba TJ, Bateman ED. Safety and Immunogenicity of Adenovirus 35 Tuberculosis Vaccine Candidate in Adults with Active or Previous Tuberculosis. A Randomized Trial. Am J Respir Crit Care Med 2017; 195:1171-1180. [PMID: 28060545 DOI: 10.1164/rccm.201603-0654oc] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
RATIONALE Administration of tuberculosis (TB) vaccines in participants with previous or current pulmonary TB may have the potential for causing harmful postvaccination immunologic (Koch-type) reactions. OBJECTIVES To assess the safety and immunogenicity of three dose levels of the AERAS-402 live, replication-deficient adenovirus 35-vectored TB candidate vaccine, containing three mycobacterial antigens, in individuals with current or previous pulmonary TB. METHODS We performed a phase II randomized, placebo-controlled, double-blinded dose-escalation study in an HIV-negative adult South African cohort (n = 72) with active pulmonary TB (on treatment for 1-4 mo) or pulmonary TB treated at least 12 months before study entry and considered cured. Safety endpoints included clinical assessment, flow volume curves, diffusing capacity of the lung for carbon monoxide, pulse oximetry, chest radiograph, and high-resolution thoracic computerized tomography scans. Cytokine expression by CD4 and CD8 T cells, after stimulation with Ag85A, Ag85B, and TB10.4 peptide pools, was examined by intracellular cytokine staining. MEASUREMENTS AND MAIN RESULTS No apparent temporal or dose-related changes in clinical status (specifically acute, Koch phenomenon-like reactions), lung function, or radiology attributable to vaccine were observed. Injection site reactions were mild or moderate. Hematuria (by dipstick only) occurred in 25 (41%) of 61 AERAS-402 recipients and 3 (27%) of 11 placebo recipients, although no gross hematuria was reported. AERAS-402 induced robust CD8+ and moderate CD4+ T-cell responses, mainly to Ag85B in both vaccine groups. CONCLUSIONS Administration of the AERAS-402 candidate TB vaccine to participants with current or previous pulmonary TB induced a robust immune response and is not associated with clinically significant pulmonary complications. Clinical trial registered with www.clinicaltrials.gov (NCT 02414828) and in the South African National Clinical Trials Register ( www.sanctr.gov.za DOH 27-0808-2060).
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Affiliation(s)
- Richard N van Zyl-Smit
- 1 University of Cape Town Lung Institute, Division of Pulmonology, Department of Medicine
| | - Aliasgar Esmail
- 1 University of Cape Town Lung Institute, Division of Pulmonology, Department of Medicine
| | - Mary E Bateman
- 1 University of Cape Town Lung Institute, Division of Pulmonology, Department of Medicine
| | - Rodney Dawson
- 1 University of Cape Town Lung Institute, Division of Pulmonology, Department of Medicine
| | | | - Eva van Rikxoort
- 3 Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Macaya Douoguih
- 4 Crucell Holland B.V., a Janssen Pharmaceutical company of Johnson & Johnson, Leiden, the Netherlands
| | - Maria Grazia Pau
- 4 Crucell Holland B.V., a Janssen Pharmaceutical company of Johnson & Johnson, Leiden, the Netherlands
| | - Jerald C Sadoff
- 4 Crucell Holland B.V., a Janssen Pharmaceutical company of Johnson & Johnson, Leiden, the Netherlands
| | | | | | | | | | | | | | | | | | - Benjamin M N Kagina
- 6 South African TB Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Division of Immunology, Department of Pathology, and.,7 Vaccines for Africa Initiative, Division of Medical Microbiology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Brian Abel
- 6 South African TB Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Division of Immunology, Department of Pathology, and.,8 Singapore Immunology Network, Agency for Science, Technology and Research, Singapore
| | - Willem A Hanekom
- 6 South African TB Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Division of Immunology, Department of Pathology, and
| | - Thomas J Scriba
- 6 South African TB Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine, Division of Immunology, Department of Pathology, and
| | - Eric D Bateman
- 1 University of Cape Town Lung Institute, Division of Pulmonology, Department of Medicine
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53
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Abstract
Among the animal models of tuberculosis (TB), the non-human primates, particularly rhesus macaques (Macaca fascicularis) and cynomolgus macaques (Macaca mulatta), share the greatest anatomical and physiological similarities with humans. Macaques are highly susceptible to Mycobacterium tuberculosis infection and manifest the complete spectrum of clinical and pathological manifestations of TB as seen in humans. Therefore, the macaque models have been used extensively for investigating the pathogenesis of M. tuberculosis infection and for preclinical testing of drugs and vaccines against TB. This review focuses on published major studies that exemplify how the rhesus and cynomolgus macaques have enhanced and may continue to advance global efforts in TB research.
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54
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Verreck FAW, Tchilian EZ, Vervenne RAW, Sombroek CC, Kondova I, Eissen OA, Sommandas V, van der Werff NM, Verschoor E, Braskamp G, Bakker J, Langermans JAM, Heidt PJ, Ottenhoff THM, van Kralingen KW, Thomas AW, Beverley PCL, Kocken CHM. Variable BCG efficacy in rhesus populations: Pulmonary BCG provides protection where standard intra-dermal vaccination fails. Tuberculosis (Edinb) 2017; 104:46-57. [PMID: 28454649 DOI: 10.1016/j.tube.2017.02.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 02/13/2017] [Accepted: 02/15/2017] [Indexed: 01/22/2023]
Abstract
M.bovis BCG vaccination against tuberculosis (TB) notoriously displays variable protective efficacy in different human populations. In non-human primate studies using rhesus macaques, despite efforts to standardise the model, we have also observed variable efficacy of BCG upon subsequent experimental M. tuberculosis challenge. In the present head-to-head study, we establish that the protective efficacy of standard parenteral BCG immunisation varies among different rhesus cohorts. This provides different dynamic ranges for evaluation of investigational vaccines, opportunities for identifying possible correlates of protective immunity and for determining why parenteral BCG immunisation sometimes fails. We also show that pulmonary mucosal BCG vaccination confers reduced local pathology and improves haematological and immunological parameters post-infection in animals that are not responsive to induction of protection by standard intra-dermal BCG. These results have important implications for pulmonary TB vaccination strategies in the future.
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Affiliation(s)
- Frank A W Verreck
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands.
| | - Elma Z Tchilian
- The Peter Medawar Building for Pathogen Research, University of Oxford, South Parks Road, Oxford, UK.
| | - Richard A W Vervenne
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Claudia C Sombroek
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Ivanela Kondova
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Okke A Eissen
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Vinod Sommandas
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Nicole M van der Werff
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Ernst Verschoor
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Gerco Braskamp
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Jaco Bakker
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Jan A M Langermans
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Peter J Heidt
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Tom H M Ottenhoff
- Department of Infectious Diseases, Leiden University Medical Centre (LUMC), Albinusdreef 2, 2333-ZA, Leiden, The Netherlands
| | - Klaas W van Kralingen
- Department of Pulmonology, Leiden University Medical Centre (LUMC), Albinusdreef 2, 2333-ZA, Leiden, The Netherlands
| | - Alan W Thomas
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Peter C L Beverley
- The Peter Medawar Building for Pathogen Research, University of Oxford, South Parks Road, Oxford, UK.
| | - Clemens H M Kocken
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
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55
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Unique cellular and humoral immunogenicity profiles generated by aerosol, intranasal, or parenteral vaccination in rhesus macaques. Vaccine 2016; 35:639-646. [PMID: 28041780 DOI: 10.1016/j.vaccine.2016.12.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 10/31/2016] [Accepted: 12/02/2016] [Indexed: 11/22/2022]
Abstract
Respiratory mucosa immunization is capable of eliciting both local and distal mucosal immune responses; it is a potentially powerful yet largely unused modality for vaccination against respiratory diseases. Targeting the lower versus upper airways by aerosol delivery alters the immunogenicity profile of a vaccine, although the full extent of this impact is not well characterized. We set out to define the cellular and humoral response profiles elicited by immunization via intranasal, small aerosol droplets, and large aerosol droplets. We compared responses following adenovirus-vectored vaccination by these routes in macaques, either for the generation of primary immune responses or for the boosting of previously primed systemic responses. Aerosol delivery (4 or 10μm diameter droplets, addressing lower or upper airways, respectively) generated the highest magnitude lung CD4 and CD8 T-cell responses, reaching 10-30% vaccine-specific levels in bronchoalveolar lavage cells. In contrast, intranasal delivery was less immunogenic with >10-fold lower peak lung T-cell responses. Systemic (blood) T-cell responses were only observed following 4μm aerosol (and parenteral) immunization, while all delivery routes elicited similar humoral responses. These data demonstrate distinct immune response profiles with each respiratory tract vaccination modality and suggest that small droplet aerosol offers several immunological advantages over other respiratory routes.
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56
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Abstract
ABSTRACT
Immunological memory is a central feature of the adaptive immune system and a prerequisite for generating effective vaccines. Understanding long-term memory responses to
Mycobacterium tuberculosis
will thus provide us with valuable insights that can guide us in the search for a novel vaccine against tuberculosis (TB). For many years, triggering CD4 T cells and, in particular, those secreting interferon-γ has been the goal of most TB vaccine research, and numerous data from animals and humans support the key role of this subset in protective immunity. More recently, we have learned that the memory response required for effective control of
M. tuberculosis
is much more complex, probably involving several phenotypically different CD4 T cell subsets as well as other cell types that are yet to be defined. Herein, we describe recent insights into memory immunity to TB in the context of both animal models and the human infection. With the increasing amount of data generated from clinical testing of novel TB vaccines, we also summarize recent knowledge of vaccine-induced memory immunity.
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57
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Sharpe S, White A, Sarfas C, Sibley L, Gleeson F, McIntyre A, Basaraba R, Clark S, Hall G, Rayner E, Williams A, Marsh PD, Dennis M. Alternative BCG delivery strategies improve protection against Mycobacterium tuberculosis in non-human primates: Protection associated with mycobacterial antigen-specific CD4 effector memory T-cell populations. Tuberculosis (Edinb) 2016; 101:174-190. [PMID: 27865390 PMCID: PMC5120991 DOI: 10.1016/j.tube.2016.09.004] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 09/11/2016] [Indexed: 12/01/2022]
Abstract
Intradermal (ID) BCG injection provides incomplete protection against TB in humans and experimental models. Alternative BCG vaccination strategies may improve protection in model species, including rhesus macaques. This study compares the immunogenicity and efficacy of BCG administered by ID and intravenous (IV) injection, or as an intratracheal mucosal boost (ID + IT), against aerosol challenge with Mycobacterium tuberculosis Erdman strain. Disease pathology was significantly reduced, and survival improved, by each BCG vaccination strategy, relative to unvaccinated animals. However, IV induced protection surpassed that achieved by all other routes, providing an opportunity to explore protective immunological mechanisms using antigen-specific IFN-γ ELISpot and polychromatic flow cytometry assays. IFN-γ spot forming units and multifunctional CD4 T-cell frequencies increased significantly following each vaccination regimen and were greatest following IV immunisation. Vaccine-induced multifunctional CD4 T-cells producing IFN-γ and TNF-α were associated with reduced disease pathology following subsequent M.tb challenge; however, high frequencies of this population following M.tb infection correlated with increased pathology. Cytokine producing T-cells primarily occupied the CD4 transitional effector memory phenotype, implicating this population as central to the mycobacterial response, potentially contributing to the stringent control observed in IV vaccinated animals. This study demonstrates the protective efficacy of IV BCG vaccination in rhesus macaques, offering a valuable tool for the interrogation of immunological mechanisms and potential correlates of protection.
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Affiliation(s)
- S Sharpe
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK.
| | - A White
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - C Sarfas
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - L Sibley
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - F Gleeson
- Churchill Hospital, Headington, Oxford, UK
| | - A McIntyre
- Churchill Hospital, Headington, Oxford, UK
| | - R Basaraba
- Colorado State University, Fort Collins, CO, USA
| | - S Clark
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - G Hall
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - E Rayner
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - A Williams
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - P D Marsh
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - M Dennis
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
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58
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Graves AJ, Hokey DA. Tuberculosis vaccine development: Shifting focus amid increasing development challenges. Hum Vaccin Immunother 2016; 11:1910-6. [PMID: 26125249 PMCID: PMC4635864 DOI: 10.1080/21645515.2015.1040955] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
A new tuberculosis vaccine is needed to replace or enhance BCG, which induces variable protection against Mycobacterium tuberculosis pulmonary infections in adults. Development of new TB vaccine candidates is severely hampered by the lack of a correlate of immunity, unproven animal models, and limited funding opportunities. One candidate, MVA85A, recently failed to meet its efficacy endpoint goals despite promising early-phase trial data. As a result, some in the field believe we should now shift our focus away from product development and toward a research-oriented approach. Here, we outline our suggestions for this research-oriented strategy including diversification of the candidate pipeline, expanding measurements of immunity, improving pre-clinical animal models, and investing in combination pre-clinical/experimental medicine studies. As with any evolution, this change in strategy comes at a cost but may also represent an opportunity for advancing the field.
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59
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Afkhami S, Yao Y, Xing Z. Methods and clinical development of adenovirus-vectored vaccines against mucosal pathogens. MOLECULAR THERAPY-METHODS & CLINICAL DEVELOPMENT 2016; 3:16030. [PMID: 27162933 PMCID: PMC4847555 DOI: 10.1038/mtm.2016.30] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 03/27/2016] [Accepted: 03/28/2016] [Indexed: 12/20/2022]
Abstract
Adenoviruses represent the most widely used viral-vectored platform for vaccine design, showing a great potential in the fight against intracellular infectious diseases to which either there is a lack of effective vaccines or the traditional vaccination strategy is suboptimal. The extensive understanding of the molecular biology of adenoviruses has made the new technologies and reagents available to efficient generation of adenoviral-vectored vaccines for both preclinical and clinical evaluation. The novel adenoviral vectors including nonhuman adenoviral vectors have emerged to be the further improved vectors for vaccine design. In this review, we discuss the latest adenoviral technologies and their utilization in vaccine development. We particularly focus on the application of adenoviral-vectored vaccines in mucosal immunization strategies against mucosal pathogens including Mycobacterium tuberculosis, flu virus, and human immunodeficiency virus.
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Affiliation(s)
- Sam Afkhami
- Department of Pathology and Molecular Medicine, McMaster Immunology Research Centre, McMaster University , Hamilton, Ontario, Canada
| | - Yushi Yao
- Department of Pathology and Molecular Medicine, McMaster Immunology Research Centre, McMaster University , Hamilton, Ontario, Canada
| | - Zhou Xing
- Department of Pathology and Molecular Medicine, McMaster Immunology Research Centre, McMaster University , Hamilton, Ontario, Canada
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de Oliveira FM, Trentini MM, Junqueira-Kipnis AP, Kipnis A. The mc2-CMX vaccine induces an enhanced immune response against Mycobacterium tuberculosis compared to Bacillus Calmette-Guérin but with similar lung inflammatory effects. Mem Inst Oswaldo Cruz 2016; 111:223-31. [PMID: 27074251 PMCID: PMC4830111 DOI: 10.1590/0074-02760150411] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 02/24/2016] [Indexed: 01/15/2023] Open
Abstract
Although the attenuated Mycobacterium bovis Bacillus Calmette-Guérin (BCG) vaccine has been used since 1921, tuberculosis (TB) control still proceeds at a slow pace. The main reason is the variable efficacy of BCG protection against TB among adults, which ranges from 0-80%. Subsequently, the mc2-CMX vaccine was developed with promising results. Nonetheless, this recombinant vaccine needs to be compared to the standard BCG vaccine. The objective of this study was to evaluate the immune response induced by mc2-CMX and compare it to the response generated by BCG. BALB/c mice were immunised with both vaccines and challenged with Mycobacterium tuberculosis (Mtb). The immune and inflammatory responses were evaluated by ELISA, flow cytometry, and histopathology. Mice vaccinated with mc2-CMX and challenged with Mtb induced an increase in the IgG1 and IgG2 levels against CMX as well as recalled specific CD4+ T-cells that produced T-helper 1 cytokines in the lungs and spleen compared with BCG vaccinated and challenged mice. Both vaccines reduced the lung inflammatory pathology induced by the Mtb infection. The mc2-CMX vaccine induces a humoral and cellular response that is superior to BCG and is efficiently recalled after challenge with Mtb, although both vaccines induced similar inflammatory reductions.
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Affiliation(s)
- Fábio Muniz de Oliveira
- Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde
Pública, Laboratório de Bacteriologia Molecular, Goiânia, GO, Brasil
| | - Monalisa Martins Trentini
- Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde
Pública, Laboratório de Imunopatologia das Doenças Infecciosas, Goiânia, GO,
Brasil
| | - Ana Paula Junqueira-Kipnis
- Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde
Pública, Laboratório de Imunopatologia das Doenças Infecciosas, Goiânia, GO,
Brasil
| | - André Kipnis
- Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde
Pública, Laboratório de Bacteriologia Molecular, Goiânia, GO, Brasil
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61
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Tuberculosis vaccines--state of the art, and novel approaches to vaccine development. Int J Infect Dis 2016; 32:5-12. [PMID: 25809749 DOI: 10.1016/j.ijid.2014.11.026] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 11/21/2014] [Accepted: 11/25/2014] [Indexed: 11/20/2022] Open
Abstract
The quest for a vaccine that could have a major impact in reducing the current global burden of TB disease in humans continues to be extremely challenging. Significant gaps in our knowledge and understanding of the pathogenesis and immunology of tuberculosis continue to undermine efforts to break new ground, and traditional approaches to vaccine development have thus far met with limited success. Existing and novel candidate vaccines are being assessed in the context of their ability to impact the various stages that culminate in disease transmission and an increase in the global burden of disease. Innovative methods of vaccine administration and delivery have provided a fresh stimulus to the search for the elusive vaccine. Here we discuss the current status of preclinical vaccine development, providing insights into alternative approaches to vaccine delivery and promising candidate vaccines. The state of the art of clinical development also is reviewed.
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62
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Sharpe S, White A, Gleeson F, McIntyre A, Smyth D, Clark S, Sarfas C, Laddy D, Rayner E, Hall G, Williams A, Dennis M. Ultra low dose aerosol challenge with Mycobacterium tuberculosis leads to divergent outcomes in rhesus and cynomolgus macaques. Tuberculosis (Edinb) 2016; 96:1-12. [DOI: 10.1016/j.tube.2015.10.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 10/02/2015] [Accepted: 10/06/2015] [Indexed: 11/25/2022]
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63
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Lenaerts A, Barry CE, Dartois V. Heterogeneity in tuberculosis pathology, microenvironments and therapeutic responses. Immunol Rev 2015; 264:288-307. [PMID: 25703567 PMCID: PMC4368385 DOI: 10.1111/imr.12252] [Citation(s) in RCA: 228] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Tuberculosis (TB) lesions are extremely complex and dynamic. Here, we review the multiple types and fates of pulmonary lesions that form following infection by Mycobacterium tuberculosis and the impact of this spatial and temporal heterogeneity on the bacteria they harbor. The diverse immunopathology of granulomas and cavities generates a plethora of microenvironments to which M. tuberculosis bacilli must adapt. This in turn affects the replication, metabolism, and relative density of bacterial subpopulations, and consequently their respective susceptibility to chemotherapy. We outline recent developments that support a paradigm shift in our understanding of lesion progression. The simple model according to which lesions within a single individual react similarly to the systemic immune response no longer prevails. Host-pathogen interactions within lesions are a dynamic process, driven by subtle and local differences in signaling pathways, resulting in diverging trajectories of lesions within a single host. The spectrum of TB lesions is a continuum with a large overlap in the lesion types found in latently infected and active TB patients. We hope this overview will guide TB researchers in the design, choice of read-outs, and interpretation of future studies in the search for predictive biomarkers and novel therapies.
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Affiliation(s)
- Anne Lenaerts
- Department of Microbiology, Immunology and Pathology, Colorado State University, Ft. Collins, CO, USA
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64
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Ronacher K, Joosten SA, van Crevel R, Dockrell HM, Walzl G, Ottenhoff THM. Acquired immunodeficiencies and tuberculosis: focus on HIV/AIDS and diabetes mellitus. Immunol Rev 2015; 264:121-37. [PMID: 25703556 DOI: 10.1111/imr.12257] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The spread of human immunodeficiency virus (HIV) infection within Africa led to marked increases in numbers of cases of tuberculosis (TB), and although the epidemic peaked in 2006, there were still 1.8 million new cases in 2013, with 29.2 million prevalent cases. Half of all TB cases in Africa are in those with HIV co-infection. A brief review of the well-documented main immunological mechanisms of HIV-associated increased susceptibility to TB is presented. However, a new threat is facing TB control, which presents itself in the form of a rapid increase in the number of people living with type II diabetes mellitus (T2DM), particularly in areas that are already hardest hit by the TB epidemic. T2DM increases susceptibility to TB threefold, and the TB burden attributable to T2DM is 15%. This review addresses the much smaller body of research information available on T2DM-TB, compared to HIV-TB comorbidity. We discuss the altered clinical presentation of TB in the context of T2DM comorbidity, changes in innate and adaptive immune responses, including lymphocyte subsets and T-cell phenotypes, the effect of treatment of the different comorbidities, changes in biomarker expression and genetic predisposition to the respective morbidities, and other factors affecting the comorbidity. Although significant gains have been made in improving our understanding of the underlying mechanisms of T2DM-associated increased susceptibility, knowledge gaps still exist that require urgent attention.
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Affiliation(s)
- Katharina Ronacher
- DST/NRF Centre of Excellence for Biomedical Tuberculosis Research and MRC Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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65
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Kaushal D, Foreman TW, Gautam US, Alvarez X, Adekambi T, Rangel-Moreno J, Golden NA, Johnson AMF, Phillips BL, Ahsan MH, Russell-Lodrigue KE, Doyle LA, Roy CJ, Didier PJ, Blanchard JL, Rengarajan J, Lackner AA, Khader SA, Mehra S. Mucosal vaccination with attenuated Mycobacterium tuberculosis induces strong central memory responses and protects against tuberculosis. Nat Commun 2015; 6:8533. [PMID: 26460802 PMCID: PMC4608260 DOI: 10.1038/ncomms9533] [Citation(s) in RCA: 150] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 09/02/2015] [Indexed: 02/07/2023] Open
Abstract
Tuberculosis (TB) is a global pandaemic, partially due to the failure of vaccination approaches. Novel anti-TB vaccines are therefore urgently required. Here we show that aerosol immunization of macaques with the Mtb mutant in SigH (MtbΔsigH) results in significant recruitment of inducible bronchus-associated lymphoid tissue (iBALT) as well as CD4+ and CD8+ T cells expressing activation and proliferation markers to the lungs. Further, the findings indicate that pulmonary vaccination with MtbΔsigH elicited strong central memory CD4+ and CD8+ T-cell responses in the lung. Vaccination with MtbΔsigH results in significant protection against a lethal TB challenge, as evidenced by an approximately three log reduction in bacterial burdens, significantly diminished clinical manifestations and granulomatous pathology and characterized by the presence of profound iBALT. This highly protective response is virtually absent in unvaccinated and BCG-vaccinated animals after challenge. These results suggest that future TB vaccine candidates can be developed on the basis of MtbΔsigH. BCG, the only vaccine currently used against tuberculosis, confers only limited protection. Here the authors show that mucosal immunization of macaques with an attenuated strain of Mycobacterium tuberculosis confers a high level of protection from a lethal challenge with the bacterium.
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Affiliation(s)
- Deepak Kaushal
- Tulane National Primate Research Center, Covington, Louisiana 70433, USA.,Department of Microbiology and Immunology, Tulane Health Sciences Center, New Orleans, Louisiana 70112, USA
| | - Taylor W Foreman
- Tulane National Primate Research Center, Covington, Louisiana 70433, USA.,Biomedical Sciences Graduate Program, Tulane Health Sciences Center, New Orleans, Louisiana 70112, USA
| | - Uma S Gautam
- Tulane National Primate Research Center, Covington, Louisiana 70433, USA
| | - Xavier Alvarez
- Tulane National Primate Research Center, Covington, Louisiana 70433, USA
| | - Toidi Adekambi
- Yerkes National Primate Research Center, Atlanta, Georgia 30329, USA.,Emory Vaccine Center, Atlanta, Georgia 30329, USA
| | | | - Nadia A Golden
- Tulane National Primate Research Center, Covington, Louisiana 70433, USA
| | | | - Bonnie L Phillips
- Tulane National Primate Research Center, Covington, Louisiana 70433, USA.,Biomedical Sciences Graduate Program, Tulane Health Sciences Center, New Orleans, Louisiana 70112, USA
| | - Muhammad H Ahsan
- Tulane National Primate Research Center, Covington, Louisiana 70433, USA
| | | | - Lara A Doyle
- Tulane National Primate Research Center, Covington, Louisiana 70433, USA
| | - Chad J Roy
- Tulane National Primate Research Center, Covington, Louisiana 70433, USA
| | - Peter J Didier
- Tulane National Primate Research Center, Covington, Louisiana 70433, USA
| | - James L Blanchard
- Tulane National Primate Research Center, Covington, Louisiana 70433, USA
| | - Jyothi Rengarajan
- Yerkes National Primate Research Center, Atlanta, Georgia 30329, USA.,Emory Vaccine Center, Atlanta, Georgia 30329, USA
| | - Andrew A Lackner
- Tulane National Primate Research Center, Covington, Louisiana 70433, USA.,Department of Microbiology and Immunology, Tulane Health Sciences Center, New Orleans, Louisiana 70112, USA.,Department of Pathology, Tulane Health Sciences Center, New Orleans, Louisiana 70112, USA
| | - Shabaana A Khader
- Department of Molecular Microbiology, Washington University at St Louis, St Louis, Missouri 63110, USA
| | - Smriti Mehra
- Tulane National Primate Research Center, Covington, Louisiana 70433, USA.,Center for Biomedical Research Excellence, Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana 70803, USA.,Department of Pathobiological Sciences, Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana 70803, USA
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66
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Jeyanathan M, Shao Z, Yu X, Harkness R, Jiang R, Li J, Xing Z, Zhu T. AdHu5Ag85A Respiratory Mucosal Boost Immunization Enhances Protection against Pulmonary Tuberculosis in BCG-Primed Non-Human Primates. PLoS One 2015; 10:e0135009. [PMID: 26252520 PMCID: PMC4529167 DOI: 10.1371/journal.pone.0135009] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 07/10/2015] [Indexed: 12/21/2022] Open
Abstract
Persisting high global tuberculosis (TB) morbidity and mortality and poor efficacy of BCG vaccine emphasizes an urgent need for developing effective novel boost vaccination strategies following parenteral BCG priming in humans. Most of the current lead TB vaccine candidates in the global pipeline were developed for parenteral route of immunization. Compelling evidence indicates respiratory mucosal delivery of vaccine to be the most effective way to induce robust local mucosal protective immunity against pulmonary TB. However, despite ample supporting evidence from various animal models, there has been a lack of evidence supporting the safety and protective efficacy of respiratory mucosal TB vaccination in non-human primates (NHP) and humans. By using a rhesus macaque TB model we have evaluated the safety and protective efficacy of a recombinant human serotype 5 adenovirus-based TB vaccine (AdHu5Ag85A) delivered via the respiratory mucosal route. We show that mucosal AdHu5Ag85A boost immunization was safe and well tolerated in parenteral BCG-primed rhesus macaques. A single AdHu5Ag85A mucosal boost immunization in BCG-primed rhesus macaques enhanced the antigen–specific T cell responses. Boost immunization significantly improved the survival and bacterial control following M.tb challenge. Furthermore, TB-related lung pathology and clinical outcomes were lessened in BCG-primed, mucosally boosted animals compared to control animals. Thus, for the first time we show that a single respiratory mucosal boost immunization with a novel TB vaccine enhances protection against pulmonary TB in parenteral BCG-primed NHP. Our study provides the evidence for the protective potential of AdHu5Ag85A as a respiratory mucosal boost TB vaccine for human application.
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Affiliation(s)
- Mangalakumari Jeyanathan
- McMaster Immunology Research Centre and Department of Pathology & Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Zhongqi Shao
- Tianjin CanSino Biotechnology, Inc., Tianjin, China
| | - Xuefeng Yu
- Tianjin CanSino Biotechnology, Inc., Tianjin, China
| | | | - Rong Jiang
- Tianjin CanSino Biotechnology, Inc., Tianjin, China
| | - Junqiang Li
- Tianjin CanSino Biotechnology, Inc., Tianjin, China
| | - Zhou Xing
- McMaster Immunology Research Centre and Department of Pathology & Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
- * E-mail: (ZX); (TZ)
| | - Tao Zhu
- Tianjin CanSino Biotechnology, Inc., Tianjin, China
- * E-mail: (ZX); (TZ)
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67
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Mehra S, Foreman TW, Didier PJ, Ahsan MH, Hudock TA, Kissee R, Golden NA, Gautam US, Johnson AM, Alvarez X, Russell-Lodrigue KE, Doyle LA, Roy CJ, Niu T, Blanchard JL, Khader SA, Lackner AA, Sherman DR, Kaushal D. The DosR Regulon Modulates Adaptive Immunity and Is Essential for Mycobacterium tuberculosis Persistence. Am J Respir Crit Care Med 2015; 191:1185-96. [PMID: 25730547 DOI: 10.1164/rccm.201408-1502oc] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
RATIONALE Hypoxia promotes dormancy by causing physiologic changes to actively replicating Mycobacterium tuberculosis. DosR controls the response of M. tuberculosis to hypoxia. OBJECTIVES To understand DosR's contribution in the persistence of M. tuberculosis, we compared the phenotype of various DosR regulon mutants and a complemented strain to M. tuberculosis in macaques, which faithfully model M. tuberculosis infection. METHODS We measured clinical and microbiologic correlates of infection with M. tuberculosis relative to mutant/complemented strains in the DosR regulon, studied lung pathology and hypoxia, and compared immune responses in lung using transcriptomics and flow cytometry. MEASUREMENTS AND MAIN RESULTS Despite being able to replicate initially, mutants in DosR regulon failed to persist or cause disease. On the contrary, M. tuberculosis and a complemented strain were able to establish infection and tuberculosis. The attenuation of pathogenesis in animals infected with the mutants coincided with the appearance of a Th1 response and organization of hypoxic lesions wherein M. tuberculosis expressed dosR. The lungs of animals infected with the mutants (but not the complemented strain) exhibited early transcriptional signatures of T-cell recruitment, activation, and proliferation associated with an increase of T cells expressing homing and proliferation markers. CONCLUSIONS Delayed adaptive responses, a hallmark of M. tuberculosis infection, not only lead to persistence but also interfere with the development of effective antituberculosis vaccines. The DosR regulon therefore modulates both the magnitude and the timing of adaptive immune responses in response to hypoxia in vivo, resulting in persistent infection. Hence, DosR regulates key aspects of the M. tuberculosis life cycle and limits lung pathology.
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68
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Evaluation of the Immunogenicity of Mycobacterium bovis BCG Delivered by Aerosol to the Lungs of Macaques. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2015; 22:992-1003. [PMID: 26108288 PMCID: PMC4550663 DOI: 10.1128/cvi.00289-15] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 06/23/2015] [Indexed: 11/20/2022]
Abstract
Nine million cases of tuberculosis (TB) were reported in 2013, with a further 1.5 million deaths attributed to the disease. When delivered as an intradermal (i.d.) injection, the Mycobacterium bovis BCG vaccine provides limited protection, whereas aerosol delivery has been shown to enhance efficacy in experimental models. In this study, we used the rhesus macaque model to characterize the mucosal and systemic immune response induced by aerosol-delivered BCG vaccine. Aerosol delivery of BCG induced both Th1 and Th17 cytokine responses. Polyfunctional CD4 T cells were detected in bronchoalveolar lavage (BAL) fluid and peripheral blood mononuclear cells (PBMCs) 8 weeks following vaccination in a dose-dependent manner. A similar trend was seen in peripheral gamma interferon (IFN-γ) spot-forming units measured by enzyme-linked immunosorbent spot (ELISpot) assay and serum anti-purified protein derivative (PPD) IgG levels. CD8 T cells predominantly expressed cytokines individually, with pronounced tumor necrosis factor alpha (TNF-α) production by BAL fluid cells. T-cell memory phenotype analysis revealed that CD4 and CD8 populations isolated from BAL fluid samples were polarized toward an effector memory phenotype, whereas the frequencies of peripheral central memory T cells increased significantly and remained elevated following aerosol vaccination. Expression patterns of the α4β1 integrin lung homing markers remained consistently high on CD4 and CD8 T cells isolated from BAL fluid and varied on peripheral T cells. This characterization of aerosol BCG vaccination highlights features of the resulting mycobacterium-specific immune response that may contribute to the enhanced protection previously reported in aerosol BCG vaccination studies and will inform future studies involving vaccines delivered to the mucosal surfaces of the lung.
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69
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Alyahya SA, Nolan ST, Smith CMR, Bishai WR, Sadoff J, Lamichhane G. Immunogenicity without Efficacy of an Adenoviral Tuberculosis Vaccine in a Stringent Mouse Model for Immunotherapy during Treatment. PLoS One 2015; 10:e0127907. [PMID: 25996375 PMCID: PMC4440646 DOI: 10.1371/journal.pone.0127907] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 04/20/2015] [Indexed: 11/19/2022] Open
Abstract
To investigate if bacterial persistence during TB drug treatment could be overcome by modulation of host immunity, we adapted a clinically-relevant model developed for the evaluation of new drugs and examined if immunotherapy with two adenoviral vaccines, Ad35-TBS (AERAS-402) and Ad26-TBS, could shorten therapy in mice. Even though immunotherapy resulted in strong splenic IFN-γ responses, no effect on bacterial replication in the lungs was seen. Multiplex assay analysis of lung samples revealed the absence of cytokine augmentation such as IFN-γ, TNF-α and IL-2, suggesting that immunization failed to induce immunity in the lungs. In this model, we show that IFN-γ levels were not associated with protection against disease relapse. The results obtained from our study raise questions regarding the traits of protective TB immunity that are relevant for the development of future immunotherapeutic and post-exposure vaccination strategies.
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Affiliation(s)
- S. Anisah Alyahya
- Crucell Holland B.V., Janssen Infectious Diseases and Vaccines, Leiden, The Netherlands
- * E-mail: (SAA); (JS); (GL)
| | - Scott T. Nolan
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Cara M. R. Smith
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - William R. Bishai
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- HHMI, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Jerald Sadoff
- Crucell Holland B.V., Janssen Infectious Diseases and Vaccines, Leiden, The Netherlands
- * E-mail: (SAA); (JS); (GL)
| | - Gyanu Lamichhane
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- * E-mail: (SAA); (JS); (GL)
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70
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Developing aerosol vaccines for Mycobacterium tuberculosis: Workshop proceedings: National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA, April 9, 2014. Vaccine 2015; 33:3038-46. [PMID: 25869894 DOI: 10.1016/j.vaccine.2015.03.060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 03/12/2015] [Accepted: 03/18/2015] [Indexed: 12/12/2022]
Abstract
On April 9, 2014, Aeras and the National Institute of Allergy and Infectious Diseases convened a workshop entitled "Developing Aerosol Vaccines for Mycobacterium tuberculosis" in Bethesda, MD. The purpose of the meeting was to explore the potential for developing aerosol vaccines capable of preventing infection with M. tuberculosis (Mtb), preventing the development of active tuberculosis (TB) among those latently infected with Mtb, or as immunotherapy for persons with active TB. The workshop was organized around four key questions relevant to developing and assessing aerosol TB vaccines: (1) What is the current knowledge about lung immune responses and early pathogenesis resulting after Mtb infection and what are the implications for aerosol TB vaccine strategies? (2) What are the technical issues surrounding aerosol vaccine delivery? (3) What is the current experience in aerosol TB vaccine development? and (4) What are the regulatory implications of developing aerosol vaccines, including those for TB? Lessons learned from the WHO effort to develop an aerosol measles vaccine served as a case example for overall discussions at the meeting. Workshop participants agreed that aerosol delivery represents a potentially important strategy in advancing TB vaccine development efforts. As no major regulatory, manufacturing or clinical impediments were identified, members of the workshop emphasized the need for greater support to further explore the potential for this delivery methodology, either alone or as an adjunct to traditional parenteral methods of vaccine administration.
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71
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Manjaly Thomas ZR, McShane H. Aerosol immunisation for TB: matching route of vaccination to route of infection. Trans R Soc Trop Med Hyg 2015; 109:175-81. [PMID: 25636950 PMCID: PMC4321022 DOI: 10.1093/trstmh/tru206] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 12/05/2014] [Accepted: 12/09/2014] [Indexed: 12/20/2022] Open
Abstract
TB remains a very significant global health burden. There is an urgent need for better tools for TB control, which include an effective vaccine. Bacillus Calmette-Guérin (BCG), the currently licensed vaccine, confers highly variable protection against pulmonary TB, the main source of TB transmission. Replacing BCG completely or boosting BCG with another vaccine are the two current strategies for TB vaccine development. Delivering a vaccine by aerosol represents a way to match the route of vaccination to the route of infection. This route of immunisation offers not only the scientific advantage of delivering the vaccine directly to the respiratory mucosa, but also practical and logistical advantages. This review summarises the state of current TB vaccine candidates in the pipeline, reviews current progress in aerosol administration of vaccines in general and evaluates the potential for TB vaccine candidates to be administered by the aerosol route.
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Affiliation(s)
| | - Helen McShane
- The Jenner Institute, Old Road Campus Research Building, Roosevelt Drive, Oxford, OX3 7DQ, UK
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72
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Abstract
The use of animal models has been invaluable for studying the pathogenesis of Mycobacterium tuberculosis infection, as well as for testing the efficacy of vaccines and drug regimens for tuberculosis. Among the applied animal models, nonhuman primates, particularly macaques, share the greatest anatomical and physiological similarities with humans. As such, macaque models have been used for investigating tuberculosis pathogenesis and preclinical testing of drugs and vaccines. This review focuses on published major studies which illustrate how the rhesus and cynomolgus macaques have enriched and may continue to advance the field of global tuberculosis research.
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73
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Abstract
Traditionally, the design of new vaccines directed against Mycobacterium tuberculosis, the most successful bacterial pathogen on the planet, has focused on prophylactic candidates that would be given to individuals while they are still young. It is becoming more apparent, however, that there are several types of vaccine candidates now under development that could be used under various conditions. Thus, in addition to prophylactic vaccines, such as recombinant Mycobacterium bovis BCG or BCG-boosting vaccines, other applications include vaccines that could prevent infection, vaccines that could be given in emergency situations as postexposure vaccines, vaccines that could be used to facilitate chemotherapy, and vaccines that could be used to reduce or prevent relapse and reactivation disease. These approaches are discussed here, including the type of immunity we are trying to specifically target, as well as the limitations of these approaches.
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74
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Rivera-Hernandez T, Carnathan DG, Moyle PM, Toth I, West NP, Young PR, Silvestri G, Walker MJ. The contribution of non-human primate models to the development of human vaccines. DISCOVERY MEDICINE 2014; 18:313-22. [PMID: 25549702 PMCID: PMC4465840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The non-human primates (NHPs) model in biomedical research has contributed to the study of human infectious, autoimmune, oncogenic, and neurological diseases. This review focuses on the importance of NHP models in vaccine development for tuberculosis, pertussis, Dengue, group A streptococcus (Streptococcus pyogenes) infection, HIV infection, and certain diseases in the elderly (influenza, for example). From understanding disease pathogenesis and mechanisms of protection, to assessing vaccine safety and efficacy, we discuss selected cases where the importance of the use of NHP models is highlighted.
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Affiliation(s)
- Tania Rivera-Hernandez
- School of Chemistry and Molecular Biosciences and Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Diane G Carnathan
- Emory Vaccine Center and Yerkes National Primate Research Center, Emory University, Atlanta, GA 30322, USA
| | - Peter M Moyle
- School of Pharmacy, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Istvan Toth
- School of Chemistry and Molecular Biosciences, Australian Infectious Diseases Research Centre, and School of Pharmacy, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Nicholas P West
- School of Chemistry and Molecular Biosciences and Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Paul R Young
- School of Chemistry and Molecular Biosciences and Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Guido Silvestri
- Emory Vaccine Center and Yerkes National Primate Research Center, Emory University, Atlanta, GA 30322, USA
| | - Mark J Walker
- School of Chemistry and Molecular Biosciences and Australian Infectious Diseases Research Centre, The University of Queensland, Brisbane, QLD, 4072, Australia
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