1
|
Grigoropoulos I, Tsioulos G, Kastrissianakis A, Shapira S, Green O, Rapti V, Tsakona M, Konstantinos T, Savva A, Kavatha D, Boumpas D, Syrigos K, Xynogalas I, Leontis K, Ntousopoulos V, Sakka V, Sardelis Z, Fotiadis A, Vlassi L, Kontogianni C, Levounets A, Poulakou G, Gaga M, MacLoughlin R, Stebbing J, Arber N, Antoniadou A, Tsiodras S. The safety and potential efficacy of exosomes overexpressing CD24 (EXO-CD24) in mild-moderate COVID-19 related ARDS. Respir Res 2024; 25:151. [PMID: 38561798 PMCID: PMC10983648 DOI: 10.1186/s12931-024-02759-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION EXO-CD24 are exosomes genetically manipulated to over-express Cluster of Differentiation (CD) 24. It consists of two breakthrough technologies: CD24, the drug, as a novel immunomodulator that is smarter than steroids without any side effects, and exosomes as the ideal natural drug carrier. METHODS A randomized, single blind, dose-finding phase IIb trial in hospitalized patients with mild to moderate Coronavirus disease 2019 (COVID-19) related Acute Respiratory Distress Syndrome (ARDS) was carried out in two medical centers in Athens. Patients received either 109 or 1010 exosome particles of EXO-CD24, daily, for five consecutive days and monitored for 28 days. Efficacy was assessed at day 7 among 91 patients who underwent randomization. The outcome was also compared in a post-hoc analysis with an income control group (n = 202) that fit the inclusion and exclusion criteria. RESULTS The mean age was 49.4 (± 13.2) years and 74.4% were male. By day 7, 83.7% showed improved respiratory signs and 64% had better oxygen saturation (SpO2) (p < 0.05). There were significant reductions in all inflammatory markers, most notably in C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, fibrinogen and an array of cytokines. Conversely, levels of the anti-inflammatory cytokine Interleukin-10 (IL-10) were increased (p < 0.05). Of all the documented adverse events, none were considered treatment related. No drug-drug interactions were noted. Two patients succumbed to COVID-19. Post-hoc analysis revealed that EXO-CD24 patients exhibited greater improvements in clinical and laboratory outcomes compared to an observational income control group. CONCLUSIONS EXO-CD24 presents a promising therapeutic approach for hyper-inflammatory state and in particular ARDS. Its unique combination of exosomes, as a drug carrier, and CD24, as an immunomodulator, coupled with inhalation administration, warrants further investigation in a larger, international, randomized, quadri-blind trial against a placebo.
Collapse
Affiliation(s)
- Ioannis Grigoropoulos
- 4, Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Georgios Tsioulos
- 4, Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Artemis Kastrissianakis
- 4, Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Shiran Shapira
- Integrated Cancer Prevention Center, Tel-Aviv Sourasky Medical Center, 6 Weizmann St., 6423906, Tel Aviv, Israel
- Department of Molecular Genetic and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Orr Green
- Integrated Cancer Prevention Center, Tel-Aviv Sourasky Medical Center, 6 Weizmann St., 6423906, Tel Aviv, Israel
| | - Vasiliki Rapti
- 3, Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, "Sotiria" General Hospital, 11527, Athens, Greece
| | - Maria Tsakona
- 4, Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Thomas Konstantinos
- 4, Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Athina Savva
- 4, Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Dimitra Kavatha
- 4, Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Dimitrios Boumpas
- 4, Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Konstantinos Syrigos
- 3, Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, "Sotiria" General Hospital, 11527, Athens, Greece
| | - Ioannis Xynogalas
- 3, Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, "Sotiria" General Hospital, 11527, Athens, Greece
| | - Konstantinos Leontis
- 3, Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, "Sotiria" General Hospital, 11527, Athens, Greece
| | - Vasileios Ntousopoulos
- 3, Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, "Sotiria" General Hospital, 11527, Athens, Greece
| | - Vissaria Sakka
- 3, Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, "Sotiria" General Hospital, 11527, Athens, Greece
| | - Zafeiris Sardelis
- 7, Respiratory Medicine Department "Sotiria" General Hospital, 11527, Athens, Greece
| | - Andreas Fotiadis
- 7, Respiratory Medicine Department "Sotiria" General Hospital, 11527, Athens, Greece
| | - Lamprini Vlassi
- 7, Respiratory Medicine Department "Sotiria" General Hospital, 11527, Athens, Greece
| | - Chrysoula Kontogianni
- 7, Respiratory Medicine Department "Sotiria" General Hospital, 11527, Athens, Greece
| | - Anastasia Levounets
- 7, Respiratory Medicine Department "Sotiria" General Hospital, 11527, Athens, Greece
| | - Garyfalia Poulakou
- 3, Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, "Sotiria" General Hospital, 11527, Athens, Greece
| | - Mina Gaga
- 7, Respiratory Medicine Department "Sotiria" General Hospital, 11527, Athens, Greece
| | - Ronan MacLoughlin
- R&D Science & Emerging Technologies, Aerogen Ltd., IDA Business Park, Dangan, Galway, Ireland
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons, Dublin, Ireland
- School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Justin Stebbing
- Department of Surgery and Cancer, Anglia Ruskin University, London, UK
- Department of Life Sciences, ARU, Cambridge, UK
| | - Nadir Arber
- Integrated Cancer Prevention Center, Tel-Aviv Sourasky Medical Center, 6 Weizmann St., 6423906, Tel Aviv, Israel.
- Department of Molecular Genetic and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Anastasia Antoniadou
- 4, Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 12462, Athens, Greece
| | - Sotirios Tsiodras
- 4, Department of Internal Medicine, University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 12462, Athens, Greece
| |
Collapse
|
2
|
Zhao T, Tani Y, Makino-Okamura C, Takita M, Yamamoto C, Kawahara E, Abe T, Sugiura S, Yoshimura H, Uchiyama T, Yamazaki I, Ishigame H, Ueno T, Okuma K, Wakui M, Fukuyama H, Tsubokura M. Diminished neutralizing activity against the XBB1.5 strain in 55.9% of individuals post 6 months COVID-19 mRNA booster vaccination: insights from a pseudovirus assay on 1,353 participants in the Fukushima vaccination community survey, Japan. Front Immunol 2024; 15:1337520. [PMID: 38562937 PMCID: PMC10983612 DOI: 10.3389/fimmu.2024.1337520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/20/2024] [Indexed: 04/04/2024] Open
Abstract
This study investigates the neutralizing activity against the XBB1.5 variant and the ancestral strain in a population post-bivalent vaccination using a pseudo virus assay validated with authentic virus assay. While bivalent booster vaccination and past infections enhanced neutralization against the XBB 1.5 strain, individuals with comorbidities showed reduced responses. The study suggests the need for continuous vaccine updates to address emerging SARS-CoV-2 variants and highlights the importance of monitoring real-world immune responses.
Collapse
Affiliation(s)
- Tianchen Zhao
- General Incorporated Association for Comprehensive Disaster Health Management Research Institute, Tokyo, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
| | - Yuta Tani
- General Incorporated Association for Comprehensive Disaster Health Management Research Institute, Tokyo, Japan
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Chieko Makino-Okamura
- Division of Immunology, Near-InfraRed Photo-Immunotherapy Research Institute, Kansai Medical University, Hirakata, Osaka, Japan
- Infectious Diseases Research Unit, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa, Japan
| | - Morihito Takita
- General Incorporated Association for Comprehensive Disaster Health Management Research Institute, Tokyo, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
| | - Chika Yamamoto
- General Incorporated Association for Comprehensive Disaster Health Management Research Institute, Tokyo, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
| | - Eiki Kawahara
- Division of Immunology, Near-InfraRed Photo-Immunotherapy Research Institute, Kansai Medical University, Hirakata, Osaka, Japan
- Infectious Diseases Research Unit, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa, Japan
- Cell Integrative Science Laboratory, Graduate School of Medical Life Science, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Toshiki Abe
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
| | - Sota Sugiura
- General Incorporated Association for Comprehensive Disaster Health Management Research Institute, Tokyo, Japan
| | - Hiroki Yoshimura
- General Incorporated Association for Comprehensive Disaster Health Management Research Institute, Tokyo, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
| | - Taiga Uchiyama
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
| | - Isato Yamazaki
- Division of Immunology, Near-InfraRed Photo-Immunotherapy Research Institute, Kansai Medical University, Hirakata, Osaka, Japan
- Infectious Diseases Research Unit, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa, Japan
- Cell Integrative Science Laboratory, Graduate School of Medical Life Science, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Harumichi Ishigame
- Division of Immunology, Near-InfraRed Photo-Immunotherapy Research Institute, Kansai Medical University, Hirakata, Osaka, Japan
- Laboratory for Tissue Dynamics, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa, Japan
| | - Takaharu Ueno
- Department of Microbiology, Kansai Medical University, School of Medicine, Hirakata, Osaka, Japan
| | - Kazu Okuma
- Department of Microbiology, Kansai Medical University, School of Medicine, Hirakata, Osaka, Japan
| | - Masatoshi Wakui
- Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hidehiro Fukuyama
- Division of Immunology, Near-InfraRed Photo-Immunotherapy Research Institute, Kansai Medical University, Hirakata, Osaka, Japan
- Infectious Diseases Research Unit, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa, Japan
- Cell Integrative Science Laboratory, Graduate School of Medical Life Science, Yokohama City University, Yokohama, Kanagawa, Japan
- INSERM EST, Strasbourg, France
| | - Masaharu Tsubokura
- General Incorporated Association for Comprehensive Disaster Health Management Research Institute, Tokyo, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
| |
Collapse
|
3
|
Bains A, Fischer K, Guan W, LiWang PJ. The Antiviral Activity of the Lectin Griffithsin against SARS-CoV-2 Is Enhanced by the Presence of Structural Proteins. Viruses 2023; 15:2452. [PMID: 38140693 PMCID: PMC10747160 DOI: 10.3390/v15122452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 12/07/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Although COVID-19 transmission has been reduced by the advent of vaccinations and a variety of rapid monitoring techniques, the SARS-CoV-2 virus itself has shown a remarkable ability to mutate and persist. With this long track record of immune escape, researchers are still exploring prophylactic treatments to curtail future SARS-CoV-2 variants. Specifically, much focus has been placed on the antiviral lectin Griffithsin in preventing spike protein-mediated infection via the hACE2 receptor (direct infection). However, an oft-overlooked aspect of SARS-CoV-2 infection is viral capture by attachment receptors such as DC-SIGN, which is thought to facilitate the initial stages of COVID-19 infection in the lung tissue (called trans-infection). In addition, while immune escape is dictated by mutations in the spike protein, coronaviral virions also incorporate M, N, and E structural proteins within the particle. In this paper, we explored how several structural facets of both the SARS-CoV-2 virion and the antiviral lectin Griffithsin can affect and attenuate the infectivity of SARS-CoV-2 pseudovirus. We found that Griffithsin was a better inhibitor of hACE2-mediated direct infection when the coronaviral M protein is present compared to when it is absent (possibly providing an explanation regarding why Griffithsin shows better inhibition against authentic SARS-CoV-2 as opposed to pseudotyped viruses, which generally do not contain M) and that Griffithsin was not an effective inhibitor of DC-SIGN-mediated trans-infection. Furthermore, we found that DC-SIGN appeared to mediate trans-infection exclusively via binding to the SARS-CoV-2 spike protein, with no significant effect observed when other viral proteins (M, N, and/or E) were present. These results provide etiological data that may help to direct the development of novel antiviral treatments, either by leveraging Griffithsin binding to the M protein as a novel strategy to prevent SARS-CoV-2 infection or by narrowing efforts to inhibit trans-infection to focus on DC-SIGN binding to SARS-CoV-2 spike protein.
Collapse
Affiliation(s)
- Arjan Bains
- Chemistry and Biochemistry, University of California Merced, 5200 North Lake Rd., Merced, CA 95343, USA;
| | - Kathryn Fischer
- Quantitative and Systems Biology, University of California Merced, 5200 North Lake Rd., Merced, CA 95343, USA;
| | - Wenyan Guan
- Materials and Biomaterials Science and Engineering, University of California Merced, 5200 North Lake Rd., Merced, CA 95343, USA;
| | - Patricia J. LiWang
- Molecular Cell Biology, Health Sciences Research Institute, University of California Merced, 5200 North Lake Rd., Merced, CA 95343, USA
| |
Collapse
|