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Arévalo-Herrera M, Miura K, Solano E, Ramírez JS, Long CA, Corradin G, Herrera S. Immunogenicity of full-length P. vivax rPvs48/45 protein formulations in BALB/c mice. Vaccine 2022; 40:133-140. [PMID: 34802791 PMCID: PMC9109962 DOI: 10.1016/j.vaccine.2021.11.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 10/12/2021] [Accepted: 11/11/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Pvs48/45 is a Plasmodium vivax gametocyte surface protein involved in the parasite fertilization process. Previous studies showed that Pvs48/45 proteins expressed in Escherichia coli (E. coli) and Chinese hamster ovary (CHO) cells were highly immunoreactive with sera from malaria-endemic areas and highly immunogenic in animal models. Here the immunogenicity in mice of three different vaccine formulations was compared. METHODS Recombinant (r) Pvs48/45 proteins were expressed in E. coli and CHO, purified, formulated in Alhydrogel, GLA-SE and Montanide ISA-51 adjuvants and used to immunize BALB/c mice. Animals were immunized on days 0, 20 and 40, and serum samples were collected for serological analyses of specific antibody responses using ELISA and immunofluorescence (IFAT). Additionally, ex-vivo transmission-reducing activity (TRA) of sera on P. vivax gametocyte-infected human blood fed to Anopheles albimanus in direct membrane feeding assays (DMFA) was evaluated. RESULTS Most immunized animals seroconverted after the first immunization, and some developed antibody peaks of 106 with all adjuvants. However, the three adjuvant formulations induced different antibody responses and TRA efficacy. While GLA-SE formulations of both proteins induced similar antibody profiles, Montanide ISA-51 formulations resulted in higher and longer-lasting antibody titers with CHO-rPvs48/45 than with the E. coli formulation. Although the CHO protein formulated in Alhydrogel generated a high initial antibody peak, antibody responses to both proteins rapidly waned. Likewise, anti-Pvs48/45 antibodies displayed differential recognition of the parasite proteins in IFAT and ex vivo blockade of parasite transmission to mosquitoes. The CHO-rPvs48/45 formulated in Montanide ISA-51 induced the most effective ex vivo parasite blockage. CONCLUSIONS Three out of six vaccine formulations elicited antibodies with ex vivo TRA. The CHO-rPvs48/45 Montanide ISA-51 formulation induced the most stable antibody response, recognizing the native protein and the most robust ex vivo TRA. These results encourage further testing of the vaccine potential of this protein.
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Affiliation(s)
- Myriam Arévalo-Herrera
- Malaria Vaccine and Drug Development Center, Cali, Colombia.,Caucaseco Scientific Research Center, Cali, Colombia.,Corresponding author: Myriam Arevalo-Herrera, PhD, , Phone: (+57 2) 521 6232, Fax: (+57 2) 521 6228, Malaria Vaccine and Drug Development Center, Carrera 37 2 Bis # 5E-08. Cali, Colombia
| | - Kazutoyo Miura
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20852, USA
| | | | | | - Carole A. Long
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20852, USA
| | | | - Sócrates Herrera
- Malaria Vaccine and Drug Development Center, Cali, Colombia.,Caucaseco Scientific Research Center, Cali, Colombia
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Siriwattananon K, Manopwisedjaroen S, Shanmugaraj B, Prompetchara E, Ketloy C, Buranapraditkun S, Tharakhet K, Kaewpang P, Ruxrungtham K, Thitithanyanont A, Phoolcharoen W. Immunogenicity Studies of Plant-Produced SARS-CoV-2 Receptor Binding Domain-Based Subunit Vaccine Candidate with Different Adjuvant Formulations. Vaccines (Basel) 2021; 9:vaccines9070744. [PMID: 34358160 PMCID: PMC8310282 DOI: 10.3390/vaccines9070744] [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: 05/15/2021] [Revised: 06/28/2021] [Accepted: 07/03/2021] [Indexed: 12/23/2022] Open
Abstract
Due to the rapid transmission of the coronavirus disease 2019 (COVID-19) causing serious public health problems and economic burden, the development of effective vaccines is a high priority for controlling the virus spread. Our group has previously demonstrated that the plant-produced receptor-binding domain (RBD) of SARS-CoV-2 fused with Fc of human IgG was capable of eliciting potent neutralizing antibody and cellular immune responses in animal studies, and the immunogenicity could be improved by the addition of an alum adjuvant. Here, we performed a head-to-head comparison of different commercially available adjuvants, including aluminum hydroxide gel (alum), AddaVax (MF59), monophosphoryl lipid A from Salmonella minnesota R595 (mPLA-SM), and polyinosinic-polycytidylic acid (poly(I:C)), in mice by combining them with plant-produced RBD-Fc, and the differences in the immunogenicity of RBD-Fc with different adjuvants were evaluated. The specific antibody responses in terms of total IgG, IgG1, and IgG2a subtypes and neutralizing antibodies, as well as vaccine-specific T-lymphocyte responses, induced by the different tested adjuvants were compared. We observed that all adjuvants tested here induced a high level of total IgG and neutralizing antibodies, but mPLA-SM and poly (I:C) showed the induction of a balanced IgG1 and IgG2a (Th2/Th1) immune response. Further, poly (I:C) significantly increased the frequency of IFN-γ-expressing cells compared with control, whereas no significant difference was observed between the adjuvanted groups. This data revealed the adjuvants' role in enhancing the immune response of RBD-Fc vaccination and the immune profiles elicited by different adjuvants, which could prove helpful for the rational development of next-generation SARS-CoV-2 RBD-Fc subunit vaccines. However, additional research is essential to further investigate the efficacy and safety of this vaccine formulation before clinical trials.
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Affiliation(s)
- Konlavat Siriwattananon
- Research Unit for Plant-Produced Pharmaceuticals, Chulalongkorn University, Bangkok 10330, Thailand;
- Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand
| | - Suwimon Manopwisedjaroen
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand; (S.M.); (A.T.)
| | | | - Eakachai Prompetchara
- Center of Excellence in Vaccine Research and Development (Chula Vaccine Research Center, Chula VRC), Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (E.P.); (C.K.); (S.B.); (K.T.); (P.K.); (K.R.)
- Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Chutitorn Ketloy
- Center of Excellence in Vaccine Research and Development (Chula Vaccine Research Center, Chula VRC), Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (E.P.); (C.K.); (S.B.); (K.T.); (P.K.); (K.R.)
- Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Supranee Buranapraditkun
- Center of Excellence in Vaccine Research and Development (Chula Vaccine Research Center, Chula VRC), Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (E.P.); (C.K.); (S.B.); (K.T.); (P.K.); (K.R.)
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Kittipan Tharakhet
- Center of Excellence in Vaccine Research and Development (Chula Vaccine Research Center, Chula VRC), Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (E.P.); (C.K.); (S.B.); (K.T.); (P.K.); (K.R.)
| | - Papatsara Kaewpang
- Center of Excellence in Vaccine Research and Development (Chula Vaccine Research Center, Chula VRC), Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (E.P.); (C.K.); (S.B.); (K.T.); (P.K.); (K.R.)
| | - Kiat Ruxrungtham
- Center of Excellence in Vaccine Research and Development (Chula Vaccine Research Center, Chula VRC), Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand; (E.P.); (C.K.); (S.B.); (K.T.); (P.K.); (K.R.)
- Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Arunee Thitithanyanont
- Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand; (S.M.); (A.T.)
| | - Waranyoo Phoolcharoen
- Research Unit for Plant-Produced Pharmaceuticals, Chulalongkorn University, Bangkok 10330, Thailand;
- Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand
- Correspondence: ; Tel.: +662-218-8359; Fax: +662-218-8357
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Tamargo Santos B, Fleitas Pérez C, Infante Bourzac JF, Márquez Nápoles Y, Ramírez González W, Bourg V, Torralba D, Pérez V, Mouriño A, Ayala J, Labrada Rosado A, Aleya L, Bungau S, Sierra González VG. Remote induction of cellular immune response in mice by anti-meningococcal nanocochleates - nanoproteoliposomes. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 668:1055-1063. [PMID: 31018447 DOI: 10.1016/j.scitotenv.2019.03.075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/05/2019] [Accepted: 03/05/2019] [Indexed: 06/09/2023]
Abstract
New adjuvant formulations, based on proteoliposomes <40 nm and cochleates <100 nm, without Al(OH)3 adjuvant, were evaluated regarding their ability to generate Th1 immune response through a Delayed -Type Hypersensitivity Test, at the mouse model, by using a Neisseria meningitidis B protein complex as antigen. The formulations were administered by intramuscular (IM) (2 inoculations - at baseline and after 14 days) and intranasal (IN) (3 inoculations at 7 days) immunization pathways. All IM immunized groups were able to induce similar response to these formulations as well as to VA-MENGOC-BC® vaccine - containing Al(OH)3 adjuvant (used as positive control of the trial). In all groups, the induced inflammation (IP) rate was statistically higher than in the negative control group (CN) (p < 0.05). Immunogenicity, measured by HSR and CD4+ lymphocyte increase was equivalent to the control vaccine and most important, granuloma reactogenicity at the site of injection was eliminated, fact demonstrated by histological study. All groups of animals immunized by IN route showed HSR reactions and statistically significant differences with respect to the CN group. However, IP values were lower, with statistical differences (p < 0.05) for the same adjuvant formulation IM administered, except the AIF2-nCh formulation that generated statistically similar induction (p > 0.05) by both immunization pathways, suggesting it to be the best candidate for the next IN trial. Proteoliposome and cochleate formulations tested were able to mount potent Th-1 immune response, equivalent to the original vaccine formulation, with the advantage of less reactogenicity in the site of the injection, caused by the toxicity of Al(OH)3 adjuvant gel.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Antonio Mouriño
- Santiago de Compostela University, Santiago de Compostela, Spain
| | - Juan Ayala
- Center for Molecular Biology "Severo Ochoa", Madrid, Spain
| | | | - Lotfi Aleya
- Laboratoire Chrono-environnement, Université de Franche-Comté, Besançon, France.
| | - Simona Bungau
- Faculty of Medicine and Pharmacy, University of Oradea, Romania
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Senapati S, Darling RJ, Loh D, Schneider IC, Wannemuehler MJ, Narasimhan B, Mallapragada SK. Pentablock Copolymer Micelle Nanoadjuvants Enhance Cytosolic Delivery of Antigen and Improve Vaccine Efficacy while Inducing Low Inflammation. ACS Biomater Sci Eng 2019; 5:1332-1342. [PMID: 33405651 PMCID: PMC8627116 DOI: 10.1021/acsbiomaterials.8b01591] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
As the focus has shifted from traditional killed or live, attenuated vaccines toward subunit vaccines, improvements in vaccine safety have been confronted with low immunogenicity of protein antigens. This issue has been addressed by synthesizing and designing a wide variety of antigen carriers and adjuvants, such as Toll-like receptor agonists (e.g., MPLA, CpG). Studies have focused on optimizing adjuvants for improved cellular trafficking, cytosolic availability, and improved antigen presentation. In this work, we describe the design of novel amphiphilic pentablock copolymer (PBC) adjuvants that exhibit high biocompatibility and reversible pH- and temperature-sensitive micelle formation. We demonstrate improved humoral immunity in mice in response to single-dose immunization with PBC micelle adjuvants compared with soluble antigen alone. With the motive of exploring the mechanism of action of these PBC micelles, we studied intracellular trafficking of these PBC micelles with a model antigen and demonstrated that the PBC micelles associate with the antigen and enhance its cytosolic delivery to antigen-presenting cells. We posit that these PBC micelles operate via immune-enhancing mechanisms that are different from that of traditional Toll-like receptor activating adjuvants. The metabolic profile of antigen-presenting cells stimulated with traditional adjuvants and the PBC micelles also suggests distinct mechanisms of action. A key finding from this study is the low production of nitric oxide and reactive oxygen species by antigen-presenting cells when stimulated by PBC micelle adjuvants in sharp contrast to TLR adjuvants. Together, these studies provide a basis for rationally developing novel vaccine adjuvants that are safe, that induce low inflammation, and that can efficiently deliver antigen to the cytosol.
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Affiliation(s)
- Sujata Senapati
- Department of Chemical and Biological Engineering, Iowa State University, Ames, Iowa 50011, United States
- Nanovaccine Institute, Iowa State University, Ames, Iowa 50011, United States
| | - Ross J. Darling
- Department of Veterinary Microbiology and Preventive Medicine, Iowa State University, Ames, Iowa 50011, United States
- Nanovaccine Institute, Iowa State University, Ames, Iowa 50011, United States
| | - Darren Loh
- Department of Chemical and Biological Engineering, Johns Hopkins University, Baltimore, Maryland 21218, United States
| | - Ian C. Schneider
- Department of Chemical and Biological Engineering, Iowa State University, Ames, Iowa 50011, United States
- Nanovaccine Institute, Iowa State University, Ames, Iowa 50011, United States
| | - Michael J. Wannemuehler
- Department of Veterinary Microbiology and Preventive Medicine, Iowa State University, Ames, Iowa 50011, United States
- Nanovaccine Institute, Iowa State University, Ames, Iowa 50011, United States
| | - Balaji Narasimhan
- Department of Chemical and Biological Engineering, Iowa State University, Ames, Iowa 50011, United States
- Nanovaccine Institute, Iowa State University, Ames, Iowa 50011, United States
| | - Surya K. Mallapragada
- Department of Chemical and Biological Engineering, Iowa State University, Ames, Iowa 50011, United States
- Nanovaccine Institute, Iowa State University, Ames, Iowa 50011, United States
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MacDonald LD, MacKay A, Kaliaperumal V, Weir G, Penwell A, Rajagopalan R, Langley JM, Halperin S, Mansour M, Stanford MM. Type III hypersensitivity reactions to a B cell epitope antigen are abrogated using a depot forming vaccine platform. Hum Vaccin Immunother 2017; 14:59-66. [PMID: 28933663 PMCID: PMC5791585 DOI: 10.1080/21645515.2017.1375637] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Peptide antigens are combined with an adjuvant in order to increase immunogenicity in vivo. The immunogenicity and safety of a RSV vaccine formulated in a novel oil-based platform, DepoVax™ (DPX), was compared to an alum formulation. A peptide B cell epitope derived from RSV small hydrophobic ectodomain (SHe) served as the antigen. Both vaccines induced SHe-specific antibodies after immunization of mice. A single dose of the DPX-based formulation resulted in anti-SHe titres for up to 20 weeks. Boosting with Alum-SHe, but not with DPX-SHe, led to unexpected clinical signs such as decreased activity, cyanosis and drop in body temperature in mice but not in rabbits. The severity of adverse reactions correlated with magnitude of SHe-specific IgG immune responses and decreased complement component 3 plasma levels, indicating a type III hypersensitivity reaction. By RP-HPLC analysis, we found that only 8-20% of the antigen was found to be adsorbed to alum in vitro, indicating that this antigen is likely released systemically upon injection in vivo. Clinical signs were not observed in rabbits, indicating the response correlates with peptide dose relative to size of animal. These results suggest that peptide antigens targeted to produce B cell mediated response may result in increased incidence of type III hypersensitivity reactions when delivered in non-depot forming vaccines. The DPX formulation induced strong antibody titres to the antigen without causing adverse events, likely due to the strength of the depot in vivo, and demonstrates the potential safety and immunogenicity of this platform for B cell peptide antigens.
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Affiliation(s)
| | - Alecia MacKay
- a Immunovaccine Inc. , Halifax , Nova Scotia , Canada
| | | | | | | | | | - Joanne M Langley
- b Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority , Dalhousie University , Halifax , Nova Scotia , Canada.,c Department of Pediatrics , Dalhousie University , Halifax , Nova Scotia , Canada.,d Community Health and Epidemiology , Dalhousie University , Halifax , Nova Scotia , Canada
| | - Scott Halperin
- b Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority , Dalhousie University , Halifax , Nova Scotia , Canada.,c Department of Pediatrics , Dalhousie University , Halifax , Nova Scotia , Canada.,e Microbiology and Immunology , Dalhousie University , Halifax , Nova Scotia , Canada
| | - Marc Mansour
- a Immunovaccine Inc. , Halifax , Nova Scotia , Canada
| | - Marianne M Stanford
- a Immunovaccine Inc. , Halifax , Nova Scotia , Canada.,b Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority , Dalhousie University , Halifax , Nova Scotia , Canada.,e Microbiology and Immunology , Dalhousie University , Halifax , Nova Scotia , Canada
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Development of recombinant vaccine candidate molecule against Shigella infection. Vaccine 2016; 34:5376-5383. [DOI: 10.1016/j.vaccine.2016.08.034] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 07/28/2016] [Accepted: 08/12/2016] [Indexed: 11/22/2022]
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Chitradevi STS, Kaur G, Uppalapati S, Yadav A, Singh D, Bansal A. Co-administration of rIpaB domain of Shigella with rGroEL of S. Typhi enhances the immune responses and protective efficacy against Shigella infection. Cell Mol Immunol 2015; 12:757-67. [PMID: 25640657 DOI: 10.1038/cmi.2014.86] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 08/15/2014] [Accepted: 08/16/2014] [Indexed: 02/07/2023] Open
Abstract
Shigella species cause severe bacillary dysentery in humans and are associated with high morbidity and mortality. The Invasion plasmid antigen (IpaB) protein, which is conserved across all Shigella spp., induces macrophage cell death and is required to invade host cells. The present study evaluates the immunogenicity and protective efficacy of the recombinant (r) domain region of IpaB (rIpaB) of S. flexneri. rIpaB was administered either alone or was co-administered with the rGroEL (heat shock protein 60) protein from S. Typhi as an adjuvant in a mouse model of intranasal immunization. The IpaB domain region (37 kDa) of S. flexneri was amplified from an invasion plasmid, cloned, expressed in BL21 Escherichia coli cells and purified. Immunization with the rIpaB domain alone stimulated both humoral and cell-mediated immune responses. Furthermore, robust antibody (IgG, IgA) and T-cell responses were induced when the rIpaB domain was co-administered with rGroEL. Antibody isotyping revealed higher IgG1 and IgG2a antibody titers and increased interferon-gamma (IFN-γ) secretion in the co-administered group. Immunization of mice with the rIpaB domain alone protected 60%-70% of the mice from lethal infection by S. flexneri, S. boydii and S. sonnei, whereas co-administration with rGroEL increased the protective efficacy to 80%-85%. Organ burden and histopathological studies also revealed a significant reduction in lung infection in the co-immunized mice compared with mice immunized with the rIpaB domain alone. This study emphasizes that the co-administration of the rIpaB domain and rGroEL protein improves immune responses in mice and increases protective efficacy against Shigella infection. This is also the first report to evaluate the potential of the GroEL (Hsp 60) protein of S. Typhi as an adjuvant molecule, thereby overcoming the need for commercial adjuvants.
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Affiliation(s)
| | - Gurpreet Kaur
- Division of Experimental Biology, Defence Institute of Physiology and Allied Sciences, Delhi, India
| | | | - Anandprakash Yadav
- Division of Immunomodulation, Defence Institute of Physiology and Allied Sciences, Delhi, India
| | - Dependrapratap Singh
- Division of Experimental Biology, Defence Institute of Physiology and Allied Sciences, Delhi, India
| | - Anju Bansal
- Division of Experimental Biology, Defence Institute of Physiology and Allied Sciences, Delhi, India
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Tomar D, Chattree V, Tripathi V, Khan AA, Bakshi AR, Rao DN. New dimensions in vaccinology: A new insight. Indian J Clin Biochem 2005; 20:213-30. [PMID: 23105525 PMCID: PMC3454171 DOI: 10.1007/bf02893073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The development of vaccines to prevent infectious diseases has been one of the most important contributions of biomedical sciences. Increasing understanding in biochemistry, molecular biology, molecular genetics and related fields have provided an opportunity for the development of new generation vaccines that are based on rational design approaches. This is possible because of proper understanding of the microbial-genetics, biochemistry, host-pathogen interaction and recent developments in molecular immunology. Another important improvement made in the quality of vaccine production is the incorporation of immunomodulators or adjuvants with modified delivery vehicles viz liposomes, Iscoms and microspheres apart from alum being used as a gold standard. This article reviews the art of vaccination from Jenner period to present day context highlighting all the developments made at each stage of the vaccine development. Various criteria have been discussed regarding the selection of epitopes that expand B & T cells, its linkage with other accessory cells of the immune system, means to overcome MHC linked immune unresponsiveness, enhanced antigen processing and presentations that specially induce either helper or cytotoxic or mucosal immune responses were critically discussed.
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Affiliation(s)
- D Tomar
- Department of Biochemistry, All India Institute of Medical Sciences, 110029 New Delhi
| | - V Chattree
- Department of Biochemistry, All India Institute of Medical Sciences, 110029 New Delhi
| | - V Tripathi
- Department of Biochemistry, All India Institute of Medical Sciences, 110029 New Delhi
| | - A A Khan
- Department of Biochemistry, All India Institute of Medical Sciences, 110029 New Delhi
| | - A R Bakshi
- Department of Biochemistry, All India Institute of Medical Sciences, 110029 New Delhi
| | - D N Rao
- Department of Biochemistry, All India Institute of Medical Sciences, 110029 New Delhi
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