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Kardani K, Basimi P, Fekri M, Bolhassani A. Antiviral therapy for the sexually transmitted viruses: recent updates on vaccine development. Expert Rev Clin Pharmacol 2020; 13:1001-1046. [PMID: 32838584 DOI: 10.1080/17512433.2020.1814743] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The sexually transmitted infections (STIs) caused by viruses including human T cell leukemia virus type-1 (HTLV-1), human immunodeficiency virus-1 (HIV-1), human simplex virus-2 (HSV-2), hepatitis C virus (HCV), hepatitis B virus (HBV), and human papillomavirus (HPV) are major public health issues. These infections can cause cancer or result in long-term health problems. Due to high prevalence of STIs, a safe and effective vaccine is required to overcome these fatal viruses. AREAS COVERED This review includes a comprehensive overview of the literatures relevant to vaccine development against the sexually transmitted viruses (STVs) using PubMed and Sciencedirect electronic search engines. Herein, we discuss the efforts directed toward development of effective vaccines using different laboratory animal models including mice, guinea pig or non-human primates in preclinical trials, and human in clinical trials with different phases. EXPERT OPINION There is no effective FDA approved vaccine against the sexually transmitted viruses (STVs) except for HBV and HPV as prophylactic vaccines. Many attempts are underway to develop vaccines against these viruses. There are several approaches for improving prophylactic or therapeutic vaccines such as heterologous prime/boost immunization, delivery system, administration route, adjuvants, etc. In this line, further studies can be helpful for understanding the immunobiology of STVs in human. Moreover, development of more relevant animal models is a worthy goal to induce effective immune responses in humans.
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Affiliation(s)
- Kimia Kardani
- Department of Hepatitis and AIDS, Pasteur Institute of Iran , Tehran, Iran
| | - Parya Basimi
- Department of Hepatitis and AIDS, Pasteur Institute of Iran , Tehran, Iran
| | - Mehrshad Fekri
- Department of Hepatitis and AIDS, Pasteur Institute of Iran , Tehran, Iran
| | - Azam Bolhassani
- Department of Hepatitis and AIDS, Pasteur Institute of Iran , Tehran, Iran
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Abstract
With high morbidity and mortality worldwide, there is great interest in effective therapies for chronic hepatitis B (CHB) virus. There are currently several dozen investigational agents being developed for treatment of CHB. They can be broadly divided into two categories: (1) direct-acting antivirals (DAAs) that interfere with a specific step in viral replication; and (2) host-targeting agents that inhibit viral replication by modifying host cell function, with the latter group further divided into the subcategories of immune modulators and agents that target other host functions. Included among the DAAs being developed are RNA interference therapies, covalently closed circular DNA (cccDNA) formation and transcription inhibitors, core/capsid inhibitors, reverse transcriptase inhibitors, hepatitis B surface antigen (HBsAg) release inhibitors, antisense oligonucleotides, and helioxanthin analogues. Included among the host-targeting agents are entry inhibitors, cyclophilin inhibitors, and multiple immunomodulatory agents, including Toll-like receptor agonists, immune checkpoint inhibitors, therapeutic vaccines, engineered T cells, and several cytokine agents, including recombinant human interleukin-7 (CYT107) and SB 9200, a novel therapy that is believed to both have direct antiviral properties and to induce endogenous interferon. In this review we discuss agents that are currently in the clinical stage of development for CHB treatment as well as strategies and agents currently at the evaluation and discovery phase and potential future targets. Effective approaches to CHB may require suppression of viral replication combined with one or more host-targeting agents. Some of the recent research advances have led to the hope that with such a combined approach we may have a functional cure for CHB in the not distant future.
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Affiliation(s)
- Altaf Dawood
- Department of Internal Medicine, Section of Gastroenterology, University of Nevada School of Medicine, Las Vegas, NV, USA
| | - Syed Abdul Basit
- Department of Internal Medicine, Section of Gastroenterology, University of Nevada School of Medicine, Las Vegas, NV, USA
| | - Mahendran Jayaraj
- Department of Internal Medicine, Section of Gastroenterology, University of Nevada School of Medicine, Las Vegas, NV, USA
| | - Robert G Gish
- Department of Internal Medicine, Section of Gastroenterology, University of Nevada School of Medicine, Las Vegas, NV, USA.
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Stanford, CA, USA.
- Hepatitis B Foundation, Doylestown, PA, USA.
- Asian Pacific Health Foundation, San Diego, CA, USA.
- National Viral Hepatitis Roundtable, Washington, DC, USA.
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Zhou C, Li C, Gong GZ, Wang S, Zhang JM, Xu DZ, Guo LM, Ren H, Xu M, Xie Q, Pan C, Xu J, Hu Z, Geng S, Zhou X, Wang X, Zhou X, Mi H, Zhao G, Yu W, Wen YM, Huang L, Wang XY, Wang B. Analysis of immunological mechanisms exerted by HBsAg-HBIG therapeutic vaccine combined with Adefovir in chronic hepatitis B patients. Hum Vaccin Immunother 2017; 13:1989-1996. [PMID: 28665747 DOI: 10.1080/21645515.2017.1335840] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
An HBsAg-HBIG therapeutic vaccine (Yeast-derived Immune Complexes, YIC) for chronic hepatitis B (CHB) patients has undergone a series of clinical trials. The HBeAg sero-conversion rate of YIC varied from 21.9% to 14% depending on the immunization protocols from 6 to 12 injections. To analyze the immunological mechanisms exerted by 6 injections of YIC, 44 CHB patients were separately immunized with YIC, alum as adjuvant control or normal saline as blank control, with add on of antiviral drug Adefovir in all groups. Kinetic increase in Th1 and Th2 cells CD4+ T cell sub-populations with association in decrease in Treg cells and increase of Tc1 and Tc17 cells in CD8+ T cells were observed in YIC immunized group. No such changes were found in the other groups. By multifunctional analysis of cytokine profiles, significant increase of IL-2 levels was observed, both in CD4+ and CD8+ T cells in the YIC immunized group, accompanied by increase in IFN-gamma and decrease of inhibitory factors (IL-10, TGF-β and Foxp3) in CD4+ T cells. In the alum immunized group, slight increase of IL-10, TGF-β and Foxp3 in CD4+ T cells was found after the second injection, but decreased after more injections, suggesting that alum induced early inflammatory responses to a certain extent. Similar patterns of responses of IL-17A and TNF-α in CD8+T cells were shown between YIC and the saline group. Results indicate that add on of Adefovir, did not affect host specific immune responses.
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Affiliation(s)
- Chenliang Zhou
- a Key Laboratory of Medical Molecular Virology , MoE/MoH, School of Basic Medical Sciences, Shanghai Medical College, Fudan University , Shanghai , People's Republic of China
| | - Chaofan Li
- a Key Laboratory of Medical Molecular Virology , MoE/MoH, School of Basic Medical Sciences, Shanghai Medical College, Fudan University , Shanghai , People's Republic of China
| | - Guo-Zhong Gong
- b The Second Xiangya Hospital , Central South University , Changsha , People's Republic of China
| | - Shuang Wang
- a Key Laboratory of Medical Molecular Virology , MoE/MoH, School of Basic Medical Sciences, Shanghai Medical College, Fudan University , Shanghai , People's Republic of China
| | - Ji-Ming Zhang
- c Huashan Hospital , Fudan University , Shanghai , People's Republic of China
| | - Dao-Zhen Xu
- d Beijing Ditan Hospital , Capital Medical University , Beijing , People's Republic of China
| | - Li-Min Guo
- d Beijing Ditan Hospital , Capital Medical University , Beijing , People's Republic of China
| | - Hong Ren
- e The Second Affiliated Hospital , Chongqing Medical University , Chongqing , People's Republic of China
| | - Min Xu
- f Guangzhou Eighth People's Hospital , Guangzhou , People's Republic of China
| | - Qing Xie
- g Ruijin Hospital , Jiaotong University , Shanghai , People's Republic of China
| | - Chen Pan
- h Fuzhou Infectious Disease Hospital , Fuzhou , People's Republic of China
| | - Jie Xu
- i The Third People's Hospital , Jiaotong University , Shanghai , People's Republic of China
| | - Zhongyu Hu
- j National Institutes for Food and Drug Control , Beijing , People's Republic of China
| | - Shuang Geng
- a Key Laboratory of Medical Molecular Virology , MoE/MoH, School of Basic Medical Sciences, Shanghai Medical College, Fudan University , Shanghai , People's Republic of China
| | - Xian Zhou
- a Key Laboratory of Medical Molecular Virology , MoE/MoH, School of Basic Medical Sciences, Shanghai Medical College, Fudan University , Shanghai , People's Republic of China
| | - Xianzheng Wang
- a Key Laboratory of Medical Molecular Virology , MoE/MoH, School of Basic Medical Sciences, Shanghai Medical College, Fudan University , Shanghai , People's Republic of China
| | - Xiaoyu Zhou
- a Key Laboratory of Medical Molecular Virology , MoE/MoH, School of Basic Medical Sciences, Shanghai Medical College, Fudan University , Shanghai , People's Republic of China
| | - Haili Mi
- a Key Laboratory of Medical Molecular Virology , MoE/MoH, School of Basic Medical Sciences, Shanghai Medical College, Fudan University , Shanghai , People's Republic of China
| | - Gan Zhao
- a Key Laboratory of Medical Molecular Virology , MoE/MoH, School of Basic Medical Sciences, Shanghai Medical College, Fudan University , Shanghai , People's Republic of China
| | - Wencong Yu
- a Key Laboratory of Medical Molecular Virology , MoE/MoH, School of Basic Medical Sciences, Shanghai Medical College, Fudan University , Shanghai , People's Republic of China
| | - Yu-Mei Wen
- a Key Laboratory of Medical Molecular Virology , MoE/MoH, School of Basic Medical Sciences, Shanghai Medical College, Fudan University , Shanghai , People's Republic of China
| | - Lihua Huang
- k Wuxi Fifth People's Hospital , Wuxi , People's Republic of China
| | - Xuan-Yi Wang
- a Key Laboratory of Medical Molecular Virology , MoE/MoH, School of Basic Medical Sciences, Shanghai Medical College, Fudan University , Shanghai , People's Republic of China
| | - Bin Wang
- a Key Laboratory of Medical Molecular Virology , MoE/MoH, School of Basic Medical Sciences, Shanghai Medical College, Fudan University , Shanghai , People's Republic of China
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Akbar SMF, Al-Mahtab M, Khan SI, Shrestha A, Tabassum S, Hiasa Y. Current trends in hepatitis B vaccination. Future Virol 2016. [DOI: 10.2217/fvl-2016-0025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
One of the major successes in the area of vaccinology is the emergence, development and usage of hepatitis B vaccine (a prophylactic vaccine against HBV). Hepatitis B vaccine has protected millions of individuals from acquiring HBV infection and has prevented liver cancer in the majority of vaccinated subjects. Although initially designed as prophylactic vaccines, accumulative evidence has shown that these vaccines may also be used to treat patients with chronic hepatitis B. At present, there are two main areas of discussion in hepatitis B vaccination; development of more effective prophylactic hepatitis B vaccine that can provide protection to all vaccine recipients, and designing hepatitis B-based therapeutic vaccines for treatment of chronic hepatitis B patients.
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Affiliation(s)
- Sheikh MF Akbar
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
| | - Mamun Al-Mahtab
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sakirul I Khan
- Department of Anatomy & Embryology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Ananta Shrestha
- Department of Hepatology, The Liver Clinic, Liver Foundation, Nepal
| | - Shahina Tabassum
- Department of Virology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Yoichi Hiasa
- Department of Gastroenterology & Metabology, Ehime University Graduate School of Medicine, Ehime, Japan
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Enhanced immune response to hepatitis B vaccination through immunization with a Pre-S1/Pre-S2/S vaccine. Med Microbiol Immunol 2015; 204:57-68. [PMID: 25557605 PMCID: PMC4305084 DOI: 10.1007/s00430-014-0374-x] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Accepted: 09/26/2014] [Indexed: 12/16/2022]
Abstract
Efficacy and safety of recombinant yeast-derived hepatitis B vaccines for prevention of hepatitis B have been demonstrated unequivocally worldwide as reflected in reduction in HBsAg carrier rates and hepatocellular carcinoma. A new generation of recombinant HBV vaccines expressed in mammalian cells containing Pre-S/S epitopes has been developed in several countries. Such vaccines are useful in special risk groups, i.e., in non-responders to conventional HBV vaccines including older adults, obese people, health care workers, patients with renal failure and on dialysis, transplant patients, patients with HIV as well as travelers on short notice to HBV endemic regions. The future of such vaccines depends on their enhanced immunogenicity and cost profile. Sci-B-Vac™ is a mammalian cell-derived recombinant Pre-S1/Pre-S2/S hepatitis B vaccine which has been shown to be highly immunogenic, inducing faster and higher seroprotection rates against HBV with higher anti-HBs levels at lower HBsAg doses as compared to conventional yeast-derived vaccines. Recently, it has been suggested that such Pre-S/S vaccines against HBV might be efficacious not only for prevention but also for intervention in persistent HBV infection. Data obtained in a recent clinical trial conducted in Vietnam in patients with chronic hepatitis B suggest that repeated monthly i.m. injections of the Sci-B-Vac™ co-administered with daily oral lamivudine treatment can suppress HBV replication and lead to anti-HBs seroconversion in ~50 % of treated patients. Optimization of protocols and efficacy of such an intervention, intended to bypass T cell exhaustion and immune tolerance to HBV remains to be explored.
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