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Zaib S, Rana N, Ali HS, Ur Rehman M, Awwad NS, Ibrahium HA, Khan I. Identification of potential inhibitors targeting yellow fever virus helicase through ligand and structure-based computational studies. J Biomol Struct Dyn 2023:1-18. [PMID: 38109183 DOI: 10.1080/07391102.2023.2294839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
Yellow fever is a flavivirus having plus-sensed RNA which encodes a single polyprotein. Host proteases cut this polyprotein into seven nonstructural proteins including a vital NS3 protein. The present study aims to identify the most effective inhibitor against the helicase (NS3) using different advanced ligand and structure-based computational studies. A set of 300 ligands was selected against helicase by chemical structural similarity model, which are similar to S-adenosyl-l-cysteine using infiniSee. This tool screens billions of compounds through a similarity search from in-built chemical spaces (CHEMriya, Galaxi, KnowledgeSpace and REALSpace). The pharmacophore was designed from ligands in the library that showed same features. According to the sequence of ligands, six compounds (29, 87, 99, 116, 148, and 208) were taken for pharmacophore designing against helicase protein. Subsequently, compounds from the library which showed the best pharmacophore shared-features were docked using FlexX functionality of SeeSAR and their optibrium properties were analyzed. Afterward, their ADME was improved by replacing the unfavorable fragments, which resulted in the generation of new compounds. The selected best compounds (301, 302, 303 and 304) were docked using SeeSAR and their pharmacokinetics and toxicological properties were evaluated using SwissADME. The optimal inhibitor for yellow fever helicase was 2-amino-N-(4-(dimethylamino)thiazol-2-yl)-4-methyloxazole-5-carboxamide (302), which exhibits promising potential for drug development.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Sumera Zaib
- Department of Basic and Applied Chemistry, Faculty of Science and Technology, University of Central Punjab, Lahore, Pakistan
| | - Nehal Rana
- Department of Basic and Applied Chemistry, Faculty of Science and Technology, University of Central Punjab, Lahore, Pakistan
| | - Hafiz Saqib Ali
- Chemistry Research Laboratory, Department of Chemistry and the INEOS Oxford Institute for Antimicrobial Research, University of Oxford, Oxford, UK
| | - Mujeeb Ur Rehman
- Department of Basic and Applied Chemistry, Faculty of Science and Technology, University of Central Punjab, Lahore, Pakistan
| | - Nasser S Awwad
- Department of Chemistry, King Khalid University, Abha, Saudi Arabia
| | - Hala A Ibrahium
- Biology Department, Faculty of Science, King Khalid University, Abha, Saudi Arabia
| | - Imtiaz Khan
- Manchester Institute of Biotechnology, The University of Manchester, Manchester, UK
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2
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Sandberg JT, Ols S, Löfling M, Varnaitė R, Lindgren G, Nilsson O, Rombo L, Kalén M, Loré K, Blom K, Ljunggren HG. Activation and Kinetics of Circulating T Follicular Helper Cells, Specific Plasmablast Response, and Development of Neutralizing Antibodies following Yellow Fever Virus Vaccination. THE JOURNAL OF IMMUNOLOGY 2021; 207:1033-1043. [PMID: 34321231 DOI: 10.4049/jimmunol.2001381] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 06/07/2021] [Indexed: 11/19/2022]
Abstract
A single dose of the replication-competent, live-attenuated yellow fever virus (YFV) 17D vaccine provides lifelong immunity against human YFV infection. The magnitude, kinetics, and specificity of B cell responses to YFV 17D are relatively less understood than T cell responses. In this clinical study, we focused on early immune events critical for the development of humoral immunity to YFV 17D vaccination in 24 study subjects. More specifically, we studied the dynamics of several immune cell populations over time and the development of neutralizing Abs. At 7 d following vaccination, YFV RNA in serum as well as several antiviral proteins were detected as a sign of YFV 17D replication. Activation of Th1-polarized circulating T follicular helper cells followed germinal center activity, the latter assessed by the surrogate marker CXCL13 in serum. This coincided with a plasmablast expansion peaking at day 14 before returning to baseline levels at day 28. FluoroSpot-based analysis confirmed that plasmablasts were specific to the YFV-E protein. The frequencies of plasmablasts correlated with the magnitude of neutralizing Ab titers measured at day 90, suggesting that this transient B cell subset could be used as an early marker of induction of protective immunity. Additionally, YFV-specific memory B cells were readily detectable at 28 and 90 d following vaccination, and all study subjects tested developed protective neutralizing Ab titers. Taken together, these studies provide insights into key immune events leading to human B cell immunity following vaccination with the YFV 17D vaccine.
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Affiliation(s)
- John Tyler Sandberg
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Sebastian Ols
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Marie Löfling
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Renata Varnaitė
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Gustaf Lindgren
- Cell Therapy and Allogenic Stem Cell Transplantation, Karolinska University Hospital, Stockholm, Sweden
| | - Ola Nilsson
- Division of Pediatric Endocrinology, Karolinska University Hospital, Stockholm, Sweden.,Center for Molecular Medicine, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,School of Medical Sciences, Örebro University and University Hospital, Örebro, Sweden
| | - Lars Rombo
- Center for Clinical Research, Eskilstuna, Sörmland, Sweden; and.,School of Medical Sciences, Örebro University and University Hospital, Örebro, Sweden
| | - Markus Kalén
- Department of Infection Medicine, Mälarsjukhuset, Eskilstuna, Sweden
| | - Karin Loré
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Kim Blom
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden;
| | - Hans-Gustaf Ljunggren
- Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
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3
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Yi HG, Kim H, Kwon J, Choi YJ, Jang J, Cho DW. Application of 3D bioprinting in the prevention and the therapy for human diseases. Signal Transduct Target Ther 2021; 6:177. [PMID: 33986257 PMCID: PMC8119699 DOI: 10.1038/s41392-021-00566-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/24/2021] [Accepted: 03/08/2021] [Indexed: 02/06/2023] Open
Abstract
Rapid development of vaccines and therapeutics is necessary to tackle the emergence of new pathogens and infectious diseases. To speed up the drug discovery process, the conventional development pipeline can be retooled by introducing advanced in vitro models as alternatives to conventional infectious disease models and by employing advanced technology for the production of medicine and cell/drug delivery systems. In this regard, layer-by-layer construction with a 3D bioprinting system or other technologies provides a beneficial method for developing highly biomimetic and reliable in vitro models for infectious disease research. In addition, the high flexibility and versatility of 3D bioprinting offer advantages in the effective production of vaccines, therapeutics, and relevant delivery systems. Herein, we discuss the potential of 3D bioprinting technologies for the control of infectious diseases. We also suggest that 3D bioprinting in infectious disease research and drug development could be a significant platform technology for the rapid and automated production of tissue/organ models and medicines in the near future.
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Affiliation(s)
- Hee-Gyeong Yi
- Department of Rural and Biosystems Engineering, College of Agriculture and Life Sciences, Chonnam National University, 77 Yongbong-Ro, Gwangju, 61186, Korea
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-Ro, Pohang, Kyungbuk, 37673, Korea
| | - Hyeonji Kim
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-Ro, Pohang, Kyungbuk, 37673, Korea
| | - Junyoung Kwon
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-Ro, Pohang, Kyungbuk, 37673, Korea
| | - Yeong-Jin Choi
- Department of Advanced Biomaterials Research, Korea Institute of Materials Science (KIMS), 797 Changwondaero, Changwon, Kyungnam, 51508, Korea
| | - Jinah Jang
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-Ro, Pohang, Kyungbuk, 37673, Korea.
- Department of Convergence IT Engineering, POSTECH, 77 Cheongam-Ro, Pohang, Kyungbuk, 37673, Korea.
- Institute of Convergence Science, Yonsei University, 50 Yonsei-Ro, Seoul, 03722, Korea.
| | - Dong-Woo Cho
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-Ro, Pohang, Kyungbuk, 37673, Korea.
- Institute of Convergence Science, Yonsei University, 50 Yonsei-Ro, Seoul, 03722, Korea.
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4
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Jaffe E, Goldfarb IT, Lyerly AD. The Costs of Contradictory Messages About Live Vaccines in Pregnancy. Am J Public Health 2021; 111:498-503. [PMID: 33476239 PMCID: PMC7893372 DOI: 10.2105/ajph.2020.306045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2020] [Indexed: 11/04/2022]
Abstract
The increased risk of harm from COVID-19 infection in pregnancy highlights the importance of including pregnant people in COVID-19 vaccine development and deployment. Promising vaccines being developed include replication-competent platforms, which are typically contraindicated during pregnancy because of theoretical risk. However, replicating vaccines are administered in and around pregnancy, either inadvertently because of unknown pregnancy status or when recommended.The historical cases of Ebola virus, yellow fever, and rubella demonstrate that contradictory messages around the safety of live vaccines in pregnancy have critical public health costs. First, restricting study or use of replicating vaccines in pregnancy may delay or deny access to the only available protection against deadly diseases. Additionally, not vaccinating pregnant people may slow epidemic control. Finally, uncertainty and worry around the safety of live vaccines may lead to terminations of otherwise desired pregnancies after inadvertent vaccination in pregnancy.If one of the vaccines deployed to combat the current global COVID-19 pandemic is replication competent, historical cases offer important lessons for ethical and effective protection for pregnant populations.
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Affiliation(s)
- Elana Jaffe
- Elana Jaffe is with the Center for Bioethics, Department of Social Medicine, School of Medicine, and the Department of Maternal, Child, and Family Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. Ilona Telefus Goldfarb is with the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Anne Drapkin Lyerly is with the Center for Bioethics, Department of Social Medicine, and the Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill
| | - Ilona Telefus Goldfarb
- Elana Jaffe is with the Center for Bioethics, Department of Social Medicine, School of Medicine, and the Department of Maternal, Child, and Family Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. Ilona Telefus Goldfarb is with the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Anne Drapkin Lyerly is with the Center for Bioethics, Department of Social Medicine, and the Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill
| | - Anne Drapkin Lyerly
- Elana Jaffe is with the Center for Bioethics, Department of Social Medicine, School of Medicine, and the Department of Maternal, Child, and Family Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. Ilona Telefus Goldfarb is with the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Anne Drapkin Lyerly is with the Center for Bioethics, Department of Social Medicine, and the Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill
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5
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Cagigi A, Loré K. Immune Responses Induced by mRNA Vaccination in Mice, Monkeys and Humans. Vaccines (Basel) 2021; 9:61. [PMID: 33477534 PMCID: PMC7831080 DOI: 10.3390/vaccines9010061] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 12/12/2022] Open
Abstract
In this concise review, we summarize the concepts behind mRNA vaccination. We discuss the innate and adaptive immune response generated by mRNA vaccines in different animal models and in humans. We give examples of viral infections where mRNA vaccines have shown to induce potent responses and we discuss in more detail the recent SARS-CoV-2 mRNA vaccine trials in humans.
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Affiliation(s)
| | - Karin Loré
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, 161 64 Solna, Sweden;
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6
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da Silva FC, Magaldi FM, Sato HK, Bevilacqua E. Yellow Fever Vaccination in a Mouse Model Is Associated With Uninterrupted Pregnancies and Viable Neonates Except When Administered at Implantation Period. Front Microbiol 2020; 11:245. [PMID: 32153534 PMCID: PMC7044120 DOI: 10.3389/fmicb.2020.00245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 02/03/2020] [Indexed: 02/05/2023] Open
Abstract
The potential risk of yellow fever (YF) infection in unvaccinated pregnant women has aroused serious concerns. In this study, we evaluated the effect of the YF vaccine during gestation using a mouse model, analyzing placental structure, immunolocalization of the virus antigen, and viral activity at the maternal-fetal barrier and in the maternal liver and fetus. The YF vaccine (17DD) was administered subcutaneously at a dose of 2.0 log10 PFU to CD-1 mice on gestational days (gd) 0.5, 5.5, and 11.5 (n = 5–10/group). The control group received sterile saline (n = 5–10/group). Maternal liver, implantation sites with fetus, and placentas were collected on gd18.5. The numbers of implantation sites, reabsorbed embryos, and stillborn fetuses were counted, and placentas and live fetuses were weighed. Tissues (placenta, fetuses, and liver) of vaccinated pregnant mice on gd5.5 (n = 15) were paraffin-embedded in 10% buffered-formalin and collected in TRIzol for immunolocalization of YF vaccine virus and PCR, respectively. PCR products were also subjected to automated sequence analysis. Fetal growth restriction (p < 0.0001) and a significant decrease in fetal viability (p < 0.0001) occurred only when the vaccine was administered on gd5.5. In stillbirths, the viral antigen was consistently immunolocalized at the maternal-fetal barrier and in fetal organs, suggesting a transplacental transfer. In stillbirths, RNA of the vaccine virus was also detected by reverse transcriptase-PCR indicating viral activity in the maternal liver and fetal tissues. In conclusion, the findings of this study in the mouse suggest that vaccination did not cause adverse outcomes with respect to fetal development except when administered during the early gestational stage, indicating the implantation period as a susceptible period in which the YF vaccine virus might interfere with pregnancy.
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Affiliation(s)
- Fernanda C da Silva
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Fernanda M Magaldi
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Helena K Sato
- Secretaria do Estado de São Paulo, Epidemiological Surveillance Center, Department of Health, São Paulo, Brazil
| | - Estela Bevilacqua
- Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
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7
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Ribeiro AF, Cavalin RF, Abdul Hamid Suleiman JM, Alves da Costa J, Januaria de Vasconcelos M, Sant'Ana Málaque CM, Sztajnbok J. Yellow Fever: Factors Associated with Death in a Hospital of Reference in Infectious Diseases, São Paulo, Brazil, 2018. Am J Trop Med Hyg 2020; 101:180-188. [PMID: 31134884 DOI: 10.4269/ajtmh.18-0882] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Faced with the reemergence of yellow fever (YF) in the metropolitan region of São Paulo, Brazil, we developed a retrospective study to describe the cases of YF attended at the Institute of Infectology Emilio Ribas from January to March 2018 and analyze the factors associated with death, from the information obtained in the hospital epidemiological investigation. A total of 72 cases of sylvatic YF were confirmed, with 21 deaths (29.2% lethality rate). Cases were concentrated in males (80.6%) and in the age group of 30 to 59 years (56.9%). Two logistic regression models were performed, with continuous variables adjusted for the time between onset of symptoms and hospitalization. The first model indicated age (odds ratiosadjusted [ORadj]: 1.038; CI 95%: 1.008-1.212), aspartate aminotransferase (AST) (ORadj: 1.038; CI 95%: 1.005-1.072), and creatinine (ORadj: 2.343; CI 95%: 1.205-4.553) were independent factors associated with mortality. The second model indicated age (ORadj: 1.136; CI 95%: 1.013-1.275), alanine aminotransferase (ALT) (ORadj: 1.118; CI 95%: 1.018-1.228), and creatinine (ORadj: 2.835; CI 95%: 1.352-5,941). The risk of death in the model with continuous variables was calculated from the increase of 1 year (age), 1 mg/dL (creatinine), and 100 U/L for AST and ALT. Another logistic regression analysis with dichotomous variables indicated AST > 1,841 IU/L (ORadj: 12.92; CI 95%: 1.50-111.37) and creatinine > 1.2 mg/dL (ORadj: 81.47; CI 95%: 11.33-585.71) as independent factors associated with death. These results may contribute to the appropriate clinical management of patients with YF in health-care services and improve the response to outbreaks and public health emergencies.
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Affiliation(s)
- Ana Freitas Ribeiro
- Institute of Infectology Emilio Ribas, São Paulo, Brazil.,Nove de Julho University, São Paulo, Brazil
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8
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Burkhard J, Ciurea A, Gabay C, Hasler P, Müller R, Niedrig M, Fehr J, Villiger P, Visser LG, de Visser AW, Walker UA, Hatz C, Bühler S. Long-term immunogenicity after yellow fever vaccination in immunosuppressed and healthy individuals. Vaccine 2020; 38:3610-3617. [PMID: 31911033 DOI: 10.1016/j.vaccine.2019.12.042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 12/11/2019] [Accepted: 12/19/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND The live-attenuated yellow fever vaccine (YFV) is generally contraindicated in immunosuppressed patients. Our aim was to investigate if immunosuppressive therapy impairs the long-term protection against yellow fever virus in patients who had received YFV prior to the start of their immunosuppressive therapy. METHODS Our study examined 35 healthy individuals and 40 immunosuppressed patients with autoimmune diseases or organ transplants. All individuals had received YFV prior to the onset of their immunosuppression. We analysed the long-term influence of the immunosuppressive therapy on the YFV protective immunity by measuring neutralising antibodies (NA) with the Plaque Reduction Neutralisation Test (PRNT). We assessed risk factors for a negative PRNT result (titre below 1: 10) and their influence on the magnitude of the NA. RESULTS A median time interval of 21.1 years (interquartile range 14.4-31.3 years) after the YFV in all patients, a total of 35 immunosuppressed patients (88%) were seropositive (PRNT ≥ 1:10) compared to 31 patients (89%) in the control group. The geometric mean titres of NA did not differ between the groups. The duration of an underlying rheumatic disease was the only risk factor found for a lower magnitude of NA. An insufficient level of NA was found in nine subjects (12%) who had received a single dose of YFV (in one subject, the number of YFV doses was unknown). CONCLUSION The use of an immunosuppressive drug started after the administration of the YFV did not affect long-term persistence of NA. A second dose of YFV may be necessary to secure long-term immunity.
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Affiliation(s)
- J Burkhard
- Department of Public Health / Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - A Ciurea
- Department of Rheumatology, University Hospital of Zurich, Zurich, Switzerland
| | - C Gabay
- Division of Rheumatology, University Hospital of Geneva, Geneva, Switzerland
| | - P Hasler
- Department of Rheumatology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - R Müller
- Division of Rheumatology, Department of Internal Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland; Division of Rheumatology and Clinical Immunology, Department of Internal Medicine Ludwig-Maximilians-University Munich, Germany
| | - M Niedrig
- Robert Koch-Institut (RKI), Berlin, Germany
| | - J Fehr
- Department of Public Health / Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - P Villiger
- Department of Rheumatology and Clinical Immunology/Allergology, University Hospital of Bern, Bern, Switzerland
| | - L G Visser
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - A W de Visser
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - U A Walker
- Department of Rheumatology, University Hospital Basel, Basel, Switzerland
| | - C Hatz
- Department of Public Health / Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland; Department of Medicine and Diagnostics, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Switzerland; Division of Infectious Diseases & Hospital Epidemiology, Kantonsspital St. Gallen, Switzerland
| | - S Bühler
- Department of Public Health / Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland; Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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9
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Veit O, Domingo C, Niedrig M, Staehelin C, Sonderegger B, Héquet D, Stoeckle M, Calmy A, Schiffer V, Bernasconi E, Flury D, Hatz C, Zwahlen M, Furrer H. Long-term Immune Response to Yellow Fever Vaccination in Human Immunodeficiency Virus (HIV)-Infected Individuals Depends on HIV RNA Suppression Status: Implications for Vaccination Schedule. Clin Infect Dis 2019; 66:1099-1108. [PMID: 29140432 DOI: 10.1093/cid/cix960] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 11/07/2017] [Indexed: 11/12/2022] Open
Abstract
Background In human immunodeficiency virus (HIV)-infected individuals, the immune response over time to yellow fever vaccination (YFV) and the necessity for booster vaccination are not well understood. Methods We studied 247 participants of the Swiss HIV Cohort Study (SHCS) with a first YFV after HIV diagnosis and determined their immune responses at 1 year, 5 years, and 10 years postvaccination by yellow fever plaque reduction neutralization titers (PRNTs) in stored blood samples. A PRNT of 1:≥10 was regarded as reactive and protective. Predictors of vaccination response were analyzed with Poisson regression. Results At vaccination, 82% of the vaccinees were taking combination antiretroviral therapy (cART), 83% had suppressed HIV RNA levels (<400 copies/mL), and their median CD4 T-cell count was 536 cells/μL. PRNT was reactive in 46% (95% confidence interval [CI], 38%-53%) before, 95% (95% CI, 91%-98%) within 1 year, 86% (95% CI, 79%-92%) at 5 years, and 75% (95% CI, 62%-85%) at 10 years postvaccination. In those with suppressed plasma HIV RNA at YFV, the proportion with reactive PRNTs remained high: 99% (95% CI, 95%-99.8%) within 1 year, 99% (95% CI, 92%-100%) at 5 years, and 100% (95% CI, 86%-100%) at 10 years. Conclusions HIV-infected patients' long-term immune response up to 10 years to YFV is primarily dependent on the control of HIV replication at the time of vaccination. For those on successful cART, immune response up to 10 years is comparable to that of non-HIV-infected adults. We recommend a single YFV booster after 10 years for patients vaccinated on successful cART, whereas those vaccinated with uncontrolled HIV RNA may need an early booster.
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Affiliation(s)
- Olivia Veit
- Department of Infectious Diseases, Bern University Hospital, University of Bern.,Department of Medicine, Swiss Tropical and Public Health Institute.,University of Basel, Switzerland.,Institute of Epidemiology, Biostatistics and Prevention, University of Zürich, Switzerland
| | | | | | - Cornelia Staehelin
- Department of Infectious Diseases, Bern University Hospital, University of Bern
| | - Beat Sonderegger
- Department of Infectious Diseases, Bern University Hospital, University of Bern
| | - Delphine Héquet
- Division of Infectious Diseases, University Hospital of Lausanne
| | - Marcel Stoeckle
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel
| | - Alexandra Calmy
- Division of Infectious Diseases, University Hospital of Geneva
| | | | - Enos Bernasconi
- Division of Infectious Diseases, Regional Hospital of Lugano
| | - Domenica Flury
- Division of Infectious Diseases, Cantonal Hospital of St Gallen
| | - Christoph Hatz
- Department of Medicine, Swiss Tropical and Public Health Institute.,University of Basel, Switzerland.,Institute of Epidemiology, Biostatistics and Prevention, University of Zürich, Switzerland
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine, University of Bern, Switzerland
| | - Hansjakob Furrer
- Department of Infectious Diseases, Bern University Hospital, University of Bern
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10
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Beck AS, Wood TG, Widen SG, Thompson JK, Barrett ADT. Analysis By Deep Sequencing of Discontinued Neurotropic Yellow Fever Vaccine Strains. Sci Rep 2018; 8:13408. [PMID: 30194325 PMCID: PMC6128858 DOI: 10.1038/s41598-018-31085-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 07/31/2018] [Indexed: 11/08/2022] Open
Abstract
Deep sequencing of live-attenuated viral vaccines has focused on vaccines in current use. Here we report characterization of a discontinued live yellow fever (YF) vaccine associated with severe adverse events. The French neurotropic vaccine (FNV) strain of YF virus was derived empirically in 1930 by 260 passages of wild-type French viscerotropic virus (FVV) in mouse brain. The vaccine was administered extensively in French-speaking Africa until discontinuation in 1982, due to high rates of post-vaccination encephalitis in children. Using rare archive strains of FNV, viral RNAs were sequenced and analyzed by massively parallel, in silico methods. Diversity and specific population structures were compared in reference to the wild-type parental strain FVV, and between the vaccine strains themselves. Lower abundance of polymorphism content was observed for FNV strains relative to FVV. Although the vaccines were of lower diversity than FVV, heterogeneity between the vaccines was observed. Reversion to wild-type identity was variably observed in the FNV strains. Specific population structures were recovered from vaccines with neurotropic properties; loss of neurotropism in mice was associated with abundance of wild-type RNA populations. The analysis provides novel sequence evidence that FNV is genetically unstable, and that adaptation of FNV contributed to the neurotropic adverse phenotype.
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Affiliation(s)
- Andrew S Beck
- Department of Pathology, Galveston, TX, 77555, USA
- University of Texas Medical Branch, Galveston, TX, 77555, USA
| | - Thomas G Wood
- Molecular Genomics Core Facility, Galveston, TX, 77555, USA
- University of Texas Medical Branch, Galveston, TX, 77555, USA
| | - Steven G Widen
- Molecular Genomics Core Facility, Galveston, TX, 77555, USA
- University of Texas Medical Branch, Galveston, TX, 77555, USA
| | - Jill K Thompson
- Molecular Genomics Core Facility, Galveston, TX, 77555, USA
- University of Texas Medical Branch, Galveston, TX, 77555, USA
| | - Alan D T Barrett
- Department of Pathology, Galveston, TX, 77555, USA.
- Sealy Institute for Vaccine Sciences, and World Health Organization Collaborating Center for Vaccine Research, Evaluation and Training on Emerging Infectious Diseases, Galveston, TX, 77555, USA.
- University of Texas Medical Branch, Galveston, TX, 77555, USA.
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11
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Giel-Moloney M, Goncalvez AP, Catalan J, Lecouturier V, Girerd-Chambaz Y, Diaz F, Maldonado-Arocho F, Gomila RC, Bernard MC, Oomen R, Delagrave S, Burdin N, Kleanthous H, Jackson N, Heinrichs J, Pugachev KV. Chimeric yellow fever 17D-Zika virus (ChimeriVax-Zika) as a live-attenuated Zika virus vaccine. Sci Rep 2018; 8:13206. [PMID: 30181550 PMCID: PMC6123396 DOI: 10.1038/s41598-018-31375-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 08/17/2018] [Indexed: 11/15/2022] Open
Abstract
Zika virus (ZIKV) is an emerging mosquito-borne pathogen representing a global health concern. It has been linked to fetal microcephaly and other birth defects and neurological disorders in adults. Sanofi Pasteur has engaged in the development of an inactivated ZIKV vaccine, as well as a live chimeric vaccine candidate ChimeriVax-Zika (CYZ) that could become a preferred vaccine depending on future ZIKV epidemiology. This report focuses on the CYZ candidate that was constructed by replacing the pre-membrane and envelope (prM-E) genes in the genome of live attenuated yellow fever 17D vaccine virus (YF 17D) with those from ZIKV yielding a viable CYZ chimeric virus. The replication rate of CYZ in the Vero cell substrate was increased by using a hybrid YF 17D-ZIKV signal sequence for the prM protein. CYZ was highly attenuated both in mice and in human in vitro models (human neuroblastoma and neuronal progenitor cells), without the need for additional attenuating modifications. It exhibited significantly reduced viral loads in organs compared to a wild-type ZIKV and a complete lack of neuroinvasion following inoculation of immunodeficient A129 mice. A single dose of CYZ elicited high titers of ZIKV-specific neutralizing antibodies in both immunocompetent and A129 mice and protected animals from ZIKV challenge. The data indicate that CYZ is a promising vaccine candidate against ZIKV.
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Affiliation(s)
| | | | - John Catalan
- Sanofi Pasteur Research & Development, Cambridge, MA, USA
| | | | | | - Fernando Diaz
- Sanofi Pasteur Research & Development, Cambridge, MA, USA.,VL46 Inc., Cambridge, MA, USA
| | | | - Raul C Gomila
- Sanofi Pasteur Research & Development, Cambridge, MA, USA
| | | | - Ray Oomen
- Sanofi Pasteur Research & Development, Cambridge, MA, USA
| | | | - Nicolas Burdin
- Sanofi Pasteur Research & Development, Marcy-l'Étoile, France
| | | | - Nicolas Jackson
- Sanofi Pasteur Research & Development, Marcy-l'Étoile, France
| | - Jon Heinrichs
- Sanofi Pasteur Research & Development, Swiftwater, PA, USA
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12
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Bonin CRB, Fernandes GC, Dos Santos RW, Lobosco M. A qualitatively validated mathematical-computational model of the immune response to the yellow fever vaccine. BMC Immunol 2018; 19:15. [PMID: 29801432 PMCID: PMC5970533 DOI: 10.1186/s12865-018-0252-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/27/2018] [Indexed: 12/13/2022] Open
Abstract
Background Although a safe and effective yellow fever vaccine was developed more than 80 years ago, several issues regarding its use remain unclear. For example, what is the minimum dose that can provide immunity against the disease? A useful tool that can help researchers answer this and other related questions is a computational simulator that implements a mathematical model describing the human immune response to vaccination against yellow fever. Methods This work uses a system of ten ordinary differential equations to represent a few important populations in the response process generated by the body after vaccination. The main populations include viruses, APCs, CD8+ T cells, short-lived and long-lived plasma cells, B cells and antibodies. Results In order to qualitatively validate our model, four experiments were carried out, and their computational results were compared to experimental data obtained from the literature. The four experiments were: a) simulation of a scenario in which an individual was vaccinated against yellow fever for the first time; b) simulation of a booster dose ten years after the first dose; c) simulation of the immune response to the yellow fever vaccine in individuals with different levels of naïve CD8+ T cells; and d) simulation of the immune response to distinct doses of the yellow fever vaccine. Conclusions This work shows that the simulator was able to qualitatively reproduce some of the experimental results reported in the literature, such as the amount of antibodies and viremia throughout time, as well as to reproduce other behaviors of the immune response reported in the literature, such as those that occur after a booster dose of the vaccine.
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Affiliation(s)
- Carla R B Bonin
- Graduate Program in Computational Modeling, Federal University of Juiz de Fora, Juiz de Fora, 36036-900, Brazil.
| | - Guilherme C Fernandes
- Presidente Antônio Carlos University - Medical School, Juiz de Fora, 36047-362, Brazil
| | - Rodrigo W Dos Santos
- Graduate Program in Computational Modeling, Federal University of Juiz de Fora, Juiz de Fora, 36036-900, Brazil
| | - Marcelo Lobosco
- Graduate Program in Computational Modeling, Federal University of Juiz de Fora, Juiz de Fora, 36036-900, Brazil
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13
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Vetter V, Denizer G, Friedland LR, Krishnan J, Shapiro M. Understanding modern-day vaccines: what you need to know. Ann Med 2018; 50:110-120. [PMID: 29172780 DOI: 10.1080/07853890.2017.1407035] [Citation(s) in RCA: 165] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Vaccines are considered to be one of the greatest public health achievements of the last century. Depending on the biology of the infection, the disease to be prevented, and the targeted population, a vaccine may require the induction of different adaptive immune mechanisms to be effective. Understanding the basic concepts of different vaccines is therefore crucial to understand their mode of action, benefits, risks, and their potential real-life impact on protection. This review aims to provide healthcare professionals with background information about the main vaccine designs and concepts of protection in a simplified way to improve their knowledge and understanding, and increase their confidence in the science of vaccination ( Supplementary Material ). KEY MESSAGE Different vaccine designs, each with different advantages and limitations, can be applied for protection against a particular disease. Vaccines may contain live-attenuated pathogens, inactivated pathogens, or only parts of pathogens and may also contain adjuvants to stimulate the immune responses. This review explains the mode of action, benefits, risks and real-life impact of vaccines by highlighting key vaccine concepts. An improved knowledge and understanding of the main vaccine designs and concepts of protection will help support the appropriate use and expectations of vaccines, increase confidence in the science of vaccination, and help reduce vaccine hesitancy.
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Affiliation(s)
| | - Gülhan Denizer
- b Regulatory Affairs Department , MSD , Brussels , Belgium
| | | | | | - Marla Shapiro
- d Department of Family and Community Medicine , University of Toronto , Toronto , Canada
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14
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Abstract
Recognition that the live yellow fever vaccine may rarely be associated with viscerotropic disease (YEL-AVD) has diminished its safety status. However, the vaccine remains the principal tool for limiting the occurrence of yellow fever, making large portions of Africa and South America more habitable. The subject has previously been exhaustively reviewed. Novel concepts in the current report include the description of a systematic method for deciding whom to vaccinate, recommendations for obtaining data helpful in making that decision, and suggestions for additional study. The vaccine is indeed a worthy friend, but its adverse reactions need to be recognized.
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Affiliation(s)
- Stephen J Seligman
- a Department of Microbiology and Immunology , New York Medical College , Valhalla , NY , USA.,b St. Giles Laboratory of Human Genetics of Infectious Diseases , The Rockefeller University , New York , NY , USA
| | - Jean-Laurent Casanova
- b St. Giles Laboratory of Human Genetics of Infectious Diseases , The Rockefeller University , New York , NY , USA.,c Howard Hughes Medical Institute , The Rockefeller University , New York , NY , USA
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15
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Otshudiema JO, Ndakala NG, Mawanda ETK, Tshapenda GP, Kimfuta JM, Nsibu LRN, Gueye AS, Dee J, Philen RM, Giese C, Murrill CS, Arthur RR, Kebela BI. Yellow Fever Outbreak - Kongo Central Province, Democratic Republic of the Congo, August 2016. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2017; 66:335-338. [PMID: 28358796 PMCID: PMC5657954 DOI: 10.15585/mmwr.mm6612a5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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16
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The Antigenic Structure of Zika Virus and Its Relation to Other Flaviviruses: Implications for Infection and Immunoprophylaxis. Microbiol Mol Biol Rev 2017; 81:81/1/e00055-16. [PMID: 28179396 DOI: 10.1128/mmbr.00055-16] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Zika virus was discovered ∼70 years ago in Uganda and maintained a low profile as a human disease agent in Africa and Asia. Only recently has it caused explosive outbreaks in previously unaffected regions, first in Oceania and then in the Americas since 2015. Of special concern is the newly identified link between congenital malformations (especially microcephaly) and Zika virus infections during pregnancy. At present, it is unclear whether Zika virus changed its pathogenicity or whether the huge number of infections allowed the recognition of a previously cryptic pathogenic property. The purpose of this review is to discuss recent data on the molecular antigenic structure of Zika virus in the context of antibody-mediated neutralization and antibody-dependent enhancement (ADE) of infection, a phenomenon that has been implicated in the development of severe disease caused by the related dengue viruses. Emphasis is given to epitopes of antibodies that potently neutralize Zika virus and also to epitopes that provide antigenic links to other important human-pathogenic flaviviruses such as dengue, yellow fever, West Nile, Japanese encephalitis, and tick-borne encephalitis viruses. The antigenic cross talk between Zika and dengue viruses appears to be of special importance, since they cocirculate in many regions of endemicity and sequential infections are likely to occur frequently. New insights into the molecular antigenic structure of Zika virus and flaviviruses in general have provided the foundation for great progress made in developing Zika virus vaccines and antibodies for passive immunization.
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17
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Amanna IJ, Slifka MK. Questions regarding the safety and duration of immunity following live yellow fever vaccination. Expert Rev Vaccines 2016; 15:1519-1533. [PMID: 27267203 PMCID: PMC5171234 DOI: 10.1080/14760584.2016.1198259] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 06/02/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The World Health Organization (WHO) and other health agencies have concluded that yellow fever booster vaccination is unnecessary since a single dose of vaccine confers lifelong immunity. Areas covered: We reviewed the clinical studies cited by health authorities in their investigation of both the safety profile and duration of immunity for the YFV-17D vaccine and examined the position that booster vaccination is no longer needed. We found that antiviral immunity may be lost in 1-in-3 to 1-in-5 individuals within 5 to 10 years after a single vaccination and that children may be at greater risk for primary vaccine failure. The safety profile of YFV-17D was compared to other licensed vaccines including oral polio vaccine (OPV) and the rotavirus vaccine, RotaShield, which have subsequently been withdrawn from the US and world market, respectively. Expert commentary: Based on these results and recent epidemiological data on vaccine failures (particularly evident at >10 years after vaccination), we believe that current recommendations to no longer administer YFV-17D booster vaccination be carefully re-evaluated, and that further development of safer vaccine approaches should be considered.
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Affiliation(s)
- Ian J. Amanna
- Najít Technologies, Inc., 505 NW 185 Avenue, Beaverton, OR 97006, USA
| | - Mark K. Slifka
- Division of Neuroscience, Oregon National Primate Research Center, Department of Molecular Microbiology and Immunology, Oregon Health & Science University, 505 NW 185 Avenue, Beaverton, OR 97006, USA
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18
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Lindsey NP, Rabe IB, Miller ER, Fischer M, Staples JE. Adverse event reports following yellow fever vaccination, 2007-13. J Travel Med 2016; 23:taw045. [PMID: 27378369 DOI: 10.1093/jtm/taw045] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 06/09/2016] [Indexed: 11/13/2022]
Abstract
BACKGROUND Yellow fever (YF) vaccines have been available since the 1930s and are generally considered safe and effective. However, rare reports of serious adverse events (SAE) following vaccination have prompted the Advisory Committee for Immunization Practices to periodically expand the list of conditions considered contraindications and precautions to vaccination. METHODS We describe adverse events following YF vaccination reported to the U.S. Vaccine Adverse Event Reporting System (VAERS) from 2007 through 2013 and calculate age- and sex-specific reporting rates of all SAE, anaphylaxis, YF vaccine-associated neurologic disease (YEL-AND) and YF vaccine-associated viscerotropic disease (YEL-AVD). RESULTS There were 938 adverse events following YF vaccination reported to VAERS from 2007 through 2013. Of these, 84 (9%) were classified as SAEs for a rate of 3.8 per 100 000 doses distributed. Reporting rates of SAEs increased with increasing age with a rate of 6.5 per 100 000 in persons aged 60-69 years and 10.3 for ≥70 years. The reporting rate for anaphylaxis was 1.3 per 100 000 doses distributed and was highest in persons ≤18 years (2.7 per 100 000). Reporting rates of YEL-AND and YEL-AVD were 0.8 and 0.3 per 100 000 doses distributed, respectively; both rates increased with increasing age. CONCLUSIONS These findings reinforce the generally acceptable safety profile of YF vaccine, but highlight the importance of continued physician and traveller education regarding the risks and benefits of YF vaccination, particularly for older travellers.
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Affiliation(s)
- Nicole P Lindsey
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, 3156 Rampart Road, Fort Collins, CO 80521, USA
| | - Ingrid B Rabe
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, 3156 Rampart Road, Fort Collins, CO 80521, USA
| | - Elaine R Miller
- Immunization Safety Office, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333, USA
| | - Marc Fischer
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, 3156 Rampart Road, Fort Collins, CO 80521, USA
| | - J Erin Staples
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, 3156 Rampart Road, Fort Collins, CO 80521, USA
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19
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Abstract
Yellow fever 17D vaccine is one of the oldest live-attenuated vaccines in current use that is recognized historically for its immunogenic and safe properties. These unique properties of 17D are presently exploited in rationally designed recombinant vaccines targeting not only flaviviral antigens but also other pathogens of public health concern. Several candidate vaccines based on 17D have advanced to human trials, and a chimeric recombinant Japanese encephalitis vaccine utilizing the 17D backbone has been licensed. The mechanism(s) of attenuation for 17D are poorly understood; however, recent insights from large in silico studies have indicated particular host genetic determinants contributing to the immune response to the vaccine, which presumably influences the considerable durability of protection, now in many cases considered to be lifelong. The very rare occurrence of severe adverse events for 17D is discussed, including a recent fatal case of vaccine-associated viscerotropic disease.
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Affiliation(s)
- Andrew S Beck
- a 1 Department of Pathology, University of Texas Medical Branch, Galveston TX 77555-0609, USA
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20
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Erickson AK, Pfeiffer JK. Spectrum of disease outcomes in mice infected with YFV-17D. J Gen Virol 2015; 96:1328-1339. [PMID: 25646269 PMCID: PMC4635484 DOI: 10.1099/vir.0.000075] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 01/27/2015] [Indexed: 11/18/2022] Open
Abstract
The host and viral factors that influence disease outcome during flavivirus infections are not fully understood. Using the live attenuated yellow fever virus (YFV) vaccine strain 17D as a model system we evaluated how viral dose, inoculation route and immunopathogenesis contributed to disease outcome in mice deficient in the type I IFN response. We found that YFV-17D infection of IFN-α/β receptor knockout mice resulted in three distinct disease outcomes: no clinical signs of disease, fatal viscerotropic disease or fatal neurotropic disease. Interestingly, viral load at disease onset did not correlate with disease outcome. However, we found increased immune infiltrates in the brain tissues of mice that developed neurotropic disease. Additionally, mice that developed viscerotropic disease, as characterized by liver and spleen pathology and/or intestinal haemorrhage, had significantly elevated levels of alanine aminotransferase, monocyte chemotactic protein and IFN-inducible protein (IP)-10 as compared with mice with no clinical signs of disease or neurotropic disease. Furthermore, mice treated with recombinant IP-10 throughout YFV-17D infection showed increased mortality and an increased percentage of mice with viscerotropic disease. Our results demonstrated that viral load did not correlate with pathogenesis, and the host immune response played a pivotal role in disease outcome and contributed to YFV-17D pathogenesis in mice.
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21
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Initial viral load determines the magnitude of the human CD8 T cell response to yellow fever vaccination. Proc Natl Acad Sci U S A 2015; 112:3050-5. [PMID: 25713354 DOI: 10.1073/pnas.1500475112] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
CD8 T cells are a potent tool for eliminating intracellular pathogens and tumor cells. Thus, eliciting robust CD8 T-cell immunity is the basis for many vaccines under development. However, the relationship between antigen load and the magnitude of the CD8 T-cell response is not well-described in a human immune response. Here we address this issue by quantifying viral load and the CD8 T-cell response in a cohort of 80 individuals immunized with the live attenuated yellow fever vaccine (YFV-17D) by sampling peripheral blood at days 0, 1, 2, 3, 5, 7, 9, 11, 14, 30, and 90. When the virus load was below a threshold (peak virus load < 225 genomes per mL, or integrated virus load < 400 genome days per mL), the magnitude of the CD8 T-cell response correlated strongly with the virus load (R(2) ∼ 0.63). As the virus load increased above this threshold, the magnitude of the CD8 T-cell responses saturated. Recent advances in CD8 T-cell-based vaccines have focused on replication-incompetent or single-cycle vectors. However, these approaches deliver relatively limited amounts of antigen after immunization. Our results highlight the requirement that T-cell-based vaccines should deliver sufficient antigen during the initial period of the immune response to elicit a large number of CD8 T cells that may be needed for protection.
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22
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Variation of the specificity of the human antibody responses after tick-borne encephalitis virus infection and vaccination. J Virol 2014; 88:13845-57. [PMID: 25253341 DOI: 10.1128/jvi.02086-14] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED Tick-borne encephalitis (TBE) virus is an important human-pathogenic flavivirus endemic in large parts of Europe and Central and Eastern Asia. Neutralizing antibodies specific for the viral envelope protein E are believed to mediate long-lasting protection after natural infection and vaccination. To study the specificity and individual variation of human antibody responses, we developed immunoassays with recombinant antigens representing viral surface protein domains and domain combinations. These allowed us to dissect and quantify antibody populations of different fine specificities in sera of TBE patients and vaccinees. Postinfection and postvaccination sera both displayed strong individual variation of antibody titers as well as the relative proportions of antibodies to different domains of E, indicating that the immunodominance patterns observed were strongly influenced by individual-specific factors. The contributions of these antibody populations to virus neutralization were quantified by serum depletion analyses and revealed a significantly biased pattern. Antibodies to domain III, in contrast to what was found in mouse immunization studies with TBE and other flaviviruses, did not play any role in the human neutralizing antibody response, which was dominated by antibodies to domains I and II. Importantly, most of the neutralizing activity could be depleted from sera by a dimeric soluble form of the E protein, which is the building block of the icosahedral herringbone-like shell of flaviviruses, suggesting that antibodies to more complex quaternary epitopes involving residues from adjacent dimers play only a minor role in the total response to natural infection and vaccination in humans. IMPORTANCE Tick-borne encephalitis (TBE) virus is a close relative of yellow fever, dengue, Japanese encephalitis, and West Nile viruses and distributed in large parts of Europe and Central and Eastern Asia. Antibodies to the viral envelope protein E prevent viral attachment and entry into cells and thus mediate virus neutralization and protection from disease. However, the fine specificity and individual variation of neutralizing antibody responses are currently not known. We have therefore developed new in vitro assays for dissecting the antibody populations present in blood serum and determining their contribution to virus neutralization. In our analysis of human postinfection and postvaccination sera, we found an extensive variation of the antibody populations present in sera, indicating substantial influences of individual-specific factors that control the specificity of the antibody response. Our study provides new insights into the immune response to an important human pathogen that is of relevance for the design of novel vaccines.
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23
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Staples JE, Diallo M, Janusz KB, Manengu C, Lewis RF, Perea W, Yactayo S, Sall AA. Yellow fever risk assessment in the Central African Republic. Trans R Soc Trop Med Hyg 2014; 108:608-15. [PMID: 24947520 DOI: 10.1093/trstmh/tru086] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Starting in 2008, the Central African Republic (CAR) experienced an unprecedented number of reported yellow fever (YF) cases. A risk assessment of YF virus (YFV) activity was conducted to estimate potential disease risk and vaccine needs. METHODS A multistage cluster sampling design was used to sample humans, non-human primates, and mosquitoes in distinct ecologic zones. Humans and non-human primates were tested for YFV-specific antibodies; mosquitoes were tested for YFV RNA. RESULTS Overall, 13.3% (125/938) of humans were found to have naturally-acquired YFV antibodies. Antibody levels were higher in zones in the southern and south central regions of CAR. All sampled non-human primates (n=56) were known YFV reservoirs; one tested positive for YFV antibodies. Several known YF vectors were identified including Aedes africanus, Ae. aegypti, Ae. luteocephalus, and Ae. simpsoni. Several more urban locations were found to have elevated Breateau and Container indices for Ae. aegypti. CONCLUSIONS A country-wide assessment of YF risk found YFV to be endemic in CAR. The potential for future YF cases and outbreaks, however, varied by ecologic zone. Improved vaccination coverage through mass campaign and childhood immunization was recommended to mitigate the YF risk.
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Affiliation(s)
- J Erin Staples
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO, 80521, USA
| | | | - Kristen B Janusz
- Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, CO, 80521, USA
| | - Casimir Manengu
- World Health Organization, 1416 Bangui, Central African Republic
| | | | - William Perea
- World Health Organization, 1211 Geneva 27, Switzerland
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Patel D, Simons H. Yellow fever vaccination: is one dose always enough? Travel Med Infect Dis 2013; 11:266-73. [PMID: 24074827 DOI: 10.1016/j.tmaid.2013.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Revised: 08/29/2013] [Accepted: 08/29/2013] [Indexed: 11/19/2022]
Abstract
In March 2013, the World Health Organization (WHO) Strategic Advisory Group of Experts on Immunisation (SAGE) considered a number of issues in order to update the WHO Position Paper on Yellow Fever (2003). A key conclusion of this review was that a single dose of yellow fever (YF) vaccine appears to confer life-long protection against YF disease, and that a booster dose of YF vaccine is not needed to maintain immunity. While the efficacy of YF vaccine in the majority of vaccine recipients is not in doubt, the WHO announcement is somewhat surprising as there are some limitations in the evidence base, but more importantly, this announcement is not accompanied by any imminent change in the International Health Regulations 2005. The tension between what is considered best clinical practice and the law will be difficult to reconcile for many health professionals, travellers, and the travel industry, in an area of travel medicine that is already subject to debate and confusion. This commentary reviews the recent WHO announcement, and considers the practical implications for health professionals providing YF vaccine to international travellers.
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Affiliation(s)
- Dipti Patel
- National Travel Health Network and Centre, London, UK; Foreign and Commonwealth Office, London, UK; Centre for Occupational and Environmental Health, School of Medicine, The University of Manchester, Manchester, UK.
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25
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Mather S, Scott S, Temperton N, Wright E, King B, Daly J. Current progress with serological assays for exotic emerging/re-emerging viruses. Future Virol 2013. [DOI: 10.2217/fvl.13.60] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Recent decades have witnessed an unprecedented rise in the outbreak occurrence of infectious and primarily zoonotic viruses. Contributing factors to this phenomenon include heightened global connectivity via air travel and international trade links, as well as man-made environmental alterations, such as deforestation and climate change, which all serve to bring humans into closer contact with animal reservoirs and alter the habitat of vectors, thus facilitating the transmission of viruses between species. Serological assays are integral to tracking the epidemiological spread of a virus and evaluating mass vaccination programs by quantifying neutralizing antibody responses raised against antigenic epitopes on the viral surface. However, conventional serological tests are somewhat marred by equipment and reagent costs, the necessity for high-containment laboratories for studying many emerging viruses, and interlaboratory variability, among other issues. This review details ‘next-generation’ assays aimed at addressing some of the persistent problems with viral serology, focusing on how manipulating the genomes of RNA viruses can produce attenuated or chimeric viruses that can be exploited as surrogate viruses in neutralization assays. Despite the undoubted promise of such novel serological platforms, it must be remembered that these assays have to withstand rigorous validation and standardization measures before they can play an integral role in curtailing the severity of future emerging virus outbreaks.
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Affiliation(s)
- Stuart Mather
- Viral Pseudotype Unit (Medway), School of Pharmacy, University of Kent, Chatham, Kent, ME4 4TB, UK
| | - Simon Scott
- Viral Pseudotype Unit (Medway), School of Pharmacy, University of Kent, Chatham, Kent, ME4 4TB, UK
| | - Nigel Temperton
- Viral Pseudotype Unit (Medway), School of Pharmacy, University of Kent, Chatham, Kent, ME4 4TB, UK
| | - Edward Wright
- Viral Pseudotype Unit (Fitzrovia), School of Life Sciences, University of Westminster, London, W1W 6UW, UK
| | - Barnabas King
- School of Veterinary Medicine & Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, UK
| | - Janet Daly
- School of Veterinary Medicine & Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, UK
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26
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Pediatric Travel Medicine: Challenges for the Primary Care and Travel Medicine Specialist. Curr Infect Dis Rep 2013; 15:216-21. [DOI: 10.1007/s11908-013-0330-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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27
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Sohn YM, Park MS, Rho HO, Chandler LJ, Shope RE, Tsai TF. Primary and booster immune responses to SA14-14-2 Japanese encephalitis vaccine in Korean infants. Vaccine 1999; 17:2259-64. [PMID: 10403593 DOI: 10.1016/s0264-410x(99)00006-7] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Attenuated SA14-14-2 Japanese encephalitis (JE) vaccine has been administered safely and effectively to more than 100 million children in China since 1988 and recently, licensure of the vaccine in Korea has been sought. In the first clinical evaluation of the vaccine outside of China, we monitored side effects in 84 children and evaluated antibody responses to a single dose given as primary JE vaccination in 68 children, 1-3 years old (mean age 27 months). No significant adverse events were noted. Neutralizing antibodies (geometric mean titer [GMT] of 188) were produced in 96% of the 68 subjects. In 10 other children who previously had been immunized with two or three doses of inactivated JE vaccine, the booster administration of SA14-14-2 vaccine produced an anamnestic response in all, with a GMT of 3378. In a comparison group of 25 children previously immunized with two doses of inactivated vaccine, neutralizing antibody titers were detected in 16 (64%). Viral specific IgM was detected in nine primary vaccinees (13%) but in others, IgM may have declined to undetectable levels in the four week postimmunization sample. Live attenuated SA14-14-2 JE vaccine is a promising alternative to the only commercially available JE vaccine for national childhood immunization programs in Asia.
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MESH Headings
- Antibodies, Viral/biosynthesis
- Child, Preschool
- Encephalitis Viruses, Japanese/immunology
- Encephalitis, Arbovirus/immunology
- Encephalitis, Arbovirus/prevention & control
- Humans
- Immunization, Secondary/adverse effects
- Immunoglobulin M/blood
- Infant
- Vaccines, Attenuated/adverse effects
- Vaccines, Attenuated/immunology
- Vaccines, Inactivated/adverse effects
- Vaccines, Inactivated/immunology
- Viral Vaccines/adverse effects
- Viral Vaccines/immunology
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Affiliation(s)
- Y M Sohn
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
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Abstract
BACKGROUND There are very few reports of anaphylactic reactions to yellow fever (YF) vaccine in the literature, and these date from the 1940s. OBJECTIVE We sought to estimate the rate of YF vaccine-related anaphylaxis. METHODS All reports of adverse reactions to YF vaccine submitted to the Vaccine Adverse Event Reporting System between 1990 and 1997 were reviewed for those meeting criteria for probable or possible anaphylactic reactions. RESULTS Of 243 reports submitted, 40 describe probable or possible anaphylactic reactions. In 22 of these 40, YF vaccine was the only vaccine administered. There were 5,236,820 doses of YF vaccine distributed in the United States during this period. By using all 40 cases, the rate of YF vaccine-related anaphylaxis would be 40 in 5, 236,820 or about 1 in 131,000. In 35 of the reports, information was provided on whether previous doses of YF vaccine had been given. In 34 of these 35, the reaction occurred after the first dose of YF vaccine, suggesting that vaccine constituents other than the viral proteins may have been the allergens. The vaccine is grown in chicken embryos and contains gelatin as a stabilizer. CONCLUSION YF vaccine can cause anaphylactic reactions. Persons presenting for YF vaccine should be asked if they have had adverse reactions to previous doses of this or other vaccines and if they are allergic to eggs, chicken, or gelatin. Health care workers administering YF vaccine should be prepared to recognize and treat anaphylactic reactions should they occur.
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Affiliation(s)
- J M Kelso
- Department of Internal Medicine (Allergy Division), Naval Medical Center, San Diego, Calif. 92134-5000, USA
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