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Salinas-Estrella E, Amaro-Estrada I, Cobaxin-Cárdenas ME, Preciado de la Torre JF, Rodríguez SD. Bovine Anaplasmosis: Will there ever be an almighty effective vaccine? Front Vet Sci 2022; 9:946545. [PMID: 36277070 PMCID: PMC9581321 DOI: 10.3389/fvets.2022.946545] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/11/2022] [Indexed: 11/04/2022] Open
Abstract
Bovine anaplasmosis is a tick-borne bacterial disease with a worldwide distribution and the cause of severe economic losses in the livestock industry in many countries, including México. In the present work, we first review the elements of the immune response of the bovine, which allows ameliorating the clinical signs while eliminating the majority of the blood forms and generating an immunologic memory such that future confrontations with the pathogen will not end in disease. On the other hand, many vaccine candidates have been evaluated for the control of bovine anaplasmosis yet without no commercial worldwide effective vaccine. Lastly, the diversity of the pathogen and how this diversity has impaired the many efforts to control the disease are reviewed.
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Yousefi Avarvand A, Meshkat Z, Khademi F, Tafaghodi M. Immunogenicity of HspX/EsxS fusion protein of Mycobacterium tuberculosis along with ISCOMATRIX and PLUSCOM nano-adjuvants after subcutaneous administration in animal model. Microb Pathog 2021; 154:104842. [PMID: 33762199 DOI: 10.1016/j.micpath.2021.104842] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 11/05/2020] [Accepted: 02/25/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Tuberculosis (TB), caused by Mycobacterium tuberculosis (M. tuberculosis), is one of the most common and dangerous infectious diseases in the world. Despite vaccination with BCG, it is still considered as a major health problem. Therefore, design and production of an effective novel vaccine against TB is necessary. Our aim was to evaluate immunogenicity of HspX/EsxS fusion protein of M. tuberculosis along with ISCOMATRIX, PLUSCOM nano-adjuvants and MPLA through the subcutaneous route in mice model. METHODS HspX/EsxS fused protein of M. tuberculosis was cloned, expressed and purified in the prokaryotic system. ISCOMATRIX and PLUSCOM nano-adjuvants were prepared by film hydration method. Subcutaneous immunization of BALB/c mice was performed by different formulations. IFN-γ, IL-4, IL-17 and TGF-β cytokines levels as well as serum IgG1, IgG2a. RESULTS Our results showed that subcutaneous administration of mice with HspX/EsxS along with three adjuvants, ISCOMATRIX, PLUSCOM and MPLA increased immunogenicity of multi-stage fusion protein of M. tuberculosis. Additionally, HspX/EsxS protein + ISCOMATRIX or + PLUSCOM nano-adjuvants induced stronger Th1, IgG2a and IgG1 immune responses compared to MPLA adjuvant. Totally, HspX/EsxS/ISCOMATRIX/MPLA, HspX/EsxS/PLUSCOM/MPLA and two BCG booster groups could significantly induce higher Th1 and IgG2a immune responses. CONCLUSION With regard to ability of ISCOMATRIX, PLUSCOM and MPLA adjuvants to increase immunogenicity of HspX/EsxS protein through induction of IFN-γ and IgG2a immune responses, it seems that these adjuvants and especially ISCOMATRIX and PLUSCOM, could also improve BCG efficacy as a BCG booster.
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Affiliation(s)
- Arshid Yousefi Avarvand
- Department of Laboratory Sciences, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Zahra Meshkat
- Antimicrobial Resistance Research Center, Department of Medical Bacteriology and Virology, Qaem University Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Farzad Khademi
- Department of Microbiology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Mohsen Tafaghodi
- Nanotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Cunha IALD, Zulpo DL, Taroda A, Barros LDD, Almeida JCD, Candim ST, Navarro IT, Garcia JL. Protection against Toxoplasma gondii cysts in pigs immunized with rROP2 plus Iscomatrix. ACTA ACUST UNITED AC 2020; 29:e012620. [PMID: 33053057 DOI: 10.1590/s1984-29612020077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/21/2020] [Indexed: 11/22/2022]
Abstract
This study aimed to evaluate the humoral immune response in pigs immunized intranasally and intramuscularly with recombinant Toxoplasma gondii rROP2 protein in combination with the adjuvant Iscomatrix. Twelve mixed breed pigs divided into three groups (n=4) were used, G1 received recombinant ROP2 proteins (200 µg/dose) plus Iscomatrix, G2 received PBS plus Iscomatrix, and G3 as the control group. The intranasal (IN) and intramuscular (IM) routes were used. Animals were challenged orally with VEG strain oocysts and treated on day three after challenge. Fever, anorexia, and prostration were the clinical signs observed in all animals. All the G1 animals produced antibodies above the cut-off on the day of the challenge, while the G2 and G3 remained below the cut-off. Better partial protection against parasitemia and cyst tissue formation was observed in G1 than G3. The protection factors against tissue cyst formation were 40.0% and 6.1% for G1 and G2, respectively, compared to G3. In conclusion, there were not systemic antibody responses in pigs with IN immunization with rROP2+Iscomatrix; however, after IM immunization, those animals produced higher titers than animal controls. We associated these results with partial protection obtained against parasitemia and tissue cysts formation.
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Affiliation(s)
- Ivo Alexandre Leme da Cunha
- Laboratório de Parasitologia Aplicada, Centro de Ciências Agrárias e Ambientais, Universidade Federal do Maranhão - UFMA, Chapadinha, MA, Brasil
| | - Dauton Luiz Zulpo
- Faculdade de Medicina Veterinária, Pontifícia Universidade Católica do Paraná - PUCPR, Toledo, PR, Brasil
| | - Alexandra Taroda
- Laboratório de Protozoologia Animal, Departamento de Medicina Veterinária Preventiva, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | - Luiz Daniel de Barros
- Laboratório de Protozoologia Animal, Departamento de Medicina Veterinária Preventiva, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | - Jonatas Campos de Almeida
- Laboratório de Protozoologia Animal, Departamento de Medicina Veterinária Preventiva, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | - Sérgio Tosi Candim
- Laboratório de Protozoologia Animal, Departamento de Medicina Veterinária Preventiva, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | - Italmar Teodorico Navarro
- Laboratório de Protozoologia Animal, Departamento de Medicina Veterinária Preventiva, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
| | - João Luis Garcia
- Laboratório de Protozoologia Animal, Departamento de Medicina Veterinária Preventiva, Universidade Estadual de Londrina - UEL, Londrina, PR, Brasil
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Pimentel LS, Turini CA, Santos PS, Morais MAD, Souza AG, Barbosa MB, Martins EMDN, Coutinho LB, Furtado CA, Ladeira LO, Martins JR, Goulart LR, Faria PCBD. Balanced Th1/Th2 immune response induced by MSP1a functional motif coupled to multiwalled carbon nanotubes as anti-anaplasmosis vaccine in murine model. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2019; 24:102137. [PMID: 31857182 DOI: 10.1016/j.nano.2019.102137] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/02/2019] [Accepted: 11/22/2019] [Indexed: 12/21/2022]
Abstract
Anaplasmosis is one of the most prevalent tick-borne diseases of cattle caused by Anaplasma marginale. MSP1a surface protein has been shown to be involved in eliciting immunity to infected cattle. Carbon nanotubes (CNTs) has been increasingly highlighted due to their needle like structure, which contain multiple attachment sites for biomolecules and may interact with or cross biological membranes, increasing antigen availability to immune system. Here, we have successfully designed a nanocomplex of a synthetic peptide noncovalently attached to multiwalled CNT (MWCNT). Peptide comprising the core motif of the MSP1a was efficiently adsorb onto the nanoparticle surface. The MWCNT-Am1 nanocomplex exhibited high stability and good dispersibility and in vivo immunization showed high levels of IgG1 and IgG2a, followed by increased expression of pro-inflammatory and anti-inflammatory cytokines. This is a proof-of-concept of a nanovaccine that was able to generate a strong immune response compared to the common antigen-adjuvant vaccine without the nanoparticles.
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Affiliation(s)
- Leticia Santos Pimentel
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, MG, Brazil.
| | - Carolina Alvarenga Turini
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Paula Souza Santos
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Mariana Abilio de Morais
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Aline Gomes Souza
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Mariana Botelho Barbosa
- Laboratory of Chemistry of Carbon Nanostructures, Nuclear Technology Development Center, CDTN, Belo Horizonte, MG, Brazil
| | | | | | - Clascídia Aparecida Furtado
- Laboratory of Chemistry of Carbon Nanostructures, Nuclear Technology Development Center, CDTN, Belo Horizonte, MG, Brazil
| | - Luiz Orlando Ladeira
- Laboratory of Nanomaterials, Department of Physics, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - João Ricardo Martins
- Laboratory of Parasitology, Institute of Veterinary Research Desidério Finamor, Eldorado do Sul, RS, Brazil
| | - Luiz Ricardo Goulart
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, MG, Brazil
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Cangussu ASR, Mariúba LAM, Lalwani P, Pereira KDES, Astolphi-Filho S, Orlandi PP, Epiphanio S, Viana KF, Ribeiro MFB, Silva HM, Marinho CRF, Nogueira PA. A hybrid protein containing MSP1a repeats and Omp7, Omp8 and Omp9 epitopes protect immunized BALB/c mice against anaplasmosis. Vet Res 2018; 49:6. [PMID: 29351812 PMCID: PMC5775529 DOI: 10.1186/s13567-018-0503-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 12/20/2017] [Indexed: 12/23/2022] Open
Abstract
Anaplasma marginale (A. marginale) has a remarkable impact on livestock production, and an effective vaccine is not currently available due to the inexistence of a small animal model. Recently, BALB/c mice were successfully infected with A. marginale, resulting in an acute and persistent anaplasmosis infection. Here, we designed a hybrid protein containing repeats of polypeptide 1a from major surface protein-1 complex (MSP1a) repeats and common epitopes of outer membrane proteins (OMPs) OMP7, OMP8 and OMP9 expressed in Escherichia coli. Our proof-of-concept assessed vaccinal effectiveness against a challenge with live bacteria. The MSP1a/OMP7/8/9 immunized BALB/C mice exhibited a strong reduction in rickettsemia and had no signs of anaplasmosis or hepatic lesions. In contrast, the non-immunized mice exhibited signs of anaplasmosis and a body weight loss associated with increases in monocyte and neutrophil counts. Furthermore, the non-immunized mice displayed atrophies with chronic inflammatory infiltrates in the spleen and increased binucleation and hydropic degeneration in the hepatocytes. Our findings demonstrated that immunization with our hybrid protein induced a strong reduction in rickettsemia and conferred protection against anaplasmosis. Therefore, given the strong evidence of the protective effect against anaplasmosis, hybrid protein designs are potential candidates for the rational design of vaccinal subunits.
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Affiliation(s)
- Alex Sander R Cangussu
- Universidade Federal do Amazonas-Programa de pós-graduação em Rede de Biodiversidade e Biotecnologia da Amazônia Legal, Manaus, AM/Brasil, Brazil. .,Universidade Federal do Tocantins-Engenharia de Bioprocessos e Biotecnologia, Gurupi, TO/Brazil, Brazil.
| | - Luis André M Mariúba
- Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas/Brazil, Brazil
| | - Pritesh Lalwani
- Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas/Brazil, Brazil
| | | | - Spartaco Astolphi-Filho
- Universidade Federal do Amazonas-Programa de pós-graduação em Rede de Biodiversidade e Biotecnologia da Amazônia Legal, Manaus, AM/Brasil, Brazil
| | - Patricia P Orlandi
- Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas/Brazil, Brazil
| | - Sabrina Epiphanio
- Departamento de Análises Clínicas e Toxicológicas da Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, São Paulo/Brazil, Brazil
| | - Kelvison F Viana
- Universidade Federal do Tocantins-Engenharia de Bioprocessos e Biotecnologia, Gurupi, TO/Brazil, Brazil
| | - Mucio Flavio B Ribeiro
- Departamento de Parasitologia do Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais/Brazil, Brazil
| | - Hidelberto M Silva
- Faculdade de Medicina, Centro Universitário Unirg, Gurupi, Tocantins/Brazil, Brazil
| | - Claudio R F Marinho
- Departamento de Parasitologia do Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo A Nogueira
- Instituto Leônidas e Maria Deane-Fiocruz Amazônia, Manaus, Amazonas/Brazil, Brazil
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Palacios C, Torioni de Echaide S, Mattion N. Evaluation of the immune response to Anaplasma marginale MSP5 protein using a HSV-1 amplicon vector system or recombinant protein. Res Vet Sci 2014; 97:514-20. [PMID: 25458492 DOI: 10.1016/j.rvsc.2014.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 09/29/2014] [Accepted: 10/10/2014] [Indexed: 11/26/2022]
Abstract
Anaplasma marginale is an intraerythrocytic vector-borne infectious agent of cattle. Immunization with the current vaccine, based on parasitized erythrocytes with live Anaplasma centrale, shows some constraints and confers partial protection, suggesting the feasibility for the development of new generation of vaccines. The aim of the present study was to assess the effect of sequential immunization of BALB/c mice, with herpesvirus amplicon vector-based vaccines combined with protein-based vaccines, on the quality of the immune response against the major surface protein 5 of A. marginale. The highest antibody titers against MSP5 were elicited in mice that received two doses of adjuvanted recombinant protein (p < 0.0001). Mice treated with a heterologous prime-boost strategy generated sustained antibody titers at least up to 200 days, and a higher specific cellular response. The results presented here showed that sequential immunization with HSV-based vectors and purified antigen enhances the quality of the immune response against A. marginale.
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Affiliation(s)
- Carlos Palacios
- Centro de Virología Animal, Instituto de Ciencia y Tecnología Dr. Cesar Milstein, CONICET, Saladillo 2468, C1440FFX, Ciudad de Buenos Aires, Argentina
| | - Susana Torioni de Echaide
- Instituto Nacional de Tecnología Agropecuaria, Estación Experimental Agropecuaria Rafaela, Ruta 34 Km 227, CP 2300, Rafaela, Santa Fe, Argentina
| | - Nora Mattion
- Centro de Virología Animal, Instituto de Ciencia y Tecnología Dr. Cesar Milstein, CONICET, Saladillo 2468, C1440FFX, Ciudad de Buenos Aires, Argentina.
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Gasparini MR, Vieira RFDC, Nascimento DAGD, Garcia JL, Vidotto O, Vidotto MC. Immune response of calves inoculated with proteins of Anaplasma marginale bound to an immunostimulant complex. ACTA ACUST UNITED AC 2014; 22:253-9. [PMID: 23856733 DOI: 10.1590/s1984-29612013000200044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 05/16/2013] [Indexed: 11/22/2022]
Abstract
Despite our current knowledge of the immunology, pathology, and genetics of Anaplasma marginale, prevention in cattle is currently based on old standbys, including live attenuated vaccines, antibiotic treatment, and maintaining enzootic stability in cattle herds. In the present study, we evaluated the use of an immunostimulant complex (ISCOMATRIX) adjuvant, associated with a pool of recombinant major surface proteins (rMSP1a, rMSP1b, rMSP4 and rMSP5) to improve the humoral immune response triggered in calves mainly by IgG2. Ten calves were divided in three groups: 4 calves were inoculated with the ISCOMATRIX/rMSPs (G1); 2 calves were inoculated with ISCOMATRIX adjuvant (G2); and 4 calves received saline (G3). Three inoculations were administered at 21-day intervals. In G1, the calves showed significant increases in total IgG, IgG1 and IgG2 levels 21 days after the second inoculation, compared to the control group (p < 0.05), and G1 calves remained above the cut-off value 28 days after the third inoculation (p < 0.05). The post-immunized sera from calves in G1 reacted specifically for each of the rMSPs used. In conclusion, the ISCOMATRIX/rMSPs induced antigen-specific seroconversion in calves. Therefore, additional testing to explore the protection induced by rMSPs, both alone and in conjunction with proteins previously identified as subdominant epitopes, is warranted.
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Silvestre BT, Rabelo ÉM, Versiani AF, da Fonseca FG, Silveira JA, Bueno LL, Fujiwara RT, Ribeiro MF. Evaluation of humoral and cellular immune response of BALB/c mice immunized with a recombinant fragment of MSP1a from Anaplasma marginale using carbon nanotubes as a carrier molecule. Vaccine 2014; 32:2160-6. [DOI: 10.1016/j.vaccine.2014.02.062] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 02/12/2014] [Accepted: 02/14/2014] [Indexed: 10/25/2022]
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Epitope-based vaccines with the Anaplasma marginale MSP1a functional motif induce a balanced humoral and cellular immune response in mice. PLoS One 2013; 8:e60311. [PMID: 23579784 PMCID: PMC3620323 DOI: 10.1371/journal.pone.0060311] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 02/25/2013] [Indexed: 11/19/2022] Open
Abstract
Bovine anaplasmosis is a hemoparasitic disease that causes considerable economic loss to the dairy and beef industries. Cattle immunized with the Anaplasma marginale MSP1 outer membrane protein complex presents a protective humoral immune response; however, its efficacy is variable. Immunodominant epitopes seem to be a key-limiting factor for the adaptive immunity. We have successfully demonstrated that critical motifs of the MSP1a functional epitope are essential for antibody recognition of infected animal sera, but its protective immunity is yet to be tested. We have evaluated two synthetic vaccine formulations against A. marginale, using epitope-based approach in mice. Mice infection with bovine anaplasmosis was demonstrated by qPCR analysis of erythrocytes after 15-day exposure. A proof-of-concept was obtained in this murine model, in which peptides conjugated to bovine serum albumin were used for immunization in three 15-day intervals by intraperitoneal injections before challenging with live bacteria. Blood samples were analyzed for the presence of specific IgG2a and IgG1 antibodies, as well as for the rickettsemia analysis. A panel containing the cytokines’ transcriptional profile for innate and adaptive immune responses was carried out through qPCR. Immunized BALB/c mice challenged with A. marginale presented stable body weight, reduced number of infected erythrocytes, and no mortality; and among control groups mortality rates ranged from 15% to 29%. Additionally, vaccines have significantly induced higher IgG2a than IgG1 response, followed by increased expression of pro-inflammatory cytokines. This is a successful demonstration of epitope-based vaccines, and protection against anaplasmosis may be associated with elicitation of effector functions of humoral and cellular immune responses in murine model.
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Sun HX, Xie Y, Ye YP. ISCOMs and ISCOMATRIX. Vaccine 2009; 27:4388-401. [PMID: 19450632 DOI: 10.1016/j.vaccine.2009.05.032] [Citation(s) in RCA: 170] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Revised: 02/22/2009] [Accepted: 05/09/2009] [Indexed: 10/25/2022]
Abstract
Immunostimulatory complexes (ISCOMs) are particulate antigen delivery systems composed of antigen, cholesterol, phospholipid and saponin, while ISCOMATRIX is a particulate adjuvant comprising cholesterol, phospholipid and saponin but without antigen. The combination of an antigen with ISCOMATRIX is called an ISCOMATRIX vaccine. ISCOMs and ISCOMATRIX combine the advantages of a particulate carrier system with the presence of an in-built adjuvant (Quil A) and consequently have been found to be more immunogenic, while removing its haemolytic activity of the saponin, producing less toxicity. ISCOMs and ISCOMATRIX vaccines have now been shown to induce strong antigen-specific cellular or humoral immune responses to a broad range of antigens of viral, bacterial, parasite origin or tumor in a number of animal species including non-human primates and humans. These vaccines produced by well controlled and reproducible processes have also been evaluated in human clinical trials. In this review, we summarize the recent progress of ISCOMs and ISCOMATRIX, including preparation technology as well as their application in humans and veterinary vaccine designs with particular emphasis on the current understanding of the properties and features of ISCOMs and ISCOMATRIX vaccines to induce immune responses. The mechanisms of adjuvanticity are also discussed in the light of recent findings.
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Affiliation(s)
- Hong-Xiang Sun
- Key Laboratory of Animal Epidemic Etiology & Immunological Prevention of Ministry of Agriculture, College of Animal Sciences, Zhejiang University, Kaixuan Road 268, Hangzhou 310029, Zhejiang, China.
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Induced immune response of DNA vaccine encoding an association MSP1a, MSP1b, and MSP5 antigens of Anaplasma marginale. Vaccine 2008; 26:3522-7. [DOI: 10.1016/j.vaccine.2008.04.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2007] [Revised: 04/01/2008] [Accepted: 04/09/2008] [Indexed: 11/21/2022]
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