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Masjedi M, Montahaei T, Sharafi Z, Jalali A. Pulmonary vaccine delivery: An emerging strategy for vaccination and immunotherapy. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Heida R, Hinrichs WL, Frijlink HW. Inhaled vaccine delivery in the combat against respiratory viruses: a 2021 overview of recent developments and implications for COVID-19. Expert Rev Vaccines 2021; 21:957-974. [PMID: 33749491 DOI: 10.1080/14760584.2021.1903878] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION As underlined by the late 2019 outbreak of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), vaccination remains the cornerstone of global health-care. Although vaccines for SARS-CoV-2 are being developed at a record-breaking pace, the majority of those that are licensed or currently registered in clinical trials are formulated as an injectable product, requiring a tightly regulated cold-chain infrastructure, and primarily inducing systemic immune responses. AREAS COVERED Here, we shed light on the status of inhaled vaccines against viral pathogens, providing background to the role of the mucosal immune system and elucidating what factors determine an inhalable vaccine's efficacy. We also discuss whether the development of an inhalable powder vaccine formulation against SARS-CoV-2 could be feasible. The review was conducted using relevant studies from PubMed, Web of Science and Google Scholar. EXPERT OPINION We believe that the scope of vaccine research should be broadened toward inhalable dry powder formulations since dry vaccines bear several advantages. Firstly, their dry state can tremendously increase vaccine stability and shelf-life. Secondly, they can be inhaled using disposable inhalers, omitting the need for trained health-care personnel and, therefore, facilitating mass-vaccination campaigns. Thirdly, inhalable vaccines may provide improved protection since they can induce an IgA-mediated mucosal immune response.
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Affiliation(s)
- Rick Heida
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands
| | - Wouter Lj Hinrichs
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands
| | - Henderik W Frijlink
- Department of Pharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, The Netherlands
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Azegami T, Yuki Y, Nakahashi R, Itoh H, Kiyono H. Nanogel-based nasal vaccines for infectious and lifestyle-related diseases. Mol Immunol 2017; 98:19-24. [PMID: 29096936 DOI: 10.1016/j.molimm.2017.10.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/23/2017] [Accepted: 10/26/2017] [Indexed: 12/12/2022]
Abstract
Because the mucosa is the major entry route for most pathogens, the development of mucosal vaccines is a rational approach for protecting against these undesired agents. Mucosal administration of vaccine antigen is useful for non-infectious chronic diseases as well, because of its advantages over injection routes, including comparable efficacy in the induction of systemic immune responses, less pain, and no risk of adverse events at the injection site. However, because it is difficult to effectively induce and regulate antigen-specific mucosal and systemic immune responses when antigen alone is mucosally administered, an appropriate form of mucosal delivery vehicle must be used. Antigen delivery systems involving nanogels, which act as artificial chaperones and mucosal adhesives, are a promising approach to overcoming this problem. Here, we introduce current perspectives regarding the development of nanogel-based nasal vaccines for both infectious and lifestyle-related diseases.
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Affiliation(s)
- Tatsuhiko Azegami
- Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; Division of Mucosal Immunology, Department of Microbiology and Immunology, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan; International Research and Development Center for Mucosal Vaccines, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
| | - Yoshikazu Yuki
- Division of Mucosal Immunology, Department of Microbiology and Immunology, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan; International Research and Development Center for Mucosal Vaccines, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
| | - Rika Nakahashi
- Division of Mucosal Immunology, Department of Microbiology and Immunology, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan; International Research and Development Center for Mucosal Vaccines, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
| | - Hiroshi Itoh
- Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hiroshi Kiyono
- Division of Mucosal Immunology, Department of Microbiology and Immunology, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan; International Research and Development Center for Mucosal Vaccines, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan; Department of Immunology, Graduate School of Medicine, Chiba University, Chiba, Japan.
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de Swart RL, de Vries RD, Rennick LJ, van Amerongen G, McQuaid S, Verburgh RJ, Yüksel S, de Jong A, Lemon K, Nguyen DT, Ludlow M, Osterhaus ADME, Duprex WP. Needle-free delivery of measles virus vaccine to the lower respiratory tract of non-human primates elicits optimal immunity and protection. NPJ Vaccines 2017; 2:22. [PMID: 29263877 PMCID: PMC5627256 DOI: 10.1038/s41541-017-0022-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 05/26/2017] [Accepted: 06/08/2017] [Indexed: 11/09/2022] Open
Abstract
Needle-free measles virus vaccination by aerosol inhalation has many potential benefits. The current standard route of vaccination is subcutaneous injection, whereas measles virus is an airborne pathogen. However, the target cells that support replication of live-attenuated measles virus vaccines in the respiratory tract are largely unknown. The aims of this study were to assess the in vivo tropism of live-attenuated measles virus and determine whether respiratory measles virus vaccination should target the upper or lower respiratory tract. Four groups of twelve cynomolgus macaques were immunized with 104 TCID50 of recombinant measles virus vaccine strain Edmonston-Zagreb expressing enhanced green fluorescent protein. The vaccine virus was grown in MRC-5 cells and formulated with identical stabilizers and excipients as used in the commercial MVEZ vaccine produced by the Serum Institute of India. Animals were immunized by hypodermic injection, intra-tracheal inoculation, intra-nasal instillation, or aerosol inhalation. In each group six animals were euthanized at early time points post-vaccination, whereas the other six were followed for 14 months to assess immunogenicity and protection from challenge infection with wild-type measles virus. At early time-points, enhanced green fluorescent protein-positive measles virus-infected cells were detected locally in the muscle, nasal tissues, lungs, and draining lymph nodes. Systemic vaccine virus replication and viremia were virtually absent. Infected macrophages, dendritic cells and tissue-resident lymphocytes predominated. Exclusive delivery of vaccine virus to the lower respiratory tract resulted in highest immunogenicity and protection. This study sheds light on the tropism of a live-attenuated measles virus vaccine and identifies the alveolar spaces as the optimal site for respiratory delivery of measles virus vaccine.
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Affiliation(s)
- Rik L de Swart
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Rory D de Vries
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Linda J Rennick
- Department of Microbiology, Boston University School of Medicine, Boston, MA USA
| | - Geert van Amerongen
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands.,Viroclinics Biosciences, Rotterdam, Netherlands
| | | | - R Joyce Verburgh
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands.,Present Address: ProQR Therapeutics, Leiden, Netherlands
| | - Selma Yüksel
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Alwin de Jong
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Ken Lemon
- Queen's University of Belfast, Belfast, Northern Ireland UK.,Present Address: Agri-Food and Biosciences Institute, Belfast, UK
| | - D Tien Nguyen
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Martin Ludlow
- Department of Microbiology, Boston University School of Medicine, Boston, MA USA.,Present Address: University of Veterinary Medicine Hannover, Hannover, Germany
| | - Albert D M E Osterhaus
- Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands.,Present Address: University of Veterinary Medicine Hannover, Hannover, Germany
| | - W Paul Duprex
- Department of Microbiology, Boston University School of Medicine, Boston, MA USA
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Díaz Ortega JL, Castaneda D, Arellano Quintanilla DM, Martínez D, Trumbo SP, Fernández de Castro J. Antibody persistence in children aged 6–7 years one year following booster immunization with two MMR vaccines applied by aerosol or by injection. Vaccine 2017; 35:3116-3122. [DOI: 10.1016/j.vaccine.2017.04.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/10/2017] [Accepted: 04/11/2017] [Indexed: 11/26/2022]
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Booster immune response in children 6–7 years of age, randomly assigned to four groups with two MMR vaccines applied by aerosol or by injection. Vaccine 2014; 32:3680-6. [DOI: 10.1016/j.vaccine.2014.04.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 02/25/2014] [Accepted: 04/14/2014] [Indexed: 11/22/2022]
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Escriou N, Callendret B, Lorin V, Combredet C, Marianneau P, Février M, Tangy F. Protection from SARS coronavirus conferred by live measles vaccine expressing the spike glycoprotein. Virology 2014; 452-453:32-41. [PMID: 24606680 PMCID: PMC7111909 DOI: 10.1016/j.virol.2014.01.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 11/07/2013] [Accepted: 01/03/2014] [Indexed: 11/24/2022]
Abstract
The recent identification of a novel human coronavirus responsible of a SARS-like illness in the Middle-East a decade after the SARS pandemic, demonstrates that reemergence of a SARS-like coronavirus from an animal reservoir remains a credible threat. Because SARS is contracted by aerosolized contamination of the respiratory tract, a vaccine inducing mucosal long-term protection would be an asset to control new epidemics. To this aim, we generated live attenuated recombinant measles vaccine (MV) candidates expressing either the membrane-anchored SARS-CoV spike (S) protein or its secreted soluble ectodomain (Ssol). In mice susceptible to measles virus, recombinant MV expressing the anchored full-length S induced the highest titers of neutralizing antibodies and fully protected immunized animals from intranasal infectious challenge with SARS-CoV. As compared to immunization with adjuvanted recombinant Ssol protein, recombinant MV induced stronger and Th1-biased responses, a hallmark of live attenuated viruses and a highly desirable feature for an antiviral vaccine. Generation of live recombinant measles vaccine expressing SARS-CoV spike protein. Induction of high titers anti-SARS-CoV neutralizing antibodies in mice. Protection of immunized mice from intranasal infectious challenge with SARS-CoV. Induction of Th1-biased responses and IgA.
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Affiliation(s)
- Nicolas Escriou
- Institut Pasteur, Unité de Génétique Moléculaire des Virus à ARN, Département de Virologie, F-75015 Paris, France; CNRS, UMR 3569, F-75015 Paris, France; Univ. Paris Diderot, Sorbonne, Paris Cité, EA 302, F-75015 Paris, France.
| | - Benoît Callendret
- Institut Pasteur, Unité de Génétique Moléculaire des Virus à ARN, Département de Virologie, F-75015 Paris, France; CNRS, UMR 3569, F-75015 Paris, France; Univ. Paris Diderot, Sorbonne, Paris Cité, EA 302, F-75015 Paris, France
| | - Valérie Lorin
- Institut Pasteur, Unité de Génétique Moléculaire des Virus à ARN, Département de Virologie, F-75015 Paris, France; CNRS, UMR 3569, F-75015 Paris, France; Univ. Paris Diderot, Sorbonne, Paris Cité, EA 302, F-75015 Paris, France
| | - Chantal Combredet
- Institut Pasteur, Unité de Génomique Virale et Vaccination, Département de Virologie, F-75015 Paris, France; CNRS, UMR 3569, F-75015 Paris, France
| | - Philippe Marianneau
- Institut Pasteur, Unité de Biologie des Infections Virales Emergentes, Département de Virologie, F-69007 Lyon, France
| | - Michèle Février
- Institut Pasteur, Unité de Génomique Virale et Vaccination, Département de Virologie, F-75015 Paris, France; CNRS, UMR 3569, F-75015 Paris, France
| | - Frédéric Tangy
- Institut Pasteur, Unité de Génomique Virale et Vaccination, Département de Virologie, F-75015 Paris, France; CNRS, UMR 3569, F-75015 Paris, France.
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Hausner M, Schamberger A, Naumann W, Jacobs E, Dumke R. Development of protective anti-Mycoplasma pneumoniae antibodies after immunization of guinea pigs with the combination of a P1-P30 chimeric recombinant protein and chitosan. Microb Pathog 2013; 64:23-32. [PMID: 23948467 DOI: 10.1016/j.micpath.2013.07.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 07/26/2013] [Accepted: 07/30/2013] [Indexed: 10/26/2022]
Abstract
The attachment organelle of the human respiratory tract pathogen Mycoplasma pneumoniae is essential for colonization of the host mucosa. Furthermore, adherence-related proteins such as the major adhesin P1 and protein P30 represent vaccine candidates. Using the chimeric recombinant protein HP14/30, which combines surface-localized and adherence-involved regions of both proteins, we developed an optimized strategy to immunize guinea pigs. The vaccination protocol includes subcutaneous prime immunization followed by presentation of the antigen directly to the respiratory mucosa by two intranasal (i.n.) administrations and combination of antigen with the mucosal adjuvant chitosan. The immunization scheme induced high, consistent and long-lasting IgA levels in respiratory tract samples (BAL, nasal and throat washing fluid) from the animals. In comparison with a preimmune serum, incubation of M. pneumoniae cells with sera from these animals reduced the mean adhesion of bacteria to HeLa cells to 6%. After i.n. infection, immunized animals showed significantly decreased numbers of M. pneumoniae-specific genome copies, especially in the upper respiratory tract, in comparison with the control group. The results demonstrated that optimized immunization with the chimeric protein HP14/30 is promising for further vaccination efforts to prevent host colonization with M. pneumoniae.
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Affiliation(s)
- Marius Hausner
- TU Dresden, Institute of Medical Microbiology and Hygiene, Dresden, Germany
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Depreter F, Pilcer G, Amighi K. Inhaled proteins: Challenges and perspectives. Int J Pharm 2013; 447:251-80. [DOI: 10.1016/j.ijpharm.2013.02.031] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 02/12/2013] [Indexed: 12/26/2022]
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The status of live viral vaccination in early life. Vaccine 2012; 31:2531-7. [PMID: 23026688 DOI: 10.1016/j.vaccine.2012.09.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Revised: 08/17/2012] [Accepted: 09/17/2012] [Indexed: 11/20/2022]
Abstract
The need for neonatal vaccines is supported by the high disease burden during the first year of life particularly in the first month. Two-thirds of childhood deaths are attributable to infectious diseases of which viruses represent key pathogens. Many infectious diseases have the highest incidence, severity and mortality in the first months of life, and therefore early life vaccination would provide significant protection and life savings. For some childhood viral diseases successful vaccines exist, such as against measles, mumps, rubella, varicella, influenza poliovirus, and rotavirus, but their use in the first year particularly at birth is not yet practiced. Vaccines against other key pathogens continue to elude scientists such as against respiratory syncytial virus. The obstacles for early and neonatal vaccination are complex and include host factors, such as a developing immune system and the interference of passively acquired antibodies, as well vaccine-specific issues, such as optimal route of administration, titer and dosing requirements. Importantly, additional host and infrastructure barriers also present obstacles to neonatal vaccination in the developing world where morbidity and mortality rates are highest. This review will highlight the current live viral vaccines and their use in the first year of life, focusing on efficacy and entertaining the barriers that exist. It is important to understand the successes of current vaccines and use this knowledge to determine strategies that are successful in young infants and for the development of new vaccines for use in early life.
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Diaz-Ortega JL, Bennett JV, Castaneda D, Martinez D, Fernandez de Castro J. Aerosolized MMR vaccine: evaluating potential transmission of components to vaccine administrators and contacts of vaccinees. Biologicals 2012; 40:278-81. [PMID: 22494953 DOI: 10.1016/j.biologicals.2012.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Revised: 02/15/2012] [Accepted: 03/11/2012] [Indexed: 11/19/2022] Open
Abstract
Although numerous operative and immunological advantages accompany aerosol immunization, potential vaccine virus transmission from the aerosol device to vaccine administrators or from aerosol vaccinees to their contacts requires further study. We conducted a clinical and serological follow-up study of vaccine administrators and matched classroom or household contacts of young adults who received the MMR vaccines by aerosol or injection. Differences in incidence of clinical adverse events between vaccinees and contacts were not statistically significant. No seroresponses to any components of MMR vaccine were noted among 25 matched contacts of persons receiving injected vaccines, and only one equivocal seroresponse was noted among 25 matched contacts of aerosol recipients. No seroresponses were observed in 3 persons who administered aerosol vaccine. The composite findings of this study provide additional evidence of the safety of this approach.
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Diaz-Ortega JL, V. Bennett J, Castaneda D, Ma Arellano D, Martinez D, Fernandez de Castro J. Safety and Antibody Responses to Aerosolized MMR II Vaccine in Adults: An Exploratory Study. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/wjv.2012.22008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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New insights in mucosal vaccine development. Vaccine 2011; 30:142-54. [PMID: 22085556 DOI: 10.1016/j.vaccine.2011.11.003] [Citation(s) in RCA: 149] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 10/25/2011] [Accepted: 11/01/2011] [Indexed: 12/30/2022]
Abstract
Mucosal surfaces are the major entrance for infectious pathogens and therefore mucosal immune responses serve as a first line of defence. Most current immunization procedures are obtained by parenteral injection and only few vaccines are administered by mucosal route, because of its low efficiency. However, targeting of mucosal compartments to induce protective immunity at both mucosal sites and systemic level represents a great challenge. Major efforts are made to develop new mucosal candidate vaccines by selecting appropriate antigens with high immunogenicity, designing new mucosal routes of administration and selecting immune-stimulatory adjuvant molecules. The aim of mucosal vaccines is to induce broad potent protective immunity by specific neutralizing antibodies at mucosal surfaces and by induction of cellular immunity. Moreover, an efficient mucosal vaccine would make immunization procedures easier and be better suited for mass administration. This review focuses on contemporary developments of mucosal vaccination approaches using different routes of administration.
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Higginson D, Theodoratou E, Nair H, Huda T, Zgaga L, Jadhav SS, Omer SB, Rudan I, Campbell H. An evaluation of respiratory administration of measles vaccine for prevention of acute lower respiratory infections in children. BMC Public Health 2011; 11 Suppl 3:S31. [PMID: 21501450 PMCID: PMC3231905 DOI: 10.1186/1471-2458-11-s3-s31] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Measles was responsible for an estimated 100,000 deaths worldwide in 2008. Despite being a vaccine-preventable disease, measles remains a major cause of morbidity and mortality in young children. Although a safe and effective injectable measles vaccine has been available for over 50 years it has not been possible to achieve the uniformly high levels of coverage (required to achieve measles eradication) in most parts of the developing world. Aerosolised measles vaccines are now under development with the hope of challenging the delivery factors currently limiting the coverage of the existing vaccine. Methods We used a modified CHNRI methodology for setting priorities in health research investments to assess the strengths and weaknesses of this emerging intervention to decrease the burden of childhood pneumonia. This was done in two stages. In Stage I, we systematically reviewed the literature related to emerging aerosol vaccines against measles relevant to several criteria of interest. Although there are a number of different aerosol vaccine approaches under development, for the purpose of this exercise, all were considered as one intervention. The criteria of interest were: answerability; cost of development, production and implementation; efficacy and effectiveness; deliverability, affordability and sustainability; maximum potential impact on disease burden reduction; acceptability to the end users and health workers; and effect on equity. In Stage II, we conducted an expert opinion exercise by inviting 20 experts (leading basic scientists, international public health researchers, international policy makers and representatives of pharmaceutical companies). The policy makers and industry representatives accepted our invitation on the condition of anonymity, due to the sensitive nature of their involvement in such exercises. They answered questions from the CHNRI framework and their “collective optimism” towards each criterion was documented on a scale from 0 to 100%. Results The panel of experts expressed mixed feelings about an aerosol measles vaccine. The group expressed low levels of optimism regarding the criteria of likelihood of efficacy and low cost of development (scores around 50%); moderate levels of optimism regarding answerability, low cost of production, low cost of implementation and affordability (score around 60%); and high levels of optimism regarding deliverability, impact on equity and acceptability to health workers and end-users (scores over 80%). Finally, the experts felt that this intervention will have a modest but nevertheless important impact on reduction of burden of disease due to childhood pneumonia (median: 5%, interquartile range 1-15%, minimum 0%, maximum 45%). Conclusion Aerosol measles vaccine is at an advanced stage of development, with evidence of good immunogenicity. This new intervention will be presented as a feasible candidate strategy in the campaign for global elimination of measles. It also presents an unique opportunity to decrease the overall burden of disease due to severe pneumonia in young children.
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Affiliation(s)
- Daisy Higginson
- Centre for Population Health Sciences, Global Health Academy, The University of Edinburgh, UK
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Simon JK, Ramirez K, Cuberos L, Campbell JD, Viret JF, Muñoz A, Lagos R, Levine MM, Pasetti MF. Mucosal IgA responses in healthy adult volunteers following intranasal spray delivery of a live attenuated measles vaccine. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2011; 18:355-61. [PMID: 21228137 PMCID: PMC3067370 DOI: 10.1128/cvi.00354-10] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Revised: 11/01/2010] [Accepted: 01/05/2011] [Indexed: 11/20/2022]
Abstract
Measles remains an important cause of morbidity and mortality among children in the developing world. The goal of this study was to examine measles virus-specific mucosal immune responses in healthy immune (n = 24; plaque reduction neutralization [PRN] titers of ≥200 mIU/ml) and nonimmune (n = 24) young adult volunteers who received the monovalent Moraten measles vaccine via intranasal (spray delivery) or subcutaneous immunization. Serum, oral fluid, and nasal wash samples were examined for measles virus-specific and total IgG and IgA on day 0 (prior to vaccination) and on days 14, 28, and 90 after vaccination. Nonimmune subjects vaccinated subcutaneously developed high levels of measles virus PRN, IgG, and IgA antibodies in serum, oral fluid, and nasal washes. Total IgG and secretory IgA (sIgA) titers were increased in nasal washes, and total IgG was increased in oral fluid specimens. There was a strong correlation between PRN and measles virus-specific IgG titers measured in serum, oral fluid, and nasal washes, whereas a weak correlation was found between PRN and measles virus-specific IgA titers. Notably, intranasal measles vaccination resulted in increased production of measles virus-specific sIgA in oral fluid and nasal washes in nonimmune individuals, without evidence of a systemic immune response. In contrast, no significant vaccine-induced responses were observed in immune subjects, regardless of the route of immunization. These results demonstrate that (i) intranasal measles immunization can elicit a mucosal response independent of the induction of serum antibodies and (ii) both mucosal and systemic antibody responses following nasal or subcutaneous immunization are blunted by preexisting measles immunity.
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Affiliation(s)
- Jakub K. Simon
- Center for Vaccine Development, Departments of Pediatrics, Medicine, University of Maryland School of Medicine, Baltimore, Maryland, Berna Biotech Ltd., Bern, Switzerland, Center for Vaccine Development, Hospital Roberto del Rio, Santiago, Chile
| | - Karina Ramirez
- Center for Vaccine Development, Departments of Pediatrics, Medicine, University of Maryland School of Medicine, Baltimore, Maryland, Berna Biotech Ltd., Bern, Switzerland, Center for Vaccine Development, Hospital Roberto del Rio, Santiago, Chile
| | - Lilian Cuberos
- Center for Vaccine Development, Departments of Pediatrics, Medicine, University of Maryland School of Medicine, Baltimore, Maryland, Berna Biotech Ltd., Bern, Switzerland, Center for Vaccine Development, Hospital Roberto del Rio, Santiago, Chile
| | - James D. Campbell
- Center for Vaccine Development, Departments of Pediatrics, Medicine, University of Maryland School of Medicine, Baltimore, Maryland, Berna Biotech Ltd., Bern, Switzerland, Center for Vaccine Development, Hospital Roberto del Rio, Santiago, Chile
| | - Jean F. Viret
- Center for Vaccine Development, Departments of Pediatrics, Medicine, University of Maryland School of Medicine, Baltimore, Maryland, Berna Biotech Ltd., Bern, Switzerland, Center for Vaccine Development, Hospital Roberto del Rio, Santiago, Chile
| | - Alma Muñoz
- Center for Vaccine Development, Departments of Pediatrics, Medicine, University of Maryland School of Medicine, Baltimore, Maryland, Berna Biotech Ltd., Bern, Switzerland, Center for Vaccine Development, Hospital Roberto del Rio, Santiago, Chile
| | - Rosanna Lagos
- Center for Vaccine Development, Departments of Pediatrics, Medicine, University of Maryland School of Medicine, Baltimore, Maryland, Berna Biotech Ltd., Bern, Switzerland, Center for Vaccine Development, Hospital Roberto del Rio, Santiago, Chile
| | - Myron M. Levine
- Center for Vaccine Development, Departments of Pediatrics, Medicine, University of Maryland School of Medicine, Baltimore, Maryland, Berna Biotech Ltd., Bern, Switzerland, Center for Vaccine Development, Hospital Roberto del Rio, Santiago, Chile
| | - Marcela F. Pasetti
- Center for Vaccine Development, Departments of Pediatrics, Medicine, University of Maryland School of Medicine, Baltimore, Maryland, Berna Biotech Ltd., Bern, Switzerland, Center for Vaccine Development, Hospital Roberto del Rio, Santiago, Chile
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Jin TH, Tsao E, Goudsmit J, Dheenadhayalan V, Sadoff J. Stabilizing formulations for inhalable powders of an adenovirus 35-vectored tuberculosis (TB) vaccine (AERAS-402). Vaccine 2010; 28:4369-75. [DOI: 10.1016/j.vaccine.2010.04.059] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Revised: 03/29/2010] [Accepted: 04/19/2010] [Indexed: 10/19/2022]
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Affiliation(s)
- Saad B Omer
- Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA.
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Diaz-Ortega JL, Bennett JV, Castaneda D, Vieyra JR, Valdespino-Gomez JL, de Castro JF. Successful seroresponses to measles and rubella following aerosolized Triviraten vaccine, but poor response to aerosolized mumps (Rubini) component: comparisons with injected MMR. Vaccine 2009; 28:692-8. [PMID: 19861187 DOI: 10.1016/j.vaccine.2009.10.083] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2009] [Revised: 10/06/2009] [Accepted: 10/15/2009] [Indexed: 11/28/2022]
Abstract
Seroresponses to measles, rubella and mumps were evaluated following the injection of MMR II and injection or aerosol administration of Triviraten in young adults. Response to aerosolized Rubini mumps strain was a focus of interest, given robust responses to aerosolized mumps vaccine (Leningrad-Zagreb strain) in a prior study using aerosolized MMR vaccine. The aerosolized Edmonston-Zagreb (EZ) measles vaccine was significantly more immunogenic than injected EZ vaccine, and comparable to results following injected Moraten measles vaccine having twice the dosage. Responses to rubella were comparable in the three MMR study groups. Aerosolized Rubini vaccine was very highly and unexpectedly less immunogenic than either injected Rubini or Jeryl-Lyn strains. The high attenuation of Rubini vaccine appears to have limited its affinity for respiratory tract receptors, which may underlie its lack of clinical effectiveness.
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Affiliation(s)
- Jose Luis Diaz-Ortega
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública (INSP), Ave. Universidad #655, Colonia Santa María Ahuacatitlán, 62508 Cuernavaca, Morelos, Mexico.
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24
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Bennett JV, Fernandez de Castro J, Poblete RM, Alcantara MLG, Diaz EG, Angeles MAM, Wong Chew RM, Toledo EA, Witham C, Santos Preciado JI. A new, rapid, and promising approach to aerosol immunization: Inflatable bags and valved masks. Vaccine 2009; 27:4571-5. [DOI: 10.1016/j.vaccine.2009.05.086] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Revised: 05/28/2009] [Accepted: 05/31/2009] [Indexed: 11/30/2022]
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25
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de Vries RD, Stittelaar KJ, Osterhaus ADME, de Swart RL. Measles vaccination: new strategies and formulations. Expert Rev Vaccines 2008; 7:1215-23. [PMID: 18844595 DOI: 10.1586/14760584.7.8.1215] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Measles is a highly contagious viral disease. With 1 million deaths reported in 1996, measles was the leading cause of vaccine-preventable deaths. However, in recent years, significant progress has been made in measles control, reducing deaths attributed to measles to 454,000 in 2004 and 242,000 in 2006. The main strategy behind this reduction has been the improvement of vaccination coverage and implementation of a second opportunity for immunization with the live-attenuated measles vaccine. The Measles Initiative, a partnership between the American Red Cross, CDC, UNICEF, WHO and UN Foundation, has had a significant role in this achievement. Here, we provide an overview of old and new vaccination strategies, and discuss changes in the route of administration of the existing live-attenuated vaccine, the development of new-generation nonreplicating measles virus vaccine candidates and attempts to use recombinant measles virus as a vector for vaccination against other pathogens.
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Affiliation(s)
- Rory D de Vries
- Department of Virology, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
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26
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Burger JL, Cape SP, Braun CS, McAdams DH, Best JA, Bhagwat P, Pathak P, Rebits LG, Sievers RE. Stabilizing Formulations for Inhalable Powders of Live-Attenuated Measles Virus Vaccine. J Aerosol Med Pulm Drug Deliv 2008; 21:25-34. [DOI: 10.1089/jamp.2007.0658] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jessica L. Burger
- Center for Pharmaceutical Biotechnology, Department of Chemistry and Biochemistry, and CIRES, University of Colorado, Boulder, Colorado
| | - Stephen P. Cape
- Center for Pharmaceutical Biotechnology, Department of Chemistry and Biochemistry, and CIRES, University of Colorado, Boulder, Colorado
| | - Chad S. Braun
- Center for Pharmaceutical Biotechnology, Department of Chemistry and Biochemistry, and CIRES, University of Colorado, Boulder, Colorado
| | - David H. McAdams
- Center for Pharmaceutical Biotechnology, Department of Chemistry and Biochemistry, and CIRES, University of Colorado, Boulder, Colorado
| | - Jessica A. Best
- Center for Pharmaceutical Biotechnology, Department of Chemistry and Biochemistry, and CIRES, University of Colorado, Boulder, Colorado
| | | | | | | | - Robert E. Sievers
- Center for Pharmaceutical Biotechnology, Department of Chemistry and Biochemistry, and CIRES, University of Colorado, Boulder, Colorado
- AKTIV-DRY, LLC, Boulder, Colorado
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27
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Immunogenicity and safety of aerosolized measles vaccine: Systematic review and meta-analysis. Vaccine 2008; 26:383-98. [DOI: 10.1016/j.vaccine.2007.11.010] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2007] [Revised: 11/02/2007] [Accepted: 11/04/2007] [Indexed: 11/21/2022]
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28
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Measles vaccine. Vaccines (Basel) 2008. [DOI: 10.1016/b978-1-4160-3611-1.50022-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] Open
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29
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30
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Minne A, Louahed J, Mehauden S, Baras B, Renauld JC, Vanbever R. The delivery site of a monovalent influenza vaccine within the respiratory tract impacts on the immune response. Immunology 2007; 122:316-25. [PMID: 17521369 PMCID: PMC2266027 DOI: 10.1111/j.1365-2567.2007.02641.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Pulmonary vaccination is a promising immunization route. However, there still remains a crucial need to characterize the different parameters affecting the efficacy of inhaled vaccination. This study aimed at assessing the impact of antigen distribution within the respiratory tract on the immune response to a monovalent A/Panama/2007/99 H3N2 influenza split virus vaccine administered to BALB/c mice. Varying the administration technique allowed the targeting of the vaccine to different sites of the mouse respiratory tract, i.e. the nasal cavity, the upper or central airways, or the deep lung. This targeting was verified by using ovalbumin as a tracer compound. The immune responses generated following influenza vaccine administration to the different respiratory tract sites were compared to each other and to those elicited by intramuscular and peroral intragastric immunization. Delivery of the vaccine to the different respiratory regions generated systemic, local and cellular virus-specific immune responses, which increased with the depth of vaccine deposition, culminating in deep-lung vaccination. The latter induced virus-specific serum immunoglobulin G and neutralizing antibody titres as elevated as intramuscular vaccination, whereas the production of mucosal secretory immunoglobulin A was significantly superior in deep-lung-vaccinated animals. The analysis of cytokines secreted by mononuclear cells during an in vitro recall response indicated that deep-lung vaccination induced a local shift of the cellular immune response towards a T helper type 1 phenotype as compared to intramuscular vaccination. In conclusion, antigen distribution within the respiratory tract has a major effect on the immune response, with the deep lung as the best target for inhaled influenza vaccination.
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MESH Headings
- Administration, Inhalation
- Administration, Intranasal
- Administration, Oral
- Animals
- Antibodies, Viral/biosynthesis
- Female
- Immunity, Cellular
- Immunization/methods
- Immunoglobulin A, Secretory/biosynthesis
- Immunoglobulin G/biosynthesis
- Immunoglobulin G/blood
- Influenza A Virus, H3N2 Subtype/immunology
- Influenza Vaccines/administration & dosage
- Influenza Vaccines/immunology
- Injections, Intramuscular
- Mice
- Mice, Inbred BALB C
- Mice, Inbred Strains
- Respiratory System/immunology
- Th1 Cells/immunology
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Affiliation(s)
- Antoine Minne
- Department of Pharmaceutical Technology, Université Catholique de Louvain, Brussels, Belgium
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31
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Valdespino-Gómez JL, de Lourdes Garcia-Garcia M, Fernandez-de-Castro J, Henao-Restrepo AM, Bennett J, Sepulveda-Amor J. Measles aerosol vaccination. Curr Top Microbiol Immunol 2007; 304:165-93. [PMID: 16989270 DOI: 10.1007/3-540-36583-4_10] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Measles ranks fifth among the five major childhood conditions which are responsible for 21% of all deaths in low and middle-income countries. Measles immunization is considered the most cost-effective public health intervention in the world. In recent years, there has been a critical need to identify alternative routes of measles immunization, which are rapid, reliable, cost-effective, needle-free, and suitable for use in mass campaigns. Aerosol administration of measles vaccines in mass campaigns was first proposed by Dr. Albert Sabin. We review the different clinical trials that have been conducted using the classic Mexican device as well as issues regarding vaccine strain, presentation, and manufacturer. Results of clinical trials indicate that the method is safe and immunogenic in infants and school age children. The viral inoculum will probably need to be increased when administered to infants. From the logistical point of view, the use of the aerosol method has not been evaluated in routine immunization although feasibility of its routine implementation was proved in mass campaigns in Mexico. Cost savings will probably be demonstrated. As to licensure, its compliance with the appropriate international regulatory requirements for medical aerosol delivery devices is in process.
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Affiliation(s)
- J L Valdespino-Gómez
- Coordination of the National Institutes of Health, Periférico Sur, Del Alvaro Obregón, Mexico.
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32
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de Swart RL, LiCalsi C, Quirk AV, van Amerongen G, Nodelman V, Alcock R, Yüksel S, Ward GH, Hardy JG, Vos H, Witham CL, Grainger CI, Kuiken T, Greenspan BJ, Gard TG, Osterhaus ADME. Measles vaccination of macaques by dry powder inhalation. Vaccine 2006; 25:1183-90. [PMID: 17084489 DOI: 10.1016/j.vaccine.2006.10.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2006] [Revised: 10/09/2006] [Accepted: 10/10/2006] [Indexed: 10/24/2022]
Abstract
Measles vaccination via the aerosol route has proven effective under field conditions, using vaccine reconstituted prior to nebulization. Inhalation of a dry powder aerosol vaccine would have additional benefits, including easier logistics of administration, reduced cold chain dependence and the potential of single dose administration. We have evaluated two candidate dry powder measles vaccine formulations in macaques. Specific immune responses were demonstrated, but levels of immunity were lower than in animals vaccinated by injection or by nebulized aerosol. These studies provide proof of principle that dry powder inhalation is a possible route for measles vaccination, but suggest that either the vaccine formulation or the method of delivery need to be improved for a better immune response.
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Affiliation(s)
- Rik L de Swart
- Department of Virology, Erasmus MC, Postgraduate School of Molecular Medicine, Rotterdam, The Netherlands.
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33
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de Swart RL, Kuiken T, Fernandez-de Castro J, Papania MJ, Bennett JV, Valdespino JL, Minor P, Witham CL, Yüksel S, Vos H, van Amerongen G, Osterhaus ADME. Aerosol measles vaccination in macaques: preclinical studies of immune responses and safety. Vaccine 2006; 24:6424-36. [PMID: 16934375 DOI: 10.1016/j.vaccine.2006.05.125] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2006] [Revised: 05/26/2006] [Accepted: 05/29/2006] [Indexed: 10/24/2022]
Abstract
The comparative efficacy and safety of measles vaccination via the aerosol route versus subcutaneous injection has not been fully resolved. We vaccinated cynomolgus monkeys (Macaca fascicularis) with the live-attenuated Edmonston-Zagreb measles virus (MV) vaccine and compared different routes of administration in the immunocompetent and the immunocompromised host. Immunogenicity and protective efficacy of aerosol vaccination using devices similar to those previously used in humans were comparable to those in animals vaccinated by injection. No evidence for a safety hazard associated with the route of vaccination was detected. The results of this study support further clinical evaluation of aerosol vaccination for measles.
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Affiliation(s)
- Rik L de Swart
- Department of Virology, Erasmus MC, Postgraduate School of Molecular Medicine, Dr Molewaterplein 50, 3015 GE, Rotterdam, The Netherlands.
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34
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Shinoda K, Xin KQ, Kojima Y, Saha S, Okuda K, Okuda K. Robust HIV-specific immune responses were induced by DNA vaccine prime followed by attenuated recombinant vaccinia virus (LC16m8 strain) boost. Clin Immunol 2006; 119:32-7. [PMID: 16458074 DOI: 10.1016/j.clim.2005.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2005] [Revised: 12/05/2005] [Accepted: 12/12/2005] [Indexed: 11/16/2022]
Abstract
Recombinant vaccinia virus-based vaccine combined with DNA vaccine has produced a protective immune response against HIV infection in non-human primates. In this study, we explored the immunogenicity of a recombinant vaccinia virus (LC16m8 strain), which has been used in children without severe side effects. The vaccinia virus expressing an HIV(89.6)env gene (vLC-Env) alone or combined with a DNA vaccine expressing the HIV(89.6)env gene (pCAG-Env) was characterized in BALB/c mice. Vaccination of vLC-Env induced much higher HIV-specific humoral and cell-mediated immune responses than that of pCAG-Env. Priming with pCAG-Env further enhanced vLC-Env induced immune responses, especially cell-mediated immune response. Moreover, efficient expression of Env protein was achieved following infection of bone marrow dendritic cells by vLC-Env in vitro. Administration of vLC-Env-infected dendritic cells to mice generated a high cell-mediated immune response. These results demonstrate that priming with pCAG-Env and boosting with vLC-Env represents a logical candidate for vaccination against HIV infection.
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MESH Headings
- AIDS Vaccines/genetics
- AIDS Vaccines/immunology
- Animals
- Dendritic Cells/immunology
- Dendritic Cells/metabolism
- Dendritic Cells/transplantation
- Female
- Gene Expression/genetics
- Gene Products, rev/genetics
- Gene Products, rev/immunology
- HIV Envelope Protein gp120/genetics
- HIV Envelope Protein gp120/immunology
- HIV Envelope Protein gp160/genetics
- HIV Envelope Protein gp160/immunology
- HIV-1/immunology
- Immunity, Cellular/immunology
- Immunization, Secondary/methods
- Interferon-gamma/metabolism
- Mice
- Mice, Inbred BALB C
- Recombination, Genetic
- Spleen/cytology
- Spleen/immunology
- Spleen/metabolism
- Vaccination/methods
- Vaccines, Attenuated/genetics
- Vaccines, Attenuated/immunology
- Vaccines, DNA/immunology
- Vaccines, Synthetic/genetics
- Vaccines, Synthetic/immunology
- Vaccinia virus/genetics
- Vaccinia virus/immunology
- rev Gene Products, Human Immunodeficiency Virus
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Affiliation(s)
- Kaori Shinoda
- Department of Molecular Biodefense Research, Yokohama City University School of Medicine, 3-9 Fukuura, Yokohama 236-0004, Japan
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35
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Lührmann A, Tschernig T, Pabst R, Niewiesk S. Improved intranasal immunization with live-attenuated measles virus after co-inoculation of the lipopeptide MALP-2. Vaccine 2005; 23:4721-6. [PMID: 15964669 DOI: 10.1016/j.vaccine.2005.05.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2004] [Accepted: 05/16/2005] [Indexed: 11/23/2022]
Abstract
The macrophage-activating lipopeptide with a molecular weight of 2kDa (MALP-2) activates antigen presenting cells of human, mouse and rat origin in vitro and in vivo. Here, we demonstrate that MALP-2 induces MIP1alpha and beta, MIP-2, Gro, TNFalpha, IL1alpha and IL6 in cells of cotton rats (Sigmodon hispidus) in vitro. Intranasal inoculation into cotton rats leads to migration of neutrophils and other leucocytes into the lung lumen and lung tissue. After intranasal co-inoculation of MALP-2 with live-attenuated measles vaccine virus, higher titers of neutralizing antibodies are induced but the proliferative T cell response did not increase. Immunization leads to protective immunity in the absence, but not in the presence of passively transferred measles virus (MV) specific antibodies.
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Affiliation(s)
- Anke Lührmann
- Functional and Applied Anatomy, Medical School of Hannover, Hannover, Germany
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36
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Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize important papers concerning measles disease and measles-containing vaccines published in 2004. RECENT FINDINGS Endemic measles has been successfully controlled in the Americas and, to a lesser extent, in Europe. This has been achieved with a high uptake of two doses of a measles-containing vaccine. Even in industrialized countries, where vaccine uptake is poor, for example Japan, the disease is still a significant cause of morbidity and mortality. Vaccine failure is predominantly due to primary vaccine failure, which may, in part, be genetic in origin and related to HLA type. Measles-containing vaccines have been shown to be associated with febrile convulsions, but there is no strong evidence of a link with atopy. There is considerable evidence that there is no causal relationship with autistic disorders. In spite of this, many parents and some professionals have concerns about the safety of the vaccines, which may lead to their underuse. SUMMARY It is possible to eliminate measles with a high uptake of two doses of measles-containing vaccine, but concerns about safety persist and need to be tackled. More research is required into how to do this effectively and also to elucidate the causes of vaccine failure.
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Affiliation(s)
- David Elliman
- Islington PCT and Great Ormond Street Hospital, London, UK.
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37
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Abstract
Plant-based vaccination strategies have the potential to overcome the limitations of the current measles vaccine. The measles virus hemagglutinin (MV-H) protein has been expressed in tobacco. Oral immunisation of mice with plant-derived MV-H protein resulted in MV-specific antibodies and secretory IgA, indicative of humoral and mucosal immune responses. In addition, boosting with oral plant-derived MV-H protein following a MV-H DNA prime, resulted in a greater response than could be induced with either vaccine alone. Collectively, this research represents a significant step towards an effective oral measles vaccine that would be temperature-stable, easy to administer and amenable to inexpensive manufacture.
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Affiliation(s)
- D E Webster
- Children's Vaccines Group, MacFarlane Burnet Institute for Medical Research and Public Health, P.O. Box 2284, Melbourne, Vic. 3001, Australia.
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38
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Bellanti JA, Sabra A, Zeligs BJ. Gastrointestinal immunopathology and food allergy. Ann Allergy Asthma Immunol 2004; 93:S26-32. [PMID: 15562871 DOI: 10.1016/s1081-1206(10)61729-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To review the current data that support the pivotal function of the gastrointestinal immune system in health and disease and its critical role in the pathogenesis of a wide variety of clinical disorders associated with food allergy (FA). DATA SOURCES Internet-based literature search and our own data. STUDY SELECTION The studies included in this review were selected based on the expert opinion of the authors. RESULTS In contrast to the beneficial expressions of gastrointestinal-associated lymphoid tissue, which are seen with relevance to newer methods of delivery of vaccines directly applied to the gastrointestinal mucosal surfaces (eg, oral poliovirus, rotavirus, Salmonella typhi vaccines), the adverse consequences of a mucosal immune response gone astray are evidenced in many diseases such as FA. A classification of clinical disorders associated with FA based on classic mechanisms of immunologic injury is presented, which includes the following: (1) IgE-mediated, (2) non-IgE-mediated, and (3) mixed IgE- and non-IgE-mediated disorders. Our study of immunologic disturbance in patients with non-IgE FA revealed a pattern of increased CD4+ and decreased TH1 cell counts in peripheral blood mononuclear cells in contrast to patients with celiac disease, where a pattern of increased CD8+ and TH1 cell counts in peripheral blood mononuclear cells and increased CD8+ cell counts was seen. CONCLUSIONS The gastrointestinal immune response thus plays a pivotal role in maintaining protective immunity in health and a critical role in the pathogenesis of a wide variety of clinical disorders associated with FA.
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Affiliation(s)
- Joseph A Bellanti
- Department of Pediatrics, the International Center for Interdisciplinary Studies of Immunology, Georgetown University Medical Center, Washington, DC 20007, USA.
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