1
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John TJ, Dharmapalan D, Hirschhorn N. Intestinal mucosal immunity is unimportant for polio eradication: the failure of oral polio vaccination. Infect Dis (Lond) 2024; 56:669-677. [PMID: 38889538 DOI: 10.1080/23744235.2024.2367742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 06/07/2024] [Indexed: 06/20/2024] Open
Abstract
AIMS To explore if intestinal immunity induced by infection with live viruses in the oral poliovirus vaccine (OPV) is essential, necessary or even helpful in interrupting transmission of wild poliovirus (WPV) for global polio eradication. METHODS We reviewed the biology of virus-host interactions in WPV infection and its alterations by OPV-induced immunity for direct evidence of the usefulness of intestinal immunity. We also explored indirect evidence by way of the effect of the inactivated poliovirus vaccine (IPV) on the biology and on transmission dynamics of WPV. RESULTS Immunity, systemic and intestinal, induced by infection with WPV or vaccine viruses, does not prevent re-infection with WPV or vaccine viruses respectively, when exposed. Such re-infected hosts shed virus in the throat and in faeces and are sources of further transmission. Immunity protects against polio paralysis-hence reinfection always remain asymptommatic and silent. CONCLUSION Vaccine virus-induced intestinal immunity is not necessary for polio eradication. The continued and intensive vaccination efforts using OPV under the assumption of its superiority over IPV have resulted in the well-known undesirable effects, namely vaccine associated paralytic polio and the emergence of de-attenuated circulating vaccine-derived polioviruses, in addition to the delay in completing global WPV eradication.
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Affiliation(s)
- T Jacob John
- Christian Medical College, Vellore, Tamil Nadu, India
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2
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Babona Nshuti MA, Touray K, Muluh TJ, Ubong GA, Ngofa RO, Mohammed BI, Roselyne I, Oviaesu D, Bakata EMO, Lau F, Kipterer J, Green HHW, Seaman V, Ahmed JA, Ndoutabe M. Development of a Consolidated Health Facility Masterlist Using Data From Polio Electronic Surveillance in the World Health Organization African Region. JMIR Public Health Surveill 2024; 10:e54250. [PMID: 38904997 PMCID: PMC11226925 DOI: 10.2196/54250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/15/2024] [Accepted: 03/14/2024] [Indexed: 06/22/2024] Open
Abstract
Geospatial data reporting from surveillance and immunization efforts is a key aspect of the World Health Organization (WHO) Global Polio Eradication Initiative in Africa. These activities are coordinated through the WHO Regional Office for Africa Geographic Information Systems Centre. To ensure the accuracy of field-collected data, the WHO Regional Office for Africa Geographic Information Systems Centre has developed mobile phone apps such as electronic surveillance (eSURV) and integrated supportive supervision (ISS) geospatial data collection programs. While eSURV and ISS have played a vital role in efforts to eradicate polio and control other communicable diseases in Africa, disease surveillance efforts have been hampered by incomplete and inaccurate listings of health care sites throughout the continent. To address this shortcoming, data compiled from eSURV and ISS are being used to develop, update, and validate a Health Facility master list for the WHO African region that contains comprehensive listings of the names, locations, and types of health facilities in each member state. The WHO and Ministry of Health field officers are responsible for documenting and transmitting the relevant geospatial location information regarding health facilities and traditional medicine sites using the eSURV and ISS form; this information is then used to update the Health Facility master list and is also made available to national ministries of health to update their respective health facility lists. This consolidation of health facility information into a single registry is expected to improve disease surveillance and facilitate epidemiologic research for the Global Polio Eradication Initiative, as well as aid public health efforts directed at other diseases across the African continent. This review examines active surveillance using eSURV at the district, country, and regional levels, highlighting its role in supporting polio surveillance and immunization efforts, as well as its potential to serve as a fundamental basis for broader public health initiatives and research throughout Africa.
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Affiliation(s)
| | - Kebba Touray
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | | | - Godwin Akpan Ubong
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Reuben Opara Ngofa
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Bello Isa Mohammed
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Ishimwe Roselyne
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - David Oviaesu
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | | | - Fiona Lau
- Bill & Melinda Gates Foundation, Seattle, WA, United States
| | - John Kipterer
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Hugh Henry W Green
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Vincent Seaman
- Bill & Melinda Gates Foundation, Seattle, WA, United States
| | - Jamal A Ahmed
- World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Modjirom Ndoutabe
- World Health Organization Regional Office for Africa, Brazzaville, Congo
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3
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Bandyopadhyay AS, Burke RM, Hawes KM. Polio Eradication: Status, Struggles and Strategies. Pediatr Infect Dis J 2024; 43:e207-e211. [PMID: 38564755 DOI: 10.1097/inf.0000000000004330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Ananda S Bandyopadhyay
- From the Polio, Global Development, Bill & Melinda Gates Foundation, Seattle, Washington
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4
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Voorman A, Lyons H, Shuaib F, Adamu US, Korir C, Erbeto T, Bandyopadhyay AS, Okiror S. Impact of Supplementary Immunization Activities using Novel Oral Polio Vaccine Type 2 during a Large outbreak of Circulating Vaccine-Derived Poliovirus in Nigeria. J Infect Dis 2024; 229:805-812. [PMID: 37357964 PMCID: PMC10938209 DOI: 10.1093/infdis/jiad222] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Novel oral poliovirus vaccine (OPV) type 2 (nOPV2) has been made available for outbreak response under an emergency use listing authorization based on supportive clinical trial data. Since 2021 more than 350 million doses of nOPV2 were used for control of a large outbreak of circulating vaccine-derived poliovirus type 2 (cVDPV2) in Nigeria. METHODS Using a bayesian time-series susceptible-infectious-recovered model, we evaluate the field effectiveness of nOPV2 immunization campaigns in Nigeria compared with campaigns using monovalent OPV type 2 (mOPV2). RESULTS We found that both nOPV2 and mOPV2 campaigns were highly effective in reducing transmission of cVDPV2, on average reducing the susceptible population by 42% (95% confidence interval, 28-54%) and 38% (20-51%) per campaign, respectively, which were indistinguishable from each other in this analysis (relative effect, 1.1 [.7-1.9]). Impact was found to vary across areas and between immunization campaigns. CONCLUSIONS These results are consistent with the comparable individual immunogenicity of nOPV2 and mOPV2 found in clinical trials but also suggest that outbreak response campaigns may have small impacts in some areas requiring more campaigns than are suggested in current outbreak response procedures.
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Affiliation(s)
- Arend Voorman
- The Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | - Hil Lyons
- The Bill & Melinda Gates Foundation, Seattle, Washington, USA
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Usman S Adamu
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Charles Korir
- World Health Organization, Nigeria Country Office, Abuja, Nigeria
| | - Tesfaye Erbeto
- World Health Organization, Nigeria Country Office, Abuja, Nigeria
| | | | - Samuel Okiror
- The Bill & Melinda Gates Foundation, Seattle, Washington, USA
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5
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Bandyopadhyay AS, Cooper LV, Zipursky S. One billion doses and WHO prequalification of nOPV2: Implications for the global polio situation and beyond. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002920. [PMID: 38335217 PMCID: PMC10857585 DOI: 10.1371/journal.pgph.0002920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Affiliation(s)
| | - Laura V. Cooper
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Simona Zipursky
- Bill & Melinda Gates Foundation, Seattle, Washington, United States of America
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6
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Thompson KM, Badizadegan K. Evolution of global polio eradication strategies: targets, vaccines, and supplemental immunization activities (SIAs). Expert Rev Vaccines 2024; 23:597-613. [PMID: 38813792 DOI: 10.1080/14760584.2024.2361060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/24/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Despite multiple revisions of targets and timelines in polio eradication plans since 1988, including changes in supplemental immunization activities (SIAs) that increase immunity above routine immunization (RI) coverage, poliovirus transmission continues as of 2024. METHODS We reviewed polio eradication plans and Global Polio Eradication Initiative (GPEI) annual reports and budgets to characterize key phases of polio eradication, the evolution of poliovirus vaccines, and the role of SIAs. We used polio epidemiology to provide context for successes and failures and updated prior modeling to show the contribution of SIAs in achieving and maintaining low polio incidence compared to expected incidence for the counterfactual of RI only. RESULTS We identified multiple phases of polio eradication that included shifts in targets and timelines and the introduction of different poliovirus vaccines, which influenced polio epidemiology. Notable shifts occurred in GPEI investments in SIAs since 2001, particularly since 2016. Modeling results suggest that SIAs play(ed) a key role in increasing (and maintaining) high population immunity to levels required to eradicate poliovirus transmission globally. CONCLUSIONS Shifts in polio eradication strategy and poliovirus vaccine usage in SIAs provide important context for understanding polio epidemiology, delayed achievement of polio eradication milestones, and complexity of the polio endgame.
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7
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Picon MA, Wang L, Da Fonseca Ferreira A, Dong C, Marzouka GR. Extracellular Vesicles as Delivery Systems in Disease Therapy. Int J Mol Sci 2023; 24:17134. [PMID: 38138963 PMCID: PMC10742668 DOI: 10.3390/ijms242417134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/24/2023] Open
Abstract
Extracellular vesicles (EVs)/exosomes are nanosized membrane-bound structures that are released by virtually all cells. EVs have attracted great attention in the scientific community since the discovery of their roles in cell-to-cell communication. EVs' enclosed structure protects bioactive molecules from degradation in the extracellular space and targets specific tissues according to the topography of membrane proteins. Upon absorption by recipient cells, EV cargo can modify the transcription machinery and alter the cellular functions of these cells, playing a role in disease pathogenesis. EVs have been tested as the delivery system for the mRNA COVID-19 vaccine. Recently, different therapeutic strategies have been designed to use EVs as a delivery system for microRNAs and mRNA. In this review, we will focus on the exciting and various platforms related to using EVs as delivery vehicles, mainly in gene editing using CRISPR/Cas9, cancer therapy, drug delivery, and vaccines. We will also touch upon their roles in disease pathogenesis.
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Affiliation(s)
- Manuel Alejandro Picon
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.A.P.); (A.D.F.F.)
| | - Liyong Wang
- John T. Macdonald Foundation Department of Human Genetics and the John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL 33136, USA;
| | - Andrea Da Fonseca Ferreira
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.A.P.); (A.D.F.F.)
| | - Chunming Dong
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.A.P.); (A.D.F.F.)
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Section of Cardiology, Department of Medicine, Miami VA Health System, University of Miami, Miami, FL 33125, USA
| | - George R. Marzouka
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Section of Cardiology, Department of Medicine, Miami VA Health System, University of Miami, Miami, FL 33125, USA
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8
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Nyenswah TG, Schue JL. nOPV2 development as a global effort for polio outbreak response - Authors' reply. Lancet Glob Health 2023; 11:e1696. [PMID: 37858580 DOI: 10.1016/s2214-109x(23)00374-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 08/01/2023] [Indexed: 10/21/2023]
Affiliation(s)
- Tolbert G Nyenswah
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Jessica L Schue
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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9
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Davlantes E, Jorba J, Henderson E, Bullard K, Deka MA, Kfutwah A, Martin J, Bessaud M, Shulman LM, Hawes K, Diop OM, Bandyopadhyay AS, Zipursky S, Burns CC. Notes from the Field: Circulating Vaccine-Derived Poliovirus Type 2 Emergences Linked to Novel Oral Poliovirus Vaccine Type 2 Use - Six African Countries, 2021-2023. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2023; 72:1041-1042. [PMID: 37733626 PMCID: PMC10519714 DOI: 10.15585/mmwr.mm7238a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
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10
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Kwong KWY, Xin Y, Lai NCY, Sung JCC, Wu KC, Hamied YK, Sze ETP, Lam DMK. Oral Vaccines: A Better Future of Immunization. Vaccines (Basel) 2023; 11:1232. [PMID: 37515047 PMCID: PMC10383709 DOI: 10.3390/vaccines11071232] [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: 06/13/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
Oral vaccines are gaining more attention due to their ease of administration, lower invasiveness, generally greater safety, and lower cost than injectable vaccines. This review introduces certified oral vaccines for adenovirus, recombinant protein-based, and transgenic plant-based oral vaccines, and their mechanisms for inducing an immune response. Procedures for regulatory approval and clinical trials of injectable and oral vaccines are also covered. Challenges such as instability and reduced efficacy in low-income countries associated with oral vaccines are discussed, as well as recent developments, such as Bacillus-subtilis-based and nanoparticle-based delivery systems that have the potential to improve the effectiveness of oral vaccines.
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Affiliation(s)
- Keith Wai-Yeung Kwong
- Research Department, DreamTec Cytokines Limited, Hong Kong, China
- Oristry BioTech (HK) Limited, Hong Kong, China
- Theratide BioTech (HK) Limited, Hong Kong, China
| | - Ying Xin
- Research Department, DreamTec Cytokines Limited, Hong Kong, China
| | - Nelson Cheuk-Yin Lai
- Research Department, DreamTec Cytokines Limited, Hong Kong, China
- Oristry BioTech (HK) Limited, Hong Kong, China
- Theratide BioTech (HK) Limited, Hong Kong, China
| | - Johnny Chun-Chau Sung
- Research Department, DreamTec Cytokines Limited, Hong Kong, China
- Oristry BioTech (HK) Limited, Hong Kong, China
- Theratide BioTech (HK) Limited, Hong Kong, China
| | - Kam-Chau Wu
- Research Department, DreamTec Cytokines Limited, Hong Kong, China
| | | | - Eric Tung-Po Sze
- School of Science and Technology, Hong Kong Metropolitan University, Hong Kong, China
| | - Dominic Man-Kit Lam
- DrD Novel Vaccines Limited, Hong Kong, China
- Torsten Wiesel International Research Institute, Sichuan University, Chengdu 610064, China
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11
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Yeh MT, Smith M, Carlyle S, Konopka-Anstadt JL, Burns CC, Konz J, Andino R, Macadam A. Genetic stabilization of attenuated oral vaccines against poliovirus types 1 and 3. Nature 2023; 619:135-142. [PMID: 37316671 PMCID: PMC10322712 DOI: 10.1038/s41586-023-06212-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/12/2023] [Indexed: 06/16/2023]
Abstract
Vaccination with Sabin, a live attenuated oral polio vaccine (OPV), results in robust intestinal and humoral immunity and has been key to controlling poliomyelitis. As with any RNA virus, OPV evolves rapidly to lose attenuating determinants critical to the reacquisition of virulence1-3 resulting in vaccine-derived, virulent poliovirus variants. Circulation of these variants within underimmunized populations leads to further evolution of circulating, vaccine-derived poliovirus with higher transmission capacity, representing a significant risk of polio re-emergence. A new type 2 OPV (nOPV2), with promising clinical data on genetic stability and immunogenicity, recently received authorization from the World Health Organization for use in response to circulating, vaccine-derived poliovirus outbreaks. Here we report the development of two additional live attenuated vaccine candidates against type 1 and 3 polioviruses. The candidates were generated by replacing the capsid coding region of nOPV2 with that from Sabin 1 or 3. These chimeric viruses show growth phenotypes similar to nOPV2 and immunogenicity comparable to their parental Sabin strains, but are more attenuated. Our experiments in mice and deep sequencing analysis confirmed that the candidates remain attenuated and preserve all the documented nOPV2 characteristics concerning genetic stability following accelerated virus evolution. Importantly, these vaccine candidates are highly immunogenic in mice as monovalent and multivalent formulations and may contribute to poliovirus eradication.
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Affiliation(s)
- Ming Te Yeh
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA, USA
| | - Matthew Smith
- National Institute for Biological Standards and Control, South Mimms, UK
| | - Sarah Carlyle
- National Institute for Biological Standards and Control, South Mimms, UK
| | - Jennifer L Konopka-Anstadt
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Center for Vaccine Innovation and Access, PATH, Seattle, WA, USA
| | - Cara C Burns
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John Konz
- Center for Vaccine Innovation and Access, PATH, Seattle, WA, USA
| | - Raul Andino
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA, USA.
| | - Andrew Macadam
- National Institute for Biological Standards and Control, South Mimms, UK.
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12
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Singanayagam A, Klapsa D, Burton-Fanning S, Hand J, Wilton T, Stephens L, Mate R, Shillitoe B, Celma C, Slatter M, Flood T, Gopal R, Martin J, Zambon M. Asymptomatic immunodeficiency-associated vaccine-derived poliovirus infections in two UK children. Nat Commun 2023; 14:3413. [PMID: 37296153 PMCID: PMC10251316 DOI: 10.1038/s41467-023-39094-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/18/2023] [Indexed: 06/12/2023] Open
Abstract
Increasing detections of vaccine-derived poliovirus (VDPV) globally, including in countries previously declared polio free, is a public health emergency of international concern. Individuals with primary immunodeficiency (PID) can excrete polioviruses for prolonged periods, which could act as a source of cryptic transmission of viruses with potential to cause neurological disease. Here, we report on the detection of immunodeficiency-associated VDPVs (iVDPV) from two asymptomatic male PID children in the UK in 2019. The first child cleared poliovirus with increased doses of intravenous immunoglobulin, the second child following haematopoetic stem cell transplantation. We perform genetic and phenotypic characterisation of the infecting strains, demonstrating intra-host evolution and a neurovirulent phenotype in transgenic mice. Our findings highlight a pressing need to strengthen polio surveillance. Systematic collection of stool from asymptomatic PID patients who are at high risk for poliovirus excretion could improve the ability to detect and contain iVDPVs.
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Affiliation(s)
- Anika Singanayagam
- Polio Reference Service, UK Health Security Agency, Colindale, London, UK.
- Department of Infectious Disease, Imperial College London, London, UK.
| | - Dimitra Klapsa
- Division of Vaccines, National Institute for Biological Standards and Control, Medicines and Healthcare products Regulatory Agency, Potters Bar, London, UK
| | - Shirelle Burton-Fanning
- Microbiology and Virology Services, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Julian Hand
- Polio Reference Service, UK Health Security Agency, Colindale, London, UK
| | - Thomas Wilton
- Division of Vaccines, National Institute for Biological Standards and Control, Medicines and Healthcare products Regulatory Agency, Potters Bar, London, UK
| | - Laura Stephens
- Division of Vaccines, National Institute for Biological Standards and Control, Medicines and Healthcare products Regulatory Agency, Potters Bar, London, UK
| | - Ryan Mate
- Division of Vaccines, National Institute for Biological Standards and Control, Medicines and Healthcare products Regulatory Agency, Potters Bar, London, UK
| | - Benjamin Shillitoe
- Paediatric Stem Cell Transplant Unit, Great North Children's Hospital, Newcastle upon Tyne, UK
- Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Cristina Celma
- Polio Reference Service, UK Health Security Agency, Colindale, London, UK
| | - Mary Slatter
- Paediatric Stem Cell Transplant Unit, Great North Children's Hospital, Newcastle upon Tyne, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Terry Flood
- Paediatric Stem Cell Transplant Unit, Great North Children's Hospital, Newcastle upon Tyne, UK
| | - Robin Gopal
- Polio Reference Service, UK Health Security Agency, Colindale, London, UK
| | - Javier Martin
- Division of Vaccines, National Institute for Biological Standards and Control, Medicines and Healthcare products Regulatory Agency, Potters Bar, London, UK
| | - Maria Zambon
- Polio Reference Service, UK Health Security Agency, Colindale, London, UK.
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13
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Kim CY, Piamonte B, Allen R, Thakur KT. Threat of resurgence or hope for global eradication of poliovirus? Curr Opin Neurol 2023; 36:229-237. [PMID: 37078665 DOI: 10.1097/wco.0000000000001156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
PURPOSE OF REVIEW Recent outbreaks of poliomyelitis in countries that have been free of cases for decades highlight the challenges of eradicating polio in a globalized interconnected world beset with a novel viral pandemic. We provide an epidemiological update, advancements in vaccines, and amendments in public health strategy of poliomyelitis in this review. RECENT FINDINGS Last year, new cases of wild poliovirus type 1 (WPV1) were documented in regions previously documented to have eradicated WPV1 and reports of circulating vaccine-derived poliovirus type 2 (cVDPV2) and 3 (cVDPV3) in New York and Jerusalem made international headlines. Sequencing of wastewater samples from environmental surveillance revealed that the WPV1 strains were related to WPV1 lineages from endemic countries and the cVDPV2 strains from New York and Jerusalem were not only related to each other but also to environmental isolates found in London. The evidence of importation of WPV1 cases from endemic countries, and global transmission of cVDPVs justifies renewed efforts in routine vaccination programs and outbreak control measures that were interrupted by the COVID-19 pandemic. After the novel oral poliovirus vaccine type 2 (nOPV2) received emergency authorization for containment of cVDPV2 outbreaks in 2021, subsequent reduced incidence, transmission rates, and vaccine adverse events, alongside increased genetic stability of viral isolates substantiates the safety and efficacy of nOPV2. The nOPV1 and nOPV3 vaccines, against type 1 and 3 cVDPVs, and measures to increase accessibility and efficacy of inactivated poliovirus vaccine (IPV) are in development. SUMMARY A revised strategy utilizing more genetically stable vaccine formulations, with uninterrupted vaccination programs and continued active surveillance optimizes the prospect of global poliomyelitis eradication.
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Affiliation(s)
- Carla Y Kim
- Department of Neurology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York, USA
| | - Bernadeth Piamonte
- University of the Philippines - Philippine General Hospital, Manila, Philippines
| | - Rebecca Allen
- Columbia University College of Physicians and Surgeons, New York, New York
| | - Kiran T Thakur
- Department of Neurology, Columbia University Irving Medical Center-New York Presbyterian Hospital, New York, New York, USA
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14
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Gong YM, Wei XF, Zheng YY, Li Y, Yu Q, Li PF, Zhu B. Combining Phage Display Technology with In Silico-Designed Epitope Vaccine to Elicit Robust Antibody Responses against Emerging Pathogen Tilapia Lake Virus. J Virol 2023; 97:e0005023. [PMID: 36975794 PMCID: PMC10134809 DOI: 10.1128/jvi.00050-23] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/27/2023] [Indexed: 03/29/2023] Open
Abstract
Antigen epitope identification is a critical step in the vaccine development process and is a momentous cornerstone for the development of safe and efficient epitope vaccines. In particular, vaccine design is difficult when the function of the protein encoded by the pathogen is unknown. The genome of Tilapia lake virus (TiLV), an emerging virus from fish, encodes protein functions that have not been elucidated, resulting in a lag and uncertainty in vaccine development. Here, we propose a feasible strategy for emerging viral disease epitope vaccine development using TiLV. We determined the targets of specific antibodies in serum from a TiLV survivor by panning a Ph.D.-12 phage library, and we identified a mimotope, TYTTRMHITLPI, referred to as Pep3, which provided protection against TiLV after prime-boost vaccination; its immune protection rate was 57.6%. Based on amino acid sequence alignment and structure analysis of the target protein from TiLV, we further identified a protective antigenic site (399TYTTRNEDFLPT410) which is located on TiLV segment 1 (S1). The epitope vaccine with keyhole limpet hemocyanin (KLH-S1399-410) corresponding to the mimotope induced the tilapia to produce a durable and effective antibody response after immunization, and the antibody depletion test confirmed that the specific antibody against S1399-410 was necessary to neutralize TiLV. Surprisingly, the challenge studies in tilapia demonstrated that the epitope vaccine elicited a robust protective response against TiLV challenge, and the survival rate reached 81.8%. In conclusion, this study revealed a concept for screening antigen epitopes of emerging viral diseases, providing promising approaches for development and evaluation of protective epitope vaccines against viral diseases. IMPORTANCE Antigen epitope determination is an important cornerstone for developing efficient vaccines. In this study, we attempted to explore a novel approach for epitope discovery of TiLV, which is a new virus in fish. We investigated the immunogenicity and protective efficacy of all antigenic sites (mimotopes) identified in serum of primary TiLV survivors by using a Ph.D.-12 phage library. We also recognized and identified the natural epitope of TiLV by bioinformatics, evaluated the immunogenicity and protective effect of this antigenic site by immunization, and revealed 2 amino acid residues that play important roles in this epitope. Both Pep3 and S1399-410 (a natural epitope identified by Pep3) elicited antibody titers in tilapia, but S1399-410 was more prominent. Antibody depletion studies showed that anti-S1399-410-specific antibodies were essential for neutralizing TiLV. Our study demonstrated a model for combining experimental and computational screens to identify antigen epitopes, which is attractive for epitope-based vaccine development.
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Affiliation(s)
- Yu-Ming Gong
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, China
| | - Xue-Feng Wei
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, China
| | - Yu-Ying Zheng
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, China
| | - Yang Li
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, China
| | - Qing Yu
- Guangxi Key Laboratory of Aquatic Biotechnology and Modern Ecological Aquaculture, Guangxi Academy of Marine Sciences, Guangxi Academy of Sciences, Nanning, Guangxi, China
| | - Peng-Fei Li
- Guangxi Key Laboratory of Aquatic Biotechnology and Modern Ecological Aquaculture, Guangxi Academy of Marine Sciences, Guangxi Academy of Sciences, Nanning, Guangxi, China
| | - Bin Zhu
- College of Animal Science and Technology, Northwest A&F University, Yangling, Shaanxi, China
- Key Laboratory of Livestock Biology, Northwest A&F University, Yangling, Shaanxi, China
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15
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Arita M, Fuchino H. Characterization of Anti-Poliovirus Compounds Isolated from Edible Plants. Viruses 2023; 15:v15040903. [PMID: 37112883 PMCID: PMC10145814 DOI: 10.3390/v15040903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 04/29/2023] Open
Abstract
Poliovirus (PV) is the causative agent of poliomyelitis and is a target of the global eradication programs of the World Health Organization (WHO). After eradication of type 2 and 3 wild-type PVs, vaccine-derived PV remains a substantial threat against the eradication as well as type 1 wild-type PV. Antivirals could serve as an effective means to suppress the outbreak; however, no anti-PV drugs have been approved at present. Here, we screened for effective anti-PV compounds in a library of edible plant extracts (a total of 6032 extracts). We found anti-PV activity in the extracts of seven different plant species. We isolated chrysophanol and vanicoside B (VCB) as the identities of the anti-PV activities of the extracts of Rheum rhaponticum and Fallopia sachalinensis, respectively. VCB targeted the host PI4KB/OSBP pathway for its anti-PV activity (EC50 = 9.2 μM) with an inhibitory effect on in vitro PI4KB activity (IC50 = 5.0 μM). This work offers new insights into the anti-PV activity in edible plants that may serve as potent antivirals for PV infection.
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Affiliation(s)
- Minetaro Arita
- Department of Virology II, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi 208-0011, Tokyo, Japan
| | - Hiroyuki Fuchino
- Research Center for Medicinal Plant Resources, National Institutes of Biomedical Innovation, Health and Nutrition, 1-2 Hachimandai, Tsukuba 305-0843, Ibaraki, Japan
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16
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Durrheim DN. Eliminating all circulating vaccine-derived poliovirus: a prerequisite to declaring global polio eradication. Int Health 2023; 15:109-110. [PMID: 36271900 PMCID: PMC9977216 DOI: 10.1093/inthealth/ihac068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 10/14/2022] [Indexed: 11/13/2022] Open
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17
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Rüttimann RW. Vaccination and surveillance: Two basic tools for a final poliomyelitis eradication. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2023. [DOI: 10.47102/annals-acadmedsg.20236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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18
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Zaman K, Bandyopadhyay AS, Hoque M, Gast C, Yunus M, Jamil KM, Mainou BA, Konopka-Anstadt JL, Hendley WS, Vincent A, Clemens R, Clemens SAC, Ross AG, Clemens JD, Tritama E. Evaluation of the safety, immunogenicity, and faecal shedding of novel oral polio vaccine type 2 in healthy newborn infants in Bangladesh: a randomised, controlled, phase 2 clinical trial. Lancet 2023; 401:131-139. [PMID: 36495882 PMCID: PMC9860215 DOI: 10.1016/s0140-6736(22)02397-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/11/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Type 2 circulating vaccine-derived polioviruses (cVDPV2) from Sabin oral poliovirus vaccines (OPVs) are the leading cause of poliomyelitis. A novel type 2 OPV (nOPV2) has been developed to be more genetically stable with similar tolerability and immunogenicity to that of Sabin type 2 vaccines to mitigate the risk of cVDPV2. We aimed to assess these aspects of nOPV2 in poliovirus vaccine-naive newborn infants. METHODS In this randomised, double-blind, controlled, phase 2 trial we enrolled newborn infants at the Matlab Health Research Centre, Chandpur, Bangladesh. We included infants who were healthy and were a single birth after at least 37 weeks' gestation. Infants were randomly assigned (2:1) to receive either two doses of nOPV2 or placebo, administered at age 0-3 days and at 4 weeks. Exclusion criteria included receipt of rotavirus or any other poliovirus vaccine, any infection or illness at the time of enrolment (vomiting, diarrhoea, or intolerance to liquids), diagnosis or suspicion of any immunodeficiency disorder in the infant or a close family member, or any contraindication for venipuncture. The primary safety outcome was safety and tolerability after one and two doses of nOPV2, given 4 weeks apart in poliovirus vaccine-naive newborn infants and the primary immunogenicity outcome was the seroconversion rate for neutralising antibodies against type 2 poliovirus, measured 28 days after the first and second vaccinations with nOPV2. Study staff recorded solicited and unsolicited adverse events after each dose during daily home visits for 7 days. Poliovirus neutralising antibody responses were measured in sera drawn at birth and at age 4 weeks and 8 weeks. This study is registered on ClinicalTrials.gov, NCT04693286. FINDINGS Between Sept 21, 2020, and Aug 16, 2021, we screened 334 newborn infants, of whom three (<1%) were found to be ineligible and one (<1%) was withdrawn by the parents; the remaining 330 (99%) infants were assigned to receive nOPV2 (n=220 [67%]) or placebo (n=110 [33%]). nOPV2 was well tolerated; 154 (70%) of 220 newborn infants in the nOPV2 group and 78 (71%) of 110 in the placebo group had solicited adverse events, which were all mild or moderate in severity. Severe unsolicited adverse events in 11 (5%) vaccine recipients and five (5%) placebo recipients were considered unrelated to vaccination. 306 (93%) of 330 infants had seroprotective maternal antibodies against type 2 poliovirus at birth, decreasing to 58 (56%) of 104 in the placebo group at 8 weeks. In the nOPV2 group 196 (90%) of 217 infants seroconverted by week 8 after two doses, when 214 (99%) had seroprotective antibodies. INTERPRETATION nOPV2 was well tolerated and immunogenic in newborn infants, with two doses, at birth and 4 weeks, resulting in almost 99% of infants having protective neutralising antibodies. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Khaelqu Zaman
- International Centre for Diarrhoeal Disease Research, Chandpur, Bangladesh
| | | | - Masuma Hoque
- International Centre for Diarrhoeal Disease Research, Chandpur, Bangladesh
| | | | - Mohammad Yunus
- International Centre for Diarrhoeal Disease Research, Chandpur, Bangladesh
| | - Khondoker M Jamil
- National Polio and Measles Laboratory, Institute of Public Health, Dhaka, Bangladesh
| | | | | | | | - Annelet Vincent
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ralf Clemens
- Global Research in Infectious Diseases, Rio de Janeiro, Brazil
| | - Sue Ann Costa Clemens
- Global Research in Infectious Diseases, Rio de Janeiro, Brazil; Department of Paediatrics, Oxford University, Oxford, UK
| | - Allen G Ross
- International Centre for Diarrhoeal Disease Research, Chandpur, Bangladesh; Rural Health Research Institute, Charles Sturt University, Wagga Wagga, NSW, Australia
| | - John D Clemens
- International Centre for Diarrhoeal Disease Research, Chandpur, Bangladesh; International Vaccine Institute, Seoul, South Korea
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19
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Nanque LM, Fisker AB. Maximising the lessons learned from trial data after emergency use listing of a novel oral polio vaccine. Lancet 2023; 401:83-85. [PMID: 36495877 DOI: 10.1016/s0140-6736(22)02455-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Line M Nanque
- Bandim Health Project, OPEN, Odense Patient Data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Copenhagen, Denmark; Bandim Health Project, INDEPTH network, 1004 Bissau Codex, Guinea-Bissau
| | - Ane Bærent Fisker
- Bandim Health Project, OPEN, Odense Patient Data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Copenhagen, Denmark; Bandim Health Project, INDEPTH network, 1004 Bissau Codex, Guinea-Bissau.
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