1
|
Tamrakar D, Poudel P, Thapa P, Singh S, Khadgi A, Thapa S, Tamrakar R, Shrestha A, Madhup S, Rai GK, Gupta BP, Saluja T, Sahastrabuddhe S, Shrestha R. Safety and immunogenicity of conjugate vaccine for typhoid (Vi-DT): Finding from an observer-blind, active-controlled, randomized, non-inferiority, phase III clinical trial among healthy volunteers. Hum Vaccin Immunother 2024; 20:2301631. [PMID: 38189360 PMCID: PMC10793708 DOI: 10.1080/21645515.2023.2301631] [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: 08/21/2023] [Accepted: 12/31/2023] [Indexed: 01/09/2024] Open
Abstract
Typhoid fever is a significant public health concern with most of the sufferers between 15 and 25 y of age in Nepal. We undertook this study to demonstrate Vi polysaccharide conjugated with diphtheria toxoid (Vi-DT) conjugate vaccine which is non-inferior to Typbar typhoid conjugate vaccine, a Vi polysaccharide vaccine conjugated with tetanus toxoid (Vi-TT) with a focus on the adult population from Dhulikhel Hospital which was one of the total four sites in Nepal. In this study, we assigned the eligible participants in 1:1:1:1 ratio by block randomization, and stratified into three age groups (6 months to less than 2 y, 2 y to less than 18 y, and 18 y to 45 y), allotted to Group A, B, C, and D. Group A, B, and C received 25 μg (0.5 mL) of Vi-DT study vaccine and participants in Group D received 25 μg (0.5 mL) Vi-TT vaccine. We descriptively analyzed safety in all the participants receiving one dose of the investigational vaccine. The anti-Vi-IgG seroconversion rate in Vi-DT recipients was 99.71% (97.5% CI 98.04-99.96; 344 of 345 participants) and 99.13% (94.27-99.87; 114 of 115) in Vi-TT recipients which indicates that Vi-DT vaccine is non-inferior to Vi-TT vaccine. In safety aspect, 16.81% of total subject had at least one solicited adverse reaction and 22.61% of the Vi-TT participants experienced at least one solicited adverse reaction with most of them being local adverse reactions. None of the enrolled participants reported serious adverse events. Our study shows that a single dose of the Vi-DT vaccine is immunogenic, safe to administer and non-inferior to the Vi-TT vaccine four weeks after vaccination.
Collapse
Affiliation(s)
- Dipesh Tamrakar
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal
| | - Pranodan Poudel
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal
| | - Pragya Thapa
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal
| | - Srijana Singh
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal
| | - Amit Khadgi
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal
| | - Sameera Thapa
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal
| | | | - Anmol Shrestha
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal
| | - Surendra Madhup
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal
| | | | | | - Tarun Saluja
- International Vaccine Institute, Seoul, Republic of Korea
| | | | - Rajeev Shrestha
- Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal
| |
Collapse
|
2
|
Agarwal N, Gupta N, Nishant, H S S, Dutta T, Mahajan M. Typhoid Conjugate Vaccine: A Boon for Endemic Regions. Cureus 2024; 16:e56454. [PMID: 38650789 PMCID: PMC11034893 DOI: 10.7759/cureus.56454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/25/2024] Open
Abstract
Typhoid fever has the highest disease burden in countries in low- and middle-income countries, primarily located in Asia and Sub-Saharan Africa. Previous typhoid vaccines such as the live attenuated typhoid (Ty21a) vaccine and Vi (virulence) capsular polysaccharide vaccine had the limitation that they could not be administered with other standard childhood immunizations and were ineffective in children under two years of age. To address these shortcomings of the previous vaccines, typhoid conjugate vaccines (TCVs) were developed and prequalified by the World Health Organization. Cross-reacting material and tetanus toxoid are widely used as carrier proteins in TCVs. According to various studies, TCV has higher efficacy, has a more extended protection period, and is safe and immunogenic in infants as young as six months. This review article aims to comprehensively appraise the data available on TCVs' efficacy, duration of protection, safety, and immunogenicity in endemic regions.
Collapse
Affiliation(s)
- Nitesh Agarwal
- Department of Pediatrics, Southern Gem Hospital, Hyderabad, IND
| | - Naveen Gupta
- Department of Pediatrics, Happy Family Hospital, Karnal, IND
| | - Nishant
- Department of Pediatrics, Nihan Medical Children Hospital, Patna, IND
| | - Surendra H S
- Department of Pediatrics, Natus Women and Children Hospital, Bengaluru, IND
| | - Trayambak Dutta
- Department of Infectious Disease, Zydus Lifesciences, Ahmedabad, IND
| | | |
Collapse
|
3
|
Molina Estupiñan JL, Aradottir Pind AA, Foroutan Pajoohian P, Jonsdottir I, Bjarnarson SP. The adjuvants dmLT and mmCT enhance humoral immune responses to a pneumococcal conjugate vaccine after both parenteral or mucosal immunization of neonatal mice. Front Immunol 2023; 13:1078904. [PMID: 36741402 PMCID: PMC9896006 DOI: 10.3389/fimmu.2022.1078904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/12/2022] [Indexed: 01/21/2023] Open
Abstract
Immaturity of the neonatal immune system contributes to increased susceptibility to infectious diseases and poor vaccine responses. Therefore, better strategies for early life vaccination are needed. Adjuvants can enhance the magnitude and duration of immune responses. In this study we assessed the effects of the adjuvants dmLT and mmCT and different immunization routes, subcutaneous (s.c.) and intranasal (i.n.), on neonatal immune response to a pneumococcal conjugate vaccine Pn1-CRM197. Pn1-specific antibody (Ab) levels of neonatal mice immunized with Pn1-CRM197 alone were low. The adjuvants enhanced IgG Ab responses up to 8 weeks after immunization, more after s.c. than i.n. immunization. On the contrary, i.n. immunization with either adjuvant enhanced serum and salivary IgA levels more than s.c. immunization. In addition, both dmLT and mmCT enhanced germinal center formation and accordingly, dmLT and mmCT enhanced the induction and persistence of Pn1-specific IgG+ Ab-secreting cells (ASCs) in spleen and bone marrow (BM), irrespective of the immunization route. Furthermore, i.n. immunization enhanced Pn1-specific IgA+ ASCs in BM more than s.c. immunizatiofimmu.2022.1078904n. However, a higher i.n. dose of the Pn1-CRM197 was needed to achieve IgG response comparable to that elicited by s.c. immunization with either adjuvant. We conclude that dmLT and mmCT enhance both induction and persistence of the neonatal immune response to the vaccine Pn1-CRM197, following mucosal or parenteral immunization. This indicates that dmLT and mmCT are promising adjuvants for developing safe and effective early life vaccination strategies.
Collapse
Affiliation(s)
- Jenny Lorena Molina Estupiñan
- Department of Immunology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Audur Anna Aradottir Pind
- Department of Immunology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Poorya Foroutan Pajoohian
- Department of Immunology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Ingileif Jonsdottir
- Department of Immunology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Stefania P. Bjarnarson
- Department of Immunology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland,*Correspondence: Stefania P. Bjarnarson,
| |
Collapse
|
4
|
Capeding MR, Sil A, Tadesse BT, Saluja T, Teshome S, Alberto E, Kim DR, Park EL, Park JY, Yang JS, Chinaworapong S, Park J, Jo SK, Chon Y, Yang SY, Ryu JH, Cheong I, Shim KY, Lee Y, Kim H, Lynch JA, Kim JH, Excler JL, Wartel TA, Sahastrabuddhe S. Safety and immunogenicity of Vi-DT conjugate vaccine among 6-23-month-old children: Phase II, randomized, dose-scheduling, observer-blind Study. EClinicalMedicine 2020; 27:100540. [PMID: 33150320 PMCID: PMC7599314 DOI: 10.1016/j.eclinm.2020.100540] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/13/2020] [Accepted: 08/21/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Typhoid causes significant mortality among young children in resource-limited settings. Conjugate typhoid vaccines could significantly reduce typhoid-related child deaths, but only one WHO-prequalified typhoid conjugate vaccine exists for young children. To address this gap, we investigated the safety, immunogenicity and dose-scheduling of Vi-DT typhoid conjugate vaccine among children aged 6-23 months. METHODS In this single center, observer blind, phase II trial, participants were randomly assigned (2:2:1) to receive one or two doses of Vi-DT or comparator vaccine. Anti-Vi IgG titer and geometric mean titers (GMT) were determined at 0, 4, 24 and 28 weeks. Data were analyzed using per-protocol and immunogenicity (a subset of intention-to-treat analysis) sets. The trial is registered with ClinicalTrials.gov (NCT03527355). FINDINGS Between April and July 2018, 285 children were randomized; 114 received one or two doses of Vi-DT while 57 received comparator. 277 completed the study follow-up per protocol; 112 and 110 from single- and two-dose Vi-DT schedules, respectively and 55 from the placebo group were included in the per protocol analysis. Safety profile is satisfactory. Thirteen serious adverse events were reported during the 28-week follow-up, none of which were related to Vi-DT. The seroconversion rate four weeks after the first dose was 100% (95% CI 98·3-100) in Vi-DT recipients and 7·0% (95% CI 2·8-16·7) in comparator recipients (p<0·0001). Similarly, the seroconversion rate 4 weeks after the second dose was 98·2% (95% CI 93· 6-99·5) and 21·8% (95% CI 13·0-34·4) among Vi-DT and comparator groups, respectively (p<0·0001). Anti-Vi IgG GMT was significantly higher in Vi-DT than in control group at all post-vaccination visits (p<0·0001). INTERPRETATION Both single and two doses of Vi-DT vaccine are safe, well tolerated, and immunogenic for infants and toddlers in a moderately endemic setting.
Collapse
Affiliation(s)
| | - Arijit Sil
- International Vaccine Institute, Seoul, Republic of Korea
| | | | - Tarun Saluja
- International Vaccine Institute, Seoul, Republic of Korea
| | | | - Edison Alberto
- Research Institute for Tropical Medicine, Manila, The Philippines
| | - Deok Ryun Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | | | - Ju Yeon Park
- International Vaccine Institute, Seoul, Republic of Korea
| | - Jae Seung Yang
- International Vaccine Institute, Seoul, Republic of Korea
| | | | - Jiwook Park
- International Vaccine Institute, Seoul, Republic of Korea
| | - Sue-Kyoung Jo
- International Vaccine Institute, Seoul, Republic of Korea
| | - Yun Chon
- International Vaccine Institute, Seoul, Republic of Korea
| | | | | | | | | | | | - Hun Kim
- SK bioscience, Seoul, Republic of Korea
| | - Julia A Lynch
- International Vaccine Institute, Seoul, Republic of Korea
| | - Jerome H Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | | | - T Anh Wartel
- International Vaccine Institute, Seoul, Republic of Korea
| | | |
Collapse
|
5
|
Sahastrabuddhe S, Saluja T. Overview of the Typhoid Conjugate Vaccine Pipeline: Current Status and Future Plans. Clin Infect Dis 2020; 68:S22-S26. [PMID: 30767002 PMCID: PMC6376107 DOI: 10.1093/cid/ciy884] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Typhoid fever remains a common and serious disease in populations that live in low- and middle-income countries. Treatment usually consists of antibiotics, but problems with drug-resistant strains have been increasing in endemic countries, making treatment prolonged and costly. Improved sanitation and food hygiene have been effective in controlling the disease in the industrialized world, but these steps are associated with socioeconomic progress that has been slow in most of the affected areas. Therefore, vaccination is an effective way to prevent the disease for the short to medium term. Oral typhoid vaccine and Vi polysaccharide typhoid vaccine (Vi polysaccharide) have been available for many years, yet a large population, in particular infants and children aged <2 years, remains at higher risk. Recently, with the availability of Vi polysaccharide–based conjugate vaccines and funding to support vaccination from the Gavi alliance, there is great momentum for typhoid prevention efforts. Supply of the vaccine will be critical, and there are multiple efforts to make new typhoid vaccines accessible and available to populations that desperately need them.
Collapse
Affiliation(s)
| | - Tarun Saluja
- International Vaccine Institute, Seoul, Republic of Korea
| |
Collapse
|
6
|
Karimi Bavandpour A, Bakhshi B, Najar-Peerayeh S. The roles of mesoporous silica and carbon nanoparticles in antigen stability and intensity of immune response against recombinant subunit B of cholera toxin in a rabbit animal model. Int J Pharm 2019; 573:118868. [PMID: 31765785 DOI: 10.1016/j.ijpharm.2019.118868] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 11/09/2019] [Accepted: 11/11/2019] [Indexed: 01/21/2023]
Abstract
Vaccines are the front line in the fight against diseases. However, setbacks with existing cholera vaccines have ignited a considerable effort to develop more suitable vaccine formulations. In this study, we aim to investigate the effect of antigen stability and controlled release in inducing an immune response. Therefore, two types of silica and carbon mesoporous nanoparticles of the same size and shape but different pore architectures were synthesized and loaded with recombinant cholera toxin subunit B to serve as a model for antigen stability and controlled release of antigenic CTB. In order to evaluate immune response efficacy for these model formulations, IgG and IgA responses and fluid accumulation (FA) index were measured in immunized rabbits, which were challenged with wild-type Vibrio cholerae. Our result suggests that mesoporous silica nanoparticles have greater efficacy in inducing mucosal immune responses, and it proved more proficiency in overall immune responses in challenge experiments and FA index (p < 0.05). These findings indicate that mesoporous nanoparticles and, in particular, mesoporous silica nanoparticles, could be used in oral vaccine formulation against cholera.
Collapse
Affiliation(s)
- Ali Karimi Bavandpour
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Bita Bakhshi
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Shahin Najar-Peerayeh
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| |
Collapse
|
7
|
Capeding MR, Alberto E, Sil A, Saluja T, Teshome S, Kim DR, Park JY, Yang JS, Chinaworapong S, Park J, Jo SK, Chon Y, Yang SY, Ham DS, Ryu JH, Lynch J, Kim JH, Kim H, Excler JL, Wartel TA, Sahastrabuddhe S. Immunogenicity, safety and reactogenicity of a Phase II trial of Vi-DT typhoid conjugate vaccine in healthy Filipino infants and toddlers: A preliminary report. Vaccine 2019; 38:4476-4483. [PMID: 31585725 PMCID: PMC7273193 DOI: 10.1016/j.vaccine.2019.09.074] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 09/20/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Typhoid fever remains an important public health problem in developing countries and is endemic in many parts of Asia and Africa where the incidence of disease typically peaks in school-aged children. Age restrictions and other limitations of existing oral live-attenuated typhoid and parenteral Vi polysaccharide vaccines have triggered the development of Vi conjugate vaccines with improved immunological properties, use in younger age range, and longer durability of protection. We present the safety, reactogenicity, and immunogenicity data from a Phase II study after a single dose of Vi polysaccharide conjugated to diphtheria toxoid (Vi-DT) conducted in 6-23-month old Filipino children. METHODS This is a randomized, observer-blinded Phase II study to assess the immunogenicity, safety and reactogenicity of Vi-DT compared to placebo, conducted in Muntinlupa City, The Philippines. Participants aged 6-23 months were enrolled and randomized to Vi-DT (25 µg) or placebo (0.9% sodium chloride) and evaluated for immunogenicity and overall safety 28 days post vaccination. RESULTS A total of 285 participants were enrolled and age-stratified: 6 to < 9 months, 9-12 months, and 13-23 months. Seventy-six (76) participants received Vi-DT and 19 received placebo per each strata. All participants seroconverted after a single dose of Vi-DT versus 7% of placebo recipients. Anti-Vi IgG GMT was 444.38 [95% CI (400.28; 493.34)] after a single dose of Vi-DT; there was no change in GMT after placebo administration, 0.41 [95% CI (0.33; 0.51), p < 0.0001]. A similar pattern of immunogenicity was reported across all age strata. The vaccine reported to be safe and well tolerated. CONCLUSIONS Vi-DT vaccine was immunogenic, safe, and well tolerated in children aged 6-23 months. ClinicalTrials.gov registration number: NCT03527355.
Collapse
Affiliation(s)
| | - Edison Alberto
- Research Institute for Tropical Medicine, Manila, Philippines
| | - Arijit Sil
- International Vaccine Institute, Seoul, Republic of Korea
| | - Tarun Saluja
- International Vaccine Institute, Seoul, Republic of Korea.
| | - Samuel Teshome
- International Vaccine Institute, Seoul, Republic of Korea
| | - Deok Ryun Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Ju Yeon Park
- International Vaccine Institute, Seoul, Republic of Korea
| | - Jae Seung Yang
- International Vaccine Institute, Seoul, Republic of Korea
| | | | - Jiwook Park
- International Vaccine Institute, Seoul, Republic of Korea
| | - Sue-Kyoung Jo
- International Vaccine Institute, Seoul, Republic of Korea
| | - Yun Chon
- International Vaccine Institute, Seoul, Republic of Korea
| | | | | | | | - Julia Lynch
- International Vaccine Institute, Seoul, Republic of Korea
| | - Jerome H Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Hun Kim
- SK Bioscience, Seoul, Republic of Korea
| | | | - T Anh Wartel
- International Vaccine Institute, Seoul, Republic of Korea
| | | |
Collapse
|
8
|
Aradottir Pind AA, Dubik M, Thorsdottir S, Meinke A, Harandi AM, Holmgren J, Del Giudice G, Jonsdottir I, Bjarnarson SP. Adjuvants Enhance the Induction of Germinal Center and Antibody Secreting Cells in Spleen and Their Persistence in Bone Marrow of Neonatal Mice. Front Immunol 2019; 10:2214. [PMID: 31616417 PMCID: PMC6775194 DOI: 10.3389/fimmu.2019.02214] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 09/02/2019] [Indexed: 12/16/2022] Open
Abstract
Immaturity of the immune system contributes to poor vaccine responses in early life. Germinal center (GC) activation is limited due to poorly developed follicular dendritic cells (FDC), causing generation of few antibody-secreting cells (ASCs) with limited survival and transient antibody responses. Herein, we compared the potential of five adjuvants, namely LT-K63, mmCT, MF59, IC31, and alum to overcome limitations of the neonatal immune system and to enhance and prolong responses of neonatal mice to a pneumococcal conjugate vaccine Pnc1-TT. The adjuvants LT-K63, mmCT, MF59, and IC31 significantly enhanced GC formation and FDC maturation in neonatal mice when co-administered with Pnc1-TT. This enhanced GC induction correlated with significantly enhanced vaccine-specific ASCs by LT-K63, mmCT, and MF59 in spleen 14 days after immunization. Furthermore, mmCT, MF59, and IC31 prolonged the induction of vaccine-specific ASCs in spleen and increased their persistence in bone marrow up to 9 weeks after immunization, as previously shown for LT-K63. Accordingly, serum Abs persisted above protective levels against pneumococcal bacteremia and pneumonia. In contrast, alum only enhanced the primary induction of vaccine-specific IgG Abs, which was transient. Our comparative study demonstrated that, in contrast to alum, LT-K63, mmCT, MF59, and IC31 can overcome limitations of the neonatal immune system and enhance both induction and persistence of protective immune response when administered with Pnc1-TT. These adjuvants are promising candidates for early life vaccination.
Collapse
Affiliation(s)
- Audur Anna Aradottir Pind
- Department of Immunology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Magdalena Dubik
- Department of Immunology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Sigrun Thorsdottir
- Department of Immunology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | | | - Ali M Harandi
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Vaccine Evaluation Center, BC Children's Hospital Research Institute, The University of British Columbia, Vancouver, BC, Canada
| | - Jan Holmgren
- Department of Microbiology and Immunology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Vaccine Research Institute (GUVAX), Department of Microbiology and Immunology, University of Gothenburg, Gothenburg, Sweden
| | | | - Ingileif Jonsdottir
- Department of Immunology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,deCODE Genetics/Amgen, Reykjavík, Iceland
| | - Stefania P Bjarnarson
- Department of Immunology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| |
Collapse
|
9
|
Prasanna M, Soulard D, Camberlein E, Ruffier N, Lambert A, Trottein F, Csaba N, Grandjean C. Semisynthetic glycoconjugate based on dual role protein/PsaA as a pneumococcal vaccine. Eur J Pharm Sci 2018; 129:31-41. [PMID: 30572107 DOI: 10.1016/j.ejps.2018.12.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/02/2018] [Accepted: 12/15/2018] [Indexed: 11/15/2022]
Abstract
Pneumococcal infections remain a major public health concern worldwide. The currently available vaccines in the market are based on pneumococcal capsular polysaccharides but they still need to be improved to secure an optimal coverage notably in population at risk. To circumvent this, association of virulence pneumococcal proteins to the polysaccharide valencies has been proposed with the hope to observe an additive - if not synergistic - protective effect. Along this line, the use of the highly conserved and ubiquitous pneumococcal surface adhesin A (PsaA) as a protein carrier for a synthetic pneumococcal oligosaccharide is demonstrated herein for the first time. A tetrasaccharide mimicking functional antigenic determinants from the S. pneumoniae serotype 14 capsular polysaccharide (Pn14TS) was chemically synthesised. The mature PsaA (mPsaA) was expressed in E. coli and purified using affinity chromatography. The Pn14PS was conjugated to mPsaA using maleimide-thiol coupling chemistry to obtain mPsaA-Pn14PS conjugate (protein/sugar molar ratio: 1/5.4). The mPsaA retained the structural conformation after the conjugation and lyophilisation. The prepared glycoconjugate adjuvanted with α-galactosylceramide, a potent activator of invariant Natural Killer T cells, was tested in mice for its immunological response upon subcutaneous injection in comparison with mPsaA alone and a model BSA conjugate (BSA-Pn14PS, used here as a control). Mice immunised with the mPsaA-Pn14TS produced a robust IgG response against mPsaA and against the capsular polysaccharide from pneumococcal serotype 14. These data provide the basis for novel pneumococcal vaccine development.
Collapse
Affiliation(s)
- Maruthi Prasanna
- Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Health Research Institute of Santiago de Compostela (IDIS), Dept. of Pharmacology, Pharmacy and Pharmaceutical Technology, School of Pharmacy, Univ. of Santiago de Compostela, 15872 Santiago de Compostela, Spain; Unité Fonctionnalité et Ingénierie des Protéines (UFIP), UMR CNRS 6286, Université de Nantes, 2 rue de la Houssinière, BP92208, 44322 Nantes Cedex, France
| | - Daphnée Soulard
- Centre d'Infection et d'Immunité de Lille, Inserm U1019, CNRS UMR 8204, Université de Lille, CHU Lille, Institut Pasteur de Lille, 59000 Lille, France
| | - Emilie Camberlein
- Unité Fonctionnalité et Ingénierie des Protéines (UFIP), UMR CNRS 6286, Université de Nantes, 2 rue de la Houssinière, BP92208, 44322 Nantes Cedex, France
| | - Nicolas Ruffier
- Unité Fonctionnalité et Ingénierie des Protéines (UFIP), UMR CNRS 6286, Université de Nantes, 2 rue de la Houssinière, BP92208, 44322 Nantes Cedex, France
| | - Annie Lambert
- Unité Fonctionnalité et Ingénierie des Protéines (UFIP), UMR CNRS 6286, Université de Nantes, 2 rue de la Houssinière, BP92208, 44322 Nantes Cedex, France
| | - François Trottein
- Centre d'Infection et d'Immunité de Lille, Inserm U1019, CNRS UMR 8204, Université de Lille, CHU Lille, Institut Pasteur de Lille, 59000 Lille, France
| | - Noemi Csaba
- Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Health Research Institute of Santiago de Compostela (IDIS), Dept. of Pharmacology, Pharmacy and Pharmaceutical Technology, School of Pharmacy, Univ. of Santiago de Compostela, 15872 Santiago de Compostela, Spain
| | - Cyrille Grandjean
- Unité Fonctionnalité et Ingénierie des Protéines (UFIP), UMR CNRS 6286, Université de Nantes, 2 rue de la Houssinière, BP92208, 44322 Nantes Cedex, France.
| |
Collapse
|
10
|
Capeding MR, Teshome S, Saluja T, Syed KA, Kim DR, Park JY, Yang JS, Kim YH, Park J, Jo SK, Chon Y, Kothari S, Yang SY, Ham DS, Ryu JH, Hwang HS, Mun JH, Lynch JA, Kim JH, Kim H, Excler JL, Sahastrabuddhe S. Safety and immunogenicity of a Vi-DT typhoid conjugate vaccine: Phase I trial in Healthy Filipino adults and children. Vaccine 2018; 36:3794-3801. [PMID: 29776750 PMCID: PMC6005168 DOI: 10.1016/j.vaccine.2018.05.038] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/03/2018] [Accepted: 05/07/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Typhoid fever remains a major public health problem in low- and middle-income countries where children aged 2-14 years bear the greatest burden. Vi polysaccharide is poorly immunogenic in children <2 years of age, and protection in adults is modest. The limitations of Vi polysaccharide vaccines can be overcome by conjugation of the Vi to a carrier protein. A typhoid conjugate vaccine composed of Vi polysaccharide conjugated to diphtheria toxoid (Vi-DT) has been developed. The Phase I study results are presented here. METHODS This was a randomized, observer-blinded Phase I study to assess the safety and immunogenicity of Vi-DT compared to Vi polysaccharide vaccine, conducted in Manila, Philippines. Participants enrolled in an age de-escalation manner (18-45, 6-17 and 2-5 years) were randomized between Test (Vi-DT, 25 µg) administered at 0 and 4 weeks and Comparator (Vi polysaccharide, Typhim Vi® and Vaxigrip®, Sanofi Pasteur) vaccines. RESULTS A total of 144 participants were enrolled (48 by age strata, 24 in Test and Comparator groups each). No serious adverse event was reported in either group. Solicited and unsolicited adverse events were mild or moderate in both groups with the exception of a 4-year old girl in Test group with grade 3 fever which resolved without sequelae. All participants in Test group seroconverted after first and second doses of Vi-DT while the proportions in the Comparator group were 97.1% and 97.2%, after first dose of Typhim Vi® and second dose of Vaxigrip®, respectively. Vi-DT showed 4-fold higher Geometric Mean Titers (GMT) compared to Typhim Vi® (adjusted for age strata, p < 0.001). No further increase of GMT was detected after the second dose of Vi-DT. Anti-DT IgG seroresponse rates were 81.2% and 84.5% post first and second Vi-DT doses, respectively. CONCLUSIONS Vi-DT vaccine was safe, well-tolerated and immunogenic in participants aged 2-45 years. ClinicalTrials.gov registration number: NCT02645032.
Collapse
Affiliation(s)
| | - Samuel Teshome
- International Vaccine Institute, Seoul, Republic of Korea
| | - Tarun Saluja
- International Vaccine Institute, Seoul, Republic of Korea.
| | | | - Deok Ryun Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Ju Yeon Park
- International Vaccine Institute, Seoul, Republic of Korea
| | - Jae Seung Yang
- International Vaccine Institute, Seoul, Republic of Korea
| | - Yang Hee Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Jiwook Park
- International Vaccine Institute, Seoul, Republic of Korea
| | - Sue-Kyoung Jo
- International Vaccine Institute, Seoul, Republic of Korea
| | - Yun Chon
- International Vaccine Institute, Seoul, Republic of Korea
| | - Sudeep Kothari
- International Vaccine Institute, Seoul, Republic of Korea
| | | | | | | | | | | | - Julia A Lynch
- International Vaccine Institute, Seoul, Republic of Korea
| | - Jerome H Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | - Hun Kim
- SK Chemicals, Seoul, Republic of Korea
| | | | | |
Collapse
|
11
|
Pérez-Toledo M, Valero-Pacheco N, Pastelin-Palacios R, Gil-Cruz C, Perez-Shibayama C, Moreno-Eutimio MA, Becker I, Pérez-Tapia SM, Arriaga-Pizano L, Cunningham AF, Isibasi A, Bonifaz LC, López-Macías C. Salmonella Typhi Porins OmpC and OmpF Are Potent Adjuvants for T-Dependent and T-Independent Antigens. Front Immunol 2017; 8:230. [PMID: 28337196 PMCID: PMC5344031 DOI: 10.3389/fimmu.2017.00230] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 02/17/2017] [Indexed: 02/05/2023] Open
Abstract
Several microbial components, such as bacterial DNA and flagellin, have been used as experimental vaccine adjuvants because of their inherent capacity to efficiently activate innate immune responses. Likewise, our previous work has shown that the major Salmonella Typhi (S. Typhi) outer membrane proteins OmpC and OmpF (porins) are highly immunogenic protective antigens that efficiently stimulate innate and adaptive immune responses in the absence of exogenous adjuvants. Moreover, S. Typhi porins induce the expression of costimulatory molecules on antigen-presenting cells through toll-like receptor canonical signaling pathways. However, the potential of major S. Typhi porins to be used as vaccine adjuvants remains unknown. Here, we evaluated the adjuvant properties of S. Typhi porins against a range of experimental and clinically relevant antigens. Co-immunization of S. Typhi porins with ovalbumin (OVA), an otherwise poorly immunogenic antigen, enhanced anti-OVA IgG titers, antibody class switching, and affinity maturation. This adjuvant effect was dependent on CD4+ T-cell cooperation and was associated with an increase in IFN-γ, IL-17A, and IL-2 production by OVA-specific CD4+ T cells. Furthermore, co-immunization of S. Typhi porins with an inactivated H1N1 2009 pandemic influenza virus experimental vaccine elicited higher hemagglutinating anti-influenza IgG titers, antibody class switching, and affinity maturation. Unexpectedly, co-administration of S. Typhi porins with purified, unconjugated Vi capsular polysaccharide vaccine (Vi CPS)—a T-independent antigen—induced higher IgG antibody titers and class switching. Together, our results suggest that S. Typhi porins OmpC and OmpF are versatile vaccine adjuvants, which could be used to enhance T-cell immune responses toward a Th1/Th17 profile, while improving antibody responses to otherwise poorly immunogenic T-dependent and T-independent antigens.
Collapse
Affiliation(s)
- Marisol Pérez-Toledo
- Medical Research Unit on Immunochemistry, Specialties Hospital, National Medical Centre "Siglo XXI", Mexican Social Security Institute, Mexico City, Mexico; Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Nuriban Valero-Pacheco
- Medical Research Unit on Immunochemistry, Specialties Hospital, National Medical Centre "Siglo XXI", Mexican Social Security Institute, Mexico City, Mexico; Departamento de Inmunología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | | | - Cristina Gil-Cruz
- Institute of Immunobiology, Kantonsspital St. Gallen , St. Gallen , Switzerland
| | | | - Mario A Moreno-Eutimio
- Immunity and Inflammation Research Unit, Hospital Juárez de México, Ministry of Health , Mexico City , Mexico
| | - Ingeborg Becker
- Facultad de Medicina, Departamento de Medicina Experimental, Universidad Nacional Autónoma de México , Mexico City , Mexico
| | - Sonia Mayra Pérez-Tapia
- Unit of R&D in Bioprocesses (UDIBI), Department of Immunology, National School of Biological Sciences, National Polytechnic Institute , Mexico City , Mexico
| | - Lourdes Arriaga-Pizano
- Medical Research Unit on Immunochemistry, Specialties Hospital, National Medical Centre "Siglo XXI", Mexican Social Security Institute , Mexico City , Mexico
| | - Adam F Cunningham
- MRC Centre for Immune Regulation, College of Medical and Dental Sciences, Institute of Immunology and Immunotherapy, University of Birmingham , Birmingham , UK
| | - Armando Isibasi
- Medical Research Unit on Immunochemistry, Specialties Hospital, National Medical Centre "Siglo XXI", Mexican Social Security Institute , Mexico City , Mexico
| | - Laura C Bonifaz
- Medical Research Unit on Immunochemistry, Specialties Hospital, National Medical Centre "Siglo XXI", Mexican Social Security Institute , Mexico City , Mexico
| | - Constantino López-Macías
- Medical Research Unit on Immunochemistry, Specialties Hospital, National Medical Centre "Siglo XXI", Mexican Social Security Institute, Mexico City, Mexico; Nuffield Department of Medicine, University of Oxford, Oxford, UK
| |
Collapse
|
12
|
C3d adjuvant effects are mediated through the activation of C3d-specific autoreactive T cells. Immunol Cell Biol 2014; 93:189-97. [PMID: 25385064 PMCID: PMC4323994 DOI: 10.1038/icb.2014.89] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 09/12/2014] [Accepted: 09/12/2014] [Indexed: 01/08/2023]
Abstract
Complement fragment C3d covalently attached to antigens enhances immune responses, particularly for antigens lacking T cell epitopes. Enhancement has been attributed to receptor cross-linking between complement receptor CR2 (CD21) and polysaccharide antigen to surface IgM on naïve B cells. Paradoxically, C3d has still been shown to increase immune responses in CD21 KO mice, suggesting that an auxiliary activation pathway exists. In prior studies, we demonstrated the CD21-independent C3d adjuvant effect might be due to T cell recognition of C3d T helper epitopes processed and presented by MHC class II on the B cell surface. C3d peptide sequences containing concentrated clusters of putative human C3 T cell epitopes were identified using the epitope-mapping algorithm, EpiMatrix. These peptide sequences were synthesized and shown in vitro to bind multiple HLA-DR alleles with high affinity, and induce IFNγ responses in healthy donor PBMCs. In the present studies, we establish further correlations between HLA binding and HLA-specific lymphocyte reactions with select epitope clusters. Additionally, we show that the T cell phenotype of C3d-specific reactive T cells is CD4+CD45RO+ memory T cells. Finally, mutation of a single T cell epitope residing within the P28 peptide segment of C3d resulted in significantly diminished adjuvant activity in BALB/c mice. Collectively, these studies support the hypothesis that the paradoxical enhancement of immune responses by C3d in the absence of CD21 is due to internalization and processing of C3d into peptides that activate autoreactive CD4+ T helper cells in the context of HLA class II.
Collapse
|
13
|
Patel GB, Chen W. Archaeal lipid mucosal vaccine adjuvant and delivery system. Expert Rev Vaccines 2014; 9:431-40. [DOI: 10.1586/erv.10.34] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
14
|
Pérez O, Romeu B, Cabrera O, González E, Batista-Duharte A, Labrada A, Pérez R, Reyes LM, Ramírez W, Sifontes S, Fernández N, Lastre M. Adjuvants are Key Factors for the Development of Future Vaccines: Lessons from the Finlay Adjuvant Platform. Front Immunol 2013; 4:407. [PMID: 24348475 PMCID: PMC3845353 DOI: 10.3389/fimmu.2013.00407] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 11/10/2013] [Indexed: 11/13/2022] Open
Abstract
The development of effective vaccines against neglected diseases, especially those associated with poverty and social deprivation, is urgently needed. Modern vaccine technologies and a better understanding of the immune response have provided scientists with the tools for rational and safer design of subunit vaccines. Often, however, subunit vaccines do not elicit strong immune responses, highlighting the need to incorporate better adjuvants; this step therefore becomes a key factor for vaccine development. In this review we outline some key features of modern vaccinology that are linked with the development of better adjuvants. In line with the increased desire to obtain novel adjuvants for future vaccines, the Finlay Adjuvant Platform offers a novel approach for the development of new and effective adjuvants. The Finlay Adjuvants (AFs), AFPL (proteoliposome), and AFCo (cochleate), were initially designed for parenteral and mucosal applications, and constitute potent adjuvants for the induction of Th1 responses against several antigens. This review summarizes the status of the Finlay technology in producing promising adjuvants for unsolved-vaccine diseases including mucosal approaches and therapeutic vaccines. Ideas related to adjuvant classification, adjuvant selection, and their possible influence on innate recognition via multiple toll-like receptors are also discussed.
Collapse
Affiliation(s)
- Oliver Pérez
- Immunology Department, Research and Development Vice-presidency, Finlay Institute , Havana , Cuba ; Havana Medical Sciences University , Havana , Cuba
| | - Belkis Romeu
- Immunology Department, Research and Development Vice-presidency, Finlay Institute , Havana , Cuba
| | - Osmir Cabrera
- Immunology Department, Research and Development Vice-presidency, Finlay Institute , Havana , Cuba
| | - Elizabeth González
- Immunology Department, Research and Development Vice-presidency, Finlay Institute , Havana , Cuba
| | - Alexander Batista-Duharte
- Toxicology and Biomedicine Center (TOXIMED), Medical Sciences University Santiago de Cuba , Santiago de Cuba , Cuba
| | - Alexis Labrada
- Centro Nacional de Biopreparados (BioCen) , Mayabeque , Cuba
| | - Rocmira Pérez
- Immunology Department, Research and Development Vice-presidency, Finlay Institute , Havana , Cuba
| | - Laura M Reyes
- Immunology Department, Research and Development Vice-presidency, Finlay Institute , Havana , Cuba
| | - Wendy Ramírez
- Centro Nacional de Biopreparados (BioCen) , Mayabeque , Cuba
| | - Sergio Sifontes
- Centro de Bioactivos Químicos (CBQ), Universidad Central Marta Abreu de Las Villas , Villa Clara , Cuba
| | | | - Miriam Lastre
- Immunology Department, Research and Development Vice-presidency, Finlay Institute , Havana , Cuba
| |
Collapse
|
15
|
Yang J, Zhong M, Zhang Y, Zhang E, Sun Y, Cao Y, Li Y, Zhou D, He B, Chen Y, Yang Y, Yu J, Yan H. Antigen replacement of domains D2 and D3 in flagellin promotes mucosal IgA production and attenuates flagellin-induced inflammatory response after intranasal immunization. Hum Vaccin Immunother 2013; 9:1084-92. [PMID: 23377752 DOI: 10.4161/hv.23809] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Targeting early infection in mucosal sites is one of the primary goals for mucosal vaccines so as to prevent pathogen mucosal transmission and infection. The TLR5 agonist flagellin was deemed to be a mucosal adjuvant candidate for clinical usage. However, the high antigenicity of flagellin and the possible inflammatory injury induced by flagellin might restrict its clinical usage. Here HIV-1 p24 protein was selected as an antigen model and we replaced the main antigenicity region domains D2 and D3 of non-pathogenic E.coli-derived flagellin (KF). The derived soluble protein KFD-p24 3D was then compared with KF-p24, which fused p24 directly to the C-terminal of KF. In vitro and ex vivo experiments showed that KFD-p24 3D has lower TLR5 agonist efficacy and less immunocyte-activating efficacy. Interestingly, the production of KF- specific antibody was highly reduced, and KFD-p24 3D induced IgA-biased antibody responses in mucosal sites. Moreover, KFD-p24 3D induced far fewer systemic inflammatory responses and abrogated detectable inflammatory side effects on mice, even at the high dose. The properties of enhanced IgA generation and attenuated inflammatory responses broaden the safe-dose range of KFD-p24 3D flagellin, creating a potentially promising mucosal adjuvant.
Collapse
Affiliation(s)
- Jingyi Yang
- Mucosal Immunity Research Group; State Key Laboratory of Virology; Wuhan Institute of Virology; Chinese Academy of Sciences; Wuhan, P.R. China
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
van den Biggelaar AHJ, Pomat WS. Immunization of newborns with bacterial conjugate vaccines. Vaccine 2012; 31:2525-30. [PMID: 22728221 DOI: 10.1016/j.vaccine.2012.06.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Revised: 05/20/2012] [Accepted: 06/06/2012] [Indexed: 11/29/2022]
Abstract
Bacterial conjugate vaccines are based on the principle of coupling immunogenic bacterial capsular polysaccharides to a carrier protein to facilitate the induction of memory T-cell responses. Following the success of Haemophilus influenzae type b conjugate vaccines in the 1980s, conjugate vaccines for Streptococcus pneumoniae and Neisseria meningitidis infections were developed and proven to be effective in protecting children against invasive disease. In this review, the use of conjugate vaccines in human newborns is discussed. Neonatal Haemophilus influenzae type b and pneumococcal conjugate vaccination schedules have been trialed and proven to be safe, with the majority of studies demonstrating no evidence for the induction of immune tolerance. Whether their neonatal administration also results in an earlier induction of clinical protection in the first 2-3 critical months of life is still to be demonstrated.
Collapse
Affiliation(s)
- Anita H J van den Biggelaar
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, PO Box 855, West Perth, WA 6872, Australia.
| | | |
Collapse
|
17
|
Wang T, Jiang H, Zhao Q, Wang S, Zou M, Cheng G. Enhanced mucosal and systemic immune responses obtained by porous silica nanoparticles used as an oral vaccine adjuvant: effect of silica architecture on immunological properties. Int J Pharm 2012; 436:351-8. [PMID: 22721849 DOI: 10.1016/j.ijpharm.2012.06.028] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Revised: 05/28/2012] [Accepted: 06/05/2012] [Indexed: 11/25/2022]
Abstract
Three different kinds of silica (S2, S1 and SBA-15) with different particle sizes (130, 430 nm and 1-2 μm) and different pore characteristics (i.e. pore size and shape) were developed as oral vaccine immunological adjuvants and the relationship between the silica architecture and immunological properties was investigated. The silica particles were characterized using SEM, TEM and nitrogen adsorption. Model antigen bovine serum albumin (BSA) was successfully entrapped into the silica pores to produce a sustained release vaccine delivery system. Compared with the responsiveness induced by parenteral administration of BSA emulsified in Freund's complete adjuvant (FCA), oral immunization with the silica/BSA formulation produced a stimulated humoral and mucosal (sIgA) response. The IgG and IgA titers induced by loading BSA was as follows: S1>S2>SBA-15. The highest IgG and IgA titers of S1 were attributed to its large honeycombed pores and the optimal particle diameter of 430 nm. The corresponding IgG1 and IgG2a titers were also investigated to confirm that BSA loaded in nanoparticles by oral immunization can induce both T-helper 1- and T-helper 2- (Th1 or Th2) mediated responses. We believe that the results of our research will open up new avenues for the formulation of oral vaccines.
Collapse
Affiliation(s)
- Tianyi Wang
- Department of Pharmaceutics, Shenyang Pharmaceutical University, P.O. Box 32, 103 Wenhua Road, Shenhe District, Shenyang, Liaoning Province 110016, PR China
| | | | | | | | | | | |
Collapse
|
18
|
Romeu B, Gonzalez E, Lastre M, Pérez O. Can mucosal adjuvants contribute to the induction of immunological memory induced via unconjugated T-cell-independent antigens? J Drug Target 2012; 20:502-8. [PMID: 22632258 DOI: 10.3109/1061186x.2012.693497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Vaccination remains the most cost-effective method for preventing infectious diseases. Key to vaccine design is the development of immunological memory, which is an essential property of the adaptive immune system. Bacterial polysaccharide conjugate vaccines are the gold standard currently used to confer protection of the host by inducing humoral immune responses against T-cell-independent antigens. Conjugate vaccines are effective, but we propose that local mucosal immune responses are likely to also play an important role in inducing immunity, and they have been less explored than systemic and adaptive immune responses. Adjuvants have been used to improve the immune response to vaccine antigens, however, no mucosal adjuvant has been licensed for human use. Here we describe the recent progress in the use of mucosal adjuvants to achieve significant immune responses against T-cell-independent antigens. We also introduce the idea that studying the mechanisms that induce cell sub-populations with strong immunological memory may facilitate the design of novel vaccine formulations, in particular in cases of B-cell unresponsiveness to thymus-independent stimuli.
Collapse
Affiliation(s)
- Belkis Romeu
- Immunology Department, Research and Development, Finlay Institute, Havana, Cuba
| | | | | | | |
Collapse
|
19
|
Wang T, Zou M, Jiang H, Ji Z, Gao P, Cheng G. Synthesis of a novel kind of carbon nanoparticle with large mesopores and macropores and its application as an oral vaccine adjuvant. Eur J Pharm Sci 2011; 44:653-9. [PMID: 22064451 DOI: 10.1016/j.ejps.2011.10.012] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 10/09/2011] [Accepted: 10/21/2011] [Indexed: 11/29/2022]
Abstract
The purpose of this study is to develop a novel kind of adjuvant for oral vaccine delivery. In order to effectively prevent the degradation of antigens in the gastrointestinal tract and optimize the uptake for M cells, a novel kind of hydrophobic carbon nanoparticle (C1) with the size of 470nm was synthesized by taking silica as a template and sucrose as a carbon source. Notably, there were large mesopores and macropores mainly of 40-60nm, which made it to be excellent candidate as an antigen carrier. C1 was characterized using SEM, TEM and nitrogen adsorption. Following oral immunization with BSA loaded in C1, the IgG titer reached to a level almost equal to that of parenteral administration of antigen emulsified in Freund's complete adjuvant (FCA). Mucosal IgA was also detected in intestinal, salivary and vaginal secretions, suggesting an effective stimulation of mucosal immune response. Besides, both T-helper 1 and T-helper 2 (Th1 or Th2) mediated responses were induced. We believe that the research will help in the design of novel vaccine adjuvant for improvement their potential on modulation of immune response.
Collapse
Affiliation(s)
- Tianyi Wang
- Department of Pharmaceutics, Shenyang Pharmaceutical University, Shenyang, Liaoning Province, PR China
| | | | | | | | | | | |
Collapse
|
20
|
Patel GB, Zhou H, Ponce A, Harris G, Chen W. Intranasal immunization with an archaeal lipid mucosal vaccine adjuvant and delivery formulation protects against a respiratory pathogen challenge. PLoS One 2010; 5:e15574. [PMID: 21206916 PMCID: PMC3012068 DOI: 10.1371/journal.pone.0015574] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Accepted: 11/15/2010] [Indexed: 12/03/2022] Open
Abstract
Archaeal lipid mucosal vaccine adjuvant and delivery (AMVAD) is a safe mucosal adjuvant that elicits long lasting and memory boostable mucosal and systemic immune responses to model antigens such as ovalbumin. In this study, we evaluated the potential of the AMVAD system for eliciting protective immunity against mucosal bacterial infections, using a mouse model of intranasal Francisella tularensis LVS (LVS) challenge. Intranasal immunization of mice with cell free extract of LVS (LVSCE) adjuvanted with the AMVAD system (LVSCE/AMVAD) induced F. tularensis-specific antibody responses in sera and bronchoalveolar lavage fluids, as well as antigen-specific splenocyte proliferation and IL-17 production. More importantly, the AMVAD vaccine partially protected the mice against a lethal intranasal challenge with LVS. Compared to LVSCE immunized and naïve mice, the LVSCE/AMVAD immunized mice showed substantial to significant reduction in pathogen burdens in the lungs and spleens, reduced serum and pulmonary levels of proinflammatory cytokines/chemokines, and longer mean time to death as well as significantly higher survival rates (p<0.05). These results suggest that the AMVAD system is a promising mucosal adjuvant and vaccine delivery technology, and should be explored further for its applications in combating mucosal infectious diseases.
Collapse
Affiliation(s)
- Girishchandra B Patel
- Institute for Biological Sciences, National Research Council Canada, Ottawa, Canada.
| | | | | | | | | |
Collapse
|
21
|
Chen W, Kuolee R, Yan H. The potential of 3',5'-cyclic diguanylic acid (c-di-GMP) as an effective vaccine adjuvant. Vaccine 2010; 28:3080-5. [PMID: 20197136 DOI: 10.1016/j.vaccine.2010.02.081] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 02/12/2010] [Accepted: 02/15/2010] [Indexed: 12/27/2022]
Abstract
3', 5'-Cyclic diguanylic acid (c-di-GMP) is a bacterial intracellular signaling molecule that plays a crucial role in the regulation of bacterial motility, adhesion, cell-to-cell communication, exopolysaccharide synthesis, biofilm formation and virulence. The recent finding that c-di-GMP can act as a danger signal on eukaryotic cells has prompted the study of the immunostimulatory and immunomodulatory properties of c-di-GMP in an effort to determine whether c-di-GMP might be further developed as a potential vaccine adjuvant. In this review, we discussed the recent in vitro and in vivo studies of the immunostimulatory properties of c-di-GMP and the progress that has been made in the preclinical development of c-di-GMP as a potential vaccine adjuvant for systemic and mucosal vaccination.
Collapse
Affiliation(s)
- Wangxue Chen
- Institute for Biological Sciences, National Research Council Canada, Ottawa, Ontario, Canada.
| | | | | |
Collapse
|
22
|
Brynjolfsson SF, Bjarnarson SP, Mori E, Del Giudice G, Jonsdottir I. Neonatal immune response and serum bactericidal activity induced by a meningococcal conjugate vaccine is enhanced by LT-K63 and CpG2006. Vaccine 2008; 26:4557-62. [PMID: 18597905 DOI: 10.1016/j.vaccine.2008.05.083] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2008] [Revised: 05/13/2008] [Accepted: 05/29/2008] [Indexed: 11/20/2022]
Abstract
Neonates have a poorly developed immune system. Therefore it is important to develop vaccination strategies that induce protective immunity and immunological memory against pathogens early in life. The immunogenicity of a meningococcal serogroup C polysaccharide conjugate (MenC-CRM(197)) was assessed in neonatal mice, and effects of LT-K63 and CpG2006 and immunisation routes were compared. Neonatal mice were primed subcutaneously (s.c.) or intranasally (i.n.) with MenC-CRM(197) with or without LT-K63 or CpG2006 and re-immunised 16 and 30 days later by the same route and formulation. Antibody levels were measured and generation of immunological memory assessed by affinity maturation and kinetics of the Ab response. Serum bactericidal activity (SBA) was measured to evaluate protective efficacy. The second and third dose of MenC-CRM(197) mixed with either LT-K63 or CpG2006 induced a rapid increase in MenC-specific IgG antibodies, to levels higher than elicited by MenC-CRM(197) alone (P<0.01) and in unimmunised mice (P<0.001), indicating efficient generation of memory by priming through both s.c. and i.n. routes. SBA was detected after three s.c. immunisations with MenC-CRM(197) s.c. alone. However, only two doses of MenC-CRM(197)+LT-K63 or MenC-CRM(197)+CpG2006 were needed to induce SBA levels>16. LT-K63 and CpG2006 enhanced neonatal antibody responses, affinity maturation, immunological memory to the conjugate MenC-CRM(197) and protective immunity. These results encourage the development of neonatal vaccination strategies to induce protective immunity and immunological memory against meningococcal disease.
Collapse
|
23
|
Knopf PM, Rivera DS, Hai SH, McMurry J, Martin W, De Groot AS. Novel function of complement C3d as an autologous helper T-cell target. Immunol Cell Biol 2008; 86:221-5. [PMID: 18180801 DOI: 10.1038/sj.icb.7100147] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The C3d fragment of complement component C3 has been shown to enhance immune responses to antigens that lack T-cell epitopes such as bacterial polysaccharides. C3d binds to the B-cell complement receptor 2 (CR2 or CD21); this binding serves as a co-activation signal to the B cell when the polysaccharide antigen portion binds simultaneously to the B-cell receptor (surface Ig). Bringing together receptor-associated signal transduction molecules CD19 and Igalpha/beta, respectively, results in a lower threshold of activation. Paradoxically, C3d has also been shown to enhance antibody titers in the CD21 knockout (KO) mouse model as well as increase Th1 and Th2 cytokine secretion, suggesting that that an auxiliary CR2-independent pathway of immune activation may exist. We hypothesized that in addition to its molecular adjuvant property that enhances signal 1 during B-cell activation (co-signal 1), C3d also contains T-cell epitopes that are able to stimulate autoreactive C3d peptide-specific helper T cells which we term 'co-signal 2'. Using the EpiMatrix T-cell epitope-mapping algorithm, we identified 11 putative T-cell epitopes in C3d, a very high epitope density for a 302 amino-acid sequence. Eight of these epitope candidates were synthesized and shown to bind a variety of class II HLA-DR molecules of different haplotypes, and to stimulate C3d peptide-specific T cells to secrete pro-inflammatory cytokines in vitro. Further, we demonstrate a C3d-peptide specific increase in CD4(+) intracellular IFN-gamma(+) T cells in peripheral blood mononuclear cells (PBMCs) exposed to C3d peptides in vitro. We believe that the discovery of these autologous T cells autoreactive for C3d provides evidence supporting the 'co-signal 2' hypothesis and may offer a novel explanation of the CD21 KO paradox.
Collapse
Affiliation(s)
- Paul M Knopf
- Department of Molecular Microbiology and Immunology, Brown University, Providence, RI 02912, USA.
| | | | | | | | | | | |
Collapse
|
24
|
Mucosal and systemic immune responses by intranasal immunization using archaeal lipid-adjuvanted vaccines. Vaccine 2007; 25:8622-36. [PMID: 17959279 DOI: 10.1016/j.vaccine.2007.09.042] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2007] [Accepted: 09/19/2007] [Indexed: 10/22/2022]
Abstract
The utility of archaeal polar lipids as an adjuvant/delivery system for elicitation of antigen-specific mucosal immune responses in intranasally administered vaccines was investigated. Although unilamellar archaeosomes (liposomes made from archaeal polar lipids) with encapsulated ovalbumin (OVA/archaeosomes) induced anti-OVA IgG antibody responses in sera, they failed to induce anti-OVA IgA antibody responses at mucosal sites. However, the addition of CaCl2 to convert OVA/archaeosomes into an archaeal lipid mucosal vaccine adjuvant and delivery (AMVAD) vaccine (OVA/AMVAD) consisting of larger, particulate, aggregated structures resulted in an efficacious intranasal (i.n.) vaccine. Intranasal immunization of mice with OVA/AMVAD vaccines prepared from various archaeal polar lipid compositions elicited anti-OVA IgA antibody responses in sera, feces, bile, vaginal and nasal wash samples. The i.n. immunization also induced anti-OVA IgG, IgG1 and IgG2a antibody responses in sera, as well as cytotoxic T lymphocyte responses. The mucosal and systemic immune responses induced by OVA/AMVAD immunization were generally sustained over several months, and were subject to memory boost responses. Thus, polar archaeal lipids appear to be promising for developing a non-replicating mucosal adjuvant and vaccine delivery system.
Collapse
|
25
|
Jónsdóttir I. Maturation of Mucosal Immune Responses and Influence of Maternal Antibodies. J Comp Pathol 2007; 137 Suppl 1:S20-6. [PMID: 17559864 DOI: 10.1016/j.jcpa.2007.04.007] [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: 01/31/2023]
Abstract
The mucosae represent the primary point of contact between the major respiratory and enteric pathogens and the innate and adaptive immune response. The microanatomy and function of the mucosal immune system is now well-characterized, in particular the major effector mechanism that involves the production and translocation of secretory immunoglobulin A (IgA). Mucosal delivery of antigen has the potential to induce potent local and systemic immunity, although such responses may differ between neonatal, infant and adult mice. In younger animals mucosal immune responses are Th2 biased, whereas in adults there is a broader Th1 and Th2 responsiveness. There is much interest in the development of mucosally delivered vaccines which can be tailored to enhance Th1 immunity or to avoid potential interference from maternally derived antibodies (MDA). Accordingly, a range of mucosal adjuvants (particularly those derived from bacteria) has been tested, and live recombinant vectored vaccines may also be effectively delivered by this route.
Collapse
Affiliation(s)
- I Jónsdóttir
- Department of Immunology, Landspitali University Hospital, University of Iceland and de CODE genetics, Hringbraut, 101 Reykjavík, Iceland.
| |
Collapse
|
26
|
Klossek JM, Quinet B, Bingen E, François M, Gaudelus J, Larnaudie S, Liard F, Péan Y, Roger G, Reveillaud O, Serrano E. [Current management of acute pediatric rhinosinusitis in France]. Med Mal Infect 2007; 37:127-52. [PMID: 17317063 PMCID: PMC7119127 DOI: 10.1016/j.medmal.2006.11.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2006] [Accepted: 11/13/2006] [Indexed: 11/30/2022]
Abstract
Un groupe de médecins généralistes et multidisciplinaire de spécialistes contribue à définir les différentes formes de sinusites ou rhinosinusites aiguës de l'enfant à partir des principaux symptômes et signes cliniques. Le rôle des pathologies associées telles que l'allergie, les troubles immunitaires est envisagé. L'incidence, la présentation clinique et la prise en charge des complications sont présentées. Les indications des examens radiologiques et biologiques sont analysées. La prise en charge médicale en particulier, la place et le type des antibiotiques sont discutés. Des propositions de prise en charge selon des situations cliniques rencontrées en pratique sont présentées.
Collapse
Affiliation(s)
- J-M Klossek
- Service ORL, Hôpital Jean-Bernard, CHU, Poitiers, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Hirano T, Jiao X, Chen Z, Van Waes C, Gu XX. Kinetics of mouse antibody and lymphocyte responses during intranasal vaccination with a lipooligosaccharide-based conjugate vaccine. Immunol Lett 2006; 107:131-9. [PMID: 17030407 DOI: 10.1016/j.imlet.2006.08.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2006] [Revised: 08/21/2006] [Accepted: 08/24/2006] [Indexed: 10/24/2022]
Abstract
We investigated the kinetics of humoral immunity and its related cellular immune responses to intranasal (IN) immunization with a detoxified lipooligosaccharide (dLOS)-tetanus toxoid (TT) conjugate against nontypeable Haemophilus influenzae (NTHi) in mice. IN vaccination with dLOS-TT elicited high titers of LOS-specific IgA in nasal washes and IgG in sera during a course of 4 inoculations while high titers of TT-specific IgA and IgG were found in sera. A significant increase of LOS-specific IgA antibody forming cells (AFCs) was observed in nasopharyngeal-associated lymphoid tissue (NALT) and nasal passages. However, TT induced broad responses with higher numbers of IgA and IgG AFCs found in NALT and nasal passages, less but significant IgA AFCs in cervical lymphoid nodes (CLN), spleen, and lungs. Phenotypic analysis revealed a significant rise of total B220+ B-lymphocytes in NALT and CLN, particularly a rise in IgA+/IgM+ cells in the NALT after the immunization. The latter result was complied with a significant rise of IL-4 but not IFN-gamma positive CD4+ T-lymphocytes in NALT. Analysis of IgG antibody subclasses showed that an IgG1 response to both LOS and TT epitopes dominated in serum when compared to IgG2a. These kinetic antibody patterns and cellular responses may provide useful information regarding to effective mucosal vaccines against NTHi infections.
Collapse
Affiliation(s)
- Takashi Hirano
- Vaccine Research Section, National Institute on Deafness and Other Communication Disorders, Rockville, MD, USA
| | | | | | | | | |
Collapse
|
28
|
Tonnaer ELGM, Graamans K, Sanders EAM, Curfs JHAJ. Advances in understanding the pathogenesis of pneumococcal otitis media. Pediatr Infect Dis J 2006; 25:546-52. [PMID: 16732155 DOI: 10.1097/01.inf.0000222402.47887.09] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In this review, a state of the art on otitis media research is provided with emphasis on the role of Streptococcus pneumoniae in the pathogenesis of this disease. Articles have been selected by MEDLINE search supplemented with a manual crosscheck of bibliographies. Pathogenic mechanisms in middle ear and eustachian tube are described. Furthermore, pneumococcal characteristics and pneumococcus-host interactions are highlighted as well as the possible role of biofilms in persistence or recurrence of otitis media. Because of the availability of new techniques, an increasing number of pneumococcal features contributing in the pathogenesis of otitis media are identified and in-depth knowledge of pneumococcus-host interactions has been gained. The present advances in research on otitis media open up new perspectives for therapeutic or preventive strategies.
Collapse
Affiliation(s)
- Edith L G M Tonnaer
- Department of Otorhinolaryngology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | | | | | | |
Collapse
|
29
|
Sabirov A, Metzger DW. Intranasal vaccination of neonatal mice with polysaccharide conjugate vaccine for protection against pneumococcal otitis media. Vaccine 2006; 24:5584-92. [PMID: 16730398 DOI: 10.1016/j.vaccine.2006.04.033] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2005] [Revised: 02/16/2006] [Accepted: 04/19/2006] [Indexed: 10/24/2022]
Abstract
Streptococcus pneumoniae is the leading bacterial cause of acute otitis media (OM) in young children, and can often produce invasive disease. Typical intramuscular routes of vaccination are poorly protective against development of OM. In the present study, we intranasally (i.n.) inoculated neonatal 1-week-old mice with pneumococcal polysaccharide conjugate vaccine using IL-12 as a mucosal adjuvant. The protective efficacy of this treatment was tested by challenging immunized infant (3-week-old) mice with bacteria to induce OM and invasive disease. i.n. vaccination was found to enhance levels of specific antibodies in middle ear (ME) washes and sera from wild-type (but not IFN-gamma(-/-)) mice. Immunization in the presence of IL-12 resulted in enhanced clearance of S. pneumoniae from the ME. Opsonization of bacteria with ME wash fluids or sera from immunized mice caused increased bacterial clearance from the ME of naïve mice. In addition, immunized mice demonstrated 89% survival after OM-induced invasive pneumococcal infection, compared to 22% survival in unvaccinated mice. These results indicate that i.n. vaccination of neonatal mice in the presence of IL-12 is able to enhance IFN-gamma dependent ME mucosal and systemic immune responses to pneumococci and efficiently protect against both OM and invasive infection.
Collapse
MESH Headings
- Administration, Intranasal
- Animals
- Animals, Newborn
- Antibodies, Bacterial/biosynthesis
- Antibodies, Bacterial/blood
- Antibody Specificity
- Ear, Middle/immunology
- Ear, Middle/microbiology
- Immunity, Mucosal
- Interferon-gamma/immunology
- Interleukin-12/administration & dosage
- Interleukin-12/immunology
- Mice
- Mice, Inbred BALB C
- Mice, Knockout
- Otitis Media/immunology
- Otitis Media/microbiology
- Otitis Media/prevention & control
- Pneumococcal Infections/immunology
- Pneumococcal Infections/prevention & control
- Pneumococcal Vaccines/administration & dosage
- Pneumococcal Vaccines/immunology
- Streptococcus pneumoniae/immunology
- Vaccines, Conjugate/administration & dosage
- Vaccines, Conjugate/immunology
Collapse
Affiliation(s)
- Albert Sabirov
- Center for Immunology & Microbial Disease, Albany Medical College (MC-151), 47 New Scotland Ave., Albany, NY 12208, USA
| | | |
Collapse
|
30
|
Fletcher MA, Laufer DS, McIntosh EDG, Cimino C, Malinoski FJ. Controlling invasive pneumococcal disease: is vaccination of at-risk groups sufficient? Int J Clin Pract 2006; 60:450-6. [PMID: 16620359 PMCID: PMC1448695 DOI: 10.1111/j.1368-5031.2006.00858.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Risk factors for invasive pneumococcal disease (IPD) include young and old age, comorbidities (such as splenic dysfunction, immunodeficiencies, chronic renal disease, chronic heart or lung disease or cerebral spinal fluid leak), crowded environments or poor socioeconomic conditions. Universal use of the 7-valent pneumococcal conjugate (7vPncCRM) vaccine for infants and young children has led to significant decreases in IPD in the vaccinated population (direct protection), and there has also been a decrease in the incidence of IPD among the nonvaccinated population (indirect immunity; herd protection). While 7vPncCRM vaccine is administered universally to children in USA, many countries of the European Union have chosen to target children with comorbidities. This review aims to highlight individual risk factors for IPD, describe studies that evaluated pneumococcal conjugate vaccines in at-risk groups and estimate the proportion of at-risk children who may have been vaccinated in the European Union since the 7vPncCRM vaccine was introduced, using UK as an example. Although immunisation targeting only children with comorbidities may achieve satisfactory results for a few, many otherwise healthy children at risk simply because of their age will be neglected, and herd protection might not be established.
Collapse
|
31
|
Cuello M, Cabrera O, del Campo JM, Parajón E, Sotolongo F, Camaraza MA, Arnet A, Suárez M, Pérez O. Mucosal immune responses to meningococcal C polysaccharide–protein conjugate in mice. Vaccine 2006; 24 Suppl 2:S2-72-3. [PMID: 16823934 DOI: 10.1016/j.vaccine.2005.01.129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Mucosal delivery of vaccines represents an attractive approach because this is a region of first contact point for inhaled antigens. We have obtained a meningococcal group C polysaccharide-tetanus toxoid conjugate (MGCP-TT) and evaluated it for intranasal route in mice. The conjugate was obtained by a developed method in our laboratory. The specific IgA in saliva and specific IgA and IgG in serum were measured by ELISA methods and bactericidal antibodies in sera against a meningococcal group C strain were measured. The conjugated elicited a significant increase in anti-MGCP salivary IgA and serum IgG and bactericidal antibodies concentrations, while specific serum IgA was not observed. These results indicated that after conjugation, there was a change in the responses for MGCP from thymus-independent to thymus-dependent and that it was effective by intranasal route.
Collapse
Affiliation(s)
- Maribel Cuello
- Immunology Department, Finlay Institute, 27 Avenue No. 19805, P.O. Box 16017, Havana, Cuba.
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Wiertsema SP, Veenhoven RH, Sanders EAM, Rijkers GT. Immunologic screening of children with recurrent otitis media. Curr Allergy Asthma Rep 2005; 5:302-7. [PMID: 15967072 DOI: 10.1007/s11882-005-0070-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Some 5% to 10% of all infants and toddlers suffer from four or more episodes of otitis per year. Usually, this is a temporary problem that resolves with increasing age. In a minority of cases, otitis episodes are frequent or have an abnormal course, with complications such as mastoiditis. In these cases, immunologic screening is indicated, to exclude an immunodeficiency. Agammaglobulinemia or hypogammaglobulinemia is rare among these patients. Other immune defects that occur more often are deficient or lowered immunoglobulin (Ig)A or decreased levels of one or more IgG subclass, in particular IgG2. The specific antibody response to bacterial capsular polysaccharides often is disturbed. These findings can give direction to the treatment of children with frequent, recurrent otitis.
Collapse
Affiliation(s)
- Selma P Wiertsema
- Department of Immunology, University Medical Center Utrecht, Wilhelmina Children's Hospital, KC03.063.0, Lundlaan 6, 3584 EA Utrecht, The Netherlands
| | | | | | | |
Collapse
|
33
|
Abstract
Host defenses against Streptococcus pneumoniae involve opsonophagocytosis mediated by antibodies and complement. Because the pneumococcus is a respiratory pathogen, mucosal immunity may play an important role in the defense against infection. The mechanism for protection in mucosal immunity consists of induction of immunity by the activation of lymphocytes within the mucosal-associated lymphoid tissues, transport of antigen-specific B and T cells from inductive sites through bloodstream and distribute to distant mucosal effector sites. Secretory IgA is primarily involved in protection of mucosal surfaces. Mucosal immunization is an effective way of inducing immune responses at mucosal surfaces. Several mucosal vaccines are in various stages of development. A number of mucosal adjuvants have been proposed. CpG oligodeoxynucleotide (ODN) has been shown to be an effective mucosal adjuvant for various antigens. Mucosal immunity induced by intranasal immunization was studied with a pneumococcal glycoconjugate, using CpG ODN as adjuvant. Mice immunized with type 9V polysaccharide (PS) conjugated to inactivated pneumolysin (Ply) plus CpG produced high levels of 9V PS IgG and IgA antibodies compared to the group that received the conjugate alone. High levels of subclasses of IgGI, IgG2 and IgG3 antibodies were also observed in sera of mice immunized with 9V PS-Ply plus CpG. In addition, high IgG and IgA antibody responses were observed in sera of young mice immunized with 9V PS-Ply plus CpG or the conjugate plus non-CpG compared with the group received the conjugate alone. These results reveal that mucosal immunization with pneumococcal glycoconjugate using CpG as adjuvant can confer protective immunity against pneumococcal infection.
Collapse
Affiliation(s)
- Chi-Jen Lee
- Center for Biologics and Research, Food and Drug Administration, Rockville, MD 20852, USA.
| | | | | |
Collapse
|
34
|
|
35
|
Lucero MG, Dulalia VE, Parreno RN, Lim-Quianzon DM, Nohynek H, Makela H, Williams G. Pneumococcal conjugate vaccines for preventing vaccine-type invasive pneumococcal disease and pneumonia with consolidation on x-ray in children under two years of age. Cochrane Database Syst Rev 2004:CD004977. [PMID: 15495133 DOI: 10.1002/14651858.cd004977] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Pneumonia, most commonly caused by Streptococcus pneumoniae (Pnc), is a major cause of morbidity and mortality among young children especially in developing countries. Recently, the prevalence of antibiotic-resistant Pnc has increased worldwide such that the effectiveness of preventive strategies, like the new pneumococcal conjugate vaccines (PCV) on rates of invasive pneumococcal disease (IPD) and pneumonia, needs to be evaluated. OBJECTIVES To determine the efficacy of PCV in reducing the incidence of IPD due to vaccine serotypes (VT) and x-ray confirmed pneumonia with consolidation of unspecified etiology in children who received PCV before 12 months of age. SEARCH STRATEGY We searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 1 2004), MEDLINE (1990 to March 2004) and EMBASE (1990 to December 2003). Reference list of articles, and books of abstracts of relevant symposia, were hand searched. Researchers in the field were also contacted. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing PCV with placebo, or another vaccine, among children below two years with IPD and clinical/radiographic pneumonia as outcomes. DATA COLLECTION AND ANALYSIS Two reviewers independently identified eligible studies, assessed trial quality, and extracted data. Differences were resolved by discussion. The inverse variance method was used to pool effect sizes. MAIN RESULTS We identified four trials assessing the efficacy of PCV in reducing the incidence of IPD, two on x-ray confirmed pneumonia as outcome, and one on clinical pneumonia, with or without x-ray confirmation. Results from pooling HIV-1 negative children from the South African study with the other studies were as follows: the pooled vaccine efficacy (VE) for vaccine-type IPD was 88% (95% confidence interval (CI) 73% to 94%; fixed effect and random effects models), the effect measure was statistically significant (p <0.00001) and there was no heterogeneity (p = 0.77I2 0%); the pooled VE for all-serotype IPD was 66% (95% CI 46% to 79%; fixed effect model), the effect measure was statistically significant (p <0.00001) and there was no statistical heterogeneity (p = 0.09, I2 51%); the pooled VE for x-ray confirmed pneumonia was 22% (95% CI 11% to 31%; both fixed effect and random effects models) and there was no statistical heterogeneity (p = 0.80, I2 0%). Analyses that included all the children in the South African study (HIV-1 negative and HIV-1 positive children) and pooled with data from the other studies gave very similar results. REVIEWERS' CONCLUSIONS PCV is effective in reducing the incidence of IPD from all serotypes but exerts a greater effect in reducing VT IPD. Although PCV is also effective in reducing the incidence of x-ray confirmed pneumonia, there are still uncertainties about the definition of this outcome. Additional randomised controlled trials are currently in progress.
Collapse
Affiliation(s)
- M G Lucero
- Department of Medicine, Research Institute for Tropical Medicine, Filinvest Corporate City, Alabang, Muntinlupa City, 1781, Philippines.
| | | | | | | | | | | | | |
Collapse
|
36
|
Sun K, Johansen FE, Eckmann L, Metzger DW. An Important Role for Polymeric Ig Receptor-Mediated Transport of IgA in Protection againstStreptococcus pneumoniaeNasopharyngeal Carriage. THE JOURNAL OF IMMUNOLOGY 2004; 173:4576-81. [PMID: 15383591 DOI: 10.4049/jimmunol.173.7.4576] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The importance of IgA for protection at mucosal surfaces remains unclear, and in fact, it has been reported that IgA-deficient mice have fully functional vaccine-induced immunity against several bacterial and viral pathogens. The role of respiratory Ab in preventing colonization by Streptococcus pneumoniae has now been examined using polymeric IgR knockout (pIgR(-/-)) mice, which lack the ability to actively secrete IgA into the mucosal lumen. Intranasal vaccination with a protein conjugate vaccine elicited serotype-specific anti-capsular polysaccharide Ab locally and systemically, and pIgR(-/-) mice produced levels of total serum Ab after vaccination that were similar to wild-type mice. However, pIgR(-/-) mice had approximately 5-fold more systemic IgA and 6-fold less nasal IgA Ab than wild-type mice due to defective transport into mucosal tissues. Wild-type, but not pIgR(-/-) mice were protected against infection with serotype 14 S. pneumoniae, which causes mucosal colonization but does not induce systemic inflammatory responses in mice. The relative importance of secretory IgA in host defense was further shown by the finding that intranasally vaccinated IgA gene-deficient mice were not protected from colonization. Although secretory IgA was found to be important for protection against nasal carriage, it does not appear to have a crucial role in immunity to systemic pneumococcus infection, because both vaccinated wild-type and pIgR(-/-) mice were fully protected from lethal systemic infection by serotype 3 pneumococci. The results demonstrate the critical role of secretory IgA in protection against pneumococcal nasal colonization and suggest that directed targeting to mucosal tissues will be needed for effective vaccination in humans.
Collapse
MESH Headings
- Administration, Intranasal
- Animals
- Antibodies, Bacterial/biosynthesis
- Antibodies, Bacterial/blood
- Antibodies, Bacterial/physiology
- Bacterial Capsules/administration & dosage
- Bacterial Capsules/immunology
- Immunity, Mucosal
- Immunoglobulin A, Secretory/genetics
- Immunoglobulin A, Secretory/metabolism
- Immunoglobulin A, Secretory/physiology
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Nasopharynx/immunology
- Nasopharynx/metabolism
- Nasopharynx/microbiology
- Pneumococcal Vaccines/administration & dosage
- Pneumococcal Vaccines/immunology
- Protein Transport/immunology
- Receptors, Polymeric Immunoglobulin/deficiency
- Receptors, Polymeric Immunoglobulin/genetics
- Receptors, Polymeric Immunoglobulin/physiology
- Respiratory Mucosa/immunology
- Respiratory Mucosa/metabolism
- Respiratory Mucosa/microbiology
- Serotyping
- Streptococcal Infections/immunology
- Streptococcal Infections/microbiology
- Streptococcal Infections/prevention & control
- Streptococcus pneumoniae/classification
- Streptococcus pneumoniae/growth & development
- Streptococcus pneumoniae/immunology
- Vaccines, Conjugate/administration & dosage
- Vaccines, Conjugate/immunology
Collapse
Affiliation(s)
- Keer Sun
- Center for Immunology and Microbial Disease, Albany Medical College, Albany, NY 12208, USA
| | | | | | | |
Collapse
|
37
|
Abstract
PURPOSE OF REVIEW The purpose of this review is to update and summarize information concerning the epidemiology of infections due to Streptococcus pneumoniae and the early results of effectiveness studies of the heptavalent pneumococcal conjugate vaccine. This vaccine was licensed in the US in 2000, and has been used increasingly since that time. RECENT FINDINGS Several studies have documented a dramatic decline in the rate of invasive infections due to S. pneumoniae in children under 5 years of age. There has been a simultaneous decrease in serious infections in persons over 20 years of age, presumably because of a decrease in transmission of S. pneumoniae to unvaccinated individuals. Three different studies have shown a modest reduction in the overall number of cases of acute otitis media in children who have received the vaccine. Although the overall number of cases has decreased there has been an increase in the number of cases of acute otitis media caused by serotypes of S. pneumoniae not contained in the vaccine. Worldwide, many studies have appeared that examine the prevalence of different pneumococcal serotypes/serogroups as a cause of invasive and respiratory disease, to assess the likelihood that the vaccine will be effective in particular geographic areas. SUMMARY Use of the heptavalent pneumococcal conjugate vaccine has led to a major decline in the prevalence of invasive pneumococcal disease (bacteremia, meningitis) and a more modest decrease in respiratory tract infections (acute otitis media, pneumonia). Continued surveillance is essential to document future trends in the occurrence of pneumococcal infections and the enduring protectiveness of the heptavalent pneumococcal conjugate vaccine.
Collapse
Affiliation(s)
- Klara M Posfay-Barbe
- Children's Hospital of Pittsburgh, Division of Allergy, Immunology and Infectious Diseases, Pittsburgh, Pennsylvania 15213, USA
| | | |
Collapse
|