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Münter R, Christensen E, Andresen TL, Larsen JB. Studying how administration route and dose regulates antibody generation against LNPs for mRNA delivery with single-particle resolution. Mol Ther Methods Clin Dev 2023; 29:450-459. [PMID: 37251983 PMCID: PMC10220314 DOI: 10.1016/j.omtm.2023.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 05/08/2023] [Indexed: 05/31/2023]
Abstract
Following the recent approval of both siRNA- and mRNA-based therapeutics, nucleic acid therapies are considered a game changer in medicine. Their envisioned widespread use for many therapeutic applications with an array of cellular target sites means that various administration routes will be employed. Concerns exist regarding adverse reactions against the lipid nanoparticles (LNPs) used for mRNA delivery, as PEG coatings on nanoparticles can induce severe antibody-mediated immune reactions, potentially being boosted by the inherently immunogenic nucleic acid cargo. While exhaustive information is available on how physicochemical features of nanoparticles affects immunogenicity, it remains unexplored how the fundamental choice of administration route regulates anti-particle immunity. Here, we directly compared antibody generation against PEGylated mRNA-carrying LNPs administered by the intravenous, intramuscular, or subcutaneous route, using a novel sophisticated assay capable of measuring antibody binding to authentic LNP surfaces with single-particle resolution. Intramuscular injections in mice were found to generate overall low and dose-independent levels of anti-LNP antibodies, while both intravenous and subcutaneous LNP injections generated substantial and highly dose-dependent levels. These findings demonstrate that before LNP-based mRNA medicines can be safely applied to new therapeutic applications, it will be crucial to carefully consider the choice of administration route.
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Affiliation(s)
- Rasmus Münter
- Biotherapeutic Engineering and Drug Targeting, Department of Health Technology, Technical University of Denmark (DTU), 2800 Kongens Lyngby, Denmark
| | - Esben Christensen
- Biotherapeutic Engineering and Drug Targeting, Department of Health Technology, Technical University of Denmark (DTU), 2800 Kongens Lyngby, Denmark
| | - Thomas L. Andresen
- Biotherapeutic Engineering and Drug Targeting, Department of Health Technology, Technical University of Denmark (DTU), 2800 Kongens Lyngby, Denmark
| | - Jannik B. Larsen
- Biotherapeutic Engineering and Drug Targeting, Department of Health Technology, Technical University of Denmark (DTU), 2800 Kongens Lyngby, Denmark
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Rama TA, Miranda J, Silva D, Amaral L, Castro E, Coimbra A, Moreira A, Plácido JL. COVID-19 Vaccination Is Safe among Mast Cell Disorder Patients, under Adequate Premedication. Vaccines (Basel) 2022; 10:vaccines10050718. [PMID: 35632474 PMCID: PMC9146268 DOI: 10.3390/vaccines10050718] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022] Open
Abstract
Reported cases of anaphylaxis following COVID-19 vaccination raised concerns about the safety of these vaccines, namely in patients suffering from clonal mast cell (MC) disorders—a heterogenous group of disorders in which patients may be prone to anaphylaxis caused by vaccination. This study aimed to assess the safety of COVID-19 vaccines in patients with clonal MC disorders. We performed an ambidirectional cohort study with 30 clonal MC disorder patients (n = 26 in the prospective arm and n = 4 in the retrospective arm), that were submitted to COVID-19 vaccination. Among these, 11 (37%) were males, and median age at vaccination date was 41 years (range: 5y to 76y). One patient had prior history of anaphylaxis following vaccination. Those in the prospective arm received a premedication protocol including H1- and H2-antihistamines and montelukast, while those in the retrospective arm did not premedicate. Overall, patients received a total of 81 doses, 73 under premedication and 8 without premedication. No MC activation symptoms were reported. COVID-19 vaccination seems to be safe in patients with clonal mast cell disorders, including those with prior anaphylaxis following vaccination. Robust premedication protocols may allow for vaccination in ambulatory settings.
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Affiliation(s)
- Tiago Azenha Rama
- Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, 4200-319 Porto, Portugal; (J.M.); (D.S.); (L.A.); (E.C.); (A.C.); (A.M.); (J.L.P.)
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
- EPIUnit—Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
- Correspondence:
| | - Joana Miranda
- Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, 4200-319 Porto, Portugal; (J.M.); (D.S.); (L.A.); (E.C.); (A.C.); (A.M.); (J.L.P.)
| | - Diana Silva
- Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, 4200-319 Porto, Portugal; (J.M.); (D.S.); (L.A.); (E.C.); (A.C.); (A.M.); (J.L.P.)
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
- EPIUnit—Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
| | - Luís Amaral
- Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, 4200-319 Porto, Portugal; (J.M.); (D.S.); (L.A.); (E.C.); (A.C.); (A.M.); (J.L.P.)
| | - Eunice Castro
- Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, 4200-319 Porto, Portugal; (J.M.); (D.S.); (L.A.); (E.C.); (A.C.); (A.M.); (J.L.P.)
| | - Alice Coimbra
- Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, 4200-319 Porto, Portugal; (J.M.); (D.S.); (L.A.); (E.C.); (A.C.); (A.M.); (J.L.P.)
| | - André Moreira
- Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, 4200-319 Porto, Portugal; (J.M.); (D.S.); (L.A.); (E.C.); (A.C.); (A.M.); (J.L.P.)
- Serviço de Imunologia Básica e Clínica, Departamento de Patologia, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
- EPIUnit—Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
| | - José Luís Plácido
- Serviço de Imunoalergologia, Centro Hospitalar Universitário São João, 4200-319 Porto, Portugal; (J.M.); (D.S.); (L.A.); (E.C.); (A.C.); (A.M.); (J.L.P.)
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Cubital Tunnel Syndrome Temporally after COVID-19 Vaccination. Trop Med Infect Dis 2022; 7:tropicalmed7040062. [PMID: 35448837 PMCID: PMC9028216 DOI: 10.3390/tropicalmed7040062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/09/2022] [Accepted: 04/14/2022] [Indexed: 02/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is the most dramatic pandemic of the new millennium. To counter it, specific vaccines have been launched in record time under emergency use authorization or conditional marketing authorization and have been subjected to additional monitoring. The European Medicines Agency recommend reporting any suspected adverse reactions during this additional monitoring phase. For the first time in the available medical literature, we report a left cubital tunnel syndrome in a 28-year-old right-handed healthy male after seven days from the first dose of Spikevax® (formerly Moderna COVID-19 Vaccine). Histochemistry for Alcian Blue performed on the tissue harvested from the cubital site reveals myxoid degeneration of the small nerve collaterals, a clear sign of nerve injury. It still remains unclear why the syndrome occurs in a localized and not generalized form to all osteofibrous tunnels. Today, modified messenger ribonucleic acid vaccines as Spikevax® represent an avantgarde technological platform with a lot of potential, but one which needs careful monitoring in order to identify in advance those patients who may experience adverse events after their administration.
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