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Bland WA, Mitra D, Owens S, McEvoy K, Hogan CH, Boccuzzi L, Kirillov V, Meyer TJ, Khairallah C, Sheridan BS, Forrest JC, Krug LT. A replication-deficient gammaherpesvirus vaccine protects mice from lytic disease and reduces latency establishment. NPJ Vaccines 2024; 9:116. [PMID: 38914546 PMCID: PMC11196663 DOI: 10.1038/s41541-024-00908-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 06/11/2024] [Indexed: 06/26/2024] Open
Abstract
Gammaherpesviruses are oncogenic viruses that establish lifelong infections and are significant causes of morbidity and mortality. Vaccine strategies to limit gammaherpesvirus infection and disease are in development, but there are no FDA-approved vaccines for Epstein-Barr or Kaposi sarcoma herpesvirus. As a new approach to gammaherpesvirus vaccination, we developed and tested a replication-deficient virus (RDV) platform, using murine gammaherpesvirus 68 (MHV68), a well-established mouse model for gammaherpesvirus pathogenesis studies and preclinical therapeutic evaluations. We employed codon-shuffling-based complementation to generate revertant-free RDV lacking expression of the essential replication and transactivator protein encoded by ORF50 to arrest viral gene expression early after de novo infection. Inoculation with RDV-50.stop exposes the host to intact virion particles and leads to limited lytic gene expression in infected cells yet does not produce additional infectious particles. Prime-boost vaccination of mice with RDV-50.stop elicited virus-specific neutralizing antibody and effector T cell responses in the lung and spleen. In contrast to vaccination with heat-inactivated WT MHV68, vaccination with RDV-50.stop resulted in a near complete abolishment of virus replication in the lung 7 days post-challenge and reduction of latency establishment in the spleen 16 days post-challenge with WT MHV68. Ifnar1-/- mice, which lack the type I interferon receptor, exhibit severe disease and high mortality upon infection with WT MHV68. RDV-50.stop vaccination of Ifnar1-/- mice prevented wasting and mortality upon challenge with WT MHV68. These results demonstrate that prime-boost vaccination with a gammaherpesvirus that is unable to undergo lytic replication offers protection against acute replication, impairs the establishment of latency, and prevents severe disease upon the WT virus challenge. Our study also reveals that the ability of a gammaherpesvirus to persist in vivo despite potent pre-existing immunity is an obstacle to obtaining sterilizing immunity.
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Affiliation(s)
- Wesley A Bland
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Environment, Health and Safety, University of North Carolina, Chapel Hill, NC, USA
| | - Dipanwita Mitra
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, MD, USA
| | - Shana Owens
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Kyle McEvoy
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, NY, USA
| | - Chad H Hogan
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, MD, USA
- Graduate Program in Genetics, Stony Brook University, Stony Brook, NY, USA
- Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Luciarita Boccuzzi
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, MD, USA
- Doctor of Medicine Program, Rush University Medical Center, 1650, West Harrison Street, Chicago, IL, USA
| | - Varvara Kirillov
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, NY, USA
| | - Thomas J Meyer
- CCR Collaborative Bioinformatics Resource, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
- Advanced Biomedical Computational Science, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Camille Khairallah
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, NY, USA
| | - Brian S Sheridan
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, NY, USA
| | - J Craig Forrest
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Laurie T Krug
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, MD, USA.
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, NY, USA.
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Li M, Zhu G, Guo Y, Ye Q. Association between emphysema and other pulmonary computed tomography patterns in primary varicella pneumonia: A retrospective cohort study. Medicine (Baltimore) 2024; 103:e38185. [PMID: 38758910 PMCID: PMC11098192 DOI: 10.1097/md.0000000000038185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/18/2024] [Indexed: 05/19/2024] Open
Abstract
This study aims to evaluate chest computed tomography (CT) findings in hospital patients with primary varicella pneumonia (PVP). We retrospectively analyzed CT images of 77 PVP patients using 3D Slicer, an open-source software, to model lesions and lungs. This retrospective cohort study was approved by the Institutional Review Board (Ethical Committee, Renmin Hospital, Hubei University of Medicine, Shiyan, China) and waived the requirement for written informed consent. The left lung was more frequently and severely affected in PVP, with significant differences between the 2 groups in CT involvement percentage of each lung region, except for total lung inflation. Group A showed higher median percentages of lung collapse compared to Group B. The extent of left lung involvement is a critical predictor of emphysema in PVP patients, highlighting the importance of also monitoring the right lung for more severe cases. Lower emphysema levels correspond to more collapsed and infiltrated lung segments, suggesting a more severe clinical presentation.
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Affiliation(s)
- Meng Li
- Department of Pulmonary & Critical Care Medicine, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, PR China
| | - Guijuan Zhu
- Department of Gynecology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, PR China
| | - Yajun Guo
- Department of Pulmonary & Critical Care Medicine, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, PR China
| | - Qing Ye
- Department of Pulmonary & Critical Care Medicine, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, PR China
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Ramachandran P, Grose C. Serious neurological adverse events in immunocompetent children and adolescents caused by viral reactivation in the years following varicella vaccination. Rev Med Virol 2024; 34:e2538. [PMID: 38658176 PMCID: PMC11170866 DOI: 10.1002/rmv.2538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/05/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
Serious adverse events following vaccination include medical complications that require hospitalisation. The live varicella vaccine that was approved by the Food and Drug Administration in the United States in 1995 has an excellent safety record. Since the vaccine is a live virus, adverse events are more common in immunocompromised children who are vaccinated inadvertently. This review includes only serious adverse events in children considered to be immunocompetent. The serious adverse event called varicella vaccine meningitis was first reported in a hospitalised immunocompetent child in 2008. When we carried out a literature search, we found 15 cases of immunocompetent children and adolescents with varicella vaccine meningitis; the median age was 11 years. Eight of the children had received two varicella vaccinations. Most of the children also had a concomitant herpes zoster rash, although three did not. The children lived in the United States, Greece, Germany, Switzerland, and Japan. During our literature search, we found five additional cases of serious neurological events in immunocompetent children; these included 4 cases of progressive herpes zoster and one case of acute retinitis. Pulses of enteral corticosteroids as well as a lack of herpes simplex virus antibody may be risk factors for reactivation in immunocompetent children. All 20 children with adverse events were treated with acyclovir and recovered; 19 were hospitalised and one child was managed as an outpatient. Even though the number of neurological adverse events remains exceedingly low following varicella vaccination, we recommend documentation of those caused by the vaccine virus.
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Affiliation(s)
- Prashanth Ramachandran
- Peter Doherty Institute for Infection and Immunity, University of Melbourne; Department of Neurology, Royal Melbourne Hospital; and Department of Neurology, St. Vincent’s Hospital, Melbourne, Victoria, Australia
| | - Charles Grose
- Division of Infectious Diseases, Virology Laboratory, Department of Pediatrics, University of Iowa, Iowa City, Iowa, United States
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Xuan K, Zhang N, Li T, Pang X, Li Q, Zhao T, Wang B, Zha Z, Tang J. Epidemiological Characteristics of Varicella in Anhui Province, China, 2012-2021: Surveillance Study. JMIR Public Health Surveill 2024; 10:e50673. [PMID: 38579276 PMCID: PMC11031691 DOI: 10.2196/50673] [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: 07/10/2023] [Revised: 09/08/2023] [Accepted: 03/01/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Varicella is a mild, self-limited disease caused by varicella-zoster virus (VZV) infection. Recently, the disease burden of varicella has been gradually increasing in China; however, the epidemiological characteristics of varicella have not been reported for Anhui Province. OBJECTIVE The aim of this study was to analyze the epidemiology of varicella in Anhui from 2012 to 2021, which can provide a basis for the future study and formulation of varicella prevention and control policies in the province. METHODS Surveillance data were used to characterize the epidemiology of varicella in Anhui from 2012 to 2021 in terms of population, time, and space. Spatial autocorrelation of varicella was explored using the Moran index (Moran I). The Kulldorff space-time scan statistic was used to analyze the spatiotemporal aggregation of varicella. RESULTS A total of 276,115 cases of varicella were reported from 2012 to 2021 in Anhui, with an average annual incidence of 44.8 per 100,000, and the highest incidence was 81.2 per 100,000 in 2019. The male-to-female ratio of cases was approximately 1.26, which has been gradually decreasing in recent years. The population aged 5-14 years comprised the high-incidence group, although the incidence in the population 30 years and older has gradually increased. Students accounted for the majority of cases, and the proportion of cases in both home-reared children (aged 0-7 years who are not sent to nurseries, daycare centers, or school) and kindergarten children (aged 3-6 years) has changed slightly in recent years. There were two peaks of varicella incidence annually, except for 2020, and the incidence was typically higher in the winter peak than in summer. The incidence of varicella in southern Anhui was higher than that in northern Anhui. The average annual incidence at the county level ranged from 6.61 to 152.14 per 100,000, and the varicella epidemics in 2018-2021 were relatively severe. The spatial and temporal distribution of varicella in Anhui was not random, with a positive spatial autocorrelation found at the county level (Moran I=0.412). There were 11 districts or counties with high-high clusters, mainly distributed in the south of Anhui, and 3 districts or counties with high-low or low-high clusters. Space-time scan analysis identified five possible clusters of areas, and the most likely cluster was distributed in the southeastern region of Anhui. CONCLUSIONS This study comprehensively describes the epidemiology and changing trend of varicella in Anhui from 2012 to 2021. In the future, preventive and control measures should be strengthened for the key populations and regions of varicella.
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Affiliation(s)
- Kun Xuan
- Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, China
| | - Ning Zhang
- Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, China
| | - Tao Li
- Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, China
| | - Xingya Pang
- Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, China
| | - Qingru Li
- Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, China
| | - Tianming Zhao
- School of Health Management, Anhui Medical University, Hefei, China
| | - Binbing Wang
- Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, China
| | - Zhenqiu Zha
- Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, China
| | - Jihai Tang
- Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui Province, China
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Singal A, Schwartz RA, Bhate C. Herpes zoster infection in pregnancy: features and consequences. Arch Dermatol Res 2024; 316:107. [PMID: 38489022 DOI: 10.1007/s00403-024-02842-3] [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: 02/06/2024] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 03/17/2024]
Abstract
Herpes (varicella) zoster (HZ) infection occurs in 4 people per 1000 in the general US population (irrespective of prior varicella infection and vaccination status) each year and has been the subject of scientific inquiry for decades. The consequences of infection are myriad and may depend on the dermatome of involvement as well as host factors such as age, comorbidities, prior treatment or immunization, and immunologic status. Pregnancy is associated with an altered immune and hormonal status in the mother. While maternal HZ infection during pregnancy is not uncommon, the implications for both mother and child are not well established, although multiple studies of perinatal maternal HZ infection suggest no intrauterine transmission to the fetus. We review the current literature on herpes zoster infection in pregnancy, including epidemiology, diagnosis, potential immunologic sequelae, and strategies for prevention and treatment.
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Affiliation(s)
- Amit Singal
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Robert A Schwartz
- Dermatology and Pathology, Rutgers New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA.
| | - Chinmoy Bhate
- Dermatology and Pathology, Rutgers New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA
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Miller C, Taylor-Salmon E, Emuren L, Landry M, Gershon A, Miller G. Progressive shingles in a toddler due to reactivation of Varicella Zoster vaccine virus four days after infection with SARS-CoV-2; a case report. BMC Infect Dis 2023; 23:854. [PMID: 38057696 PMCID: PMC10698951 DOI: 10.1186/s12879-023-08809-5] [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: 04/04/2023] [Accepted: 11/09/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Herpes zoster (HZ) is the clinical syndrome associated with reactivation of latent varicella-zoster virus (VZV). Several factors have been implicated to promote VZV reactivation; these include immunosuppression, older age, mechanical trauma, physiologic stress, lymphopenia, and more recently, infection with severe acute respiratory syndrome coronavirus-2 (SARS- CoV-2). Recent reports suggest an increase in the number of HZ cases in the general population during the global COVID-19 pandemic. However, it is unknown what proportion of HZ during the pandemic is due to reactivation of wild-type or vaccine-strain VZV. CASE Here we report the first known case of HZ concomitant with SARS-CoV2 infection in a 20-month-old female who was treated with a single dose of dexamethasone, due to reactivation of the vaccine-type strain of VZV after presenting with a worsening vesicular rash. CONCLUSION In this case, we were able to show vaccine-strain VZV reactivation in the context of a mild acute symptomatic COVID-19 infection in a toddler. Being able to recognize HZ quickly and effectively in a pediatric patient can help stave off the significant morbidity and mortality associated with disease process.
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Affiliation(s)
- Christine Miller
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine, 464 Congress Ave, New Haven, CT, 06519, USA
| | - Emma Taylor-Salmon
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine, 464 Congress Ave, New Haven, CT, 06519, USA
| | - Leonard Emuren
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine, 464 Congress Ave, New Haven, CT, 06519, USA
| | - Marie Landry
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Anne Gershon
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - George Miller
- Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine, 464 Congress Ave, New Haven, CT, 06519, USA.
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Bland WA, Owens S, McEvoy K, Hogan CH, Boccuzzi L, Kirillov V, Khairallah C, Sheridan BS, Forrest JC, Krug LT. Replication-dead gammaherpesvirus vaccine protects against acute replication, reactivation from latency, and lethal challenge in mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.09.26.559621. [PMID: 37808844 PMCID: PMC10557649 DOI: 10.1101/2023.09.26.559621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Gammaherpesviruses (GHVs) are oncogenic viruses that establish lifelong infections and are significant causes of human morbidity and mortality. While several vaccine strategies to limit GHV infection and disease are in development, there are no FDA-approved vaccines for human GHVs. As a new approach to gammaherpesvirus vaccination, we developed and tested a replication-dead virus (RDV) platform, using murine gammaherpesvirus 68 (MHV68), a well-established mouse model for gammaherpesvirus pathogenesis studies and preclinical therapeutic evaluations. We employed codon-shuffling-based complementation to generate revertant-free RDV lacking expression of the essential replication and transactivator protein (RTA) encoded by ORF50 to arrest viral gene expression early after de novo infection. Inoculation with RDV-50.stop exposes the host to intact virion particles and leads to limited lytic gene expression in infected cells. Prime-boost vaccination of mice with RDV-50.stop elicited virus-specific neutralizing antibody and effector T cell responses in the lung and spleen. Vaccination with RDV-50.stop resulted in a near complete abolishment of virus replication in the lung 7 days post-challenge and virus reactivation from spleen 16 days post-challenge with WT MHV68. Ifnar1-/- mice, which lack the type I interferon receptor, exhibit severe disease upon infection with WT MHV68. RDV-50.stop vaccination of Ifnar1-/- mice prevented wasting and mortality upon challenge with WT MHV68. These results demonstrate that prime-boost vaccination with a GHV that is unable to undergo lytic replication offers protection against acute replication, reactivation, and severe disease upon WT virus challenge.
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Affiliation(s)
- Wesley A Bland
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Shana Owens
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Kyle McEvoy
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, New York, USA
| | - Chad H Hogan
- Graduate Program in Genetics, Stony Brook University, Stony Brook, New York, USA
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Luciarita Boccuzzi
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Varvara Kirillov
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, New York, USA
| | - Camille Khairallah
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, New York, USA
| | - Brian S Sheridan
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, New York, USA
| | - J Craig Forrest
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Laurie T Krug
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, New York, USA
- HIV and AIDS Malignancy Branch, National Cancer Institute, Bethesda, Maryland, USA
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Choi UY, Kim KH, Cho HK, Kim DH, Ma SH, Choi YY, Kim CS, Capeding MR, Kobashi IAR, Kim H, Ryu JH, Lee SJ, Park HK, Kim JH. Immunogenicity and Safety of a Newly Developed Live Attenuated Varicella Vaccine in Healthy Children: A Multi-National, Randomized, Double-Blinded, Active-Controlled, Phase 3 Study. Vaccines (Basel) 2023; 11:1416. [PMID: 37766093 PMCID: PMC10537027 DOI: 10.3390/vaccines11091416] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/07/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Korean manufacturers have developed a new varicella vaccine, NBP608. This phase 3, randomized, double-blind, multicenter study aimed to compare the immunogenicity and safety of NBP608 in healthy children to those of VarivaxTM (control). Children aged 12 months to 12 years were randomized in a ratio of 1:1 to receive either NBP608 or the control vaccine. Serum samples were obtained before vaccination and within six to eight weeks after vaccination. In total, 499 participants (NBP608, n = 251; control, n = 248) were enrolled. The seroconversion rate (SCR) measured using a FAMA assay was 99.53% in the NBP608 group, and the lower limit of the 95% confidence interval (95% LCL) for the SCR difference (NBP608 minus the control) was 0.52%. This 95% LCL for the difference was higher than the specified non-inferiority margin of -15%. In an assessment using gpELISA, the SCR was 99.53% in the NBP608 group, and the 95% LCL for the SCR difference was 6.5%, which was higher than the specified non-inferiority margin of -15%. There were no significant differences between the NBP608 and control group with respect to the proportions of participants who demonstrated local and systemic solicited AEs. This study indicated that NBP608 had a clinically acceptable safety profile and was not immunologically inferior to VarivaxTM.
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Affiliation(s)
- Ui Yoon Choi
- Department of Pediatrics, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea;
| | - Ki Hwan Kim
- Department of Pediatrics, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 21431, Republic of Korea;
| | - Hye-Kyung Cho
- Department of Pediatrics, Gachon University College of Medicine, Incheon 21936, Republic of Korea;
| | - Dong Ho Kim
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul 01812, Republic of Korea;
| | - Sang Hyuk Ma
- Department of Pediatrics, Changwon Fatima Hospital, Changwon 51394, Republic of Korea;
| | - Young Youn Choi
- Department of Pediatrics, Chonnam National University Medical School, Gwangju 61469, Republic of Korea;
| | - Chun Soo Kim
- Department of Pediatrics, Keimyung University School of Medicine, Daegu 42601, Republic of Korea;
| | - Maria Rosario Capeding
- Department of Microbiology, Research Institute for Tropical Medicine, Manila 1781, Philippines;
| | | | - Hun Kim
- SK Bioscience, Seongnam 13494, Republic of Korea; (H.K.); (J.H.R.); (S.J.L.); (H.K.P.)
| | - Ji Hwa Ryu
- SK Bioscience, Seongnam 13494, Republic of Korea; (H.K.); (J.H.R.); (S.J.L.); (H.K.P.)
| | - Su Jeen Lee
- SK Bioscience, Seongnam 13494, Republic of Korea; (H.K.); (J.H.R.); (S.J.L.); (H.K.P.)
| | - Ho Keun Park
- SK Bioscience, Seongnam 13494, Republic of Korea; (H.K.); (J.H.R.); (S.J.L.); (H.K.P.)
| | - Jong-Hyun Kim
- Department of Pediatrics, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon 16247, Republic of Korea
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Jin X, Wang W, Zhao X, Jiang W, Shao Q, Chen Z, Huang C. The battle between the innate immune cGAS-STING signaling pathway and human herpesvirus infection. Front Immunol 2023; 14:1235590. [PMID: 37600809 PMCID: PMC10433641 DOI: 10.3389/fimmu.2023.1235590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023] Open
Abstract
The incidence of human herpesvirus (HHVs) is gradually increasing and has affected a wide range of population. HHVs can result in serious consequences such as tumors, neonatal malformations, sexually transmitted diseases, as well as pose an immense threat to the human health. The cGAS-STING pathway is one of the innate immune pattern-recognition receptors discovered recently. This article discusses the role of the cGAS-STING pathway in human diseases, especially in human herpesvirus infections, as well as highlights how these viruses act on this pathway to evade the host immunity. Moreover, the author provides a comprehensive overview of modulators of the cGAS-STING pathway. By focusing on the small molecule compounds based on the cGAS-STING pathway, novel targets and concepts have been proposed for the development of antiviral drugs and vaccines, while also providing a reference for the investigation of disease models related to the cGAS-STING pathway. HHV is a double-stranded DNA virus that can trigger the activation of intracellular DNA sensor cGAS, after which the host cells initiate a cascade of reactions that culminate in the secretion of type I interferon to restrict the viral replication. Meanwhile, the viral protein can interact with various molecules in the cGAS-STING pathway. Viruses can evade immune surveillance and maintain their replication by inhibiting the enzyme activity of cGAS and reducing the phosphorylation levels of STING, TBK1 and IRF3 and suppressing the interferon gene activation. Activators and inhibitors of the cGAS-STING pathway have yielded numerous promising research findings in vitro and in vivo pertaining to cGAS/STING-related disease models. However, there remains a dearth of small molecule modulators that have been successfully translated into clinical applications, which serves as a hurdle to be overcome in the future.
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Affiliation(s)
- Ximing Jin
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenjia Wang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinwei Zhao
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenhua Jiang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qingqing Shao
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhuo Chen
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cong Huang
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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10
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Jo T, Kubota-Koketsu R, Kaneko Y, Sakai T, Noguchi K, Irie S, Matsuo M, Taguchi J, Abe K, Shigematsu K. Live attenuated VZV vaccination induces antitumor immunity in ATLL patients. Cancer Immunol Immunother 2023; 72:929-944. [PMID: 36181532 PMCID: PMC10025209 DOI: 10.1007/s00262-022-03301-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/20/2022] [Indexed: 11/05/2022]
Abstract
Adult T cell leukemia/lymphoma (ATLL) is a CD4-positive peripheral T cell lymphoma caused by human T cell lymphotropic virus type 1 (HTLV-1). Although ATLL is quite difficult to be cured, up-regulation of cellular immunity such as HTLV-1 Tax-specific cytotoxic T lymphocytes (CTLs) has been proved to be important to obtain long-term survival. At present, no efficacious method to activate ATLL-specific cellular immunity is available. This study aimed to investigate whether live attenuated varicella-zoster virus (VZV) vaccination to ATLL can activate HTLV-1 Tax-specific cellular immune response. A total of 3 indolent- and 3 aggressive-type ATLL patients were enrolled. All aggressive-type patients had the VZV vaccination after completing anti-ATLL treatment including mogamulizumab, which is a monoclonal antibody for C-C chemokine receptor 4 antigen, plus combination chemotherapy, whereas all indolent-type patients had the VZV vaccination without any antitumor treatment. Cellular immune responses including Tax-specific CTLs were analyzed at several time points of pre- and post-VZV vaccination. After the VZV vaccination, a moderate increase in 1 of 3 indolent-type patients and obvious increase in all 3 aggressive-type patients in Tax-specific CTLs percentage were observed. The increase in the cell-mediated immunity against VZV was observed in all indolent- and aggressive-type patients after VZV vaccination. To conclude, VZV vaccination to aggressive-type ATLL patients after mogamulizumab plus chemotherapy led to the up-regulation of HTLV-1 Tax-specific CTLs without any adverse event. Suppression of regulatory T lymphocytes by mogamulizumab may have contributed to increase tumor immunity in aggressive-type ATLL patients. Japan Registry of Clinical Trials number, jRCTs051180107.
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Affiliation(s)
- Tatsuro Jo
- Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan.
| | - Ritsuko Kubota-Koketsu
- Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Yohei Kaneko
- Department of Laboratory, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Takahiro Sakai
- Department of Laboratory, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Kazuhiro Noguchi
- Department of Laboratory, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Sadaharu Irie
- Department of Pharmacy, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Masatoshi Matsuo
- Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Jun Taguchi
- Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Kuniko Abe
- Department of Pathology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Kazuto Shigematsu
- Department of Pathology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
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11
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Vafai N, Self K, Sheffield B, Hojvat S, Kusi-Appiah A, Vaughan P, Cowan E, Vafai A. Rapid, sensitive, and specific lateral-flow immunochromatographic point-of-care device for detection of varicella-zoster virus immunoglobulin G antibodies in fingerstick blood. J Immunol Methods 2023; 514:113429. [PMID: 36690067 DOI: 10.1016/j.jim.2023.113429] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/11/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
Varicella zoster virus (VZV) causes childhood chickenpox, becomes latent in sensory ganglia and reactivates years later to cause shingles (Zoster) and postherpetic neuralgia in the elderly and immunosuppressed individuals. Serologic IgG tests can be used to determine if a person has antibodies to VZV from past varicella infection or had received varicella or zoster (shingles) vaccination. Commercial enzyme-linked immunosorbent assays (ELISAs) are currently used for the detection of VZV IgG antibodies in patient serum samples. However, ELISA tests require collection and processing of blood samples in a CLIA laboratory to separate serum or plasma for further testing. In this paper, we describe the development and testing of an antibody based Lateral Flow Immunochromatographic assay (LFA) device for the detection of VZV IgG in fingerstick whole blood. Analytical and clinical analyses were performed to compare the performance characteristics of the Viro VZV IgG LFA (VZV LFA) and the Diamedix VZV IgG ELISA. Analytical studies demonstrated the higher sensitivity of the VZV LFA compared to the ELISA by testing dilutions of the WHO VZV IgG serum International Standard. Clinical performance characteristics of the VZV LFA fingerstick whole blood assay were assessed at three point of care (POC) facilities by untrained users testing samples from 300 prospectively enrolled study subjects. VZV LFA results were compared with results obtained by testing serum samples obtained from the same study participants by the Diamedix VZV IgG ELISA. Two specimens with invalid results by the LFA assay were not included in the LFA performance calculations and nine equivocal ELISA results were included as positive for IgG results. The results from all three POC clinical sites demonstrated the higher sensitivity/positive percent agreement (PPA) (99.26%, 95% CI: 97.34-99.80) of the VZV LFA compared to the Diamedix VZV IgG ELISA (94.08%, 95% CI: 90.72-96.27). The specificity/negative percent agreement (NPA) of the VZV LFA compared to the ELISA test was calculated initially to be 39.29% (95% CI: 23.57-57.59) with 19 discordant test results out of 298 test results between the two assays (17 LFA positive/ELISA negative and two LFA negative/ELISA positive). The PPA and true NPA of the VZV LFA were determined by testing all 298 samples, including the discordant (19) and all concordant negative and positive (279) study subject serum samples, before and after blocking VZV gE antibody sites in the samples by spiking with VZV LFA gE capture antigen. The NPA improved to 100% (95% CI: 74.12-100) after the procedure when compared to the ELISA test results. The comparator ELISA PPA based on the spiking/blocking study remained as 94.08%, (95% CI: 90.72-96.27), comparable to test results from untreated samples. The VZV LFA has been demonstrated to be simple and sufficiently robust for use in CLIA-waived POC facilities by untrained healthcare professionals and to detect VZV IgG in 20 min from fingerstick whole blood. The VZV LFA therefore provides a fast, reliable, and highly sensitive method of determining prior VZV viral infection or varicella and zoster vaccination status.
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Affiliation(s)
- Nicholas Vafai
- Viro Research, 2326 Wisteria Drive, Suite 220, Snellville, GA 30078, United States of America.
| | - Kevin Self
- DCN Diagnostics, 3193 Lionshead Avenue, Carlsbad, CA 92010, United States of America
| | - Bret Sheffield
- DCN Diagnostics, 3193 Lionshead Avenue, Carlsbad, CA 92010, United States of America
| | - Sally Hojvat
- Partners in Diagnostics, 199 East Montgomery Avenue, Suite 100, Rockville, MD 20850, United States of America
| | - Aubrey Kusi-Appiah
- Viro Research, 2326 Wisteria Drive, Suite 220, Snellville, GA 30078, United States of America
| | - Patrick Vaughan
- DCN Diagnostics, 3193 Lionshead Avenue, Carlsbad, CA 92010, United States of America
| | - Elliot Cowan
- Partners in Diagnostics, 199 East Montgomery Avenue, Suite 100, Rockville, MD 20850, United States of America
| | - Abbas Vafai
- Viro Research, 2326 Wisteria Drive, Suite 220, Snellville, GA 30078, United States of America
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12
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Pan D, Wang W, Cheng T. Current Methods for the Detection of Antibodies of Varicella-Zoster Virus: A Review. Microorganisms 2023; 11:microorganisms11020519. [PMID: 36838484 PMCID: PMC9965970 DOI: 10.3390/microorganisms11020519] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Infection with the varicella-zoster virus (VZV) causes chickenpox and shingles, which lead to significant morbidity and mortality globally. The detection of serum VZV-specific antibodies is important for the clinical diagnosis and sero-epidemiological research of VZV infection, and for assessing the effect of VZV vaccine immunization. Over recent decades, a variety of methods for VZV antibody detection have been developed. This review summarizes and compares the current methods for detecting VZV antibodies, and discussed future directions for this field.
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13
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Rodrigues F, Marlow R, Gouveia C, Correia P, Brett A, Silva C, Gameiro I, Rua I, Dias J, Martins M, Diogo R, Lopes T, Hipólito E, Moreira D, Costa Alves M, Prata F, Labrusco M, Gomes S, Fernandes A, Andrade A, Granjo Morais C, João Virtuoso M, Manuel Zarcos M, Teresa Raposo A, Boon A, Finn A. Prospective study of loss of health-related quality adjusted life years in children and their families due to uncomplicated and hospitalised varicella. Vaccine 2023; 41:1182-1189. [PMID: 36522267 DOI: 10.1016/j.vaccine.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/06/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION AND AIMS Although usually benign, varicella can lead to serious complications and sometimes long-term sequelae. Vaccines are safe and effective but not yet included in immunisation programmes in many countries. We aimed to quantify the impact on health-related quality of life (HRQoL) in terms of quality-adjusted life years (QALY) in children with varicella and their families, key to assessing cost-utility in countries with low mortality due to this infection. METHODS Children with varicella in the community and admitted to hospitals in Portugal were included over 18 months from January 2019. Children's and carers' HRQoL losses were assessed prospectively using standard multi-attribute utility instruments for measuring HRQoL (EQ-5D and CHU9D), from presentation to recovery, allowing the calculation of QALYs. RESULTS Among 109 families with children with varicella recruited from attendees at a pediatric emergency service (community arm), the mean HRQoL loss/child was 2.0 days (95 % CI 1.9-2.2, n = 101) (mean 5.4 QALYs/1000 children (95 % CI 5.3-6.1) and 1.3 days/primary carer (95 % CI 1.2-1.6, n = 103) (mean 3.6 QALYs /1000 carers (95 % CI 3.4-4.4). Among 114 families with children admitted to hospital because of severe varicella or a complication (hospital arm), the mean HRQoL loss/child was 9.8 days (95 % CI 9.4-10.6, n = 114) (mean 26.8 QALYs /1000 children (95 % CI 25.8-29.0) and 8.5 days/primary carer (95 % CI 7.4-9.6, n = 114) (mean 23.4 QALYs/1000 carers (95 % CI 20.3-26.2). Mean QALY losses/1000 patients were particularly high for bone and joint infections [67.5 (95 % CI 43.9-97.6)]. Estimates for children's QALYs lost using the CHU9D tool were well correlated with those obtained using EQ-5D, but substantially lower. CONCLUSIONS The impact of varicella on HRQoL is substantial. We report the first measurements of QALYs lost in hospitalised children and in the families of children both in the community and admitted to hospital, providing important information to guide vaccination policy recommendations.
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Affiliation(s)
- Fernanda Rodrigues
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal; Faculdade de Medicina, Universidade de Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal.
| | - Robin Marlow
- Bristol Vaccine Centre, Schools of Population Health Sciences and of Cellular and Molecular Medicine, University of Bristol, BS2 8AE, UK
| | - Catarina Gouveia
- Hospital D. Estefânia, Centro Hospitalar Lisboa Central, Rua Jacinta Marto, 1150-191 Lisboa, Portugal
| | - Paula Correia
- Hospital Prof. Doutor Fernando Fonseca, IC 19, 2720-276 Amadora, Portugal
| | - Ana Brett
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal; Faculdade de Medicina, Universidade de Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Catarina Silva
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
| | - Inês Gameiro
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
| | - Inês Rua
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
| | - João Dias
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
| | - Marta Martins
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
| | - Rui Diogo
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
| | - Teresa Lopes
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Av. Afonso Romão, 3000-602 Coimbra, Portugal
| | - Elsa Hipólito
- Hospital Infante D. Pedro, Av. Dr. Artur Ravara, 3810-164 Aveiro, Portugal
| | - Diana Moreira
- Centro Hospitalar de Vila Nova de Gaia/Espinho (Unidade 2), Rua Dr. Francisco Sá Carneiro, 4400-129 Vila Nova de Gaia, Portugal
| | - Manuela Costa Alves
- Hospital de Braga, Rua das Comunidades Lusíadas 133, 4710-243 Braga, Portugal
| | - Filipa Prata
- Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Miguel Labrusco
- Hospital Beatriz Ângelo, Av. Carlos Teixeira, 2674-514 Loures, Portugal
| | - Susana Gomes
- Hospital do Espírito Santo, Largo Senhor da Pobreza, 7000-811 Évora, Portugal
| | - Alexandre Fernandes
- Centro Materno Infantil do Norte, Largo da Maternidade de Júlio Dinis, 4050-651 Porto, Portugal
| | - Alexandra Andrade
- Hospital Nélio Mendonça, Av. Luís de Camões 6180, 9000-177 Funchal, Portugal
| | - Catarina Granjo Morais
- Centro Hospitalar e Universitário de S. João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Maria João Virtuoso
- Hospital de Faro, Centro Hospitalar e Universitário do Algarve, Rua Leão Penedo, 8000-386 Faro, Portugal
| | - Maria Manuel Zarcos
- Hospital de Santo André, Centro Hospitalar Leiria Pombal, Rua de Santo André, 2410-197 Leiria, Portugal
| | - Ana Teresa Raposo
- Hospital do Divino Espírito Santo, Av. D. Manuel I, 9500-370 Ponta Delgada, Portugal
| | - Adam Boon
- Bristol Vaccine Centre, Schools of Population Health Sciences and of Cellular and Molecular Medicine, University of Bristol, BS2 8AE, UK
| | - Adam Finn
- Bristol Vaccine Centre, Schools of Population Health Sciences and of Cellular and Molecular Medicine, University of Bristol, BS2 8AE, UK
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14
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Advances in Next-Generation Coronavirus Vaccines in Response to Future Virus Evolution. Vaccines (Basel) 2022; 10:vaccines10122035. [PMID: 36560445 PMCID: PMC9785936 DOI: 10.3390/vaccines10122035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022] Open
Abstract
Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread to more than 230 countries and territories worldwide since its outbreak in late 2019. In less than three years, infection by SARS-CoV-2 has resulted in over 600 million cases of COVID-19 and over 6.4 million deaths. Vaccines have been developed with unimaginable speed, and 11 have already been approved by the World Health Organization and given Emergency Use Listing. The administration of several first-generation SARS-CoV-2 vaccines has successfully decelerated the spread of COVID-19 but not stopped it completely. In the ongoing fight against viruses, genetic mutations frequently occur in the viral genome, resulting in a decrease in vaccine-induced antibody neutralization and widespread breakthrough infection. Facing the evolution and uncertainty of SARS-CoV-2 in the future, and the possibility of the spillover of other coronaviruses to humans, the need for vaccines with a broad spectrum of antiviral variants against multiple coronaviruses is recognized. It is imperative to develop a universal coronavirus or pan-coronavirus vaccine or drug to combat the ongoing COVID-19 pandemic as well as to prevent the next coronavirus pandemic. In this review, in addition to summarizing the protective effect of approved vaccines, we systematically summarize current work on the development of vaccines aimed at suppressing multiple SARS-CoV-2 variants of concern as well as multiple coronaviruses.
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15
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Marin M, Seward JF, Gershon AA. 25 Years of Varicella Vaccination in the United States. J Infect Dis 2022; 226:S375-S379. [PMID: 36265845 DOI: 10.1093/infdis/jiac251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/16/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Mona Marin
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jane F Seward
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,ASRT, Inc, Contractor, Smyrna, Georgia, USA
| | - Anne A Gershon
- Columbia University College of Physicians and Surgeons, New York, New York, USA
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16
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Cohen R, Gillet Y, Le Guen CG, Weil-Olivier C, Hau I, Dufour V, Pinquier D, Romain O, Raymond J, Faye A, Dommergues MA, Haas H, Levy C, Grimprel E. Vaccination, or how to alleviate the crisis in pediatric emergency units. Infect Dis Now 2022; 52:386-388. [DOI: 10.1016/j.idnow.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/05/2022] [Indexed: 10/14/2022]
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17
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Tommasi C, Breuer J. The Biology of Varicella-Zoster Virus Replication in the Skin. Viruses 2022; 14:982. [PMID: 35632723 PMCID: PMC9147561 DOI: 10.3390/v14050982] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 02/07/2023] Open
Abstract
The replication of varicella-zoster virus (VZV) in skin is critical to its pathogenesis and spread. Primary infection causes chickenpox, which is characterised by centrally distributed skin blistering lesions that are rich in infectious virus. Cell-free virus in the cutaneous blistering lesions not only spreads to cause further cases, but infects sensory nerve endings, leading to the establishment of lifelong latency in sensory and autonomic ganglia. The reactivation of virus to cause herpes zoster is again characterised by localised painful skin blistering rash containing infectious virus. The development of in vitro and in vivo models of VZV skin replication has revealed aspects of VZV replication and pathogenesis in this important target organ and improved our understanding of the vaccine strain vOKa attenuation. In this review, we outline the current knowledge on VZV interaction with host signalling pathways, the viral association with proteins associated with epidermal terminal differentiation, and how these interconnect with the VZV life cycle to facilitate viral replication and shedding.
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Affiliation(s)
- Cristina Tommasi
- School of Cellular and Molecular Medicine, University of Bristol, Bristol BS8 1TD, UK
| | - Judith Breuer
- Department of Infection, Institute of Child Health, University College London, London WC1N 1EH, UK
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18
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Wang W, Pan D, Cheng T, Zhu H. Rational Design of a Skin- and Neuro-Attenuated Live Varicella Vaccine: A Review and Future Perspectives. Viruses 2022; 14:848. [PMID: 35632591 PMCID: PMC9144592 DOI: 10.3390/v14050848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/18/2022] [Accepted: 04/18/2022] [Indexed: 11/21/2022] Open
Abstract
Primary varicella-zoster virus (VZV) infection causes varicella, which remains a prominent public health concern in children. Current varicella vaccines adopt the live-attenuated Oka strain, vOka, which retains the ability to infect neurons, establish latency and reactivate, leading to vaccine-associated zoster in some vaccinees. Therefore, it is necessary to develop a safer next-generation varicella vaccine to help reduce vaccine hesitancy. This paper reviews the discovery and identification of the skin- and neuro-tropic factor, the open reading frame 7 (ORF7) of VZV, as well as the development of a skin- and neuro-attenuated live varicella vaccine comprising an ORF7-deficient mutant, v7D. This work could provide insights into the research of novel virus vaccines based on functional genomics and reverse genetics.
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Affiliation(s)
- Wei Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Life Sciences, School of Public Health, Xiamen University, Xiamen 361102, China; (W.W.); (D.P.)
| | - Dequan Pan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Life Sciences, School of Public Health, Xiamen University, Xiamen 361102, China; (W.W.); (D.P.)
| | - Tong Cheng
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Life Sciences, School of Public Health, Xiamen University, Xiamen 361102, China; (W.W.); (D.P.)
| | - Hua Zhu
- Department of Microbiology and Molecular Genetics, New Jersey Medical School, Rutgers University, Newark, NJ 070101, USA
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