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Cui J, Zhao Y, Wang H, Qiu B, Cao Z, Li Q, Zhang Y, Yan F, Jin H, Wang T, Sun W, Feng N, Gao Y, Sun J, Wang Y, Perlman S, Zhao J, Yang S, Xia X. Equine Immunoglobulin and Equine Neutralizing F(ab')₂ Protect Mice from West Nile Virus Infection. Viruses 2016; 8:v8120332. [PMID: 27999340 PMCID: PMC5192393 DOI: 10.3390/v8120332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 12/13/2016] [Indexed: 12/16/2022] Open
Abstract
West Nile virus (WNV) is prevalent in Africa, Europe, the Middle East, West Asia, and North America, and causes epidemic encephalitis. To date, no effective therapy for WNV infection has been developed; therefore, there is urgent need to find an efficient method to prevent WNV disease. In this study, we prepared and evaluated the protective efficacy of immune serum IgG and pepsin-digested F(ab′)2 fragments from horses immunized with the WNV virus-like particles (VLP) expressing the WNV M and E proteins. Immune equine F(ab′)2 fragments and immune horse sera efficiently neutralized WNV infection in tissue culture. The passive transfer of equine immune antibodies significantly accelerated the virus clearance in the spleens and brains of WNV infected mice, and reduced mortality. Thus, equine immunoglobulin or equine neutralizing F(ab′)2 passive immunotherapy is a potential strategy for the prophylactic or therapeutic treatment of patients infected with WNV.
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Affiliation(s)
- Jiannan Cui
- College of Veterinary Medicine, Northeast Agricultural University, Harbin 150030, China.
- Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun 130122, China.
| | - Yongkun Zhao
- Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun 130122, China.
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Disease and Zoonoses, Yangzhou 225009, China.
| | - Hualei Wang
- Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun 130122, China.
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Disease and Zoonoses, Yangzhou 225009, China.
| | - Boning Qiu
- College of Veterinary Medicine, Jilin University, Changchun 130062, China.
| | - Zengguo Cao
- Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun 130122, China.
| | - Qian Li
- Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun 130122, China.
| | - Yanbo Zhang
- Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun 130122, China.
| | - Feihu Yan
- Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun 130122, China.
| | - Hongli Jin
- College of Veterinary Medicine, Jilin University, Changchun 130062, China.
| | - Tiecheng Wang
- Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun 130122, China.
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Disease and Zoonoses, Yangzhou 225009, China.
| | - Weiyang Sun
- Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun 130122, China.
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Disease and Zoonoses, Yangzhou 225009, China.
| | - Na Feng
- Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun 130122, China.
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Disease and Zoonoses, Yangzhou 225009, China.
| | - Yuwei Gao
- Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun 130122, China.
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Disease and Zoonoses, Yangzhou 225009, China.
| | - Jing Sun
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
| | - Yanqun Wang
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
| | - Stanley Perlman
- Department of Microbiology, University of Iowa, Iowa City, IA 52242, USA.
| | - Jincun Zhao
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
| | - Songtao Yang
- Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun 130122, China.
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Disease and Zoonoses, Yangzhou 225009, China.
| | - Xianzhu Xia
- Institute of Military Veterinary, Academy of Military Medical Sciences, Changchun 130122, China.
- Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Disease and Zoonoses, Yangzhou 225009, China.
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Roggendorf M, Kosinska AD, Liu J, Lu M. The Woodchuck, a Nonprimate Model for Immunopathogenesis and Therapeutic Immunomodulation in Chronic Hepatitis B Virus Infection. Cold Spring Harb Perspect Med 2015; 5:cshperspect.a021451. [PMID: 26511761 DOI: 10.1101/cshperspect.a021451] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The woodchuck hepatitis virus (WHV) and its host, the eastern woodchuck, is a very valuable model system for hepatitis B virus infection. Many aspects of WHV replication and pathogenesis resemble acute and chronic hepatitis B infection in patients. Since the establishment of immunological tools, woodchucks were used to develop new therapeutic vaccines and immunomodulatory approaches to treat chronic hepadnaviral infections. Combination therapy of nucleos(t)ide analogs, with prime-boost vaccination and triple therapy, including immunomodulatory strategies by blocking the interaction of the programmed death-1 (PD-1) receptor with its ligand inducing a potent T-cell response in chronic WHV carrier woodchucks, suppression of viral replication, and complete elimination of the virus in 30% of the animals. Both strategies may be used for future therapies in patients with chronic hepatitis B.
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Affiliation(s)
- Michael Roggendorf
- Institute for Virology, University of Duisburg-Essen, 45122 Essen, Germany
| | - Anna D Kosinska
- Institute for Virology, University of Duisburg-Essen, 45122 Essen, Germany
| | - Jia Liu
- Institute for Virology, University of Duisburg-Essen, 45122 Essen, Germany
| | - Mengji Lu
- Institute for Virology, University of Duisburg-Essen, 45122 Essen, Germany
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3
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Enhanced immune response to hepatitis B vaccination through immunization with a Pre-S1/Pre-S2/S vaccine. Med Microbiol Immunol 2015; 204:57-68. [PMID: 25557605 PMCID: PMC4305084 DOI: 10.1007/s00430-014-0374-x] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Accepted: 09/26/2014] [Indexed: 12/16/2022]
Abstract
Efficacy and safety of recombinant yeast-derived hepatitis B vaccines for prevention of hepatitis B have been demonstrated unequivocally worldwide as reflected in reduction in HBsAg carrier rates and hepatocellular carcinoma. A new generation of recombinant HBV vaccines expressed in mammalian cells containing Pre-S/S epitopes has been developed in several countries. Such vaccines are useful in special risk groups, i.e., in non-responders to conventional HBV vaccines including older adults, obese people, health care workers, patients with renal failure and on dialysis, transplant patients, patients with HIV as well as travelers on short notice to HBV endemic regions. The future of such vaccines depends on their enhanced immunogenicity and cost profile. Sci-B-Vac™ is a mammalian cell-derived recombinant Pre-S1/Pre-S2/S hepatitis B vaccine which has been shown to be highly immunogenic, inducing faster and higher seroprotection rates against HBV with higher anti-HBs levels at lower HBsAg doses as compared to conventional yeast-derived vaccines. Recently, it has been suggested that such Pre-S/S vaccines against HBV might be efficacious not only for prevention but also for intervention in persistent HBV infection. Data obtained in a recent clinical trial conducted in Vietnam in patients with chronic hepatitis B suggest that repeated monthly i.m. injections of the Sci-B-Vac™ co-administered with daily oral lamivudine treatment can suppress HBV replication and lead to anti-HBs seroconversion in ~50 % of treated patients. Optimization of protocols and efficacy of such an intervention, intended to bypass T cell exhaustion and immune tolerance to HBV remains to be explored.
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Kosinska AD, Liu J, Lu M, Roggendorf M. Therapeutic vaccination and immunomodulation in the treatment of chronic hepatitis B: preclinical studies in the woodchuck. Med Microbiol Immunol 2014; 204:103-14. [PMID: 25535101 PMCID: PMC4305085 DOI: 10.1007/s00430-014-0379-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Accepted: 09/18/2014] [Indexed: 12/12/2022]
Abstract
Infection with hepatitis B virus (HBV) may lead to subclinical, acute or chronic hepatitis. In the prevaccination era, HBV infections were endemic due to frequent mother to child transmission in large regions of the world. However, there are still estimated 240 million chronic HBV carriers today and ca. 620,000 patients die per year due to HBV-related liver diseases. Recommended treatment of chronic hepatitis B with interferon-α and/or nucleos(t)ide analogues does not lead to satisfactory results. Induction of HBV-specific T cells by therapeutic vaccination or immunomodulation may be an innovative strategy to overcome virus persistence. Vaccination with commercially available HBV vaccines in patients with or without therapeutic reduction of viral load did not result in effective immune control of HBV infection, suggesting that combination of antiviral treatment with new formulations of therapeutic vaccines is needed. The woodchuck (Marmota monax) and its HBV-like woodchuck hepatitis virus are a useful preclinical animal model for developing new therapeutic approaches in chronic hepadnaviral infections. Several innovative approaches combining antiviral treatments using nucleos(t)ide analogues, with prime-boost vaccination using DNA vaccines, new hepadnaviral antigens or recombinant adenoviral vectors were tested in the woodchuck model. In this review, we summarize these encouraging results obtained with these therapeutic vaccines. In addition, we present potential innovations in immunostimulatory strategies by blocking the interaction of the inhibitory programmed death receptor 1 with its ligand in this animal model.
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Affiliation(s)
- Anna D Kosinska
- Institute for Virology, University Hospital of Essen, University of Duisburg-Essen, Virchowstrasse 179, 45122, Essen, Germany
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5
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Protection from infection with influenza A H7N9 virus in a mouse model by equine neutralizing F(ab')2. Int Immunopharmacol 2014; 23:134-8. [PMID: 25192652 PMCID: PMC7106124 DOI: 10.1016/j.intimp.2014.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 08/17/2014] [Accepted: 08/20/2014] [Indexed: 11/23/2022]
Abstract
Influenza A H7N9 virus has demonstrated considerable pandemic potential in China ever since early spring 2013. Until now, there have been no specific medicines to treat influenza A H7N9 virus infected patients. Development of a safe and effective H7N9 therapeutic preparation is urgently needed. To this end, we prepared and evaluated the pepsin-digested F(ab′)2 fragments of serum IgGs from the horses inoculated with a inactivated influenza A H7N9 whole virus antigens. The protective effects of the F(ab′)2 fragments against H7N9 virus infection were determined in cultured MDCK cells by cytopathic effect (CPE) and evaluated in a BALB/c mouse model by observing death, weight loss and viral load. The in vitro results showed that the F(ab′)2 fragments had an HI titer of 1:2048 and a neutralization titer of 1: 31,623. The in vivo assays suggested that 600U of the preparations could efficiently protect BALB/c mice from a lethal dose of A/Anhui/01/2013 (H7N9) infection even when administered two days post infection. Thus, this highly purified preparation should be a potential candidate for treating severe patients suffering from influenza A H7N9.
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Wang J, Wang B, Huang S, Song Z, Wu J, Zhang E, Zhu Z, Zhu B, Yin Y, Lin Y, Xu Y, Zheng X, Lu M, Yang D. Immunosuppressive drugs modulate the replication of hepatitis B virus (HBV) in a hydrodynamic injection mouse model. PLoS One 2014; 9:e85832. [PMID: 24465734 PMCID: PMC3897536 DOI: 10.1371/journal.pone.0085832] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Accepted: 12/02/2013] [Indexed: 12/23/2022] Open
Abstract
Hepatitis B virus (HBV) reactivation and recurrence are common in patients under immunosuppression and can be controlled by hepatitis B immunoglobulin, antivirals, and hepatitis B vaccine. However, the detailed analysis of HBV infection under immunosuppression is essential for the prophylaxis and therapy for HBV reactivation and recurrence. In this study, HBV replication and T cell responses were analyzed in a HBV-transfected mouse model under immunosuppressive therapy. During the treatment, HBV replication was at a high level in mice treated with dexamethasone, cyclosporine, and cyclophosphamide, whereas was terminated in mice treated with mycophenolate mofetil. After the withdrawal, HBV replication was at low or high levels in the dexamethasone-treated mice or in both cyclosporine- and cyclophosphamide-treated mice. The early withdrawal of cyclosporine allowed the recovery of suppressed T cell responses and led to subsequent HBV clearance, while the adoptive immune transfer to the mice with HBV persistence led to HBV suppression. Taken together, long-term HBV persistence under immunosuppression depends on the immunosuppressive drugs used and on the treatment duration and is mediated by the suppressed intrahepatic CD8 T cell response. These data may be helpful for individualized immunosuppressive therapy in patients with high risk of HBV reactivation and recurrence, and the mouse system is suitable for studying HBV reactivation and recurrence under immunosuppression.
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Affiliation(s)
- Junzhong Wang
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Baoju Wang
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shunmei Huang
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhitao Song
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Wu
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ejuan Zhang
- Department of Microbiology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhenni Zhu
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bin Zhu
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Yin
- Department of Microbiology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Lin
- Department of Microbiology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Xu
- Department of Microbiology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xin Zheng
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengji Lu
- Institute of Virology, University Hospital Essen, University of Duisburg-Essen, Germany
- * E-mail: (DlY); (MgL)
| | - Dongliang Yang
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- * E-mail: (DlY); (MgL)
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7
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Beckebaum S, Kabar I, Cicinnati VR. Hepatitis B and C in liver transplantation: new strategies to combat the enemies. Rev Med Virol 2012; 23:172-93. [PMID: 23239274 DOI: 10.1002/rmv.1734] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Revised: 10/29/2012] [Accepted: 11/01/2012] [Indexed: 12/16/2022]
Abstract
Hepatitis B immune globulin-free therapeutic regimens with a nucleos(t)ide analogue (NUC) or NUC combinations after liver transplantation (LT) are currently being investigated for their efficacy and safety as HBV re-infection prophylaxis in clinical studies. Recurrence rates differ among these studies as most of them are limited by a non-randomised study design, small sample size, lack of long-term data and varying time intervals for the switch from combined to purely virostatic prophylaxis. Post-transplant pre-emptive antiviral therapy with pegylated IFN and ribavirin is associated with low sustained virological response rates and was found to have no advantage over treatment of manifest HCV re-infection. Safety and efficacy of triple antiviral therapy including boceprevir or telaprevir in patients with manifest HCV re-infection are currently under investigation in clinical trials. Relevant drug interactions have been shown to occur during calcineurin inhibitor (CNI) and concomitant triple antiviral therapy, which vary with type of CNI and choice of HCV protease inhibitor. Newer direct-acting antivirals with lower or minimal toxicity, when used in combination with immunosuppressives, are worthy of further study in LT patients. This review focuses on hot topics in the management of hepatitis B and C patients before and after LT and offers a critical summarised selection of the corresponding relevant studies published in the current literature or presented at recent liver congresses.
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Affiliation(s)
- Susanne Beckebaum
- Department of Transplant Medicine, University Hospital Münster, Münster, Germany.
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8
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The role of HBIg as hepatitis B reinfection prophylaxis following liver transplantation. Langenbecks Arch Surg 2011; 397:697-710. [DOI: 10.1007/s00423-011-0795-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Accepted: 03/28/2011] [Indexed: 12/23/2022]
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9
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Adoptive Immune Transfer of Hepatitis B Virus Specific Immunity From Immunized Living Liver Donors to Liver Recipients. Transplantation 2009; 87:103-11. [DOI: 10.1097/tp.0b013e31818bfc85] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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10
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Beckebaum S, Sotiropoulos GC, Gerken G, Cicinnati VR. Hepatitis B and liver transplantation: 2008 update. Rev Med Virol 2009; 19:7-29. [DOI: 10.1002/rmv.595] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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11
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Lu M, Yao X, Xu Y, Lorenz H, Dahmen U, Chi H, Dirsch O, Kemper T, He L, Glebe D, Gerlich WH, Wen Y, Roggendorf M. Combination of an antiviral drug and immunomodulation against hepadnaviral infection in the woodchuck model. J Virol 2008; 82:2598-603. [PMID: 18160442 PMCID: PMC2258919 DOI: 10.1128/jvi.01613-07] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Accepted: 12/14/2007] [Indexed: 12/29/2022] Open
Abstract
The essential role of multispecific immune responses for the control of hepatitis B virus (HBV) infection implies the need of multimodal therapeutic strategies for chronic HBV infection, including antiviral chemotherapy and immunomodulation. This hypothesis was tested in the woodchuck model by a combination of lamivudine pretreatment and subsequent immunizations of woodchucks chronically infected with woodchuck hepatitis virus. The immunizations were performed with DNA vaccines or antigen-antibody immune complexes (IC)/DNA vaccines. Immunizations with IC/DNA vaccines led to an anti-woodchuck hepatitis virus surface antibody response and significant reductions of viral load and antigenemia, suggesting that such a strategy may be effective against chronic HBV infection.
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Affiliation(s)
- Mengji Lu
- Institut für Virologie, Universitätsklinikum Essen, Hufelandstrasse 55, 45122 Essen, Germany.
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12
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Luo D, Ni B, Zhao G, Jia Z, Zhou L, Pacal M, Zhang L, Zhang S, Xing L, Lin Z, Wang L, Li J, Liang Y, Shi X, Zhao T, Zou L, Wu Y, Wang X. Protection from infection with severe acute respiratory syndrome coronavirus in a Chinese hamster model by equine neutralizing F(ab')2. Viral Immunol 2007; 20:495-502. [PMID: 17931120 DOI: 10.1089/vim.2007.0038] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
To warrant potential clinical testing, the equine anti-severe acute respiratory syndrome coronavirus (SARS-CoV) F(ab')(2) requires evaluation in as many animal models as possible. In this study, we established a new animal model, the Chinese hamster, susceptible to SARS-CoV infection. SARS-CoV could propagate effectively and sustain high levels for 1 wk in animal lungs. All animals were protected from SARS-CoV infection in preventive settings. Further, when used therapeutically this antibody led to an approximately 4-log(10) decrease in viral burden in infected animal lungs. The pathological changes in lungs correlated closely with the dose of antibody administered. The excellent preventive and therapeutic roles of equine anti-SARS-CoV F(ab')(2) in several animal models, including the novel Chinese hamster model described in this study, have provided exciting data concerning its potential clinical study.
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Affiliation(s)
- Deyan Luo
- Department of Immunology, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, People's Republic of China
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13
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Kulkarni K, Jacobson IM, Tennant BC. The role of the woodchuck model in the treatment of hepatitis B virus infection. Clin Liver Dis 2007; 11:707-25, vii. [PMID: 17981226 DOI: 10.1016/j.cld.2007.08.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Experimental studies of animals with chronic hepadnavirus infection could provide valuable insight into optimal therapeutic strategies for individuals with chronic HBV infection. In this review, we focus on the contributions of the woodchuck model to our understanding of HBV biology and on its role in the development of antiviral drug. Furthermore, we consider the implications of studies focusing on the natural history of WHV infection for the management of HBV and the capacity of treatment to prevent complications of chronic hepatitis B infection.
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Affiliation(s)
- Ketan Kulkarni
- Division of Gastroenterology and Hepatology, Department of Medicine, Weill Medical College of Cornell University, 1305 York Avenue, 4th floor, New York, NY 10021, USA
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Xu Y, Jia Z, Zhou L, Wang L, Li J, Liang Y, Zhao T, Ni B, Wu Y. Evaluation of the safety, immunogenicity and pharmacokinetics of equine anti-SARS-CoV F(ab')(2) in macaque. Int Immunopharmacol 2007; 7:1834-40. [PMID: 17996696 PMCID: PMC7106090 DOI: 10.1016/j.intimp.2007.09.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2007] [Revised: 09/08/2007] [Accepted: 09/11/2007] [Indexed: 01/09/2023]
Abstract
To warrant potential clinical testing, the equine anti-SARS-CoV F(ab')(2) requires evaluation in as many animal models as possible and a safety test in a primate model. In this study, we evaluated the pharmacokinetics, tolerance and immunity of this kind of antibody in macaques and rats. Results showed that the F(ab')(2) fragments had a normal metabolism in injected animals. The general physiological indexes did not differ between animals injected with anti-SARS-CoV F(ab')(2) or saline. However, a mild inflammatory response in local injection site and a moderate immune response against this antibody in the successively injected animals were observed, which however recovered 3 weeks after the last injection. The antibody titring from 1:100 to 400 against the equine anti-SARS-CoV F(ab')(2) in the inoculated hosts could be detected at week 2 during the successive injections of the equine F(ab')(2). The considerable safety of this antibody used in primates and the fact that the immune system of the host can be motivated by post-injection of the F(ab')(2) indicate that this type of anti-SARS-CoV antibody can be used for prevention and treatment of SASR, especially at the early stage of this virus infection. In addition, it can also provide the precious time for the combined use of other anti-SARS-CoV agents such as antiviral drug and vaccine.
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Affiliation(s)
- Yunsheng Xu
- Department of Dermatology, the First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, People's Republic of China
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15
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Olivera-Martínez MA, Gallegos-Orozco JF. Recurrent viral liver disease (hepatitis B and C) after liver transplantation. Arch Med Res 2007; 38:691-701. [PMID: 17613360 DOI: 10.1016/j.arcmed.2006.09.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2006] [Accepted: 09/20/2006] [Indexed: 12/19/2022]
Abstract
Hepatitis C represents more than 35% of liver transplant candidates worldwide. Meanwhile, hepatitis B continues to be an important cause of end-stage liver disease and hepatocellular carcinoma in Asia and Africa. Recurrent viral liver disease is a significant event after liver transplantation and continues to be one of the main causes of graft dysfunction and loss in the middle and long-term follow-up. Mechanisms of liver reinfection and disease recurrence vary between these two viruses and pre-emptive as well as the therapeutic approaches are different. Hepatitis B patients can be managed with immune globulin immediately after liver transplant and various agents such as nucleotide and nucleoside analogues can be associated. As a result, disease recurrence has been delayed or prevented in these patients. Individuals transplanted for hepatitis C are known to have universal reinfection and a high rate of disease recurrence has been reported in the literature. Strategies to treat hepatitis C recurrence are limited to the use of pegylated interferon and ribavirin when disease is demonstrated histologically and biochemically, although other strategies have been described with limited or no success. We herein review the mechanisms of disease recurrence and the current as well as the future therapeutic approaches to prevent and to treat these diseases.
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Affiliation(s)
- Marco Antonio Olivera-Martínez
- Department of Organ Transplantation, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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Sugawara Y, Makuuchi M. Liver transplantation for hepatitis B-related cirrhosis: recent advances. ACTA ACUST UNITED AC 2007; 13:378-81. [PMID: 17013710 DOI: 10.1007/s00534-005-1077-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2005] [Accepted: 10/30/2005] [Indexed: 01/14/2023]
Abstract
In the absence of preventative therapy, deceased-donor liver transplantation indicated for hepatitis B virus (HBV) cirrhosis results in dismal graft and patient survival due to HBV infection of the liver graft. Major advances in the management of HBV-infected recipients during the past 15 years have reduced the rate of graft infection, resulting in improved outcomes, comparable to those for patients transplanted for non-HBV indications. Long-term use of hepatitis B immunoglobulin for passive immunotherapy is effective in preventing re-infection. Combination therapy with hepatitis B immunoglobulin and lamivudine after liver transplantation reduces HBV recurrence. Adefovir dipoxil is a safe and effective alternative oral antiviral treatment for lamivudine-resistant mutant HBV. The high cost of hepatitis B immunoglobulin remains a problem that must be overcome by the development of HBV vaccines and potent adjuvants.
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Affiliation(s)
- Yasuhiko Sugawara
- Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Lalazar G, Rund D, Shouval D. Screening, prevention and treatment of viral hepatitis B reactivation in patients with haematological malignancies. Br J Haematol 2007; 136:699-712. [PMID: 17338776 DOI: 10.1111/j.1365-2141.2006.06465.x] [Citation(s) in RCA: 238] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The prevalence of hepatitis B virus (HBV) infection in patients with haematological malignancies is increased compared with the general population worldwide. HBV reactivation is common following chemotherapy and is associated with a high mortality despite prompt anti-viral treatment. HBV reactivation may necessitate interruption of chemotherapy with adverse prognostic consequences for the haematological disease. Chemotherapy-induced immune suppression may lead to increased HBV replication. Immune reconstitution within the weeks and months following recovery from chemotherapy may be associated with a flare of hepatitis B manifested by hepatocellular injury. Risk factors associated with HBV reactivation include detectable hepatitis B surface antigen (HBsAg), HBV DNA, Hepatitis B e (HBeAg) antigen, antibodies to hepatitis B core antigen (anti-HBc), treatment with corticosteroids, young age and male gender. Lamivudine is effective during HBV reactivation due to immune suppression. Clinical trials have demonstrated that pre-emptive antiviral treatment with lamivudine is superior to deferred treatment. Current recommendations emphasise screening for HBV infection in all haematology patients, particularly prior to chemotherapy. Patients who are HBsAg positive or HBV DNA positive should receive pre-emptive treatment with lamivudine before chemotherapy. The duration of lamivudine treatment may be prolonged commensurate with the degree of immunosuppression. HBV naïve patients should be immunised against hepatitis B, as should haematopoietic stem cell donors. In summary, overt and occult HBV pose a serious, but preventable, threat. Pre-treatment screening of patients at risk should be practiced diligently by all clinicians that treat patients with malignancies.
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Affiliation(s)
- Gadi Lalazar
- Liver Unit, Departments of Medicine, Hadassah-Hebrew University Hospital, Jerusalem, Israel
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18
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Menne S, Cote PJ. The woodchuck as an animal model for pathogenesis and therapy of chronic hepatitis B virus infection. World J Gastroenterol 2007; 13:104-24. [PMID: 17206759 PMCID: PMC4065868 DOI: 10.3748/wjg.v13.i1.104] [Citation(s) in RCA: 123] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This review describes the woodchuck and the woodchuck hepatitis virus (WHV) as an animal model for pathogenesis and therapy of chronic hepatitis B virus (HBV) infection and disease in humans. The establishment of woodchuck breeding colonies, and use of laboratory-reared woodchucks infected with defined WHV inocula, have enhanced our understanding of the virology and immunology of HBV infection and disease pathogenesis, including major sequelae like chronic hepatitis and hepatocellular carcinoma. The role of persistent WHV infection and of viral load on the natural history of infection and disease progression has been firmly established along the way. More recently, the model has shed new light on the role of host immune responses in these natural processes, and on how the immune system of the chronic carrier can be manipulated therapeutically to reduce or delay serious disease sequelae through induction of the recovery phenotype. The woodchuck is an outbred species and is not well defined immunologically due to a limitation of available host markers. However, the recent development of several key host response assays for woodchucks provides experimental opportunities for further mechanistic studies of outcome predictors in neonatal- and adult-acquired infections. Understanding the virological and immunological mechanisms responsible for resolution of self-limited infection, and for the onset and maintenance of chronic infection, will greatly facilitate the development of successful strategies for the therapeutic eradication of established chronic HBV infection. Likewise, the results of drug efficacy and toxicity studies in the chronic carrier woodchucks are predictive for responses of patients chronically infected with HBV. Therefore, chronic WHV carrier woodchucks provide a well-characterized mammalian model for preclinical evaluation of the safety and efficacy of drug candidates, experimental therapeutic vaccines, and immunomodulators for the treatment and prevention of HBV disease sequelae.
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Affiliation(s)
- Stephan Menne
- Department of Clinical Sciences, College of Veterinary Medicine, Veterinary Medical Center, Cornell University, Ithaca, NY 14853, USA.
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Shouval D. Adoptive transfer of immunity to HBV in liver transplant patients: a step forward toward the proof of concept for therapeutic vaccination or a transient immunologic phenomenon? Liver Transpl 2007; 13:14-7. [PMID: 17192904 DOI: 10.1002/lt.20953] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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20
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Luo Y, Lo CM, Cheung CK, Lau GK, Fan ST, Wong J. Identification of hepatitis B virus-specific lymphocytes in human liver grafts from HBV-immune donors. Liver Transpl 2007; 13:71-9. [PMID: 17031830 DOI: 10.1002/lt.20887] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Both animal and human studies have demonstrated the adoptive transfer of immunity against hepatitis B virus (HBV) through liver transplantation that may be attributed to the presence of HBV-specific immunocompetent cells of donor origin in liver grafts. In this study, we characterized the resident lymphocytes in 41 human liver grafts by immunohistochemical staining and flow cytometry and directly identified the intragraft HBV-specific lymphocytes in relation to the donor's and subsequent recipient's immunity using enzyme-linked immunospot assay. A significant number of HBV-specific T and B cells were detectable in 59.4% (19/32) and 28.1% (9/32), respectively, of liver grafts from HBV-immune donors. The presence of various HBV-specific lymphocytes was closely associated with each other and with a higher serum titer of antibody against hepatitis B surface antigen (anti-HBs) in donors (P < 0.05). After liver transplantation, 17 of 35 (48.6%) patients with chronic HBV infection showed a spontaneous anti-HBs production, which was significantly associated with a higher number of donor-derived T lymphocytes specific for hepatitis B surface antigen (P = 0.043). In conclusion, the presence of considerable numbers of donor-derived HBV-specific immunocompetent cells in grafts may account for the adoptive transfer of HBV immunity through liver transplantation.
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Affiliation(s)
- Ying Luo
- Department of Surgery, Centre for the Study of Liver Disease, The University of Hong Kong, Pokfulam, Hong Kong, China
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21
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Zhou L, Ni B, Luo D, Zhao G, Jia Z, Zhang L, Lin Z, Wang L, Zhang S, Xing L, Li J, Liang Y, Shi X, Zhao T, Zhou L, Wu Y, Wang X. Inhibition of infection caused by severe acute respiratory syndrome-associated coronavirus by equine neutralizing antibody in aged mice. Int Immunopharmacol 2006; 7:392-400. [PMID: 17276898 PMCID: PMC7106264 DOI: 10.1016/j.intimp.2006.10.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2006] [Revised: 10/19/2006] [Accepted: 10/20/2006] [Indexed: 12/28/2022]
Abstract
The high susceptibility of elderly to severe acute respiratory syndrome-associated coronavirus (SARS-CoV) indicates how crucial it is to protect the elderly by various strategies. Aged BALB/c mice displayed a high susceptibility to SARS-CoV and have been a valuable platform for evaluation of strategies against SARS-CoV infection. In this study, we confirmed the validity of this model using various methods, and verified that equine anti-SARS-CoV F(ab')2 can prevent aged animals from SARS-CoV infection. In a therapeutic setting, treatment with anti-SARS-CoV F(ab')2 decreased viral load more than several thousand folds in the lungs. Thus, this antibody should be a potential candidate for treatment of elderly patients suffering from SARS.
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Affiliation(s)
- Lili Zhou
- Department of Immunology, Institute of Microbiology Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, China
| | - Bing Ni
- Institute of Immunology, Third Military Medical University, Chongqing 400038, China
| | - Deyan Luo
- Department of Immunology, Institute of Microbiology Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, China
| | - Guangyu Zhao
- Department of Immunology, Institute of Microbiology Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, China
| | - Zhengcai Jia
- Institute of Immunology, Third Military Medical University, Chongqing 400038, China
| | - Liangyan Zhang
- Department of Immunology, Institute of Microbiology Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, China
| | - Zhihua Lin
- College of Bioengineering, Chongqing Institute of Technology, Chongqing 400050, China
| | - Li Wang
- Institute of Immunology, Third Military Medical University, Chongqing 400038, China
| | - Songle Zhang
- Department of Immunology, Institute of Microbiology Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, China
| | - Li Xing
- Department of Immunology, Institute of Microbiology Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, China
| | - Jintao Li
- Institute of Immunology, Third Military Medical University, Chongqing 400038, China
| | - Yunfei Liang
- Institute of Immunology, Third Military Medical University, Chongqing 400038, China
| | - Xinfu Shi
- Department of Immunology, Institute of Microbiology Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, China
| | - TingTing Zhao
- Institute of Immunology, Third Military Medical University, Chongqing 400038, China
| | - Liyun Zhou
- Institute of Immunology, Third Military Medical University, Chongqing 400038, China
| | - Yuzhang Wu
- Institute of Immunology, Third Military Medical University, Chongqing 400038, China
- Corresponding authors. Wang is to be contacted at State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Science, Beijing 100071, China. Wu, Institute of Immunology, Third Military Medical University, Chongqing 400038, China.
| | - Xiliang Wang
- Department of Immunology, Institute of Microbiology Epidemiology, Academy of Military Medical Sciences, Beijing, 100071, China
- Corresponding authors. Wang is to be contacted at State Key Laboratory of Pathogen and Biosecurity, Institute of Microbiology and Epidemiology, Academy of Military Medical Science, Beijing 100071, China. Wu, Institute of Immunology, Third Military Medical University, Chongqing 400038, China.
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22
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Lu J, Guo Z, Pan X, Wang G, Zhang D, Li Y, Tan B, Ouyang L, Yu X. Passive immunotherapy for influenza A H5N1 virus infection with equine hyperimmune globulin F(ab')2 in mice. Respir Res 2006; 7:43. [PMID: 16553963 PMCID: PMC1459145 DOI: 10.1186/1465-9921-7-43] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Accepted: 03/23/2006] [Indexed: 11/28/2022] Open
Abstract
Background Avian influenza virus H5N1 has demonstrated considerable pandemic potential. Currently, no effective vaccines for H5N1 infection are available, so passive immunotherapy may be an alternative strategy. To investigate the possible therapeutic effect of antibody against highly pathogenic H5N1 virus on a mammal host, we prepared specific equine anti-H5N1 IgGs from horses vaccinated with inactivated H5N1 virus, and then obtained the F(ab')2 fragments by pepsin digestion of IgGs. Methods The horses were vaccinated with inactivated H5N1 vaccine to prepare anti-H5N1 IgGs. The F(ab')2 fragments were purified from anti-H5N1 hyperimmune sera by a protocol for 'enhanced pepsin digestion'. The protective effect of the F(ab')2 fragments against H5N1 virus infection was determined in cultured MDCK cells by cytopathic effect (CPE) assay and in a BALB/c mouse model by survival rate assay. Results By the protocol for 'enhanced pepsin digestion', total 16 g F(ab')2 fragments were finally obtained from one liter equine antisera with the purity of over 90%. The H5N1-specific F(ab')2 fragments had a HI titer of 1:1024, and the neutralization titre of F(ab')2 reached 1: 2048. The in vivo assay showed that 100 μg of the F(ab')2 fragments could protect BALB/c mice infected with a lethal dose of influenza H5N1 virus. Conclusion The availability of highly purified H5N1-specific F(ab')2 fragments may be promising for treatment of influenza H5N1 infection. Our work has provided experimental support for the application of the therapeutic equine immunoglobulin in future large primate or human trials.
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Affiliation(s)
- Jiahai Lu
- Sun Yat-sen University, Guangzhou 510080, China.
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Samuel D, Shouval D. The questionable role of immunization against hepatitis B in HBV infected liver transplant patients. J Hepatol 2005; 43:203-6. [PMID: 15975686 DOI: 10.1016/j.jhep.2005.05.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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24
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Wang X, Ni B, Du X, Zhao G, Gao W, Shi X, Zhang S, Zhang L, Wang D, Luo D, Xing L, Jiang H, Li W, Jiang M, Mao L, He Y, Xiao Y, Wu Y. Protection of Mammalian Cells from Severe Acute Respiratory Syndrome Coronavirus Infection by Equine Neutralizing Antibody. Antivir Ther 2005. [DOI: 10.1177/135965350501000504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aetiological agent for severe acute respiratory syndrome (SARS) has been determined to be a new type of coronavirus (SARS-CoV) that infects a wide range of mammalian hosts. Up to now, there have been no specific drugs to protect against SARS-CoV infection, thus developing effective strategies against this newly emerged viral infection warrants urgent efforts. Adoptive immune therapy with pathogen-specific heterologous immunoglobulin has been successfully used to control the dissemination of many viral infections. To investigate whether a neutralizing antibody against SARS-CoV raised in an artiodactylous host can have a protective role on primate cells, we prepared serum IgGs and their pepsin-digested F(ab’)2 fragments from horses inoculated with purified SARS-CoV (BJ-01 strain). The protective effect of the F(ab’)2 fragments against SARS-CoV infection was determined in cultured Vero E6 cells by cytopathic effect (CPE), MTT and plaque-forming assays and in a Balb/c mouse model by CPE and quantitative RT-PCR. The results showed the neutralization titres of F(ab’)2 from three horses all reached at least 1:1600, and 50 μg of the F(ab’)2 fragments could completely neutralize 1x104 TCID50 SARS-CoV in vivo. Additionally, we observed that F(ab’)2 against BJ-01 strain could also protect cells from infection by the variant GZ-01 strain in vitro and in vivo. Our work has provided experimental support for testing the protective equine immunoglobulin in future large primate or human trials.
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Affiliation(s)
- Xiliang Wang
- Department of Immunology, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Bing Ni
- Institute of Immunology, Third Military Medical University, Chongqing, China
| | - Xinan Du
- Department of Immunology, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Guangyu Zhao
- Department of Immunology, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Wenda Gao
- Beth Israel Deaconess Medical Centre, Harvard Medical School, Boston, MA, USA
| | - Xinfu Shi
- Department of Immunology, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Songle Zhang
- Department of Immunology, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Liangyan Zhang
- Department of Immunology, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Dong Wang
- Department of Immunology, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Deyan Luo
- Department of Immunology, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Li Xing
- Department of Immunology, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Haiyan Jiang
- Department of Immunology, Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, China
| | - Wanling Li
- Institute of Immunology, Third Military Medical University, Chongqing, China
| | - Man Jiang
- Institute of Immunology, Third Military Medical University, Chongqing, China
| | - Liwei Mao
- Institute of Immunology, Third Military Medical University, Chongqing, China
| | - Yangdong He
- Institute of Immunology, Third Military Medical University, Chongqing, China
| | - Yu Xiao
- Institute of Immunology, Third Military Medical University, Chongqing, China
| | - Yuzhang Wu
- Institute of Immunology, Third Military Medical University, Chongqing, China
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Vierling JM. Management of HBV Infection in Liver Transplantation Patients. Int J Med Sci 2005; 2:41-49. [PMID: 15968339 PMCID: PMC1142224 DOI: 10.7150/ijms.2.41] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2004] [Accepted: 01/01/2005] [Indexed: 12/17/2022] Open
Abstract
In the absence of preventative therapy, reinfection of allografts with hepatitis B virus (HBV) after orthotopic liver transplantation (OLT) resulted in dismal allograft and patient survival. Major advances in the management of HBV-infected recipients of OLT during the past 15 years have steadily reduced the rate of reinfection, resulting in improved outcomes. Initially, long-term use of hepatitis B immune globulin (HBIG) as a source of anti-HBs antibodies was effective in preventing or delaying reinfection. Lamivudine monotherapy made it possible to suppress HBV replication prior to OLT, markedly decreasing the risk of reinfection. Although lamivudine monotherapy used before and after OLT could prevent reinfection, its effectiveness was limited by progressive development of lamivudine-resistant mutant infections. Combination therapy with HBIG and lamivudine after OLT reduced both HBV recurrence and the risk of lamivudine resistance even in patients with active HBV replication. Introduction of adefovir provided a safe, alternative oral antiviral able to treat effectively lamivudine-resistant mutants HBV. Available strategies to prevent reinfection have resulted in OLT outcomes for HBV-infected patients comparable to those for patients transplanted for non-HBV indications. In the future, combination therapies of HBIG and both nucleoside and/or nucleotide agents will undoubtedly be optimized. Development of new drugs to treat HBV will increase opportunities to combine agents to enhance safety, efficacy and prevent emergence of HBV escape mutants. New vaccines and adjuvants may make it possible to generate anti-HBs in immunosuppressed patients, eliminating the need for HBIG.
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Fiedler M, Rödicker F, Salucci V, Lu M, Aurisicchio L, Dahmen U, Jun L, Dirsch O, Pützer BM, Palombo F, Roggendorf M. Helper-dependent adenoviral vector-mediated delivery of woodchuck-specific genes for alpha interferon (IFN-alpha) and IFN-gamma: IFN-alpha but not IFN-gamma reduces woodchuck hepatitis virus replication in chronic infection in vivo. J Virol 2004; 78:10111-21. [PMID: 15331744 PMCID: PMC515010 DOI: 10.1128/jvi.78.18.10111-10121.2004] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Alpha interferon (IFN-alpha) and IFN-gamma are able to suppress hepadnavirus replication. The intrahepatic expression of high levels of IFN may enhance the antiviral activity. We investigated the effects of woodchuck-specific IFN-alpha (wIFN-alpha) and IFN-gamma(wIFN-gamma) on woodchuck hepatitis virus (WHV) replication in vivo by helper-dependent adenoviral (HD-Ad) vector-mediated gene transfer. The expression of biologically active IFNs was demonstrated in vitro after transduction of woodchuck cells with HD-Ad vectors encoding wIFN-alpha (HD-AdwIFN-alpha) or wIFN-gamma (HD-AdwIFN-gamma). The transduction efficacy of the HD-Ad vector in woodchuck liver in vivo was tested with a vector expressing green fluorescence protein (GFP). Immunohistochemical staining of liver samples on day 5 after injection showed expression of GFP in a high percentage of liver cells surrounding the central vein. The transduction of livers of WHV carriers in vivo with HD-AdwIFN-alpha or HD-AdwIFN-gamma induced levels of biologically active IFN, which could be measured in the sera of these animals. Expression of wIFN-alpha in the liver reduced intrahepatic WHV replication and WHV DNA in sera of about 1 log step in two of two woodchucks. Transduction with HD-AdwIFN-gamma, however, reduced WHV replicative intermediates only slightly in two of three animals, which was not accompanied with significant changes in the WHV DNA in sera. We demonstrated for the first time the successful HD-Ad vector-mediated transfer of genes for IFN-alpha and IFN-gamma in vivo and timely limited reduction of WHV replication by wIFN-alpha, but not by wIFN-gamma.
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MESH Headings
- Adenoviridae/genetics
- Animals
- Cells, Cultured
- Gene Expression
- Genetic Therapy/adverse effects
- Genetic Therapy/methods
- Genetic Vectors
- Green Fluorescent Proteins
- Helper Viruses/genetics
- Hepatitis B Virus, Woodchuck/immunology
- Hepatitis B Virus, Woodchuck/pathogenicity
- Hepatitis B Virus, Woodchuck/physiology
- Hepatitis, Viral, Animal/immunology
- Hepatitis, Viral, Animal/therapy
- Hepatitis, Viral, Animal/virology
- Hepatocytes/immunology
- Hepatocytes/virology
- In Vitro Techniques
- Interferon-alpha/biosynthesis
- Interferon-alpha/genetics
- Interferon-gamma/biosynthesis
- Interferon-gamma/genetics
- Luminescent Proteins/biosynthesis
- Luminescent Proteins/genetics
- Marmota/genetics
- Marmota/immunology
- Recombinant Proteins/biosynthesis
- Recombinant Proteins/genetics
- Transduction, Genetic
- Virus Replication
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Affiliation(s)
- Melanie Fiedler
- Institute of Virology, University Clinic Essen, Essen D-45122, Germany.
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