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Lani R, Thariq IM, Suhaimi NS, Hassandarvish P, Abu Bakar S. From defense to offense: Modulating toll-like receptors to combat arbovirus infections. Hum Vaccin Immunother 2024; 20:2306675. [PMID: 38263674 DOI: 10.1080/21645515.2024.2306675] [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: 09/08/2023] [Accepted: 01/14/2024] [Indexed: 01/25/2024] Open
Abstract
Arboviruses are a significant threat to global public health, with outbreaks occurring worldwide. Toll-like receptors (TLRs) play a crucial role in the innate immune response against these viruses by recognizing pathogen-associated molecular patterns and initiating an inflammatory response. Significantly, TLRs commonly implicated in the immune response against viral infections include TLR2, TLR4, TLR6, TLR3, TLR7, and TLR8; limiting or allowing them to replicate and spread within the host. Modulating TLRs has emerged as a promising approach to combat arbovirus infections. This review summarizes recent advances in TLR modulation as a therapeutic target in arbovirus infections. Studies have shown that the activation of TLRs can enhance the immune response against arbovirus infections, leading to increased viral clearance and protection against disease. Conversely, inhibition of TLRs can reduce the excessive inflammation and tissue damage associated with arbovirus infection. Modulating TLRs represents a potential therapeutic strategy to combat arbovirus infections.
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Affiliation(s)
- Rafidah Lani
- Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ilya Maisarah Thariq
- Tropical Infectious Diseases Research and Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nuramira Syazreen Suhaimi
- Tropical Infectious Diseases Research and Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Pouya Hassandarvish
- Tropical Infectious Diseases Research and Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Sazaly Abu Bakar
- Tropical Infectious Diseases Research and Education Centre, Universiti Malaya, Kuala Lumpur, Malaysia
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Flacco ME, Bianconi A, Cioni G, Fiore M, Calò GL, Imperiali G, Orazi V, Tiseo M, Troia A, Rosso A, Manzoli L. Immunogenicity, Safety and Efficacy of the Dengue Vaccine TAK-003: A Meta-Analysis. Vaccines (Basel) 2024; 12:770. [PMID: 39066408 PMCID: PMC11281463 DOI: 10.3390/vaccines12070770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 07/05/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
The TAK-003 dengue vaccine was licensed in Europe in December 2022, and the official recommendations from most EU countries are still under formulation. To support policymakers, we performed a meta-analysis to quantify TAK-003's immunogenicity, efficacy and safety among seronegative and seropositive populations after the administration of one or two vaccine doses. We included trials retrieved from MEDLINE, Scopus and ClinicalTrials.gov. The outcomes were the rates of seroconversion, virologically confirmed dengue fever and serious adverse events after each vaccine dose. Data were combined using random-effect proportion or head-to-head meta-analyses. We retrieved a total of 19 datasets, including >20,000 participants. TAK-003 showed an excellent safety profile, and the immunogenicity after two doses against the four DENV serotypes was ≥90% among both adults and children/adolescents who were either seronegative or seropositive at baseline. A single dose was able to elicit a high immunogenic response among adults (≥70%) and children/adolescents (≥90%). The primary two-dose immunization course halved the risk of all types of virologically confirmed dengue fever among seropositive children/adolescents, but seronegative minors were only protected against the diseases caused by DENV-1 and DENV-2. Overall, the results support the use of TAK-003 for the prevention of dengue fever in the pediatric population of endemic countries. Uncertainties remain on the use of a single vaccine dose in non-endemic countries.
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Affiliation(s)
- Maria Elena Flacco
- Department of Environmental and Prevention Sciences, School of Public Health, University of Ferrara, Via Fossato di Mortara 44, 44121 Ferrara, Italy; (M.E.F.); (G.C.); (G.L.C.); (G.I.); (V.O.); (M.T.); (A.T.); (A.R.)
| | - Alessandro Bianconi
- Department of Medical and Surgical Sciences, School of Public Health, University of Bologna, Via San Giacomo 12, 40138 Bologna, Italy; (A.B.); (M.F.)
| | - Giovanni Cioni
- Department of Environmental and Prevention Sciences, School of Public Health, University of Ferrara, Via Fossato di Mortara 44, 44121 Ferrara, Italy; (M.E.F.); (G.C.); (G.L.C.); (G.I.); (V.O.); (M.T.); (A.T.); (A.R.)
| | - Matteo Fiore
- Department of Medical and Surgical Sciences, School of Public Health, University of Bologna, Via San Giacomo 12, 40138 Bologna, Italy; (A.B.); (M.F.)
| | - Giovanna Letizia Calò
- Department of Environmental and Prevention Sciences, School of Public Health, University of Ferrara, Via Fossato di Mortara 44, 44121 Ferrara, Italy; (M.E.F.); (G.C.); (G.L.C.); (G.I.); (V.O.); (M.T.); (A.T.); (A.R.)
| | - Gianmarco Imperiali
- Department of Environmental and Prevention Sciences, School of Public Health, University of Ferrara, Via Fossato di Mortara 44, 44121 Ferrara, Italy; (M.E.F.); (G.C.); (G.L.C.); (G.I.); (V.O.); (M.T.); (A.T.); (A.R.)
| | - Vittorio Orazi
- Department of Environmental and Prevention Sciences, School of Public Health, University of Ferrara, Via Fossato di Mortara 44, 44121 Ferrara, Italy; (M.E.F.); (G.C.); (G.L.C.); (G.I.); (V.O.); (M.T.); (A.T.); (A.R.)
| | - Marco Tiseo
- Department of Environmental and Prevention Sciences, School of Public Health, University of Ferrara, Via Fossato di Mortara 44, 44121 Ferrara, Italy; (M.E.F.); (G.C.); (G.L.C.); (G.I.); (V.O.); (M.T.); (A.T.); (A.R.)
| | - Anastasia Troia
- Department of Environmental and Prevention Sciences, School of Public Health, University of Ferrara, Via Fossato di Mortara 44, 44121 Ferrara, Italy; (M.E.F.); (G.C.); (G.L.C.); (G.I.); (V.O.); (M.T.); (A.T.); (A.R.)
| | - Annalisa Rosso
- Department of Environmental and Prevention Sciences, School of Public Health, University of Ferrara, Via Fossato di Mortara 44, 44121 Ferrara, Italy; (M.E.F.); (G.C.); (G.L.C.); (G.I.); (V.O.); (M.T.); (A.T.); (A.R.)
| | - Lamberto Manzoli
- Department of Medical and Surgical Sciences, School of Public Health, University of Bologna, Via San Giacomo 12, 40138 Bologna, Italy; (A.B.); (M.F.)
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Guo H, Ding X, Hua D, Liu M, Yang M, Gong Y, Ye N, Chen X, He J, Zhang Y, Xu X, Li J. Enhancing Dengue Virus Production and Immunogenicity with Celcradle™ Bioreactor: A Comparative Study with Traditional Cell Culture Methods. Vaccines (Basel) 2024; 12:563. [PMID: 38932292 PMCID: PMC11209354 DOI: 10.3390/vaccines12060563] [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: 03/24/2024] [Revised: 05/12/2024] [Accepted: 05/13/2024] [Indexed: 06/28/2024] Open
Abstract
The dengue virus, the primary cause of dengue fever, dengue hemorrhagic fever, and dengue shock syndrome, is the most widespread mosquito-borne virus worldwide. In recent decades, the prevalence of dengue fever has increased markedly, presenting substantial public health challenges. Consequently, the development of an efficacious vaccine against dengue remains a critical goal for mitigating its spread. Our research utilized Celcradle™, an innovative tidal bioreactor optimized for high-density cell cultures, to grow Vero cells for dengue virus production. By maintaining optimal pH levels (7.0 to 7.4) and glucose concentrations (1.5 g/L to 3.5 g/L) during the proliferation of cells and viruses, we achieved a peak Vero cell count of approximately 2.46 × 109, nearly ten times the initial count. The use of Celcradle™ substantially decreased the time required for cell yield and virus production compared to conventional Petri dish methods. Moreover, our evaluation of the immunogenicity of the Celcradle™-produced inactivated DENV4 through immunization of mice revealed that sera from these mice demonstrated cross-reactivity with DENV4 cultured in Petri dishes and showed elevated antibody titers compared to those from mice immunized with virus from Petri dishes. These results indicate that the dengue virus cultivated using the Celcradle™ system exhibited enhanced immunogenicity relative to that produced in traditional methods. In conclusion, our study highlights the potential of the Celcradle™ bioreactor for large-scale production of inactivated dengue virus vaccines, offering significant promise for reducing the global impact of dengue virus infections and accelerating the development of effective vaccination strategies.
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Affiliation(s)
- Hongxia Guo
- Department of Biosafety, School of Basic Medicine, Army Medical University, Chongqing 400038, China; (H.G.); (X.D.); (D.H.); (M.L.); (M.Y.); (Y.G.); (N.Y.); (X.C.); (J.H.); (Y.Z.); (X.X.)
| | - Xiaoyan Ding
- Department of Biosafety, School of Basic Medicine, Army Medical University, Chongqing 400038, China; (H.G.); (X.D.); (D.H.); (M.L.); (M.Y.); (Y.G.); (N.Y.); (X.C.); (J.H.); (Y.Z.); (X.X.)
- Department of Pediatrics, Ludwig-Maximilians University of Munich, 80337 Munich, Germany
| | - Dong Hua
- Department of Biosafety, School of Basic Medicine, Army Medical University, Chongqing 400038, China; (H.G.); (X.D.); (D.H.); (M.L.); (M.Y.); (Y.G.); (N.Y.); (X.C.); (J.H.); (Y.Z.); (X.X.)
| | - Minchi Liu
- Department of Biosafety, School of Basic Medicine, Army Medical University, Chongqing 400038, China; (H.G.); (X.D.); (D.H.); (M.L.); (M.Y.); (Y.G.); (N.Y.); (X.C.); (J.H.); (Y.Z.); (X.X.)
| | - Maocheng Yang
- Department of Biosafety, School of Basic Medicine, Army Medical University, Chongqing 400038, China; (H.G.); (X.D.); (D.H.); (M.L.); (M.Y.); (Y.G.); (N.Y.); (X.C.); (J.H.); (Y.Z.); (X.X.)
| | - Yuanxin Gong
- Department of Biosafety, School of Basic Medicine, Army Medical University, Chongqing 400038, China; (H.G.); (X.D.); (D.H.); (M.L.); (M.Y.); (Y.G.); (N.Y.); (X.C.); (J.H.); (Y.Z.); (X.X.)
| | - Nan Ye
- Department of Biosafety, School of Basic Medicine, Army Medical University, Chongqing 400038, China; (H.G.); (X.D.); (D.H.); (M.L.); (M.Y.); (Y.G.); (N.Y.); (X.C.); (J.H.); (Y.Z.); (X.X.)
| | - Xiaozhong Chen
- Department of Biosafety, School of Basic Medicine, Army Medical University, Chongqing 400038, China; (H.G.); (X.D.); (D.H.); (M.L.); (M.Y.); (Y.G.); (N.Y.); (X.C.); (J.H.); (Y.Z.); (X.X.)
| | - Jiuxiang He
- Department of Biosafety, School of Basic Medicine, Army Medical University, Chongqing 400038, China; (H.G.); (X.D.); (D.H.); (M.L.); (M.Y.); (Y.G.); (N.Y.); (X.C.); (J.H.); (Y.Z.); (X.X.)
| | - Yu Zhang
- Department of Biosafety, School of Basic Medicine, Army Medical University, Chongqing 400038, China; (H.G.); (X.D.); (D.H.); (M.L.); (M.Y.); (Y.G.); (N.Y.); (X.C.); (J.H.); (Y.Z.); (X.X.)
| | - Xiaofeng Xu
- Department of Biosafety, School of Basic Medicine, Army Medical University, Chongqing 400038, China; (H.G.); (X.D.); (D.H.); (M.L.); (M.Y.); (Y.G.); (N.Y.); (X.C.); (J.H.); (Y.Z.); (X.X.)
| | - Jintao Li
- Department of Biosafety, School of Basic Medicine, Army Medical University, Chongqing 400038, China; (H.G.); (X.D.); (D.H.); (M.L.); (M.Y.); (Y.G.); (N.Y.); (X.C.); (J.H.); (Y.Z.); (X.X.)
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Freedman DO. A new dengue vaccine (TAK-003) now WHO recommended in endemic areas; what about travellers? J Travel Med 2023; 30:taad132. [PMID: 37847608 DOI: 10.1093/jtm/taad132] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/19/2023]
Abstract
Qdenga (Takeda) is now WHO recommended for residents of highly endemic areas. Travellers from dengue non-endemic countries with previous travel-related dengue (any serotype) will benefit from TAK-003 vaccination to prevent a secondary dengue infection during future dengue risk travel. Dengue-naïve travellers have less potential benefit and use will remain discretionary for now.
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Affiliation(s)
- David O Freedman
- Division of Infectious Diseases, Gorgas Memorial Institute, University of Alabama at Birmingham, Birmingham, AL, USA
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Patel SS, Winkle P, Faccin A, Nordio F, LeFevre I, Tsoukas CG. An open-label, Phase 3 trial of TAK-003, a live attenuated dengue tetravalent vaccine, in healthy US adults: immunogenicity and safety when administered during the second half of a 24-month shelf-life. Hum Vaccin Immunother 2023; 19:2254964. [PMID: 37846724 PMCID: PMC10583633 DOI: 10.1080/21645515.2023.2254964] [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: 05/11/2023] [Accepted: 08/31/2023] [Indexed: 10/18/2023] Open
Abstract
Dengue is caused by a mosquito-transmitted flavivirus. The disease is now endemic to many tropical and subtropical regions, manifesting as approximately 96 million symptomatic cases of dengue each year. Clinical trials have shown TAK-003 (Qdenga®), a live attenuated dengue tetravalent vaccine, to be well-tolerated, immunogenic, and efficacious in adults with no prior exposure to dengue virus infection living in non-endemic regions, as well as in adults and children living in dengue-endemic areas. This open-label, single-arm phase 3 trial (NCT03771963) was conducted in two dengue non-endemic areas of the USA, and it evaluated the immunogenicity and safety of naturally-aged TAK-003 administered to adult participants. Overall, the immunogenicity data from this trial are consistent with those reported from other TAK-003 phase 2 and 3 trials, and the safety data are consistent with the broader integrated safety data analysis. The data show that naturally-aged TAK-003 had a well-tolerated reactogenicity and adverse events profile when administered in the second half of its clinical 24-month shelf-life and that it still elicited an immune response that persisted up to 6 months after the second dose against all four dengue serotypes, with no important safety risks identified during the trial.
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Affiliation(s)
- Sanjay S. Patel
- Takeda Pharmaceuticals International AG, Zurich, Switzerland
| | | | - Alice Faccin
- Takeda Pharmaceuticals International AG, Zurich, Switzerland
| | | | - Inge LeFevre
- Takeda Pharmaceuticals International AG, Zurich, Switzerland
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Angelin M, Sjölin J, Kahn F, Ljunghill Hedberg A, Rosdahl A, Skorup P, Werner S, Woxenius S, Askling HH. Qdenga® - A promising dengue fever vaccine; can it be recommended to non-immune travelers? Travel Med Infect Dis 2023; 54:102598. [PMID: 37271201 DOI: 10.1016/j.tmaid.2023.102598] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/01/2023] [Indexed: 06/06/2023]
Abstract
Qdenga® has been approved by the European Medicines Agency (EMA) for individuals > 4 years of age and for use according to national recommendations. The vaccine shows high efficacy against virologically confirmed dengue and severe dengue in clinical studies on 4-16-year old's living in endemic areas. For individuals 16-60 years old only serological data exists and there is no data for individuals > 60 years. Its use as a travel vaccine is still unclear. We present the studies behind the approval and the recommendations for travelers as issued by the Swedish Society for Infectious Diseases Physicians.
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Affiliation(s)
- Martin Angelin
- Department of Clinical Microbiology, Infectious Diseases, Umeå University, Sweden
| | - Jan Sjölin
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Sweden
| | - Fredrik Kahn
- Department of Clinical Sciences, Division of Infection Medicine, Lund University, Sweden
| | - Anna Ljunghill Hedberg
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Sweden
| | - Anja Rosdahl
- School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden
| | - Paul Skorup
- Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Sweden
| | - Simon Werner
- Department of Infectious Diseases, Skåne University Hospital, Malmö, Region Skåne, Sweden
| | - Susanne Woxenius
- Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helena H Askling
- Department of Medicine, Solna, Division of Infectious Diseases, Karolinska Institutet, Sweden; Academic Specialist Centre, Stockholm County Health Care Services, Region Stockholm, Sweden.
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