1
|
Meng CY, Sun S, Liang Y, Xu H, Zhang C, Zhang M, Wang FS, Fu YX, Peng H. Engineered anti-PDL1 with IFNα targets both immunoinhibitory and activating signals in the liver to break HBV immune tolerance. Gut 2023; 72:1544-1554. [PMID: 36316098 PMCID: PMC10359590 DOI: 10.1136/gutjnl-2022-327059] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 10/12/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE The purpose of this study is to develop an anti-PDL1-based interferon (IFN) fusion protein to overcome the chronic hepatitis B virus (HBV)-induced immune tolerance, and combine this immunotherapy with a HBV vaccine to achieve the functional cure of chronic hepatitis B (CHB) infection. DESIGN We designed an anti-PDL1-IFNα heterodimeric fusion protein, in which one arm was derived from anti-PDL1 antibody and the other arm was IFNα, to allow targeted delivery of IFNα into the liver by anti-PDL1 antibody. The effect of the anti-PDL1-IFNα heterodimer on overcoming hepatitis B surface antigen (HBsAg) vaccine resistance was evaluated in chronic HBV carrier mice. RESULTS The anti-PDL1-IFNα heterodimer preferentially targeted the liver and resulted in viral suppression, the PD1/PDL1 immune checkpoint blockade and dendritic cell activation/antigen presentation to activate HBsAg-specific T cells, thus breaking immune tolerance in chronic HBV carrier mice. When an HBsAg vaccine was administered soon after anti-PDL1-IFNα heterodimer treatment, we observed strong anti-HBsAg antibody and HBsAg-specific T cell responses for efficient HBsAg clearance in chronic HBV carrier mice that received the combination treatment but not in those that received either single treatment. CONCLUSIONS Targeting the liver with an engineered anti-PDL1-IFNα heterodimer can break HBV-induced immune tolerance to an HBsAg vaccine, offering a promising translatable therapeutic strategy for the functional cure of CHB.
Collapse
Affiliation(s)
- Chao-Yang Meng
- Key Laboratory of Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Shiyu Sun
- Key Laboratory of Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Yong Liang
- Department of Basic Medical Sciences, School of Medicine, Tsinghua University, Beijing, China
| | - Hairong Xu
- Key Laboratory of Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Chao Zhang
- Senior Department of Infectious Diseases, 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Min Zhang
- Senior Department of Liver Disease, 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Fu-Sheng Wang
- Senior Department of Infectious Diseases, 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yang-Xin Fu
- Department of Basic Medical Sciences, School of Medicine, Tsinghua University, Beijing, China
| | - Hua Peng
- Key Laboratory of Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
2
|
Freyre FM, Aguiar JA, Cinza Z, Figueroa N, Diaz PA, Muzio VL, Lemos G, Freyre G, Coizeau E, Rodríguez C, Pentón E, Campos M, Santos IL, Mahtab MA, Akbar SMF, Guillen GE, Aguilar JC. Impact of the Route and Schedule of Immunization on the Serological and Virological Response of Chronic Hepatitis B Patients Treated with HeberNasvac. Euroasian J Hepatogastroenterol 2023; 13:73-78. [PMID: 38222949 PMCID: PMC10785140 DOI: 10.5005/jp-journals-10018-1402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 10/20/2023] [Indexed: 01/16/2024] Open
Abstract
HeberNasvac is a recently developed therapeutic vaccine for chronic hepatitis B (CHB) administered by intranasal (IN) and subcutaneous (SC) routes in a 14 days/10 doses schedule. To compare different schedules and routes of immunizations, a group of patients received four different vaccination regimens in a placebo-controlled factorial study. Subsequently, patients were followed for a minimum time of 48 weeks. Samples collected at the end of the follow-up were compared with initial samples. Groups I and II received the product by IN/SC routes, every 14 and 7 days, respectively. Groups III and IV were treated by SC route alone following a 14 and 7 days schedule. A group of 21 CHB patients received the vaccine in four different schedules and eight patients received placebo for a total of 29 patients enrolled. The 61.9% of vaccinees reduced their VL ≥2Log compared with baseline levels and 25% in placebo group. The 47.6% of vaccines reduced HBV levels to undetectable, 25% in placebo. HBeAg loss and seroconversion to anti-HBeAg was only achieved in vaccinees, 4 out of 9 (44.4%), and 40% (8 out of 20) developed anti-HBs response, none in placebo group. Reduction of HBsAg level in ≥1Log was achieved in the 35.0% of vaccinees and in none of the placebo-treated patients. Considering the individual and factorial analysis, significant HBV DNA reduction was detected in groups I and II, immunized by IN/SC routes. A significantly higher proportion of patients reducing VL to ≥2Log was also detected grouping the patients treated by IN/SC routes (G I + II) and grouping those inoculated every 14 days (G I + III), with 72.7% and 63.6%, respectively, compared with the placebo group (25.0%). The patients immunized every 14 days (G I + G III) also reduced the HBsAg levels compared with baseline. In conclusion, after more than 48 weeks of treatment-free follow-up, HeberNasvac-treated patients demonstrated superior responses compared with the placebo group in terms of antiviral and serological responses. The factorial analysis evidenced that the schedule combining the IN route of immunization and the frequency of 14 days resulted in the stronger antiviral and serological responses. Present results support the study of IN-only immunization schedules in future and was consistent with previous results. Long-lasting follow-ups were done to explore histological variables and the progression of serological variables in order to detect late responders. How to cite this article Freyre FM, Aguiar JA, Cinza Z, et al. Impact of the Route and Schedule of Immunization on the Serological and Virological Response of Chronic Hepatitis B Patients Treated with HeberNasvac. Euroasian J Hepato-Gastroenterol 2023;13(2):73-78.
Collapse
Affiliation(s)
- Freya Milagros Freyre
- Direction of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Jorge A Aguiar
- Direction of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Zurina Cinza
- Direction of Clinical Trials, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Nelvis Figueroa
- Direction of Clinical Trials, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Pablo Arsenio Diaz
- Direction of Clinical Trials, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Verena Lucila Muzio
- Direction of Clinical Trials, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Gilda Lemos
- Department of Regulatory Affairs, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Giselle Freyre
- Department of Regulatory Affairs, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Edelgis Coizeau
- Department of Regulatory Affairs, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Chabeli Rodríguez
- Direction of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Eduardo Pentón
- Direction of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Magalys Campos
- Direction of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Iván Luis Santos
- Direction of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Mamun Al Mahtab
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sheikh Mohammad Fazle Akbar
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan; Research Center for Global and Local Infectious Diseases, Oita University, Oita, Japan; Miyakawa Memorial Research Foundation, Tokyo, Japan
| | - Gerardo E Guillen
- Direction of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Julio Cesar Aguilar
- Direction of Biomedical Research, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| |
Collapse
|
3
|
Chuai X, Chen P, Chen H, Wang W, Deng Y, Ruan L, Li W, Tan W. Protective efficacy and hepatitis B virus clearance in mice enhanced by cell-mediated immunity with novel prime-boost regimens. J Viral Hepat 2017; 24:337-345. [PMID: 27885748 DOI: 10.1111/jvh.12649] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 10/13/2016] [Indexed: 12/30/2022]
Abstract
In this study, anti-hepatitis B virus (HBV) immunity was evaluated in mice using several regimens of the HBV recombinant protein vaccine HBSS1 that expressed in CHO cells containing S (1-223 aa) and preS1 (21-47 aa) and recombinant adenovirus rAdSS1 vaccine. Further, the protective efficacy of these vaccine regimens was studied in a mouse model. High titres of antigen-specific antibodies and neutralizing activity were elicited in mice after vaccination. However, robust multi-antigen (preS1 and S)-specific cell-mediated immunity (CMI) was only detected in mice primed with HBSS1 and boosted with rAdSS1. Moreover, functional T-cell responses with high levels of cytokines and antigen-specific cytotoxic T-cell responses (CD107a+ CD8+ ) were also detected in the mice. Rapid clearance of hepatitis B surface antigen and HBV DNA in blood and significantly decreased hepatitis B envelope antigen levels were observed in mice immunized with the heterogeneous prime-boost vaccine after hepatitis B virus challenge by hydrodynamic injection (HI) of pCS-HBV1.3. The clearance of HBV correlated well with antigen-specific CMI (Th1 and CTL responses) and cytokine profiles (IFN-γ, TNF-α, IL-2) elicited by vaccination. Taken together, our results might contribute to the development of new human HBV vaccines and a better understanding of the mechanisms underlying immune protection and clearance of hepatitis B virus infection.
Collapse
Affiliation(s)
- X Chuai
- Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.,Department of Pathogenic Biology, Hebei Medical University, Shijiazhuang, Heibei Province, China
| | - P Chen
- National Institute of Biological Sciences, Beijing, China
| | - H Chen
- Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - W Wang
- Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Y Deng
- Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - L Ruan
- Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - W Li
- National Institute of Biological Sciences, Beijing, China
| | - W Tan
- Key Laboratory of Medical Virology, Ministry of Health, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
4
|
Ward H, Tang L, Poonia B, Kottilil S. Treatment of hepatitis B virus: an update. Future Microbiol 2016; 11:1581-1597. [PMID: 27855500 DOI: 10.2217/fmb-2016-0128] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Chronic hepatitis B virus infection is a global health concern as it affects over 240 million people worldwide and an estimated 686,000 people die annually as a result of complications of the disease. With the development of newer antiviral drugs, viral suppression of HBV is achievable, however elimination of HBV from infected individuals (functional cure) remains an issue. Due to persistence of HBV DNA (cccDNA) in infected cells, chronically infected patients who discontinue therapy prior to HBsAg loss or seroconversion are likely to relapse. Several novel therapeutic strategies are being researched and studied in clinical trials. Here we review these novel strategies to achieve sustained cure or elimination of HBV. These strategies include the targeting of the host or viral factors required for viral persistence as well as therapeutic vaccines.
Collapse
Affiliation(s)
- Haley Ward
- Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA
| | - Lydia Tang
- Division of Clinical Care & Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Bhawna Poonia
- Division of Clinical Care & Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Shyam Kottilil
- Division of Clinical Care & Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| |
Collapse
|
5
|
Treatment of Hepatitis B: A Concise Review. Clin Transl Gastroenterol 2016; 7:e190. [PMID: 27628420 PMCID: PMC5288592 DOI: 10.1038/ctg.2016.46] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 07/26/2016] [Indexed: 02/07/2023] Open
|
6
|
Zhu D, Liu L, Yang D, Fu S, Bian Y, Sun Z, He J, Su L, Zhang L, Peng H, Fu YX. Clearing Persistent Extracellular Antigen of Hepatitis B Virus: An Immunomodulatory Strategy To Reverse Tolerance for an Effective Therapeutic Vaccination. THE JOURNAL OF IMMUNOLOGY 2016; 196:3079-87. [PMID: 26936879 DOI: 10.4049/jimmunol.1502061] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 02/01/2016] [Indexed: 12/14/2022]
Abstract
Development of therapeutic vaccines/strategies to control chronic hepatitis B virus (HBV) infection has been challenging because of HBV-induced tolerance. In this study, we explored strategies for breaking tolerance and restoring the immune response to the HBV surface Ag in tolerant mice. We demonstrated that immune tolerance status is attributed to the level and duration of circulating HBsAg in HBV carrier models. Removal of circulating HBsAg by a monoclonal anti-HBsAg Ab in tolerant mice could gradually reduce tolerance and reestablish B cell and CD4(+) T cell responses to subsequent Engerix-B vaccination, producing protective IgG. Furthermore, HBsAg-specific CD8(+) T cells induced by the addition of a TLR agonist resulted in clearance of HBV in both serum and liver. Thus, generation of protective immunity can be achieved by clearing extracellular viral Ag with neutralizing Abs followed by vaccination.
Collapse
Affiliation(s)
- Danming Zhu
- Institute of Biophysics-University of Texas Group for Immunotherapy, Chinese Academy of Sciences Key Laboratory for Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Chaoyang District, Beijing 100101, China
| | - Longchao Liu
- Institute of Biophysics-University of Texas Group for Immunotherapy, Chinese Academy of Sciences Key Laboratory for Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Chaoyang District, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Dan Yang
- Institute of Biophysics-University of Texas Group for Immunotherapy, Chinese Academy of Sciences Key Laboratory for Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Chaoyang District, Beijing 100101, China
| | - Sherry Fu
- Department of Pathology and Immunology, University of Texas Southwestern Medical Center, Dallas, TX 75225; and
| | - Yingjie Bian
- Institute of Biophysics-University of Texas Group for Immunotherapy, Chinese Academy of Sciences Key Laboratory for Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Chaoyang District, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhichen Sun
- Institute of Biophysics-University of Texas Group for Immunotherapy, Chinese Academy of Sciences Key Laboratory for Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Chaoyang District, Beijing 100101, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Junming He
- Institute of Biophysics-University of Texas Group for Immunotherapy, Chinese Academy of Sciences Key Laboratory for Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Chaoyang District, Beijing 100101, China
| | - Lishan Su
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Liguo Zhang
- Institute of Biophysics-University of Texas Group for Immunotherapy, Chinese Academy of Sciences Key Laboratory for Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Chaoyang District, Beijing 100101, China
| | - Hua Peng
- Institute of Biophysics-University of Texas Group for Immunotherapy, Chinese Academy of Sciences Key Laboratory for Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Chaoyang District, Beijing 100101, China;
| | - Yang-Xin Fu
- Institute of Biophysics-University of Texas Group for Immunotherapy, Chinese Academy of Sciences Key Laboratory for Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Chaoyang District, Beijing 100101, China; Department of Pathology and Immunology, University of Texas Southwestern Medical Center, Dallas, TX 75225; and
| |
Collapse
|
7
|
Backes S, Jäger C, Dembek CJ, Kosinska AD, Bauer T, Stephan AS, Dišlers A, Mutwiri G, Busch DH, Babiuk LA, Gasteiger G, Protzer U. Protein-prime/modified vaccinia virus Ankara vector-boost vaccination overcomes tolerance in high-antigenemic HBV-transgenic mice. Vaccine 2016; 34:923-32. [DOI: 10.1016/j.vaccine.2015.12.060] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 11/30/2015] [Accepted: 12/24/2015] [Indexed: 12/31/2022]
|
8
|
Brahmania M, Feld J, Arif A, Janssen HLA. New therapeutic agents for chronic hepatitis B. THE LANCET. INFECTIOUS DISEASES 2016; 16:e10-21. [PMID: 26795693 DOI: 10.1016/s1473-3099(15)00436-3] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/13/2015] [Accepted: 11/03/2015] [Indexed: 12/11/2022]
Abstract
The treatment goal for chronic hepatitis B is true eradication of the hepatitis B virus, but this is rarely achieved with first-line treatment regimens because of an inability to disrupt covalently closed circular DNA and an inadequate host immune response. Therefore, new antiviral agents are needed to target various stages of the hepatitis B virus lifecycle and modulation of the immune system. This Review provides a summary of available regimens with their strengths and limitations, and highlights future therapeutic strategies to target the virus and host immune response. These new agents can hopefully lead to a finite duration of treatment, and provide a functional and durable cure for chronic hepatitis B infection.
Collapse
Affiliation(s)
- Mayur Brahmania
- Toronto Centre for Liver Diseases, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Jordan Feld
- Toronto Centre for Liver Diseases, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Ambreen Arif
- Toronto Centre for Liver Diseases, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Harry L A Janssen
- Toronto Centre for Liver Diseases, Toronto Western Hospital, University Health Network, Toronto, ON, Canada; Department of Gastroenterology and Hepatology, Erasmus Medical Center University Hospital, Rotterdam, Netherlands.
| |
Collapse
|
9
|
Yu D, Liu H, Shi S, Dong L, Wang H, Wu N, Gao H, Cheng Z, Zheng Q, Cai J, Zou L, Zou Z. A novel dendritic-cell-targeting DNA vaccine for hepatitis B induces T cell and humoral immune responses and potentiates the antivirus activity in HBV transgenic mice. Immunol Lett 2015; 168:293-9. [PMID: 26475398 DOI: 10.1016/j.imlet.2015.10.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/24/2015] [Accepted: 10/09/2015] [Indexed: 12/28/2022]
Abstract
Strategies for inducing an effective immune response following vaccination have focused on targeting antigens to dendritic cells (DCs) through the DC-specific surface molecule DEC-205. The immunogenicity and efficacy of DNA vaccination can also be enhanced by fusing the encoded antigen to single-chain antibodies directed against DEC-205. Here, we investigated this promising approach for its enhancement of hepatitis B virus (HBV)-specific cellular and humoral immune responses and its antiviral effects in HBV transgenic mice. A plasmid DNA vaccine encoding mouse DEC-205 single-chain fragment variable (mDEC-205-scFv) linked with the hepatitis B surface antigen (HBsAg) was constructed. Vaccination with this fusion DNA vaccine in HBV transgenic mice induced robust antiviral T cell and antibody immunity against HBsAg. The levels of serum-circulating HBsAg and the HBV DNA copy number were downregulated by the induction of a higher HBsAg-specific response. Thus, in this study, we demonstrated the therapeutic efficacy of the novel mDEC-205-scFv-fused DNA vaccine in a mouse model of immune-tolerant, chronic HBV infection.
Collapse
Affiliation(s)
- Debin Yu
- Key Laboratory for Molecular Enzymology and Engineering of the Ministry of Education, National Engineering Laboratory for AIDS Vaccine, School of Life Science, Jilin University, Changchun 130012, China
| | - Hong Liu
- Zhejiang Normal University-Jinhua People's Hospital Joint Center for Biomedical Research, Jinhua, China
| | - Shuai Shi
- Zhejiang Normal University-Jinhua People's Hospital Joint Center for Biomedical Research, Jinhua, China
| | - Liwei Dong
- Key Laboratory for Molecular Enzymology and Engineering of the Ministry of Education, National Engineering Laboratory for AIDS Vaccine, School of Life Science, Jilin University, Changchun 130012, China
| | - Hongge Wang
- Key Laboratory for Molecular Enzymology and Engineering of the Ministry of Education, National Engineering Laboratory for AIDS Vaccine, School of Life Science, Jilin University, Changchun 130012, China
| | - Nuoting Wu
- Key Laboratory for Molecular Enzymology and Engineering of the Ministry of Education, National Engineering Laboratory for AIDS Vaccine, School of Life Science, Jilin University, Changchun 130012, China
| | - Hui Gao
- Zhejiang Normal University-Jinhua People's Hospital Joint Center for Biomedical Research, Jinhua, China
| | - Zhaojun Cheng
- Zhejiang Normal University-Jinhua People's Hospital Joint Center for Biomedical Research, Jinhua, China
| | - Qun Zheng
- Zhejiang Normal University-Jinhua People's Hospital Joint Center for Biomedical Research, Jinhua, China
| | - Jiaojiao Cai
- Zhejiang Normal University-Jinhua People's Hospital Joint Center for Biomedical Research, Jinhua, China
| | - Libo Zou
- Zhejiang Normal University-Jinhua People's Hospital Joint Center for Biomedical Research, Jinhua, China.
| | - Zhihua Zou
- Key Laboratory for Molecular Enzymology and Engineering of the Ministry of Education, National Engineering Laboratory for AIDS Vaccine, School of Life Science, Jilin University, Changchun 130012, China.
| |
Collapse
|
10
|
Chang J, Guo JT. Treatment of chronic hepatitis B with pattern recognition receptor agonists: Current status and potential for a cure. Antiviral Res 2015. [PMID: 26205674 DOI: 10.1016/j.antiviral.2015.07.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Hepatitis B virus (HBV) has been considered to be a "stealth virus" that induces negligible innate immune responses during the early phase of infection. However, recent studies with newly developed experimental systems have revealed that virus infection can be recognized by pattern recognition receptors (PRR), eliciting a cytokine response that controls the replication of the virus. The molecular mechanisms by which interferons and other inflammatory cytokines suppress HBV replication and modulate HBV cccDNA metabolism and function are just beginning to be revealed. In agreement with the notion that the developmental and functional status of intrahepatic innate immunity determines the activation and maturation of the HBV-specific adaptive immune response and thus the outcome of HBV infection, pharmacological activation of intrahepatic innate immune responses with TLR7/8/9 or STING agonists efficiently controls HBV infection in preclinical studies and thus holds great promise for the cure of chronic hepatitis B. This article forms part of a symposium in Antiviral Research on "An unfinished story: from the discovery of the Australia antigen to the development of new curative therapies for hepatitis B."
Collapse
Affiliation(s)
- Jinhong Chang
- Department of Experimental Therapeutics, The Baruch S. Blumberg Institute, Hepatitis B Foundation, 3805 Old Easton Road, Doylestown, PA 18902, USA.
| | - Ju-Tao Guo
- Department of Experimental Therapeutics, The Baruch S. Blumberg Institute, Hepatitis B Foundation, 3805 Old Easton Road, Doylestown, PA 18902, USA
| |
Collapse
|
11
|
Abstract
PURPOSE OF REVIEW Hepatitis B virus (HBV) causes a large proportion of chronic liver disease worldwide. The limited efficiency of current treatments based on the use of nucleotide/nucleoside analogues or interferon-alpha requires the development of new therapeutic tools for the treatment of chronic HBV. We summarize the most recent therapeutic strategies designed to directly target HBV-infected hepatocytes or to restore antiviral immunity during chronic HBV infection. RECENT FINDINGS Novel therapies directly target HBV-infected hepatocytes by inducing covalently closed circular DNA degradation or by inhibiting HBV entry or the expression of viral proteins. In addition, immunotherapeutic approaches may boost HBV-specific T-cell responses or stimulate the intrahepatic innate response. SUMMARY These new therapeutic approaches have mainly been tested in animal models. In humans, therapeutic strategies could be tailored to different chronic HBV patients in relation to their clinical and virological disease profile.
Collapse
|
12
|
Lee YB, Lee JH, Kim YJ, Yoon JH, Lee HS. The effect of therapeutic vaccination for the treatment of chronic hepatitis B virus infection. J Med Virol 2015; 87:575-82. [DOI: 10.1002/jmv.24091] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2014] [Indexed: 01/05/2023]
Affiliation(s)
- Yun Bin Lee
- Department of Internal Medicine and Liver Research Institute; Seoul National University College of Medicine; Seoul Korea
- Department of Internal Medicine; CHA Bundang Medical Center; CHA University; Seongnam Korea
| | - Jeong-Hoon Lee
- Department of Internal Medicine and Liver Research Institute; Seoul National University College of Medicine; Seoul Korea
| | - Yoon Jun Kim
- Department of Internal Medicine and Liver Research Institute; Seoul National University College of Medicine; Seoul Korea
| | - Jung-Hwan Yoon
- Department of Internal Medicine and Liver Research Institute; Seoul National University College of Medicine; Seoul Korea
| | - Hyo-Suk Lee
- Department of Internal Medicine and Liver Research Institute; Seoul National University College of Medicine; Seoul Korea
| |
Collapse
|
13
|
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.
Collapse
|
14
|
Zheng J, Hu L, Zhang M, Xu J, He P. An electrochemical sensing strategy for the detection of the hepatitis B virus sequence with homogenous hybridization based on host–guest recognition. RSC Adv 2015. [DOI: 10.1039/c5ra16204a] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Schematic for electrochemically sensing DNA with hybridization in homogeneous solutionviahost–guest recognition based on MNPs/β-CD.
Collapse
Affiliation(s)
- Jing Zheng
- Department of Chemistry & Chemical Engineering
- Shanghai University of Engineering Science
- Shanghai
- P. R. China
- Department of Chemistry
| | - Liping Hu
- Department of Chemistry & Chemical Engineering
- Shanghai University of Engineering Science
- Shanghai
- P. R. China
| | - Min Zhang
- Department of Chemistry & Chemical Engineering
- Shanghai University of Engineering Science
- Shanghai
- P. R. China
| | - Jingli Xu
- Department of Chemistry & Chemical Engineering
- Shanghai University of Engineering Science
- Shanghai
- P. R. China
| | - Pingang He
- Department of Chemistry
- East China Normal University
- Shanghai
- P. R. China
| |
Collapse
|
15
|
Gordon D, Kelley P, Heinzel S, Cooper P, Petrovsky N. Immunogenicity and safety of Advax™, a novel polysaccharide adjuvant based on delta inulin, when formulated with hepatitis B surface antigen: a randomized controlled Phase 1 study. Vaccine 2014; 32:6469-77. [PMID: 25267153 PMCID: PMC4253909 DOI: 10.1016/j.vaccine.2014.09.034] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/15/2014] [Accepted: 09/17/2014] [Indexed: 12/19/2022]
Abstract
There is a need for additional safe and effective human vaccine adjuvants. Advax™ is a novel adjuvant produced from semi-crystalline particles of delta inulin. In animal studies Advax enhanced humoral and cellular immunity to hepatitis B surface antigen (HBsAg) without inducing local or systemic reactogenicity. This first-in-man Phase 1 clinical trial tested the safety and tolerability of three intramuscular doses of HBsAg formulated with Advax in a group of healthy adult subjects. Advax was well tolerated with injection site pain scores not significantly different to subjects receiving HBsAg alone and no adverse events were reported in subjects that received Advax. Seroprotection and HBsAb geometric mean titers (GMT) after three immunizations were higher in the Advax 5mg (seroprotection 5/6, 83.3%, GMT 40.7, 95% CI 11.9-139.1) and 10mg (seroprotection 4/5, 80%, GMT 51.6, 95% CI 10.0-266.2) groups versus HBsAg alone (seroprotection 1/5, 20%, GMT 4.1, 95% CI 1.3-12.8). Similarly the proportion of subjects with positive CD4 T-cell responses to HBsAg was higher in the Advax 5mg (4/6, 67%) and Advax 10mg (4/5, 80%) groups versus HBsAg alone (1/5, 20%). These results confirm the safety, tolerability and immunogenicity of Advax adjuvant observed in preclinical studies. Advax may represent a suitable replacement for alum adjuvants in prophylactic human vaccines subject to confirmation of current results in larger studies. Australia and New Zealand Clinical Trial Registry: ACTRN12607000598482.
Collapse
Affiliation(s)
- David Gordon
- Department of Microbiology and Infectious Diseases, Flinders Medical Centre/Flinders University, Adelaide 5042, Australia
| | - Peter Kelley
- Department of Microbiology and Infectious Diseases, Flinders Medical Centre/Flinders University, Adelaide 5042, Australia
| | | | - Peter Cooper
- Vaxine Pty Ltd, Bedford Park, Adelaide 5042, Australia; Cancer Research Laboratory, Australian National University Medical School at The Canberra Hospital, Garran, ACT 2605, Australia; John Curtin School of Medical Research, Australian National University, Acton, ACT 2601, Australia
| | - Nikolai Petrovsky
- Vaxine Pty Ltd, Bedford Park, Adelaide 5042, Australia; Department of Endocrinology, Flinders Medical Centre/Flinders University, Adelaide 5042, Australia.
| |
Collapse
|
16
|
Gehring AJ, Ann D'Angelo J. Dissecting the dendritic cell controversy in chronic hepatitis B virus infection. Cell Mol Immunol 2014; 12:283-91. [PMID: 25363524 DOI: 10.1038/cmi.2014.95] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 08/26/2014] [Accepted: 08/29/2014] [Indexed: 12/14/2022] Open
Abstract
Therapeutic vaccines to boost endogenous T-cell immunity rely on the stimulatory capacity of dendritic cells (DCs). The functionality of DCs in chronic hepatitis B virus (HBV) infection has been a long-standing debate. Therefore, we have attempted to summarize multiple studies investigating DC function in chronic HBV patients to determine whether common observations can be drawn. We found that the frequency and function of ex vivo-tested myeloid and plasmacytoid DCs were largely intact in patients with HBV infection and similar to those of healthy donor DCs. The main exception was reduced IFN-α production by plasmacytoid DC from chronic HBV patients. This reduced IFN-α production correlated with liver inflammation in multiple studies but not with viral load, suggesting that viral antigens have little effect on DC function. The majority of the confusion about DC function arises from studies reporting the reduced function of healthy donor DCs exposed to various sources of HBV in vitro. These direct effects of viral antigens are in contrast to data from HBV-infected patients. The variations in the assays used and areas that require further investigation are also covered.
Collapse
Affiliation(s)
- Adam J Gehring
- 1] Molecular Microbiology and Immunology, Saint Louis University School of Medicine, Saint Louis, MO, USA [2] Saint Louis University Liver Center, Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - June Ann D'Angelo
- Molecular Microbiology and Immunology, Saint Louis University School of Medicine, Saint Louis, MO, USA
| |
Collapse
|
17
|
Therapeutic strategies for a functional cure of chronic hepatitis B virus infection. Acta Pharm Sin B 2014; 4:248-57. [PMID: 26579392 PMCID: PMC4629125 DOI: 10.1016/j.apsb.2014.05.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 05/20/2014] [Accepted: 05/23/2014] [Indexed: 02/07/2023] Open
Abstract
Treatment of chronic hepatitis B virus (HBV) infection with the viral DNA polymerase inhibitors or pegylated alpha-interferon has led to a significant retardation in HBV-related disease progression and reduction in mortality related to chronic hepatitis B associated liver decompensation and hepatocellular carcinoma. However, chronic HBV infection remains not cured. The reasons for the failure to eradicate HBV infection by long-term antiviral therapy are not completely understood. However, clinical studies suggest that the intrinsic stability of the nuclear form of viral genome, the covalently closed circular (ccc) DNA, sustained low level viral replication under antiviral therapy and homeostatic proliferation of hepatocytes are the critical virological and pathophysiological factors that affect the persistence and therapeutic outcomes of HBV infection. More importantly, despite potent suppression of HBV replication in livers of the treated patients, the dysfunction of HBV-specific antiviral immunity persists. The inability of the immune system to recognize cells harboring HBV infection and to cure or eliminate cells actively producing virus is the biggest challenge to finding a cure. Unraveling the complex virus–host interactions that lead to persistent infection should facilitate the rational design of antivirals and immunotherapeutics to cure chronic HBV infection.
Collapse
|
18
|
Cesar Aguilar J, Y L. Immunotherapy for Chronic Hepatitis B using HBsAg-based Vaccine Formulations: From Preventive Commercial Vaccines to Therapeutic Approach Julio Cesar Aguilar. Euroasian J Hepatogastroenterol 2014; 4:92-97. [PMID: 29699355 PMCID: PMC5913903 DOI: 10.5005/jp-journals-10018-1109] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 09/25/2014] [Indexed: 12/19/2022] Open
Abstract
Despite the existence of effective prophylactic vaccines, hepatitis B virus (HBV) infections remain a major public health problem. It has been estimated that about 370 million people are chronically infected with this virus worldwide. These individuals act as a reservoir for viral spread and chronic infection also increases the risk of liver diseases, such as cirrhosis and hepatocellular carcinoma. Current antiviral therapies fail to control viral replication in the long term in most patients. Viral persistence has been associated with a defect in the development of HBV-specific cellular immunity. The limitations of the current available therapies underline the need for alternative therapies. Specific immunotherapeutic strategies target not only the induction or stimulation of CD4(+) and CD8(+) T-cell responses but also the induction of proinflammatory cytokines capable of controlling viral replication. Therapeutic vaccination has been extensively studied in chronic hepatitis B (CHB) based in the properties of hepatitis B surface antigen (HBsAg) and taking advantage of its previous use in preventive vaccination. In this sense, pioneer studies were carried out employing HBsAg-based vaccines, including prophylactic commercial vaccines and HBsAg-based formulations with novel adjuvants. The results and general knowledge coming from these studies are discussed in the present review. The decision on developing new generations of vaccines including new antigens or formulations should take into account the experience with HBsAg-based vaccine formulations in order to decide about changing the vaccine antigen or adding new antigens to improve the composition. How to cite this article: Aguilar JC, Lobaina Y. Immunotherapy for Chronic Hepatitis B using HBsAg-based Vaccine Formulations: From Preventive Commercial Vaccines to Therapeutic Approach. Euroasian J Hepato-Gastroenterol 2014;4(2):92-97.
Collapse
Affiliation(s)
- Julio Cesar Aguilar
- Department of Hepatitis B, Biomedical Research Unit, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Lobaina Y
- Department of Hepatitis B, Biomedical Research Unit, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| |
Collapse
|
19
|
Abstract
Chronic HBV infection is a major public health concern affecting over 240 million people worldwide. Although suppression of HBV replication is achieved in the majority of patients with currently available newer antivirals, discontinuation of therapy prior to hepatitis B surface antigen loss or seroconversion is associated with relapse of HBV in the majority of cases. Thus, new therapeutic modalities are needed to achieve eradication of the virus from chronically infected patients in the absence of therapy. The basis of HBV persistence includes viral and host factors. Here, we review novel strategies to achieve sustained cure or elimination of HBV. The novel approaches include targeting the viral and or host factors required for viral persistence, and novel immune-based therapies, including therapeutic vaccines.
Collapse
Affiliation(s)
- Rama Kapoor
- Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research Inc., (formerly SAIC-Frederick, Inc.) Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA
- Laboratory of Immunoregulation, National Institute of Allergy & Infectious Diseases, NIH, Department of Health & Human Services, Bethesda, MD 20892, USA
| | - Shyam Kottilil
- Laboratory of Immunoregulation, National Institute of Allergy & Infectious Diseases, NIH, Department of Health & Human Services, Bethesda, MD 20892, USA
| |
Collapse
|
20
|
Obeng-Adjei N, Hutnick NA, Yan J, Chu JS, Myles DJF, Morrow MP, Sardesai NY, Weiner DB. DNA vaccine cocktail expressing genotype A and C HBV surface and consensus core antigens generates robust cytotoxic and antibody responses in mice and Rhesus macaques. Cancer Gene Ther 2013; 20:652-62. [PMID: 24310062 DOI: 10.1038/cgt.2013.65] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 09/30/2013] [Accepted: 10/15/2013] [Indexed: 12/15/2022]
Abstract
There are well over a quarter of a billion chronic hepatitis B virus (HBV) carriers across the globe. Most carriers are at high risk for development of liver cirrhosis and subsequent progression to hepatocellular carcinoma. It is therefore imperative to develop new approaches for immunotherapy against this infection. Antibodies and cytotoxic T cells to different HBV antigens are believed to be important for reducing viral load and clearing HBV-infected cells from the liver. Some of the major challenges facing current vaccine candidates have been their inability to induce both humoral and cellular immunity to multiple antigenic targets and the induction of potent immune responses against the major genotypes of HBV. In this study, highly optimized synthetic DNA plasmids against the HBV consensus core (HBc) and surface (HBs) antigens genotypes A and C were developed and evaluated for their immune potential. These plasmids, which encode the most prevalent genotypes of the virus, were observed to individually induce binding antibodies to HBs antigens and drove robust cell-mediated immunity in animal models. Similar responses to both HBc and HBs antigens were observed when mice and non-human primates were inoculated with the HBc-HBs cocktails. In addition to the cytotoxic T lymphocyte activities exhibited by the immunized mice, the vaccine-induced responses were broadly distributed across multiple antigenic epitopes. These elements are believed to be important to develop an effective therapeutic vaccine. These data support further evaluation of multivalent synthetic plasmids as therapeutic HBV vaccines.
Collapse
Affiliation(s)
- N Obeng-Adjei
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - N A Hutnick
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - J Yan
- Inovio Pharmaceuticals Inc., Blue Bell, PA, USA
| | - J S Chu
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - D J F Myles
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - M P Morrow
- Inovio Pharmaceuticals Inc., Blue Bell, PA, USA
| | | | - D B Weiner
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
21
|
Chuai X, Chen H, Wang W, Deng Y, Wen B, Ruan L, Tan W. Poly(I:C)/alum mixed adjuvant priming enhances HBV subunit vaccine-induced immunity in mice when combined with recombinant adenoviral-based HBV vaccine boosting. PLoS One 2013; 8:e54126. [PMID: 23335993 PMCID: PMC3545998 DOI: 10.1371/journal.pone.0054126] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 12/06/2012] [Indexed: 12/30/2022] Open
Abstract
Background Virus-specific cellular immune responses play a critical role in virus clearance during acute or chronic HBV infection. Currently, the commercially available HBV vaccine is combined with alum adjuvant, which stimulates mainly Th2 immune responses. Therefore, development of new therapeutic HBV vaccine adjuvants and immune strategies that also promote Th1 and CTL responses is urgently needed. Methodology/Principal findings To improve the immunity induced by the novel HBSS1 HBV vaccine, we evaluated the ability of adjuvants, including alum, CpG and polyriboinosinic polyribocytidylic acid [poly(I:C)], to enhance the response when boosted with the recombinant adenoviral vector vaccine rAdSS1. The immune responses to different adjuvant combinations were assessed in C57BL/6 mice by enzyme-linked immunosorbent assay (ELISA), ELISpot and cytokine release assays. Among the combinations tested, a HBV protein particle vaccine with CpG/alum and poly(I:C)/alum priming combinations accelerated specific seroconversion and produced high antibody (anti-PreS1, anti-S antibody) titres with a Th1 bias. After boosting with recombinant adenoviral vector vaccine rAdSS1, both groups produced a strong multi-antigen (S and PreS1)-specific cellular immune response. HBSS1 immunisation with poly(I:C)/alum priming also generated high-level CD4+ and CD8+ T cell responses in terms of Th1 cytokines (IFN-γand IL-2). Conclusions The protein-vaccine HBSS1 with mixed poly(I:C)/alum adjuvant priming, followed by a rAdSS1 vaccine boost, maximises specific antibody and Th1-biased cellular immune responses. This regime might prove useful in the development of HBV therapeutic vaccines. Furthermore, this promising strategy might be applied to vaccines against other persistent infections, such as human immunodeficiency virus and tuberculosis.
Collapse
Affiliation(s)
- Xia Chuai
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
- Department of Microbiology, Hebei Medical University, Shijiazhuang, Heibei Province, People’s Republic of China
| | - Hong Chen
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Wen Wang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Yao Deng
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Bo Wen
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
- College of Life Science, Jilin University, Changchun,Jinlin Province, People’s Republic of China
| | - Li Ruan
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Wenjie Tan
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
- * E-mail:
| |
Collapse
|
22
|
Saade F, Honda-Okubo Y, Trec S, Petrovsky N. A novel hepatitis B vaccine containing Advax™, a polysaccharide adjuvant derived from delta inulin, induces robust humoral and cellular immunity with minimal reactogenicity in preclinical testing. Vaccine 2013; 31:1999-2007. [PMID: 23306367 DOI: 10.1016/j.vaccine.2012.12.077] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 12/24/2012] [Accepted: 12/28/2012] [Indexed: 12/12/2022]
Abstract
Although current HBV vaccines have an outstanding record of safety and efficacy, reduced immunogenicity is a problem in those of older age, or having renal impairment or diabetes mellitus. In this study, we tested the ability of Advax™ adjuvant, a novel polysaccharide adjuvant based on delta inulin, to enhance the immunogenicity of hepatitis B surface antigen (HBs) in mice and guinea pigs by comparison to the traditional alum adjuvant. Advax™ provided antigen-sparing, significantly enhanced both anti-HBs antibody titers, and anti-HBs CD4 and CD8 T-cells, with increases in Th1, Th2 and Th17 cytokine responses. Unlike alum, the adjuvant effect of Advax™ was seen even when injected 24h before the HBs antigen. Advax™ adjuvant similarly enhanced humoral and cellular immune responses in guinea pigs to a third generation preS-HBs antigen. Advax™ adjuvant when combined with HBs antigen could provide enhanced protection over current generation HBV vaccines for immunization of low responder populations.
Collapse
Affiliation(s)
- Fadi Saade
- Vaxine Pty Ltd., Bedford Park, Adelaide 5042, Australia
| | | | | | | |
Collapse
|
23
|
Peppa D, Maini MK. Pathogenesis of hepatitis B virus infection and potential for new therapies. Br J Hosp Med (Lond) 2012; 73:581-4. [PMID: 23124289 DOI: 10.12968/hmed.2012.73.10.581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Chronic hepatitis B virus infection leads to about 1 million deaths per year, making it one of the top ten causes of death worldwide. An improved understanding of defective antiviral responses in chronic hepatitis B virus infection could allow specific immunotherapeutic interventions, enhancing the immune response to hepatitis B virus.
Collapse
|
24
|
Chen H, Chuai X, Deng Y, Wen B, Wang W, Xiong S, Ruan L, Tan W. Optimisation of prime-boost immunization in mice using novel protein-based and recombinant vaccinia (Tiantan)-based HBV vaccine. PLoS One 2012; 7:e43730. [PMID: 22970140 PMCID: PMC3435326 DOI: 10.1371/journal.pone.0043730] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 07/24/2012] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND A therapeutic vaccine for chronic hepatitis B virus (HBV) infection that enhances virus-specific cellular immune responses is urgently needed. The "prime-boost" regimen is a widely used vaccine strategy against many persistence infections. However, few reports have addressed this strategy applying for HBV therapeutic vaccine development. METHODOLOGY/PRINCIPAL FINDINGS To develop an effective HBV therapeutic vaccine, we constructed a recombinant vaccinia virus (Tiantan) containing the S+PreS1 fusion antigen (RVJSS1) combined with the HBV particle-like subunit vaccine HBVSS1 to explore the most effective prime-boost regimen against HBV. The immune responses to different prime-boost regimens were assessed in C57BL/C mice by ELISA, ELISpot assay and Intracellular cytokine staining analysis. Among the combinations tested, an HBV protein particle vaccine priming and recombinant vaccinia virus boosting strategy accelerated specific seroconversion and produced high antibody (anti-PreS1, anti-S antibody) titres as well as the strongest multi-antigen (PreS1, and S)-specific cellular immune response. HBSS1 protein prime/RVJSS1 boost immunization was also generated more significant level of both CD4+ and CD8+ T cell responses for Th1 cytokines (TNF-α and IFN-γ). CONCLUSIONS The HBSS1 protein-vaccine prime plus RVJSS1 vector boost elicits specific antibody as well as CD4 and CD8 cells secreting Th1-like cytokines, and these immune responses may be important parameters for the future HBV therapeutic vaccines.
Collapse
Affiliation(s)
- Hong Chen
- Biotech Center for Viral Diseases Emergency, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Xia Chuai
- Biotech Center for Viral Diseases Emergency, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
- Department of Microbiology, Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Yao Deng
- Biotech Center for Viral Diseases Emergency, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Bo Wen
- Biotech Center for Viral Diseases Emergency, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
- College of Life Science, Jilin University, Changchun, People's Republic of China
| | - Wen Wang
- Biotech Center for Viral Diseases Emergency, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Shaoqing Xiong
- School of Life Science and Bio-engineering, Beijing University of Technology, Beijing, People's Republic of China
| | - Li Ruan
- Biotech Center for Viral Diseases Emergency, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Wenjie Tan
- Biotech Center for Viral Diseases Emergency, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| |
Collapse
|
25
|
Zhang Z, Zhang JY, Wang LF, Wang FS. Immunopathogenesis and prognostic immune markers of chronic hepatitis B virus infection. J Gastroenterol Hepatol 2012; 27:223-30. [PMID: 22004062 DOI: 10.1111/j.1440-1746.2011.06940.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Host immune responses induced by hepatitis B virus (HBV) infection not only substantially drive disease progression, but also significantly influence efficacy of antiviral treatments in HBV-infected individuals. Therefore, it is important to fully understand the course of immune pathogenesis and to find efficient immunological markers that can predict the disease progression of chronic HBV infection. This review introduces the current progress in clinical immunology and analyzes the mechanisms of antiviral effects and liver injury, which are induced by both innate and adaptive immune responses. The recently identified immunological markers indicated to be closely correlated with disease progression and antiviral efficacy during HBV infection are also summarized. Careful monitoring of these immune markers may help physicians to make decisions on when to begin or withdraw antiviral drugs, or to formulate the prognosis of acute-on-chronic liver failure (ACLF) patients in the clinic. Finally, this review highlights some novel therapeutic strategies to modulate host immunity that have been proposed to sustain antiviral control of chronic HBV infection, as well as the challenges that we are presently facing in the field.
Collapse
Affiliation(s)
- Zheng Zhang
- The Institute of Translational Hepatology, The Research Center for Biological Therapy, Beijing 302 Hospital, Beijing, China
| | | | | | | |
Collapse
|
26
|
Abstract
Chronic hepatitis B (CHB) is a global health problem affecting more than 350 million people worldwide. Chronic carriage of HBV is related to the age when the infection occurs; the younger the age the higher the chronicity rate. Knowledge of the natural history of CHB is important for the management of the disease. The goal of hepatitis B treatment is to prevent cirrhosis, liver decompensation and hepatocellular carcinoma. In clinical practice, treatment response is determined by the suppression of serum HBV DNA levels. However, current antiviral therapies are usually unable to achieve sustained off-treatment responses and eradicate the infection. Impairment of immune responses including defective innate non-cytolytic antiviral function together with exhausted T cells and the tolerogenic liver environment may all contribute to the poor clinical response. A more comprehensive understanding of the immunological phases of CHB, potential triggers of liver flares and molecular mechanisms underlying viral persistence and immunopathology will help to tailor future therapeutic strategies. A synergistic approach of boosting the immune response of the host by specific immunotherapeutic interventions and effective viral load suppression will be needed to promote sustained viral clearance in chronic infection.
Collapse
Affiliation(s)
- G Nebbia
- Department of Immunology and Molecular Pathology, Division of Infection and Immunity, University College London, London, UK
| | | | | |
Collapse
|
27
|
Enhanced effect of DNA immunization plus in vivo electroporation with a combination of hepatitis B virus core-PreS1 and S-PreS1 plasmids. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2011; 18:1789-95. [PMID: 21900535 DOI: 10.1128/cvi.05113-11] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
To develop a novel, effective HBV therapeutic vaccine, we constructed two HBV DNA immunogens that contained PreS1, HBSS1, and HBCS1. Several delivery methods, such as intramuscular (i.m.) injection, intramuscular injection plus electroporation (i.m.-EP), and intradermal injection plus electroporation (i.d.-EP) were used in a murine model to analyze and compare the immune responses that were induced by the DNA immunogens. We found that i.d.-EP accelerated specific antibody seroconversion and produced high antibody (anti-PreS1, anti-S, and anti-C antibody) titers after HBSS1 and HBCS1 immunization. Combining the HBSS1 and HBCS1 DNA immunogens with i.d.-EP produced the strongest multiantigen (PreS1, S, and C)-specific cellular immune response and the highest specific PreS1 antibody levels. The results indicated that DNA immunization using HBSS1 and HBCS1 might be an ideal candidate, with its ability to elicit robust B and T cell immune responses against multiantigen when combined with optimized delivery technology. The present study provides a basis for the design and rational application of a novel HBV DNA vaccine.
Collapse
|
28
|
Therapeutic vaccines and immune-based therapies for the treatment of chronic hepatitis B: perspectives and challenges. J Hepatol 2011; 54:1286-96. [PMID: 21238516 DOI: 10.1016/j.jhep.2010.12.031] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2010] [Revised: 11/23/2010] [Accepted: 12/20/2010] [Indexed: 12/24/2022]
Abstract
The treatment of chronic hepatitis B virus (HBV) infection has greatly improved over the last 10 years, but alternative treatments are still needed. Therapeutic vaccination is a promising new strategy for controlling chronic infection. However, this approach has not been as successful as initially anticipated for chronic hepatitis B. General impairment of the immune responses generated during persistent HBV infection, with exhausted T cells not responding correctly to therapeutic vaccination, is probably responsible for the poor clinical responses observed to date. Intensive research efforts are now focusing on increasing the efficacy of therapeutic vaccination without causing liver disease. Here we describe new approaches to use with therapeutic vaccination, in order to overcome the inhibitory mechanisms impairing immune responses. We also describe innovative strategies for generating functional immune responses and inducing sustained control of this persistent infection.
Collapse
|
29
|
Morrey JD, Motter NE, Chang S, Fairman J. Breaking B and T cell tolerance using cationic lipid--DNA complexes (CLDC) as a vaccine adjuvant with hepatitis B virus (HBV) surface antigen in transgenic mice expressing HBV. Antiviral Res 2011; 90:227-30. [PMID: 21545812 DOI: 10.1016/j.antiviral.2011.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 03/01/2011] [Accepted: 04/19/2011] [Indexed: 12/14/2022]
Abstract
Cationic lipid DNA complexes (CLDC), referred to here as JVRS-100, were evaluated as an adjuvant for hepatitis B surface antigen (HBsAg) for eliciting B and T cell responses in transgenic mice expressing hepatitis B virus (HBV). To confirm the immunogenicity of HBsAg+JVRS-1000, a study was conducted in C57BL/6 mice, the genetic background of the HBV transgenic mice used in the study. HBsAg+JVRS-100 elicited a T cell response and B cell response as evidenced by interferon-gamma (IFN-γ) secretion by re-stimulated splenocytes and anti-HBsAg IgG induction, respectively, whereas, HBsAg only elicited a B cell response. In HBV transgenic mice, HBsAg did not elicit either T or B cell responses, unlike the HBsAg+JVRS-100 that elicited both. Energix-B vaccine did perform better than the HBsAg by eliciting a B cell response in the transgenic mice, but it did not perform as HBsAg+JVRS-100 since it did not elicit a T cell response. The response by HBsAg+JVRS-100 was not sufficient to cause destruction of infected liver cells, but it did suppress HBV DNA non-cytolytically. From these results, JVRS-100 might be considered for further development as an adjuvant for HBV therapeutic vaccines.
Collapse
Affiliation(s)
- John D Morrey
- Institute for Antiviral Research, Department of Animal, Dairy, and Veterinary Sciences, Utah State University, Logan, UT 84322-4700, USA.
| | | | | | | |
Collapse
|
30
|
Grimm D, Thimme R, Blum HE. HBV life cycle and novel drug targets. Hepatol Int 2011; 5:644-53. [PMID: 21484123 DOI: 10.1007/s12072-011-9261-3] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 02/04/2011] [Indexed: 12/19/2022]
Abstract
With up to 400 million affected people worldwide, chronic hepatitis B virus (HBV) infection is still a major health care problem. During the last decade, several novel therapeutic approaches have been developed and evaluated. In most regions of the world, interferon-α, and nucleos(t)ide analogues (NUCs) are currently approved. Despite major improvements, none of the existing therapies is optimal since viral clearance is rarely achieved. Recently, a better understanding of the HBV life cycle and the development of novel model systems of HBV infection have led to the development of novel antiviral strategies and drug targets. This review will focus on current and potential future drug targets in the HBV life cycle and strategies to modulate the virus-host interaction.
Collapse
Affiliation(s)
- Daniel Grimm
- Department of Medicine II, University of Freiburg, Freiburg, Germany
| | | | | |
Collapse
|
31
|
Bertoletti A, Maini MK, Ferrari C. The host-pathogen interaction during HBV infection: immunological controversies. Antivir Ther 2011; 15 Suppl 3:15-24. [PMID: 21041900 DOI: 10.3851/imp1620] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
HBV is a hepatotropic and non-cytopathic virus that causes more than one million deaths annually from liver cirrhosis and hepatocellular carcinoma. As the virus itself is non-cytopathic, it is widely accepted that both viral control and liver pathology are mediated by the host immune system. Until recently, the focus has been on the crucial role of adaptive immune responses in controlling HBV infection, but the potential contribution of the innate system is now an important area of controversy. Unanswered questions include whether and when HBV can trigger components of innate immunity, and whether HBV can actively suppress the induction of innate immunity. We discuss the data available from animal models and human HBV infection addressing the role of innate immunity in the first part of this review. In the second part, we address the immunopathogenesis of the inflammatory events that characterize chronic hepatitis B. The mechanisms thought to be responsible for liver inflammation, namely the intrahepatic recruitment of inflammatory cells, which is orchestrated by chemokines, have been described; however, the underlying immunological triggers are much less clear. The prevailing idea is that liver inflammation results from a recovery of HBV-specific T-cells directly causing liver injury, but this scenario is supported by scanty experimental data. By contrast, recent findings raise the possibility of a contribution from innate components, such as natural killer cells.
Collapse
Affiliation(s)
- Antonio Bertoletti
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.
| | | | | |
Collapse
|
32
|
Protzer U, Abken H. Can engineered "designer" T cells outsmart chronic hepatitis B? HEPATITIS RESEARCH AND TREATMENT 2010; 2010:901216. [PMID: 21188203 PMCID: PMC3004001 DOI: 10.1155/2010/901216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Revised: 07/14/2010] [Accepted: 07/15/2010] [Indexed: 01/02/2023]
Abstract
More than 350 million people worldwide are persistently infected with human heptatitis B virus (HBV) and at risk to develop liver cirrhosis and hepatocellular carcinoma making long-term treatment necessary. While a vaccine is available and new antiviral drugs are being developed, elimination of persistently infected cells is still a major issue. Recent efforts in adoptive cell therapy are experimentally exploring immunotherapeutic elimination of HBV-infected cells by means of a biological attack with genetically engineered "designer" T cells.
Collapse
Affiliation(s)
- U. Protzer
- Institut für Virologie, Technische Universität München/Helmholtz Zentrum München, 81675 München, Germany
| | - H. Abken
- Zentrum für Molekulare Medizin Köln und Klinik I für Innere Medizin Köln, Universität zu Köln, Robert-Koch-Str. 21, 50931 Köln, Germany
| |
Collapse
|
33
|
A vesicular stomatitis virus-based hepatitis B virus vaccine vector provides protection against challenge in a single dose. J Virol 2010; 84:7513-22. [PMID: 20504927 DOI: 10.1128/jvi.00200-10] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
As one of the world's most common infectious diseases, hepatitis B virus (HBV) is a serious worldwide public health problem, with HBV-associated liver disease accounting for more than half a million deaths each year. Although there is an effective prophylactic vaccine currently available to prevent infection, it has a number of characteristics that are suboptimal: multiple doses are needed to induce long-lasting immunity, immunity declines over time, it does not elicit protection in some individuals, and it is not effective therapeutically. We produced a recombinant vesicular stomatitis virus (VSV)-based vaccine vector expressing the HBV middle envelope surface protein (MS) and found that this vector was able to efficiently generate a strong HBs-specific antibody response following a single immunization in mice. A single immunization with the VSV-MS vector also induced robust CD8 T-cell activation. The CD8 T-cell response was greater in magnitude and broader in specificity than the response generated by a vaccinia virus-based vaccine vector or by recombinant protein immunization. Furthermore, a single VSV-MS immunization provided protection against virus challenge in mice. Given the similar antibody titers and superior T-cell responses elicited from a single immunization, a VSV-based HBV vaccine may have advantages over the current recombinant protein vaccine.
Collapse
|
34
|
Maini MK, Schurich A. The molecular basis of the failed immune response in chronic HBV: therapeutic implications. J Hepatol 2010; 52:616-9. [PMID: 20185199 DOI: 10.1016/j.jhep.2009.12.017] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Revised: 12/07/2009] [Accepted: 12/08/2009] [Indexed: 12/31/2022]
Abstract
There is a pressing need to develop new immunotherapeutic interventions in chronic hepatitis B virus (HBV) infection in order to limit the high costs and risks of toxicity or viral resistance associated with maintenance antiviral treatment. Here we review recent advances in our understanding of the molecular defects underlying the profound T cell depletion characteristic of these patients. We propose that T cells are driven to apoptosis by the combination of a persistent, high antigen load and excessive inhibitory signals encountered in the hepatic microenvironment. The feasibility of boosting sustained antiviral control by targeted reversal of key tolerising mechanisms is discussed.
Collapse
Affiliation(s)
- Mala K Maini
- Department of Immunology & Molecular Pathology, University College London, UK.
| | | |
Collapse
|