Mucosal and Systemic Immunization using Cochleate and Liposome Vaccines

In Vitro and In Vivo Evaluation of Essential Oil from Artemisia absinthium L. Formulated in Nanocochleates against Cutaneous Leishmaniasis

Background: Leishmaniasis is a zoonotic disease caused by protozoan parasites from Leishmania genus. Currently, there are no effective vaccines available and the available therapies are far from ideal. In particular, the development of new therapeutic strategies to reduce the infection caused by Leishmania amazonensis could be considered desirable. Different plant-derived products have demonstrated antileishmanial activity, including the essential oil (EO) from Artemisia absinthium L. (EO-Aa), Asteraceae. Methods: In the present study, the EO-Aa formulated in nanocochleates (EO-Aa-NC) was investigated in vitro against intracellular amastigotes of L. amazonensis and non-infected macrophages from BALB/c mice. In addition, the EO-Aa-NC was also evaluated in vivo against on experimental cutaneous leishmaniasis, which body weight, lesion progression, and parasite load were determined. Results: EO-Aa-NC displayed IC₅₀ values of 21.5 ± 2.5 μg/mL and 27.7 ± 5.6 μg/mL against intracellular amastigotes of L. amazonensis and non-infected peritoneal macrophage, respectively. In the animal model, the EO-Aa-NC (30 mg/kg/intralesional route/every 4 days 4 times) showed no deaths or weight loss greater than 10%. In parallel, the EO-Aa-NC suppressed the infection in the murine model by approximately 50%, which was statistically superior (p < 0.05) than controls and mice treated with EO-Aa. In comparison with Glucantime^®, EO-Aa-NC inhibited the progression of infection as efficiently (p > 0.05) as administration of the reference drug. Conclusions: Encochleation of EO-Aa resulted in a stable, tolerable, and efficacious antileishmanial formulation, facilitating systemic delivery of EO, with increased activity compared to administration of the free EO-Aa. This new formulation shows promising potential to future studies aimed at a new therapeutic strategy to treat leishmaniasis.

An insight into cochleates, a potential drug delivery system

Cochleates are solid particulates made up of large continuous lipid bilayer sheets rolled up in a spiral structure with little or no internal aqueous phase. Cochleates improve the oral bioavailability and efficacy of the drugs by decreasing side effects.

Formulation design considerations for oral vaccines

Whilst oral vaccination is a potentially preferred route in terms of patient adherence and mass vaccination, the ability to formulate effective oral vaccines remains a challenge. The primary barrier to oral vaccination is effective delivery of the vaccine through the GI tract owing to the many obstacles it presents, including low pH, enzyme degradation and bile-salt solubilization, which can result in breakdown/deactivation of a vaccine. For effective immune responses after oral administration, particulates need to be taken up by the M cells however, these are few in number. To enhance M-cell uptake, particle characteristics can be optimized with particle size, surface charge, targeting groups and bioadhesive properties all being considerations. Yet improved uptake may not translate into enhanced immune responses and formulating particulates with inherent adjuvant properties can offer advantages. Within this article, we establish the options available for consideration when building effective oral particulate vaccines.

Safety Evaluation of Calcium Administered Intranasally to Mice

Calcium, a component of approved human vaccines administered via systemic routes, has a good safety profile. Recently, intranasally administered vaccines containing calcium have shown promise in generating mucosal immune responses in animal models. However, the safety of intranasally administered calcium is unknown. This study evaluates the safety of intranasally administered calcium at 2- to 13-fold higher doses than used in experimental vaccines. At a calcium dose of 22 mg/kg, 80% of the Balb/c and 20% of the C57BL/6 mice die within the first 24 hours. At 11.0 mg/kg, there is no overt toxicity in either strain, based on body weight, clinical scores, blood chemistry, and histopathology of major organs at 7 days post administration. In C57BL/6 mice, apart from acute and subacute inflammation in the lungs at up to 3 days post administration, especially at the 22-mg/kg dose, there is no overt toxicity. Doses of calcium up to 11 mg/kg appear to be safe in a mouse model.

Recent advances in immunological adjuvants: the development of particulate antigen delivery systems

New generation vaccines, including those based on recombinant proteins, are safer than traditional vaccines, but are less immunogenic. Therefore, there is an urgent need for the development of new and improved vaccine adjuvants. A number of potent immunostimulatory molecules obtained from bacterial cells or plants have been extensively evaluated as adjuvants. However, a number of these molecules have displayed significant toxicity, both in preclinical animal models and in human clinical trials. An alternative approach to the development of novel adjuvants involves the preparation of particulate antigen delivery systems of similar dimensions to natural pathogens. In the absence of additional immunostimulatory molecules, emulsion droplets and microparticles have been shown to be potent adjuvants for the induction of both humoral and cell-mediated immune responses following systemic administration. Moreover, particulate delivery systems have been shown to display an acceptable toxicity profile in a number of clinical trials. Particulate antigen delivery systems also have the potential to function as potent adjuvants following administration by mucosal routes, including oral and intranasal. An alternative approach to the mucosal delivery of vaccines involves the use of genetically detoxified mutant toxins, e.g., LT-K63, as mucosal adjuvants. The use of novel adjuvants and antigen delivery systems is likely to extend the use of vaccines into the area of therapeutics, involving the eradication of infectious diseases and cancers, or the amelioration of autoimmune disorders.

DNA vaccines for the prophylaxis and modulation of HSV infections

There is currently no acceptable vaccine available for the control of herpes simplex virus (HSV) infection. This review discusses the reasons for the past failures and evaluates the prospect that a fresh approach, such as that provided by plasmid DNA encoding viral proteins, could provide a solution. The issues addressed include immune responses generated by plasmids encoding glycoproteins of HSV, the mechanism of HSV, the nature of the response in neonates, mucosal barrier immunity, attempts at improving immunogenicity of DNA vaccines and the immunomodulation potential with DNA encoding cytokines. The review concludes that DNA vaccines against HSV may merit evaluation in man, but DNA vaccine research may be more useful for uncovering mechanisms by which the immune system functions against HSV infection.

Optimisation of DNA vaccines for the prophylaxis and modulation of herpes simplex virus infections

Herpes simplex virus (HSV) lacks an effective vaccine. Despite its prevalence and importance HSV infection is not controlled with an acceptable vaccine. Perhaps the best candidate and so far untested approach is the use of plasmid DNA encoding viral proteins. Immunomodulators are also holding some hope as a potential therapeutic. In this review various DNA vaccine approaches used in animal model systems to prevent HSV infections are discussed. Judgements are made as to which of these may prove effective for prophylactic or therapeutic vaccines in humans.

DNA vaccines: a review

Therapeutic and prophylactic DNA vaccine clinical trials for a variety of pathogens and cancers are underway (Chattergoon et al., 1997; Taubes, 1997). The speed with which initiation of these trials occurred is no less than astounding; clinical trials for a human immunodeficiency virus (HIV) gp160 DNA-based vaccine were underway within 36 months of the first description of "genetic immunization" (Tang et al., 1992) and within 24 months of publication of the first article describing intramuscular delivery of a DNA vaccine (Ulmer et al., 1993). Despite the relative fervor with which clinical trials have progressed, it can be safely stated that DNA-based vaccines will not be an immunological "silver bullet." In this regard, it was satisfying to see a publication entitled "DNA Vaccines--A Modern Gimmick or a Boon to Vaccinology?" (Manickan et al., 1997b). There is no doubt that this technology is well beyond the phenomenology phase of study. Research niches and models have been established and will allow the truly difficult questions of mechanism and application to target species to be studied. These two aspects of future studies are intricately interwoven and will ultimately determine the necessity for mechanistic understanding and the evolution of target species studies. The basic science of DNA vaccines has yet to be clearly defined and will ultimately determine the success or failure of this technology to find a place in the immunological arsenal against disease. In a commentary on a published study describing DNA vaccine-mediated protection against heterologous challenge with HIV-1 in chimpanzees, Ronald Kennedy (1997) states, "As someone who has been in the trenches of AIDS vaccine research for over a decade and who, together with collaborators, has attempted a number of different vaccine approaches that have not panned out, I have a relatively pessimistic view of new AIDS vaccine approaches." Kennedy then goes on to summarize a DNA-based multigene vaccine approach and the subsequent development of neutralizing titers and potent CTL activity in immunized chimpanzees (Boyer et al., 1997). Dr. Kennedy closes his commentary by stating. "The most exciting aspect of this report is the experimental challenge studies.... Viraemia was extremely transient and present at low levels during a single time point. These animals remained seronegative ... for one year after challenge" and "Overall, these observations engender some excitement". (Kennedy, 1997). Although this may seem a less than rousing cheer for DNA vaccine technology, it is a refreshingly hopeful outlook for a pathogen to which experience has taught humility. It has also been suggested that DNA vaccine technology may find its true worth as a novel alternative option for the development of vaccines against diseases that conventional vaccines have been unsuccessful in controlling (Manickan et al., 1997b). This is a difficult task for any vaccine, let alone a novel technology. DNA-based vaccine technology represents a powerful and novel entry into the field of immunological control of disease. The spinoff research has also been dramatic, and includes the rediscovery of potent bacterially derived immunomodulatory DNA sequences (Gilkeson et al., 1989), as well as availability of a methodology that allows extremely rapid assessment and dissection of both antigens and immunity. The benefits of potent Th1-type immune responses to DNA vaccines must not be overlooked, particularly in the light of suggestions that Western culture immunization practices may be responsible for the rapid increases in adult allergic and possibly autoimmune disorders (Rook and Stanford, 1998). The full utility of this technology has not yet been realized, and yet its broad potential is clearly evident. Future investigations of this technology must not be hindered by impatience, misunderstanding, and lack of funding or failure of an informed collective and collaborative effort.

Potential for plasmid DNAs as vaccines for the new millennium

The advent of new technology and the unmet needs of old and new epidemics of infectious diseases have stimulated a new era of vaccinology. One of the most novel approaches employs plasmid DNA engineered to express one or more genes of the pathogen in mammalian cells. Plasmids may also express cytokine or costimulatory molecules to 'direct' the immune response and/or express altered forms of the antigen to direct it to a specific intracellular compartment or a specific extracellular receptor. The quality of immune responses generated by DNA vaccines in animals has previously only been equaled by live attenuated viral vaccines. The immune stimulating activity of DNA vaccines, combined with their versatility, suggests vast potential for these vaccines.

Cholesterol phosphate derivatives: synthesis and incorporation into a phosphatase and calcium-sensitive triggered release liposome

A series of cholesterol derivatives that position a phosphate monoester at increasing distance from the sterol ring system was synthesized, and their utility as a triggered release liposome tested. Stable anionic liposomes consisting of the novel cholesterol phosphate derivatives and dioleoylphosphatidylethanolamine (DOPE) can be induced to collapse upon phosphatase-catalyzed removal of the phosphate group. Control liposomes containing DOPE and cholesterol phosphate or phosphatidic acid, which are not phosphatase substrates, do not undergo phosphatase-mediated collapse. The phosphatase-sensitive liposomes also collapse in the presence of calcium. The precise concentration of calcium that induces the collapse is controlled by the structure of the cholesterol phosphate derivative. Plasmid DNA encoding luciferase, encapsulated in the cholesterol derivative/DOPE liposomes, transfected cells in vitro. The level of transfection is dependent upon the cholesterol derivative and is mediated by both a calcium-independent and a calcium-dependent pathway; however, the involvement of phosphatase in the latter mechanism is not yet resolved. The transfection efficiency is between 10(6) and 10(7) of luciferase activity in relative light units per milligram of protein, which is similar to transfection values reported using other triggered release liposomes.

DNA increases the potency of vaccination against infectious diseases

In the past couple of years, the idea that naked DNA can be used to vaccinate against infections has been rapidly developing. In contrast to traditional protein or live attenuated vaccines, there is no risk of disease caused by DNA vaccines as only selected proteins are encoded. The ease with which DNA may be manipulated means that vaccines can be custom designed to meet many needs. In animal model systems, DNA vaccines have proved to be as effective as traditional vaccines. Additionally, this technology may also be used to control existing chronic infections. Possibilities for treating hepatitis B, herpes simplex virus-2 and HIV, as well as infections with parasites, are being explored with success.

Induction of mucosal immunity against herpes simplex virus by plasmid DNA immunization

The ability of mucosally delivered plasmid DNA encoding glycoprotein B (gB) of herpes simplex virus type 1 (HSV-1) to generate systemic as well as distal mucosal immunity was evaluated. BALB/c mice were immunized intranasally (i.n.) with gB DNA or DNA expressing beta-galactosidase (beta-Gal). Two days following immunization, gB and beta-Gal gene expression was detected by reverse transcription (RT)-PCR in lungs and cervical lymph nodes (CLN). Histological analysis showed that beta-Gal protein was expressed in vivo in the lungs and the CLN of animals immunized with i.n. administered beta-Gal DNA. The immune responses generated by i.n. administration of gB DNA with or without cholera toxin (CT) were compared to those generated by intramuscular (i.m.) gB DNA and i.n. live HSV administration. Three i.n. doses of gB DNA over a 3-week period resulted in a distal mucosal immunoglobulin A (IgA) response. In addition, the mucosal IgA response was enhanced by coadministration of CT with gB DNA. The i.m. route of immunization induced a strong IgG response in the serum and vagina but was inefficient in generating a mucosal IgA response. Antigen-specific cytokine ELISPOT analyses as well as the serum IgG1/IgG2a ratio indicated induction of stronger Th2 responses following the additional i.n. administration of CT compared to i.n. or i.m. gB DNA or i.n. live HSV immunization. In addition, mucosal immunization with gB DNA induced anti-HSV cell-mediated immunity in vivo as measured by delayed-type hypersensitivity. Although i.n. DNA immunization was an effective means of inducing mucosal antibody, it was inferior to i.m. DNA delivery in providing protection against lethal HSV challenge via the vaginal route. In addition, both i.m. and i.n. plasmid immunizations failed to generate an immune barrier to viral invasion of the mucosa.