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Rossi JF, Frayssinet P, Matciyak M, Tupitsyn N. Azoximer bromide and hydroxyapatite: promising immune adjuvants in cancer. Cancer Biol Med 2024; 20:j.issn.2095-3941.2023.0222. [PMID: 38318840 PMCID: PMC10845929 DOI: 10.20892/j.issn.2095-3941.2023.0222] [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: 06/19/2023] [Accepted: 11/24/2023] [Indexed: 02/07/2024] Open
Abstract
Immune adjuvants are immune modulators that have been developed in the context of infectious vaccinations. There is currently a growing interest in immune adjuvants due to the development of immunotherapy against cancers. Immune adjuvant mechanisms of action are focused on the initiation and amplification of the inflammatory response leading to the innate immune response, followed by the adaptive immune response. The main activity lies in the support of antigen presentation and the maturation and functions of dendritic cells. Most immune adjuvants are associated with a vaccine or incorporated into the new generation of mRNA vaccines. Few immune adjuvants are used as drugs. Hydroxyapatite (HA) ceramics and azoximer bromide (AZB) are overlooked molecules that were used in early clinical trials, which demonstrated clinical efficacy and excellent tolerance profiles. HA combined in an autologous vaccine was previously developed in the veterinary field for use in canine spontaneous lymphomas. AZB, an original immune modulator derived from a class of heterochain aliphatic polyamines that is licensed in Russia, the Commonwealth of Independent States, and Slovakia for infectious and inflammatory diseases, is and now being developed for use in cancer with promising results. These two immune adjuvants can be combined in various immunotherapy strategies.
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Affiliation(s)
- Jean-François Rossi
- Institut du Cancer Avignon-Provence, Sainte Catherine – Department of Hematology-Biotherapy, Avignon 84918, France
- University of Montpellier, UFR Médecine, Montpellier 34090, France
| | | | | | - Nikolai Tupitsyn
- Laboratory of Immunology of Hematopoiesis, N.N. Blokhin Cancer Research Center (RCRC), Moscow 123112, Russia
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Covarrubias CE, Rivera TA, Soto CA, Deeks T, Kalergis AM. Current GMP standards for the production of vaccines and antibodies: An overview. Front Public Health 2022; 10:1021905. [PMID: 36743162 PMCID: PMC9891391 DOI: 10.3389/fpubh.2022.1021905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
The manufacture of pharmaceutical products made under good manufacturing practices (GMP) must comply with the guidelines of national regulatory bodies based on international or regional compendia. The existence of this type of regulation allows pharmaceutical laboratories to count on the standardization of high-quality production processes, obtaining a safe product for human use, with a positive impact on public health. In addition, the COVID-19 pandemic highlights the importance of having more and better-distributed manufacturing plants, emphasizing regions such as Latin America. This review shows the most important GMP standards in the world and, in particular, their relevance in the production of vaccines and antibodies.
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Affiliation(s)
- Consuelo E. Covarrubias
- Millenium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Thomas A. Rivera
- Millenium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Catalina A. Soto
- Millenium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Trevor Deeks
- Deeks Pharmaceutical Consulting Services, Rockville, MD, United States
| | - Alexis M. Kalergis
- Millenium Institute on Immunology and Immunotherapy, Departamento de Genética Molecular y Microbiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Suresh S, Zafack J, Pham-Huy A, Derfalvi B, Sadarangani M, McConnell A, Tapiéro B, Halperin SA, De Serres G, M Pernica J, Top KA. Physician vaccination practices in mild to moderate inborn errors of immunity and retrospective review of vaccine completeness in IEI: results from the Canadian Immunization Research Network. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2022; 18:32. [PMID: 35397595 PMCID: PMC8994318 DOI: 10.1186/s13223-022-00667-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 03/08/2022] [Indexed: 11/26/2022]
Abstract
Background and objectives Safety and effectiveness concerns may preclude physicians from recommending vaccination in mild/moderate inborn errors of immunity (IEI). This study describes attitudes and practices regarding vaccination among physicians who care for patients with mild/moderate B cell or mild/moderate combined immunodeficiencies (CID) and vaccination completeness among patients diagnosed with IEIs. Methods Canadian physicians caring for children with IEI were surveyed about attitudes and practices regarding vaccination in mild/moderate IEI. Following informed consent, immunization records of pediatric patients with IEI evaluated before 7 years of age were reviewed. Vaccine completeness was defined at age 2 years as 4 doses of diphtheria-tetanus-pertussis (DTaP), 3 doses pneumococcal conjugate (PCV), and 1 dose measles-mumps-rubella (MMR) vaccines. At 7 years 5 doses of DTP and 2 doses MMR were required. Results Forty-five physicians from 8 provinces completed the survey. Most recommended inactivated vaccines for B cell deficiency: (84% (38/45) and CID (73% (33/45). Fewer recommended live attenuated vaccines (B cell: 53% (24/45), CID 31% (14/45)). Of 96 patients with IEI recruited across 7 centers, vaccination completeness at age 2 was 25/43 (58%) for predominantly antibody, 3/13 (23%) for CID, 7/35 (20%) for CID with syndromic features, and 4/4 (100%) for innate/phagocyte defects. Completeness at age 7 was 15%, 17%, 5%, and 33%, respectively. Conclusion Most physicians surveyed recommended inactivated vaccines in children with mild to moderate IEI. Vaccine completeness for all IEI was low, particularly at age 7. Further studies should address the reasons for low vaccine uptake among children with IEI and whether those with mild-moderate IEI, where vaccination is recommended, eventually receive all indicated vaccines. Supplementary Information The online version contains supplementary material available at 10.1186/s13223-022-00667-1.
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Affiliation(s)
- Sneha Suresh
- Division of Immunology, Department of Pediatrics, Edmonton Clinic Health Academy, 3-529, 11405 87 Ave, Edmonton, AB, T6G 1C9, Canada. .,Division of Infectious Disease and IHOPE, Department of Paediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Canada.
| | | | - Anne Pham-Huy
- Division of Infectious Diseases, Immunology and Allergy, Department of Paediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Canada
| | - Beata Derfalvi
- Division of Immunology, Departments of Paediatrics and Microbiology and Immunology, IWK Health Centre, Dalhousie University, Halifax, Canada
| | - Manish Sadarangani
- Vaccine Evaluation Center, BC Children's Hospital Research Institute, Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Athena McConnell
- Division of Infectious Diseases, Department of Pediatrics, Jim Pattison Children's Hospital, University of Saskatchewan, Saskatoon, Canada
| | - Bruce Tapiéro
- Division of Infectious Diseases, Department of Pediatrics, CHU Sainte Justine, Université de Montreal, Montreal, Canada
| | - Scott A Halperin
- Departments of Paediatrics and Microbiology and Immunology, Canadian Center for Vaccinology IWK Health Centre, Dalhousie University, Halifax, Canada
| | - Gaston De Serres
- Department of Social and Preventive Medicine, Institut Nationale de Santé Publique du Québec, Université Laval, Québec, Canada
| | - Jeffrey M Pernica
- Division of Infectious Diseases, Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Karina A Top
- Departments of Pediatrics and Community Health and Epidemiology, Canadian Center for Vaccinology, IWK Health Centre, Dalhousie University, Halifax, Canada.
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Kompier R, Neels P, Beyer W, Hardman T, Lioznov D, Kharit S, Kostinov M. Analysis of the safety and immunogenicity profile of an azoximer bromide polymer-adjuvanted subunit influenza vaccine. F1000Res 2022; 11:259. [PMID: 36176546 PMCID: PMC9493399 DOI: 10.12688/f1000research.75869.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
A systematic review of clinical trials conducted with a low-dose inactivated influenza vaccine adjuvanted by azoximer bromide (AZB, Polyoxidonium), was performed to compare vaccine reactogenicity against non-adjuvant vaccines. We also assessed whether lower amounts of antigen per viral strain in AZB-adjuvanted vaccines affected antibody responses. A robust search strategy identified scientific publications reporting 30 clinical trials, comprising data on 11,736 participants and 86 trial arms, for inclusion in the analysis. Local reaction rates (R lr) appeared to be lower in AZB-adjuvanted vaccine treatment arms versus comparator vaccine treatment arms. Meta‑regression analysis revealed that AZB did not contribute to vaccine reactogenicity. Post-vaccination geometric mean titres in those exposed to AZB-adjuvanted vaccine and comparator vaccine treatment arms were similar in both children and adults aged 18-60 years, implying an antigen-sparing effect by AZB.
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Affiliation(s)
- Ronald Kompier
- Ruijgenhoeck 6, 2201 EW Noordwijk, Vaccine Consultancy, The Netherlands, Netherlands Antilles
| | | | - Walter Beyer
- Ruijgenhoeck 6, 2201 EW Noordwijk, Vaccine Consultancy, The Netherlands, Netherlands Antilles,Niche Science and Technology Ltd., Unit 26, Falstaff House, Bardolph Road, Niche Science and Technology, London, UK
| | - Tim Hardman
- Niche Science and Technology Ltd., Unit 26, Falstaff House, Bardolph Road, Niche Science and Technology, London, UK,
| | - Dmitry Lioznov
- Smorodintsev Research Institute of Influenza, Saint Petersburg, Russian Federation,First Pavlov State Medical University, Saint Petersburg, Russian Federation
| | - Susanna Kharit
- Scientific Research Institute of Children’s Infections of the Russian Federal Biomedical Agency, St. Petersburg, Russian Federation
| | - Michail Kostinov
- Department of Allergology, I.I. Mechnikov Research Institute of Vaccines and Sera, Moscow, Russian Federation,Moscow State Medical University, Department of Epidemiology and Modern Vaccination Technologies, Sechenov First, Moscow, Russian Federation
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Quinti I, Locatelli F, Carsetti R. The Immune Response to SARS-CoV-2 Vaccination: Insights Learned From Adult Patients With Common Variable Immune Deficiency. Front Immunol 2022; 12:815404. [PMID: 35126372 PMCID: PMC8807657 DOI: 10.3389/fimmu.2021.815404] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/21/2021] [Indexed: 12/23/2022] Open
Abstract
CVID patients have an increased susceptibility to vaccine-preventable infections. The question on the potential benefits of immunization of CVID patients against SARS-CoV-2 offered the possibility to analyze the defective mechanisms of immune responses to a novel antigen. In CVID, as in immunocompetent subjects, the role of B and T cells is different between infected and vaccinated individuals. Upon vaccination, variable anti-Spike IgG responses have been found in different CVID cohorts. Immunization with two doses of mRNA vaccine did not generate Spike-specific classical memory B cells (MBCs) but atypical memory B cells (ATM) with low binding capacity to Spike protein. Spike-specific T-cells responses were also induced in CVID patients with a variable frequency, differently from specific T cells produced after multiple exposures to viral antigens following influenza virus immunization and infection. The immune response elicited by SARS-CoV-2 infection was enhanced by subsequent immunization underlying the need to immunize convalescent COVID-19 CVID patients after recovery. In particular, immunization after SARS-Cov-2 infection generated Spike-specific classical memory B cells (MBCs) with low binding capacity to Spike protein and Spike-specific antibodies in a high percentage of CVID patients. The search for a strategy to elicit an adequate immune response post-vaccination in CVID patients is necessary. Since reinfection with SARS-CoV-2 has been documented, at present SARS-CoV-2 positive CVID patients might benefit from new preventing strategy based on administration of anti-SARS-CoV-2 monoclonal antibodies.
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Affiliation(s)
- Isabella Quinti
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
- *Correspondence: Isabella Quinti,
| | - Franco Locatelli
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- Dipartimento Materno-Infantile e Scienze Urologiche, Sapienza University of Rome, Rome, Italy
| | - Rita Carsetti
- Diagnostic Immunology Research Unit, Multimodal Medicine Research Area, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- Diagnostic Immunology Clinical Unit, Bambino Gesù Children’s Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
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Pulvirenti F, Fernandez Salinas A, Milito C, Terreri S, Piano Mortari E, Quintarelli C, Di Cecca S, Lagnese G, Punziano A, Guercio M, Bonanni L, Auria S, Villani F, Albano C, Locatelli F, Spadaro G, Carsetti R, Quinti I. B Cell Response Induced by SARS-CoV-2 Infection Is Boosted by the BNT162b2 Vaccine in Primary Antibody Deficiencies. Cells 2021; 10:cells10112915. [PMID: 34831138 PMCID: PMC8616496 DOI: 10.3390/cells10112915] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/19/2021] [Accepted: 10/24/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Patients with primary antibody deficiencies are at risk in the current COVID-19 pandemic due to their impaired response to infection and vaccination. Specifically, patients with common variable immunodeficiency (CVID) generated poor spike-specific antibody and T cell responses after immunization. Methods: Thirty-four CVID convalescent patients after SARS-CoV-2 infection, 38 CVID patients immunized with two doses of the BNT162b2 vaccine, and 20 SARS-CoV-2 CVID convalescents later and immunized with BNT162b2 were analyzed for the anti-spike IgG production and the generation of spike-specific memory B cells and T cells. Results: Spike-specific IgG was induced more frequently after infection than after vaccination (82% vs. 34%). The antibody response was boosted in convalescents by vaccination. Although immunized patients generated atypical memory B cells possibly by extra-follicular or incomplete germinal center reactions, convalescents responded to infection by generating spike-specific memory B cells that were improved by the subsequent immunization. Poor spike-specific T cell responses were measured independently from the immunological challenge. Conclusions: SARS-CoV-2 infection primed a more efficient classical memory B cell response, whereas the BNT162b2 vaccine induced non-canonical B cell responses in CVID. Natural infection responses were boosted by subsequent immunization, suggesting the possibility to further stimulate the immune response by additional vaccine doses in CVID.
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Affiliation(s)
- Federica Pulvirenti
- Regional Reference Centre for Primary Immune Deficiencies, Azienda Ospedaliera Universitaria Policlinico Umberto I, 00185 Rome, Italy; (F.P.); (L.B.); (S.A.); (F.V.)
| | - Ane Fernandez Salinas
- Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.F.S.); (C.M.)
- Diagnostic Immunology Research Unit, Multimodal Medicine Research Area, Bambino Gesù Children’s Hospital, IRCCS, Viale di San Paolo, 00146 Rome, Italy; (S.T.); (E.P.M.); (C.A.); (R.C.)
| | - Cinzia Milito
- Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.F.S.); (C.M.)
| | - Sara Terreri
- Diagnostic Immunology Research Unit, Multimodal Medicine Research Area, Bambino Gesù Children’s Hospital, IRCCS, Viale di San Paolo, 00146 Rome, Italy; (S.T.); (E.P.M.); (C.A.); (R.C.)
| | - Eva Piano Mortari
- Diagnostic Immunology Research Unit, Multimodal Medicine Research Area, Bambino Gesù Children’s Hospital, IRCCS, Viale di San Paolo, 00146 Rome, Italy; (S.T.); (E.P.M.); (C.A.); (R.C.)
| | - Concetta Quintarelli
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, 00116 Rome, Italy; (C.Q.); (S.D.C.); (M.G.); (F.L.)
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Stefano Di Cecca
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, 00116 Rome, Italy; (C.Q.); (S.D.C.); (M.G.); (F.L.)
| | - Gianluca Lagnese
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (G.L.); (A.P.); (G.S.)
| | - Alessandra Punziano
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (G.L.); (A.P.); (G.S.)
| | - Marika Guercio
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, 00116 Rome, Italy; (C.Q.); (S.D.C.); (M.G.); (F.L.)
| | - Livia Bonanni
- Regional Reference Centre for Primary Immune Deficiencies, Azienda Ospedaliera Universitaria Policlinico Umberto I, 00185 Rome, Italy; (F.P.); (L.B.); (S.A.); (F.V.)
| | - Stefania Auria
- Regional Reference Centre for Primary Immune Deficiencies, Azienda Ospedaliera Universitaria Policlinico Umberto I, 00185 Rome, Italy; (F.P.); (L.B.); (S.A.); (F.V.)
| | - Francesca Villani
- Regional Reference Centre for Primary Immune Deficiencies, Azienda Ospedaliera Universitaria Policlinico Umberto I, 00185 Rome, Italy; (F.P.); (L.B.); (S.A.); (F.V.)
| | - Christian Albano
- Diagnostic Immunology Research Unit, Multimodal Medicine Research Area, Bambino Gesù Children’s Hospital, IRCCS, Viale di San Paolo, 00146 Rome, Italy; (S.T.); (E.P.M.); (C.A.); (R.C.)
| | - Franco Locatelli
- Department Onco-Haematology, and Cell and Gene Therapy, Bambino Gesù Children Hospital, IRCCS, 00116 Rome, Italy; (C.Q.); (S.D.C.); (M.G.); (F.L.)
- Dipartimento Materno-Infantile e Scienze Urologiche, Sapienza University of Rome, 00185 Rome, Italy
| | - Giuseppe Spadaro
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (G.L.); (A.P.); (G.S.)
| | - Rita Carsetti
- Diagnostic Immunology Research Unit, Multimodal Medicine Research Area, Bambino Gesù Children’s Hospital, IRCCS, Viale di San Paolo, 00146 Rome, Italy; (S.T.); (E.P.M.); (C.A.); (R.C.)
| | - Isabella Quinti
- Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy; (A.F.S.); (C.M.)
- Correspondence: ; Tel.: +39-0649972007
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