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Weil-Olivier C, Salisbury D, Navarro-Alonso JA, Tzialla C, Zhang Y, Esposito S, Midulla F, Tenenbaum T. Immunization technologies: Time to consider new preventative solutions for respiratory syncytial virus infections. Hum Vaccin Immunother 2023; 19:2209000. [PMID: 37193673 DOI: 10.1080/21645515.2023.2209000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/27/2023] [Indexed: 05/18/2023] Open
Abstract
New technologies for the prevention of infectious diseases are emerging to address unmet medical needs, in particular, the use of long-acting monoclonal antibodies (mAb) to prevent Respiratory Syncytial Virus (RSV) lower respiratory tract disease in infants during their first RSV season. The lack of precedent for mAbs for broad population protection creates challenges in the assessment of upcoming prophylactic long-acting mAbs for RSV, with associated consequences in legislative and registration categorization, as well as in recommendation, funding, and implementation pathways. We suggest that the legislative and regulatory categorization of preventative solutions should be decided by the effect of the product in terms of its impact on the population and health-care systems rather than by the technology used or its mechanism of action. Immunization can be passive and active, both having the same objective of prevention of infectious diseases. Long-acting prophylactic mAbs work as passive immunization, as such, their recommendations for use should fall under the remit of National Immunization Technical Advisory Groups or other relevant recommending bodies for inclusion into National Immunization Programs. Current regulations, policy, and legislative frameworks need to evolve to embrace such innovative preventative technologies and acknowledge them as one of key immunization and public health tools.
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Affiliation(s)
| | - David Salisbury
- Programme for Global Health, Royal Institute of International Affairs, Chatham House, London, UK
| | | | - Chryssoula Tzialla
- Infectious Diseases Working Group, Italian Society of Neonatology, Neonatal and Pediatric Unit, P.O Oltrepò - ASST Pavia, Pavia, Italy
| | - Yan Zhang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Diseases Control and Prevention, Beijing, People's Republic of China
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Fabio Midulla
- Department of Maternal Science and Urology, Sapienza University of Rome, Rome, Italy
| | - Tobias Tenenbaum
- Sana Klinikum Lichtenberg, Clinic for Child and Adolescent Medicine, Academic Teaching Hospital Charité-Universitätsmedizin, Berlin, Germany
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Fan W, You B, Wang X, Zheng X, Xu A, Liu Y, Peng H, Yin W, Xu M, Dong X, Liu Y, Zhao P, Liang X. Safety and efficacy of lentinan nasal drops in patients infected with the variant of COVID-19: a randomized, placebo-controlled trial. Front Pharmacol 2023; 14:1292479. [PMID: 38108068 PMCID: PMC10722177 DOI: 10.3389/fphar.2023.1292479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/22/2023] [Indexed: 12/19/2023] Open
Abstract
Objective: Lentinan has antiviral, anti-tumor, immunomodulatory, stimulating interferon production, and other pharmacological effects. Previous animal experiments have shown that lentinan nasal drops can assist [Corona Virus Disease 2019) COVID-19] vaccine to induce high levels of neutralizing antibodies and can effectively resist the invasion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to evaluate the safety and efficacy of lentinan nasal drops in patients infected with Omicron (SARS-CoV-2 variant) through a dose-escalation study and a placebo-controlled trial. Methods: A randomized, placebo-controlled trial. The study was divided into two phases: Phase I: a dose escalation trial in which 24 COVID-19 patients were enrolled, that is, 12 in the escalation dose group (50, 75, and 100 µg/day) and 12 in the standard treatment group. The aim was to evaluate the safety and tolerance of lentinan nasal drops. The second stage was a placebo-controlled study. The optimal dose group of the first stage was used as the therapeutic dose, and the sample size was expanded to verify the anti-COVID-19 efficacy of lentinan nasal drops. Results: In the dose-increasing study, lentinan nasal drops showed good safety, and no serious adverse reactions occurred. The virus shedding time of the 100 µg dose group was significantly shorter than that in the control group (7.75 ± 1.71 VS 13.41 ± 3.8 days) (p = 0.01), and the 100 µg/day lentinan nasal drops were tolerated well. The results of the placebo-controlled study showed that compared with that in the placebo group, the time for COVID-19 antigen to turn negative was significantly shorter in the 100 µg lentinan nasal drop group (p = 0.0298), but no significant difference was observed in symptom improvement between the two groups. In the placebo-controlled study, two patients experienced mild nasal discomfort with nasal drops, but the symptoms relieved themselves. Conclusion: Lentinan nasal drops are tolerated well and can shorten the time of virus clearance.
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Affiliation(s)
- Wenhan Fan
- Department of Infection Diseases, First Affiliated Hospital of Navy Military Medical University, Shanghai, China
| | - Benming You
- Department of Pharmacy, First Affiliated Hospital of Navy Military Medical University, Shanghai, China
| | - Xinyu Wang
- Department of Infection Diseases, First Affiliated Hospital of Navy Military Medical University, Shanghai, China
| | - Xu Zheng
- Department of Microbiology, PLA Key Laboratory of Biodetection and Biodefense, Shanghai Key Laboratory of Medical Biodefense, Navy Military Medical University, Shanghai, China
| | - Aijing Xu
- Department of Infection Diseases, First Affiliated Hospital of Navy Military Medical University, Shanghai, China
| | - Yangang Liu
- Department of Microbiology, PLA Key Laboratory of Biodetection and Biodefense, Shanghai Key Laboratory of Medical Biodefense, Navy Military Medical University, Shanghai, China
| | - Haoran Peng
- Department of Microbiology, PLA Key Laboratory of Biodetection and Biodefense, Shanghai Key Laboratory of Medical Biodefense, Navy Military Medical University, Shanghai, China
| | - Wei Yin
- Department of Infection Diseases, First Affiliated Hospital of Navy Military Medical University, Shanghai, China
| | - Mingxiao Xu
- Department of Infection Diseases, First Affiliated Hospital of Navy Military Medical University, Shanghai, China
| | - Xu Dong
- Department of Infection Diseases, First Affiliated Hospital of Navy Military Medical University, Shanghai, China
| | - Yayun Liu
- Department of Infection Diseases, First Affiliated Hospital of Navy Military Medical University, Shanghai, China
| | - Ping Zhao
- Department of Microbiology, PLA Key Laboratory of Biodetection and Biodefense, Shanghai Key Laboratory of Medical Biodefense, Navy Military Medical University, Shanghai, China
| | - Xuesong Liang
- Department of Infection Diseases, First Affiliated Hospital of Navy Military Medical University, Shanghai, China
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