1
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Tsounis EP, Mouzaki A, Triantos C. Nucleic acid vaccines: A taboo broken and prospect for a hepatitis B virus cure. World J Gastroenterol 2021; 27:7005-7013. [PMID: 34887624 PMCID: PMC8613654 DOI: 10.3748/wjg.v27.i41.7005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/07/2021] [Accepted: 10/14/2021] [Indexed: 02/06/2023] Open
Abstract
Although a prophylactic vaccine is available, hepatitis B virus (HBV) remains a major cause of liver-related morbidity and mortality. Current treatment options are improving clinical outcomes in chronic hepatitis B; however, true functional cure is currently the exception rather than the rule. Nucleic acid vaccines are among the emerging immunotherapies that aim to restore weakened immune function in chronically infected hosts. DNA vaccines in particular have shown promising results in vivo by reducing viral replication, breaking immune tolerance in a sustained manner, or even decimating the intranuclear covalently closed circular DNA reservoir, the hallmark of HBV treatment. Although DNA vaccines encoding surface antigens administered by conventional injection elicit HBV-specific T cell responses in humans, initial clinical trials failed to demonstrate additional therapeutic benefit when administered with nucleos(t)ide analogs. In an attempt to improve vaccine immunogenicity, several techniques have been used, including codon/promoter optimization, coadministration of cytokine adjuvants, plasmids engineered to express multiple HBV epitopes, or combinations with other immunomodulators. DNA vaccine delivery by electroporation is among the most efficient strategies to enhance the production of plasmid-derived antigens to stimulate a potent cellular and humoral anti-HBV response. Preliminary results suggest that DNA vaccination via electroporation efficiently invigorates both arms of adaptive immunity and suppresses serum HBV DNA. In contrast, the study of mRNA-based vaccines is limited to a few in vitro experiments in this area. Further studies are needed to clarify the prospects of nucleic acid vaccines for HBV cure.
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Affiliation(s)
- Efthymios P Tsounis
- Division of Gastroenterology, Department of Internal Medicine, University of Patras, Patras 26504, Greece
| | - Athanasia Mouzaki
- Division of Hematology, Department of Internal Medicine, University of Patras, Patras 26504, Greece
| | - Christos Triantos
- Division of Gastroenterology, Department of Internal Medicine, University of Patras, Patras 26504, Greece
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2
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Kardani K, Basimi P, Fekri M, Bolhassani A. Antiviral therapy for the sexually transmitted viruses: recent updates on vaccine development. Expert Rev Clin Pharmacol 2020; 13:1001-1046. [PMID: 32838584 DOI: 10.1080/17512433.2020.1814743] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The sexually transmitted infections (STIs) caused by viruses including human T cell leukemia virus type-1 (HTLV-1), human immunodeficiency virus-1 (HIV-1), human simplex virus-2 (HSV-2), hepatitis C virus (HCV), hepatitis B virus (HBV), and human papillomavirus (HPV) are major public health issues. These infections can cause cancer or result in long-term health problems. Due to high prevalence of STIs, a safe and effective vaccine is required to overcome these fatal viruses. AREAS COVERED This review includes a comprehensive overview of the literatures relevant to vaccine development against the sexually transmitted viruses (STVs) using PubMed and Sciencedirect electronic search engines. Herein, we discuss the efforts directed toward development of effective vaccines using different laboratory animal models including mice, guinea pig or non-human primates in preclinical trials, and human in clinical trials with different phases. EXPERT OPINION There is no effective FDA approved vaccine against the sexually transmitted viruses (STVs) except for HBV and HPV as prophylactic vaccines. Many attempts are underway to develop vaccines against these viruses. There are several approaches for improving prophylactic or therapeutic vaccines such as heterologous prime/boost immunization, delivery system, administration route, adjuvants, etc. In this line, further studies can be helpful for understanding the immunobiology of STVs in human. Moreover, development of more relevant animal models is a worthy goal to induce effective immune responses in humans.
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Affiliation(s)
- Kimia Kardani
- Department of Hepatitis and AIDS, Pasteur Institute of Iran , Tehran, Iran
| | - Parya Basimi
- Department of Hepatitis and AIDS, Pasteur Institute of Iran , Tehran, Iran
| | - Mehrshad Fekri
- Department of Hepatitis and AIDS, Pasteur Institute of Iran , Tehran, Iran
| | - Azam Bolhassani
- Department of Hepatitis and AIDS, Pasteur Institute of Iran , Tehran, Iran
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3
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Wang F, Qin Z, Lu H, He S, Luo J, Jin C, Song X. Clinical translation of gene medicine. J Gene Med 2019; 21:e3108. [PMID: 31246328 DOI: 10.1002/jgm.3108] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/30/2019] [Accepted: 06/13/2019] [Indexed: 02/05/2023] Open
Abstract
Gene therapy has recently witnessed accelerated progress as a new therapeutic strategy with the potential to treat a range of inherited and acquired diseases. Billions of dollars have been invested in basic and clinical research on gene medicine, with ongoing clinical trials focused on cancer, monogenic diseases, cardiovascular diseases and other refractory diseases. Advances addressing the inherent challenges of gene therapy, particularly those related to retaining the delivery efficacy and minimizing unwanted immune responses, provide the basis for the widespread clinical application of gene medicine. Several types of genes delivered by viral or non-viral delivery vectors have demonstrated encouraging results in both animals and humans. As augmented by clinical indications, gene medicine techniques have rapidly become a promising alternative to conventional therapeutic strategies because of their better clinical benefit and lower toxicities. Their application in the clinic has been extensive as a result of the approval of many gene therapy drugs in recent years. In this review, we provide a comprehensive overview of the clinical translation of gene medicine, focusing on the key events and latest progress made regarding clinical gene therapy products. We also discuss the gene types and non-viral materials with respect to developing gene therapeutics in clinical trials.
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Affiliation(s)
- Fazhan Wang
- Department of Pharmacy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, China
| | - Zhou Qin
- Department of Pharmacy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, China
| | - Hansi Lu
- Department of Pharmacy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, China
| | - Siyan He
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Jing Luo
- Department of Pharmacy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, China
| | - Chaohui Jin
- Department of Pharmacy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, China
| | - Xiangrong Song
- Department of Pharmacy, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Sichuan University, Chengdu, China
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4
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Cronjé TF, Gaynor PT. Electroporation of Ishikawa cells: analysis by flow cytometry. IET Nanobiotechnol 2019; 13:58-65. [PMID: 30964039 PMCID: PMC8676626 DOI: 10.1049/iet-nbt.2018.5194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 07/04/2018] [Accepted: 07/31/2018] [Indexed: 12/25/2022] Open
Abstract
Electroporation facilitates loading of cells with molecules and substances that are normally membrane impermeable. Flow cytometry is used in this study to examine the effects of the application of electroporation-level monopolar electric field pulses of varying electrical field strength on Ishikawa endometrial adenocarcinoma cells. Analysis of the fluorescence versus forward scatter plots corroborates the well-recognised threshold and cell size dependence characteristics of electroporation, but also shows the progression of cell lysis and generation of particulate material. Two 500 µs monopolar rectangular pulses ranging from 1.0 × 105 to 2.5 × 105 V/m were used to electroporate the cells. Electroporation yields (fraction of viable cells exhibiting significant propidium iodide uptake) ranged from 0 to 97%, with viability ranging between 78 and 34% over the electric field strength range tested. The higher electric field strength pulses not only reduced cell viability, but also generated a substantial amount of sub-cellular sized particulate material indicating cells have been physically disrupted enough to create these particles.
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Affiliation(s)
- Thomas F Cronjé
- Department of Engineering and Architectural Studies, Ara Institute of Canterbury, Christchurch, New Zealand.
| | - Paul T Gaynor
- Department of Electrical and Computer Engineering, University of Canterbury, Christchurch, New Zealand
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5
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Xia Y, Liang TJ. Development of Direct-acting Antiviral and Host-targeting Agents for Treatment of Hepatitis B Virus Infection. Gastroenterology 2019; 156:311-324. [PMID: 30243618 PMCID: PMC6340783 DOI: 10.1053/j.gastro.2018.07.057] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/13/2018] [Accepted: 07/23/2018] [Indexed: 02/06/2023]
Abstract
Hepatitis B virus (HBV) infection affects approximately 300 million people worldwide. Although antiviral therapies have improved the long-term outcomes, patients often require life-long treatment and there is no cure for HBV infection. New technologies can help us learn more about the pathogenesis of HBV infection and develop therapeutic agents to reduce its burden. We review recent advances in development of direct-acting antiviral and host-targeting agents, some of which have entered clinical trials. We also discuss strategies for unbiased high-throughput screens to identify compounds that inhibit HBV and for repurposing existing drugs.
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Affiliation(s)
- Yuchen Xia
- Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, 20892
| | - T Jake Liang
- Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, 20892.
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6
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Rao GK, Wong A, Collinge M, Sarhan J, Yarovinsky TO, Ramgolam VS, Gaestel M, Pardi R, Bender JR. T cell LFA-1-induced proinflammatory mRNA stabilization is mediated by the p38 pathway kinase MK2 in a process regulated by hnRNPs C, H1 and K. PLoS One 2018; 13:e0201103. [PMID: 30048492 PMCID: PMC6065199 DOI: 10.1371/journal.pone.0201103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 07/09/2018] [Indexed: 11/18/2022] Open
Abstract
Activation of the β2 integrin lymphocyte function-associated antigen-1 (LFA-1) in T cells induces stabilization of proinflammatory AU-rich element (ARE)-bearing mRNAs, by triggering the nuclear-to-cytoplasmic translocation of the mRNA-binding and -stabilizing protein HuR. However, the mechanism by which LFA-1 engagement controls HuR localization is not known. Here, we identify and characterize four key regulators of LFA-1-induced changes in HuR activity: the p38 pathway kinase MK2 and the constitutive nuclear proteins hnRNPs C, H1 and K. LFA-1 engagement results in rapid, sequential activation of p38 and MK2. Post-LFA-1 activation, MK2 inducibly associates with both hnRNPC and HuR, resulting in the dissociation of HuR from hnRNPs C, H1 and K. Freed from the three hnRNPs, HuR translocates from the nucleus to the cytoplasm, and mediates the stabilization of labile cytokine transcripts. Our results suggest that the modulation of T cell cytokine mRNA half-life is an intricate process that is negatively regulated by hnRNPs C, H1 and K and requires MK2 as a critical activator.
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Affiliation(s)
- Gautham K. Rao
- Department of Internal Medicine, Section of Cardiovascular Medicine,
Cardiovascular Research Center, Yale University School of Medicine, New Haven,
Connecticut, United States of America
- Department of Immunobiology, Yale University School of Medicine, New
Haven, Connecticut, United States of America
- Raymond and Beverly Sackler Foundation Cardiovascular Laboratory, New
Haven, Connecticut, United States of America
| | - Albert Wong
- Raymond and Beverly Sackler Foundation Cardiovascular Laboratory, New
Haven, Connecticut, United States of America
- Department of Cell Biology, Yale University School of Medicine, New
Haven, Connecticut, United States of America
| | - Mark Collinge
- Department of Internal Medicine, Section of Cardiovascular Medicine,
Cardiovascular Research Center, Yale University School of Medicine, New Haven,
Connecticut, United States of America
- Department of Immunobiology, Yale University School of Medicine, New
Haven, Connecticut, United States of America
- Raymond and Beverly Sackler Foundation Cardiovascular Laboratory, New
Haven, Connecticut, United States of America
| | - Joseph Sarhan
- Department of Internal Medicine, Section of Cardiovascular Medicine,
Cardiovascular Research Center, Yale University School of Medicine, New Haven,
Connecticut, United States of America
- Department of Immunobiology, Yale University School of Medicine, New
Haven, Connecticut, United States of America
- Raymond and Beverly Sackler Foundation Cardiovascular Laboratory, New
Haven, Connecticut, United States of America
| | - Timur O. Yarovinsky
- Department of Internal Medicine, Section of Cardiovascular Medicine,
Cardiovascular Research Center, Yale University School of Medicine, New Haven,
Connecticut, United States of America
- Department of Immunobiology, Yale University School of Medicine, New
Haven, Connecticut, United States of America
- Raymond and Beverly Sackler Foundation Cardiovascular Laboratory, New
Haven, Connecticut, United States of America
| | - Vinod S. Ramgolam
- Department of Internal Medicine, Section of Cardiovascular Medicine,
Cardiovascular Research Center, Yale University School of Medicine, New Haven,
Connecticut, United States of America
- Department of Immunobiology, Yale University School of Medicine, New
Haven, Connecticut, United States of America
- Raymond and Beverly Sackler Foundation Cardiovascular Laboratory, New
Haven, Connecticut, United States of America
| | - Matthias Gaestel
- Institute of Biochemistry, Medical School Hannover, Hannover,
Germany
| | - Ruggero Pardi
- Faculty of Medicine and Surgery, Università Vita-Salute San Raffaele,
Milan, Italy
| | - Jeffrey R. Bender
- Department of Internal Medicine, Section of Cardiovascular Medicine,
Cardiovascular Research Center, Yale University School of Medicine, New Haven,
Connecticut, United States of America
- Department of Immunobiology, Yale University School of Medicine, New
Haven, Connecticut, United States of America
- Raymond and Beverly Sackler Foundation Cardiovascular Laboratory, New
Haven, Connecticut, United States of America
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7
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Gene therapy research in Asia. Gene Ther 2017; 24:572-577. [DOI: 10.1038/gt.2017.62] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 07/13/2017] [Accepted: 07/14/2017] [Indexed: 12/18/2022]
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8
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Li J, Bao M, Ge J, Ren S, Zhou T, Qi F, Pu X, Dou J. Research progress of therapeutic vaccines for treating chronic hepatitis B. Hum Vaccin Immunother 2017; 13:986-997. [PMID: 28118084 DOI: 10.1080/21645515.2016.1276125] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Hepatitis B virus (HBV) is a member of Hepadnavirus family, which leads to chronic infection in around 5% of patients with a high risk of developing liver cirrhosis, liver failure, and hepatocellular carcinoma. 1 Despite the availability of prophylactic vaccines against hepatitis B for over 3 decades, there are still more than 2 billion people have been infected and 240 million of them were chronic. Antiviral therapies currently used in the treatment of CHB (chronic hepatitis B) infection include peg-interferon, standard α-interferon and nucleos/tide analogs (NAs), but none of them can provide sustained control of viral replication. As an alternative strategy, therapeutic vaccines for CHB patients have been widely studied and showed some promising efficacies in dozens of preclinical and clinical trials. In this article, we review current research progress in several types of therapeutic vaccines for CHB treatment, including protein-based vaccines, DNA-based vaccines, live vector-based vaccines, peptide-based vaccines and cell-based therapies. These researches may provide some clues for developing new treatments in CHB infection.
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Affiliation(s)
- Jianqiang Li
- a Jiangsu Theravac Bio-pharmaceutical Co., Ltd. , Nanjing , China
| | - Mengru Bao
- a Jiangsu Theravac Bio-pharmaceutical Co., Ltd. , Nanjing , China
| | - Jun Ge
- a Jiangsu Theravac Bio-pharmaceutical Co., Ltd. , Nanjing , China
| | - Sulin Ren
- a Jiangsu Theravac Bio-pharmaceutical Co., Ltd. , Nanjing , China
| | - Tong Zhou
- a Jiangsu Theravac Bio-pharmaceutical Co., Ltd. , Nanjing , China
| | - Fengchun Qi
- a Jiangsu Theravac Bio-pharmaceutical Co., Ltd. , Nanjing , China
| | - Xiuying Pu
- b School of Life Science and Engineering, Lanzhou University of Technology , Lanzhou , China
| | - Jia Dou
- c Dalian Institute for Drug Control , Dalian , China
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9
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Yang FQ, Rao GR, Wang GQ, Li YQ, Xie Y, Zhang ZQ, Deng CL, Mao Q, Li J, Zhao W, Wang MR, Han T, Chen SJ, Pan C, Tan DM, Shang J, Zhang MX, Zhang YX, Yang JM, Chen GM. Phase IIb trial of in vivo electroporation mediated dual-plasmid hepatitis B virus DNA vaccine in chronic hepatitis B patients under lamivudine therapy. World J Gastroenterol 2017; 23:306-317. [PMID: 28127204 PMCID: PMC5236510 DOI: 10.3748/wjg.v23.i2.306] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/30/2016] [Accepted: 10/27/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the efficacy and safety of in vivo electroporation (EP)-mediated dual-plasmid hepatitis B virus (HBV) DNA vaccine vs placebo for sequential combination therapy with lamivudine (LAM) in patients with chronic hepatitis B.
METHODS Two hundred and twenty-five patients were randomized to receive either LAM + vaccine (vaccine group, n = 109) or LAM + placebo (control group, n = 116). LAM treatment lasted 72 wk. Patients received the DNA vaccine or placebo by intramuscular injection mediated by EP at weeks 12 (start of treatment with vaccine or placebo, SOT), 16, 24, and 36 (end of treatment with vaccine or placebo, EOT).
RESULTS In the modified intent-to-treat population, more patients had a decrease in HBV DNA > 2 log10 IU/mL in the vaccine group at week 12 after EOT compared with the control group. A trend toward a difference in the number of patients with undetectable HBV DNA at week 28 after EOT was obtained. Adverse events were similar. In the dynamic per-protocol set, which excluded adefovir (ADV) add-on cases at each time point instantly after ADV administration due to LAM antiviral failure, more patients had a decrease in HBV DNA > 2 log10 IU/mL in the vaccine group at week 12 and 28 after EOT compared with the control group. More patients with undetectable HBV DNA at week 28 after EOT in the vaccine group were also observed. Among patients with a viral load < 1000 copies/mL at week 12, more patients achieved HBeAg seroconversion in the vaccine group than among controls at week 36 after EOT, as well as less virological breakthrough and YMDD mutations.
CONCLUSION The primary endpoint was not achieved using the HBV DNA vaccine. The HBV DNA vaccine could only be beneficial in subjects that have achieved initial virological response under LAM chemotherapy.
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MESH Headings
- Adult
- DNA, Viral/administration & dosage
- DNA, Viral/adverse effects
- DNA, Viral/isolation & purification
- DNA, Viral/therapeutic use
- Double-Blind Method
- Drug Resistance, Viral/drug effects
- Electroporation/methods
- Female
- Hepatitis B Vaccines/administration & dosage
- Hepatitis B Vaccines/adverse effects
- Hepatitis B Vaccines/therapeutic use
- Hepatitis B virus/genetics
- Hepatitis B virus/isolation & purification
- Hepatitis B, Chronic/drug therapy
- Humans
- Injections, Intramuscular
- Lamivudine/administration & dosage
- Lamivudine/therapeutic use
- Male
- Plasmids
- Reverse Transcriptase Inhibitors/administration & dosage
- Reverse Transcriptase Inhibitors/therapeutic use
- Treatment Outcome
- Vaccines, DNA/administration & dosage
- Vaccines, DNA/adverse effects
- Vaccines, DNA/therapeutic use
- Viral Load
- Young Adult
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10
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Tsutsumi S, Shinkai N, Tanaka Y. Recent advances in hepatitis B research and drug development. KANZO 2017; 58:217-227. [DOI: 10.2957/kanzo.58.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Affiliation(s)
- Susumu Tsutsumi
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences
| | - Noboru Shinkai
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences
| | - Yasuhito Tanaka
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences
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11
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Affiliation(s)
- Lucyna Cova
- INSERM U1052, Centre de Recherche en Cancérologie de Lyon (CRCL), University Lyon 1, Lyon, France
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12
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Ghasemi F, Rostami S, Ghayour-Mobarhan M, Meshkat Z. Current progress in the development of therapeutic vaccines for chronic hepatitis B virus infection. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2016; 19:692-704. [PMID: 27635192 PMCID: PMC5010840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 04/28/2016] [Indexed: 11/11/2022]
Abstract
Chronic hepatitis B is still a major public health issue despite the successful prophylactic vaccination attempts. Chronicity of hepatitis B virus (HBV) is mainly due to its ability to debilitate host's immune system. Therefore, major measures have been taken to stop this process and help patients with chronic hepatitis B infection recover from their illness. While satisfactory results have been achieved using preventive HBV vaccines, a reliable and effective therapeutic treatment is still in need of extensive studies. Current treatments for chronic hepatitis B include direct antiviral agents and nucleoside/nucleotide analogs, which are not always effective and are also costly. In addition, due to the fact that chronic HBV is responsible for debilitation of the immune system, studies have focused on developing therapeutic vaccines to help host's immune system recover and limit the infection. Several approaches including but not restricted to recombinant peptide-based, DNA-based, viral vector-based, and cell-based approaches are currently in use to develop therapeutic vaccines against the chronic form of HBV infection. In the current review, the authors will first discuss the role of the immune system in chronic hepatitis B infection and will then focus on latest advancements in therapeutic vaccination of HBV especially the clinical trials that have been carried out so far.
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Affiliation(s)
- Faezeh Ghasemi
- Department of New Sciences and Technology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sina Rostami
- The Influenza Centre, Department of Clinical Science, University of Bergen, N-5021 Bergen, Norway
| | - Majid Ghayour-Mobarhan
- Biochemistry of Nutrition Research Center; School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Meshkat
- Antimicrobial Resistance Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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13
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Lambricht L, Lopes A, Kos S, Sersa G, Préat V, Vandermeulen G. Clinical potential of electroporation for gene therapy and DNA vaccine delivery. Expert Opin Drug Deliv 2015; 13:295-310. [PMID: 26578324 DOI: 10.1517/17425247.2016.1121990] [Citation(s) in RCA: 148] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Electroporation allows efficient delivery of DNA into cells and tissues, thereby improving the expression of therapeutic or immunogenic proteins that are encoded by plasmid DNA. This simple and versatile method holds a great potential and could address unmet medical needs such as the prevention or treatment of many cancers or infectious diseases. AREAS COVERED This review explores the electroporation mechanism and the parameters affecting its efficacy. An analysis of past and current clinical trials focused on DNA electroporation is presented. The pathologies addressed, the protocol used, the treatment outcome and the tolerability are highlighted. In addition, several of the possible optimization strategies for improving patient compliance and therapeutic efficacy are discussed such as plasmid design, use of genetic adjuvants for DNA vaccines, choice of appropriate delivery site and electrodes as well as pulse parameters. EXPERT OPINION The growing number of clinical trials and the results already available underline the strong potential of DNA electroporation which combines both safety and efficiency. Nevertheless, it remains critical to further increase fundamental knowledge to refine future strategies, to develop concerted and common DNA electroporation protocols and to continue exploring new electroporation-based therapeutic options.
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Affiliation(s)
- Laure Lambricht
- a Université catholique de Louvain, Louvain Drug Research Institute , Advanced Drug Delivery and Biomaterials , Brussels , Belgium
| | - Alessandra Lopes
- a Université catholique de Louvain, Louvain Drug Research Institute , Advanced Drug Delivery and Biomaterials , Brussels , Belgium
| | - Spela Kos
- b Institute of Oncology Ljubljana , Department of Experimental Oncology , Ljubljana , Slovenia
| | - Gregor Sersa
- b Institute of Oncology Ljubljana , Department of Experimental Oncology , Ljubljana , Slovenia
| | - Véronique Préat
- a Université catholique de Louvain, Louvain Drug Research Institute , Advanced Drug Delivery and Biomaterials , Brussels , Belgium
| | - Gaëlle Vandermeulen
- a Université catholique de Louvain, Louvain Drug Research Institute , Advanced Drug Delivery and Biomaterials , Brussels , Belgium
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14
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Therapeutic vaccines in treating chronic hepatitis B: the end of the beginning or the beginning of the end? Med Microbiol Immunol 2014; 204:121-9. [DOI: 10.1007/s00430-014-0381-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 09/15/2014] [Indexed: 12/13/2022]
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15
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Wang YM, Zhou JJ, Wang Y, Watson D, Zhang GY, Hu M, Wu H, Zheng G, Wang Y, Durkan AM, Harris DCH, Alexander SI. Daedalic DNA vaccination against self antigens as a treatment for chronic kidney disease. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2013; 6:326-333. [PMID: 23412421 PMCID: PMC3563188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 01/17/2013] [Indexed: 06/01/2023]
Abstract
Chronic kidney disease (CKD) is a major cause of death and morbidity in Australia and worldwide. DNA vaccination has been used for targeting foreign antigens to induce immune responses and prevent autoimmune disease, viral infection and cancer. However, the use of DNA vaccination has been restricted by a limited ability to induce strong immune responses, especially against self-antigens which are limited by mechanisms of self-tolerance. Furthermore, there have been few studies on the potential of DNA vaccination in chronic inflammatory diseases, including CKD. We have established strategies of DNA vaccination targeting specific self-antigens in the immune system including co-stimulatory pathways, T cell receptors and chemokine molecules, which have been effective in protecting against the development of CKD in a variety of animal models. In particular, we find that the efficacy of DNA vaccination is improved by dendritic cell (DC) targeting and can protect against animal models of autoimmune nephritis mimicking human membranous nephropathy. In this review, we summarize several approaches that have been tested to improve the efficacy of DNA vaccination in CKD models, including enhanced DNA vaccine delivery methods, DNA vaccine modifications and new molecular targets for DNA vaccination. Finally, we discuss the specific application of DNA vaccination for preventing and treating CKD.
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Affiliation(s)
- Yuan Min Wang
- Centre for Kidney Research, Children's Hospital at Westmead Sydney, NSW, Australia.
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16
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Khawaja G, Buronfosse T, Jamard C, Abdul F, Guerret S, Zoulim F, Luxembourg A, Hannaman D, Evans CF, Hartmann D, Cova L. In vivo electroporation improves therapeutic potency of a DNA vaccine targeting hepadnaviral proteins. Virology 2012; 433:192-202. [PMID: 22921316 DOI: 10.1016/j.virol.2012.07.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 06/01/2012] [Accepted: 07/16/2012] [Indexed: 12/15/2022]
Abstract
This preclinical study investigated the therapeutic efficacy of electroporation (EP)-based delivery of plasmid DNA (pDNA) encoding viral proteins (envelope, core) and IFN-γ in the duck model of chronic hepatitis B virus (DHBV) infection. Importantly, only DNA EP-therapy resulted in a significant decrease in mean viremia titers and in intrahepatic covalently closed circular DNA (cccDNA) levels in chronic DHBV-carrier animals, compared with standard needle pDNA injection (SI). In addition, DNA EP-therapy stimulated in all virus-carriers a humoral response to DHBV preS protein, recognizing a broader range of major antigenic regions, including neutralizing epitopes, compared with SI. DNA EP-therapy led also to significant higher intrahepatic IFN-γ RNA levels in DHBV-carriers compared to other groups, in the absence of adverse effects. We provide the first evidence on DNA EP-therapy benefit in terms of hepadnaviral infection clearance and break of immune tolerance in virus-carriers, supporting its clinical application for chronic hepatitis B.
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MESH Headings
- Animals
- Antibodies, Viral/biosynthesis
- Antibodies, Viral/immunology
- Chronic Disease
- DNA, Circular/genetics
- DNA, Circular/immunology
- Disease Models, Animal
- Ducks
- Electroporation
- Epitopes
- Hepadnaviridae Infections/immunology
- Hepadnaviridae Infections/prevention & control
- Hepadnaviridae Infections/veterinary
- Hepadnaviridae Infections/virology
- Hepatitis B Vaccines/administration & dosage
- Hepatitis B Vaccines/immunology
- Hepatitis B Virus, Duck/immunology
- Hepatitis, Viral, Animal/immunology
- Hepatitis, Viral, Animal/prevention & control
- Hepatitis, Viral, Animal/virology
- Immune Tolerance
- Immunity, Humoral
- Interferon-gamma/biosynthesis
- Interferon-gamma/immunology
- Plasmids
- Vaccines, DNA/administration & dosage
- Vaccines, DNA/immunology
- Viral Core Proteins/genetics
- Viral Core Proteins/immunology
- Viral Envelope Proteins/genetics
- Viral Envelope Proteins/immunology
- Viremia/immunology
- Viremia/prevention & control
- Viremia/veterinary
- Viremia/virology
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17
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Enhanced magnitude and breadth of neutralizing humoral response to a DNA vaccine targeting the DHBV envelope protein delivered by in vivo electroporation. Virology 2012; 425:61-9. [DOI: 10.1016/j.virol.2012.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Revised: 12/23/2011] [Accepted: 01/03/2012] [Indexed: 02/08/2023]
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18
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Abstract
Chronic HBV infection remains a leading cause of serious liver disease and hepatocellular carcinoma in spite of the existence of an effective preventive vaccine. Although the actual antiviral treatments have greatly improved, they only rarely clear viral infection. In this regard, therapeutic DNA vaccination appears to have great promise to stimulate and restore the impaired immune responses in chronic HBV carriers. This review examines preclinical studies of preventive and therapeutic DNA vaccines in different animal models (mouse, woodchuck and duck) and the first clinical studies in chronically infected patients. We also focused on different approaches aimed at enhancing the effectiveness of DNA vaccines such as combination therapy with antiviral drugs and in vivo DNA electroporation.
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Affiliation(s)
- Lucyna Cova
- Université Claude Bernard Lyon 1, Inserm U1052, CRCL team 15, 151 cours Albert Thomas, 69003 Lyon, France
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19
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Rochard A, Scherman D, Bigey P. Genetic immunization with plasmid DNA mediated by electrotransfer. Hum Gene Ther 2011; 22:789-98. [PMID: 21631165 DOI: 10.1089/hum.2011.092] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The concept of DNA immunization was first advanced in the early 1990s, but was not developed because of an initial lack of efficiency. Recent technical advances in plasmid design and gene delivery techniques have allowed renewed interest in the idea. Particularly, a better understanding of genetic immunization has led to construction of optimized plasmids and the use of efficient molecular adjuvants. The field also took great advantage of new delivery techniques such as electrotransfer. This is a simple physical technique consisting of injecting plasmid DNA into a target tissue and applying an electric field, allowing up to a thousandfold more expression of the transgene than naked DNA. DNA immunization mediated by electrotransfer is now effective in a variety of preclinical models against infectious or acquired diseases such as cancer or autoimmune diseases, and is making its way through the clinics in several ongoing phase I human clinical trials. This review will briefly describe genetic immunization mediated by electrotransfer and the main fields of application.
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Affiliation(s)
- Alice Rochard
- Unité de Pharmacologie Chimique et Génétique et d'Imagerie, CNRS, UMR8151, Paris, F-75006 France
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20
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Sardesai NY, Weiner DB. Electroporation delivery of DNA vaccines: prospects for success. Curr Opin Immunol 2011; 23:421-9. [PMID: 21530212 PMCID: PMC3109217 DOI: 10.1016/j.coi.2011.03.008] [Citation(s) in RCA: 293] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 03/23/2011] [Accepted: 03/25/2011] [Indexed: 01/12/2023]
Abstract
A number of noteworthy technology advances in DNA vaccines research and development over the past few years have led to the resurgence of this field as a viable vaccine modality. Notably, these include--optimization of DNA constructs; development of new DNA manufacturing processes and formulations; augmentation of immune responses with novel encoded molecular adjuvants; and the improvement in new in vivo delivery strategies including electroporation (EP). Of these, EP mediated delivery has generated considerable enthusiasm and appears to have had a great impact in vaccine immunogenicity and efficacy by increasing antigen delivery upto a 1000 fold over naked DNA delivery alone. This increased delivery has resulted in an improved in vivo immune response magnitude as well as response rates relative to DNA delivery by direct injection alone. Indeed the immune responses and protection from pathogen challenge observed following DNA administration via EP in many cases are comparable or superior to other well studied vaccine platforms including viral vectors and live/attenuated/inactivated virus vaccines. Significantly, the early promise of EP delivery shown in numerous pre-clinical animal models of many different infectious diseases and cancer are now translating into equally enhanced immune responses in human clinical trials making the prospects for this vaccine approach to impact diverse disease targets tangible.
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Affiliation(s)
- Niranjan Y Sardesai
- Inovio Pharmaceuticals, 1787 Sentry Parkway, Blue Bell, PA 19422, United States.
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21
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Heat shock protein gp96 enhances humoral and T cell responses, decreases Treg frequency and potentiates the anti-HBV activity in BALB/c and transgenic mice. Vaccine 2011; 29:6342-51. [PMID: 21600951 DOI: 10.1016/j.vaccine.2011.05.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 12/07/2010] [Accepted: 05/05/2011] [Indexed: 02/08/2023]
Abstract
More than 350 million people worldwide are chronically infected with hepatitis B virus (HBV). Broad repertoire and strong magnitude of HBV-specific T cell responses are thought to play key roles for virus control and clearance. Previous studies together with ours showed that heat shock protein gp96 as adjuvant induces antigen specific T cell responses, yet little is known for its anti-viral properties. Here, we investigated the role of gp96 mediated cellular and humoral immunity in antiviral effects in HBV transgenic mice. Immunization with HBV surface (HBsAg) and core (HBcAg) antigens combined formulation along with gp96 induced robust antiviral T-cell and antibody immunity against HBsAg and HBcAg. Compared with non-immunized control, immunization with gp96 adjuvant vaccine led to decrease of serum HBs level and HBc expression in hepatocyte by 45% and 90% at maximum, respectively, and decreased serum HBV-DNA level to below or close to the detection limit 4 weeks after the last immunization, suggesting the therapeutic effect. A significant enhancement in cellular responses towards HBcAg and increased infiltration of CD8+ T cells in liver of transgenic were observed under treatment with gp96 compared with no treatment (P<0.05 or 0.01). Treatment with gp96 was capable of reducing Tregs by overall 30-40%. The superior immune responses induced with the aid of gp96 correlated with improved antiviral effect by vaccination with HBsAg and HBcAg. We conclude that gp96 may contribute to enhanced antiviral immunity in transgenic mice at least partly by Treg down-regulation. HBcAg may act as potent adjuvant for Th1 response. Our study reveals the novel property of gp96 in immune modulation and its potential use for breaking immunotolerance in immunotherapy of chronic HBV infection.
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22
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Donate A, Coppola D, Cruz Y, Heller R. Evaluation of a novel non-penetrating electrode for use in DNA vaccination. PLoS One 2011; 6:e19181. [PMID: 21559474 PMCID: PMC3084774 DOI: 10.1371/journal.pone.0019181] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Accepted: 03/29/2011] [Indexed: 02/07/2023] Open
Abstract
Current progress in the development of vaccines has decreased the incidence of fatal and non-fatal infections and increased longevity. However, new technologies need to be developed to combat an emerging generation of infectious diseases. DNA vaccination has been demonstrated to have great potential for use with a wide variety of diseases. Alone, this technology does not generate a significant immune response for vaccination, but combined with delivery by electroporation (EP), can enhance plasmid expression and immunity. Most EP systems, while effective, can be invasive and painful making them less desirable for use in vaccination. Our lab recently developed a non-invasive electrode known as the multi-electrode array (MEA), which lies flat on the surface of the skin without penetrating the tissue. In this study we evaluated the MEA for its use in DNA vaccination using Hepatitis B virus as the infectious model. We utilized the guinea pig model because their skin is similar in thickness and morphology to humans. The plasmid encoding Hepatitis B surface antigen (HBsAg) was delivered intradermally with the MEA to guinea pig skin. The results show increased protein expression resulting from plasmid delivery using the MEA as compared to injection alone. Within 48 hours of treatment, there was an influx of cellular infiltrate in experimental groups. Humoral responses were also increased significantly in both duration and intensity as compared to injection only groups. While this electrode requires further study, our results suggest that the MEA has potential for use in electrically mediated intradermal DNA vaccination.
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Affiliation(s)
- Amy Donate
- College of Medicine, University of South Florida, Tampa, Florida, United States of America
- Center for Bioelectrics, Old Dominion University, Norfolk, Virginia, United States of America
| | - Domenico Coppola
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, United States of America
| | - Yolmari Cruz
- College of Medicine, University of South Florida, Tampa, Florida, United States of America
| | - Richard Heller
- Center for Bioelectrics, Old Dominion University, Norfolk, Virginia, United States of America
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, United States of America
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23
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Electroporation enhances immunogenicity of a DNA vaccine expressing woodchuck hepatitis virus surface antigen in woodchucks. J Virol 2011; 85:4853-62. [PMID: 21389124 DOI: 10.1128/jvi.02437-10] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The development of therapeutic vaccines for chronic hepatitis B virus (HBV) infection has been hampered by host immune tolerance and the generally low magnitude and inconsistent immune responses to conventional vaccines and proposed new delivery methods. Electroporation (EP) for plasmid DNA (pDNA) vaccine delivery has demonstrated the enhanced immunogenicity of HBV antigens in various animal models. In the present study, the efficiency of the EP-based delivery of pDNA expressing various reporter genes first was evaluated in normal woodchucks, and then the immunogenicity of an analog woodchuck hepatitis virus (WHV) surface antigen (WHsAg) pDNA vaccine was studied in this model. The expression of reporter genes was greatly increased when the cellular uptake of pDNA was facilitated by EP. The EP of WHsAg-pDNA resulted in enhanced, dose-dependent antibody and T-cell responses to WHsAg compared to those of the conventional hypodermic needle injection of WHsAg-pDNA. Although subunit WHsAg protein vaccine elicited higher antibody titers than the DNA vaccine delivered with EP, T-cell response rates were comparable. However, in WHsAg-stimulated mononuclear cell cultures, the mRNA expression of CD4 and CD8 leukocyte surface markers and Th1 cytokines was more frequent and was skewed following DNA vaccination compared to that of protein immunization. Thus, the EP-based vaccination of normal woodchucks with pDNA-WHsAg induced a skew in the Th1/Th2 balance toward Th1 immune responses, which may be considered more appropriate for approaches involving therapeutic vaccines to treat chronic HBV infection.
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24
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Hemachandra A, Puls RL, Sirivichayakul S, Kerr S, Thantiworasit P, Ubolyam S, Cooper DA, Emery S, Phanuphak P, Kelleher A, Ruxrungtham K. An HIV-1 clade A/E DNA prime, recombinant fowlpox virus boost vaccine is safe, but non-immunogenic in a randomized phase I/IIa trial in Thai volunteers at low risk of HIV infection. HUMAN VACCINES 2010; 6:835-40. [PMID: 20864808 DOI: 10.4161/hv.6.10.12635] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previously demonstrated safe and highly immunogenic in non-human primates, this study assessed DNA (pHIS-HIV-AE) prime, recombinant fowlpox (rFPV-HIV-AE) boost vaccines in humans. RESULTS Eight participants (6 active vaccine, 2 placebo) received all vaccinations; local and systemic reactions were mild to moderate. The percentage CD4(+) and CD8(+) T cells responding to HIV-1 Gag antigens by ICS (mean ± SD) was 0.16 ± 0.12 and 0.10 ± 0.12 for active and 0.01 ± 0.01 and 0.00 ± 0.00 for placebo vaccine respectively. The percentage of T cells responding did not reach pre-defined thresholds to be considered positive responses. Consequently, the Data Safety Monitoring Board recommended cessation of further recruitment. Existing volunteers were followed to 52 weeks. METHODS Vectors expressing homologous HIV-1 clade A/E gag, pol, env and regulatory genes or matched placebo were administered intramuscularly at weeks 0, 4, 8 (6 mg pHIS-HIV-AE) and week 12 (3.0 x 10(8) pfu rFPV-HIV-AE) in this randomized, double-blind, placebo-controlled phase I/IIa study in healthy Thai adults at low risk of HIV infection. Immunogenicity was determined by interferon-gamma and IL-2 expression using intracellular cytokine staining assay (ICS), 13 weeks after randomization. Interim analysis was performed when eight volunteers reached 16 weeks follow-up. CONCLUSIONS Vaccine candidates were generally well tolerated, but showed limited immunogenicity. Better vaccines and delivery systems are required.
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26
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Un K, Kawakami S, Suzuki R, Maruyama K, Yamashita F, Hashida M. Enhanced Transfection Efficiency into Macrophages and Dendritic Cells by a Combination Method Using Mannosylated Lipoplexes and Bubble Liposomes with Ultrasound Exposure. Hum Gene Ther 2010; 21:65-74. [DOI: 10.1089/hum.2009.106] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Keita Un
- Department of Drug Delivery Research, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501, Japan
| | - Shigeru Kawakami
- Department of Drug Delivery Research, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501, Japan
| | - Ryo Suzuki
- Department of Biopharmaceutics, School of Pharmaceutical Sciences, Teikyo University, Kanagawa 229-0195, Japan
| | - Kazuo Maruyama
- Department of Biopharmaceutics, School of Pharmaceutical Sciences, Teikyo University, Kanagawa 229-0195, Japan
| | - Fumiyoshi Yamashita
- Department of Drug Delivery Research, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501, Japan
| | - Mitsuru Hashida
- Department of Drug Delivery Research, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501, Japan
- Institute for Integrated Cell-Material Sciences, Kyoto University, Kyoto 606-8302, Japan
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