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Falcón-Cama V, Montero-González T, Acosta-Medina EF, Guillen-Nieto G, Berlanga-Acosta J, Fernández-Ortega C, Alfonso-Falcón A, Gilva-Rodríguez N, López-Nocedo L, Cremata-García D, Matos-Terrero M, Pentón-Rol G, Valdés I, Oramas-Díaz L, Suarez-Batista A, Noa-Romero E, Cruz-Sui O, Sánchez D, Borrego-Díaz AI, Valdés-Carreras JE, Vizcaino A, Suárez-Alba J, Valdés-Véliz R, Bergado G, González MA, Hernandez T, Alvarez-Arzola R, Ramírez-Suárez AC, Casillas-Casanova D, Lemos-Pérez G, Blanco-Águila OR, Díaz A, González Y, Bequet-Romero M, Marín-Prida J, Hernández-Perera JC, Del Rosario-Cruz L, Marin-Díaz AP, González-Bravo M, Borrajero I, Acosta-Rivero N. Evidence of SARS-CoV-2 infection in postmortem lung, kidney, and liver samples, revealing cellular targets involved in COVID-19 pathogenesis. Arch Virol 2023; 168:96. [PMID: 36842152 PMCID: PMC9968404 DOI: 10.1007/s00705-023-05711-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/29/2022] [Indexed: 02/27/2023]
Abstract
There is an urgent need to understand severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-host interactions involved in virus spread and pathogenesis, which might contribute to the identification of new therapeutic targets. In this study, we investigated the presence of SARS-CoV-2 in postmortem lung, kidney, and liver samples of patients who died with coronavirus disease (COVID-19) and its relationship with host factors involved in virus spread and pathogenesis, using microscopy-based methods. The cases analyzed showed advanced stages of diffuse acute alveolar damage and fibrosis. We identified the SARS-CoV-2 nucleocapsid (NC) in a variety of cells, colocalizing with mitochondrial proteins, lipid droplets (LDs), and key host proteins that have been implicated in inflammation, tissue repair, and the SARS-CoV-2 life cycle (vimentin, NLRP3, fibronectin, LC3B, DDX3X, and PPARγ), pointing to vimentin and LDs as platforms involved not only in the viral life cycle but also in inflammation and pathogenesis. SARS-CoV-2 isolated from a patient´s nasal swab was grown in cell culture and used to infect hamsters. Target cells identified in human tissue samples included lung epithelial and endothelial cells; lipogenic fibroblast-like cells (FLCs) showing features of lipofibroblasts such as activated PPARγ signaling and LDs; lung FLCs expressing fibronectin and vimentin and macrophages, both with evidence of NLRP3- and IL1β-induced responses; regulatory cells expressing immune-checkpoint proteins involved in lung repair responses and contributing to inflammatory responses in the lung; CD34+ liver endothelial cells and hepatocytes expressing vimentin; renal interstitial cells; and the juxtaglomerular apparatus. This suggests that SARS-CoV-2 may directly interfere with critical lung, renal, and liver functions involved in COVID-19-pathogenesis.
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Affiliation(s)
- Viviana Falcón-Cama
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba. .,Latin American School of Medicine, Calle Panamericana Km 3 1/2, Playa, 11600, Havana, Cuba.
| | | | - Emilio F Acosta-Medina
- Center for Advanced Studies of Cuba, Havana, Cuba. .,Latin American School of Medicine, Calle Panamericana Km 3 1/2, Playa, 11600, Havana, Cuba.
| | - Gerardo Guillen-Nieto
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba.,Latin American School of Medicine, Calle Panamericana Km 3 1/2, Playa, 11600, Havana, Cuba
| | - Jorge Berlanga-Acosta
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba.,Latin American School of Medicine, Calle Panamericana Km 3 1/2, Playa, 11600, Havana, Cuba
| | - Celia Fernández-Ortega
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba.,Latin American School of Medicine, Calle Panamericana Km 3 1/2, Playa, 11600, Havana, Cuba
| | | | - Nathalie Gilva-Rodríguez
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba
| | - Lilianne López-Nocedo
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba
| | - Daina Cremata-García
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba
| | - Mariuska Matos-Terrero
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba
| | - Giselle Pentón-Rol
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba.,Latin American School of Medicine, Calle Panamericana Km 3 1/2, Playa, 11600, Havana, Cuba
| | - Iris Valdés
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba
| | - Leonardo Oramas-Díaz
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba
| | - Anamarys Suarez-Batista
- Department of Virology, Civilian Defense Scientific Research Center (CICDC), Havana, Mayabeque, Cuba
| | - Enrique Noa-Romero
- Department of Virology, Civilian Defense Scientific Research Center (CICDC), Havana, Mayabeque, Cuba
| | - Otto Cruz-Sui
- Department of Virology, Civilian Defense Scientific Research Center (CICDC), Havana, Mayabeque, Cuba
| | | | | | | | | | - José Suárez-Alba
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba
| | - Rodolfo Valdés-Véliz
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba
| | - Gretchen Bergado
- Direction of Immunology and Immunotherapy, Center of Molecular Immunology, Havana, Cuba
| | - Miguel A González
- Direction of Immunology and Immunotherapy, Center of Molecular Immunology, Havana, Cuba
| | - Tays Hernandez
- Direction of Immunology and Immunotherapy, Center of Molecular Immunology, Havana, Cuba
| | - Rydell Alvarez-Arzola
- Direction of Immunology and Immunotherapy, Center of Molecular Immunology, Havana, Cuba
| | - Anna C Ramírez-Suárez
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba
| | - Dionne Casillas-Casanova
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba
| | - Gilda Lemos-Pérez
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba
| | | | | | | | - Mónica Bequet-Romero
- Center for Genetic Engineering and Biotechnology (CIGB), Ave 31 be/ 158 and 190, Cubanacán, Playa, PO Box 6162, 10699, Havana, Cuba
| | - Javier Marín-Prida
- Center for Research and Biological Evaluations, Institute of Pharmacy and Food, University of Havana, Havana, Cuba
| | | | | | - Alina P Marin-Díaz
- International Orthopedic Scientific Complex 'Frank Pais Garcia', Havana, Cuba
| | - Maritza González-Bravo
- Latin American School of Medicine, Calle Panamericana Km 3 1/2, Playa, 11600, Havana, Cuba
| | | | - Nelson Acosta-Rivero
- Center for Protein Studies, Department of Biochemistry, Faculty of Biology, University of Habana, Calle 25 entre J e I, #455, Plaza de la Revolucion, 10400, Havana, Cuba. .,Department of Infectious Diseases, Centre for Integrative Infectious Disease Research (CIID), Molecular Virology, University of Heidelberg, Medical Faculty Heidelberg, INF 344, GO.1, 69120, Heidelberg, Germany.
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2
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Toledo-Romani ME, García-Carmenate M, Verdecia-Sánchez L, Pérez-Rodríguez S, Rodriguez-González M, Valenzuela-Silva C, Paredes-Moreno B, Sanchez-Ramirez B, González-Mugica R, Hernández-Garcia T, Orosa-Vázquez I, Díaz-Hernández M, Pérez-Guevara MT, Enriquez-Puertas J, Noa-Romero E, Palenzuela-Diaz A, Baro-Roman G, Mendoza-Hernández I, Muñoz Y, Gómez-Maceo Y, Santos-Vega BL, Fernandez-Castillo S, Climent-Ruiz Y, Rodríguez-Noda L, Santana-Mederos D, García-Vega Y, Chen GW, Doroud D, Biglari A, Boggiano-Ayo T, Valdés-Balbín Y, Rivera DG, García-Rivera D, Vérez-Bencomo V. Safety and immunogenicity of anti-SARS-CoV-2 heterologous scheme with SOBERANA 02 and SOBERANA Plus vaccines: Phase IIb clinical trial in adults. Med (N Y) 2022; 3:760-773.e5. [PMID: 35998623 PMCID: PMC9359498 DOI: 10.1016/j.medj.2022.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/17/2022] [Accepted: 08/02/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND SOBERANA 02 has been evaluated in phase I and IIa studies comparing homologous versus heterologous schedule (this one, including SOBERANA Plus). Here, we report results of immunogenicity, safety, and reactogenicity of SOBERANA 02 in a two- or three-dose heterologous scheme in adults. METHOD Phase IIb was a parallel, multicenter, adaptive, double-blind, randomized, and placebo-controlled trial. Subjects (n = 810) aged 19-80 years were randomized to receive two doses of SARS-CoV-2 RBD conjugated to tetanus toxoid (SOBERANA 02) and a third dose of dimeric RBD (SOBERANA Plus) 28 days apart; two production batches of active ingredients of SOBERANA 02 were evaluated. Primary outcome was the percentage of seroconverted subjects with ≥4-fold the anti-RBD immunoglobulin G (IgG) concentration. Secondary outcomes were safety, reactogenicity, and neutralizing antibodies. FINDINGS Seroconversion rate in vaccinees was 76.3% after two doses and 96.8% after the third dose of SOBERANA Plus (7.3% in the placebo group). Neutralizing IgG antibodies were detected against D614G and variants of concern (VOCs) Alpha, Beta, Delta, and Omicron. Specific, functional antibodies were detected 7-8 months after the third dose. The frequency of serious adverse events (AEs) associated with vaccination was very low (0.1%). Local pain was the most frequent AE. CONCLUSIONS Two doses of SOBERANA 02 were safe and immunogenic in adults. The heterologous combination with SOBERANA Plus increased neutralizing antibodies, detectable 7-8 months after the third dose. TRIAL REGISTRY https://rpcec.sld.cu/trials/RPCEC00000347 FUNDING: This work was supported by Finlay Vaccine Institute, BioCubaFarma, and the Fondo Nacional de Ciencia y Técnica (FONCI-CITMA-Cuba, contract 2020-20).
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Affiliation(s)
| | - Mayra García-Carmenate
- "19 de Abril" Polyclinic, Tulipan St. between Panorama y Oeste, Nuevo Vedado, Plaza de la Revolución, Havana 10400, Cuba
| | | | - Suzel Pérez-Rodríguez
- "19 de Abril" Polyclinic, Tulipan St. between Panorama y Oeste, Nuevo Vedado, Plaza de la Revolución, Havana 10400, Cuba
| | | | - Carmen Valenzuela-Silva
- Cybernetics, Mathematics and Physics Institute, 15th St. #55, Vedado, Plaza de la Revolución, Havana 10400, Cuba
| | - Beatriz Paredes-Moreno
- Finlay Vaccine Institute, 21st Avenue Nº 19810 Between 198 and 200 St, Atabey, Playa, Havana, Cuba
| | | | - Raúl González-Mugica
- Finlay Vaccine Institute, 21st Avenue Nº 19810 Between 198 and 200 St, Atabey, Playa, Havana, Cuba
| | - Tays Hernández-Garcia
- Center of Molecular Immunology, 15th Avenue and 216 St, Siboney, Playa, Havana, Cuba
| | - Ivette Orosa-Vázquez
- Center of Molecular Immunology, 15th Avenue and 216 St, Siboney, Playa, Havana, Cuba
| | | | | | | | - Enrique Noa-Romero
- National Civil Defense Research Laboratory, San José de las Lajas, Mayabeque, Cuba
| | | | - Gerardo Baro-Roman
- Centre for Immunoassays, 134 St. and 25, Cubanacán, Playa, Havana 11600 Cuba
| | - Ivis Mendoza-Hernández
- National Clinical Trials Coordinating Center, 5th Avenue and 62, Miramar, Playa, Havana, Cuba
| | - Yaima Muñoz
- National Clinical Trials Coordinating Center, 5th Avenue and 62, Miramar, Playa, Havana, Cuba
| | | | - Bertha Leysi Santos-Vega
- "19 de Abril" Polyclinic, Tulipan St. between Panorama y Oeste, Nuevo Vedado, Plaza de la Revolución, Havana 10400, Cuba
| | - Sonsire Fernandez-Castillo
- Finlay Vaccine Institute, 21st Avenue Nº 19810 Between 198 and 200 St, Atabey, Playa, Havana, Cuba,Corresponding author
| | - Yanet Climent-Ruiz
- Finlay Vaccine Institute, 21st Avenue Nº 19810 Between 198 and 200 St, Atabey, Playa, Havana, Cuba
| | - Laura Rodríguez-Noda
- Finlay Vaccine Institute, 21st Avenue Nº 19810 Between 198 and 200 St, Atabey, Playa, Havana, Cuba
| | - Darielys Santana-Mederos
- Finlay Vaccine Institute, 21st Avenue Nº 19810 Between 198 and 200 St, Atabey, Playa, Havana, Cuba
| | - Yanelda García-Vega
- Center of Molecular Immunology, 15th Avenue and 216 St, Siboney, Playa, Havana, Cuba
| | - Guang-Wu Chen
- Chengdu Olisynn Biotech. Co. Ltd., Chengdu 610041, People’s Republic of China,State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, People’s Republic of China
| | - Delaram Doroud
- Pasteur Institute of Iran, No. 69, Pasteur Avenue, Tehran 1316943551, Islamic Republic of Iran
| | - Alireza Biglari
- Pasteur Institute of Iran, No. 69, Pasteur Avenue, Tehran 1316943551, Islamic Republic of Iran
| | - Tammy Boggiano-Ayo
- Center of Molecular Immunology, 15th Avenue and 216 St, Siboney, Playa, Havana, Cuba
| | - Yury Valdés-Balbín
- Finlay Vaccine Institute, 21st Avenue Nº 19810 Between 198 and 200 St, Atabey, Playa, Havana, Cuba
| | - Daniel G. Rivera
- Laboratory of Synthetic and Biomolecular Chemistry, Faculty of Chemistry, University of Havana, Havana 10400, Cuba
| | - Dagmar García-Rivera
- Finlay Vaccine Institute, 21st Avenue Nº 19810 Between 198 and 200 St, Atabey, Playa, Havana, Cuba
| | - Vicente Vérez-Bencomo
- Finlay Vaccine Institute, 21st Avenue Nº 19810 Between 198 and 200 St, Atabey, Playa, Havana, Cuba,Corresponding author
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3
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Ochoa-Azze R, Chang-Monteagudo A, Climent-Ruiz Y, Macías-Abraham C, Valenzuela-Silva C, de Los Ángeles García-García M, Jerez-Barceló Y, Triana-Marrero Y, Ruiz-Villegas L, Dairon Rodríguez-Prieto L, Guerra-Chaviano PP, Sánchez-Ramírez B, Hernández-García T, Orosa-Vázquez I, Díaz-Hernández M, Chiodo F, Calcagno A, Ghisetti V, Rodríguez-Acosta M, Noa-Romero E, Enríquez-Puertas J, Ortega-León D, Valdivia-Álvarez I, Delahanty-Fernández A, Palenzuela-Díaz A, Rodríguez-Noda L, González-Mugica R, Valdés-Balbín Y, García-Rivera D, Verez-Bencomo V. Safety and immunogenicity of the FINLAY-FR-1A vaccine in COVID-19 convalescent participants: an open-label phase 2a and double-blind, randomised, placebo-controlled, phase 2b, seamless, clinical trial. Lancet Respir Med 2022; 10:785-795. [PMID: 35691295 PMCID: PMC9183216 DOI: 10.1016/s2213-2600(22)00100-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/15/2022] [Accepted: 03/15/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND A phase 1, clinical trial to evaluate FINLAY-FR-1A vaccine in COVID-19 convalescent individuals was completed. Here, we report results of the phase 2, clinical trial. METHODS We studied 450 convalescent participants with a history of asymptomatic, mild, or moderate COVID-19 at the National Institute of Hematology and Immunology and the National Centre for Sexual Education in Havana, Cuba. The study included adults aged 19-78 years who had recovered from COVID-19 and had had a negative PCR test at least 2 months before the initiation of the study. Phase 2 was done sequentially in two stages. The first stage to assess safety comprised an open, non-controlled phase 2a study in participants aged 60-78 years who received a single dose of the FINLAY-FR-1A vaccine (50 μg of recombinant dimeric receptor binding domain [RBD]). The second stage comprised the placebo-controlled, double-blind, phase 2b trial in participants aged 19-78 years, where participants were randomly assigned (4:1) into two groups: an experimental group vaccinated with a single dose of the FINLAY-FR-1A vaccine, and a control (placebo) group injected with vaccine excipient. The primary outcomes were safety, evaluated 28 days after vaccination by the occurrence of serious adverse events in all participants, and successful immune response, assessed by neutralising antibody ELISA, and defined as half-maximal surrogate virus neutralisation titres of 250 or more. Secondary endpoints included vaccine immunogenicity assessed by ELISA anti-RBD and live-virus neutralisation test. All randomly assigned participants were included in the safety analysis (safety population), and immunogenicity was evaluated in participants without study interruptions (per-protocol population). The trial is registered with the Cuban Public Registry of Clinical Trials, RPCEC00000366-En and WHO-ICTRP and is complete. FINDINGS From April 9, 2021, to April 17, 2021, 663 COVID-19 convalescent participants were enrolled in the study; 213 participants did not meet the selection criteria and 450 volunteers were recruited. 20 participants aged 60-78 years were included in the open, single-group, phase 2a study and 430 participants were randomly assigned to the experimental (n=344) or control groups (n=86) in the phase 2b study of participants aged 19-78 years. 19 (95%) of 20 phase 2a volunteers achieved a successful immune response after vaccination. No vaccine-associated serious adverse events were reported in the whole study population. Minor adverse events were found, the most common being pain at the injection site (105 [29%] of 364 in the intervention group; 13 [15%] of 86 in the placebo group). A successful immune response was found in 289 (81%) of 358 participants 28 days after vaccination. The vaccine elicited a greater than 31-times increase in anti-RBD-IgG antibodies compared with prevaccination rates, and the seroconversion rate was 302 (84%) of 358 on day 28 after vaccination; the geometric mean titres of live-virus neutralisation test increased from 15·4 (95% CI 10·3-23·2) to 400·3 (272·4-588·1) and high response was found against alpha, beta, and delta variants of concern. INTERPRETATION A single dose of the FINLAY-FR-1A vaccine against SARS-CoV-2 strengthened the pre-existing natural immunity, with excellent safety profile. FUNDING Cuba's Ministry of Science, Technology, and Environment.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Fabrizio Chiodo
- Finlay Vaccine Institute, Atabey, Playa, Havana, Cuba; Department of Molecular Cell Biology and Immunology, Amsterdam UMC, Vrije Universiteit Amsterdam, Netherlands and Institute of Biomolecular Chemistry, National Research Council, Pozzuoli, Napoli, Italy
| | - Andrea Calcagno
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Valeria Ghisetti
- Laboratory of Microbiology and Virology, Amedeo di Savoia Hospital, ASL, Turin, Italy
| | | | - Enrique Noa-Romero
- Research Centre of Civil Defence, San José de las Lajas, Mayabeque, Cuba
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Hernández-Bernal F, Ricardo-Cobas MC, Martín-Bauta Y, Navarro-Rodríguez Z, Piñera-Martínez M, Quintana-Guerra J, Urrutia-Pérez K, Urrutia-Pérez K, Chávez-Chong CO, Azor-Hernández JL, Rodríguez-Reinoso JL, Lobaina-Lambert L, Colina-Ávila E, Bizet-Almeida J, Rodríguez-Nuviola J, del Valle-Piñera S, Ramírez-Domínguez M, Tablada-Ferreiro E, Alonso-Valdés M, Lemos-Pérez G, Guillén-Nieto GE, Palenzuela-Díaz A, Noa-Romero E, Limonta-Fernández M, Fernández-Ávila JM, Ali-Mros NA, del Toro-Lahera L, Remedios-Reyes R, Ayala-Ávila M, Muzio-González VL. Safety, tolerability, and immunogenicity of a SARS-CoV-2 recombinant spike RBD protein vaccine: A randomised, double-blind, placebo-controlled, phase 1-2 clinical trial (ABDALA Study). EClinicalMedicine 2022; 46:101383. [PMID: 35434578 PMCID: PMC8994669 DOI: 10.1016/j.eclinm.2022.101383] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/10/2022] [Accepted: 03/21/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Multiple vaccine candidates against COVID-19 are currently being evaluated. We evaluate the safety and immunogenicity protein of a novel SARS-CoV-2 virus receptor-binding domain (RBD) vaccine. METHODS A phase 1-2, randomised, double-blind, placebo-controlled trial was carried out in "Saturnino Lora" Hospital, Santiago de Cuba, Cuba. Subjects (healthy or those with controlled chronic diseases) aged between 19 and 80 years, who gave written informed consent were eligible. Subjects were randomly assigned (1:1:1, in blocks) to three groups: placebo, 25 µg and 50 µg RBD vaccine (Abdala). The product was administered intramuscularly, 0·5 mL in the deltoid region. During the first phase, two immunization schedules were studied: 0-14-28 days (short) and 0-28-56 days (long). In phase 2, only the short schedule was evaluated. The organoleptic characteristics and presentations of vaccine and placebo were identical. All participants (subjects, clinical researchers, statisticians, laboratory technicians, and monitors) remained masked during the study period. The main endpoints were safety and the proportion of subjects with seroconversion of anti-RBD IgG antibodies, analysed by intention to treat and per protocol, respectively. The trial is registered with the Cuban Public Registry of Clinical Trials, RPCEC00000346. FINDINGS Between Dec 7, 2020, and Feb 9, 2021, 792 subjects were included; 132 (66 in each vaccination schedule, divided into 22 for each group) in phase 1, and 660 (220 in each group plus 66 from the short scheme of phase 1) in phase 2. The product was well tolerated. No severe adverse events were reported. During phase 1, the incidence of adverse events in the 25 µg, 50 µg, and placebo arms for the short schedule were 6/22 (27·3%), 6/22 (27·3%), 3/22 (13·6%), respectively, and for the long schedule were 8/22 (36·4%), 9/22 (40·9%), 4/22 (18·2%), respectively. In phase 2, adverse reactions were reported by 53/242 (21·9%), 75/242 (31·0%) and 41/242 (16·9%) participants in the 25 µg, 50 µg, and placebo group, respectively. Adverse reactions were minimal, mostly mild, and from the injection site, which resolved in the first 24-48 hours. In phase 1, seroconversion at day 56 was seen in 95·2% of the participants (20/21) in the 50 μg group, 81% (17/21) in the 25 μg group, and none in the placebo group (0/22). For the long schedule, seroconversion at day 70 was seen in 100% of the participants (21/21) in the 50 μg group, 94·7% (18/19) in the 25 μg group, and none in the placebo group (0/22). In phase 2, seroconversion of anti-RBD IgG antibodies at day 56 was seen in 89·2% of the participants in the 50 μg group (214/240; 95% CI 84·5-92·82), 77·7% in the 25 μg group (185/238; 72·0-82·9) and 4·6% in the placebo group (11/239; 2·3-8·1). Compared with the placebo arm, the differences in the proportion of participants with seroconversion were 73·1% (95% CI 66·8-79·5) and 84·6% (79·4-89·7) in the 25 μg and 50 μg groups, respectively. The seroconversion rate in the 50 μg group was significantly higher than in the 25 μg group (p=0·0012). INTERPRETATION The Abdala vaccine was safe, well tolerated, and induced humoral immune responses against SARS-CoV-2. These results, in the context of the emergency COVID-19 pandemic, support the 50 μg dose, applied in a 0-14-28 days schedule, for further clinical trials to confirm vaccine efficacy. FUNDING Centre for Genetic Engineering and Biotechnology (CIGB), Havana, Cuba.
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Affiliation(s)
- Francisco Hernández-Bernal
- Centre for Genetic Engineering and Biotechnology, P.O. Box 6162, Havana, Cuba
- Corresponding author: Dr. Francisco Hernández-Bernal, Clinical Research Direction, Centre for Genetic Engineering and Biotechnology, P.O. Box 6162, Havana, Cuba.
| | | | - Yenima Martín-Bauta
- Centre for Genetic Engineering and Biotechnology, P.O. Box 6162, Havana, Cuba
| | | | | | | | - Karen Urrutia-Pérez
- Centre for Genetic Engineering and Biotechnology, P.O. Box 6162, Havana, Cuba
| | | | | | | | | | | | | | | | | | | | | | | | - Marel Alonso-Valdés
- Centre for Genetic Engineering and Biotechnology, P.O. Box 6162, Havana, Cuba
| | - Gilda Lemos-Pérez
- Centre for Genetic Engineering and Biotechnology, P.O. Box 6162, Havana, Cuba
| | | | | | - Enrique Noa-Romero
- Civilian Defense Scientific Research Centre, San José de las Lajas, Mayabeque, Cuba
| | | | | | | | | | | | - Marta Ayala-Ávila
- Centre for Genetic Engineering and Biotechnology, P.O. Box 6162, Havana, Cuba
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Chang-Monteagudo A, Ochoa-Azze R, Climent-Ruiz Y, Macías-Abraham C, Rodríguez-Noda L, Valenzuela-Silva C, Sánchez-Ramírez B, Perez-Nicado R, Hernández-García T, Orosa-Vázquez I, Díaz-Hernández M, García-García MDLÁ, Jerez-Barceló Y, Triana-Marrero Y, Ruiz-Villegas L, Rodríguez-Prieto LD, Puga-Gómez R, Guerra-Chaviano PP, Zúñiga-Rosales Y, Marcheco-Teruel B, Rodríguez-Acosta M, Noa-Romero E, Enríquez-Puertas J, Porto-González D, Fernández-Medina O, Valdés-Zayas A, Chen GW, Herrera-Martínez L, Valdés-Balbín Y, García-Rivera D, Verez-Bencomo V. A single dose of SARS-CoV-2 FINLAY-FR-1A vaccine enhances neutralization response in COVID-19 convalescents, with a very good safety profile: An open-label phase 1 clinical trial. Lancet Reg Health Am 2021; 4:100079. [PMID: 34541571 PMCID: PMC8442527 DOI: 10.1016/j.lana.2021.100079] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND As a first step towards a vaccine protecting COVID-19 convalescents from reinfection, we evaluated FINLAY-FR-1A vaccine in a clinical trial. METHODS Thirty COVID-19 convalescents aged 22-57 years were studied: convalescents of mild COVID-19, asymptomatic convalescents, both with PCR-positive at the moment of diagnosis; and individuals with subclinical infection detected by viral-specific IgG. They received a single intramuscular injection of the FINLAY-FR-1A vaccine (50 µg of the recombinant dimeric receptor binding domain). The primary outcomes were safety and reactogenicity, assessed over 28 days after vaccination. The secondary outcome was vaccine immunogenicity. Humoral response at baseline and following vaccination was evaluated by ELISA and live-virus neutralization test. The effector T cellular response was also assessed. Cuban Public Registry of Clinical Trials, WHO-ICTRP: https://rpcec.sld.cu/en/trials/RPCEC00000349-En. FINDINGS No serious adverse events were reported. Minor adverse events were found, the most common, local pain: 3 (10%) and redness: 2 (6·7%). The vaccine elicited a >21 fold increase in IgG anti-RBD antibodies 28 days after vaccination. The median of inhibitory antibody titres (94·0%) was three times greater than that of the COVID-19 convalescent panel. Virus neutralization titres higher than 1:160 were found in 24 (80%) participants. There was also an increase in RBD-specific T cells producing IFN-γ and TNF-α. INTERPRETATION A single dose of the FINLAY-FR-1A vaccine against SARS-CoV-2 was an efficient booster of pre-existing natural immunity, with excellent safety profile. FUNDING Partial funding for this study was received from the Project-2020-20, Fondo de Ciencia e Innovación (FONCI), Ministry of Science, Technology and the Environment, Cuba. RESUMEN. ANTECEDENTES Como un primer paso hacia una vacuna que proteja a los convalecientes de COVID-19 de la reinfección, evaluamos la vacuna FINLAY-FR-1A en un ensayo clínico. MÉTODOS Se estudiaron treinta convalecientes de COVID-19 de 22 a 57 años: convalecientes de COVID-19 leve y convalecientes asintomáticos, ambos con prueba PCR positiva al momento del diagnóstico; e individuos con infección subclínica detectada por IgG específica viral. Los participantes recibieron una dosis única por vía intramuscular de la vacuna FINLAY-FR-1A (50 µg del dominio de unión al receptor recombinante dimérico del SARS CoV-2). Las variables de medida primarias fueron la seguridad y la reactogenicidad, evaluadas durante 28 días después de la vacunación. La variable secundaria, la inmunogenicidad. La respuesta humoral, al inicio del estudio y después de la vacunación, se evaluó por ELISA y mediante la prueba de neutralización del virus vivo. También se evaluó la respuesta de células T efectoras. Registro Público Cubano de Ensayos Clínicos, WHO-ICTRP: https://rpcec.sld.cu/en/trials/RPCEC00000349-En. RESULTADOS No se reportaron eventos adversos graves. Se encontraron eventos adversos leves, los más comunes, dolor local: 3 (10%) y enrojecimiento: 2 (6·7%). La vacuna estimuló un incremento >21 veces de los anticuerpos IgG anti-RBD 28 días después de la vacunación. La mediana de los títulos de anticuerpos inhibidores (94·0%) fue aproximadamente tres veces mayor que la del panel de convalecientes de COVID-19. Se encontraron títulos de neutralización viral superiores a 1:160 en 24 (80%) de los participantes. También hubo un aumento en las células T específicas de RBD que producen IFN-γ y TNF-α. INTERPRETACIÓN Una sola dosis de la vacuna FINLAY-FR-1A contra el SARS-CoV-2 reforzó eficazmente la inmunidad natural preexistente, con un excelente perfil de seguridad. FINANCIAMIENTO Se recibió un financiamiento parcial del Proyecto-2020-20, Fondo de Ciencia e Innovación (FONCI), Ministerio de Ciencia, Tecnología y Medio Ambiente, Cuba.
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Affiliation(s)
- Arturo Chang-Monteagudo
- National Institute of Hematology and Immunology, 8th Ave. N° 460 between 17 and 19 Streets, Vedado, Havana, Cuba
| | - Rolando Ochoa-Azze
- Finlay Vaccine Institute, 21st Ave. N° 19810 between 198 and 200 Streets, Atabey, Playa, Havana, Cuba
- Corresponding author: Rolando Ochoa-Azze, MD, PhD. Finlay Vaccine Institute, 21st Ave. N° 19810 between 198 and 200 Streets, Atabey, Playa, Havana, Cuba, Tel: (53) 72719131
| | - Yanet Climent-Ruiz
- Finlay Vaccine Institute, 21st Ave. N° 19810 between 198 and 200 Streets, Atabey, Playa, Havana, Cuba
| | - Consuelo Macías-Abraham
- National Institute of Hematology and Immunology, 8th Ave. N° 460 between 17 and 19 Streets, Vedado, Havana, Cuba
| | - Laura Rodríguez-Noda
- Finlay Vaccine Institute, 21st Ave. N° 19810 between 198 and 200 Streets, Atabey, Playa, Havana, Cuba
| | | | | | - Rocmira Perez-Nicado
- Finlay Vaccine Institute, 21st Ave. N° 19810 between 198 and 200 Streets, Atabey, Playa, Havana, Cuba
| | - Tays Hernández-García
- Center of Molecular Immunology, 15 Ave. and 216 Street, Siboney, Playa, Havana, Cuba
| | - Ivette Orosa-Vázquez
- Center of Molecular Immunology, 15 Ave. and 216 Street, Siboney, Playa, Havana, Cuba
| | | | | | - Yanet Jerez-Barceló
- National Institute of Hematology and Immunology, 8th Ave. N° 460 between 17 and 19 Streets, Vedado, Havana, Cuba
| | - Yenisey Triana-Marrero
- National Institute of Hematology and Immunology, 8th Ave. N° 460 between 17 and 19 Streets, Vedado, Havana, Cuba
| | - Laura Ruiz-Villegas
- National Institute of Hematology and Immunology, 8th Ave. N° 460 between 17 and 19 Streets, Vedado, Havana, Cuba
| | - Luis Dairon Rodríguez-Prieto
- National Institute of Hematology and Immunology, 8th Ave. N° 460 between 17 and 19 Streets, Vedado, Havana, Cuba
| | | | - Pedro Pablo Guerra-Chaviano
- National Coordinating Center of Clinical Trials, 5 Ave. between 60 and 62 Ave., Miramar, Playa, Havana, Cuba
| | - Yaíma Zúñiga-Rosales
- National Center of Medical Genetics, 31 Ave. N° 3102 and 146 Street, Cubanacán, Playa, Havana, Cuba
| | - Beatriz Marcheco-Teruel
- National Center of Medical Genetics, 31 Ave. N° 3102 and 146 Street, Cubanacán, Playa, Havana, Cuba
| | | | - Enrique Noa-Romero
- Research Center of Civil Defense. San José de las Lajas, Mayabeque, Cuba
| | | | | | | | - Anet Valdés-Zayas
- Center of Molecular Immunology, 15 Ave. and 216 Street, Siboney, Playa, Havana, Cuba
| | - Guang-Wu Chen
- Chengdu Olisynn Biotech. Co. Ltd., People's Republic of China
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | | | - Yury Valdés-Balbín
- Finlay Vaccine Institute, 21st Ave. N° 19810 between 198 and 200 Streets, Atabey, Playa, Havana, Cuba
| | - Dagmar García-Rivera
- Finlay Vaccine Institute, 21st Ave. N° 19810 between 198 and 200 Streets, Atabey, Playa, Havana, Cuba
| | - Vicente Verez-Bencomo
- Finlay Vaccine Institute, 21st Ave. N° 19810 between 198 and 200 Streets, Atabey, Playa, Havana, Cuba
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Ruibal-Brunet IJ, Cuevas MT, Díaz-Torres H, Villahermosa ML, Noa-Romero E, Vázquez de Parga E, Blanco de Armas M, Pérez-Alvarez L. Genotypic resistance mutations to antiretroviral drugs in HIV-1 B and non-B subtypes from Cuba. Rev Panam Salud Publica 2001; 10:174-80. [PMID: 11702373 DOI: 10.1590/s1020-49892001000900005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To determine the prevalence of drug resistance and to analyze the subtyping in HIV-1 samples from Cuba. METHODS From an estimated total number of 1,950 HIV-1-infected persons in Cuba, a sample of 103 patients were studied, 76 of whom had received drug treatment for HIV and 27 who had not. The RNA plasma viral load was measured, and automated sequencing was used to assess resistance mutations to reverse transcriptase inhibitors (RTIs) and to protease inhibitors (PIs). Subtyping in the V3 region was performed using heteroduplex mobility assay (HMA). In order to corroborate the HMA results, sequencing of env (C2-V3-C3) was done with one-third of the samples in each of the subtype groups detected by HMA. RESULTS Out of the 103 samples, 81 of them (78.6%) were classified as subtype B, 19 (18.5%) as subtype A, and 3 (2.9%) as subtype C. The prevalence of resistance mutations was 26.2% to RTIs, none to PIs alone, and 3.9% to both categories of drugs. The prevalence of resistance to nucleoside RTIs (NRTIs) was 27.6% in treated patients and 7.4% in the untreated patients, and for nonnucleoside RTIs (NNRTIs) it was 5.3% and 0%, respectively. Among treated patients a low frequency (2.6%) of dual resistance to zidovudine (ZDV) plus lamivudine (3TC) and abacavir (ABC) was detected, and multidrug resistance to NRTIs was not found. In relation to PIs together with RTIs, the prevalence of resistance was 5.3% for treated patients and 0% for untreated patients. CONCLUSIONS Even though Cuba is generally considered an area where subtype B is dominant, we detected a high proportion of non-B subtype viruses. The low prevalence of resistance mutations to RTIs and PIs reflects the delay in introducing these drugs to Cuba. Multidrug resistance to RTIs was not found, so, as of now, the use of these drugs continues to be an option for Cuban patients.
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