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Gunale B, Farinola N, Kamat CD, Poonawalla CS, Pisal SS, Dhere RM, Miller C, Kulkarni PS. An observer-blind, randomised, placebo-controlled, phase 1, single ascending dose study of dengue monoclonal antibody in healthy adults in Australia. Lancet Infect Dis 2024:S1473-3099(24)00030-6. [PMID: 38408457 DOI: 10.1016/s1473-3099(24)00030-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Dengue is highly prevalent in Asia and Latin America and has no specific dengue antiviral treatment. A recombinant monoclonal antibody (VIS513) that neutralises all four serotypes of the dengue virus has been developed in India. After confirmation of safety and efficacy in preclinical studies, it was tested in a first-in-human study to assess the safety and pharmacokinetics. METHODS This was a partially blind (observer-blind), randomised, placebo-controlled, phase 1, single ascending dose study in Australia. Participants were dengue naive, healthy adults (aged 18-45 years) with no clinically significant disorders or immunosuppressive conditions. Four dose levels of dengue monoclonal antibody (ie, 1 mg/kg, 3 mg/kg, 7 mg/kg, and 12 mg/kg; n=4 for 1 mg/kg and n=10 each for 3 mg/kg, 7 mg/kg, and 12 mg/kg doses) were assessed in a dose-ascending way with a placebo control (n=2 for each dose cohort, total n=6) for each cohort except for 1 mg/kg. Within each cohort, participants were first randomly assigned (1:1) in a sentinel sub-cohort and then randomly assigned (9:1) in an expansion sub-cohort to dengue monoclonal antibody or placebo except for the 1 mg/kg cohort. Participants, investigators, and outcome assessors were masked and treatment administrators were not masked. 40 participants received a single intravenous injection or infusion of either dengue monoclonal antibody or placebo over a period of 3 min to 2 h and were followed up until day 85. The primary outcomes were proportion of participants with adverse events and serious adverse events (SAEs) up to 84 days after dosing whereas the secondary outcomes were to assess the pharmacokinetic profile of dengue monoclonal antibody and to assess the presence of anti-drug antibody (ADA) to dengue monoclonal antibody. All participants were included in the safety analysis and the pharmacokinetic population involved participants receiving dengue monoclonal antibody. This study is registered with ClinicalTrials.gov, NCT03883620. FINDINGS Between March 22 and Dec 23, 2019, 40 healthy adults were randomly assigned and all completed the study. There were no SAEs reported. None of the placebo recipients (n=6) reported any adverse events. 31 (91%) of 34 participants receiving dengue monoclonal antibody reported 143 adverse events (1 mg/kg: four [100%] of four participants; 3 mg/kg: ten [100%] of ten participants; 7 mg/kg: seven [70%] of ten participants; 12 mg/kg: ten [100%] of ten participants). Of these 143 adverse events, 80 were treatment-related adverse events in 28 (82%) of 34 participants. Headache (16 [47%] of 34), infusion reaction (11 [32%] of 34), lymphopenia (seven [21%] of 34), fatigue (five [15%] of 34), and pyrexia (four [12%] of 34) were the most common reactions. Infusion reactions were reduced in the 7 mg/kg (two [20%] of ten participants) and 12 mg/kg (three [30%] of ten) cohorts with paracetamol premedication compared with the 3 mg/kg cohort (five [50%] of ten). The majority of adverse events were grade 1 or grade 2 in severity, and resolved completely. Median maximum serum concentrations ranged from 28 μg/mL (1 mg/kg) to 525 μg/mL (12 mg/kg). The median elimination half-life ranged from 775 h (1 mg/kg) to 878 h (12 mg/kg). No ADA against dengue monoclonal antibody was detected. INTERPRETATION Dengue monoclonal antibody was safe and well tolerated. It showed a dose-proportionate increase in pharmacokinetic exposure. These data support further evaluation of dengue monoclonal antibody in patients with dengue for safety and efficacy. FUNDING Serum Institute of India.
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Ghosh S, Pawar R, Kangralkar V, Mallya AD, Dhere RM, Bolgiano B, Ravenscroft N. Acid hydrolysis conditions for quantification of meningococcal X polysaccharide in a pentavalent vaccine using HPAEC-PAD/ESI-MS. Anal Biochem 2023; 683:115363. [PMID: 37866526 DOI: 10.1016/j.ab.2023.115363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 10/10/2023] [Accepted: 10/19/2023] [Indexed: 10/24/2023]
Abstract
A selective and sensitive method was evaluated for quantitation of meningococcal X (Men X) polysaccharide in pentavalent meningococcal A, C, W, Y and X conjugate vaccine using different acid hydrolysis conditions like HCl, TFA, HF, HF-TFA, and HF-HCl. High-performance anion exchange chromatography with pulsed amperometric detection (HPAEC-PAD) using CarboPac PA10 column was used to identify the hydrolyzed products based on retention time and its comparison with monosaccharide standards. Complete release of glucosamine (GlcN) from Men X in monovalent bulk and pentavalent vaccine samples was achieved using HF hydrolysis at 80 °C for 2 h. The Men X HF-hydrolyzed polysaccharide to glucosamine along with the reference standard was identified using collision-induced dissociation (CID) electrospray mass spectroscopy and the MS/MS fragments of m/z 162, m/z 144 and m/z 84. Meningococcal polysaccharide concentration was determined with a correlation coefficient r2 >0.99 using polysaccharide reference standard. The serogroups A, W, and Y were converted to their monosaccharides units and quantified using this method however, milder acid hydrolysis 0.1 M HCl 80 °C 2 h for release of sialic acid for Men C polysaccharide was found to be more suitable. These methods will provide necessary tools and prove to be beneficial to laboratories developing new saccharide-based vaccine combinations.
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Affiliation(s)
- Saurav Ghosh
- Serum Institute of India Pvt Ltd, Serum Biopharma Park, 212/2, Hadapsar, Pune, 411 028, Maharashtra, India
| | - Rakesh Pawar
- Serum Institute of India Pvt Ltd, Serum Biopharma Park, 212/2, Hadapsar, Pune, 411 028, Maharashtra, India
| | - Vivek Kangralkar
- Serum Institute of India Pvt Ltd, Serum Biopharma Park, 212/2, Hadapsar, Pune, 411 028, Maharashtra, India
| | - Asha D Mallya
- Serum Institute of India Pvt Ltd, Serum Biopharma Park, 212/2, Hadapsar, Pune, 411 028, Maharashtra, India.
| | - Rajeev M Dhere
- Serum Institute of India Pvt Ltd, Serum Biopharma Park, 212/2, Hadapsar, Pune, 411 028, Maharashtra, India
| | - Barbara Bolgiano
- National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, South Mimms, AL3 6DP, United Kingdom
| | - Neil Ravenscroft
- Department of Chemistry, University of Cape Town, Rondebosch, 7701, South Africa
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Gaikwad WK, Dhere RM, Jana SK, Mallya AD, Soni DJ, Gholap M, Ravenscroft N, Kodam KM. Effect of trifluoroacetic acid on the antigenicity of capsular polysaccharides obtained from various Streptococcus pneumoniae serotypes. Carbohydr Polym 2023; 320:121204. [PMID: 37659807 DOI: 10.1016/j.carbpol.2023.121204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 06/26/2023] [Accepted: 07/12/2023] [Indexed: 09/04/2023]
Abstract
Determining the safety, antigenicity, and immunogenicity by in vitro and in vivo studies is a prerequisite for the development of new vaccines. And this study investigated it for a vaccine made from Streptococcus pneumoniae serotypes 2, 5, 12F, 18C, and 22F. The crude CPS was purified and partially depolymerized by conventional and trifluoroacetic acid methods. 1H NMR analysis confirmed the identity of the depolymerized CPS which gave similar profiles to reference polysaccharides, except for serotype 18C which was de-O-acetylated during TFA treatment. The antigenicity of the depolymerized CPS prepared by either method was comparable to that of the native CPS for serotypes 2, 5, 18C, and 22F based on multiplex bead based competitive inhibition assay. This study demonstrated a relationship between antigenicity and immunogenicity, which offers more suitable candidates for conjugation. It was found that after partial depolymerization process, the CPS with optimal molecular size resulted in higher antigenicity. The immunogenicity of S. pneumoniae serotype 2 conjugates in mice was evaluated by opsonophagocytic assay and a multiplex bead-based assay, wherein on day 42 after immunization, the total and functional IgG titer was found to be increased by 32-fold.
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Affiliation(s)
- Walmik Karbhari Gaikwad
- Department of Technology, Savitribai Phule Pune University, Pune 411007, India; Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune 411028, India
| | - Rajeev M Dhere
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune 411028, India.
| | - Swapan K Jana
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune 411028, India
| | - Asha D Mallya
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune 411028, India
| | - Dipen J Soni
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune 411028, India
| | - Makrand Gholap
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune 411028, India
| | - Neil Ravenscroft
- Department of Chemistry, University of Cape Town, Rondebosch 7701, South Africa
| | - Kisan M Kodam
- Division of Biochemistry, Department of Chemistry, Savitribai Phule Pune University, Pune 411007, India.
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Gunale B, Farinola N, Yeolekar L, Shrivastava S, Girgis H, Poonawalla CS, Dhere RM, Arankalle V, Chandra Mishra A, Mehla R, Kulkarni PS. A Phase 1, double-blind, randomized, placebo-controlled study to evaluate the safety and immunogenicity of a tetravalent live attenuated dengue vaccine in adults. Vaccine 2023; 41:5614-5621. [PMID: 37532611 DOI: 10.1016/j.vaccine.2023.07.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/05/2023] [Accepted: 07/23/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Dengue fever is an important public health problem, especially in Asia and South America. A tetravalent live attenuated dengue vaccine was manufactured in India after receipt of vaccine strains from NIAID, NIH, USA. METHODS This was a Phase 1, double-blind, randomized, placebo-controlled study performed in 60 healthy adults of 18 to 45 years. Participants were randomized 2:1 to receive a single subcutaneous injection of either a tetravalent live attenuated dengue vaccine or placebo. Safety was assessed by unsolicited adverse events (AEs) and solicited reactions through 21 days after vaccination and serious adverse events (SAEs) through the entire study period of 180 days. Dengue viremia was assessed at baseline and on day 9, 11 and 13 post-vaccination using a plaque assay. Immunogenicity was assessed using the plaque reduction neutralization test (PRNT) assay using vaccine-matched wild virus serotypes (DENV 1, DENV 2, DENV 3 and DENV 4) at baseline and on 56-, 84- and 180-days post-vaccination. PRNT assay using circulating wild type DENV 1, DENV 2, DENV 3 and DENV 4 were done on day 1 and day 85 for a subset of 31 participants. RESULTS 60 participants were randomized to receive dengue vaccine (n = 40) or placebo (n = 20). 23 participants (59 %) showed DENV vaccine viremia post- vaccination for any of the four serotypes with majority on day 9 and day 11. At baseline, all participants were naïve by dengue PRNT50 for all four serotypes in both the study groups except for four in the dengue vaccine group and two in the placebo group. On day 57, the GMTs of neutralizing antibodies ranged from 66.76 (95 % CI 36.63, 121.69) to 293.84 (95 % CI 192.25, 449.11) for all four serotypes in the dengue vaccine group. On day 181 though the titers declined, they still remained much higher than the baseline. The titers in the placebo group did not change after vaccination. Seroconversion through day 85 ranged from 79.5 % for DENV 1 to 100 % for DENV2 while in the placebo group, no participant showed seroconversion through day 85. Similar trends were noted when PRNT was done using wild DENV serotypes in both vaccine and placebo groups. Among solicited reactions, injection site erythema, rash, headache, fatigue, myalgia and arthralgia were reported more frequently in the vaccine group than placebo group. All solicited reactions were of grade 1 or grade 2 severity and completely resolved. One unrelated serious adverse event was reported in the vaccine group. CONCLUSION A single dose of dengue vaccine was safe and well tolerated in adults. The vaccine was highly immunogenic with trivalent or tetravalent seroconversion and seropositivity in most of the participants. The study was funded by Serum Institute of India Pvt. Ltd., Pune, India. CLINICALTRIALS gov: NCT04035278.
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Affiliation(s)
| | | | | | | | - Hanna Girgis
- PPD, 3900 Paramount Pkwy, Morrisville, NC 27560, USA
| | | | | | - Vidya Arankalle
- Interactive Research School for Health Affairs (IRSHA), Pune, India
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Shende N, Karale A, Bore P, Bhagade S, Gulhane A, Mallya AD, Dhere RM. Evaluation of structural modification induced activation of pneumococcal polysaccharide by GC-MS for the conjugate vaccine. Carbohydr Res 2023; 531:108878. [PMID: 37390792 DOI: 10.1016/j.carres.2023.108878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 05/09/2023] [Accepted: 06/18/2023] [Indexed: 07/02/2023]
Abstract
Polysaccharide (Ps) activation evaluation is an imperative quality attribute in a conjugate vaccine. Pneumococcal polysaccharide (PnPs) serotypes 5, 6B, 14, 19A and 23F were cyanylated for 3 and 8 min. The cyanylated and non-cyanylated polysaccharides were methanolysed and derivatized to assess the activation of each sugar by GC-MS. The activation of 22 and 27% serotype 6B and 11 and 36% in serotype 23 F Ps at 3 and 8 min respectively showed controlled conjugation kinetics with CRM197 carrier protein estimated by SEC-HPLC and optimal absolute molar mass by SEC-MALS. The Glc and Gal are the most commonly activated sugars of all PnPs serotypes while N-acetyl sugars PneuNAc, GalNAc and Rha in serotypes 5, 14 and 19A respectively showed >50% activation which contributes to conjugate aggregate formation at 8 min compared to 3 min cyanylation. The GC-MS analysis of structural modifications at functional groups entails important information to characterize the activated polysaccharide for consistent conjugate vaccine manufacturing.
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Affiliation(s)
- Niraj Shende
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, Maharashtra, 411028, India
| | - Abhijeet Karale
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, Maharashtra, 411028, India
| | - Prashant Bore
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, Maharashtra, 411028, India
| | - Sudhakar Bhagade
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, Maharashtra, 411028, India
| | - Ashishkumar Gulhane
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, Maharashtra, 411028, India
| | - Asha D Mallya
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, Maharashtra, 411028, India.
| | - Rajeev M Dhere
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, Maharashtra, 411028, India
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Ghosh S, Gulhane A, Sharma P, Kale S, Kangralkar V, Pawar R, Goel SK, Mallya AD, Dhere RM. Quantitation of free cyanide using ion exchange chromatography in Neisseria meningitidis serogroups A, C, W, Y and X conjugates used in vaccine manufacture. Biologicals 2023; 81:101664. [PMID: 36791627 DOI: 10.1016/j.biologicals.2023.101664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 11/11/2022] [Accepted: 01/14/2023] [Indexed: 02/16/2023] Open
Abstract
Polysaccharide vaccines essentially used in the prevention of bacterial infections are known to be good immunogens when conjugated to an immunogenic protein using various cyanylating agents. Analysis of residual cyanide in polysaccharide conjugate vaccines is an ardent task due to the complexity of the sample matrices and the lack of suitable methods. We report a selective ion chromatography method with electrochemical detection using IonPac AS7 column for estimation of residual cyanide in meningococcal serogroups A, C, W, Y and X bulk conjugates in presence of other interfering ions. Gold electrode and Ag/AgCl reference electrode ensures sensitivity and reproducibility of cyanide quantitation. The calibration curve of the method is linear having r2 ≥0.990 over the concentration range 1.45 ng/mL to 93.10 ng/mL. The recovery of cyanide in bulk conjugates ranged between 96.0% and 108.9%. The limits of detection and quantitation were 0.50 ng/mL and 1.45 ng/mL which corresponds to 0.31 ng/μg and 0.91 ng/μg of polysaccharide respectively. The method validation and feasibility study were performed using Men W and Men X bulk conjugates respectively with in house residual cyanide specification due to unavailability of pharmacopeia guidelines. The method is reproducible and can accurately quantify residual cyanide in purified meningococcal bulk conjugates.
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Affiliation(s)
- Saurav Ghosh
- Serum Institute of India Pvt Ltd, Serum, Biopharma Park, 212/2, Hadapsar, Pune, 411 028, Maharashtra, India
| | - Ashishkumar Gulhane
- Serum Institute of India Pvt Ltd, Serum, Biopharma Park, 212/2, Hadapsar, Pune, 411 028, Maharashtra, India
| | - Pankaj Sharma
- Serum Institute of India Pvt Ltd, Serum, Biopharma Park, 212/2, Hadapsar, Pune, 411 028, Maharashtra, India
| | - Sameer Kale
- Serum Institute of India Pvt Ltd, Serum, Biopharma Park, 212/2, Hadapsar, Pune, 411 028, Maharashtra, India
| | - Vivek Kangralkar
- Serum Institute of India Pvt Ltd, Serum, Biopharma Park, 212/2, Hadapsar, Pune, 411 028, Maharashtra, India
| | - Rakesh Pawar
- Serum Institute of India Pvt Ltd, Serum, Biopharma Park, 212/2, Hadapsar, Pune, 411 028, Maharashtra, India
| | - Sunil Kumar Goel
- Serum Institute of India Pvt Ltd, Serum, Biopharma Park, 212/2, Hadapsar, Pune, 411 028, Maharashtra, India
| | - Asha D Mallya
- Serum Institute of India Pvt Ltd, Serum, Biopharma Park, 212/2, Hadapsar, Pune, 411 028, Maharashtra, India.
| | - Rajeev M Dhere
- Serum Institute of India Pvt Ltd, Serum, Biopharma Park, 212/2, Hadapsar, Pune, 411 028, Maharashtra, India
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Gaikwad WK, Jana SK, Dhere RM, Ravenscroft N, Kodam KM. Purification of capsular polysaccharides isolated from S. pneumoniae serotype 2 by hydrogen peroxide and endonuclease. Carbohydr Polym 2022; 294:119783. [DOI: 10.1016/j.carbpol.2022.119783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/13/2022] [Accepted: 06/22/2022] [Indexed: 11/02/2022]
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Shende N, Karale A, Marne K, Deshpande H, Belapurkar H, Mallya AD, Dhere RM. Quantitation of endotoxin by gas chromatography-mass spectrometry in Neisseria meningitidis serogroups A, C, W, Y and X during polysaccharide purification used in conjugate vaccine. J Pharm Biomed Anal 2021; 209:114536. [PMID: 34953414 DOI: 10.1016/j.jpba.2021.114536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/10/2021] [Accepted: 12/10/2021] [Indexed: 10/19/2022]
Abstract
Bacterial lipopolysaccharide (LPS) responsible for endotoxin effect induces inflammatory reactions. The endotoxins are difficult to separate from the gram-negative polysaccharide (PS) during polysaccharide purification. The most common method to quantify LPS is the limulus amebocyte lysate (LAL) test which interferes with the agents used during PS purification. The gas chromatography-mass spectrometry (GC-MS) provides a suitable alternative by estimating lipid-A chain anchored 3-hydroxy fatty acid methyl ester (FAME) to estimate LPS however, there are no reports of its application in natural polysaccharides used for vaccine preparation. The transesterification of LPS and meningococcal PS yielded primary target 3-O-acetylated myristic acid which was detected by GC-MS and provided quantitative estimation of endotoxin. The GC-MS method was found in agreement with the LAL values showing lower endotoxin content< 10Eu/µg in meningococcal C and Y serogroup polysaccharides in comparison to higher endotoxin 177-523 Eu/µg in meningococcal A, W and X serogroups. The high endotoxin content in purified polysaccharide was attributed to it being detected in its intermediate stage by GC-MS unlike the LAL test. Thus GC-MS serves as a valuable method for endotoxin monitoring and quantitation in gram-negative meningococcal intermediate and purified PS during vaccine preparation.
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Affiliation(s)
- Niraj Shende
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, Maharashtra 411028, India
| | - Abhijeet Karale
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, Maharashtra 411028, India
| | - Kishor Marne
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, Maharashtra 411028, India
| | - Hrishikesh Deshpande
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, Maharashtra 411028, India
| | - Hrushikesh Belapurkar
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, Maharashtra 411028, India
| | - Asha D Mallya
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, Maharashtra 411028, India.
| | - Rajeev M Dhere
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, Maharashtra 411028, India
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Bolgiano B, Moran E, Beresford NJ, Gao F, Care R, Desai T, Nordgren IK, Rudd TR, Feavers IM, Bore P, Patni S, Gavade V, Mallya A, Kale S, Sharma P, Goel SK, Gairola S, Hattarki S, Avalaskar N, Sarma AD, LaForce M, Ravenscroft N, Khandke L, Alderson MR, Dhere RM, Pisal SS. Evaluation of Critical Quality Attributes of a Pentavalent (A, C, Y, W, X) Meningococcal Conjugate Vaccine for Global Use. Pathogens 2021; 10:928. [PMID: 34451392 PMCID: PMC8400332 DOI: 10.3390/pathogens10080928] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/09/2021] [Accepted: 07/19/2021] [Indexed: 11/16/2022] Open
Abstract
Towards achieving the goal of eliminating epidemic outbreaks of meningococcal disease in the African meningitis belt, a pentavalent glycoconjugate vaccine (NmCV-5) has been developed to protect against Neisseria meningitidis serogroups A, C, Y, W and X. MenA and X polysaccharides are conjugated to tetanus toxoid (TT) while MenC, Y and W polysaccharides are conjugated to recombinant cross reactive material 197 (rCRM197), a non-toxic genetic variant of diphtheria toxin. This study describes quality control testing performed by the manufacturer, Serum Institute of India Private Limited (SIIPL), and the independent control laboratory of the U.K. (NIBSC) on seven clinical lots of the vaccine to ensure its potency, purity, safety and consistency of its manufacturing. In addition to monitoring upstream-manufactured components, samples of drug substance, final drug product and stability samples were evaluated. This paper focuses on the comparison of the vaccine's critical quality attributes and reviews key indicators of its stability and immunogenicity. Comparable results were obtained by the two laboratories demonstrating sufficient levels of polysaccharide O-acetylation, consistency in size of the bulk conjugate molecules, integrity of the conjugated saccharides in the drug substance and drug product, and acceptable endotoxin content in the final drug product. The freeze-dried vaccine in 5-dose vials was stable based on molecular sizing and free saccharide assays. Lot-to-lot manufacturing consistency was also demonstrated in preclinical studies for polysaccharide-specific IgG and complement-dependent serum bactericidal activity for each serogroup. This study demonstrates the high quality and stability of NmCV-5, which is now undergoing Phase 3 clinical trials in Africa and India.
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Affiliation(s)
- Barbara Bolgiano
- National Institute for Biological Standards and Control, South Mimms, Potters Bar EN6 3QG, UK; (E.M.); (N.J.B.); (F.G.); (R.C.); (T.D.); (I.K.N.); (T.R.R.); (I.M.F.)
| | - Eilís Moran
- National Institute for Biological Standards and Control, South Mimms, Potters Bar EN6 3QG, UK; (E.M.); (N.J.B.); (F.G.); (R.C.); (T.D.); (I.K.N.); (T.R.R.); (I.M.F.)
| | - Nicola J. Beresford
- National Institute for Biological Standards and Control, South Mimms, Potters Bar EN6 3QG, UK; (E.M.); (N.J.B.); (F.G.); (R.C.); (T.D.); (I.K.N.); (T.R.R.); (I.M.F.)
| | - Fang Gao
- National Institute for Biological Standards and Control, South Mimms, Potters Bar EN6 3QG, UK; (E.M.); (N.J.B.); (F.G.); (R.C.); (T.D.); (I.K.N.); (T.R.R.); (I.M.F.)
| | - Rory Care
- National Institute for Biological Standards and Control, South Mimms, Potters Bar EN6 3QG, UK; (E.M.); (N.J.B.); (F.G.); (R.C.); (T.D.); (I.K.N.); (T.R.R.); (I.M.F.)
| | - Trusha Desai
- National Institute for Biological Standards and Control, South Mimms, Potters Bar EN6 3QG, UK; (E.M.); (N.J.B.); (F.G.); (R.C.); (T.D.); (I.K.N.); (T.R.R.); (I.M.F.)
| | - Ida Karin Nordgren
- National Institute for Biological Standards and Control, South Mimms, Potters Bar EN6 3QG, UK; (E.M.); (N.J.B.); (F.G.); (R.C.); (T.D.); (I.K.N.); (T.R.R.); (I.M.F.)
| | - Timothy R. Rudd
- National Institute for Biological Standards and Control, South Mimms, Potters Bar EN6 3QG, UK; (E.M.); (N.J.B.); (F.G.); (R.C.); (T.D.); (I.K.N.); (T.R.R.); (I.M.F.)
| | - Ian M. Feavers
- National Institute for Biological Standards and Control, South Mimms, Potters Bar EN6 3QG, UK; (E.M.); (N.J.B.); (F.G.); (R.C.); (T.D.); (I.K.N.); (T.R.R.); (I.M.F.)
| | - Prashant Bore
- Serum Institute of India Pvt. Ltd., Hadapsar, Pune 411028, India; (P.B.); (S.P.); (V.G.); (A.M.); (S.K.); (P.S.); (S.K.G.); (S.G.); (S.H.); (N.A.); (A.D.S.); (M.L.); (R.M.D.); (S.S.P.)
| | - Sushil Patni
- Serum Institute of India Pvt. Ltd., Hadapsar, Pune 411028, India; (P.B.); (S.P.); (V.G.); (A.M.); (S.K.); (P.S.); (S.K.G.); (S.G.); (S.H.); (N.A.); (A.D.S.); (M.L.); (R.M.D.); (S.S.P.)
| | - Vinay Gavade
- Serum Institute of India Pvt. Ltd., Hadapsar, Pune 411028, India; (P.B.); (S.P.); (V.G.); (A.M.); (S.K.); (P.S.); (S.K.G.); (S.G.); (S.H.); (N.A.); (A.D.S.); (M.L.); (R.M.D.); (S.S.P.)
| | - Asha Mallya
- Serum Institute of India Pvt. Ltd., Hadapsar, Pune 411028, India; (P.B.); (S.P.); (V.G.); (A.M.); (S.K.); (P.S.); (S.K.G.); (S.G.); (S.H.); (N.A.); (A.D.S.); (M.L.); (R.M.D.); (S.S.P.)
| | - Sameer Kale
- Serum Institute of India Pvt. Ltd., Hadapsar, Pune 411028, India; (P.B.); (S.P.); (V.G.); (A.M.); (S.K.); (P.S.); (S.K.G.); (S.G.); (S.H.); (N.A.); (A.D.S.); (M.L.); (R.M.D.); (S.S.P.)
| | - Pankaj Sharma
- Serum Institute of India Pvt. Ltd., Hadapsar, Pune 411028, India; (P.B.); (S.P.); (V.G.); (A.M.); (S.K.); (P.S.); (S.K.G.); (S.G.); (S.H.); (N.A.); (A.D.S.); (M.L.); (R.M.D.); (S.S.P.)
| | - Sunil K. Goel
- Serum Institute of India Pvt. Ltd., Hadapsar, Pune 411028, India; (P.B.); (S.P.); (V.G.); (A.M.); (S.K.); (P.S.); (S.K.G.); (S.G.); (S.H.); (N.A.); (A.D.S.); (M.L.); (R.M.D.); (S.S.P.)
| | - Sunil Gairola
- Serum Institute of India Pvt. Ltd., Hadapsar, Pune 411028, India; (P.B.); (S.P.); (V.G.); (A.M.); (S.K.); (P.S.); (S.K.G.); (S.G.); (S.H.); (N.A.); (A.D.S.); (M.L.); (R.M.D.); (S.S.P.)
| | - Suhas Hattarki
- Serum Institute of India Pvt. Ltd., Hadapsar, Pune 411028, India; (P.B.); (S.P.); (V.G.); (A.M.); (S.K.); (P.S.); (S.K.G.); (S.G.); (S.H.); (N.A.); (A.D.S.); (M.L.); (R.M.D.); (S.S.P.)
| | - Nikhil Avalaskar
- Serum Institute of India Pvt. Ltd., Hadapsar, Pune 411028, India; (P.B.); (S.P.); (V.G.); (A.M.); (S.K.); (P.S.); (S.K.G.); (S.G.); (S.H.); (N.A.); (A.D.S.); (M.L.); (R.M.D.); (S.S.P.)
| | - Annamraju D. Sarma
- Serum Institute of India Pvt. Ltd., Hadapsar, Pune 411028, India; (P.B.); (S.P.); (V.G.); (A.M.); (S.K.); (P.S.); (S.K.G.); (S.G.); (S.H.); (N.A.); (A.D.S.); (M.L.); (R.M.D.); (S.S.P.)
| | - Marc LaForce
- Serum Institute of India Pvt. Ltd., Hadapsar, Pune 411028, India; (P.B.); (S.P.); (V.G.); (A.M.); (S.K.); (P.S.); (S.K.G.); (S.G.); (S.H.); (N.A.); (A.D.S.); (M.L.); (R.M.D.); (S.S.P.)
| | - Neil Ravenscroft
- Department of Chemistry, University of Cape Town, Rondebosch, Cape Town 7701, South Africa;
| | - Lakshmi Khandke
- Center for Vaccine Innovation and Access, PATH, Seattle, WA 98121, USA; (L.K.); (M.R.A.)
| | - Mark R. Alderson
- Center for Vaccine Innovation and Access, PATH, Seattle, WA 98121, USA; (L.K.); (M.R.A.)
| | - Rajeev M. Dhere
- Serum Institute of India Pvt. Ltd., Hadapsar, Pune 411028, India; (P.B.); (S.P.); (V.G.); (A.M.); (S.K.); (P.S.); (S.K.G.); (S.G.); (S.H.); (N.A.); (A.D.S.); (M.L.); (R.M.D.); (S.S.P.)
| | - Sambhaji S. Pisal
- Serum Institute of India Pvt. Ltd., Hadapsar, Pune 411028, India; (P.B.); (S.P.); (V.G.); (A.M.); (S.K.); (P.S.); (S.K.G.); (S.G.); (S.H.); (N.A.); (A.D.S.); (M.L.); (R.M.D.); (S.S.P.)
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Tapia MD, Sow SO, Naficy A, Diallo F, Haidara FC, Chaudhari A, Martellet L, Traore A, Townsend-Payne K, Borrow R, Hosken N, Smolenov I, Pisal SS, LaForce FM, Dhere RM, Kapse D, Tang Y, Alderson MR, Kulkarni PS. Meningococcal Serogroup ACWYX Conjugate Vaccine in Malian Toddlers. N Engl J Med 2021; 384:2115-2123. [PMID: 34077644 DOI: 10.1056/nejmoa2013615] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Neisseria meningitidis serogroups A, B, C, W, X, and Y cause outbreaks of meningococcal disease. Quadrivalent conjugate vaccines targeting the A, C, W, and Y serogroups are available. A pentavalent vaccine that also includes serogroup X (NmCV-5) is under development. METHODS We conducted a phase 2, observer-blinded, randomized, controlled trial involving Malian children 12 to 16 months of age. Participants were assigned in a 2:2:1 ratio to receive nonadjuvanted NmCV-5, alum-adjuvanted NmCV-5, or the quadrivalent vaccine MenACWY-D, administered intramuscularly in two doses 12 weeks apart. Participants were followed for safety for 169 days. Immunogenicity was assessed with an assay for serum bactericidal antibody (SBA) with rabbit complement on days 0, 28, 84, and 112. RESULTS A total of 376 participants underwent randomization, with 150 assigned to each NmCV-5 group and 76 to the MenACWY-D group; 362 participants received both doses of vaccine. A total of 1% of the participants in the nonadjuvanted NmCV-5 group, 1% of those in the adjuvanted NmCV-5 group, and 4% of those in the MenACWY-D group reported local solicited adverse events; 6%, 5%, and 7% of the participants, respectively, reported systemic solicited adverse events. An SBA titer of at least 128 was seen in 91 to 100% (for all five serotypes) of the participants in the NmCV-5 groups and in 36 to 99% (excluding serogroup X) of those in the MenACWY-D group at day 84 (before the second dose); the same threshold was met in 99 to 100% (for all five serotypes) of the participants in the NmCV-5 groups and in 92 to 100% (excluding serogroup X) of those in the MenACWY-D group at day 112. Immune responses to the nonadjuvanted and adjuvanted NmCV-5 formulations were similar. CONCLUSIONS No safety concerns were identified with two doses of NmCV-5. A single dose of NmCV-5 elicited immune responses that were similar to those observed with two doses of MenACWY-D. Adjuvanted NmCV-5 provided no discernible benefit over nonadjuvanted NmCV-5. (Funded by the U.K. Foreign, Commonwealth, and Development Office; ClinicalTrials.gov number, NCT03295318.).
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Affiliation(s)
- Milagritos D Tapia
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Samba O Sow
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Abdi Naficy
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Fatoumata Diallo
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Fadima C Haidara
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Amol Chaudhari
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Lionel Martellet
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Awa Traore
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Kelly Townsend-Payne
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Ray Borrow
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Nancy Hosken
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Igor Smolenov
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Sambhaji S Pisal
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - F Marc LaForce
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Rajeev M Dhere
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Dhananjay Kapse
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Yuxiao Tang
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Mark R Alderson
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
| | - Prasad S Kulkarni
- From Centre pour le Développement des Vaccins du Mali, Bamako (M.D.T., S.O.S., F.D., F.C.H., A.T.); the Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (M.D.T.); PATH, Seattle (A.N., L.M., N.H., I.S., Y.T., M.R.A.); the Serum Institute of India, Pune (A.C., S.S.P., F.M.L., R.M.D., D.K., P.S.K.); and the Vaccine Evaluation Unit, Public Health England, Manchester Royal Infirmary, Manchester, United Kingdom (K.T.-P., R.B.)
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Gaikwad WK, Kodam KM, Dhere RM, Jana SK, Gautam M, Mallya AD, Soni D, Bhagade S, Gulahne A. Simultaneous purification and depolymerization of Streptococcus pneumoniae serotype 2 capsular polysaccharides by trifluoroacetic acid. Carbohydr Polym 2021; 261:117859. [PMID: 33766348 DOI: 10.1016/j.carbpol.2021.117859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 10/22/2022]
Abstract
Development of an effective purification process in order to provide low cost and high-quality vaccine is the necessity of glycoconjugate vaccine manufacturing industries. In the present study, we have attempted to develop a method for simultaneous purification and depolymerization process for capsular polysaccharides (CPS) derived from Streptococcus pneumoniae serotype 2. Trifluoroacetic acid (TFA) was used to precipitate impurities which were then removed by centrifugation. It was observed that the TFA treatment could simultaneously depolymerize the CPS and purify it. The purified and depolymerized CPS was analyzed for its purity, structural identity and conformity, molecular size, antigenicity to meet desired quality specifications. The obtained results showed that the purification and depolymerization of S. pneumoniae serotype 2 CPS did not affect the antigenicity of CPS.
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Affiliation(s)
- Walmik Karbhari Gaikwad
- Department of Technology, Savitribai Phule Pune University, Pune, 411007, India; Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, 411028, Maharashtra, India
| | - Kisan M Kodam
- Division of Biochemistry, Department of Chemistry, Savitribai Phule Pune University, Pune, 411007, India.
| | - Rajeev M Dhere
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, 411028, Maharashtra, India.
| | - Swapan K Jana
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, 411028, Maharashtra, India
| | - Manish Gautam
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, 411028, Maharashtra, India
| | - Asha D Mallya
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, 411028, Maharashtra, India
| | - Dipen Soni
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, 411028, Maharashtra, India
| | - Sudhakar Bhagade
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, 411028, Maharashtra, India
| | - Ashishkumar Gulahne
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, 411028, Maharashtra, India
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Soni D, Sahoo I, Mallya AD, Kamthe P, Sahai A, Goel SK, Kulkarni PS, Dhere RM. Development of competitive inhibition ELISA as an effective potency test to analyze human rabies vaccines and assessment of the antigenic epitope of rabies glycoprotein. J Immunol Methods 2020; 492:112939. [PMID: 33309752 DOI: 10.1016/j.jim.2020.112939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 11/17/2022]
Abstract
The potency of all modern tissue culture human rabies vaccines is measured based on the National Institute of Health (NIH) potency test that is laborious, time-consuming, involves large test variations and requires sacrifice of large number of animals. To circumvent these limitations, several researchers and WHO expert working groups have discussed development of alternative in vitro methods to replace the NIH potency test. Although several immunochemical methods have been proposed to quantify rabies glycoprotein (G-protein) using multiple murine monoclonal antibodies, we report an In vitro competitive inhibition ELISA (CIA) method based on the use of a neutralizing rabies glycoprotein site III directed novel therapeutic human rabies monoclonal antibody (RAB1) that shows equivalence to the mice NIH potency test in recognition of neutralization site of the glycoprotein. In vitro potency testing of WHO 7th International Standard for rabies vaccine (IS) by CIA using RAB1 and In-house reference standard (IHRS) as a standard to assess its suitability for the assessment of validation parameters showed accurate and precise values with <15% coefficient variance. The method was validated using 5PL standard curve with linearity r2 > 0.98 and LLOQ of 0.125 IU/mL indicating sensitivity of the method. The method was found to be precise, robust and accurate to quantitate intact rabies glycoprotein in final vaccine and showed a strong correlation (Pearson's r = 0.81) with the NIH potency values of licensed Vero cell rabies vaccine. The CIA test using RAB1 was able to accurately quantitate degradation of rabies vaccine and assess loss in antigenicity of lyophilized and reconstituted liquid rabies vaccine under thermal stress conditions. The method was able to differentiate between potent and reduced potency vaccine samples. The new in vitro competitive inhibition ELISA method using RAB1 thus can be a valid alternative to the NIH test.
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Affiliation(s)
- Dipen Soni
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune 410028, Maharashtra, India
| | - Itishree Sahoo
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune 410028, Maharashtra, India
| | - Asha D Mallya
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune 410028, Maharashtra, India.
| | - Praveen Kamthe
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune 410028, Maharashtra, India
| | - Ashish Sahai
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune 410028, Maharashtra, India
| | - Sunil Kumar Goel
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune 410028, Maharashtra, India
| | - Prasad S Kulkarni
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune 410028, Maharashtra, India
| | - Rajeev M Dhere
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune 410028, Maharashtra, India
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Shende N, Karale A, Marathe P, Chakraborty S, Mallya AD, Dhere RM. Quantitation of residual sodium dodecyl sulfate in meningococcal polysaccharide by gas chromatography-mass spectrometry. Biologicals 2019; 60:68-74. [PMID: 31126703 DOI: 10.1016/j.biologicals.2019.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/20/2019] [Accepted: 05/01/2019] [Indexed: 11/28/2022] Open
Abstract
Sodium dodecyl sulfate (SDS) is a commonly used surfactant in protein solubilization and also during the polysaccharide purification. A GC-MS method has been developed to quantitate residual SDS in meningococcal polysaccharide serogroups A,C,W,Y and X circumventing the need of spectroscopic assays and HPLC based methods which are either unstable or requires the confirmation by MS. The developed method is based on quantitative conversion of SDS to 1-dodecanol at elevated temperature. Meningococcal polysaccharides and SDS standards were treated with methanolic-HCl and extracted in n-Hexane. The conversion of SDS to 1-dodecanol was confirmed by mass spectra and separation was achieved using a DB-5ms column. The mass spectral analysis of 1-dodecanol showed characteristic ions at m/z 168, 140 and 125. The GC-MS method validation performed on intermediate and purified meningococcal polysaccharides showed linearity with r2 > 0.99 over the concentration range of 2.5-200 μg/ml with LOD and LOQ of 1.27 and 3.85 respectively. The method was found to be precise, robust and accurate with spike recovery ranging 83-117%. The GC-MS method can be used in the quantitation of residual SDS during polysaccharide purification and provides valuable information about consistency of polysaccharide manufacturing process for development of pentavalent meningococcal conjugate vaccine.
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Affiliation(s)
- Niraj Shende
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, 411028, Maharashtra, India
| | - Abhijeet Karale
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, 411028, Maharashtra, India
| | - Preeti Marathe
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, 411028, Maharashtra, India
| | - Sourish Chakraborty
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, 411028, Maharashtra, India
| | - Asha D Mallya
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, 411028, Maharashtra, India.
| | - Rajeev M Dhere
- Research and Development Department, Serum Institute of India Pvt. Ltd, Hadapsar, Pune, 411028, Maharashtra, India
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Wang Y, Zade J, Moon SS, Weldon W, Pisal SS, Glass RI, Dhere RM, Jiang B. Lack of immune interference between inactivated polio vaccine and inactivated rotavirus vaccine co-administered by intramuscular injection in two animal species. Vaccine 2019; 37:698-704. [PMID: 30626530 DOI: 10.1016/j.vaccine.2018.12.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/12/2018] [Accepted: 12/16/2018] [Indexed: 11/27/2022]
Abstract
A parenteral inactivated rotavirus vaccine (IRV) in development could address three problems with current live oral rotavirus vaccines (ORV): their lower efficacy in low and middle-income countries (LMICs), lingering concerns about their association with intussusception, and their requirement for a separate supply chain with large volume cold storage. Adding a new parenteral IRV to the current schedule of childhood immunizations would be more acceptable if it could be combined with another injectable vaccine such as inactivated polio vaccine (IPV). Current plans for polio eradication call for phasing out oral polio vaccine (OPV) and transitioning to IPV, initially in LMICs as a single dose booster after two doses of OPV and ultimately as a two dose schedule. Today in many LMICs, IPV is administered as a standalone vaccine, which involves a separate cold chain and is relatively costly. We therefore tested in two animal models formulations of IPV with IRV to determine whether co-administration might interfere with the immune response to each product and spare antigen dose for both vaccines. Our results demonstrate that IRV when adjuvanted with alum and administered alone or in combination with IPV did not impair the immune responses to either rotavirus or poliovirus serotypes 1, 2 and 3. Similarly, IPV when formulated and administered alone or together with IRV induced comparable levels of neutralizing antibody to poliovirus type 1, 2 and 3. Furthermore, comparable antibody titers were observed in animals vaccinated with low, middle or high dose of IPV or IRV in combination. This dose sparing and the lack of interference between IPV and IRV administered together represent another step to support the further development of this novel combination vaccine for children.
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Affiliation(s)
- Yuhuan Wang
- Division of Viral Diseases, Centers for Diseases Control and Prevention, Atlanta, GA, United States
| | | | - Sung-Sil Moon
- Division of Viral Diseases, Centers for Diseases Control and Prevention, Atlanta, GA, United States
| | - William Weldon
- Division of Viral Diseases, Centers for Diseases Control and Prevention, Atlanta, GA, United States
| | - S S Pisal
- Serum Institute of India Pvt. Ltd., Pune, India
| | - Roger I Glass
- Division of Viral Diseases, Centers for Diseases Control and Prevention, Atlanta, GA, United States; Fogarty International Center, National Institutes of Health, Bethesda, MD, United States
| | | | - Baoming Jiang
- Division of Viral Diseases, Centers for Diseases Control and Prevention, Atlanta, GA, United States.
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Chen WH, Neuzil KM, Boyce CR, Pasetti MF, Reymann MK, Martellet L, Hosken N, LaForce FM, Dhere RM, Pisal SS, Chaudhari A, Kulkarni PS, Borrow R, Findlow H, Brown V, McDonough ML, Dally L, Alderson MR. Safety and immunogenicity of a pentavalent meningococcal conjugate vaccine containing serogroups A, C, Y, W, and X in healthy adults: a phase 1, single-centre, double-blind, randomised, controlled study. Lancet Infect Dis 2018; 18:1088-1096. [PMID: 30120069 DOI: 10.1016/s1473-3099(18)30400-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/31/2018] [Accepted: 06/13/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Invasive meningococcal disease is an important public health problem, especially in sub-Saharan Africa. After introduction of MenAfriVac in 2010, Neisseria meningitidis serogroup A disease has been almost eliminated from the region. However, serogroups C, W, Y, and X continue to cause disease outbreaks. We assessed the NmCV-5 pentavalent meningococcal conjugate vaccine targeting A, C, Y, W, and X serogroups in a first-in-man, phase 1 study. METHODS We did a single-centre, double-blind, randomised controlled trial at a research clinic in Baltimore (MD, USA). Participants were healthy adults aged 18-45 years with no history of meningococcal vaccination or previous meningococcal infection. We randomly assigned participants (1:1:1) by an SAS-generated random schedule to a single, 0·5 mL, intramuscular injection of aluminium-phosphate adjuvanted NmCV-5, non-adjuvanted NmCV-5, or control (the quadrivalent meningococcal conjugate vaccine Menactra). The randomisation sequence used a permuted block design with randomly chosen block sizes of three and six. The vaccines were prepared, labelled, and administered with procedures to ensure participants and study personnel remained masked to treatment. After vaccination, participants were observed in the clinic for 60 min for adverse reactions. Participants recorded daily temperature and injection site or systemic reactions at home and returned to the clinic for follow-up visits on days 7, 28, and 84 for safety assessments; blood samples were also collected on day 7 for safety laboratory assessment. A phone call contact was made 6 months after vaccination. Serum was collected before vaccination and 28 days after vaccination for immunological assessment with a rabbit complement-dependent serum bactericidal antibody (rSBA) assay. The primary objective was an intention-to-treat assessment of safety, measuring local and systemic reactogenicity over 7 days, unsolicited adverse events through 28 days, and serious adverse events over 6 months. The secondary objective for the assessment of immunogenicity, was a per-protocol analysis of rSBA before and 28 days after vaccination. This trial is registered with ClinicalTrials.gov, number NCT02810340. FINDINGS Between Aug 17, 2016, and Feb 16, 2017, we assigned 20 participants to each vaccine. All vaccines were well-tolerated. Pain was the most common local reaction, occurring in 12 (60%), ten (50%), and seven (35%) participants in the adjuvanted NmCV-5, non-adjuvanted NmCV-5, and control groups, respectively. Headache was the most common systemic reaction, occurring in five (25%), three (15%), and three (15%), respectively. Most solicited reactogenicity adverse reactions were mild (60 [74%] of 81) and all were self-limiting. None of the differences in proportions of individuals with each solicited reaction was significant (p>0·300 for all comparisons) between the three vaccination groups. There were no serious adverse events and 19 unsolicited non-serious adverse events in 14 (23%) participants. Both adjuvanted and non-adjuvanted NmCV-5 elicited high rSBA titres against all five meningococcal serogroups. The pre-vaccination geometric mean titres (GMTs) ranged from 3·36 to 53·80 for the control, from 6·28 to 187·00 for the adjuvanted vaccine, and from 4·29 to 350·00 for the non-adjuvanted vaccine, and the post-vaccination GMT ranged from 3·14 to 3214 for the control, from 1351 to 8192 for the adjuvanted vaccine, and from 1607 to 11 191 for the non-adjuvanted vaccine. Predicted seroprotective responses (ie, an increase in rSBA titres of eight times or more) for the adjuvanted and non-adjuvanted NmCV-5 were similar to control responses for all five serogroups. INTERPRETATION The adjuvanted and non-adjuvanted NmCV-5 vaccines were well tolerated and did not produce concerning adverse effects and resulted in immune responses that are predicted to confer protection against all five targeted serogroups of invasive meningococcal disease. Further clinical testing of NmCV-5 is ongoing, and additional clinical trials are necessary to confirm the safety and immunogenicity of NmCV-5 in target populations. FUNDING UK Department for International Development.
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Affiliation(s)
- Wilbur H Chen
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Kathleen M Neuzil
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
| | - C Rebecca Boyce
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Marcela F Pasetti
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Mardi K Reymann
- Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | | | | | | | | | | | | | - Ray Borrow
- Vaccine Evaluation Unit, Public Health England, Manchester, UK
| | - Helen Findlow
- Vaccine Evaluation Unit, Public Health England, Manchester, UK
| | | | | | - Len Dally
- The Emmes Corporation, Rockville, MD, USA
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Naik SP, Zade JK, Sabale RN, Pisal SS, Menon R, Bankar SG, Gairola S, Dhere RM. Stability of heat stable, live attenuated Rotavirus vaccine (ROTASIIL®). Vaccine 2017; 35:2962-2969. [DOI: 10.1016/j.vaccine.2017.04.025] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 04/04/2017] [Accepted: 04/05/2017] [Indexed: 02/07/2023]
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17
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Kulkarni PS, Sahai A, Gunale B, Dhere RM. Development of a new purified vero cell rabies vaccine (Rabivax-S) at the serum institute of India Pvt Ltd. Expert Rev Vaccines 2017; 16:303-311. [DOI: 10.1080/14760584.2017.1294068] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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18
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Abstract
A bovine rotavirus pentavalent vaccine (BRV-PV) containing rotavirus human-bovine (UK) reassortant strains of serotype G1, G2, G3, G4 and G9 has been developed by the Serum Institute of India Ltd, in collaboration with the National Institute of Allergy and Infectious Diseases (NIAID), USA. The vaccine underwent animal toxicity studies and Phase I and II studies in adults, toddlers and infants. It has been found safe and immunogenic and will undergo a large Phase III study to assess efficacy against severe rotavirus gastroenteritis.
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19
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Phalgune DS, Yervadekar RC, Sharma HJ, Dhere RM, Parekh SS, Chandak AO, Safai AA, Shewale SD. Sero-surveillance to assess rubella susceptibility and assessment of immunogenicity and reactogenicity of rubella vaccine in Indian girls aged 18-24 years. Hum Vaccin Immunother 2014; 10:2813-8. [PMID: 25483461 DOI: 10.4161/21645515.2014.970947] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Rubella infection though a mild infection, may cause foetal death or a variety of congenital anomalies. Multiple sero-surveys confirmed that 5-10% women are unexposed to natural or vaccinated rubella virus and remain susceptible to rubella infection. The current study was conducted in 600 girls, aged 18-24 y from Symbiosis International University (SIU), Pune, India to assess their sero-status against rubella infection and to estimate the immunogenicity of rubella vaccine in achieving sero-protective antibody titres. Prior to administration of a single i.m. dose of rubella vaccine (R-vac®) to eligible participants, blood sample (pre-vaccination) was collected. During the 4-6 weeks observation period, adverse events were noted. Then, a second blood sample (post-vaccination) was collected. Significant increase was noted in sero-protection response, viz., 98.6% (post-vaccination) vis-à-vis 66.5% (pre-vaccination); Geometric mean titer (GMT) was significantly higher post-vaccination. Effective measures to introduce rubella vaccination on a larger scale need to be undertaken. An immunization policy with mandatory rubella vaccination for all girls in the reproductive age group and its inclusion in national immunization schedule is highly desirable.
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20
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Agarkhedkar S, Kulkarni PS, Winston S, Sievers R, Dhere RM, Gunale B, Powell K, Rota PA, Papania M. Safety and immunogenicity of dry powder measles vaccine administered by inhalation: A randomized controlled Phase I clinical trial. Vaccine 2014; 32:6791-7. [DOI: 10.1016/j.vaccine.2014.09.071] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 09/29/2014] [Accepted: 09/30/2014] [Indexed: 10/24/2022]
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21
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Chilukuri SR, Reddy P, Avalaskar N, Mallya A, Pisal S, Dhere RM. Process development and immunogenicity studies on a serogroup ‘X’ Meningococcal polysaccharide conjugate vaccine. Biologicals 2014; 42:160-8. [DOI: 10.1016/j.biologicals.2013.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 12/03/2013] [Accepted: 12/05/2013] [Indexed: 10/25/2022] Open
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22
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Kulkarni PS, Raut SK, Dhere RM. A post-marketing surveillance study of a human live-virus pandemic influenza A (H1N1) vaccine (Nasovac (®) ) in India. Hum Vaccin Immunother 2013; 9:122-4. [PMID: 23442586 DOI: 10.4161/hv.22317] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A live attenuated pandemic H1N1 influenza vaccine was developed in India. A post marketing surveillance was conducted retrospectively in healthy individuals (³ 3 years) who were vaccinated intranasally around one year before. After consent, the subjects recorded adverse events developing within 42 days. Among 7565 individuals (3 - 85 years), a total of 81 solicited adverse reactions (1%) were reported in 49 subjects (0.65%). The reactions included mild to moderate respiratory symptoms. No H1N1 case was encountered during one year postvaccination. The data show the safety of the live attenuated influenza vaccine platform developed in India.
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23
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Kulkarni PS, Jadhav SS, Dhere RM. Horizontal transmission of live vaccines. Hum Vaccin Immunother 2013; 9:197. [PMID: 23442591 DOI: 10.4161/hv.22132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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24
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Yeolekar LR, Dhere RM. Development and validation of an egg-based potency assay for a trivalent live attenuated influenza vaccine. Biologicals 2012; 40:146-50. [DOI: 10.1016/j.biologicals.2011.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 09/23/2011] [Accepted: 10/13/2011] [Indexed: 11/25/2022] Open
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Sharma HJ, Padbidri VS, Kapre SV, Jadhav SS, Dhere RM, Parekh SS, Dudhane AD, Shewale SD, Namjoshi GS. Seroprevalence of rubella and immunogenicity following rubella vaccination in adolescent girls in India. J Infect Dev Ctries 2011; 5:874-81. [DOI: 10.3855/jidc.1847] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Accepted: 02/22/2011] [Indexed: 10/31/2022] Open
Abstract
Introduction: Serologic surveys conducted in different countries indicate that rubella is a worldwide infection. Several such sero surveys conducted in India have also confirmed that 6-47% of women are susceptible to rubella infection. The current study was conducted on 1,329 female adolescents in 12 districts of Maharashtra, India, to assess their serological status in terms of rubella exposure. Methodology: After enrollment, a pre-vaccination blood sample was collected from the participants followed by rubella vaccination (R-vac). Adverse events were monitored for the next 6-8 weeks, at which time a post-vaccination sample was collected. Results: Pre-vaccination rubella immunity was higher in the urban (80.2%) population compared to the rural (73.1%) population. Following R-vac vaccination, out of 1,159 participants who completed the study, all (100%) in the urban and 99.5% of participants in the rural area developed antibodies against rubella. Conclusion: Substantial numbers of women reach childbearing age without immunity against rubella and thus are at a risk of passing the infection to their fetuses, who can then develop subsequent congenital defects leading to congenital rubella syndrome (CRS). An immunization policy recommending vaccination with rubella or rubella containing vaccine is highly desirable to prevent rubella and CRS.
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Sharma HJ, Oun SA, Bakr SSA, Kapre SV, Jadhav SS, Dhere RM, Bhardwaj S. No demonstrable association between the Leningrad-Zagreb mumps vaccine strain and aseptic meningitis in a large clinical trial in Egypt. Clin Microbiol Infect 2010; 16:347-52. [PMID: 20222892 DOI: 10.1111/j.1469-0691.2010.03121.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To address the claim that the Leningrad-Zagreb (L-Z) mumps vaccine strain is causally associated with aseptic meningitis, a prospective, post-marketing safety study was conducted with a measles-mumps-rubella vaccine (MMR) (TRESIVAC(R); Serum Institute of India Ltd., Pune, India), which uses the L-Z strain as its mumps component in Egypt. In all, 453 119 children (65 423 children aged 16-24 months and 329 211 children aged 5-7 years) received MMR. The control groups which, as a result of local health regulations, were slightly younger than vaccinees, comprised 12 253 and 46 232 children, respectively. Using questionnaires, the parents recorded solicited local, systemic and neurological adverse events for up to 42 days post-vaccination. All data were analysed externally on an intention-to-treat basis by individuals not participating in the study. Local and/or systemic reactions were reported in a small percentage of participants, with pain, fever and parotitis being the most common signs among vaccinees in both age groups. No case of aseptic meningitis, encephalitis, anaphylaxis or convulsions was observed in any participant. Thus, in this series of more than 450 000 Egyptian children, the L-Z mumps vaccine strain in this vaccine did not cause aseptic meningitis. The vaccine is considerably cheaper than Western competitors and a valid alternative to other MMR vaccines.
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Affiliation(s)
- H J Sharma
- Serum Institute of India Ltd., Pune, India.
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27
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Raut SK, Kulkarni PS, Phadke MA, Jadhav SS, Kapre SV, Dhere RM, Dhorje SP, Godse SR. Persistence of antibodies induced by measles-mumps-rubella vaccine in children in India. Clin Vaccine Immunol 2007; 14:1370-1. [PMID: 17699834 PMCID: PMC2168128 DOI: 10.1128/cvi.00246-07] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Antibody levels in 41 Indian girls were measured 6 years after measles-mumps-rubella (MMR) vaccination. Rates of seropositivity were 88% (measles antibodies), 95% (mumps antibodies), and 100% (rubella antibodies). The MMR vaccine induces long-term immunity in a majority of vaccinees; however, due to the observation of some seronegative vaccinees, the policy of administering a second dose of the MMR vaccine seems appropriate.
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Affiliation(s)
- S K Raut
- Serum Institute of India Ltd., Pune, 212/2, Hadapsar, India
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Peltola H, Kulkarni PS, Kapre SV, Paunio M, Jadhav SS, Dhere RM. Mumps outbreaks in Canada and the United States: time for new thinking on mumps vaccines. Clin Infect Dis 2007; 45:459-66. [PMID: 17638194 DOI: 10.1086/520028] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2007] [Accepted: 04/04/2007] [Indexed: 11/04/2022] Open
Abstract
Mumps epidemics in Canada and the United States prompted us to review evidence for the effectiveness of 5 different vaccine strains. Early trials with the Jeryl Lynn vaccine strain demonstrated an efficacy of approximately 95%, but in epidemic conditions, the effectiveness has been as low as 62%; this is still considerably better than the effectiveness of another safe strain, Rubini (which has an effectiveness of close to 0% in epidemic conditions). The Urabe vaccine strain has an effectiveness of 54%-87% but is prone to cause aseptic meningitis. Little epidemiological information is available for other vaccines. The Leningrad-Zagreb vaccine strain, which is widely used in developing countries and costs a fraction of what vaccines cost in the developed world, seems to have encouraging results; in 1 study, the effectiveness of this vaccine exceeded 95%. Aseptic meningitis has also been reported in association with this vaccine, but the benign nature of the associated meningitis was shown recently in Croatia. Also, the Leningrad-3 strain seems to be effective but causes less-benign meningitis. No mumps vaccine equals the best vaccines in quality, but the virtually complete safety of some strains may not offset their low effectiveness. Epidemiological data are pivotal in mumps, because serological testing is subject to many interpretation problems.
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Affiliation(s)
- Heikki Peltola
- HUCH Hospital, Hospital for Children and Adolescents, University of Helsinki, Finland.
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Kulkarni-Kale U, Ojha J, Manjari GS, Deobagkar DD, Mallya AD, Dhere RM, Kapre SV. Mapping antigenic diversity and strain specificity of mumps virus: A bioinformatics approach. Virology 2007; 359:436-46. [PMID: 17081582 DOI: 10.1016/j.virol.2006.09.040] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2006] [Revised: 08/18/2006] [Accepted: 09/15/2006] [Indexed: 11/30/2022]
Abstract
Mumps is an acute infectious disease caused by mumps virus, a member of the family Paramyxoviridae. With the implementation of vaccination programs, mumps infection is under control. However, due to resurgence of mumps epidemics, there is a renewed interest in understanding the antigenic diversity of mumps virus. Hemagglutinin-neuraminidase (HN) is the major surface antigen and is known to elicit neutralizing antibodies. Mutational analysis of HN of wild-type and vaccine strains revealed that the hypervariable positions are distributed over the entire length with no detectable pattern. In the absence of experimentally derived 3D structure data, the structure of HN protein of mumps virus was predicted using homology modeling. Mutations mapped on the predicted structures were found to cluster on one of the surfaces. A predicted conformational epitope encompasses experimentally characterized epitopes suggesting that it is a major site for neutralization. These analyses provide rationale for strain specificity, antigenic diversity and varying efficacy of mumps vaccines.
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