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Barry H, Lhomme E, Surénaud M, Nouctara M, Robinson C, Bockstal V, Valea I, Somda S, Tinto H, Meda N, Greenwood B, Thiébaut R, Lacabaratz C. Helminth exposure and immune response to the two-dose heterologous Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen. PLoS Negl Trop Dis 2024; 18:e0011500. [PMID: 38603720 PMCID: PMC11037528 DOI: 10.1371/journal.pntd.0011500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 04/23/2024] [Accepted: 02/28/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND The exposure to parasites may influence the immune response to vaccines in endemic African countries. In this study, we aimed to assess the association between helminth exposure to the most prevalent parasitic infections, schistosomiasis, soil transmitted helminths infection and filariasis, and the Ebola virus glycoprotein (EBOV GP) antibody concentration in response to vaccination with the Ad26.ZEBOV, MVA-BN-Filo vaccine regimen in African and European participants using samples obtained from three international clinical trials. METHODS/PRINCIPAL FINDINGS We conducted a study in a subset of participants in the EBL2001, EBL2002 and EBL3001 clinical trials that evaluated the Ad26.ZEBOV, MVA-BN-Filo vaccine regimen against EVD in children, adolescents and adults from the United Kingdom, France, Burkina Faso, Cote d'Ivoire, Kenya, Uganda and Sierra Leone. Immune markers of helminth exposure at baseline were evaluated by ELISA with three commercial kits which detect IgG antibodies against schistosome, filarial and Strongyloides antigens. Luminex technology was used to measure inflammatory and activation markers, and Th1/Th2/Th17 cytokines at baseline. The association between binding IgG antibodies specific to EBOV GP (measured on day 21 post-dose 2 and on Day 365 after the first dose respectively), and helminth exposure at baseline was evaluated using a multivariable linear regression model adjusted for age and study group. Seventy-eight (21.3%) of the 367 participants included in the study had at least one helminth positive ELISA test at baseline, with differences of prevalence between studies and an increased prevalence with age. The most frequently detected antibodies were those to Schistosoma mansoni (10.9%), followed by Acanthocheilonema viteae (9%) and then Strongyloides ratti (7.9%). Among the 41 immunological analytes tested, five were significantly (p < .003) lower in participants with at least one positive helminth ELISA test result: CCL2/MCP1, FGFbasic, IL-7, IL-13 and CCL11/Eotaxin compared to participants with negative helminth ELISA tests. No significant association was found with EBOV-GP specific antibody concentration at 21 days post-dose 2, or at 365 days post-dose 1, adjusted for age group, study, and the presence of any helminth antibodies at baseline. CONCLUSIONS/SIGNIFICANCE No clear association was found between immune markers of helminth exposure as measured by ELISA and post-vaccination response to the Ebola Ad26.ZEBOV/ MVA-BN-Filo vaccine regimen. TRIAL REGISTRATION NCT02416453, NCT02564523, NCT02509494. ClinicalTrials.gov.
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Affiliation(s)
- Houreratou Barry
- Centre MURAZ, Institut National de Santé Publique Bobo-Dioulasso, Burkina Faso
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inria SISTM team, Bordeaux, France
| | - Edouard Lhomme
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inria SISTM team, Bordeaux, France
- CHU Bordeaux, Department of Medical Information, Bordeaux, France
- Vaccine Research Institute (VRI), Créteil, France
| | - Mathieu Surénaud
- Vaccine Research Institute (VRI), Créteil, France
- Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France
| | - Moumini Nouctara
- Centre MURAZ, Institut National de Santé Publique Bobo-Dioulasso, Burkina Faso
| | | | - Viki Bockstal
- Janssen Vaccines & Prevention B.V., Leiden, Netherlands
| | - Innocent Valea
- Centre MURAZ, Institut National de Santé Publique Bobo-Dioulasso, Burkina Faso
- Institut de Recherche en Sciences de la Santé/Unité de Recherche Clinique de Nanoro, Burkina Faso
| | - Serge Somda
- Centre MURAZ, Institut National de Santé Publique Bobo-Dioulasso, Burkina Faso
- Université Nazi BONI, UFR Sciences Exactes et Appliquées, Bobo-Dioulasso, Burkina Faso
| | - Halidou Tinto
- Centre MURAZ, Institut National de Santé Publique Bobo-Dioulasso, Burkina Faso
- Institut de Recherche en Sciences de la Santé/Unité de Recherche Clinique de Nanoro, Burkina Faso
| | - Nicolas Meda
- Centre MURAZ, Institut National de Santé Publique Bobo-Dioulasso, Burkina Faso
- UFR Sciences de la santé, Université joseph Ki Zerbo, Ouagadougou, Burkina Faso
| | - Brian Greenwood
- London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom
| | - Rodolphe Thiébaut
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inria SISTM team, Bordeaux, France
- CHU Bordeaux, Department of Medical Information, Bordeaux, France
- Vaccine Research Institute (VRI), Créteil, France
| | - Christine Lacabaratz
- Vaccine Research Institute (VRI), Créteil, France
- Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France
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Anderson EM, Coller BAG. Translational success of fundamental virology: a VSV-vectored Ebola vaccine. J Virol 2024; 98:e0162723. [PMID: 38305150 PMCID: PMC10994820 DOI: 10.1128/jvi.01627-23] [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] [Indexed: 02/03/2024] Open
Abstract
Ebola virus disease (EVD) caused by Ebola virus (EBOV) is a severe, often fatal, hemorrhagic disease. A critical component of the public health response to curb EVD epidemics is the use of a replication-competent, recombinant vesicular stomatitis virus (rVSV)-vectored Ebola vaccine, rVSVΔG-ZEBOV-GP (ERVEBO). In this Gem, we will discuss the past and ongoing development of rVSVΔG-ZEBOV-GP, highlighting the importance of basic science and the strength of public-private partnerships to translate fundamental virology into a licensed VSV-vectored Ebola vaccine.
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Slomski A. Ebola Vaccines Safe and Immunogenic in 2 Trials. JAMA 2023; 329:278-279. [PMID: 36692563 DOI: 10.1001/jama.2022.23561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Ishola D, Manno D, Afolabi MO, Keshinro B, Bockstal V, Rogers B, Owusu-Kyei K, Serry-Bangura A, Swaray I, Lowe B, Kowuor D, Baiden F, Mooney T, Smout E, Köhn B, Otieno GT, Jusu M, Foster J, Samai M, Deen GF, Larson H, Lees S, Goldstein N, Gallagher KE, Gaddah A, Heerwegh D, Callendret B, Luhn K, Robinson C, Leyssen M, Greenwood B, Douoguih M, Leigh B, Watson-Jones D. Safety and long-term immunogenicity of the two-dose heterologous Ad26.ZEBOV and MVA-BN-Filo Ebola vaccine regimen in adults in Sierra Leone: a combined open-label, non-randomised stage 1, and a randomised, double-blind, controlled stage 2 trial. Lancet Infect Dis 2022; 22:97-109. [PMID: 34529963 PMCID: PMC7613326 DOI: 10.1016/s1473-3099(21)00125-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/18/2020] [Accepted: 02/15/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Ebola epidemics in west Africa and the Democratic Republic of the Congo highlight an urgent need for safe and effective vaccines to prevent Ebola virus disease. We aimed to assess the safety and long-term immunogenicity of a two-dose heterologous vaccine regimen, comprising the adenovirus type 26 vector-based vaccine encoding the Ebola virus glycoprotein (Ad26.ZEBOV) and the modified vaccinia Ankara vector-based vaccine, encoding glycoproteins from Ebola virus, Sudan virus, and Marburg virus, and the nucleoprotein from the Tai Forest virus (MVA-BN-Filo), in Sierra Leone, a country previously affected by Ebola. METHODS The trial comprised two stages: an open-label, non-randomised stage 1, and a randomised, double-blind, controlled stage 2. The study was done at three clinics in Kambia district, Sierra Leone. In stage 1, healthy adults (aged ≥18 years) residing in or near Kambia district, received an intramuscular injection of Ad26.ZEBOV (5 × 1010 viral particles) on day 1 (first dose) followed by an intramuscular injection of MVA-BN-Filo (1 × 108 infectious units) on day 57 (second dose). An Ad26.ZEBOV booster vaccination was offered at 2 years after the first dose to stage 1 participants. The eligibility criteria for adult participants in stage 2 were consistent with stage 1 eligibility criteria. Stage 2 participants were randomly assigned (3:1), by computer-generated block randomisation (block size of eight) via an interactive web-response system, to receive either the Ebola vaccine regimen (Ad26.ZEBOV followed by MVA-BN-Filo) or an intramuscular injection of a single dose of meningococcal quadrivalent (serogroups A, C, W135, and Y) conjugate vaccine (MenACWY; first dose) followed by placebo on day 57 (second dose; control group). Study team personnel, except those with primary responsibility for study vaccine preparation, and participants were masked to study vaccine allocation. The primary outcome was the safety of the Ad26.ZEBOV and MVA-BN-Filo vaccine regimen, which was assessed in all participants who had received at least one dose of study vaccine. Safety was assessed as solicited local and systemic adverse events occurring in the first 7 days after each vaccination, unsolicited adverse events occurring in the first 28 days after each vaccination, and serious adverse events or immediate reportable events occurring up to each participant's last study visit. Secondary outcomes were to assess Ebola virus glycoprotein-specific binding antibody responses at 21 days after the second vaccine in a per-protocol set of participants (ie, those who had received both vaccinations within the protocol-defined time window, had at least one evaluable post-vaccination sample, and had no major protocol deviations that could have influenced the immune response) and to assess the safety and tolerability of the Ad26.ZEBOV booster vaccination in stage 1 participants who had received the booster dose. This study is registered at ClinicalTrials.gov, NCT02509494. FINDINGS Between Sept 30, 2015, and Oct 19, 2016, 443 participants (43 in stage 1 and 400 in stage 2) were enrolled; 341 participants assigned to receive the Ad26.ZEBOV and MVA-BN-Filo regimen and 102 participants assigned to receive the MenACWY and placebo regimen received at least one dose of study vaccine. Both regimens were well tolerated with no safety concerns. In stage 1, solicited local adverse events (mostly mild or moderate injection-site pain) were reported in 12 (28%) of 43 participants after Ad26.ZEBOV vaccination and in six (14%) participants after MVA-BN-Filo vaccination. In stage 2, solicited local adverse events were reported in 51 (17%) of 298 participants after Ad26.ZEBOV vaccination, in 58 (24%) of 246 after MVA-BN-Filo vaccination, in 17 (17%) of 102 after MenACWY vaccination, and in eight (9%) of 86 after placebo injection. In stage 1, solicited systemic adverse events were reported in 18 (42%) of 43 participants after Ad26.ZEBOV vaccination and in 17 (40%) after MVA-BN-Filo vaccination. In stage 2, solicited systemic adverse events were reported in 161 (54%) of 298 participants after Ad26.ZEBOV vaccination, in 107 (43%) of 246 after MVA-BN-Filo vaccination, in 51 (50%) of 102 after MenACWY vaccination, and in 39 (45%) of 86 after placebo injection. Solicited systemic adverse events in both stage 1 and 2 participants included mostly mild or moderate headache, myalgia, fatigue, and arthralgia. The most frequent unsolicited adverse event after the first dose was headache in stage 1 and malaria in stage 2. Malaria was the most frequent unsolicited adverse event after the second dose in both stage 1 and 2. No serious adverse event was considered related to the study vaccine, and no immediate reportable events were observed. In stage 1, the safety profile after the booster vaccination was not notably different to that observed after the first dose. Vaccine-induced humoral immune responses were observed in 41 (98%) of 42 stage 1 participants (geometric mean binding antibody concentration 4784 ELISA units [EU]/mL [95% CI 3736-6125]) and in 176 (98%) of 179 stage 2 participants (3810 EU/mL [3312-4383]) at 21 days after the second vaccination. INTERPRETATION The Ad26.ZEBOV and MVA-BN-Filo vaccine regimen was well tolerated and immunogenic, with persistent humoral immune responses. These data support the use of this vaccine regimen for Ebola virus disease prophylaxis in adults. FUNDING Innovative Medicines Initiative 2 Joint Undertaking and Janssen Vaccines & Prevention BV.
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Affiliation(s)
- David Ishola
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Daniela Manno
- London School of Hygiene & Tropical Medicine, London, UK.
| | - Muhammed O Afolabi
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | | | - Viki Bockstal
- Janssen Vaccines and Prevention BV, Leiden, Netherlands
| | - Baimba Rogers
- EBOVAC Project, Kambia, Kambia district, Sierra Leone; College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Kwabena Owusu-Kyei
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Alimamy Serry-Bangura
- EBOVAC Project, Kambia, Kambia district, Sierra Leone; College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Ibrahim Swaray
- EBOVAC Project, Kambia, Kambia district, Sierra Leone; College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Brett Lowe
- London School of Hygiene & Tropical Medicine, London, UK; KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - Dickens Kowuor
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Frank Baiden
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Thomas Mooney
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Elizabeth Smout
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Brian Köhn
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Godfrey T Otieno
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone
| | - Morrison Jusu
- London School of Hygiene & Tropical Medicine, London, UK; EBOVAC Project, Kambia, Kambia district, Sierra Leone; College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Julie Foster
- London School of Hygiene & Tropical Medicine, London, UK
| | - Mohamed Samai
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Gibrilla Fadlu Deen
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Heidi Larson
- London School of Hygiene & Tropical Medicine, London, UK; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA
| | - Shelley Lees
- London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | | | | | - Kerstin Luhn
- Janssen Vaccines and Prevention BV, Leiden, Netherlands
| | | | | | | | | | - Bailah Leigh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Deborah Watson-Jones
- London School of Hygiene & Tropical Medicine, London, UK; Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
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Mahon BE, Simon J, Widdowson MA, Samai M, Rogier E, Legardy-Williams J, Liu K, Schiffer J, Lange J, DeByle C, Pinner R, Schuchat A, Slutsker L, Goldstein S. Baseline Asymptomatic Malaria Infection and Immunogenicity of Recombinant Vesicular Stomatitis Virus-Zaire Ebola Virus Envelope Glycoprotein. J Infect Dis 2021; 224:1907-1915. [PMID: 34013349 PMCID: PMC8643414 DOI: 10.1093/infdis/jiab243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/15/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The effect of malaria infection on the immunogenicity of the recombinant vesicular stomatitis virus-Zaire Ebola virus envelope glycoprotein (GP) vaccine (rVSVΔG-ZEBOV-GP) (ERVEBO) is unknown. METHODS The Sierra Leone Trial to Introduce a Vaccine Against Ebola (STRIVE) vaccinated 7998 asymptomatic adults with rVSVΔG-ZEBOV-GP during the 2014-2016 Ebola epidemic. In STRIVE's immunogenicity substudy, participants provided blood samples at baseline and at 1, 6, and 9-12 months. Anti-GP binding and neutralizing antibodies were measured using validated assays. Baseline samples were tested for malaria parasites by polymerase chain reaction. RESULTS Overall, 506 participants enrolled in the immunogenicity substudy and had ≥1 postvaccination antibody titer. Of 499 participants with a result, baseline malaria parasitemia was detected in 73 (14.6%). All GP enzyme-linked immunosorbent assay (ELISA) and plaque reduction neutralization test (PRNT) geometric mean titers (GMTs) at 1, 6, and 9-12 months were above baseline, and 94.1% of participants showed seroresponse by GP-ELISA (≥2-fold rise and ≥200 ELISA units/mL), while 81.5% showed seroresponse by PRNT (≥4-fold rise) at ≥1 postvaccination assessment. In participants with baseline malaria parasitemia, the PRNT seroresponse proportion was lower, while PRNT GMTs and GP-ELISA seroresponse and GMTs showed a trend toward lower responses at 6 and 9-12 months. CONCLUSION Asymptomatic adults with or without malaria parasitemia had robust immune responses to rVSVΔG-ZEBOV-GP, persisting for 9-12 months. Responses in those with malaria parasitemia were somewhat lower.
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Affiliation(s)
- Barbara E Mahon
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jakub Simon
- Global Clinical Development–Vaccines, Merck & Co, Inc., Kenilworth, New Jersey, USA
| | | | - Mohamed Samai
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Eric Rogier
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Kenneth Liu
- Biostatistics, Merck & Co, Inc., Kenilworth, New Jersey, USA
| | - Jarad Schiffer
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James Lange
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carolynn DeByle
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Robert Pinner
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anne Schuchat
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Susan Goldstein
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Pinski AN, Messaoudi I. Therapeutic vaccination strategies against EBOV by rVSV-EBOV-GP: the role of innate immunity. Curr Opin Virol 2021; 51:179-189. [PMID: 34749265 DOI: 10.1016/j.coviro.2021.10.007] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/14/2021] [Accepted: 10/19/2021] [Indexed: 12/30/2022]
Abstract
Zaire Ebola virus (EBOV) is a member of the Filoviridae family. Infection with EBOV causes Ebola virus disease (EVD) characterized by excessive inflammation, lymphocyte death, coagulopathy, and multi-organ failure. In 2019, the FDA-approved the first anti-EBOV vaccine, rVSV-EBOV-GP (Ervebo® by Merck). This live-recombinant vaccine confers both prophylactic and therapeutic protection to nonhuman primates and humans. While mechanisms conferring prophylactic protection are well-investigated, those underlying protection conferred shortly before and after exposure to EBOV remain poorly understood. In this review, we review data from in vitro and in vivo studies analyzing early immune responses to rVSV-EBOV-GP and discuss the role of innate immune activation in therapeutic protection.
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Affiliation(s)
- Amanda N Pinski
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA, USA
| | - Ilhem Messaoudi
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA, USA; Center for Virus Research, University of California, Irvine, Irvine, CA, USA; Institute for Immunology, University of California, Irvine, Irvine, CA, USA; Department of Microbiology, Immunology and Molecular Genetics, College of Medicine, University of Kentucky, Lexington, KY, USA.
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Barry H, Mutua G, Kibuuka H, Anywaine Z, Sirima SB, Meda N, Anzala O, Eholie S, Bétard C, Richert L, Lacabaratz C, McElrath MJ, De Rosa S, Cohen KW, Shukarev G, Robinson C, Gaddah A, Heerwegh D, Bockstal V, Luhn K, Leyssen M, Douoguih M, Thiébaut R. Safety and immunogenicity of 2-dose heterologous Ad26.ZEBOV, MVA-BN-Filo Ebola vaccination in healthy and HIV-infected adults: A randomised, placebo-controlled Phase II clinical trial in Africa. PLoS Med 2021; 18:e1003813. [PMID: 34714820 PMCID: PMC8555783 DOI: 10.1371/journal.pmed.1003813] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 09/13/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND We investigated safety, tolerability, and immunogenicity of the heterologous 2-dose Ebola vaccination regimen in healthy and HIV-infected adults with different intervals between Ebola vaccinations. METHODS AND FINDINGS In this randomised, observer-blind, placebo-controlled Phase II trial, 668 healthy 18- to 70-year-olds and 142 HIV-infected 18- to 50-year-olds were enrolled from 1 site in Kenya and 2 sites each in Burkina Faso, Cote d'Ivoire, and Uganda. Participants received intramuscular Ad26.ZEBOV followed by MVA-BN-Filo at 28-, 56-, or 84-day intervals, or saline. Females represented 31.4% of the healthy adult cohort in contrast to 69.7% of the HIV-infected cohort. A subset of healthy adults received booster vaccination with Ad26.ZEBOV or saline at Day 365. Following vaccinations, adverse events (AEs) were collected until 42 days post last vaccination and serious AEs (SAEs) were recorded from signing of the ICF until the end of the study. The primary endpoint was safety, and the secondary endpoint was immunogenicity. Anti-Ebola virus glycoprotein (EBOV GP) binding and neutralising antibodies were measured at baseline and at predefined time points throughout the study. The first participant was enrolled on 9 November 2015, and the date of last participant's last visit was 12 February 2019. No vaccine-related SAEs and mainly mild-to-moderate AEs were observed among the participants. The most frequent solicited AEs were injection-site pain (local), and fatigue, headache, and myalgia (systemic), respectively. Twenty-one days post-MVA-BN-Filo vaccination, geometric mean concentrations (GMCs) with 95% confidence intervals (CIs) of EBOV GP binding antibodies in healthy adults in 28-, 56-, and 84-day interval groups were 3,085 EU/mL (2,648 to 3,594), 7,518 EU/mL (6,468 to 8,740), and 7,300 EU/mL (5,116 to 10,417), respectively. In HIV-infected adults in 28- and 56-day interval groups, GMCs were 4,207 EU/mL (3,233 to 5,474) and 5,283 EU/mL (4,094 to 6,817), respectively. Antibody responses were observed until Day 365. Ad26.ZEBOV booster vaccination after 1 year induced an anamnestic response. Study limitations include that some healthy adult participants either did not receive dose 2 or received dose 2 outside of their protocol-defined interval and that the follow-up period was limited to 365 days for most participants. CONCLUSIONS Ad26.ZEBOV, MVA-BN-Filo vaccination was well tolerated and immunogenic in healthy and HIV-infected African adults. Increasing the interval between vaccinations from 28 to 56 days improved the magnitude of humoral immune responses. Antibody levels persisted to at least 1 year, and Ad26.ZEBOV booster vaccination demonstrated the presence of vaccination-induced immune memory. These data supported the approval by the European Union for prophylaxis against EBOV disease in adults and children ≥1 year of age. TRIAL REGISTRATION ClinicalTrials.gov NCT02564523.
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Affiliation(s)
| | - Gaudensia Mutua
- KAVI—Institute of Clinical Research University of Nairobi, Nairobi, Kenya
| | - Hannah Kibuuka
- Makerere University—Walter Reed Project, Kampala, Uganda
| | - Zacchaeus Anywaine
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Sodiomon B. Sirima
- Centre National de Recherche et de Formation sur le Paludisme (CNRFP), Unité de Recherche Clinique de Banfora, Ouagadougou, Burkina Faso
| | | | - Omu Anzala
- KAVI—Institute of Clinical Research University of Nairobi, Nairobi, Kenya
| | - Serge Eholie
- Unit of Infectious and Tropical Diseases, BPV3, Treichville University Teaching Hospital, Abidjan, Côte d’Ivoire
| | - Christine Bétard
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inria SISTM team; CHU Bordeaux; CIC 1401, EUCLID/F-CRIN Clinical Trials Platform, F-33000, Bordeaux, France
| | - Laura Richert
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inria SISTM team; CHU Bordeaux; CIC 1401, EUCLID/F-CRIN Clinical Trials Platform, F-33000, Bordeaux, France
- Vaccine Research Institute (VRI), Créteil, France
| | - Christine Lacabaratz
- Vaccine Research Institute (VRI), Créteil, France
- Université Paris-Est Créteil, Faculté de Médecine, INSERM U955, Team 16, Créteil, France
| | - M. Juliana McElrath
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Stephen De Rosa
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Kristen W. Cohen
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | | | | | | | | | - Viki Bockstal
- Janssen Vaccines and Prevention, Leiden, the Netherlands
| | - Kerstin Luhn
- Janssen Vaccines and Prevention, Leiden, the Netherlands
| | | | | | - Rodolphe Thiébaut
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219; Inria SISTM team; CHU Bordeaux; CIC 1401, EUCLID/F-CRIN Clinical Trials Platform, F-33000, Bordeaux, France
- Vaccine Research Institute (VRI), Créteil, France
- * E-mail:
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Liu Y, Sun B, Pan J, Feng Y, Ye W, Xu J, Lan M, Sun H, Zhang X, Sun Y, Yang S, Shi J, Zhang F, Cheng L, Jiang D, Yang K. Construction and evaluation of DNA vaccine encoding Ebola virus glycoprotein fused with lysosome-associated membrane protein. Antiviral Res 2021; 193:105141. [PMID: 34274417 DOI: 10.1016/j.antiviral.2021.105141] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/20/2021] [Accepted: 07/14/2021] [Indexed: 10/20/2022]
Abstract
Ebola virus (EBOV) of the genus Ebolavirus belongs to the family Filoviridae, which cause disease in both humans and non-human primates. Zaire Ebola virus accounts for the highest fatality rate, reaching 90%. Considering that EBOV has a high infection and fatality rate, the development of a highly effective vaccine has become a top public health priority. Glycoprotein (GP) plays a critical role during infection and protective immune responses. Herein, we developed an EBOV GP recombinant DNA vaccine that targets the major histocompatibility complex (MHC) class II compartment by fusing with lysosomal-associated membrane protein 1 (LAMP1). Through lysosome trafficking and antigen presentation transferring, the LAMP1 targeting strategy successfully improved both humoral and cellular EBOV-GP-specific immune responses. After three consecutive immunizations, the serum antibody titers, especially the neutralizing activity of mice immunized with the pVAX-LAMP/GPEBO vaccine were significantly higher than those of the other groups. Antigen-specific T cells showed positive activity against three dominant peptides, EAAVSHLTTLATIST, IGEWAFWETKKNLTR, and ELRTFSILNRKAIDF, with high affinity for MHC class II molecules predicted by IEDB-recommended. Preliminary safety observation denied histological alterations. DNA vaccine candidate pVAX-LAMP/GPEBO shows promise against Ebola epidemic and further evaluation is guaranteed.
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MESH Headings
- Animals
- Antibodies, Neutralizing/blood
- Antibodies, Viral/blood
- BALB 3T3 Cells
- Ebola Vaccines/administration & dosage
- Ebola Vaccines/adverse effects
- Ebola Vaccines/genetics
- Ebola Vaccines/immunology
- Ebolavirus/genetics
- Ebolavirus/immunology
- Female
- Glycoproteins/genetics
- Glycoproteins/immunology
- Hemorrhagic Fever, Ebola/immunology
- Hemorrhagic Fever, Ebola/prevention & control
- Humans
- Lysosomal Membrane Proteins/genetics
- Lysosomal Membrane Proteins/immunology
- Mice
- Neutralization Tests
- Recombinant Fusion Proteins/genetics
- Recombinant Fusion Proteins/immunology
- Vaccines, DNA/administration & dosage
- Vaccines, DNA/adverse effects
- Vaccines, DNA/immunology
- Vaccines, Synthetic/administration & dosage
- Vaccines, Synthetic/adverse effects
- Vaccines, Synthetic/genetics
- Vaccines, Synthetic/immunology
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Affiliation(s)
- Yang Liu
- Department of Immunology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China
| | - Baozeng Sun
- Department of Immunology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China
| | - Jingyu Pan
- Department of Immunology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China
| | - Yuancai Feng
- Department of Immunology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China
| | - Wei Ye
- Department of Microbiology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China
| | - Jiahao Xu
- Department of Immunology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China
| | - Mingfu Lan
- Department of Immunology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China
| | - Hao Sun
- Department of Immunology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China
| | - Xiyang Zhang
- Department of Immunology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China
| | - Yuanjie Sun
- Department of Immunology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China
| | - Shuya Yang
- Department of Immunology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China
| | - Jingqi Shi
- Department of Immunology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China
| | - Fanglin Zhang
- Department of Microbiology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China
| | - Linfeng Cheng
- Department of Microbiology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China
| | - Dongbo Jiang
- Department of Immunology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China.
| | - Kun Yang
- Department of Immunology, Basic Medicine School, Air-Force Medical University (the Fourth Military Medical University), Xi'an, Shaanxi, 86-710032, PR China.
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9
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Lehrer AT, Chuang E, Namekar M, Williams CA, Wong TAS, Lieberman MM, Granados A, Misamore J, Yalley-Ogunro J, Andersen H, Geisbert JB, Agans KN, Cross RW, Geisbert TW. Recombinant Protein Filovirus Vaccines Protect Cynomolgus Macaques From Ebola, Sudan, and Marburg Viruses. Front Immunol 2021; 12:703986. [PMID: 34484200 PMCID: PMC8416446 DOI: 10.3389/fimmu.2021.703986] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/29/2021] [Indexed: 11/23/2022] Open
Abstract
Ebola (EBOV), Marburg (MARV) and Sudan (SUDV) viruses are the three filoviruses which have caused the most fatalities in humans. Transmission from animals into the human population typically causes outbreaks of limited scale in endemic regions. In contrast, the 2013-16 outbreak in several West African countries claimed more than 11,000 lives revealing the true epidemic potential of filoviruses. This is further emphasized by the difficulty seen with controlling the 2018-2020 outbreak of EBOV in the Democratic Republic of Congo (DRC), despite the availability of two emergency use-approved vaccines and several experimental therapeutics targeting EBOV. Moreover, there are currently no vaccine options to protect against the other epidemic filoviruses. Protection of a monovalent EBOV vaccine against other filoviruses has never been demonstrated in primate challenge studies substantiating a significant void in capability should a MARV or SUDV outbreak of similar magnitude occur. Herein we show progress on developing vaccines based on recombinant filovirus glycoproteins (GP) from EBOV, MARV and SUDV produced using the Drosophila S2 platform. The highly purified recombinant subunit vaccines formulated with CoVaccine HT™ adjuvant have not caused any safety concerns (no adverse reactions or clinical chemistry abnormalities) in preclinical testing. Candidate formulations elicit potent immune responses in mice, guinea pigs and non-human primates (NHPs) and consistently produce high antigen-specific IgG titers. Three doses of an EBOV candidate vaccine elicit full protection against lethal EBOV infection in the cynomolgus challenge model while one of four animals infected after only two doses showed delayed onset of Ebola Virus Disease (EVD) and eventually succumbed to infection while the other three animals survived challenge. The monovalent MARV or SUDV vaccine candidates completely protected cynomolgus macaques from infection with lethal doses of MARV or SUDV. It was further demonstrated that combinations of MARV or SUDV with the EBOV vaccine can be formulated yielding bivalent vaccines retaining full efficacy. The recombinant subunit vaccine platform should therefore allow the development of a safe and efficacious multivalent vaccine candidate for protection against Ebola, Marburg and Sudan Virus Disease.
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Affiliation(s)
- Axel T. Lehrer
- Department of Tropical Medicine, Medical Microbiology & Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Eleanore Chuang
- Department of Tropical Medicine, Medical Microbiology & Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Madhuri Namekar
- Department of Tropical Medicine, Medical Microbiology & Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Caitlin A. Williams
- Department of Tropical Medicine, Medical Microbiology & Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Teri Ann S. Wong
- Department of Tropical Medicine, Medical Microbiology & Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Michael M. Lieberman
- Department of Tropical Medicine, Medical Microbiology & Pharmacology, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
| | | | | | | | | | - Joan B. Geisbert
- Galveston National Laboratory, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, United States
| | - Krystle N. Agans
- Galveston National Laboratory, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, United States
| | - Robert W. Cross
- Galveston National Laboratory, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, United States
| | - Thomas W. Geisbert
- Galveston National Laboratory, Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, United States
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10
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He L, Chaudhary A, Lin X, Sou C, Alkutkar T, Kumar S, Ngo T, Kosviner E, Ozorowski G, Stanfield RL, Ward AB, Wilson IA, Zhu J. Single-component multilayered self-assembling nanoparticles presenting rationally designed glycoprotein trimers as Ebola virus vaccines. Nat Commun 2021; 12:2633. [PMID: 33976149 DOI: 10.1101/2020.08.22.262634] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/06/2021] [Indexed: 05/27/2023] Open
Abstract
Ebola virus (EBOV) glycoprotein (GP) can be recognized by neutralizing antibodies (NAbs) and is the main target for vaccine design. Here, we first investigate the contribution of the stalk and heptad repeat 1-C (HR1C) regions to GP metastability. Specific stalk and HR1C modifications in a mucin-deleted form (GPΔmuc) increase trimer yield, whereas alterations of HR1C exert a more complex effect on thermostability. Crystal structures are determined to validate two rationally designed GPΔmuc trimers in their unliganded state. We then display a modified GPΔmuc trimer on reengineered protein nanoparticles that encapsulate a layer of locking domains (LD) and a cluster of helper T-cell epitopes. In mice and rabbits, GP trimers and nanoparticles elicit cross-ebolavirus NAbs, as well as non-NAbs that enhance pseudovirus infection. Repertoire sequencing reveals quantitative profiles of vaccine-induced B-cell responses. This study demonstrates a promising vaccine strategy for filoviruses, such as EBOV, based on GP stabilization and nanoparticle display.
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MESH Headings
- Animals
- Antibodies, Neutralizing/blood
- Antibodies, Neutralizing/immunology
- Antigens, Viral/administration & dosage
- Antigens, Viral/genetics
- Antigens, Viral/immunology
- Antigens, Viral/ultrastructure
- B-Lymphocytes/immunology
- Crystallography, X-Ray
- Disease Models, Animal
- Ebola Vaccines/administration & dosage
- Ebola Vaccines/genetics
- Ebola Vaccines/immunology
- Ebolavirus/genetics
- Ebolavirus/immunology
- Epitopes, T-Lymphocyte/administration & dosage
- Epitopes, T-Lymphocyte/genetics
- Epitopes, T-Lymphocyte/immunology
- Epitopes, T-Lymphocyte/ultrastructure
- Female
- Glycoproteins/administration & dosage
- Glycoproteins/genetics
- Glycoproteins/immunology
- Glycoproteins/ultrastructure
- Hemorrhagic Fever, Ebola/blood
- Hemorrhagic Fever, Ebola/immunology
- Hemorrhagic Fever, Ebola/therapy
- Hemorrhagic Fever, Ebola/virology
- Humans
- Mice
- Nanoparticles/chemistry
- Protein Domains/genetics
- Protein Domains/immunology
- Protein Engineering
- Protein Multimerization/genetics
- Protein Multimerization/immunology
- Protein Stability
- Rabbits
- T-Lymphocytes, Helper-Inducer/immunology
- Vaccines, Subunit/administration & dosage
- Vaccines, Subunit/genetics
- Vaccines, Subunit/immunology
- Viral Proteins/administration & dosage
- Viral Proteins/genetics
- Viral Proteins/immunology
- Viral Proteins/ultrastructure
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Affiliation(s)
- Linling He
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, USA
| | - Anshul Chaudhary
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, USA
| | - Xiaohe Lin
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, USA
| | - Cindy Sou
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, USA
| | - Tanwee Alkutkar
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, USA
| | - Sonu Kumar
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, USA
| | - Timothy Ngo
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, USA
| | - Ezra Kosviner
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, USA
| | - Gabriel Ozorowski
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, USA
| | - Robyn L Stanfield
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, USA
| | - Andrew B Ward
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, USA
| | - Ian A Wilson
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, USA.
- Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, CA, USA.
| | - Jiang Zhu
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, USA.
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, USA.
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11
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Kinganda-Lusamaki E, Black A, Mukadi DB, Hadfield J, Mbala-Kingebeni P, Pratt CB, Aziza A, Diagne MM, White B, Bisento N, Nsunda B, Akonga M, Faye M, Faye O, Edidi-Atani F, Matondo-Kuamfumu M, Mambu-Mbika F, Bulabula J, Di Paola N, Pauthner MG, Andersen KG, Palacios G, Delaporte E, Sall AA, Peeters M, Wiley MR, Ahuka-Mundeke S, Bedford T, Tamfum JJM. Integration of genomic sequencing into the response to the Ebola virus outbreak in Nord Kivu, Democratic Republic of the Congo. Nat Med 2021; 27:710-716. [PMID: 33846610 PMCID: PMC8549801 DOI: 10.1038/s41591-021-01302-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 03/02/2021] [Indexed: 12/29/2022]
Abstract
On 1 August 2018, the Democratic Republic of the Congo (DRC) declared its tenth Ebola virus disease (EVD) outbreak. To aid the epidemiologic response, the Institut National de Recherche Biomédicale (INRB) implemented an end-to-end genomic surveillance system, including sequencing, bioinformatic analysis and dissemination of genomic epidemiologic results to frontline public health workers. We report 744 new genomes sampled between 27 July 2018 and 27 April 2020 generated by this surveillance effort. Together with previously available sequence data (n = 48 genomes), these data represent almost 24% of all laboratory-confirmed Ebola virus (EBOV) infections in DRC in the period analyzed. We inferred spatiotemporal transmission dynamics from the genomic data as new sequences were generated, and disseminated the results to support epidemiologic response efforts. Here we provide an overview of how this genomic surveillance system functioned, present a full phylodynamic analysis of 792 Ebola genomes from the Nord Kivu outbreak and discuss how the genomic surveillance data informed response efforts and public health decision making.
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Affiliation(s)
- Eddy Kinganda-Lusamaki
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo.
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo.
| | - Allison Black
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Daniel B Mukadi
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - James Hadfield
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Placide Mbala-Kingebeni
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Catherine B Pratt
- Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Amuri Aziza
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | | | - Bailey White
- Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Nella Bisento
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Bibiche Nsunda
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | - Marceline Akonga
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | | | | | - Francois Edidi-Atani
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Meris Matondo-Kuamfumu
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Fabrice Mambu-Mbika
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Junior Bulabula
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Nicholas Di Paola
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Matthias G Pauthner
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA, USA
| | - Kristian G Andersen
- Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA, USA
| | - Gustavo Palacios
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA
| | - Eric Delaporte
- TransVIHMI, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Université de Montpellier, Montpellier, France
| | | | - Martine Peeters
- TransVIHMI, Institut de Recherche pour le Développement, Institut National de la Santé et de la Recherche Médicale, Université de Montpellier, Montpellier, France
| | - Michael R Wiley
- Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Steve Ahuka-Mundeke
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Trevor Bedford
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
| | - Jean-Jacques Muyembe Tamfum
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
- Service de Microbiologie, Cliniques Universitaires de Kinshasa, Kinshasa, Democratic Republic of the Congo
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12
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Mbala-Kingebeni P, Pratt C, Ruffin MM, Pauthner MG, Bile F, Nkuba Ndaye A, Black A, Kinganda Lusamaki E, Faye M, Aziza A, Diagne MM, Mukadi D, White B, Hadfield J, Gangavarapu K, Bisento N, Kazadi D, Nsunda B, Akonga M, Tshiani O, Misasi J, Ploquin A, Epaso V, Sana Paka E, N’kasar YTT, Mambu F, Edidi F, Matondo M, Bula Bula J, Diallo B, Keita M, Belizaire MRD, Fall IS, Yam A, Sabue M, Rimion AW, Salfati E, Torkamani A, Suchard MA, Crozier I, Hensley L, Rambaut A, Faye O, Sall A, Sullivan NJ, Bedford T, Andersen KG, Wiley MR, Ahuka-Mundeke S, Muyembe Tamfum JJ. Ebola Virus Transmission Initiated by Relapse of Systemic Ebola Virus Disease. N Engl J Med 2021; 384:1240-1247. [PMID: 33789012 PMCID: PMC7888312 DOI: 10.1056/nejmoa2024670] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
During the 2018-2020 Ebola virus disease (EVD) outbreak in North Kivu province in the Democratic Republic of Congo, EVD was diagnosed in a patient who had received the recombinant vesicular stomatitis virus-based vaccine expressing a ZEBOV glycoprotein (rVSV-ZEBOV) (Merck). His treatment included an Ebola virus (EBOV)-specific monoclonal antibody (mAb114), and he recovered within 14 days. However, 6 months later, he presented again with severe EVD-like illness and EBOV viremia, and he died. We initiated epidemiologic and genomic investigations that showed that the patient had had a relapse of acute EVD that led to a transmission chain resulting in 91 cases across six health zones over 4 months. (Funded by the Bill and Melinda Gates Foundation and others.).
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Affiliation(s)
- Placide Mbala-Kingebeni
- Institut National de Recherche Biomédicale,
Kinshasa, DRC
- University of Kinshasa, Kinshasa, DRC
| | | | | | | | | | - Antoine Nkuba Ndaye
- Institut National de Recherche Biomédicale,
Kinshasa, DRC
- University of Kinshasa, Kinshasa, DRC
| | - Allison Black
- Fred Hutchinson Cancer Research Center, Seattle,
WA, USA
| | | | | | - Amuri Aziza
- Institut National de Recherche Biomédicale,
Kinshasa, DRC
| | | | - Daniel Mukadi
- Institut National de Recherche Biomédicale,
Kinshasa, DRC
| | - Bailey White
- University of Nebraska Medical Center, Omaha, NE,
USA
| | - James Hadfield
- Fred Hutchinson Cancer Research Center, Seattle,
WA, USA
| | | | - Nella Bisento
- Institut National de Recherche Biomédicale,
Kinshasa, DRC
| | | | - Bibiche Nsunda
- Institut National de Recherche Biomédicale,
Kinshasa, DRC
| | | | | | - John Misasi
- Vaccine Research Center, National Institute of
Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH),
Bethesda, Maryland, USA
| | - Aurelie Ploquin
- Vaccine Research Center, National Institute of
Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH),
Bethesda, Maryland, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | - Mulangu Sabue
- Institut National de Recherche Biomédicale,
Kinshasa, DRC
| | | | | | | | | | - Ian Crozier
- Clinical Monitoring Research Program Directorate,
Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Lisa Hensley
- Integrated Research Facility at Fort Detrick,
National Institute of Allergy and Infectious Diseases, National Institutes of
Health, Frederick, MD, USA
| | | | | | | | - Nancy J. Sullivan
- Vaccine Research Center, National Institute of
Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH),
Bethesda, Maryland, USA
| | - Trevor Bedford
- Fred Hutchinson Cancer Research Center, Seattle,
WA, USA
| | | | | | - Steve Ahuka-Mundeke
- Institut National de Recherche Biomédicale,
Kinshasa, DRC
- University of Kinshasa, Kinshasa, DRC
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13
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Anderson MS, Niemuth NA, Sabourin CL, Badorrek CS, Bounds CE, Rudge TL. Interlaboratory comparison for the Filovirus Animal Nonclinical Group (FANG) anti-Ebola virus glycoprotein immunoglobulin G enzyme-linked immunosorbent assay. PLoS One 2020; 15:e0238196. [PMID: 32841291 PMCID: PMC7447032 DOI: 10.1371/journal.pone.0238196] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/11/2020] [Indexed: 01/11/2023] Open
Abstract
The need for an efficacious vaccine against highly pathogenic filoviruses was reinforced by the devastating 2014–2016 outbreak of Ebola virus (EBOV) disease (EVD) in Guinea, Sierra Leone, and Liberia that resulted in over 28,000 cases and over 11,300 deaths. In addition, the 2018–2020 outbreak in the Democratic Republic of the Congo currently has over 3,400 cases and over 2,200 deaths. A fully licensed vaccine and at least one other investigational vaccine are being deployed to combat this EVD outbreak. To support vaccine development and pre-clinical/clinical testing a Filovirus Animal Nonclinical Group (FANG) human anti-EBOV GP IgG ELISA was developed to measure anti-EBOV GP IgG antibodies. This ELISA is currently being used in multiple laboratories. Reported here is a characterization of an interlaboratory statistical analysis of the human anti-EBOV GP IgG ELISA as part of a collaborative study between five participating laboratories. Each laboratory used similar method protocols and reagents to measure anti-EBOV GP IgG levels in human serum samples from a proficiency panel consisting of ten serum samples created by the differential dilution of a serum sample positive for anti-GP IgG antibodies (BMIZAIRE105) with negative serum (BMI529). The total assay variability (inter- and intra-assay variability) %CVs observed at each laboratory ranged from 12.2 to 30.6. Intermediate precision (inter-assay variability) for the laboratory runs ranged from 8.9 to 21.7%CV and repeatability (intra-assay variability) %CVs ranged from 7.2 to 23.7. The estimated slope for the relationship between log10(Target Concentration) and the log10(Observed Concentration) across all five laboratories was 0.95 with a 90% confidence interval of (0.93, 0.97). Equivalence test results showed that the 90% confidence interval for the ratios for the sample-specific mean concentrations at the five individual labs to the overall laboratory consensus value were within the equivalence bounds of 0.80 to 1.25 for each laboratory and test sample, except for six test samples from Lab D, two samples from Lab B1, and one sample from Lab B2. The mean laboratory concentrations for Lab D were less than those from the other laboratories by 20% on average across the serum samples. The evaluation of the proficiency panel at these laboratories provides a limited assessment of assay precision (intermediate precision, repeatability, and total assay variability), dilutional linearity, and accuracy. This evaluation suggests that the within-laboratory performance of the anti-EBOV GP IgG ELISA as implemented at the five laboratories is consistent with the intended use of the assay based on the acceptance criteria used by laboratories that have validated the assay. However, the assessment of between-laboratory performance revealed lower observed concentrations at Lab D and greater variability in assay results at Lab B1 relative to other laboratories.
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Affiliation(s)
| | | | | | - Christopher S. Badorrek
- U.S. Department of Defense (DOD) Joint Program Executive Office for Chemical, Biological, Radiological, and Nuclear Defense (JPEO-CBRND), Joint Program Manager for Chemical Biological Radiological and Nuclear Medical (JPM-CBRN Medical), Fort Detrick, Maryland, United States of America
| | - Callie E. Bounds
- U.S. Department of Defense (DOD) Joint Program Executive Office for Chemical, Biological, Radiological, and Nuclear Defense (JPEO-CBRND), Joint Program Manager for Chemical Biological Radiological and Nuclear Medical (JPM-CBRN Medical), Fort Detrick, Maryland, United States of America
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14
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Cross RW, Bornholdt ZA, Prasad AN, Geisbert JB, Borisevich V, Agans KN, Deer DJ, Melody K, Fenton KA, Feldmann H, Sprecher A, Zeitlin L, Geisbert TW. Prior vaccination with rVSV-ZEBOV does not interfere with but improves efficacy of postexposure antibody treatment. Nat Commun 2020; 11:3736. [PMID: 32719371 PMCID: PMC7385100 DOI: 10.1038/s41467-020-17446-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 07/01/2020] [Indexed: 11/09/2022] Open
Abstract
A replication-competent vesicular stomatitis virus vaccine expressing the Ebola virus (EBOV) glycoprotein (GP) (rVSV-ZEBOV) was successfully used during the 2013-16 EBOV epidemic. Additionally, chimeric and human monoclonal antibodies (mAb) against the EBOV GP have shown promise in animals and humans when administered therapeutically. Uncertainty exists regarding the efficacy of postexposure antibody treatments in the event of a known exposure of a recent rVSV-ZEBOV vaccinee. Here, we model a worst-case scenario using rhesus monkeys vaccinated or unvaccinated with the rVSV-ZEBOV vaccine. We demonstrate that animals challenged with a uniformly lethal dose of EBOV one day following vaccination, and then treated with the anti-EBOV GP mAb MIL77 starting 3 days postexposure show no evidence of clinical illness and survive challenge. In contrast, animals receiving only vaccination or only mAb-based therapy become ill, with decreased survival compared to animals vaccinated and subsequently treated with MIL77. These results suggest that rVSV-ZEBOV augments immunotherapy.
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MESH Headings
- Animals
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Viral/administration & dosage
- Antibodies, Viral/immunology
- Antibodies, Viral/therapeutic use
- Ebola Vaccines/immunology
- Hemorrhagic Fever, Ebola/immunology
- Hemorrhagic Fever, Ebola/pathology
- Hemorrhagic Fever, Ebola/prevention & control
- Hemorrhagic Fever, Ebola/virology
- Humans
- Immunoglobulin G/blood
- Immunoglobulin M/blood
- Kaplan-Meier Estimate
- Macaca mulatta
- Post-Exposure Prophylaxis
- Treatment Outcome
- Vaccination
- Vesicular stomatitis Indiana virus/immunology
- Viral Load/immunology
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Affiliation(s)
- Robert W Cross
- Galveston National Laboratory, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
| | - Zachary A Bornholdt
- Mapp Biopharmaceutical Inc., 6160 Lusk Blvd Ste C200, San Diego, CA, 92121, USA
| | - Abhishek N Prasad
- Galveston National Laboratory, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
| | - Joan B Geisbert
- Galveston National Laboratory, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
| | - Viktoriya Borisevich
- Galveston National Laboratory, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
| | - Krystle N Agans
- Galveston National Laboratory, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
| | - Daniel J Deer
- Galveston National Laboratory, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
| | - Kevin Melody
- Galveston National Laboratory, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
| | - Karla A Fenton
- Galveston National Laboratory, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA
| | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, NIAID/NIH, Hamilton, MT, 59840, USA
| | - Armand Sprecher
- Médecins Sans Frontières, Rue Arbre Benit 46, 1050, Brussels, Belgium
| | - Larry Zeitlin
- Mapp Biopharmaceutical Inc., 6160 Lusk Blvd Ste C200, San Diego, CA, 92121, USA
| | - Thomas W Geisbert
- Galveston National Laboratory, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA.
- Department of Microbiology and Immunology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77555-0610, USA.
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15
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Herst CV, Burkholz S, Sidney J, Sette A, Harris PE, Massey S, Brasel T, Cunha-Neto E, Rosa DS, Chao WCH, Carback R, Hodge T, Wang L, Ciotlos S, Lloyd P, Rubsamen R. An effective CTL peptide vaccine for Ebola Zaire Based on Survivors' CD8+ targeting of a particular nucleocapsid protein epitope with potential implications for COVID-19 vaccine design. Vaccine 2020; 38:4464-4475. [PMID: 32418793 PMCID: PMC7186210 DOI: 10.1016/j.vaccine.2020.04.034] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/07/2020] [Accepted: 04/12/2020] [Indexed: 12/21/2022]
Abstract
The 2013-2016 West Africa EBOV epidemic was the biggest EBOV outbreak to date. An analysis of virus-specific CD8+ T-cell immunity in 30 survivors showed that 26 of those individuals had a CD8+ response to at least one EBOV protein. The dominant response (25/26 subjects) was specific to the EBOV nucleocapsid protein (NP). It has been suggested that epitopes on the EBOV NP could form an important part of an effective T-cell vaccine for Ebola Zaire. We show that a 9-amino-acid peptide NP44-52 (YQVNNLEEI) located in a conserved region of EBOV NP provides protection against morbidity and mortality after mouse adapted EBOV challenge. A single vaccination in a C57BL/6 mouse using an adjuvanted microsphere peptide vaccine formulation containing NP44-52 is enough to confer immunity in mice. Our work suggests that a peptide vaccine based on CD8+ T-cell immunity in EBOV survivors is conceptually sound and feasible. Nucleocapsid proteins within SARS-CoV-2 contain multiple Class I epitopes with predicted HLA restrictions consistent with broad population coverage. A similar approach to a CTL vaccine design may be possible for that virus.
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MESH Headings
- Amino Acid Sequence
- Animals
- COVID-19
- COVID-19 Vaccines
- Coronavirus Infections/immunology
- Coronavirus Infections/prevention & control
- Disease Models, Animal
- Drug Design
- Ebola Vaccines/chemistry
- Ebola Vaccines/immunology
- Epitopes, T-Lymphocyte/chemistry
- Epitopes, T-Lymphocyte/immunology
- Hemorrhagic Fever, Ebola/immunology
- Hemorrhagic Fever, Ebola/prevention & control
- Humans
- Mice
- Mice, Inbred C57BL
- Nucleocapsid Proteins/chemistry
- Nucleocapsid Proteins/immunology
- Pandemics/prevention & control
- Pneumonia, Viral/immunology
- Pneumonia, Viral/prevention & control
- T-Lymphocytes, Cytotoxic/immunology
- Vaccines, Subunit/chemistry
- Vaccines, Subunit/immunology
- Viral Vaccines/chemistry
- Viral Vaccines/immunology
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Affiliation(s)
- C V Herst
- Flow Pharma, Inc., 3451 Vincent Road, Pleasant Hill, CA 94523, United States
| | - S Burkholz
- Flow Pharma, Inc., 3451 Vincent Road, Pleasant Hill, CA 94523, United States
| | - J Sidney
- La Jolla Institute for Allergy and Immunology, 9420 Athena Circle La Jolla, CA 92037, United States
| | - A Sette
- La Jolla Institute for Allergy and Immunology, 9420 Athena Circle La Jolla, CA 92037, United States
| | - P E Harris
- Endocrinology Division, Department of Medicine, School of Medicine, Columbia University, New York, NY, USA
| | - S Massey
- University of Texas, Medical Branch, 301 University Blvd, Galveston, TX 77555, United States
| | - T Brasel
- University of Texas, Medical Branch, 301 University Blvd, Galveston, TX 77555, United States
| | - E Cunha-Neto
- Laboratory of Clinical Immunology and Allergy-LIM60, University of São Paulo School of Medicine, São Paulo, Brazil; Institute for Investigation in Immunology (iii) INCT, São Paulo, Brazil; Heart Institute (Incor), School of Medicine, University of São Paulo, São Paulo, Brazil
| | - D S Rosa
- Institute for Investigation in Immunology (iii) INCT, São Paulo, Brazil; Department of Microbiology, Immunology and Parasitology, Federal University of São Paulo (UNIFESP/EPM), São Paulo, Brazil
| | - W C H Chao
- University of Macau, E12 Avenida da Universidade, Taipa, Macau, China
| | - R Carback
- Flow Pharma, Inc., 3451 Vincent Road, Pleasant Hill, CA 94523, United States
| | - T Hodge
- Flow Pharma, Inc., 3451 Vincent Road, Pleasant Hill, CA 94523, United States
| | - L Wang
- Flow Pharma, Inc., 3451 Vincent Road, Pleasant Hill, CA 94523, United States
| | - S Ciotlos
- Flow Pharma, Inc., 3451 Vincent Road, Pleasant Hill, CA 94523, United States
| | - P Lloyd
- Flow Pharma, Inc., 3451 Vincent Road, Pleasant Hill, CA 94523, United States
| | - R Rubsamen
- Flow Pharma, Inc., 3451 Vincent Road, Pleasant Hill, CA 94523, United States; Massachusetts General Hospital, Department of Anesthesia, Critical Care and Pain Medicine, 55 Fruit St, Boston, MA 02114, United States.
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16
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Legardy-Williams JK, Carter RJ, Goldstein ST, Jarrett OD, Szefer E, Fombah AE, Tinker SC, Samai M, Mahon BE. Pregnancy Outcomes among Women Receiving rVSVΔ-ZEBOV-GP Ebola Vaccine during the Sierra Leone Trial to Introduce a Vaccine against Ebola. Emerg Infect Dis 2020; 26:541-548. [PMID: 32017677 PMCID: PMC7045819 DOI: 10.3201/eid2603.191018] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Little information exists regarding Ebola vaccine rVSVΔG-ZEBOV-GP and pregnancy. The Sierra Leone Trial to Introduce a Vaccine against Ebola (STRIVE) randomized participants without blinding to immediate or deferred (18–24 weeks postenrollment) vaccination. Pregnancy was an exclusion criterion, but 84 women were inadvertently vaccinated in early pregnancy or became pregnant <60 days after vaccination or enrollment. Among immediate vaccinated women, 45% (14/31) reported pregnancy loss, compared with 33% (11/33) of unvaccinated women with contemporaneous pregnancies (relative risk 1.35, 95% CI 0.73–2.52). Pregnancy loss was similar among women with higher risk for vaccine viremia (conception before or <14 days after vaccination) (44% [4/9]) and women with lower risk (conception >15 days after vaccination) (45% [10/22]). No congenital anomalies were detected among 44 live-born infants examined. These data highlight the need for Ebola vaccination decisions to balance the possible risk for an adverse pregnancy outcome with the risk for Ebola exposure.
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17
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Sanchez-Lockhart M, Reyes DS, Gonzalez JC, Garcia KY, Villa EC, Pfeffer BP, Trefry JC, Kugelman JR, Pitt ML, Palacios GF. Qualitative Profiling of the Humoral Immune Response Elicited by rVSV-ΔG-EBOV-GP Using a Systems Serology Assay, Domain Programmable Arrays. Cell Rep 2020; 24:1050-1059.e5. [PMID: 30044972 DOI: 10.1016/j.celrep.2018.06.077] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 02/12/2018] [Revised: 04/20/2018] [Accepted: 06/18/2018] [Indexed: 01/02/2023] Open
Abstract
Development of an effective vaccine became a worldwide priority after the devastating 2013-2016 Ebola disease outbreak. To qualitatively profile the humoral response against advanced filovirus vaccine candidates, we developed Domain Programmable Arrays (DPA), a systems serology platform to identify epitopes targeted after vaccination or filovirus infection. We optimized the assay using a panel of well-characterized monoclonal antibodies. After optimization, we utilized the system to longitudinally characterize the immunoglobulin (Ig) isotype-specific responses in non-human primates vaccinated with rVSV-ΔG-EBOV-glycoprotein (GP). Strikingly, we observed that, although the IgM response was directed against epitopes over the whole GP, the IgG and IgA responses were almost exclusively directed against the mucin-like domain (MLD) of the glycan cap. Further research will be needed to characterize this possible biased IgG and IgA response toward the MLD, but the results corroborate that DPA is a valuable tool to qualitatively measure the humoral response after vaccination.
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Affiliation(s)
- Mariano Sanchez-Lockhart
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; Departments of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Daniel S Reyes
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; Departments of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Jeanette C Gonzalez
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Karla Y Garcia
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; Departments of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Erika C Villa
- Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Bradley P Pfeffer
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - John C Trefry
- Virology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Jeffrey R Kugelman
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Margaret L Pitt
- Virology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA
| | - Gustavo F Palacios
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA.
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18
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19
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Kurup D, Fisher CR, Smith TG, Abreu-Mota T, Yang Y, Jackson FR, Gallardo-Romero N, Franka R, Bronshtein V, Schnell MJ. Inactivated Rabies Virus-Based Ebola Vaccine Preserved by Vaporization Is Heat-Stable and Immunogenic Against Ebola and Protects Against Rabies Challenge. J Infect Dis 2019; 220:1521-1528. [PMID: 31374568 PMCID: PMC6761974 DOI: 10.1093/infdis/jiz332] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 06/11/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Ebola virus (EBOV) is a highly lethal member of the Filoviridae family associated with human hemorrhagic disease. Despite being a sporadic disease, it caused a large outbreak in 2014-2016 in West Africa and another outbreak recently in the Democratic Republic of Congo. Several vaccine candidates are currently in preclinical and clinical studies but none are stable without cold chain storage. METHODS We used preservation by vaporization (PBV), a novel processing technology to heat-stabilize FiloRab1 (inactivated rabies-based Ebola vaccine), a candidate Ebola vaccine, and stored the vials at temperatures ranging from 4°C to 50°C for 10 days to 12 months. We immunized Syrian hamsters with the best long-term stable FiloRab1 PBV vaccines and challenged them with rabies virus (RABV). RESULTS Syrian hamsters immunized with FiloRab1 PBV-processed vaccines stored at temperatures of 4°C and 37°C for 6 months, and at 50°C for 2 weeks, seroconverted against both RABV-G and EBOV-GP. Notably, all of the FiloRab1 PBV vaccines proved to be 100% effective in a RABV challenge model. CONCLUSIONS We successfully demonstrated that the FiloRab1 PBV vaccines are stable and efficacious for up to 6 months when stored at temperatures ranging from 4°C to 37°C and for up to 2 weeks at 50°C.
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Affiliation(s)
- Drishya Kurup
- Department of Microbiology and Immunology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Christine R Fisher
- Department of Microbiology and Immunology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Todd G Smith
- National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Tiago Abreu-Mota
- Department of Microbiology and Immunology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Yong Yang
- National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Felix R Jackson
- National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Nadia Gallardo-Romero
- National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, Poxvirus and Rabies Branch, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Richard Franka
- Center for Global Health, Global Immunization Division, Polio Eradication Branch, CDC, Atlanta, Georgia
| | | | - Matthias J Schnell
- Department of Microbiology and Immunology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
- Jefferson Vaccine Center, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
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20
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Anywaine Z, Whitworth H, Kaleebu P, Praygod G, Shukarev G, Manno D, Kapiga S, Grosskurth H, Kalluvya S, Bockstal V, Anumendem D, Luhn K, Robinson C, Douoguih M, Watson-Jones D. Safety and Immunogenicity of a 2-Dose Heterologous Vaccination Regimen With Ad26.ZEBOV and MVA-BN-Filo Ebola Vaccines: 12-Month Data From a Phase 1 Randomized Clinical Trial in Uganda and Tanzania. J Infect Dis 2019; 220:46-56. [PMID: 30796818 PMCID: PMC6548900 DOI: 10.1093/infdis/jiz070] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 02/19/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Ebola vaccine development was accelerated in response to the 2014 Ebola virus infection outbreak. This phase 1 study (VAC52150EBL1004) assessed safety, tolerability, and immunogenicity of heterologous 2-dose Ad26.ZEBOV, MVA-BN-Filo vaccination regimens in the Lake Victoria Basin of Tanzania and Uganda in mid-level altitude, malaria-endemic settings. METHODS Healthy volunteers aged 18-50 years from Tanzania (n = 25) and Uganda (n = 47) were randomized to receive placebo or active vaccination with Ad26.ZEBOV or MVA-BN-Filo (first vaccination), followed by MVA-BN-Filo or Ad26.ZEBOV (second vaccination) dose 2, respectively, with intervals of 28 or 56 days. RESULTS Seventy-two adults were randomized to receive vaccine (n = 60) or placebo (n = 12). No vaccine-related serious adverse events were reported. The most frequent solicited local and systemic adverse events were injection site pain (frequency, 70%, 66%, and 42% per dose for MVA-BN-Filo, Ad26.ZEBOV, and placebo, respectively) and headache (57%, 56%, and 46%, respectively). Adverse event patterns were similar among regimens. Twenty-one days after dose 2, 100% of volunteers demonstrated binding antibody responses against Ebola virus glycoprotein, and 87%-100% demonstrated neutralizing antibody responses. Ad26.ZEBOV dose 1 vaccination induced more-robust initial binding antibody and cellular responses than MVA-BN-Filo dose 1 vaccination. CONCLUSIONS Heterologous 2-dose vaccination with Ad26.ZEBOV and MVA-BN-Filo against Ebola virus is well tolerated and immunogenic in healthy volunteers. CLINICAL TRIALS REGISTRATION NCT02376400.
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Affiliation(s)
- Zacchaeus Anywaine
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Hilary Whitworth
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | - Pontiano Kaleebu
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - George Praygod
- Mwanza Research Center, National Institute for Medical Research, Mwanza, Tanzania
| | | | - Daniela Manno
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Saidi Kapiga
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | - Heiner Grosskurth
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
| | | | - Viki Bockstal
- Janssen Vaccines and Prevention, Leiden, the Netherlands
| | | | - Kerstin Luhn
- Janssen Vaccines and Prevention, Leiden, the Netherlands
| | | | | | - Deborah Watson-Jones
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania
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21
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Mutua G, Anzala O, Luhn K, Robinson C, Bockstal V, Anumendem D, Douoguih M. Safety and Immunogenicity of a 2-Dose Heterologous Vaccine Regimen With Ad26.ZEBOV and MVA-BN-Filo Ebola Vaccines: 12-Month Data From a Phase 1 Randomized Clinical Trial in Nairobi, Kenya. J Infect Dis 2019; 220:57-67. [PMID: 30796816 PMCID: PMC6548899 DOI: 10.1093/infdis/jiz071] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 02/20/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND During the 2014 West African Ebola outbreak, Ebola vaccine development was accelerated. The phase 1 VAC52150EBL1003 study was performed to investigate 2-dose heterologous vaccination with Ad26.ZEBOV and MVA-BN-Filo in an African population located in a high-altitude setting in Nairobi, Kenya. METHODS Healthy adult volunteers were randomized to receive one of four 2-dose vaccination schedules. The first vaccination was administered at baseline (Ad26.ZEBOV or MVA-BN-Filo), followed by the second vaccination with the alternate vaccine after either 28 or 56 days. Each schedule had a placebo comparator group. The primary objective was to assess the safety and tolerability of these regimens. RESULTS Seventy-two volunteers were randomized into 4 groups of 18 (15 received vaccine, and 3 received placebo). The most frequent solicited systemic adverse event was headache (frequency, 50%, 61%, and 42% per dose for MVA-BN-Filo, Ad26.ZEBOV, and placebo, respectively). The most frequent solicited local AE was injection site pain (frequency, 78%, 63%, and 33% per dose for MVA-BN-Filo, Ad26.ZEBOV, and placebo, respectively). No differences in adverse events were observed among the different vaccine regimens. High levels of binding and neutralizing anti-Ebola virus glycoprotein antibodies were induced by all regimens and sustained to day 360 after the first dose. CONCLUSIONS Two-dose heterologous vaccination with Ad26.ZEBOV and MVA-BN-Filo was well tolerated and highly immunogenic against Ebola virus glycoprotein. CLINICAL TRIALS REGISTRATION NCT02376426.
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Affiliation(s)
- Gaudensia Mutua
- Kenya AIDS Vaccine Initiative Institute of Clinical Research, College of Health Sciences, University of Nairobi, Kenya
| | - Omu Anzala
- Kenya AIDS Vaccine Initiative Institute of Clinical Research, College of Health Sciences, University of Nairobi, Kenya
| | - Kerstin Luhn
- Janssen Vaccines and Prevention, Leiden, the Netherlands
| | | | - Viki Bockstal
- Janssen Vaccines and Prevention, Leiden, the Netherlands
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Stein DR, Sroga P, Warner BM, Deschambault Y, Poliquin G, Safronetz D. Evaluating Temperature Sensitivity of Vesicular Stomatitis Virus-Based Vaccines. Emerg Infect Dis 2019; 25:1563-1566. [PMID: 31141474 PMCID: PMC6649338 DOI: 10.3201/eid2508.190281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Use of the vesicular stomatitis virus (VSV)-based Ebola virus vaccine during outbreaks and the potential use of a similar VSV-based Lassa virus vaccine has raised questions about the vaccines' stability should the cold chain fail. We demonstrated that current cold chain conditions might tolerate significant variances without affecting efficacy.
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23
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Xie L, Zai J, Yi K, Li Y. Intranasal immunization with recombinant Vaccinia virus Tiantan harboring Zaire Ebola virus gp elicited systemic and mucosal neutralizing antibody in mice. Vaccine 2019; 37:3335-3342. [PMID: 31076161 DOI: 10.1016/j.vaccine.2019.04.070] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 11/06/2018] [Revised: 03/18/2019] [Accepted: 04/24/2019] [Indexed: 01/25/2023]
Abstract
Accumulating literature revealed that human mucosa was likely one of the important routes for EBOV attachment and further infection. Therefore inducing effective mucosal immune responses play key role in preventing the virus infection. Vaccinia virus Tiantan strain (VV) was a remarkably attenuated poxvirus, which has been broadly exploited as a multifunctional vector during the development of genetically recombinant vaccine and cancer therapeutic agent. In this study, we generated a recombinant VV harboring EBOV gp (VV-Egp) that was used to immunize mice, followed by assessing immune responses, particularly the mucosal immune responses to EBOV GP. A stable and further attenuated VV-Egp, in which the VV ha gene was replaced with the EBOV gp, was generated. In BALB/c mouse model, intranasal immunization with VV-Egp elicited robust humoral and cellular immune responses, including high level of neutralizing serum IgG and IgA against EBOV, and a large amount of GP-specific IFN-γ secreting lymphocytes. More importantly, EBOV GP-specific neutralizing secreted IgA (sIgA) in nasal wash and both sIgA and IgG in vaginal wash were induced. In summary, immunization with a safe and stable recombinant VV carrying a single EBOV gp conferred robust systemic immune response and mucosal neutralizing antibodies, indicating that the recombinant virus could be utilized as a viral vector for plug-and-play universal platform in mucosal vaccine development.
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Affiliation(s)
- Lilan Xie
- Hubei Engineering Research Center of Viral Vector, Applied Biotechnology Research Center, Wuhan University of Bioengineering, Wuhan 430400, China
| | - Junjie Zai
- Hubei Engineering Research Center of Viral Vector, Applied Biotechnology Research Center, Wuhan University of Bioengineering, Wuhan 430400, China
| | - Kai Yi
- Hubei Engineering Research Center of Viral Vector, Applied Biotechnology Research Center, Wuhan University of Bioengineering, Wuhan 430400, China
| | - Yaoming Li
- Hubei Engineering Research Center of Viral Vector, Applied Biotechnology Research Center, Wuhan University of Bioengineering, Wuhan 430400, China.
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24
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Gaudinski MR, Coates EE, Novik L, Widge A, Houser KV, Burch E, Holman LA, Gordon IJ, Chen GL, Carter C, Nason M, Sitar S, Yamshchikov G, Berkowitz N, Andrews C, Vazquez S, Laurencot C, Misasi J, Arnold F, Carlton K, Lawlor H, Gall J, Bailer RT, McDermott A, Capparelli E, Koup RA, Mascola JR, Graham BS, Sullivan NJ, Ledgerwood JE. Safety, tolerability, pharmacokinetics, and immunogenicity of the therapeutic monoclonal antibody mAb114 targeting Ebola virus glycoprotein (VRC 608): an open-label phase 1 study. Lancet 2019; 393:889-898. [PMID: 30686586 PMCID: PMC6436835 DOI: 10.1016/s0140-6736(19)30036-4] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 12/11/2018] [Accepted: 12/19/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND mAb114 is a single monoclonal antibody that targets the receptor-binding domain of Ebola virus glycoprotein, which prevents mortality in rhesus macaques treated after lethal challenge with Zaire ebolavirus. Here we present expedited data from VRC 608, a phase 1 study to evaluate mAb114 safety, tolerability, pharmacokinetics, and immunogenicity. METHODS In this phase 1, dose-escalation study (VRC 608), conducted at the US National Institutes of Health (NIH) Clinical Center (Bethesda, MD, USA), healthy adults aged 18-60 years were sequentially enrolled into three mAb114 dose groups of 5 mg/kg, 25 mg/kg, and 50 mg/kg. The drug was given to participants intravenously over 30 min, and participants were followed for 24 weeks. Participants were only enrolled into increased dosing groups after interim safety assessments. Our primary endpoints were safety and tolerability, with pharmacokinetic and anti-drug antibody assessments as secondary endpoints. We assessed safety and tolerability in all participants who received study drug by monitoring clinical laboratory data and self-report and direct clinician assessment of prespecified infusion-site symptoms 3 days after infusion and systemic symptoms 7 days after infusion. Unsolicited adverse events were recorded for 28 days. Pharmacokinetic and anti-drug antibody assessments were completed in participants with at least 56 days of data. This trial is registered with ClinicalTrials.gov, number NCT03478891, and is active but no longer recruiting. FINDINGS Between May 16, and Sept 27, 2018, 19 eligible individuals were enrolled. One (5%) participant was not infused because intravenous access was not adequate. Of 18 (95%) remaining participants, three (17%) were assigned to the 5 mg/kg group, five (28%) to the 25 mg/kg group, and ten (55%) to the 50 mg/kg group, each of whom received a single infusion of mAb114 at their assigned dose. All infusions were well tolerated and completed over 30-37 min with no infusion reactions or rate adjustments. All participants who received the study drug completed the safety assessment of local and systemic reactogenicity. No participants reported infusion-site symptoms. Systemic symptoms were all mild and present only in four (22%) of 18 participants across all dosing groups. No unsolicited adverse events occurred related to mAb114 and one serious adverse event occurred that was unrelated to mAb114. mAb114 has linear pharmacokinetics and a half-life of 24·2 days (standard error of measurement 0·2) with no evidence of anti-drug antibody development. INTERPRETATION mAb114 was well tolerated, showed linear pharmacokinetics, and was easily and rapidly infused, making it an attractive and deployable option for treatment in outbreak settings. FUNDING Vaccine Research Center, US National Institute of Allergy and Infectious Diseases, and NIH.
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Affiliation(s)
- Martin R Gaudinski
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Emily E Coates
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Laura Novik
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Alicia Widge
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Katherine V Houser
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Eugeania Burch
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - LaSonji A Holman
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Ingelise J Gordon
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Grace L Chen
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Cristina Carter
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Martha Nason
- Biostatistics Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Sandra Sitar
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Galina Yamshchikov
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Nina Berkowitz
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Charla Andrews
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Sandra Vazquez
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Carolyn Laurencot
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - John Misasi
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Frank Arnold
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Kevin Carlton
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Heather Lawlor
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Jason Gall
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Robert T Bailer
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Adrian McDermott
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Edmund Capparelli
- School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego, CA, USA
| | - Richard A Koup
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - John R Mascola
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Barney S Graham
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Nancy J Sullivan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Julie E Ledgerwood
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
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Abstract
Ebolaviruses are pathogenic agents associated with a severe, potentially fatal, systemic disease in man and great apes. Four species of ebolaviruses have been identified in west or equatorial Africa. Once the more virulent forms enter the human population, transmission occurs primarily through contact with infected body fluids and can result in major epidemics in under-resourced settings. These viruses cause a disease characterised by systemic viral replication, immune suppression, abnormal inflammatory responses, major fluid and electrolyte losses, and high mortality. Despite recent progress on vaccines, and with no licensed prophylaxis or treatment available, case management is essentially supportive with management of severe multiple organ failure resulting from immune-mediated cell damage. The 2013-16 outbreak was classified by WHO as a Public Health Emergency of International Concern, which drew attention to the challenges of diseases caused by infections with ebolaviruses and questioned scientific, clinical, and societal preparation to handle future epidemics.
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Affiliation(s)
- Denis Malvy
- Department for Infectious and Tropical Diseases, University Hospital Centre of Bordeaux, Bordeaux, France; INSERM 1219, University of Bordeaux, Bordeaux, France.
| | - Anita K McElroy
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Stephan Günther
- Department of Virology, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
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26
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Meyer M, Malherbe DC, Bukreyev A. Can Ebola Virus Vaccines Have Universal Immune Correlates of protection? Trends Microbiol 2019; 27:8-16. [PMID: 30201511 PMCID: PMC6309495 DOI: 10.1016/j.tim.2018.08.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/30/2018] [Accepted: 08/15/2018] [Indexed: 12/22/2022]
Abstract
Testing vaccine efficacy against the highly lethal Ebola virus (EBOV) in humans is almost impossible due to obvious ethical reasons and the sporadic nature of outbreaks. For such situations, the 'animal rule' was established, requiring the product be tested in animal models, expected to predict the response observed in humans. For vaccines, this testing aims to identify immune correlates of protection, such as antibody or cell-mediated responses. In the wake of the 2013-2016 EBOV epidemic, and despite advancement of promising candidates into clinical trials, protective correlates remain ambiguous. In the hope of identifying a reliable correlate by comparing preclinical and clinical trial data on immune responses to vaccination, we conclude that correlates are not universal for all EBOV vaccines.
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Affiliation(s)
- Michelle Meyer
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA; Galveston National Laboratory, Galveston, TX 77555, USA; These authors contributed equally to this work
| | - Delphine C Malherbe
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA; Galveston National Laboratory, Galveston, TX 77555, USA; These authors contributed equally to this work
| | - Alexander Bukreyev
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA; Department Microbiology & Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA; Galveston National Laboratory, Galveston, TX 77555, USA.
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27
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Cagigi A, Ploquin A, Niezold T, Zhou Y, Tsybovsky Y, Misasi J, Sullivan NJ. Vaccine-Mediated Induction of an Ebolavirus Cross-Species Antibody Binding to Conserved Epitopes on the Glycoprotein Heptad Repeat 2/Membrane-Proximal External Junction. J Infect Dis 2018; 218:S537-S544. [PMID: 30137549 PMCID: PMC6249595 DOI: 10.1093/infdis/jiy450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The membrane-proximal external regions (MPER) of the human immunodeficiency virus envelope glycoprotein (GP) generate broadly reactive antibody responses and are the focus of vaccine development efforts. The conservation of amino acids within filovirus GP heptad repeat region (HR)2/MPER suggests that it may also represent a target for a pan-filovirus vaccine. We immunized a cynomolgus macaque against Ebola virus (EBOV) using a deoxyribonucleic acid/adenovirus 5 prime/boost strategy, sequenced memory B-cell receptors, and tested the antibodies for functional activity against EBOV GP. Antibody ma-C10 bound to GP with an affinity of 48 nM and was capable of inducing antibody-dependent cellular cytotoxicity. Three-dimensional reconstruction of single-particle, negative-stained, electron microscopy showed that ma-C10 bound to the HR2/MPER, and enzyme-linked immunosorbent assay reveals it binds to residues 621-631. More importantly, ma-C10 was found to bind to the GP of the 3 most clinically relevant Ebolavirus species, suggesting that a cross-species immunogen strategy targeting the residues in this region may be a feasible approach for producing a pan-filovirus vaccine.
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Affiliation(s)
- Alberto Cagigi
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Aurélie Ploquin
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Thomas Niezold
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Yan Zhou
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Yaroslav Tsybovsky
- Electron Microscopy Laboratory, Cancer Research Technology Program, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Maryland
| | - John Misasi
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
- Division of Infectious Diseases, Boston Children’s HospitalMassachusetts
| | - Nancy J Sullivan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
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28
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Warfield KL, Howell KA, Vu H, Geisbert J, Wong G, Shulenin S, Sproule S, Holtsberg FW, Leung DW, Amarasinghe GK, Swenson DL, Bavari S, Kobinger GP, Geisbert TW, Aman MJ. Role of Antibodies in Protection Against Ebola Virus in Nonhuman Primates Immunized With Three Vaccine Platforms. J Infect Dis 2018; 218:S553-S564. [PMID: 29939318 PMCID: PMC6249597 DOI: 10.1093/infdis/jiy316] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Several vaccine platforms have been successfully evaluated for prevention of Ebola virus (EBOV) disease (EVD) in nonhuman primates and humans. Despite remarkable efficacy by multiple vaccines, the immunological correlates of protection against EVD are incompletely understood. Methods We systematically evaluated the antibody response to various EBOV proteins in 79 nonhuman primates vaccinated with various EBOV vaccine platforms. We evaluated the serum immunoglobulin (Ig)G titers against EBOV glycoprotein (GP), the ability of the vaccine-induced antibodies to bind GP at acidic pH or to displace ZMapp, and virus neutralization titers. The correlation of these outcomes with survival from EVD was evaluated by appropriate statistical methods. Results Irrespective of the vaccine platform, protection from EVD strongly correlated with anti-GP IgG titers. The GP-directed antibody levels required for protection in animals vaccinated with virus-like particles (VLPs) lacking nucleoprotein (NP) was significantly higher than animals immunized with NP-containing VLPs or adenovirus-expressed GP, platforms that induce strong T-cell responses. Furthermore, protective immune responses correlated with anti-GP antibody binding strength at acidic pH, neutralization of GP-expressing pseudovirions, and the ability to displace ZMapp components from GP. Conclusions These findings suggest key quantitative and qualitative attributes of antibody response to EVD vaccines as potential correlates of protection.
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Affiliation(s)
| | | | - Hong Vu
- Integrated BioTherapeutics Inc., Rockville, Maryland
| | | | - Gary Wong
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba
| | | | | | | | - Daisy W Leung
- Departments of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Gaya K Amarasinghe
- Departments of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Dana L Swenson
- US Army Medical Research Institute of Infectious Diseases, Frederick, Maryland
| | - Sina Bavari
- US Army Medical Research Institute of Infectious Diseases, Frederick, Maryland
| | - Gary P Kobinger
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba
| | | | - M Javad Aman
- Integrated BioTherapeutics Inc., Rockville, Maryland
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29
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Vaughan K, Xu X, Peters B, Sette A. Investigation of Outbreak-Specific Nonsynonymous Mutations on Ebolavirus GP in the Context of Known Immune Reactivity. J Immunol Res 2018; 2018:1846207. [PMID: 30581874 PMCID: PMC6276448 DOI: 10.1155/2018/1846207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 10/01/2018] [Accepted: 10/22/2018] [Indexed: 11/17/2022] Open
Abstract
The global response to the most recent EBOV outbreak has led to increased generation and availability of data, which can be globally analyzed to increase our understanding of immune responses to EBOV. We analyzed the published antibody epitope data to identify regions immunogenic for humans on the main GP antigenic target and determine sequence variance/nonsynonymous mutations between historical isolates and variants from the 2013-2016 outbreak. Approximately half of the GP sequence has been reported as targeted by antibody responses. Our results show an enrichment of nonsynonymous mutations (NSMs) within epitopic regions on GP (70%, p = 0.0133). Mapping NSMs to human epitope reactivity may be useful for future therapeutic and prophylaxis development as well as for our general understanding of immunity against EBOV.
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Affiliation(s)
- Kerrie Vaughan
- La Jolla Institute for Allergy and Immunology, 9420 Athena Circle, La Jolla, CA 92037, USA
| | - Xiaojun Xu
- La Jolla Institute for Allergy and Immunology, 9420 Athena Circle, La Jolla, CA 92037, USA
| | - Bjoern Peters
- La Jolla Institute for Allergy and Immunology, 9420 Athena Circle, La Jolla, CA 92037, USA
- University of California San Diego, Department of Medicine, La Jolla, CA 92093, USA
| | - Alessandro Sette
- La Jolla Institute for Allergy and Immunology, 9420 Athena Circle, La Jolla, CA 92037, USA
- University of California San Diego, Department of Medicine, La Jolla, CA 92093, USA
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30
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Anguiano-Zarate SS, Matchett WE, Nehete PN, Sastry JK, Marzi A, Barry MA. A Replicating Single-Cycle Adenovirus Vaccine Against Ebola Virus. J Infect Dis 2018; 218:1883-1889. [PMID: 29982595 PMCID: PMC6217725 DOI: 10.1093/infdis/jiy411] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 06/29/2018] [Indexed: 11/12/2022] Open
Abstract
Recent West African Ebola virus (EBOV) epidemics have led to testing different anti-EBOV vaccines, including a replication-defective adenovirus (RD-Ad) vector (ChAd3-EBOV) and an infectious, replication-competent recombinant vesicular stomatitis virus expressing the EBOV glycoprotein (rVSV-EBOV; also known as rVSV-ZEBOV). While RD-Ads elicit protection, when scaled up to human trials, the level of protection may be much lower than that of vaccines containing viruses that can replicate. Although a replication-competent Ad (RC-Ad) vaccine might generate a level of protection approximating that of rVSV, this infectious vector would also risk causing adenovirus disease. We recently described a "single-cycle" adenovirus (SC-Ad) vector that amplifies antigen genes like RC-Ad, but that avoids the risk of adenovirus infection. Here we have tested an SC-Ad6 vector expressing the glycoprotein (GP) from a 2014 EBOV strain in mice, hamsters, and rhesus macaques. We show that SC-Ad6-EBOV GP induces a high level of serum antibodies in all species and mediates significant protection against pseudo-challenge with rVSV-EBOV expressing luciferase in mice and hamsters. These data suggest that SC-Ad6-EBOV GP may be useful during future EBOV outbreaks.
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Affiliation(s)
| | - William E Matchett
- Virology and Gene Therapy Graduate Program, Mayo Clinic, Rochester, Minnesota
| | - Pramod N Nehete
- Department of Immunology, University of Texas M. D. Anderson Cancer Center, Houston and Bastrop, Texas
- Department of Veterinary Sciences, University of Texas M. D. Anderson Cancer Center, Houston and Bastrop, Texas
| | - Jagannadha K Sastry
- Department of Immunology, University of Texas M. D. Anderson Cancer Center, Houston and Bastrop, Texas
- Department of Veterinary Sciences, University of Texas M. D. Anderson Cancer Center, Houston and Bastrop, Texas
| | - Andrea Marzi
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Michael A Barry
- Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
- Department of Immunology, Mayo Clinic, Rochester, Minnesota
- Department of Molecular Medicine, Mayo Clinic, Rochester, Minnesota
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31
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Yang R, Zhu Y, Ma J, Hao YZ, Wang X, Hou ML, Liu LP, Fan LY, Cao YX, Zhang XG, Li XJ. Neutralizing Antibody Titer Test of Ebola Recombinant Protein Vaccine and Gene Vector Vaccine pVR-GP-FC. Biomed Environ Sci 2018; 31:721-728. [PMID: 30423273 DOI: 10.3967/bes2018.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/02/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE In previous studies, we immunized mice with Ebola recombinant protein vaccine and gene vector vaccine. Both stimulated high levels of humoral immunity. In this work, we constructed a pseudovirus containing Ebola membrane proteins to verify whether the two immunization strategies can induce neutralizing antibodies in mice. METHODS A pseudovirus containing an Ebola virus membrane protein based on the HIV-1 viral gene sequence was constructed and evaluated using a known neutralizing antibody. The titer of the neutralizing antibody in the sera of mice immunized with the recombinant protein and the gene vector vaccine was examined using a neutralization test. RESULTS Ebola pseudovirus was successfully prepared and applied for neutralizing antibody detection. Immunological experiments showed that recombinant protein GP-Fc and gene vaccine pVR-modGP-Fc had good immunogenicity. The titer of the bound antibody in the serum after 8 weeks of immunization in mice was more than 1:105, and the recombinant protein induced greater humoral immunity. The results of the neutralization test based on the Ebola pseudovirus system demonstrated that both vaccines induced production of protective antibodies, while the gene vaccine induced a higher titer of neutralizing antibodies. CONCLUSION An Ebola pseudovirus detection system was successfully established and used to evaluate two Ebola vaccines. Both produced good immunogenicity. The findings lay the foundation for the development of new Ebola vaccines and screening for neutralizing monoclonal antibodies.
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Affiliation(s)
- Ren Yang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Ying Zhu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Jing Ma
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Yan Zhe Hao
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Xuan Wang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Mei Ling Hou
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Li Peng Liu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Li Yun Fan
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Yu Xi Cao
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Xiao Guang Zhang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Xiao Jing Li
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao 266033, Shandong, China; Qingdao Institute of Preventive Medicine, Qingdao 266033, Shandong, China
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Abstract
The West African Ebola virus (EBOV) epidemic has fast-tracked countermeasures for this rare, emerging zoonotic pathogen. Until 2013-2014, most EBOV vaccine candidates were stalled between the preclinical and clinical milestones on the path to licensure, because of funding problems, lack of interest from pharmaceutical companies, and competing priorities in public health. The unprecedented and devastating epidemic propelled vaccine candidates toward clinical trials that were initiated near the end of the active response to the outbreak. Those trials did not have a major impact on the epidemic but provided invaluable data on vaccine safety, immunogenicity, and, to a limited degree, even efficacy in humans. There are plenty of lessons to learn from these trials, some of which are addressed in this review. Better preparation is essential to executing an effective response to EBOV in the future; yet, the first indications of waning interest are already noticeable.
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Affiliation(s)
- Heinz Feldmann
- Laboratory of Virology, Rocky Mountain Laboratories, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana 59840, USA;
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba 93E 0J9, Canada
| | - Friederike Feldmann
- Rocky Mountain Veterinary Branch, Rocky Mountain Laboratories, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana 59840, USA
| | - Andrea Marzi
- Laboratory of Virology, Rocky Mountain Laboratories, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana 59840, USA;
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Lévy Y, Lane C, Piot P, Beavogui AH, Kieh M, Leigh B, Doumbia S, D'Ortenzio E, Lévy-Marchal C, Pierson J, Watson-Jones D, Nguyen VK, Larson H, Lysander J, Lacabaratz C, Thiebaut R, Augier A, Ishola D, Kennedy S, Chêne G, Greenwood B, Neaton J, Yazdanpanah Y. Prevention of Ebola virus disease through vaccination: where we are in 2018. Lancet 2018; 392:787-790. [PMID: 30104048 PMCID: PMC6128979 DOI: 10.1016/s0140-6736(18)31710-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 08/11/2017] [Accepted: 07/19/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Yves Lévy
- French Institute for Health and Medical Research (Inserm), Paris, France.
| | - Clifford Lane
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | - Peter Piot
- London School of Hygiene & Tropical Medicine, London, UK
| | - Abdul Habib Beavogui
- Centre National de Formation et de Recherche en Santé Rurale de Mafèrinyah, Mafèrinyah, Guinea
| | - Mark Kieh
- Partnership for Research on Ebola Virus in Liberia (PREVAIL), Monrovia, Liberia
| | - Bailah Leigh
- College of Medicine and Allied Health Sciences (COMAHS), University of Sierra Leone, Freetown, Sierra Leone
| | - Seydou Doumbia
- University of Sciences, Technique and Technology of Bamako, Bamako, Mali
| | - Eric D'Ortenzio
- French Institute for Health and Medical Research (Inserm), Paris, France
| | | | - Jerome Pierson
- National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA
| | | | - Vinh-Kim Nguyen
- Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - Heidi Larson
- London School of Hygiene & Tropical Medicine, London, UK
| | - Julia Lysander
- Partnership for Research on Ebola Virus in Liberia (PREVAIL), Monrovia, Liberia
| | | | - Rodolphe Thiebaut
- French Institute for Health and Medical Research (Inserm), Paris, France
| | - Augustin Augier
- The Alliance for International Medical Action, Dakar, Senegal
| | - David Ishola
- London School of Hygiene & Tropical Medicine, London, UK
| | - Stephen Kennedy
- Partnership for Research on Ebola Virus in Liberia (PREVAIL), Monrovia, Liberia
| | - Geneviève Chêne
- French Institute for Health and Medical Research (Inserm), Paris, France
| | | | - James Neaton
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Yazdan Yazdanpanah
- French Institute for Health and Medical Research (Inserm), Paris, France
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Gross L, Lhomme E, Pasin C, Richert L, Thiebaut R. Ebola vaccine development: Systematic review of pre-clinical and clinical studies, and meta-analysis of determinants of antibody response variability after vaccination. Int J Infect Dis 2018; 74:83-96. [PMID: 29981944 DOI: 10.1016/j.ijid.2018.06.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 04/10/2018] [Revised: 06/20/2018] [Accepted: 06/28/2018] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES For Ebola vaccine development, antibody response is a major endpoint although its determinants are not well known. We aimed to review Ebola vaccine studies and to assess factors associated with antibody response variability in humans. METHODS We searched PubMed and Scopus for preventive Ebola vaccine studies in humans or non-human primates (NHP), published up to February 2018. For each vaccination group with Ebola Zaire antibody titre measurements after vaccination, data about antibody response and its potential determinants were extracted. A random-effects meta-regression was conducted including human groups with at least 8 individuals. RESULTS We reviewed 49 studies (202 vaccination groups including 74 human groups) with various vaccine platforms and antigen inserts. Mean antibody titre was slightly higher in NHP (3.10, 95% confidence interval [293; 327]) than in humans (2.75 [257; 293]). Vaccine platform (p<0·001) and viral strain used for antibody detection (p<0·001) were associated with antibody response in humans, but adjusted heterogeneity remained at 95%. CONCLUSIONS Various platforms have been evaluated in humans, including Ad26, Ad5, ChimpAd3, DNA, MVA, and VSV. In addition to platforms, viral strain used for antibody detection influences antibody response. However, variability remained mostly unexplained. Therefore, comparison of vaccine immunogenicity needs randomised controlled trials.
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Affiliation(s)
- Lise Gross
- SISTM Team (Statistics in System Biology and Translational Medicine), INRIA Research Centre, Bordeaux, F-33000, France; Vaccine Research Institute (VRI), Créteil, F-94000, France
| | - Edouard Lhomme
- INSERM, Bordeaux Population Health Research Centre, UMR 1219, Univ. Bordeaux, ISPED, F-33000, Bordeaux, France; SISTM Team (Statistics in System Biology and Translational Medicine), INRIA Research Centre, Bordeaux, F-33000, France; Vaccine Research Institute (VRI), Créteil, F-94000, France; Pôle de Santé Publique, CHU de Bordeaux, Bordeaux, F-33000, France
| | - Chloé Pasin
- INSERM, Bordeaux Population Health Research Centre, UMR 1219, Univ. Bordeaux, ISPED, F-33000, Bordeaux, France; SISTM Team (Statistics in System Biology and Translational Medicine), INRIA Research Centre, Bordeaux, F-33000, France; Vaccine Research Institute (VRI), Créteil, F-94000, France
| | - Laura Richert
- INSERM, Bordeaux Population Health Research Centre, UMR 1219, Univ. Bordeaux, ISPED, F-33000, Bordeaux, France; SISTM Team (Statistics in System Biology and Translational Medicine), INRIA Research Centre, Bordeaux, F-33000, France; Vaccine Research Institute (VRI), Créteil, F-94000, France; Pôle de Santé Publique, CHU de Bordeaux, Bordeaux, F-33000, France
| | - Rodolphe Thiebaut
- INSERM, Bordeaux Population Health Research Centre, UMR 1219, Univ. Bordeaux, ISPED, F-33000, Bordeaux, France; SISTM Team (Statistics in System Biology and Translational Medicine), INRIA Research Centre, Bordeaux, F-33000, France; Vaccine Research Institute (VRI), Créteil, F-94000, France; Pôle de Santé Publique, CHU de Bordeaux, Bordeaux, F-33000, France.
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Öhlund P, García-Arriaza J, Zusinaite E, Szurgot I, Männik A, Kraus A, Ustav M, Merits A, Esteban M, Liljeström P, Ljungberg K. DNA-launched RNA replicon vaccines induce potent anti-Ebolavirus immune responses that can be further improved by a recombinant MVA boost. Sci Rep 2018; 8:12459. [PMID: 30127450 PMCID: PMC6102224 DOI: 10.1038/s41598-018-31003-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 08/07/2018] [Indexed: 12/28/2022] Open
Abstract
There are currently no licensed therapeutic treatment or preventive vaccines against Ebolavirus disease, and the 2013-2016 West African outbreak of Ebolavirus disease spread rapidly and resulted in almost 30,000 cases and more than 11,000 deaths. However, the devastating outbreak has spurred the development of novel Ebolavirus vaccines. Here, we demonstrate that alphavirus-based DNA-launched self-replicating RNA replicon vaccines (DREP) encoding either the glycoprotein (GP) gene or co-expressing the GP and VP40 genes of Sudan or Zaire Ebolavirus are immunogenic in mice inducing both binding and neutralizing antibodies as well as CD8 T cell responses. In addition, antibodies were cross-reactive against another Ebolavirus, although the specificity was higher for the vaccination antigen. DREP vaccines were more immunogenic than recombinant MVA vaccines expressing the same Ebolavirus antigens. However, a DREP prime followed by an MVA boost immunization regimen improved vaccine immunogenicity as compared to DREP and MVA homologous prime-boost immunizations. Moreover, we show that a bivalent approach targeting both Sudan and Zaire Ebolavirus can be employed without significant loss of immunity. This opens for further investigation of a pan-Ebolavirus or even a pan-filovirus vaccine.
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Affiliation(s)
- Pontus Öhlund
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Department of Biomedical Science and Veterinary Public Health, Virology Unit, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Juan García-Arriaza
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CNB-CSIC), Madrid, Spain
| | - Eva Zusinaite
- Institute of Technology, University of Tartu, Tartu, Estonia
| | - Inga Szurgot
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Andres Männik
- Icosagen Cell Factory OÜ, Ülenurme vald, Tartumaa, Estonia
| | - Annette Kraus
- Department of Microbiology, Public Health Agency of Sweden, Solna, Sweden
| | - Mart Ustav
- Icosagen Cell Factory OÜ, Ülenurme vald, Tartumaa, Estonia
| | - Andres Merits
- Institute of Technology, University of Tartu, Tartu, Estonia
| | - Mariano Esteban
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CNB-CSIC), Madrid, Spain
| | - Peter Liljeström
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Karl Ljungberg
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
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36
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Dhama K, Karthik K, Khandia R, Chakraborty S, Munjal A, Latheef SK, Kumar D, Ramakrishnan MA, Malik YS, Singh R, Malik SVS, Singh RK, Chaicumpa W. Advances in Designing and Developing Vaccines, Drugs, and Therapies to Counter Ebola Virus. Front Immunol 2018; 9:1803. [PMID: 30147687 PMCID: PMC6095993 DOI: 10.3389/fimmu.2018.01803] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 07/23/2018] [Indexed: 01/10/2023] Open
Abstract
Ebola virus (EBOV), a member of the family Filoviridae, is responsible for causing Ebola virus disease (EVD) (formerly named Ebola hemorrhagic fever). This is a severe, often fatal illness with mortality rates varying from 50 to 90% in humans. Although the virus and associated disease has been recognized since 1976, it was only when the recent outbreak of EBOV in 2014-2016 highlighted the danger and global impact of this virus, necessitating the need for coming up with the effective vaccines and drugs to counter its pandemic threat. Albeit no commercial vaccine is available so far against EBOV, a few vaccine candidates are under evaluation and clinical trials to assess their prophylactic efficacy. These include recombinant viral vector (recombinant vesicular stomatitis virus vector, chimpanzee adenovirus type 3-vector, and modified vaccinia Ankara virus), Ebola virus-like particles, virus-like replicon particles, DNA, and plant-based vaccines. Due to improvement in the field of genomics and proteomics, epitope-targeted vaccines have gained top priority. Correspondingly, several therapies have also been developed, including immunoglobulins against specific viral structures small cell-penetrating antibody fragments that target intracellular EBOV proteins. Small interfering RNAs and oligomer-mediated inhibition have also been verified for EVD treatment. Other treatment options include viral entry inhibitors, transfusion of convalescent blood/serum, neutralizing antibodies, and gene expression inhibitors. Repurposed drugs, which have proven safety profiles, can be adapted after high-throughput screening for efficacy and potency for EVD treatment. Herbal and other natural products are also being explored for EVD treatment. Further studies to better understand the pathogenesis and antigenic structures of the virus can help in developing an effective vaccine and identifying appropriate antiviral targets. This review presents the recent advances in designing and developing vaccines, drugs, and therapies to counter the EBOV threat.
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Affiliation(s)
- Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Kumaragurubaran Karthik
- Central University Laboratory, Tamil Nadu Veterinary and Animal Sciences University, Chennai, India
| | - Rekha Khandia
- Department of Biochemistry and Genetics, Barkatullah University, Bhopal, India
| | - Sandip Chakraborty
- Department of Veterinary Microbiology, College of Veterinary Sciences and Animal Husbandry, Agartala, India
| | - Ashok Munjal
- Department of Biochemistry and Genetics, Barkatullah University, Bhopal, India
| | - Shyma K. Latheef
- Immunology Section, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Deepak Kumar
- Division of Veterinary Biotechnology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | | | - Yashpal Singh Malik
- Division of Biological Standardization, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Rajendra Singh
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Satya Veer Singh Malik
- Division of Veterinary Public Health, ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - Raj Kumar Singh
- ICAR-Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, India
| | - Wanpen Chaicumpa
- Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Department of Parasitology, Faculty of Medicine SIriraj Hospital, Mahidol University, Bangkok, Thailand
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37
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Liu Y, Ye L, Lin F, Gomaa Y, Flyer D, Carrion R, Patterson JL, Prausnitz MR, Smith G, Glenn G, Wu H, Compans RW, Yang C. Intradermal immunization by Ebola virus GP subunit vaccines using microneedle patches protects mice against lethal EBOV challenge. Sci Rep 2018; 8:11193. [PMID: 30046140 PMCID: PMC6060117 DOI: 10.1038/s41598-018-29135-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 05/17/2018] [Indexed: 11/09/2022] Open
Abstract
Development of a safe and efficacious filovirus vaccine is of high importance to public health. In this study, we compared immune responses induced by Ebola virus (EBOV) glycoprotein (GP) subunit vaccines via intradermal immunization with microneedle (MN) patches and the conventional intramuscular (IM) injection in mice, which showed that MN delivery of GP induced higher levels and longer lasting antibody responses against GP than IM injection. Further, we found that EBOV GP in formulation with a saponin-based adjuvant, Matrix-M, can be efficiently loaded onto MN patches. Co-delivery of Matrix-M with GP significantly enhanced induction of antibody responses by MN delivery, as also observed for IM injection. Results from challenge studies showed that all mice that received the GP/adjuvant formulation by MN or IM immunizations were protected from lethal EBOV challenge. Further, 4 out of 5 mice vaccinated by MN delivery of unadjuvanted GP also survived the challenge, whereas only 1 out of 5 mice vaccinated by IM injection of unadjuvanted GP survived the challenge. These results demonstrate that MN patch delivery of EBOV GP subunit vaccines, which is expected to enable improved safety and thermal stability, can confer effective protection against EBOV infection that is superior to IM vaccination.
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MESH Headings
- Adjuvants, Immunologic/administration & dosage
- Animals
- Antibodies, Viral/genetics
- Antibodies, Viral/immunology
- Antibody Formation/immunology
- Ebola Vaccines/immunology
- Ebolavirus/immunology
- Ebolavirus/pathogenicity
- Glycoproteins/administration & dosage
- Glycoproteins/immunology
- Hemorrhagic Fever, Ebola/genetics
- Hemorrhagic Fever, Ebola/immunology
- Hemorrhagic Fever, Ebola/prevention & control
- Humans
- Immunization
- Injections, Intradermal
- Mice
- Vaccination
- Vaccines, Subunit/genetics
- Vaccines, Subunit/immunology
- Vaccines, Subunit/therapeutic use
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Affiliation(s)
- Ying Liu
- Key Laboratory of Special Animal Epidemic Disease, Ministry of Agriculture of China, Institute of Special Economic Animals and Plants, Chinese Academy of Agricultural Sciences CAAS, Changchun, Jilin 130112, P. R. China
- Emory University School of Medicine, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Ling Ye
- Emory University School of Medicine, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Fang Lin
- Emory University School of Medicine, 1518 Clifton Road, Atlanta, GA, 30322, USA
- Central Laboratory, Tangdu Hospital at the Fourth Military Medical University, Xi'An, 710038, China
| | - Yasmine Gomaa
- Georgia Institute of Technology, 311 Ferst Drive, Atlanta, GA, 30332, USA
| | - David Flyer
- Novavax Inc., 20 Firstfield Road, Gaithersburg, MD, 20878, USA
| | - Ricardo Carrion
- Texas Biomedical Research Institute, 7620 NW Loop 410, San Antonio, TX, 78227, USA
| | - Jean L Patterson
- Texas Biomedical Research Institute, 7620 NW Loop 410, San Antonio, TX, 78227, USA
| | - Mark R Prausnitz
- Georgia Institute of Technology, 311 Ferst Drive, Atlanta, GA, 30332, USA
| | - Gale Smith
- Novavax Inc., 20 Firstfield Road, Gaithersburg, MD, 20878, USA
| | - Gregory Glenn
- Novavax Inc., 20 Firstfield Road, Gaithersburg, MD, 20878, USA
| | - Hua Wu
- Key Laboratory of Special Animal Epidemic Disease, Ministry of Agriculture of China, Institute of Special Economic Animals and Plants, Chinese Academy of Agricultural Sciences CAAS, Changchun, Jilin 130112, P. R. China
| | - Richard W Compans
- Emory University School of Medicine, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Chinglai Yang
- Emory University School of Medicine, 1518 Clifton Road, Atlanta, GA, 30322, USA.
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38
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Suder E, Furuyama W, Feldmann H, Marzi A, de Wit E. The vesicular stomatitis virus-based Ebola virus vaccine: From concept to clinical trials. Hum Vaccin Immunother 2018; 14:2107-2113. [PMID: 29757706 PMCID: PMC6183239 DOI: 10.1080/21645515.2018.1473698] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 04/30/2018] [Indexed: 10/25/2022] Open
Abstract
The devastating Ebola virus (EBOV) epidemic in West Africa in 2013-2016 accelerated the progress of several vaccines and antivirals through clinical trials, including the replication-competent vesicular stomatitis virus-based vaccine expressing the EBOV glycoprotein (VSV-EBOV). Extensive preclinical testing in animal models demonstrated the prophylactic and post-exposure efficacy of this vaccine, identified the mechanism of protection, and suggested it was safe for human use. Based on these data, VSV-EBOV was extensively tested in phase 1-3 clinical trials in North America, Europe and Africa. Although some side effects of vaccination were observed, these clinical trials showed that the VSV-EBOV was safe and immunogenic in humans. Moreover, the data supported the use of VSV-EBOV as an emergency vaccine in individuals at risk for Ebola virus disease. In this review, we summarize the results of the extensive preclinical and clinical testing of the VSV-EBOV vaccine.
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MESH Headings
- Animals
- Clinical Trials as Topic
- Drug Carriers
- Drug Evaluation, Preclinical
- Drug-Related Side Effects and Adverse Reactions/epidemiology
- Drug-Related Side Effects and Adverse Reactions/pathology
- Ebola Vaccines/administration & dosage
- Ebola Vaccines/genetics
- Ebola Vaccines/immunology
- Ebola Vaccines/isolation & purification
- Hemorrhagic Fever, Ebola/prevention & control
- Humans
- Vaccines, Attenuated/administration & dosage
- Vaccines, Attenuated/genetics
- Vaccines, Attenuated/immunology
- Vaccines, Attenuated/isolation & purification
- Vaccines, Synthetic/administration & dosage
- Vaccines, Synthetic/genetics
- Vaccines, Synthetic/immunology
- Vaccines, Synthetic/isolation & purification
- Vesiculovirus/genetics
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Affiliation(s)
- Ellen Suder
- Laboratory of Virology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, MT, USA
| | - Wakako Furuyama
- Laboratory of Virology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, MT, USA
| | - Heinz Feldmann
- Laboratory of Virology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, MT, USA
| | - Andrea Marzi
- Laboratory of Virology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, MT, USA
| | - Emmie de Wit
- Laboratory of Virology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rocky Mountain Laboratories, Hamilton, MT, USA
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39
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Abstract
INTRODUCTION The Ebola virus (EBOV) disease epidemic during 2014-16 in West Africa has accelerated the clinical development of several vaccine candidates that have demonstrated efficacy in the gold standard nonhuman primate (NHP) model, namely cynomolgus macaques. AREAS COVERED This review discusses the pre-clinical research and if available, clinical evaluation of the currently available EBOV vaccine candidates, while emphasizing the translatability of pre-clinical data generated in the NHP model to clinical data in humans. EXPERT OPINION Despite the existence of many successful EBOV vaccine candidates in the pre-clinical stages, only two platforms became the focus of Phase 2/3 efficacy trials in Liberia, Sierra Leone, and Guinea near the peak of the epidemic: the Vesicular stomatitis virus (VSV)-vectored vaccine and the chimpanzee adenovirus type 3 (ChAd3)-vectored vaccine. The results of three distinct clinical trials involving these candidates may soon pave the way for a licensed, safe and efficacious EBOV vaccine to help combat future epidemics.
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Affiliation(s)
- Gary Wong
- Guangdong Key Laboratory for Diagnosis and Treatment of Emerging Infectious Diseases, Shenzhen Key Laboratory of Pathogen and Immunity, Shenzhen Third People’s Hospital, Shenzhen, China
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Medical Microbiology, Winnipeg, MB, Canada
| | - Emelissa J. Mendoza
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Immunology, University of Manitoba, Winnipeg, MB, Canada
| | | | - George F. Gao
- Guangdong Key Laboratory for Diagnosis and Treatment of Emerging Infectious Diseases, Shenzhen Key Laboratory of Pathogen and Immunity, Shenzhen Third People’s Hospital, Shenzhen, China
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Gary P. Kobinger
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Medical Microbiology, Winnipeg, MB, Canada
- Department of Immunology, University of Manitoba, Winnipeg, MB, Canada
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
- Département de microbiologie-infectiologie et d’immunologie, Universite Laval, Quebec, QC, Canada
| | - Xiangguo Qiu
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Medical Microbiology, Winnipeg, MB, Canada
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40
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Kennedy SB, Bolay F, Kieh M, Grandits G, Badio M, Ballou R, Eckes R, Feinberg M, Follmann D, Grund B, Gupta S, Hensley L, Higgs E, Janosko K, Johnson M, Kateh F, Logue J, Marchand J, Monath T, Nason M, Nyenswah T, Roman F, Stavale E, Wolfson J, Neaton JD, Lane HC. Phase 2 Placebo-Controlled Trial of Two Vaccines to Prevent Ebola in Liberia. N Engl J Med 2017; 377:1438-1447. [PMID: 29020589 PMCID: PMC5705229 DOI: 10.1056/nejmoa1614067] [Citation(s) in RCA: 164] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The safety and efficacy of vaccines to prevent Ebola virus disease (EVD) were unknown when the incidence of EVD was peaking in Liberia. METHODS We initiated a randomized, placebo-controlled, phase 3 trial of the chimpanzee adenovirus 3 vaccine (ChAd3-EBO-Z) and the recombinant vesicular stomatitis virus vaccine (rVSV∆G-ZEBOV-GP) in Liberia. A phase 2 subtrial was embedded to evaluate safety and immunogenicity. Because the incidence of EVD declined in Liberia, the phase 2 component was expanded and the phase 3 component was eliminated. RESULTS A total of 1500 adults underwent randomization and were followed for 12 months. The median age of the participants was 30 years; 36.6% of the participants were women. During the week after the administration of vaccine or placebo, adverse events occurred significantly more often with the active vaccines than with placebo; these events included injection-site reactions (in 28.5% of the patients in the ChAd3-EBO-Z group and 30.9% of those in the rVSV∆G-ZEBOV-GP group, as compared with 6.8% of those in the placebo group), headache (in 25.1% and 31.9%, vs. 16.9%), muscle pain (in 22.3% and 26.9%, vs. 13.3%), feverishness (in 23.9% and 30.5%, vs. 9.0%), and fatigue (in 14.0% and 15.4%, vs. 8.8%) (P<0.001 for all comparisons); these differences were not seen at 1 month. Serious adverse events within 12 months after injection were seen in 40 participants (8.0%) in the ChAd3-EBO-Z group, in 47 (9.4%) in the rVSV∆G-ZEBOV-GP group, and in 59 (11.8%) in the placebo group. By 1 month, an antibody response developed in 70.8% of the participants in the ChAd3-EBO-Z group and in 83.7% of those in the rVSV∆G-ZEBOV-GP group, as compared with 2.8% of those in the placebo group (P<0.001 for both comparisons). At 12 months, antibody responses in participants in the ChAd3-EBO-Z group (63.5%) and in those in the rVSV∆G-ZEBOV-GP group (79.5%) remained significantly greater than in those in the placebo group (6.8%, P<0.001 for both comparisons). CONCLUSIONS A randomized, placebo-controlled phase 2 trial of two vaccines that was rapidly initiated and completed in Liberia showed the capability of conducting rigorous research during an outbreak. By 1 month after vaccination, the vaccines had elicited immune responses that were largely maintained through 12 months. (Funded by the National Institutes of Allergy and Infectious Diseases and the Liberian Ministry of Health; PREVAIL I ClinicalTrials.gov number, NCT02344407 .).
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Affiliation(s)
- Stephen B Kennedy
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Fatorma Bolay
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Mark Kieh
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Greg Grandits
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Moses Badio
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Ripley Ballou
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Risa Eckes
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Mark Feinberg
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Dean Follmann
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Birgit Grund
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Swati Gupta
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Lisa Hensley
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Elizabeth Higgs
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Krisztina Janosko
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Melvin Johnson
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Francis Kateh
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - James Logue
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Jonathan Marchand
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Thomas Monath
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Martha Nason
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Tolbert Nyenswah
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - François Roman
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Eric Stavale
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - Julian Wolfson
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - James D Neaton
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
| | - H Clifford Lane
- From the Liberian Ministry of Health, Monrovia, Liberia (S.B.K., F.B., M.K., M.B., M.J., F.K., T.N.); the University of Minnesota, Division of Biostatistics, Minneapolis (G.G., B.G., J.W., J.D.N.); GlaxoSmithKline, Rockville (R.B.), and National Institutes of Health (R.E., D.F., L.H., E.H., M.N., H.C.L.) and AbViro (E.S.), Bethesda - all in Maryland; Merck, Kenilworth, NJ (M.F., S.G.); Battelle Memorial Institute, Columbus, OH (K.J., J.L., J.M., E.S.); International AIDS Vaccine Initiative, New York (M.F., S.G., T.M.); and GlaxoSmithKline, Rixensart, Belgium (F.R.)
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Gsell PS, Camacho A, Kucharski AJ, Watson CH, Bagayoko A, Nadlaou SD, Dean NE, Diallo A, Diallo A, Honora DA, Doumbia M, Enwere G, Higgs ES, Mauget T, Mory D, Riveros X, Oumar FT, Fallah M, Toure A, Vicari AS, Longini IM, Edmunds WJ, Henao-Restrepo AM, Kieny MP, Kéïta S. Ring vaccination with rVSV-ZEBOV under expanded access in response to an outbreak of Ebola virus disease in Guinea, 2016: an operational and vaccine safety report. Lancet Infect Dis 2017; 17:1276-1284. [PMID: 29033032 PMCID: PMC5700805 DOI: 10.1016/s1473-3099(17)30541-8] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 08/29/2017] [Accepted: 09/05/2017] [Indexed: 11/19/2022]
Abstract
Background In March, 2016, a flare-up of Ebola virus disease was reported in Guinea, and in response ring vaccination with the unlicensed rVSV-ZEBOV vaccine was introduced under expanded access, the first time that an Ebola vaccine has been used in an outbreak setting outside a clinical trial. Here we describe the safety of rVSV-ZEBOV candidate vaccine and operational feasibility of ring vaccination as a reactive strategy in a resource-limited rural setting. Methods Approval for expanded access and compassionate use was rapidly sought and obtained from relevant authorities. Vaccination teams and frozen vaccine were flown to the outbreak settings. Rings of contacts and contacts of contacts were defined and eligible individuals, who had given informed consent, were vaccinated and followed up for 21 days under good clinical practice conditions. Findings Between March 17 and April 21, 2016, 1510 individuals were vaccinated in four rings in Guinea, including 303 individuals aged between 6 years and 17 years and 307 front-line workers. It took 10 days to vaccinate the first participant following the confirmation of the first case of Ebola virus disease. No secondary cases of Ebola virus disease occurred among the vaccinees. Adverse events following vaccination were reported in 47 (17%) 6–17 year olds (all mild) and 412 (36%) adults (individuals older than 18 years; 98% were mild). Children reported fewer arthralgia events than adults (one [<1%] of 303 children vs 81 [7%] of 1207 adults). No severe vaccine-related adverse events were reported. Interpretation The results show that a ring vaccination strategy can be rapidly and safely implemented at scale in response to Ebola virus disease outbreaks in rural settings. Funding WHO, Gavi, and the World Food Programme.
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Affiliation(s)
| | - Anton Camacho
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Adam J Kucharski
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Conall H Watson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Aminata Bagayoko
- World Health Organization Ebola Vaccine Trial and Compassionate Use Team, Conakry, Guinea
| | | | - Natalie E Dean
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Abdourahamane Diallo
- World Health Organization Ebola Vaccine Trial and Compassionate Use Team, Conakry, Guinea
| | - Abdourahmane Diallo
- World Health Organization Ebola Vaccine Trial and Compassionate Use Team, Conakry, Guinea
| | - Djidonou A Honora
- World Health Organization Ebola Vaccine Trial and Compassionate Use Team, Conakry, Guinea
| | - Moussa Doumbia
- Centre National d'Appui à la Lutte contre la Maladie, Bamako, Mali; World Health Organization Ebola Vaccine Trial and Compassionate Use Team, Conakry, Guinea
| | | | - Elizabeth S Higgs
- Division of Clinical Research, National Institute of Allergy and Infectious Disease, Bethesda, MD, USA
| | - Thomas Mauget
- World Health Organization Ebola Vaccine Trial and Compassionate Use Team, Conakry, Guinea
| | - Diakite Mory
- World Health Organization Ebola Vaccine Trial and Compassionate Use Team, Conakry, Guinea
| | | | - Fofana Thierno Oumar
- World Health Organization Ebola Vaccine Trial and Compassionate Use Team, Conakry, Guinea
| | - Mosoka Fallah
- National Public Health Institute of Health, Monrovia, Liberia
| | - Alhassane Toure
- World Health Organization Ebola Vaccine Trial and Compassionate Use Team, Conakry, Guinea
| | | | - Ira M Longini
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - W J Edmunds
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Sakoba Kéïta
- Ebola Response, Ministry of Health, Conakry, Guinea
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Agnandji ST, Fernandes JF, Bache EB, Obiang Mba RM, Brosnahan JS, Kabwende L, Pitzinger P, Staarink P, Massinga-Loembe M, Krähling V, Biedenkopf N, Fehling SK, Strecker T, Clark DJ, Staines HM, Hooper JW, Silvera P, Moorthy V, Kieny MP, Adegnika AA, Grobusch MP, Becker S, Ramharter M, Mordmüller B, Lell B, Krishna S, Kremsner PG. Safety and immunogenicity of rVSVΔG-ZEBOV-GP Ebola vaccine in adults and children in Lambaréné, Gabon: A phase I randomised trial. PLoS Med 2017; 14:e1002402. [PMID: 28985239 PMCID: PMC5630143 DOI: 10.1371/journal.pmed.1002402] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 09/07/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The rVSVΔG-ZEBOV-GP vaccine prevented Ebola virus disease when used at 2 × 107 plaque-forming units (PFU) in a trial in Guinea. This study provides further safety and immunogenicity data. METHODS AND FINDINGS A randomised, open-label phase I trial in Lambaréné, Gabon, studied 5 single intramuscular vaccine doses of 3 × 103, 3 × 104, 3 × 105, 3 × 106, or 2 × 107 PFU in 115 adults and a dose of 2 × 107 PFU in 20 adolescents and 20 children. The primary objective was safety and tolerability 28 days post-injection. Immunogenicity, viraemia, and shedding post-vaccination were evaluated as secondary objectives. In adults, mild-to-moderate adverse events were frequent, but there were no serious or severe adverse events related to vaccination. Before vaccination, Zaire Ebola virus (ZEBOV)-glycoprotein (GP)-specific and ZEBOV antibodies were detected in 11% and 27% of adults, respectively. In adults, 74%-100% of individuals who received a dose 3 × 104, 3 × 105, 3 × 106, or 2 × 107 PFU had a ≥4.0-fold increase in geometric mean titres (GMTs) of ZEBOV-GP-specific antibodies at day 28, reaching GMTs of 489 (95% CI: 264-908), 556 (95% CI: 280-1,101), 1,245 (95% CI: 899-1,724), and 1,503 (95% CI: 931-2,426), respectively. Twenty-two percent of adults had a ≥4-fold increase of ZEBOV antibodies, with GMTs at day 28 of 1,015 (647-1,591), 1,887 (1,154-3,085), 1,445 (1,013-2,062), and 3,958 (2,249-6,967) for the same doses, respectively. These antibodies persisted up to day 180 for doses ≥3 × 105 PFU. Adults with antibodies before vaccination had higher GMTs throughout. Neutralising antibodies were detected in more than 50% of participants at doses ≥3 × 105 PFU. As in adults, no serious or severe adverse events related to vaccine occurred in adolescents or children. At day 2, vaccine RNA titres were higher for adolescents and children than adults. At day 7, 78% of adolescents and 35% of children had recombinant vesicular stomatitis virus RNA detectable in saliva. The vaccine induced high GMTs of ZEBOV-GP-specific antibodies at day 28 in adolescents, 1,428 (95% CI: 1,025-1,989), and children, 1,620 (95% CI: 806-3,259), and in both groups antibody titres increased up to day 180. The absence of a control group, lack of stratification for baseline antibody status, and imbalances in male/female ratio are the main limitations of this study. CONCLUSIONS Our data confirm the acceptable safety and immunogenicity profile of the 2 × 107 PFU dose in adults and support consideration of lower doses for paediatric populations and those who request boosting. TRIAL REGISTRATION Pan African Clinical Trials Registry PACTR201411000919191.
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Affiliation(s)
- Selidji T. Agnandji
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- German Centre for Infection Research (DZIF) partner sites Universitätsklinikum Tübingen and Gießen-Marburg-Langen, Germany
| | - José F. Fernandes
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
| | | | | | - Jessica S. Brosnahan
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- German Centre for Infection Research (DZIF) partner sites Universitätsklinikum Tübingen and Gießen-Marburg-Langen, Germany
| | - Lumeka Kabwende
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Paul Pitzinger
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- Bernhard Nocht Hospital for Tropical Diseases, Bernhard Nocht Institute for Tropical Medicine and University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Pieter Staarink
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Verena Krähling
- German Centre for Infection Research (DZIF) partner sites Universitätsklinikum Tübingen and Gießen-Marburg-Langen, Germany
- Institute for Virology, Philipps-Universität Marburg, Marburg, Germany
| | - Nadine Biedenkopf
- Institute for Virology, Philipps-Universität Marburg, Marburg, Germany
| | | | - Thomas Strecker
- Institute for Virology, Philipps-Universität Marburg, Marburg, Germany
| | - David J. Clark
- Centre for Diagnostics and Antimicrobial Resistance, Institute for Infection & Immunity, St. George’s, University of London, London, United Kingdom
| | - Henry M. Staines
- Centre for Diagnostics and Antimicrobial Resistance, Institute for Infection & Immunity, St. George’s, University of London, London, United Kingdom
| | - Jay W. Hooper
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
| | - Peter Silvera
- US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
| | | | | | - Akim A. Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- German Centre for Infection Research (DZIF) partner sites Universitätsklinikum Tübingen and Gießen-Marburg-Langen, Germany
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Martin P. Grobusch
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - Stephan Becker
- German Centre for Infection Research (DZIF) partner sites Universitätsklinikum Tübingen and Gießen-Marburg-Langen, Germany
- Institute for Virology, Philipps-Universität Marburg, Marburg, Germany
| | - Michael Ramharter
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- Bernhard Nocht Hospital for Tropical Diseases, Bernhard Nocht Institute for Tropical Medicine and University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benjamin Mordmüller
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- German Centre for Infection Research (DZIF) partner sites Universitätsklinikum Tübingen and Gießen-Marburg-Langen, Germany
| | - Bertrand Lell
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- German Centre for Infection Research (DZIF) partner sites Universitätsklinikum Tübingen and Gießen-Marburg-Langen, Germany
| | | | - Sanjeev Krishna
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- Centre for Diagnostics and Antimicrobial Resistance, Institute for Infection & Immunity, St. George’s, University of London, London, United Kingdom
- St. George’s University Hospitals NHS Foundation Trust, London, United Kingdom
- * E-mail: (SK); (PGK)
| | - Peter G. Kremsner
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- German Centre for Infection Research (DZIF) partner sites Universitätsklinikum Tübingen and Gießen-Marburg-Langen, Germany
- * E-mail: (SK); (PGK)
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43
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Wu L, Zhang Z, Gao H, Li Y, Hou L, Yao H, Wu S, Liu J, Wang L, Zhai Y, Ou H, Lin M, Wu X, Liu J, Lang G, Xin Q, Wu G, Luo L, Liu P, Shentu J, Wu N, Sheng J, Qiu Y, Chen W, Li L. Open-label phase I clinical trial of Ad5-EBOV in Africans in China. Hum Vaccin Immunother 2017; 13. [PMID: 28708962 DOI: 10.1002/smll.201701815] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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: 05/31/2017] [Revised: 07/31/2017] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND To determine the safety and immunogenicity of a novel recombinant adenovirus type 5 vector based Ebola virus disease vaccine (Ad5-EBOV) in Africans in China. METHODS A phase 1, dose-escalation, open-label trial was conducted. 61 healthy Africans were sequentially enrolled, with 31 participants receiving one shot intramuscular injection and 30 participants receiving a double-shot regimen. Primary and secondary end points related to safety and immunogenicity were assessed within 28 d after vaccination. This study was registered with ClinicalTrials.gov (NCT02401373). RESULTS Ad5-EBOV is well tolerated and no adverse reaction of grade 3 or above was observed. 53 (86.89%) participants reported at least one adverse reaction within 28 d of vaccination. The most common reaction was fever and the mild pain at injection site, and there were no significant difference between these 2 groups. Ebola glycoprotein-specific antibodies appeared in all 61 participants and antibodies titers peaked after 28 d of vaccination. The geometric mean titres (GMTs) were similar between these 2 groups (1919.01 vs 1684.70 P = 0.5562). The glycoprotein-specific T-cell responses rapidly peaked after 14 d of vaccination and then decreased, however, the percentage of subjects with responses were much higher in the high-dose group (60.00% vs 9.68%, P = 0.0014). Pre-existing Ad5 neutralizing antibodies could significantly dampen the specific humoral immune response and cellular response to the vaccine. CONCLUSION The application of Ad5-EBOV demonstrated safe in Africans in China and a specific GP antibody and T-cell response could occur 14 d after the first immunization. This acceptable safety profile provides a reliable basis to proceed with trials in Africa.
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MESH Headings
- Adult
- Africa/epidemiology
- Antibodies, Neutralizing/blood
- Antibodies, Viral/blood
- China
- Ebola Vaccines/administration & dosage
- Ebola Vaccines/adverse effects
- Ebola Vaccines/immunology
- Ebolavirus/immunology
- Female
- Fever/ethnology
- Healthy Volunteers
- Hemorrhagic Fever, Ebola/epidemiology
- Hemorrhagic Fever, Ebola/ethnology
- Hemorrhagic Fever, Ebola/immunology
- Hemorrhagic Fever, Ebola/prevention & control
- Humans
- Immunity, Cellular
- Immunity, Humoral
- Immunogenicity, Vaccine
- Injections, Intramuscular
- Male
- Membrane Glycoproteins/immunology
- Middle Aged
- T-Lymphocytes/immunology
- Vaccination
- Young Adult
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Affiliation(s)
- Lihua Wu
- a The First Affiliated Hospital, College of Medicine, Zhejiang University , Xiacheng District, Hangzhou , Zhejiang , China
- b The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Xiacheng District, Hangzhou , Zhejiang , China
| | - Zhe Zhang
- c Beijing Institute of Biotechnology , Haidian District, Beijing , China
| | - Hainv Gao
- b The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Xiacheng District, Hangzhou , Zhejiang , China
- d Zhejiang University International Hospital , Xiacheng District, Hangzhou , Zhejiang , China
| | - Yuhua Li
- e National Institutes for Food and Drug Control , Chongwen District, Beijing , China
| | - Lihua Hou
- c Beijing Institute of Biotechnology , Haidian District, Beijing , China
| | - Hangping Yao
- a The First Affiliated Hospital, College of Medicine, Zhejiang University , Xiacheng District, Hangzhou , Zhejiang , China
- b The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Xiacheng District, Hangzhou , Zhejiang , China
| | - Shipo Wu
- c Beijing Institute of Biotechnology , Haidian District, Beijing , China
| | - Jian Liu
- a The First Affiliated Hospital, College of Medicine, Zhejiang University , Xiacheng District, Hangzhou , Zhejiang , China
- b The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Xiacheng District, Hangzhou , Zhejiang , China
| | - Ling Wang
- e National Institutes for Food and Drug Control , Chongwen District, Beijing , China
| | - You Zhai
- a The First Affiliated Hospital, College of Medicine, Zhejiang University , Xiacheng District, Hangzhou , Zhejiang , China
- b The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Xiacheng District, Hangzhou , Zhejiang , China
| | - Huilin Ou
- a The First Affiliated Hospital, College of Medicine, Zhejiang University , Xiacheng District, Hangzhou , Zhejiang , China
- b The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Xiacheng District, Hangzhou , Zhejiang , China
| | - Meihua Lin
- a The First Affiliated Hospital, College of Medicine, Zhejiang University , Xiacheng District, Hangzhou , Zhejiang , China
- b The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Xiacheng District, Hangzhou , Zhejiang , China
| | - Xiaoxin Wu
- b The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Xiacheng District, Hangzhou , Zhejiang , China
- d Zhejiang University International Hospital , Xiacheng District, Hangzhou , Zhejiang , China
| | - Jingjing Liu
- e National Institutes for Food and Drug Control , Chongwen District, Beijing , China
| | - Guanjing Lang
- a The First Affiliated Hospital, College of Medicine, Zhejiang University , Xiacheng District, Hangzhou , Zhejiang , China
- b The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Xiacheng District, Hangzhou , Zhejiang , China
| | - Qian Xin
- f The General Hospital of People's Liberation Army , Beijing , China
| | - Guolan Wu
- a The First Affiliated Hospital, College of Medicine, Zhejiang University , Xiacheng District, Hangzhou , Zhejiang , China
- b The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Xiacheng District, Hangzhou , Zhejiang , China
| | - Li Luo
- g Department of Epidemiology and Biostatistics , School of Public Health, Southeast University , Nanjing , Jiangsu , China
| | - Pei Liu
- g Department of Epidemiology and Biostatistics , School of Public Health, Southeast University , Nanjing , Jiangsu , China
| | - Jianzhong Shentu
- a The First Affiliated Hospital, College of Medicine, Zhejiang University , Xiacheng District, Hangzhou , Zhejiang , China
- b The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Xiacheng District, Hangzhou , Zhejiang , China
| | - Nanping Wu
- a The First Affiliated Hospital, College of Medicine, Zhejiang University , Xiacheng District, Hangzhou , Zhejiang , China
- b The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Xiacheng District, Hangzhou , Zhejiang , China
| | - Jifang Sheng
- a The First Affiliated Hospital, College of Medicine, Zhejiang University , Xiacheng District, Hangzhou , Zhejiang , China
- b The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Xiacheng District, Hangzhou , Zhejiang , China
| | - Yunqing Qiu
- a The First Affiliated Hospital, College of Medicine, Zhejiang University , Xiacheng District, Hangzhou , Zhejiang , China
- b The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Xiacheng District, Hangzhou , Zhejiang , China
| | - Wei Chen
- c Beijing Institute of Biotechnology , Haidian District, Beijing , China
| | - Lanjuan Li
- a The First Affiliated Hospital, College of Medicine, Zhejiang University , Xiacheng District, Hangzhou , Zhejiang , China
- b The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases , Xiacheng District, Hangzhou , Zhejiang , China
- d Zhejiang University International Hospital , Xiacheng District, Hangzhou , Zhejiang , China
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44
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Abstract
The glycoprotein (GP) of ebolaviruses participates in a critical membrane fusion process to establish infection of a cell and therefore, represents an important target of both vaccines and antivirals. The latest reports on pan-ebolavirus monoclonal antibodies in small animal models may offer promising outcomes and insight into how best to target the GP in vaccine and antiviral discovery.
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Affiliation(s)
- Chad E Mire
- Galveston National Laboratory, Galveston, TX, USA; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA.
| | - Thomas W Geisbert
- Galveston National Laboratory, Galveston, TX, USA; Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA.
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45
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Zhao X, Howell KA, He S, Brannan JM, Wec AZ, Davidson E, Turner HL, Chiang CI, Lei L, Fels JM, Vu H, Shulenin S, Turonis AN, Kuehne AI, Liu G, Ta M, Wang Y, Sundling C, Xiao Y, Spence JS, Doranz BJ, Holtsberg FW, Ward AB, Chandran K, Dye JM, Qiu X, Li Y, Aman MJ. Immunization-Elicited Broadly Protective Antibody Reveals Ebolavirus Fusion Loop as a Site of Vulnerability. Cell 2017; 169:891-904.e15. [PMID: 28525756 PMCID: PMC5803079 DOI: 10.1016/j.cell.2017.04.038] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/20/2017] [Accepted: 04/27/2017] [Indexed: 12/30/2022]
Abstract
While neutralizing antibodies are highly effective against ebolavirus infections, current experimental ebolavirus vaccines primarily elicit species-specific antibody responses. Here, we describe an immunization-elicited macaque antibody (CA45) that clamps the internal fusion loop with the N terminus of the ebolavirus glycoproteins (GPs) and potently neutralizes Ebola, Sudan, Bundibugyo, and Reston viruses. CA45, alone or in combination with an antibody that blocks receptor binding, provided full protection against all pathogenic ebolaviruses in mice, guinea pigs, and ferrets. Analysis of memory B cells from the immunized macaque suggests that elicitation of broadly neutralizing antibodies (bNAbs) for ebolaviruses is possible but difficult, potentially due to the rarity of bNAb clones and their precursors. Unexpectedly, germline-reverted CA45, while exhibiting negligible binding to full-length GP, bound a proteolytically remodeled GP with picomolar affinity, suggesting that engineered ebolavirus vaccines could trigger rare bNAb precursors more robustly. These findings have important implications for developing pan-ebolavirus vaccine and immunotherapeutic cocktails.
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MESH Headings
- Amino Acid Sequence
- Animals
- Antibodies, Neutralizing/chemistry
- Antibodies, Neutralizing/immunology
- Antibodies, Neutralizing/isolation & purification
- Antibodies, Viral/chemistry
- Antibodies, Viral/immunology
- Antibodies, Viral/isolation & purification
- Complementarity Determining Regions
- Cross Reactions
- Ebola Vaccines/immunology
- Ebolavirus/immunology
- Epitope Mapping
- Epitopes, B-Lymphocyte/immunology
- Female
- Ferrets
- Guinea Pigs
- Hemorrhagic Fever, Ebola/immunology
- Immunoglobulin Fab Fragments/ultrastructure
- Macaca fascicularis
- Male
- Mice
- Mice, Inbred BALB C
- Models, Molecular
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Affiliation(s)
- Xuelian Zhao
- Institute for Bioscience and Biotechnology Research, University of Maryland, Rockville, MD 20878, USA
| | | | - Shihua He
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E 3R2, Canada; Deparment of Medical Microbiology, University of Manitoba, MB R3E 0J9, Canada
| | - Jennifer M Brannan
- US Army Medical Research Institute of Infectious Diseases, Frederick, MD 21701, USA
| | - Anna Z Wec
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | | | - Hannah L Turner
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Chi-I Chiang
- Institute for Bioscience and Biotechnology Research, University of Maryland, Rockville, MD 20878, USA
| | - Lin Lei
- Institute for Bioscience and Biotechnology Research, University of Maryland, Rockville, MD 20878, USA
| | - J Maximilian Fels
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Hong Vu
- Integrated BioTherapeutics, Rockville, MD 20850, USA
| | | | | | - Ana I Kuehne
- US Army Medical Research Institute of Infectious Diseases, Frederick, MD 21701, USA
| | - Guodong Liu
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E 3R2, Canada; Deparment of Medical Microbiology, University of Manitoba, MB R3E 0J9, Canada
| | - Mi Ta
- Integral Molecular, Philadelphia, PA 19104, USA
| | - Yimeng Wang
- Institute for Bioscience and Biotechnology Research, University of Maryland, Rockville, MD 20878, USA
| | - Christopher Sundling
- Immunology Division, Garvan Institute of Medical Research, Darlinghurst, New South Wales 2010, Australia
| | - Yongli Xiao
- Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892, USA
| | - Jennifer S Spence
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | | | | | - Andrew B Ward
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Kartik Chandran
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - John M Dye
- US Army Medical Research Institute of Infectious Diseases, Frederick, MD 21701, USA
| | - Xiangguo Qiu
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E 3R2, Canada; Deparment of Medical Microbiology, University of Manitoba, MB R3E 0J9, Canada
| | - Yuxing Li
- Institute for Bioscience and Biotechnology Research, University of Maryland, Rockville, MD 20878, USA; Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
| | - M Javad Aman
- Integrated BioTherapeutics, Rockville, MD 20850, USA.
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46
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Winslow RL, Milligan ID, Voysey M, Luhn K, Shukarev G, Douoguih M, Snape MD. Immune Responses to Novel Adenovirus Type 26 and Modified Vaccinia Virus Ankara-Vectored Ebola Vaccines at 1 Year. JAMA 2017; 317:1075-1077. [PMID: 28291882 DOI: 10.1001/jama.2016.20644] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Rebecca L Winslow
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Iain D Milligan
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Merryn Voysey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | | | | | - Matthew D Snape
- Department of Paediatrics, University of Oxford, Oxford, United Kingdom
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47
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Ledgerwood JE, DeZure AD, Stanley DA, Coates EE, Novik L, Enama ME, Berkowitz NM, Hu Z, Joshi G, Ploquin A, Sitar S, Gordon IJ, Plummer SA, Holman LA, Hendel CS, Yamshchikov G, Roman F, Nicosia A, Colloca S, Cortese R, Bailer RT, Schwartz RM, Roederer M, Mascola JR, Koup RA, Sullivan NJ, Graham BS. Chimpanzee Adenovirus Vector Ebola Vaccine. N Engl J Med 2017; 376:928-938. [PMID: 25426834 DOI: 10.1056/nejmoa1410863] [Citation(s) in RCA: 201] [Impact Index Per Article: 28.7] [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 The unprecedented 2014 epidemic of Ebola virus disease (EVD) prompted an international response to accelerate the availability of a preventive vaccine. A replication-defective recombinant chimpanzee adenovirus type 3-vectored ebolavirus vaccine (cAd3-EBO), encoding the glycoprotein from Zaire and Sudan species, that offers protection in the nonhuman primate model, was rapidly advanced into phase 1 clinical evaluation. METHODS We conducted a phase 1, dose-escalation, open-label trial of cAd3-EBO. Twenty healthy adults, in sequentially enrolled groups of 10 each, received vaccination intramuscularly in doses of 2×1010 particle units or 2×1011 particle units. Primary and secondary end points related to safety and immunogenicity were assessed throughout the first 8 weeks after vaccination; in addition, longer-term vaccine durability was assessed at 48 weeks after vaccination. RESULTS In this small study, no safety concerns were identified; however, transient fever developed within 1 day after vaccination in two participants who had received the 2×1011 particle-unit dose. Glycoprotein-specific antibodies were induced in all 20 participants; the titers were of greater magnitude in the group that received the 2×1011 particle-unit dose than in the group that received the 2×1010 particle-unit dose (geometric mean titer against the Zaire antigen at week 4, 2037 vs. 331; P=0.001). Glycoprotein-specific T-cell responses were more frequent among those who received the 2×1011 particle-unit dose than among those who received the 2×1010 particle-unit dose, with a CD4 response in 10 of 10 participants versus 3 of 10 participants (P=0.004) and a CD8 response in 7 of 10 participants versus 2 of 10 participants (P=0.07) at week 4. Assessment of the durability of the antibody response showed that titers remained high at week 48, with the highest titers in those who received the 2×1011 particle-unit dose. CONCLUSIONS Reactogenicity and immune responses to cAd3-EBO vaccine were dose-dependent. At the 2×1011 particle-unit dose, glycoprotein Zaire-specific antibody responses were in the range reported to be associated with vaccine-induced protective immunity in challenge studies involving nonhuman primates, and responses were sustained to week 48. Phase 2 studies and efficacy trials assessing cAd3-EBO are in progress. (Funded by the Intramural Research Program of the National Institutes of Health; VRC 207 ClinicalTrials.gov number, NCT02231866 .).
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Affiliation(s)
- Julie E Ledgerwood
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Adam D DeZure
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Daphne A Stanley
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Emily E Coates
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Laura Novik
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Mary E Enama
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Nina M Berkowitz
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Zonghui Hu
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Gyan Joshi
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Aurélie Ploquin
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Sandra Sitar
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Ingelise J Gordon
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Sarah A Plummer
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - LaSonji A Holman
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Cynthia S Hendel
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Galina Yamshchikov
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Francois Roman
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Alfredo Nicosia
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Stefano Colloca
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Riccardo Cortese
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Robert T Bailer
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Richard M Schwartz
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Mario Roederer
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - John R Mascola
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Richard A Koup
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Nancy J Sullivan
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
| | - Barney S Graham
- From the Vaccine Research Center (J.E.L., A.D.D., D.A.S., E.E.C., L.N., M.E.E., N.M.B., A.P., S.S., I.J.G., S.A.P., L.A.H., C.S.H., G.Y., R.T.B., R.M.S., M.R., J.R.M., R.A.K., N.J.S., B.S.G.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H., G.J.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD; GlaxoSmithKline Vaccines, Rixensart, Belgium (F.R.); ReiThera, Rome (A.N., S.C.), and CEINGE and the Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples (A.N.) - both in Italy; and Keires, Basel, Switzerland (R.C.)
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Affiliation(s)
- Daniel G Bausch
- From the Tulane University Health Sciences Center, New Orleans; and the U.S. Naval Medical Research Unit No. 6, Lima, Peru
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Dayer JA, Siegrist CA, Huttner A. Volunteer feedback and perceptions after participation in a phase I, first-in-human Ebola vaccine trial: An anonymous survey. PLoS One 2017; 12:e0173148. [PMID: 28273130 PMCID: PMC5342214 DOI: 10.1371/journal.pone.0173148] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 02/15/2017] [Indexed: 11/30/2022] Open
Abstract
The continued participation of volunteers in clinical trials is crucial to advances in healthcare. Few data are available regarding the satisfaction and impressions of healthy volunteers after participation in phase I trials, many of which lead to unexpected adverse events. We report feedback from over 100 adult volunteers who took part in a first-in-human trial conducted in a high-income country testing an experimental Ebola vaccine causing significant reactogenicity, as well as unexpected arthritis in one fifth of participants. The anonymous, internet-based satisfaction survey was sent by email to all participants upon their completion of this one-year trial; it asked 24 questions concerning volunteers' motivations, impressions of the trial experience, and overall satisfaction. Answers were summarized using descriptive statistics. Of the 115 trial participants, 103 (90%) filled out the survey. Fifty-five respondents (53%) were male. Thirty-five respondents (34%) were healthcare workers, many of whom would deploy to Ebola-affected countries. All respondents cited scientific advancement as their chief motivation for participation, while 100/103 (97%) and 61/103 (59%) reported additional "humanitarian reasons" and potential protection from Ebolavirus, respectively. Although investigators had documented adverse events in 97% of trial participants, only 74 of 103 respondents (72%) recalled experiencing an adverse event. All reported an overall positive experience, and 93/103 (90%) a willingness to participate in future trials. Given the high level of satisfaction, no significant associations could be detected between trial experiences and satisfaction, even among respondents reporting adverse events lasting weeks or months. Despite considerable reactogenicity and unexpected vaccine-related arthritis, all survey respondents reported overall satisfaction. While this trial's context was unique, the positive feedback is likely due at least in part to the intense communication of trial information to participants, which included both general findings and personalized results.
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Affiliation(s)
- Julie-Anne Dayer
- Division of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Claire-Anne Siegrist
- Center for Vaccinology, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
- WHO Collaborating Centre for Vaccine Immunology, Faculty of Medicine, Geneva, Switzerland
| | - Angela Huttner
- Division of Infectious Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
- Center for Vaccinology, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
- Infection Control Program, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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50
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Affiliation(s)
- Martin P Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, The Netherlands; Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Lion Heart Medical Research Unit, Yele, Sierra Leone.
| | - Abraham Goorhuis
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Division of Internal Medicine, Academic Medical Center, University of Amsterdam, 1100 DE Amsterdam, The Netherlands; Lion Heart Medical Research Unit, Yele, Sierra Leone
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