1
|
Nham E, Jang AY, Hyun H, Yoon JG, Noh JY, Cheong HJ, Kim WJ, Ahn KB, Ji HJ, Seo HS, Bae JY, Park MS, Song JY. Age-Stratified Seroprevalence of Respiratory Syncytial Virus: Analysis Using Prefusion F and G Protein Antibodies. Vaccines (Basel) 2024; 12:513. [PMID: 38793764 PMCID: PMC11126071 DOI: 10.3390/vaccines12050513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/04/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
This is a cross-sectional serosurveillance study for RSV. Between June and September of 2021, a total of 150 sera were collected from 30 individuals in each age group (<5, 5-18, 19-49, 50-64, and ≥65 years). Seroprevalence was estimated using enzyme-linked immunosorbent assays targeting two stabilized prefusion F (preF; DS-Cav1 and SC-TM) and G proteins. The overall seroprevalence was low in young children and older adults, despite them having a higher risk of severe RSV infection. There was a remarkable difference in age-stratified seroprevalence rates between anti-preF and anti-G protein antibodies. Given the high disease burden and low seroprevalence in both infants and old adults, RSV vaccination would be crucial for pregnant women and people aged over 60 years.
Collapse
Affiliation(s)
- Eliel Nham
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Republic of Korea; (E.N.); (A.-Y.J.); (H.H.); (J.G.Y.); (J.Y.N.); (H.J.C.); (W.J.K.)
- Vaccine Innovation Center-KU Medicine (VIC-K), Seoul 02841, Republic of Korea; (J.-Y.B.); (M.-S.P.)
| | - A-Yeung Jang
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Republic of Korea; (E.N.); (A.-Y.J.); (H.H.); (J.G.Y.); (J.Y.N.); (H.J.C.); (W.J.K.)
- Vaccine Innovation Center-KU Medicine (VIC-K), Seoul 02841, Republic of Korea; (J.-Y.B.); (M.-S.P.)
| | - Hakjun Hyun
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Republic of Korea; (E.N.); (A.-Y.J.); (H.H.); (J.G.Y.); (J.Y.N.); (H.J.C.); (W.J.K.)
- Vaccine Innovation Center-KU Medicine (VIC-K), Seoul 02841, Republic of Korea; (J.-Y.B.); (M.-S.P.)
| | - Jin Gu Yoon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Republic of Korea; (E.N.); (A.-Y.J.); (H.H.); (J.G.Y.); (J.Y.N.); (H.J.C.); (W.J.K.)
- Vaccine Innovation Center-KU Medicine (VIC-K), Seoul 02841, Republic of Korea; (J.-Y.B.); (M.-S.P.)
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Republic of Korea; (E.N.); (A.-Y.J.); (H.H.); (J.G.Y.); (J.Y.N.); (H.J.C.); (W.J.K.)
- Vaccine Innovation Center-KU Medicine (VIC-K), Seoul 02841, Republic of Korea; (J.-Y.B.); (M.-S.P.)
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Republic of Korea; (E.N.); (A.-Y.J.); (H.H.); (J.G.Y.); (J.Y.N.); (H.J.C.); (W.J.K.)
- Vaccine Innovation Center-KU Medicine (VIC-K), Seoul 02841, Republic of Korea; (J.-Y.B.); (M.-S.P.)
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Republic of Korea; (E.N.); (A.-Y.J.); (H.H.); (J.G.Y.); (J.Y.N.); (H.J.C.); (W.J.K.)
- Vaccine Innovation Center-KU Medicine (VIC-K), Seoul 02841, Republic of Korea; (J.-Y.B.); (M.-S.P.)
| | - Ki Bum Ahn
- Korea Atomic Energy Research Institute, Jeongeup 56212, Republic of Korea; (K.B.A.); (H.J.J.); (H.S.S.)
| | - Hyun Jung Ji
- Korea Atomic Energy Research Institute, Jeongeup 56212, Republic of Korea; (K.B.A.); (H.J.J.); (H.S.S.)
| | - Ho Seong Seo
- Korea Atomic Energy Research Institute, Jeongeup 56212, Republic of Korea; (K.B.A.); (H.J.J.); (H.S.S.)
| | - Joon-Yong Bae
- Vaccine Innovation Center-KU Medicine (VIC-K), Seoul 02841, Republic of Korea; (J.-Y.B.); (M.-S.P.)
- Department of Microbiology, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Man-Seong Park
- Vaccine Innovation Center-KU Medicine (VIC-K), Seoul 02841, Republic of Korea; (J.-Y.B.); (M.-S.P.)
- Department of Microbiology, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Republic of Korea; (E.N.); (A.-Y.J.); (H.H.); (J.G.Y.); (J.Y.N.); (H.J.C.); (W.J.K.)
- Vaccine Innovation Center-KU Medicine (VIC-K), Seoul 02841, Republic of Korea; (J.-Y.B.); (M.-S.P.)
| |
Collapse
|
2
|
Virus reduction neutralization test and LI-COR microneutralization assay bridging and WHO international standard calibration studies for respiratory syncytial virus. Bioanalysis 2022; 14:1067-1079. [PMID: 36125040 DOI: 10.4155/bio-2022-0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Respiratory syncytial virus (RSV) vaccine is an unmet medical need. The virus reduction neutralization test (VRNT) was developed to replace the LI-COR microneutralization assay to measure RSV neutralization titers. Methods: A bridging study using selected V171 phase I samples and calibration studies using the WHO international standard antiserum to RSV were performed to compare VRNT and LI-COR. Results: From the bridging study, we showed good concordance between VRNT and LI-COR titers, and similar post-/pre-vaccination titer ratios. From the calibration studies, we can convert VRNT and LI-COR titers into similar IU/ml. Conclusion: The VRNT and LI-COR microneutralization assay correlate well and the titers can be standardized as similar IU/ml, enabling direct comparison of titers from different assays.
Collapse
|
3
|
Boukhvalova MS, Mbaye A, Kovtun S, Yim KC, Konstantinova T, Getachew T, Khurana S, Falsey AR, Blanco JCG. Improving ability of RSV microneutralization assay to detect G-specific and cross-reactive neutralizing antibodies through immortalized cell line selection. Vaccine 2018; 36:4657-4662. [PMID: 29960801 DOI: 10.1016/j.vaccine.2018.06.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/08/2018] [Accepted: 06/16/2018] [Indexed: 11/29/2022]
Abstract
Respiratory syncytial virus (RSV) is a significant cause of bronchiolitis and pneumonia. Protection against RSV is associated with neutralizing antibodies against the fusion (F) and attachment (G) glycoproteins. Several RSV vaccine candidates are in development, but their immunogenicity is hard to compare due to the little-understood differences between multiple RSV neutralizing antibody assays used. Existing assays utilize primarily Vero or HEp-2 cells, but their ability to detect G-neutralizing antibodies or antibodies against specific RSV strains is unclear. In this work, we developed an RSV microneutralization assay (MNA) using unmodified RSV and immortalized cell line derived from human airway epithelial cells (A549). Performance of A549-, HEp-2- and Vero-based MNA was compared under the same assay conditions (fixed amount of virus and cells) with regards to detection of neutralizing antibodies against RSV A or B viruses, G-reactive neutralizing antibodies, and effect of complement. Our results indicate that A549 cells yield the highest MNA titers, particularly in the RSV A/A2 MNA, are least susceptible to complement-enhancing effect of neutralizing titer readout and are superior to Vero or HEp-2 MNA at recognizing G-reactive neutralizing antibodies when no complement is used. Vero cells, however, can be more consistent at recognizing neutralizing antibodies against multiple RSV strains. The choice of substrate cells thus affects the outcome of MNA, as some immortalized cells better support detection of broader range of neutralizing antibodies, while others facilitate detection of G-targeting neutralizing antibodies, a long-thought prerogative of primary airway epithelial cells.
Collapse
Affiliation(s)
- M S Boukhvalova
- Sigmovir Biosystems, Inc, 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA.
| | - A Mbaye
- Sigmovir Biosystems, Inc, 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA
| | - S Kovtun
- Sigmovir Biosystems, Inc, 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA
| | - K C Yim
- Sigmovir Biosystems, Inc, 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA
| | - T Konstantinova
- Sigmovir Biosystems, Inc, 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA
| | - T Getachew
- Sigmovir Biosystems, Inc, 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA
| | - S Khurana
- Division of Viral Products, Center for Biologics Evaluation and Research (CBER), Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - A R Falsey
- University of Rochester Medical Center, Rochester General Hospital, 1425 Portland Avenue, Infectious Diseases Unit, Rochester, NY 14621, USA
| | - J C G Blanco
- Sigmovir Biosystems, Inc, 9610 Medical Center Drive, Suite 100, Rockville, MD 20850, USA
| |
Collapse
|
4
|
Characterization of Pre-F-GCN4t, a Modified Human Respiratory Syncytial Virus Fusion Protein Stabilized in a Noncleaved Prefusion Conformation. J Virol 2017; 91:JVI.02437-16. [PMID: 28404847 DOI: 10.1128/jvi.02437-16] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 04/04/2017] [Indexed: 12/20/2022] Open
Abstract
The human respiratory syncytial virus (hRSV) fusion (F) protein is considered a major target of the neutralizing antibody response to hRSV. This glycoprotein undergoes a major structural shift from the prefusion (pre-F) to the postfusion (post-F) state at the time of virus-host cell membrane fusion. Recent evidences suggest that the pre-F state is a superior target for neutralizing antibodies compared to the post-F state. Therefore, for vaccine purposes, we have designed and characterized a recombinant hRSV F protein, called Pre-F-GCN4t, stabilized in a pre-F conformation. To show that Pre-F-GCN4t does not switch to a post-F conformation, it was compared with a recombinant post-F molecule, called Post-F-XC. Pre-F-GCN4t was glycosylated and trimeric and displayed a conformational stability different from that of Post-F-XC, as shown by chemical denaturation. Electron microscopy analysis suggested that Pre-F-GCN4t adopts a lollipop-like structure. In contrast, Post-F-XC had a typical elongated conical shape. Hydrogen/deuterium exchange mass spectrometry demonstrated that the two molecules had common rigid folding core and dynamic regions and provided structural insight for their biophysical and biochemical properties and reactivity. Pre-F-GCN4t was shown to deplete hRSV-neutralizing antibodies from human serum more efficiently than Post-F-XC. Importantly, Pre-F-GCN4t was also shown to bind D25, a highly potent monoclonal antibody specific for the pre-F conformation. In conclusion, this construct presents several pre-F characteristics, does not switch to the post-F conformation, and presents antigenic features required for a protective neutralizing antibody response. Therefore, Pre-F-GCN4t can be considered a promising candidate vaccine antigen.IMPORTANCE Human respiratory syncytial virus (RSV) is a global leading cause of infant mortality and adult morbidity. The development of a safe and efficacious RSV vaccine remains an important goal. The RSV class I fusion (F) glycoprotein is considered one of the most promising vaccine candidates, and recent evidences suggest that the prefusion (pre-F) state is a superior target for neutralizing antibodies. Our study presents the physicochemical characterization of Pre-F-GCN4t, a molecule designed to be stabilized in the pre-F conformation. To confirm its pre-F conformation, Pre-F-GCN4t was analyzed in parallel with Post-F-XC, a molecule in the post-F conformation. Our results show that Pre-F-GCN4t presents characteristics of a stabilized pre-F conformation and support its use as an RSV vaccine antigen. Such an antigen may represent a significant advance in the development of an RSV vaccine.
Collapse
|
5
|
Rubin FA, Koso-Thomas M, Isaacs MB, Piper J, Read J, Nesin M. Maternal immunization efforts of the National Institutes of Health. Vaccine 2015; 33:6380-7. [PMID: 26458798 DOI: 10.1016/j.vaccine.2015.08.097] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 08/11/2015] [Accepted: 08/24/2015] [Indexed: 11/26/2022]
Abstract
Over the last 35 years, efforts at the National Institutes of Health (NIH) to protect mothers and their infants against infectious diseases have involved a bench-to-bedside approach. Basic and translational research that provided a foundation for clinical trials of vaccines in pregnancy include natural history and vaccine antigen identification studies. Development of laboratory assays and reagents have been funded by NIAID; these are critical for the advancement of vaccine candidates through the preclinical and clinical steps along the maternal immunization research pathway to support vaccine efficacy. Animal models of maternal immunization have been developed to evaluate efficacy of vaccine candidates. Clinical studies required development of maternal immunization protocols to address specific pregnancy related issues, for enrollment and safety assessment of mothers and their infants. NIH has organized and participated in meetings, workshops and other collaborative efforts with partners have advanced maternal immunization efforts. Partners have included many institutes and offices at NIH as well as other Department of Health and Human Services agencies and offices (Food and Drug Administration, Centers for Disease Control and Prevention, National Vaccine Program Office), World Health Organization, academic investigators, Biotech and pharmaceutical companies, and nonprofit organizations such as the Bill and Melinda Gates Foundation. These research and development partnership are essential for advancing maternal immunization. Continued efforts are needed to promote maternal immunization to protect pregnant women and their infants against vaccine-preventable infectious disease, especially in resource-limited settings where the burden of infections is high.
Collapse
Affiliation(s)
| | | | | | | | | | - Mirjana Nesin
- NIH/NIAID/DMID, 5601 Fischers Lane, Office: 7G38, Rockville, MD 20852, United States.
| |
Collapse
|
6
|
Schepens B, Sedeyn K, Vande Ginste L, De Baets S, Schotsaert M, Roose K, Houspie L, Van Ranst M, Gilbert B, van Rooijen N, Fiers W, Piedra P, Saelens X. Protection and mechanism of action of a novel human respiratory syncytial virus vaccine candidate based on the extracellular domain of small hydrophobic protein. EMBO Mol Med 2015; 6:1436-54. [PMID: 25298406 PMCID: PMC4237470 DOI: 10.15252/emmm.201404005] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Infections with human respiratory syncytial virus (HRSV) occur globally in all age groups and can have devastating consequences in young infants. We demonstrate that a vaccine based on the extracellular domain (SHe) of the small hydrophobic (SH) protein of HRSV, reduced viral replication in challenged laboratory mice and in cotton rats. We show that this suppression of viral replication can be transferred by serum and depends on a functional IgG receptor compartment with a major contribution of FcγRI and FcγRIII. Using a conditional cell depletion method, we provide evidence that alveolar macrophages are involved in the protection by SHe-specific antibodies. HRSV-infected cells abundantly express SH on the cell surface and are likely the prime target of the humoral immune response elicited by SHe-based vaccination. Finally, natural infection of humans and experimental infection of mice or cotton rats does not induce a strong immune response against HRSV SHe. Using SHe as a vaccine antigen induces immune protection against HRSV by a mechanism that differs from the natural immune response and from other HRSV vaccination strategies explored to date. Hence, HRSV vaccine candidates that aim at inducing protective neutralizing antibodies or T-cell responses could be complemented with a SHe-based antigen to further improve immune protection.
Collapse
Affiliation(s)
- Bert Schepens
- VIB Inflammation Research Center, Ghent, Belgium Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Koen Sedeyn
- VIB Inflammation Research Center, Ghent, Belgium Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Liesbeth Vande Ginste
- VIB Inflammation Research Center, Ghent, Belgium Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Sarah De Baets
- VIB Inflammation Research Center, Ghent, Belgium Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Michael Schotsaert
- VIB Inflammation Research Center, Ghent, Belgium Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Kenny Roose
- VIB Inflammation Research Center, Ghent, Belgium Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Lieselot Houspie
- Laboratory of Clinical Virology, Rega Institute for Medical Research KU Leuven, Leuven, Belgium
| | - Marc Van Ranst
- Laboratory of Clinical Virology, Rega Institute for Medical Research KU Leuven, Leuven, Belgium
| | - Brian Gilbert
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Nico van Rooijen
- Department of Molecular Cell Biology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Walter Fiers
- VIB Inflammation Research Center, Ghent, Belgium Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Pedro Piedra
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Xavier Saelens
- VIB Inflammation Research Center, Ghent, Belgium Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| |
Collapse
|
7
|
Habibi MS, Jozwik A, Makris S, Dunning J, Paras A, DeVincenzo JP, de Haan CAM, Wrammert J, Openshaw PJM, Chiu C. Impaired Antibody-mediated Protection and Defective IgA B-Cell Memory in Experimental Infection of Adults with Respiratory Syncytial Virus. Am J Respir Crit Care Med 2015; 191:1040-9. [PMID: 25730467 PMCID: PMC4435460 DOI: 10.1164/rccm.201412-2256oc] [Citation(s) in RCA: 191] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 02/25/2015] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Despite relative antigenic stability, respiratory syncytial virus (RSV) reinfects throughout life. After more than 40 years of research, no effective human vaccine exists and correlates of protection remain poorly defined. Most current vaccine candidates seek to induce high levels of RSV-specific serum neutralizing antibodies, which are associated with reduced RSV-related hospitalization rates in observational studies but may not actually prevent infection. OBJECTIVES To characterize correlates of protection from infection and the generation of RSV-specific humoral memory to promote effective vaccine development. METHODS We inoculated 61 healthy adults with live RSV and studied protection from infection by serum and mucosal antibody. We analyzed RSV-specific peripheral blood plasmablast and memory B-cell frequencies and antibody longevity. MEASUREMENTS AND MAIN RESULTS Despite moderately high levels of preexisting serum antibody, 34 (56%) became infected, of whom 23 (68%) developed symptomatic colds. Prior RSV-specific nasal IgA correlated significantly more strongly with protection from polymerase chain reaction-confirmed infection than serum neutralizing antibody. Increases in virus-specific antibody titers were variable and transient in infected subjects but correlated with plasmablasts that peaked around Day 10. During convalescence, only IgG (and no IgA) RSV-specific memory B cells were detectable in peripheral blood. This contrasted with natural influenza infection, in which virus-specific IgA memory B cells were readily recovered. CONCLUSIONS This observed specific defect in IgA memory may partly explain the ability of RSV to cause recurrent symptomatic infections. If so, vaccines able to induce durable RSV-specific IgA responses may be more protective than those generating systemic antibody alone.
Collapse
Affiliation(s)
| | - Agnieszka Jozwik
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Spyridon Makris
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Jake Dunning
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Allan Paras
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - John P. DeVincenzo
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, Tennessee
| | - Cornelis A. M. de Haan
- Virology Division, Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands; and
| | - Jens Wrammert
- Department of Pediatric Infectious Disease and
- Department of Hematology and Oncology, Emory University School of Medicine, Atlanta, Georgia
| | - Peter J. M. Openshaw
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Christopher Chiu
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| |
Collapse
|
8
|
Malkin E, Yogev R, Abughali N, Sliman J, Wang CK, Zuo F, Yang CF, Eickhoff M, Esser MT, Tang RS, Dubovsky F. Safety and immunogenicity of a live attenuated RSV vaccine in healthy RSV-seronegative children 5 to 24 months of age. PLoS One 2013; 8:e77104. [PMID: 24204744 PMCID: PMC3812203 DOI: 10.1371/journal.pone.0077104] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 08/28/2013] [Indexed: 11/18/2022] Open
Abstract
UNLABELLED Despite substantial morbidity associated with respiratory syncytial virus (RSV) infection, there is no licensed vaccine. MEDI-559 is a live attenuated intranasal vaccine candidate being developed for prevention of lower respiratory illness due to RSV in young children. This randomized, placebo-controlled study evaluated safety of MEDI-559 in healthy, RSV-seronegative children. MEDI-559 or placebo was administered on 3 occasions, 2 months apart. Primary safety was based on solicited symptoms (SSs) and adverse events (AEs) collected for 28 days after each dose. Nasal wash samples were collected 3 times after each dose (days 7-10, 12-18, 28-34) and at sick visits. Serum was collected for measuring antibody immune responses to RSV prior to first vaccination and 28 days post final dose. Long-term safety was monitored for 365 days from first dose. SSs were mild and frequent (MEDI-559 84%; placebo 91%); most common SSs were runny/stuffy nose, cough, and irritability/fussiness. AEs occurred in 67% MEDI-559 and 57% placebo recipients: most common AE was upper respiratory tract infection (MEDI-559 35%; placebo 23%). Higher incidence of medically attended lower respiratory illness within 28 days after dosing occurred in the MEDI-559 arm compared to placebo (none associated with vaccine virus shedding). There was no evidence of enhanced RSV disease. Vaccine virus was detected only in MEDI-559 recipients; shedding occurred in 56%subjects, primarily post dose 1. A functional immune response was observed in 59% and 9% MEDI-559 and placebo recipients, respectively, by an RSV microneutralization assay. Vaccine take, assessed by proportion that shed vaccine-type virus or had a seroresponse against RSV, was seen in 95% MEDI-559 subjects. MEDI-559 is therefore biologically active and immunogenic in this seronegative pediatric population. Although the frequency of SSs and AEs was not considered clinically significant, the increase in medically attended lower respiratory illnesses in the vaccine group warrants expanded safety studies. TRIAL REGISTRATION ClinicalTrials.gov NCT00767416.
Collapse
Affiliation(s)
- Elissa Malkin
- Clinical Development, MedImmune, Gaithersburg, Maryland, United States of America
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
van Remmerden Y, Xu F, van Eldik M, Heldens JGM, Huisman W, Widjojoatmodjo MN. An improved respiratory syncytial virus neutralization assay based on the detection of green fluorescent protein expression and automated plaque counting. Virol J 2012; 9:253. [PMID: 23114196 PMCID: PMC3514128 DOI: 10.1186/1743-422x-9-253] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 10/17/2012] [Indexed: 12/01/2022] Open
Abstract
Background Virus neutralizing antibodies against respiratory syncytial virus (RSV) are considered important correlates of protection for vaccine evaluation. The established plaque reduction assay is time consuming, labor intensive and highly variable. Methods Here, a neutralization assay based on a modified RSV strain expressing the green fluorescent protein in combination with automated detection and quantification of plaques is described. Results The fluorescence plaque reduction assay in microplate format requires only two days to complete and is simple and reproducible. A good correlation between visual and automated counting methods to determine RSV neutralizing serum antibody titers was observed. Conclusions The developed virus neutralization assay is suitable for high-throughput testing and can be used for both animal studies and (large scale) vaccine clinical trials.
Collapse
Affiliation(s)
- Yvonne van Remmerden
- Department of Vaccine Research, Vaccinology, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | | | | | | | | |
Collapse
|
10
|
Madore DV, Meade BD, Rubin F, Deal C, Lynn F. Utilization of serologic assays to support efficacy of vaccines in nonclinical and clinical trials: meeting at the crossroads. Vaccine 2010; 28:4539-47. [PMID: 20470795 DOI: 10.1016/j.vaccine.2010.04.094] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Revised: 04/22/2010] [Accepted: 04/27/2010] [Indexed: 10/19/2022]
Abstract
In May 2009 the National Institute of Allergy and Infectious Diseases hosted a workshop on serologic assays that support vaccine efficacy evaluations. The meeting promoted exchange of ideas among investigators from varying disciplines who are working on anti-infectious agent vaccines at different stages of development. The presentations and discussions at the workshop illustrated the challenges common across various pathogens with recurring themes: (1) A thorough understanding of the science regarding the pathogen and the host response to disease and immunization is fundamental to assay selection. (2) The intended use of the immunoassay data must be clearly defined to ensure appropriate specificity, accuracy, and precision; a laboratory must also commit resources to assure data quality and reliability. (3) During vaccine development, an immunoassay may evolve with respect to quality, purpose, and degree of standardization, and, in some cases, must be changed or replaced as data are accumulated. (4) Collaboration on standardized reagents and methods, harmonization efforts, and multidisciplinary teams facilitate consistent generation of quality data. This report provides guidance for effective development and utilization of immunoassays based on the lessons learned from currently licensed vaccines. Investigators are encouraged to create additional opportunities for scientific exchange, noting that the discussed themes are relevant for immunoassays used for other purposes such as therapeutics and diagnostics.
Collapse
Affiliation(s)
- Dace V Madore
- Madore Medical Writing, LLC, Pittsford, NY 14534, USA
| | | | | | | | | | | |
Collapse
|
11
|
Current World Literature. Curr Opin Pulm Med 2008; 14:266-73. [DOI: 10.1097/mcp.0b013e3282ff8c19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|