Development of effective vaccines for old mice in a tumor model

Nano-particle vaccination combined with TLR-7 and -9 ligands triggers memory and effector CD8⁺ T-cell responses in melanoma patients

Optimal vaccine strategies must be identified for improving T-cell vaccination against infectious and malignant diseases. MelQbG10 is a virus-like nano-particle loaded with A-type CpG-oligonucleotides (CpG-ODN) and coupled to peptide(16-35) derived from Melan-A/MART-1. In this phase IIa clinical study, four groups of stage III-IV melanoma patients were vaccinated with MelQbG10, given (i) with IFA (Montanide) s.c.; (ii) with IFA s.c. and topical Imiquimod; (iii) i.d. with topical Imiquimod; or (iv) as intralymph node injection. In total, 16/21 (76%) patients generated ex vivo detectable Melan-A/MART-1-specific T-cell responses. T-cell frequencies were significantly higher when IFA was used as adjuvant, resulting in detectable T-cell responses in all (11/11) patients, with predominant generation of effector-memory-phenotype cells. In turn, Imiquimod induced higher proportions of central-memory-phenotype cells and increased percentages of CD127(+) (IL-7R) T cells. Direct injection of MelQbG10 into lymph nodes resulted in lower T-cell frequencies, associated with lower proportions of memory and effector-phenotype T cells. Swelling of vaccine site draining lymph nodes, and increased glucose uptake at PET/CT was observed in 13/15 (87%) of evaluable patients, reflecting vaccine triggered immune reactions in lymph nodes. We conclude that the simultaneous use of both Imiquimod and CpG-ODN induced combined memory and effector CD8(+) T-cell responses.

Vaccination-induced functional competence of circulating human tumor-specific CD8 T-cells

T-cells specific for foreign (e.g., viral) antigens can give rise to strong protective immune responses, whereas self/tumor antigen-specific T-cells are thought to be less powerful. However, synthetic T-cell vaccines composed of Melan-A/MART-1 peptide, CpG and IFA can induce high frequencies of tumor-specific CD8 T-cells in PBMC of melanoma patients. Here we analyzed the functionality of these T-cells directly ex vivo, by multiparameter flow cytometry. The production of multiple cytokines (IFNγ, TNFα, IL-2) and upregulation of LAMP-1 (CD107a) by tumor (Melan-A/MART-1) specific T-cells was comparable to virus (EBV-BMLF1) specific CD8 T-cells. Furthermore, phosphorylation of STAT1, STAT5 and ERK1/2, and expression of CD3 zeta chain were similar in tumor- and virus-specific T-cells, demonstrating functional signaling pathways. Interestingly, high frequencies of functionally competent T-cells were induced irrespective of patient's age or gender. Finally, CD8 T-cell function correlated with disease-free survival. However, this result is preliminary since the study was a Phase I clinical trial. We conclude that human tumor-specific CD8 T-cells can reach functional competence in vivo, encouraging further development and Phase III trials assessing the clinical efficacy of robust vaccination strategies.

Mycobacterial cell-wall skeleton as a universal vaccine vehicle for antigen conjugation

Mycobacterial cell-wall skeleton (CWS) is an immunoactive and biodegradable particulate adjuvant and has been used for immunotherapy in patients with cancer. The CWS of Mycobacterium bovis bacillus Calmette-Guérin (BCG-CWS) was studied as a universal vaccine vehicle for antigen conjugation, to develop potentially effective and safe vaccines. Here, we describe experiments in which protein antigens, such as keyhole limpet haemocyanin (KLH), ovalbumin (OVA) and bovine serum albumin (BSA) were highly efficiently coupled to 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide and N-hydroxysuccinimide (EDC/NHS)-activated carboxyl groups of BCG-CWS, and tested the immunogenicity of OVA-conjugated BCG-CWS vaccine. We found that a strong immune response was induced in mice immunised with OVA-conjugated BCG-CWS, which was similar to the enhancement of the immune responses in mice immunised with OVA and complete Freund's adjuvant. Covalent conjugation of OVA to BCG-CWS was essential for Th1-skewed immune responses, with prominent expression of IFN-γ. Furthermore, antigen-conjugated BCG-CWS vaccine is simple to manufacture, safe, and easy to use. Our results suggest that mycobacterial CWS as a universal vaccine vehicle for conjugation of a wide variety of antigens constitutes a breakthrough for development of the most promising vaccines for infections, allergic diseases, and cancer.

Vaccines for the elderly: the quest for the ideal animal model

A decline in protective immune responses following vaccination is one of the main features of immunosenescence. Improved vaccine candidates for elderly adults are thus urgently needed. For scientific and regulatory requirements, such new vaccines must first be evaluated at the preclinical level, and there is a continuing quest for the ideal animal model with which to perform such studies. The main advantages and limitations of murine models, those most commonly used for human vaccine research, and of large animal models are reviewed and discussed.

Strategies to improve the effect of vaccination in the elderly: the vaccine producer's perspective

The weakened immune system of elderly people presents particular challenges in the development of vaccines and vaccination strategies for this population. There are well recognized changes in the function of antigen presenting cells (APCs), T cells and B cells in older people. Several strategies to improve vaccination in the elderly have been explored. The use of adjuvants (e.g. emulsions and Toll-like receptor [TLR] agonists) could trigger more potent activation of APCs. The addition of T helper epitopes to the vaccine antigens could enhance T-cell responses by acting as 'intrinsic' adjuvants. The use of interleukin (IL)-7 could improve the expansion of naïve T cells in the elderly, accompanied by a broadened T-cell repertoire. A further means of enhancing antigen presentation and subsequent T-cell activation would be to increase the vaccine dose and/or antigenic content. Vaccination schedules could also be adapted. In particular, vaccination at an earlier age may trigger naïve T cells and subsequent generation of memory cells more efficiently and these cells may be recalled more easily in later life. Vaccination against cytomegalovirus (CMV) early in life has also been proposed to avoid the 'CMV bias' of the immune response that is seen in the elderly population. Immunization routes other than by intramuscular or subcutaneous injection may be more efficient, by delivering antigen to sites enriched in APCs such as the epidermis and/or dermis. Finally, the use of polysaccharide-protein conjugates might enhance the level and functionality of antibodies directed against polysaccharides. These different possibilities, alone or in combination, could improve vaccine efficacy in elderly human populations.