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Mehanny M, Lehr CM, Fuhrmann G. Extracellular vesicles as antigen carriers for novel vaccination avenues. Adv Drug Deliv Rev 2021; 173:164-180. [PMID: 33775707 DOI: 10.1016/j.addr.2021.03.016] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/01/2021] [Accepted: 03/23/2021] [Indexed: 02/07/2023]
Abstract
Antigen delivery has always been a challenge in scientific practice of vaccine formulation. Yet, mammalian extracellular vesicles (EVs) or bacterial membrane vesicles (MVs) provide an innovative avenue for safe and effective delivery of antigenic material. They include intrinsically loaded antigens from EV-secreting cells or extrinsically loaded antigens onto pre-formed vesicles. Interestingly, many studies shed light on potential novel anti-cancer vaccination immunotherapy for therapeutic applications from mammalian cell host-derived EVs, as well as conventional vaccination for prophylactic applications using bacterial cell-derived MVs against infectious diseases. Here, we discuss the rationale, status quo and potential for both vaccine applications using EVs.
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Jiang L, Schinkel M, van Essen M, Schiffelers RM. Bacterial membrane vesicles as promising vaccine candidates. Eur J Pharm Biopharm 2019; 145:1-6. [DOI: 10.1016/j.ejpb.2019.09.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/17/2019] [Accepted: 09/23/2019] [Indexed: 02/06/2023]
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Coelho C, Casadevall A. Answers to naysayers regarding microbial extracellular vesicles. Biochem Soc Trans 2019; 47:1005-1012. [PMID: 31320501 DOI: 10.1042/bst20180252] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 06/30/2019] [Accepted: 07/02/2019] [Indexed: 11/08/2023]
Abstract
It is now over 30 years since the discovery of extracellular vesicles (EVs) in Gram-negative bacteria. However, for cell-walled microbes such as fungi, mycobacteria and Gram-positive bacteria it was thought that EV release would be impossible, since such structures were not believed to cross the thick cell wall. This notion was disproven 10 years ago with the discovery of EVs in fungi, mycobacteria, and gram-positive bacteria. Today, EVs have been described in practically every species tested, ranging from Fungi through Bacteria and Archaea, suggesting that EVs are a feature of every living cell. However, there continues to be skepticism in some quarters regarding EV release and their biological significance. In this review, we list doubts that have been verbalized to us and provide answers to counter them. In our opinion, there is no doubt as to existence and physiological function of EVs and we take this opportunity to highlight the most pressing topics in our understanding of the biological processes underlying these structures.
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Affiliation(s)
- Carolina Coelho
- Medical Research Council Centre for Medical Mycology, Department of Biosciences, College of Life and Environmental Sciences, University of Exeter, Exeter, U.K.
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, U.K
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, U.S.A
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Cabasson S, Roux J, Charron M, Sarlangue J, Debeugny S, Jouhet V, Monlun E. Poor adherence to population-based vaccination in two counties after meningococcal B:14:P1.7,16 outbreak: an illustration of the growing vaccine hesitancy in France. Arch Pediatr 2019; 26:75-79. [PMID: 30617005 DOI: 10.1016/j.arcped.2018.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/05/2018] [Accepted: 12/11/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Neisseria meningitidis is a virulent bacteria provoking outbreaks of invasive meningococcal disease (IMD) that authorities may try to control with population-based vaccinations. Such campaigns are most often thoroughly followed. We assess the response of poor adherence during a population-based vaccination after a meningococcal B:14:P1.7,16 outbreak. METHODS Between July, 2012, and April, 2013, six cases including one fatality of invasive meningococcal disease related to N. meningitidis B:14:P1.7,16/ST32 were reported in two neighboring counties. A vaccination campaign with MenBVac® targeting 6911 inhabitants was implemented. People entering the vaccination schedule from January 2014 received 4CMenB. RESULTS The number of immunized patients proved to be low, with 1721 (24.1%) receiving at least one dose out of 5069 doses administered. However, the incidence of IMD in the zone dramatically fell, with only one purpura fulminans case in June 2014 with a good outcome. The campaign was stopped after 1 year and a 2-year monitoring period was implemented until June, 2016, with no new cases. CONCLUSIONS This outbreak probably self-terminated in a context of a low incidence of serogroup B IMD during 2014 in France. Poor adherence illustrates the growing vaccine hesitancy in France. Similar campaigns will have to be thoroughly planned and implemented in terms of timing, modalities of injections, and mass communication.
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Affiliation(s)
- S Cabasson
- Service de pédiatrie et réanimation pédiatrique, Centre hospitalier de Pau, Boulevard Hauterive, 64046 Pau, France.
| | - J Roux
- Service de pédiatrie et réanimation pédiatrique, Centre hospitalier de Pau, Boulevard Hauterive, 64046 Pau, France
| | - M Charron
- Cellule D'Intervention en Région (CIRE), Santé publique France, 103, rue de Belleville, 33000 Bordeaux, France
| | - J Sarlangue
- Département de pédiatrie médicale, Hôpital Pellegrin-Enfants, CHU de Bordeaux, Place Amélie-Raba-Léon, 33076 Bordeaux France
| | - S Debeugny
- Unité de recherche clinique, Centre hospitalier de Pau, Boulevard Hauterive, 64046 Pau, France
| | - V Jouhet
- Institut de Santé publique et du développement, Université Victor-Ségalen Bordeaux 2, 146, rue Léo-Saignat, 33000 Bordeaux, France
| | - E Monlun
- Service de maladies infectieuses, Centre hospitalier de Pau, Boulevard Hauterive, 64046 Pau, France
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Li J, Shao Z, Liu G, Bai X, Borrow R, Chen M, Guo Q, Han Y, Li Y, Taha MK, Xu X, Xu X, Zheng H. Meningococcal disease and control in China: Findings and updates from the Global Meningococcal Initiative (GMI). J Infect 2018; 76:429-437. [PMID: 29406154 DOI: 10.1016/j.jinf.2018.01.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/22/2017] [Accepted: 01/03/2018] [Indexed: 10/18/2022]
Abstract
The Global Meningococcal Initiative (GMI) is a global expert group, including scientists, clinicians and public health officials from a wide range of specialities. The goal of the GMI is to prevent meningococcal disease worldwide through education, research, and co-operation. The Chinese GMI roundtable meeting was held in June 2017. The GMI met with local experts to gain insight into the meningococcal disease burden in China and current prevention and vaccination strategies in place. China experienced five epidemics of serogroup A meningococcal disease (MenA) between 1938 and 1977, with peak incidence of 403/100,000 recorded in 1967. MenA incidence rates have significantly declined following the universal introduction of the MenA polysaccharide vaccine in China in the 1980s. Further, surveillance data indicates changing meningococcal epidemiology in China with the emergence of new clones of serogroup B from serogroup C clonal complex (cc) 4821 due to capsular switching, and the international spread of serogroup W cc11. The importance of carriage and herd protection for controlling meningococcal disease was highlighted with the view to introduce conjugate vaccines and serogroup B vaccines into the national immunization schedule. Improved disease surveillance and standardized laboratory techniques across and within provinces will ensure optimal epidemiological monitoring.
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Affiliation(s)
- Junhong Li
- National Immunisation Programme Department, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Zhujun Shao
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Gang Liu
- Department of Infectious Disease, Beijing Children's Hospital, Beijing, China.
| | - Xilian Bai
- Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester, UK.
| | - Ray Borrow
- Meningococcal Reference Unit, Public Health England, Manchester Royal Infirmary, Manchester, UK.
| | - Min Chen
- Department of Microbiology, Center for Disease Control and Prevention, Shanghai, China.
| | - Qinglan Guo
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China.
| | - Yue Han
- Department of Immunology, Center for Disease Control and Prevention, Liaoning, China.
| | - Yixing Li
- National Immunisation Programme Department, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Muhamed-Kheir Taha
- National Reference Centre for Meningococci, Institute Pasteur, Paris, France.
| | - Xihai Xu
- Department of Infectious Diseases, the First Affiliated Hospital of Anhui Medical University, China.
| | - Xin Xu
- Department of Immunization Programme, Center for Disease Control and Prevention, Guangdong, China.
| | - Huizhen Zheng
- Department of Immunization Programme, Center for Disease Control and Prevention, Guangdong, China.
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Predicted vs observed effectiveness of outer membrane vesicle (OMV) vaccines against meningococcal serogroup B disease: Systematic review. J Infect 2017; 75:81-94. [DOI: 10.1016/j.jinf.2017.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 03/27/2017] [Accepted: 05/03/2017] [Indexed: 11/18/2022]
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Sevestre J, Hong E, Delbos V, Terrade A, Mallet E, Deghmane AE, Lemée L, Taha MK, Caron F. Durability of immunogenicity and strain coverage of MenBvac, a meningococcal vaccine based on outer membrane vesicles: Lessons of the Normandy campaign. Vaccine 2017. [DOI: 10.1016/j.vaccine.2017.05.065] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cellular Immune Responses in Humans Induced by Two Serogroup B Meningococcal Outer Membrane Vesicle Vaccines Given Separately and in Combination. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2016; 23:353-62. [PMID: 26865595 DOI: 10.1128/cvi.00666-15] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 02/04/2016] [Indexed: 11/20/2022]
Abstract
MenBvac and MeNZB are safe and efficacious outer membrane vesicle (OMV) vaccines against serogroup B meningococcal disease. Antibody responses have previously been investigated in a clinical trial with these two OMV vaccines given separately (25 μg/dose) or in combination (12.5 and 12.5 μg/dose) in three doses administered at 6-week intervals. Here, we report the results from analyzing cellular immune responses against MenBvac and MeNZB OMVs in terms of antigen-specific CD4(+)T cell proliferation and secretion of cytokines. The proliferative CD4(+)T cell responses to the combined vaccine were of the same magnitude as the homologous responses observed for each individual vaccine. The results also showed cross-reactivity in the sense that both vaccine groups receiving separate vaccines responded to both homologous and heterologous OMV antigen when assayed for antigen-specific cellular proliferation. In addition, a multiplex bead array assay was used to analyze the presence of Th1 and Th2 cytokines in cell culture supernatants. The results showed that gamma interferon, interleukin-4 (IL-4), and IL-10 responses could be detected as a result of vaccination with both the MenBvac and the MeNZB vaccines given separately, as well as when given in combination. With respect to cross-reactivity, the cytokine results paralleled the observations made for proliferation. In conclusion, the results demonstrate that cross-reactive cellular immune responses involving both Th1 and Th2 cytokines can be induced to the same extent by different tailor-made OMV vaccines given either separately or in combination with half the dose of each vaccine.
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Sanders H, Norheim G, Chan H, Dold C, Vipond C, Derrick JP, Pollard AJ, Maiden MCJ, Feavers IM. FetA Antibodies Induced by an Outer Membrane Vesicle Vaccine Derived from a Serogroup B Meningococcal Isolate with Constitutive FetA Expression. PLoS One 2015; 10:e0140345. [PMID: 26466091 PMCID: PMC4605655 DOI: 10.1371/journal.pone.0140345] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 09/24/2015] [Indexed: 02/06/2023] Open
Abstract
Invasive meningococcal disease causes over 3500 cases each year in Europe, with particularly high incidence among young children. Among serogroup B meningococci, which cause most of the cases, high diversity in the outer membrane proteins (OMPs) is observed in endemic situations; however, comprehensive molecular epidemiological data are available for the diversity and distribution of the OMPs PorA and FetA and these can be used to rationally design a vaccine with high coverage of the case isolates. The aim of this study was to determine whether outer membrane vesicles (OMVs) derived from an isolate with constitutive FetA expression (MenPF-1 vaccine) could be used to induce antibodies against both the PorA and FetA antigens. The immunogenicity of various dose levels and number of doses was evaluated in mice and rabbits, and IgG antibody responses tested against OMVs and recombinant PorA and FetA proteins. A panel of four isogenic mutants was generated and used to evaluate the relative ability of the vaccine to induce serum bactericidal activity (SBA) against FetA and PorA. Sera from mice were tested in SBA against the four target strains. Results demonstrated that the MenPF-1 OMVs were immunogenic against PorA and FetA in both animal models. Furthermore, the murine antibodies induced were bactericidal against isogenic mutant strains, suggesting that antibodies to both PorA and FetA were functional. The data presented indicate that the MenPF-1 vaccine is a suitable formulation for presenting PorA and FetA OMPs in order to induce bactericidal antibodies, and that proceeding to a Phase I clinical trial with this vaccine candidate is justified.
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Affiliation(s)
- Holly Sanders
- National Institute of Biological Standards and Control, South Mimms, Potters Bar, United Kingdom
| | - Gunnstein Norheim
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
- Division of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Hannah Chan
- National Institute of Biological Standards and Control, South Mimms, Potters Bar, United Kingdom
- * E-mail:
| | - Christina Dold
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - Caroline Vipond
- National Institute of Biological Standards and Control, South Mimms, Potters Bar, United Kingdom
| | - Jeremy P. Derrick
- Faculty of Life Sciences, The University of Manchester, Michael Smith Building, Oxford Road, Manchester, United Kingdom
| | - Andrew J. Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom
| | | | - Ian M. Feavers
- National Institute of Biological Standards and Control, South Mimms, Potters Bar, United Kingdom
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Leca M, Bornet C, Montana M, Curti C, Vanelle P. Meningococcal vaccines: Current state and future outlook. ACTA ACUST UNITED AC 2015; 63:144-51. [DOI: 10.1016/j.patbio.2015.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 04/17/2015] [Indexed: 10/23/2022]
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Marsay L, Dold C, Green CA, Rollier CS, Norheim G, Sadarangani M, Shanyinde M, Brehony C, Thompson AJ, Sanders H, Chan H, Haworth K, Derrick JP, Feavers IM, Maiden MC, Pollard AJ. A novel meningococcal outer membrane vesicle vaccine with constitutive expression of FetA: A phase I clinical trial. J Infect 2015; 71:326-37. [PMID: 25982025 PMCID: PMC4535279 DOI: 10.1016/j.jinf.2015.05.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 05/05/2015] [Accepted: 05/09/2015] [Indexed: 12/01/2022]
Abstract
Objectives Outer membrane vesicle (OMV) vaccines are used against outbreaks of capsular group B Neisseria meningitidis (MenB) caused by strains expressing particular PorA outer membrane proteins (OMPs). Ferric enterobactin receptor (FetA) is another variable OMP that induces type-specific bactericidal antibodies, and the combination of judiciously chosen PorA and FetA variants in vaccine formulations is a potential approach to broaden protection of such vaccines. Methods The OMV vaccine MenPF-1 was generated by genetically modifying N. meningitidis strain 44/76 to constitutively express FetA. Three doses of 25 μg or 50 μg of MenPF-1 were delivered intra-muscularly to 52 healthy adults. Results MenPF-1 was safe and well tolerated. Immunogenicity was measured by serum bactericidal assay (SBA) against wild-type and isogenic mutant strains. After 3 doses, the proportion of volunteers with SBA titres ≥1:4 (the putative protective titre) was 98% for the wild-type strain, and 77% for the strain 44/76 FetAonPorAoff compared to 51% in the strain 44/76 FetAoffPorAoff, demonstrating that vaccination with MenPF-1 simultaneously induced FetA and PorA bactericidal antibodies. Conclusion This study provides a proof-of-concept for generating bactericidal antibodies against FetA after OMV vaccination in humans. Prevalence-based choice of PorA and FetA types can be used to formulate a vaccine for broad protection against MenB disease. MenB OMV vaccines' efficacy is strain-restricted by the variable antigen PorA. FetA is another variable antigen, but has iron-dependent expression. The combination of only a few PorA and FetA can induce broad-protection. A mutated OMV was created containing one PorA and one FetA. FetA induces bactericidal antibody response in addition to the PorA response in a Phase I trial.
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Affiliation(s)
- L Marsay
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, CCVTM, Churchill Lane, Oxford OX37LE, United Kingdom
| | - C Dold
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, CCVTM, Churchill Lane, Oxford OX37LE, United Kingdom
| | - C A Green
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, CCVTM, Churchill Lane, Oxford OX37LE, United Kingdom
| | - C S Rollier
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, CCVTM, Churchill Lane, Oxford OX37LE, United Kingdom.
| | - G Norheim
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, CCVTM, Churchill Lane, Oxford OX37LE, United Kingdom
| | - M Sadarangani
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, CCVTM, Churchill Lane, Oxford OX37LE, United Kingdom
| | - M Shanyinde
- Nuffield Department of Primary Health Care Sciences, Primary Care Clinical Trials Unit, University of Oxford, 23-38 Hythe Bridge Street, Oxford, United Kingdom
| | - C Brehony
- Department of Zoology, University of Oxford, South Parks Road, United Kingdom
| | - A J Thompson
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, CCVTM, Churchill Lane, Oxford OX37LE, United Kingdom
| | - H Sanders
- National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Potters Bar, Hertfordshire, United Kingdom
| | - H Chan
- National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Potters Bar, Hertfordshire, United Kingdom
| | - K Haworth
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, CCVTM, Churchill Lane, Oxford OX37LE, United Kingdom
| | - J P Derrick
- Michael Smith Building, Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom
| | - I M Feavers
- National Institute for Biological Standards and Control, Blanche Lane, South Mimms, Potters Bar, Hertfordshire, United Kingdom
| | - M C Maiden
- Department of Zoology, University of Oxford, South Parks Road, United Kingdom
| | - A J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, CCVTM, Churchill Lane, Oxford OX37LE, United Kingdom
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Whelan J, Bambini S, Biolchi A, Brunelli B, Robert–Du Ry van Beest Holle M. Outbreaks of meningococcal B infection and the 4CMenB vaccine: historical and future perspectives. Expert Rev Vaccines 2015; 14:713-36. [DOI: 10.1586/14760584.2015.1004317] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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13
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Impact of MenBvac, an outer membrane vesicle (OMV) vaccine, on the meningococcal carriage. Vaccine 2013; 31:4416-20. [DOI: 10.1016/j.vaccine.2013.06.080] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 06/24/2013] [Accepted: 06/26/2013] [Indexed: 11/22/2022]
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Sanders H, Kaaijk P, van den Dobbelsteen GP. Preclinical evaluation of MenB vaccines: prerequisites for clinical development. Expert Rev Vaccines 2013; 12:31-42. [PMID: 23256737 DOI: 10.1586/erv.12.137] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Despite the widespread use of polysaccharide and conjugate vaccines against disease caused by several serogroups of Neisseria meningitidis, vaccines targeting meningococci expressing the serogroup B capsule (MenB) have focused on subcapsular antigens, due to crossreactivity of the polysaccharide with human glycoproteins. Protein vaccines composed of outer membrane vesicles have been used successfully to control epidemics of MenB disease in several countries; however, these are specific for epidemic strains. Currently, a single serogroup B vaccine, aiming to provide comprehensive coverage, has been approved for use, and several others are undergoing clinical trials. Data on potential new vaccine candidates, from discovery to initial preclinical evaluation, are regularly published. In this review, the data required to progress from preclinical to clinical development of MenB vaccines are outlined, with reference to relevant regulatory guidelines. The issues caused by a lack of reliable animal models, particularly with respect to determination of protective efficacy, are also discussed.
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Affiliation(s)
- Holly Sanders
- Bacterial Vaccines, Crucell Holland, Leiden, The Netherlands
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Meningococcal carriage during a clonal meningococcal B outbreak in France. Eur J Clin Microbiol Infect Dis 2013; 32:1451-9. [PMID: 23728781 DOI: 10.1007/s10096-013-1897-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 05/16/2013] [Indexed: 12/21/2022]
Abstract
The aim of this study performed in Normandy, France, was to analyze the pharyngeal meningococcal carriage at the peak of a clonal meningococcal B outbreak, which was subsequently controlled using an outer membrane vesicle vaccination. This cross-sectional study included randomly selected subjects aged 1-25 years. Carriers and non carriers were compared using unconditional logistic regression. Among the 3,522 volunteers, there were 196 (standardized rate: 6.46 %) Neisseria meningitidis carriers, of which there were only five with the outbreak strain (B:14:P1.7,16/ST-32; standardized rate: 0.18 %). From the multivariate analysis, older age, smoking, higher degree of socialization, and social deprivation appear to favor the carriage of all the strains included. Prior antibiotic treatment up to 12 months before swabbing, even with β-lactam, was protective against carriage. Our data indicate a low overall meningococcal carriage rate with a surprising protective effect of prior antibiotic exposure. The observed low carriage rate of the epidemic strain (B:14:P1.7,16/ST-32) contrasts with the high incidence of invasive meningococcal diseases (IMD) due to this strain. Hence, our data underline the high virulence of the strain and suggest a low level of natural immunity of the population against this strain. Although highly resource-consuming, carriage studies are helpful in guiding the implementation of control measures of IMD, such as mass vaccination or chemoprophylaxis.
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Holst J, Oster P, Arnold R, Tatley MV, Næss LM, Aaberge IS, Galloway Y, McNicholas A, O'Hallahan J, Rosenqvist E, Black S. Vaccines against meningococcal serogroup B disease containing outer membrane vesicles (OMV): lessons from past programs and implications for the future. Hum Vaccin Immunother 2013; 9:1241-53. [PMID: 23857274 PMCID: PMC3901813 DOI: 10.4161/hv.24129] [Citation(s) in RCA: 154] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The utility of wild-type outer membrane vesicle (wtOMV) vaccines against serogroup B (MenB) meningococcal disease has been explored since the 1970s. Public health interventions in Cuba, Norway and New Zealand have demonstrated that these protein-based vaccines can prevent MenB disease. Data from large clinical studies and retrospective statistical analyses in New Zealand give effectiveness estimates of at least 70%. A consistent pattern of moderately reactogenic and safe vaccines has been seen with the use of approximately 60 million doses of three different wtOMV vaccine formulations. The key limitation of conventional wtOMV vaccines is their lack of broad protective activity against the large diversity of MenB strains circulating globally. The public health intervention in New Zealand (between 2004–2008) when MeNZB was used to control a clonal MenB epidemic, provided a number of new insights regarding international and public-private collaboration, vaccine safety surveillance, vaccine effectiveness estimates and communication to the public. The experience with wtOMV vaccines also provide important information for the next generation of MenB vaccines designed to give more comprehensive protection against multiple strains.
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Affiliation(s)
- Johan Holst
- Division of Infectious Disease Control; Norwegian Institute of Public Health; Oslo, Norway
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