Combination vaccines

Vaccination in Atherosclerosis

Atherosclerosis is the major underlying pathology of cardiovascular diseases that together are the leading cause of death worldwide. The formation of atherosclerotic plaques is driven by chronic vascular inflammation. Although several risk factors have been identified and significant progress in disease prevention and treatment has been made, no therapeutic agents targeting inflammation are clinically available. Recent clinical trials established the potential of anti-inflammatory therapies as a treatment of atherosclerosis. However, adverse impacts on host defense have raised safety concerns about these therapies. Scientific evidence during the past 40 years implicated an adaptive immune response against plaque-associated autoantigens in atherogenesis. Preclinical data have underscored the protective potential of immunization against such targets precisely and without the impairment of host defense. In this review, we discuss the current vaccination strategies against atherosclerosis, supposed mechanisms of action, therapeutic potential, and the challenges that must be overcome in translating this idea into clinical practice.

Development of combination vaccines

Breakthroughs in molecular biology, biochemistry, process development, immunology and related fields have provided the means for improving current vaccines and developing new ones. The increasing availability of these vaccines is providing the unprecedented opportunity to prevent serious infectious disease in different age groups and to significantly reduce associated morbidity and mortality. However, since the great majority of licensed and experimental vaccines in advanced clinical studies are injected, each new vaccine creates the need for additional needlesticks which could become so numerous as to discourage full compliance with immunization schedules. Therefore, the development of combination vaccines is a major way to assure compliance with immunization needs. The leading types of licensed and experimental vaccines which have been or may be made into combination vaccines will be described. In addition, key challenges common to the development of all combination vaccines will be discussed; these include pharmaceutical, immunological, clinical, regulatory, manufacturing, public health and marketing issues. In order to assure timely development and availability of such combination products, these issues must be integrated successfully early in a development program.