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Li Y, Cao H, Li Y, Li Z, Wei X, Jiao R, Cheng P, Liu X, Ma Y, Xing Y, Tang J, Wang M, Li T. Construction of a novel vaccine by conjugating a B-cell epitope of DPP4 to peptide IA2(5)-P2-1 to significantly control type 1 diabetes in NOD mice. Vaccine 2017; 35:7187-7197. [PMID: 29169891 DOI: 10.1016/j.vaccine.2017.10.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/20/2017] [Accepted: 10/12/2017] [Indexed: 01/25/2023]
Abstract
Type 1 diabetes is a chronic organ-specific autoimmune disease in which selective destruction of insulin-producing β cells leads to impaired glucose metabolism and its attendant complications. IA2(5)P2-1, a potent immunogenic carrier which designed by our laboratory, can induce high titer specific antibodies when carry a B cell epitope, such as B cell epitopes of DPP4, xanthine oxidase, and Urate transporter protein. In this report, we describe a novel multi-epitope vaccine composing a peptide of DPP4, an anti-diabetic B epitope of Insulinoma antigen-2(IA-2) and a Th2 epitope (P2:IPALDSLTPANED) of P277 peptide in human heat shock protein 60 (HSP60). Immunization with the multi-epitope vaccine in non-obese diabetic (NOD) mice successfully induced specific anti-DPP4 antibody, inhibited plasma DPP4 activity, and increased serum GLP-1 level. Moreover, this antibody titer was correlated with the dose of immunization (20μg, 100μg). Inoculation of this vaccine in NOD mice significantly control blood glucose level, improved glucose excursion and increased insulin level in vivo. Consistent with a lower diabetic and insulitis incidence, a induced splenic T cells proliferation and tolerance were observed. IFN-γ secretion reduced and IL-10 increased significantly in the D41-IA2(5)-P2-1 treated mice compared to P277 and control group due to the potential immunomodulatory effect of the epitope in the vaccine. Immunohistochemical analysis and cytometry showed a rebalance of Th1/Th2 in NOD mice. Our results demonstrate that this multi-epitope vaccine may serve as a promising therapeutic approach for type 1 diabetes.
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Affiliation(s)
- Ya Li
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, PR China
| | - Huimin Cao
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, PR China
| | - Yiping Li
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, PR China
| | - Zhixin Li
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, PR China
| | - Xiaomin Wei
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, PR China
| | - Rui Jiao
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, PR China
| | - Peng Cheng
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, PR China
| | - Xiaoran Liu
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, PR China
| | - Yanjie Ma
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, PR China
| | - Yun Xing
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, PR China
| | - Jiali Tang
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, PR China
| | - Min Wang
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, PR China
| | - Taiming Li
- School of Life Science and Technology, China Pharmaceutical University, Nanjing 210009, PR China.
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Britt RB, Brown JN. Characterizing the Severe Reactions of Parenteral Vitamin K1. Clin Appl Thromb Hemost 2016; 24:5-12. [PMID: 28301903 DOI: 10.1177/1076029616674825] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Parenteral vitamin K1 (phytonadione) is used for anticoagulant reversal, and a boxed warning exists with intravenous and intramuscular administration due to the possibility of severe reactions, including fatalities. These reactions resemble hypersensitivity or anaphylaxis, including anaphylactoid reaction, and have led to shock and cardiac and/or respiratory arrest. The objective of this review is to summarize the available literature detailing the anaphylactic/anaphylactoid reactions with parenteral vitamin K1 in order to better characterize the reaction and provide a more in-depth understanding of its importance. A comprehensive literature search of MEDLINE (1946 to June 2016) and EMBASE (1947 to June 2016) was conducted using the terms vitamin K1, phytonadione, phytomenadione, vitamin K group, anaphylaxis, polyoxyethylated castor oil, and cremophor. A total of 2 retrospective surveillance studies, 2 retrospective cohort studies, and 17 case reports were identified for inclusion and assessment. Based on a review of the literature, use of parenteral vitamin K1 may result in severe hypotension, bradycardia or tachycardia, dyspnea, bronchospasm, cardiac arrest, and death. These reactions are most consistent with a nonimmune-mediated anaphylactoid mechanism. It appears that intravenous administration is more frequently associated with these reactions and occurs at an incidence of 3 per 10 000 doses of intravenous vitamin K1. The solubilizer may also increase the risk of adverse reactions, which occurred in patients with and without previous exposure to vitamin K1. Although there are known factors that increase the risk of an adverse drug event occurring, reactions have been reported despite all precautions being properly followed.
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Affiliation(s)
- Rachel B Britt
- 1 Geriatric Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC, USA.,2 Pharmacy Service, Durham VA Medical Center, Durham, NC, USA
| | - Jamie N Brown
- 2 Pharmacy Service, Durham VA Medical Center, Durham, NC, USA
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Xiao X, Mi YN, Wang F, Zhang BH, Cao L, Cao YX. Vitamin K 1distribution following intravenous vitamin K 1-fat emulsion administration in rats. Biomed Chromatogr 2015; 29:1849-58. [DOI: 10.1002/bmc.3506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 03/30/2015] [Accepted: 05/02/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Xue Xiao
- Department of Pharmacology; School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center; Xi'an Shaanxi 710061 China
| | - Yan-Ni Mi
- Department of Pharmacology; School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center; Xi'an Shaanxi 710061 China
| | - Fa Wang
- Shaanxi Institute for Food and Drug Control; Xi'an Shaanxi 710061 China
| | - Bing-Hua Zhang
- Shaanxi Institute for Food and Drug Control; Xi'an Shaanxi 710061 China
| | - Lei Cao
- Department of Pharmacology; School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center; Xi'an Shaanxi 710061 China
| | - Yong-Xiao Cao
- Department of Pharmacology; School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center; Xi'an Shaanxi 710061 China
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Mi YN, Ping NN, Xiao X, Zhu YB, Liu J, Cao YX. The severe adverse reaction to vitamin k1 injection is anaphylactoid reaction but not anaphylaxis. PLoS One 2014; 9:e90199. [PMID: 24594861 PMCID: PMC3942416 DOI: 10.1371/journal.pone.0090199] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 01/26/2014] [Indexed: 02/02/2023] Open
Abstract
The severe adverse reaction to vitamin K1 injection is always remarkable and is thought to result from anaphylaxis. Paradoxically, however, some patients administered vitamin K1 injection for the first time have adverse reactions. Using beagle dogs, the present study tested the hypothesis that the response to vitamin K1 is an anaphylactoid reaction. The results showed that serious anaphylaxis-like symptoms appeared in beagle dogs after the administration of vitamin K1 injection for the first time. The plasma histamine concentration increased, and blood pressure decreased sharply. After sensitization, dogs were challenged with vitamin K1 injection and displayed the same degree of symptoms as prior to sensitization. However, when the vitamin K1 injection-sensitized dogs were challenged with a vitamin K1-fat emulsion without solubilizers such asTween-80, the abnormal reactions did not occur. Furthermore, there was no significant change in the plasma immunoglobulin E concentration after vitamin K1 challenge. Following treatment with vitamin K1 injection, the release of histamine and β-hexosaminidase by rat basophilic leukemia-2H3 cells as well as the rate of apoptosis increased. The Tween-80 group displayed results similar to those observed following vitamin K1 injection in vivo. However, the dogs in the vitamin K1-fat emulsion group did not display any abnormal behavior or significant change in plasma histamine. Additionally, degranulation and apoptosis did not occur in rat basophilic leukemia-2H3 cells. Our results indicate that the adverse reaction induced by vitamin K1 injection is an anaphylactoid reaction, not anaphylaxis. Vitamin K1 injection induces the release of inflammatory factors via a non-IgE-mediated immune pathway, for which the trigger may be the solubilizer.
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Affiliation(s)
- Yan-Ni Mi
- Department of Pharmacology, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, China
| | - Na-Na Ping
- Department of Pharmacology, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, China
| | - Xue Xiao
- Department of Pharmacology, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, China
| | - Yan-Bing Zhu
- Department of Pharmacology, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, China
| | - Jing Liu
- Department of Pharmacology, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, China
| | - Yong-Xiao Cao
- Department of Pharmacology, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, China
- * E-mail:
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