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Rathod V, Kadam L, Gautam M, Gumma PD, Marke K, Asokanathan C, Douglas-Bardsley A, Hassell L, Bhandare S, Gupta S, Parekh S, Pujari P, Rao H, Sharma H, Shaligram U, Gairola S. Multiplexed bead-based assay for the simultaneous quantification of human serum IgG antibodies to tetanus, diphtheria, pertussis toxin, filamentous hemagglutinin, and pertactin. Front Immunol 2023; 14:1190404. [PMID: 37342321 PMCID: PMC10278353 DOI: 10.3389/fimmu.2023.1190404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/02/2023] [Indexed: 06/22/2023] Open
Abstract
Background Luminex bead-based assays offer multiplexing to test antibodies against multiple antigens simultaneously; however, this requires validation using internationally certified reference standards. Therefore, there is an urgent need to characterize existing reference standards for the standardization of multiplex immunoassays (MIAs). Here, we report the development and validation of an MIA for the simultaneous estimation of levels of human serum immunoglobulin G (IgG) antibodies for pertussis toxin (PT), filamentous hemagglutinin (FHA), pertactin (PRN), diphtheria toxoid (DT), and tetanus toxoid (TT). Methods The MIA was assessed using a panel of human serum samples and WHO reference standards. The WHO reference standards were also studied for suitability in the MIA. Purified antigens (PT, FHA, PRN, DT, and TT) were coupled to the spectrally unique magnetic carboxylated microspheres. The method was validated in accordance with the United States Food and Drug Administration (US FDA), European Medicines Agency (EMA), and the International Committee of Harmonization Multidisciplinary (ICH M10) guidelines, and parameters such as precision, accuracy, dilutional linearity, assay range, robustness, and stability were assessed. Method agreements with commercially available IgG enzyme-linked immunosorbent assay (ELISA) assays were also evaluated. In addition, the study assessed the level of correlation between the IgG levels estimated by the MIA and the cell-based neutralizing antibody assays for PT and DT. Results We identified that an equimix of WHO international standards (i.e., 06/142, 10/262, and TE-3) afforded the best dynamic range for all the antigens in the MIA. For all five antigens, we observed that the back-fitted recoveries using the four-parameter logistic (4-PL) regression fits ranged between 80% and 120% for all calibration levels, and the percentage coefficient of variation (% CV) was < 20%. In addition, the difference in mean fluorescence intensity (MFI) between the monoplex and multiplex format was < 10% for each antigen, indicating no crosstalk among the beads. The MIA also showed good agreement with conventional and commercially available assays, and a positive correlation (> 0.75) with toxin neutralization assays for PT and DT was observed. Conclusion The MIA that was calibrated in accordance with WHO reference standards demonstrated increased sensitivity, reproducibility, and high throughput capabilities, allowing for the design of robust studies that evaluate both natural and vaccine-induced immunity.
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Affiliation(s)
- Vishal Rathod
- Clinical Bioanalytical Laboratory, Serum Institute of India Pvt. Ltd., Pune, Maharashtra, India
| | - Laxmikant Kadam
- Clinical Bioanalytical Laboratory, Serum Institute of India Pvt. Ltd., Pune, Maharashtra, India
| | - Manish Gautam
- Clinical Bioanalytical Laboratory, Serum Institute of India Pvt. Ltd., Pune, Maharashtra, India
| | - Prabhu Dasu Gumma
- Clinical Bioanalytical Laboratory, Serum Institute of India Pvt. Ltd., Pune, Maharashtra, India
| | - Kevin Marke
- Science, Research and Innovation, Medicines, and Healthcare Products Regulatory Agency, South Mimms, United Kingdom
| | - Cathy Asokanathan
- Science, Research and Innovation, Medicines, and Healthcare Products Regulatory Agency, South Mimms, United Kingdom
| | - Alex Douglas-Bardsley
- Science, Research and Innovation, Medicines, and Healthcare Products Regulatory Agency, South Mimms, United Kingdom
| | - Laura Hassell
- Science, Research and Innovation, Medicines, and Healthcare Products Regulatory Agency, South Mimms, United Kingdom
| | - Sachin Bhandare
- Clinical Bioanalytical Laboratory, Serum Institute of India Pvt. Ltd., Pune, Maharashtra, India
| | - Sumit Gupta
- Clinical Bioanalytical Laboratory, Serum Institute of India Pvt. Ltd., Pune, Maharashtra, India
| | - Sameer Parekh
- Clinical Bioanalytical Laboratory, Serum Institute of India Pvt. Ltd., Pune, Maharashtra, India
| | - Pramod Pujari
- Clinical Bioanalytical Laboratory, Serum Institute of India Pvt. Ltd., Pune, Maharashtra, India
| | - Harish Rao
- Clinical Bioanalytical Laboratory, Serum Institute of India Pvt. Ltd., Pune, Maharashtra, India
| | - Hitt Sharma
- Clinical Bioanalytical Laboratory, Serum Institute of India Pvt. Ltd., Pune, Maharashtra, India
| | - Umesh Shaligram
- Clinical Bioanalytical Laboratory, Serum Institute of India Pvt. Ltd., Pune, Maharashtra, India
| | - Sunil Gairola
- Clinical Bioanalytical Laboratory, Serum Institute of India Pvt. Ltd., Pune, Maharashtra, India
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Garland SM, Steben M, Hernandez-Avila M, Koutsky LA, Wheeler CM, Perez G, Harper DM, Leodolter S, Tang GWK, Ferris DG, Esser MT, Vuocolo SC, Nelson M, Railkar R, Sattler C, Barr E. Noninferiority of antibody response to human papillomavirus type 16 in subjects vaccinated with monovalent and quadrivalent L1 virus-like particle vaccines. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2007; 14:792-5. [PMID: 17428949 PMCID: PMC1951095 DOI: 10.1128/cvi.00478-06] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The incorporation of multiple antigens into a single human papillomavirus (HPV) vaccine may induce immune interference. To evaluate whether interference occurs when HPV type 16 (HPV16) virus-like particles are combined in a multivalent vaccine, we conducted a study to evaluate anti-HPV16 responses among subjects receiving three-dose regimens of either a monovalent HPV16 vaccine or a quadrivalent HPV (types 6, 11, 16, and 18) vaccine.
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Affiliation(s)
- Suzanne M Garland
- Microbiology and Infectious Diseases Department, Royal Women's Hospital, Carlton, University of Melbourne, Melbourne, Victoria, Australia
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Abstract
BACKGROUND During the past two decades the number of injections that are required per office visit to fulfill the recommended childhood immunization schedule has increased dramatically. METHODS By reviewing the literature, the principles associated with pediatric combination vaccines are discussed, and practical issues related to their use in clinical practice are evaluated. RESULTS The ideal combination vaccine is safe, effective and easy to store and use, and its antigenic components fit within the recommended immunization schedule. The ideal combination is associated with fewer adverse reactions than the separately administered antigens, with improved efficacy and higher immune responses compared with its component vaccines. An acceptable combination vaccine must provide comparable efficacy and safety to its component vaccines. Although there are a limited number of combination vaccines already available [diphtheria-tetanus-pertussis, inactivated poliovirus vaccine (IPV) and measles-mumps-rubella], effort is being focused on combining these vaccines with other routine vaccines of infancy including Haemophilus influenzae type b (Hib) and hepatitis B vaccine (HepB). Currently under review by the Food and Drug Administration are diphtheria-tetanus-acellular pertussis (DTPa)-HepB-IPV and DTPa-Hib-IPV combination vaccines, and two DTPa-HepB-IPV-Hib vaccines have been licensed in Europe. As more combination vaccines become available, issues such as interchangeability and administration of extra doses are raised; however, it is important not to miss a vaccination opportunity. CONCLUSIONS The number of injections required to fulfill the recommended childhood immunization schedule at each visit creates problems for patients and practitioner, sometimes risking a missed opportunity for vaccination. The development of combination vaccines will circumvent this problem and increase compliance and vaccination coverage rates.
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Affiliation(s)
- M D Decker
- Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
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Dennehy PH. Active immunization in the United States: developments over the past decade. Clin Microbiol Rev 2001; 14:872-908, table of contents. [PMID: 11585789 PMCID: PMC89007 DOI: 10.1128/cmr.14.4.872-908.2001] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The Centers for Disease Control and Prevention has identified immunization as the most important public health advance of the 20th century. The purpose of this article is to review the changes that have taken place in active immunization in the United States over the past decade. Since 1990, new vaccines have become available to prevent five infectious diseases: varicella, rotavirus, hepatitis A, Lyme disease, and Japanese encephalitis virus infection. Improved vaccines have been developed to prevent Haemophilus influenzae type b, pneumococcus, pertussis, rabies, and typhoid infections. Immunization strategies for the prevention of hepatitis B, measles, meningococcal infections, and poliomyelitis have changed as a result of the changing epidemiology of these diseases. Combination vaccines are being developed to facilitate the delivery of multiple antigens, and improved vaccines are under development for cholera, influenza, and meningococcal disease. Major advances in molecular biology have enabled scientists to devise new approaches to the development of vaccines against diseases ranging from respiratory viral to enteric bacterial infections that continue to plague the world's population.
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Affiliation(s)
- P H Dennehy
- Division of Pediatric Infectious Diseases, Rhode Island Hospital, Providence, Rhode Island 02903, USA.
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Jodar L, Duclos P, Milstien JB, Griffiths E, Aguado MT, Clements CJ. Ensuring vaccine safety in immunization programmes--a WHO perspective. Vaccine 2001; 19:1594-605. [PMID: 11166881 DOI: 10.1016/s0264-410x(00)00358-3] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Ever since vaccines were firstly used against smallpox, adverse events following immunization have been reported. As immunization programmes expand to reach even the most remote communities in the poorest countries, it is likely that many more events will be temporally linked with vaccine administration. Furthermore, the profound shift in the general public and media interest in adverse events may lead to undue concerns and allegations which may ultimately jeopardize immunization programmes world-wide. While the health professional has understood this issue for some time, the public and the media have now also become all too aware of the significance of vaccine-related adverse events. The familiar vaccines, well-tested over decades, have not changed--but the perception regarding their safety has shifted. Claims outrageous or reasonable are being made against both the old and the newly-introduced vaccines. At the same time, the immunological and genetic revolution of the last decade may well bring to our notice some hypothetical risks that need to be addressed at pre-clinical level. WHO has been at the leading edge to guarantee vaccine safety for the last 30 years and will continue to do so. The Organization's plans for the next decade and beyond include the Safe Injection Global Network (SIGN), the development and introduction of safer technologies, and the prevention, early detection and management of AEFIs. The new technologies include needle-containing injection devices such as the autodisable syringe, as well as mucosal and transcutaneous immunization. Training will continue to be at the centre of WHO's efforts, limiting human error to a minimum. Mechanisms have been set in place to detect and respond to new and unforeseen events occurring. Above all, there is a willingness to respond to new climates and new technologies so that the Organization is in the best position to ensure safe immunization for all the world's children.
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Affiliation(s)
- L Jodar
- Vaccines & Biologicals, Health Technology and Pharmaceuticals, World Health Organization, 20 Avenue Appia, 1211 27, Geneva, Switzerland.
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Pines E, Barrand M, Fabre P, Salomon H, Blondeau C, Wood SC, Hoffenbach A. New acellular pertussis-containing paediatric combined vaccines. Vaccine 1999; 17:1650-6. [PMID: 10194818 DOI: 10.1016/s0264-410x(98)00422-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Combined pediatric vaccines have the advantages of conferring protection against multiple common infectious diseases with a reduced number of injections. Their use should lead to better compliance to recommended vaccination schedules. Diphtheria (D), tetanus (T) and whole-cell pertussis vaccine (P) have been successfully combined, with or without inactivated poliovirus vaccine (IPV) in the same syringe for many years. Recently developed acellular pertussis (aP) Haemophilus influenzae type B (Hib), inactivated poliomyelitis virus and hepatitis B vaccines are ideal candidates for inclusion in current combined vaccines. Nevertheless, the development of new combinations has to face preclinical and clinical issues: the appropriate formulation of the new antigen(s) and other vaccine components needs to be determined to ensure compatibility and guard against potential additive or unexpected adverse reactions; potential immunological interference between antigens and the negative impact of other vaccine components on immunogenicity may occur, and these have to be examined also. Whole-cell pertussis vaccines are highly protective against whooping cough, but the severe adverse reactions that these vaccines sometimes produce have led to hesitation over their use, including the decision of some countries to stop pertussis immunization. To increase the acceptability of pertussis vaccination, Pasteur Mérieux Connaught has developed a combined D, T and a two-component acellular pertussis vaccine (DTaP), composed of purified pertussis toxoid (PT) and filamentous haemagglutinin (FHA), which has been shown to be effective in an efficacy trial conducted in Senegal. Acellular DTaP vaccines are immunogenic and have a better safety profile than DTP vaccines, when given either for the primary series, for the booster vaccination or for both. In order to meet worldwide demands, the combined DTaP-IPV or DTP-IPV has been developed for countries where IPV is recommended. Following the encouragement of the WHO, an H. influenzae type B tetanus-conjugated (Act-HIB) vaccine, has been combined in a full liquid formulation with the whole-cell DTP. This vaccine showed a good safety and immunogenicity profile in infants and in toddlers. A combined DTaP-IPV-PRP-T vaccine (where the Act-HIB vaccine is reconstituted by the full-liquid DTaP-IPV) also has been successfully developed both for the primary series and for booster vaccination; although, a reduced immunogenicity against PRP observed after the primary series, this did not affect vaccine priming. Hepatitis B immunization campaigns targeting high-risk groups have failed to control the disease in areas of low endemicity. In 1992, the WHO recommended that hepatitis B vaccination should be integrated into the EPI in all countries by 1997-1999. For that purpose, hepatitis B vaccine is currently evaluated in pediatric combined vaccines. Developing new combination vaccines is a difficult but essential process for maintaining high immunization rates worldwide against infectious diseases, provided that the costs are acceptable. New combined vaccines including pneumococcal and meningococcal component are under wide-scale development.
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Affiliation(s)
- E Pines
- Pasteur Mérieux Connaught, Marnes-la Coquette, France
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Abstract
Better knowledge of the pathogenesis of infections and host responses, and progress in biotechnology, have paved the way for new vaccines. In spite of rapid progress with several vaccine candidates, overoptimism is, however, not warranted. There is usually several years' delay before the new vaccine from the laboratory is available in practice. Acellular pertussis vaccine and rotavirus vaccine are examples of new vaccines that are currently being introduced; varicella, inactivated polio, and hepatitis B vaccines have been suggested for use in a new and more efficient way. In order to keep up high motivation among families and thus high vaccination coverage, more emphasis must be put on information about vaccines, their properties and proper use. Economic analyses are becoming more important in the decision to use new vaccines. Therefore, cost-benefit, cost-effectiveness and cost-utility analyses need to be conducted so that a basis can exist for determining a rational policy.
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Affiliation(s)
- J Eskola
- National Public Health Institute, Helsinki, Finland.
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