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Jelinek T, Schwarz TF, Reisinger E, Malfertheiner P, Versage E, Van Twuijver E, Hohenboken M. Safety, Tolerability, and Immunogenicity of aH5N1 Vaccine in Adults with and without Underlying Medical Conditions. Vaccines (Basel) 2024; 12:481. [PMID: 38793732 PMCID: PMC11125740 DOI: 10.3390/vaccines12050481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/18/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024] Open
Abstract
Influenza pandemics pose a serious risk to the global population, with the potential for high morbidity and mortality. An adjuvanted H5N1 vaccine (aH5N1) has been approved for prophylaxis against the avian influenza virus H5N1, which is a likely cause of future pandemics. In this phase-III, stratified, randomized, controlled, observer-blind, multicenter study, we evaluated the safety and immunogenicity of aH5N1 in four separate groups of adults: adults 18-60 years of age who were healthy or had high-risk medical conditions and older adults ≥61 years of age who were healthy or had high-risk medical conditions. Subjects were randomly assigned to aH5N1 or the comparator, adjuvanted trivalent seasonal influenza vaccine (aTIV). Antibody responses to aH5N1 were increased in all four subgroups and, within each age stratum, largely consistent between healthy subjects and those with medical conditions. Injection-site pain was reported by 66-73% of younger and 36-42% of older-aH5N1 recipients, and fatigue and myalgia were reported by 22-41% of subjects across age and health subgroups. No serious adverse events or deaths were considered related to the study vaccine. In conclusion, aH5N1 increased antibody responses regardless of age or health status and demonstrated a clinically acceptable safety and tolerability profile.
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Affiliation(s)
- Tomas Jelinek
- Berlin Center for Travel and Tropical Medicine, 10117 Berlin, Germany
| | - Tino F. Schwarz
- Department of Laboratory Medicine, Klinikum Würzburg Mitte, Standort Juliusspital, 97070 Würzburg, Germany;
| | - Emil Reisinger
- Medical Faculty, Universitätsmedizin Rostock, 18057 Rostock, Germany;
| | - Peter Malfertheiner
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto von Guericke University, 39106 Magdeburg, Germany;
| | - Eve Versage
- Seqirus, Clinical Development, Cambridge, MA 02139, USA;
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Youhanna J, Tran V, Hyer R, Domnich A. Immunogenicity of Enhanced Influenza Vaccines Against Mismatched Influenza Strains in Older Adults: A Review of Randomized Controlled Trials. Influenza Other Respir Viruses 2024; 18:e13286. [PMID: 38594827 PMCID: PMC11004266 DOI: 10.1111/irv.13286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 04/11/2024] Open
Abstract
Antigenic drift is a major driver of viral evolution and a primary reason why influenza vaccines must be reformulated annually. Mismatch between vaccine and circulating viral strains negatively affects vaccine effectiveness and often contributes to higher rates of influenza-related hospitalizations and deaths, particularly in years dominated by A(H3N2). Several countries recommend enhanced influenza vaccines for older adults, who are at the highest risk of severe influenza complications and mortality. The immunogenicity of enhanced vaccines against heterologous A(H3N2) strains has been examined in nine studies to date. In six studies, an enhanced, licensed MF59-adjuvanted trivalent inactivated influenza vaccine (aIIV3) consistently increased heterologous antibody titers relative to standard influenza vaccine, with evidence of a broad heterologous immune response across multiple genetic clades. In one study, licensed high-dose trivalent inactivated influenza vaccine (HD-IIV3) also induced higher heterologous antibody titers than standard influenza vaccine. In a study comparing a higher dose licensed quadrivalent recombinant influenza vaccine (RIV4) with HD-IIV3 and aIIV3, no significant differences in antibody titers against a heterologous strain were observed, although seroconversion rates were higher with RIV4 versus comparators. With the unmet medical need for improved influenza vaccines, the paucity of studies especially with enhanced vaccines covering mismatched strains highlights a need for further investigation of cross-protection in older adults.
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Affiliation(s)
| | - Vy Tran
- CSL Seqirus LtdSummitNew JerseyUSA
| | - Randall Hyer
- Baruch S. Blumberg InstituteDoylestownPennsylvaniaUSA
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Lim CML, Komarasamy TV, Adnan NAAB, Radhakrishnan AK, Balasubramaniam VRMT. Recent Advances, Approaches and Challenges in the Development of Universal Influenza Vaccines. Influenza Other Respir Viruses 2024; 18:e13276. [PMID: 38513364 PMCID: PMC10957243 DOI: 10.1111/irv.13276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 03/23/2024] Open
Abstract
Every year, influenza virus infections cause significant morbidity and mortality worldwide. They pose a substantial burden of disease, in terms of not only health but also the economy. Owing to the ability of influenza viruses to continuously evolve, annual seasonal influenza vaccines are necessary as a prophylaxis. However, current influenza vaccines against seasonal strains have limited effectiveness and require yearly reformulation due to the virus undergoing antigenic drift or shift. Vaccine mismatches are common, conferring suboptimal protection against seasonal outbreaks, and the threat of the next pandemic continues to loom. Therefore, there is a great need to develop a universal influenza vaccine (UIV) capable of providing broad and durable protection against all influenza virus strains. In the quest to develop a UIV that would obviate the need for annual vaccination and formulation, a multitude of strategies is currently underway. Promising approaches include targeting the highly conserved epitopes of haemagglutinin (HA), neuraminidase (NA), M2 extracellular domain (M2e) and internal proteins of the influenza virus. The identification and characterization of broadly neutralizing antibodies (bnAbs) targeting conserved regions of the viral HA protein, in particular, have provided important insight into novel vaccine designs and platforms. This review discusses universal vaccine approaches presently under development, with an emphasis on those targeting the highly conserved stalk of the HA protein, recent technological advancements used and the future prospects of a UIV in terms of its advantages, developmental obstacles and potential shortcomings.
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Affiliation(s)
- Caryn Myn Li Lim
- Infection and Immunity Research Strength, Jeffrey Cheah School of Medicine & Health SciencesMonash University MalaysiaBandar SunwayMalaysia
| | - Thamil Vaani Komarasamy
- Infection and Immunity Research Strength, Jeffrey Cheah School of Medicine & Health SciencesMonash University MalaysiaBandar SunwayMalaysia
| | - Nur Amelia Azreen Binti Adnan
- Infection and Immunity Research Strength, Jeffrey Cheah School of Medicine & Health SciencesMonash University MalaysiaBandar SunwayMalaysia
| | - Ammu Kutty Radhakrishnan
- Infection and Immunity Research Strength, Jeffrey Cheah School of Medicine & Health SciencesMonash University MalaysiaBandar SunwayMalaysia
| | - Vinod R. M. T. Balasubramaniam
- Infection and Immunity Research Strength, Jeffrey Cheah School of Medicine & Health SciencesMonash University MalaysiaBandar SunwayMalaysia
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Moa A, Kunasekaran M, Akhtar Z, Costantino V, MacIntyre CR. Systematic review of influenza vaccine effectiveness against laboratory-confirmed influenza among older adults living in aged care facilities. Hum Vaccin Immunother 2023; 19:2271304. [PMID: 37929779 PMCID: PMC10629430 DOI: 10.1080/21645515.2023.2271304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 10/12/2023] [Indexed: 11/07/2023] Open
Abstract
We estimated the effectiveness of influenza vaccines in preventing laboratory-confirmed influenza among older adults in aged care. Electronic database searches were conducted using search terms, and studies were selected as per the selection criteria. Fourteen studies were included for final review. The studies exhibited considerable variation in reported vaccine effectiveness (VE) across different seasons. Among the observational studies, VE ranged from 7.2% to 89.8% against laboratory-confirmed influenza across different vaccines. Randomized clinical trials demonstrated a 17% reduction in infection rates with the adjuvanted trivalent vaccine. The limitations include the small number of included studies conducted in different countries or regions, varied seasons, variations in diagnostic testing methods, a focus on the A/H3N2 strain, and few studies available on the effectiveness of enhanced influenza vaccines in aged care settings. Despite challenges associated with achieving optimal protection, the studies showed the benefits of influenza vaccination in the elderly residents.
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Affiliation(s)
- Aye Moa
- Biosecurity Program, The Kirby Institute, The University of New South Wales, Sydney, NSW, Australia
| | - Mohana Kunasekaran
- Biosecurity Program, The Kirby Institute, The University of New South Wales, Sydney, NSW, Australia
| | - Zubair Akhtar
- Biosecurity Program, The Kirby Institute, The University of New South Wales, Sydney, NSW, Australia
| | - Valentina Costantino
- Biosecurity Program, The Kirby Institute, The University of New South Wales, Sydney, NSW, Australia
| | - C. Raina MacIntyre
- Biosecurity Program, The Kirby Institute, The University of New South Wales, Sydney, NSW, Australia
- College of Public Service and Community Solutions, Arizona State University, Phoenix, AZ, USA
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Gupta D, Mohan S. Influenza vaccine: a review on current scenario and future prospects. J Genet Eng Biotechnol 2023; 21:154. [PMID: 38030859 PMCID: PMC10686931 DOI: 10.1186/s43141-023-00581-y] [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: 06/29/2023] [Accepted: 10/28/2023] [Indexed: 12/01/2023]
Abstract
Vaccination is a crucial tool in preventing influenza, but it requires annual updates in vaccine composition due to the ever-changing nature of the flu virus. While healthcare and economic burdens have reduced, the virus remains a challenge. Research conducted over the past decade has revealed pathways for improvement through both basic and clinical studies. Viral surveillance plays a vital role in the better selection of candidate viruses for vaccines and the early detection of drug-resistant strains.This page offers a description of future vaccine developments and an overview of current vaccine options. In the coming years, we anticipate significant changes in vaccine production, moving away from traditional egg-based methods towards innovative technologies such as DNA and RNA vaccines. These newer approaches offer significant advantages over traditional egg-based and cell culture-based influenza vaccine manufacturing.
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Affiliation(s)
- Dipanshi Gupta
- Amity Institute of Biotechnology, Amity University Uttar Pradesh (AUUP), Sector-125, Noida, Uttar Pradesh, 201303, India
| | - Sumedha Mohan
- Amity Institute of Biotechnology, Amity University Uttar Pradesh (AUUP), Sector-125, Noida, Uttar Pradesh, 201303, India.
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Fukao K, Noshi T, Shano S, Baba K, Sato K, Sakuramoto M, Kitade N, Tanioka H, Kusakabe S, Shishido T. Prophylactic Treatment with Baloxavir Protects Mice from Lethal Infection with Influenza A and B Viruses. Viruses 2023; 15:2264. [PMID: 38005940 PMCID: PMC10675732 DOI: 10.3390/v15112264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
Influenza remains a worldwide health concern. Antiviral drugs are considered as one of the useful options for its prevention as a complementary measure to vaccination. Baloxavir acid selectively inhibits the cap-dependent endonuclease of influenza viruses and exhibits marked viral titre reduction in patients. Here, we describe the prophylactic potency of baloxavir acid against lethal infection with influenza A and B viruses in mice. BALB/c mice were subcutaneously administered once with baloxavir acid suspension, or orally administered once daily for 10 days with oseltamivir phosphate solution at human relevant doses. Next, the mice were intranasally inoculated with A/PR/8/34 (H1N1) or B/Hong Kong/5/72 strain at 24 to 96 h after the initial dosing. Prophylactic treatment with the antiviral drugs significantly reduced the lung viral titres and prolonged survival time. In particular, baloxavir acid showed a greater suppressive effect on lung viral titres compared to oseltamivir phosphate. In this model, baloxavir acid maintained significant prophylactic effects against influenza A and B virus infections when the plasma concentration at the time of infection was at least 0.88 and 3.58 ng/mL, respectively. The significant prophylactic efficacy observed in our mouse model suggests the potential utility of baloxavir marboxil for prophylaxis against influenza in humans.
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Affiliation(s)
- Keita Fukao
- Shionogi & Co., Ltd., Osaka 561-0825, Japan (S.K.)
| | | | - Shinya Shano
- Shionogi TechnoAdvance Research, Co., Ltd., Osaka 561-0825, Japan
| | - Kaoru Baba
- Shionogi TechnoAdvance Research, Co., Ltd., Osaka 561-0825, Japan
| | - Kenji Sato
- Shionogi & Co., Ltd., Osaka 561-0825, Japan (S.K.)
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7
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Rockman S, Taylor B, McCauley JW, Barr IG, Longstaff R, Bahra R. Global Pandemic Preparedness: Optimizing Our Capabilities and the Influenza Experience. Vaccines (Basel) 2022; 10:vaccines10040589. [PMID: 35455338 PMCID: PMC9024617 DOI: 10.3390/vaccines10040589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/16/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has prompted rapid investigation and deployment of vaccine platforms never before used to combat human disease. The severe impact on the health system and the high economic cost of non-pharmaceutical interventions, such as lockdowns and international border closures employed to mitigate the spread of COVID-19 prior to the arrival of effective vaccines, have led to calls for development and deployment of novel vaccine technologies as part of a “100-day response ambition” for the next pandemic. Prior to COVID-19, all of the pandemics (excluding HIV) in the past century have been due to influenza viruses, and influenza remains one of the most likely future pandemic threats along with new coronaviruses. New and emerging vaccine platforms are likely to play an important role in combatting the next pandemic. However, the existing well-established, proven platforms for seasonal and pandemic influenza manufacturing will also continue to be utilized to rapidly address the next influenza threat. The field of influenza vaccine manufacturing has a long history of successes, including approval of vaccines within approximately 100 days after WHO declaration of the A(H1N1) 2009 influenza pandemic. Moreover, many advances in vaccine science and manufacturing capabilities have been made in the past decade to optimize a rapid and timely response should a new influenza pandemic threat emerge.
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Affiliation(s)
- Steven Rockman
- Seqirus Ltd., Parkville, VIC 3052, Australia
- Department of Immunology and Microbiology, University of Melbourne, Parkville, VIC 3052, Australia
- Correspondence: ; Tel.: +61-3-9389-2712
| | - Beverly Taylor
- Seqirus Ltd., Maidenhead SL6 8AA, UK; (B.T.); (R.L.); (R.B.)
| | | | - Ian G. Barr
- WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, VIC 3000, Australia;
| | - Ray Longstaff
- Seqirus Ltd., Maidenhead SL6 8AA, UK; (B.T.); (R.L.); (R.B.)
| | - Ranbir Bahra
- Seqirus Ltd., Maidenhead SL6 8AA, UK; (B.T.); (R.L.); (R.B.)
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8
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Jones RP, Ponomarenko A. Trends in Excess Winter Mortality (EWM) from 1900/01 to 2019/20-Evidence for a Complex System of Multiple Long-Term Trends. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063407. [PMID: 35329098 PMCID: PMC8953800 DOI: 10.3390/ijerph19063407] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 11/16/2022]
Abstract
Trends in excess winter mortality (EWM) were investigated from the winter of 1900/01 to 2019/20. During the 1918–1919 Spanish flu epidemic a maximum EWM of 100% was observed in both Denmark and the USA, and 131% in Sweden. During the Spanish flu epidemic in the USA 70% of excess winter deaths were coded to influenza. EWM steadily declined from the Spanish flu peak to a minimum around the 1960s to 1980s. This decline was accompanied by a shift in deaths away from the winter and spring, and the EWM calculation shifted from a maximum around April to June in the early 1900s to around March since the late 1960s. EWM has a good correlation with the number of estimated influenza deaths, but in this context influenza pandemics after the Spanish flu only had an EWM equivalent to that for seasonal influenza. This was confirmed for a large sample of world countries for the three pandemics occurring after 1960. Using data from 1980 onward the effect of influenza vaccination on EWM were examined using a large international dataset. No effect of increasing influenza vaccination could be discerned; however, there are multiple competing forces influencing EWM which will obscure any underlying trend, e.g., increasing age at death, multimorbidity, dementia, polypharmacy, diabetes, and obesity—all of which either interfere with vaccine effectiveness or are risk factors for influenza death. After adjusting the trend in EWM in the USA influenza vaccination can be seen to be masking higher winter deaths among a high morbidity US population. Adjusting for the effect of increasing obesity counteracted some of the observed increase in EWM seen in the USA. Winter deaths are clearly the outcome of a complex system of competing long-term trends.
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Affiliation(s)
- Rodney P. Jones
- Healthcare Analysis & Forecasting, Wantage OX12 0NE, UK
- Correspondence:
| | - Andriy Ponomarenko
- Department of Biophysics, Informatics and Medical Instrumentation, Odessa National Medical University, Valikhovsky Lane 2, 65082 Odessa, Ukraine;
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Constantin C, Pisani A, Bardi G, Neagu M. Nano-carriers of COVID-19 vaccines: the main pillars of efficacy. Nanomedicine (Lond) 2021; 16:2377-2387. [PMID: 34632802 PMCID: PMC8544481 DOI: 10.2217/nnm-2021-0250] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/09/2021] [Indexed: 12/30/2022] Open
Abstract
As the current COVID-19 pandemic illustrates, vaccination is the most powerful method of disease prevention and public confidence in vaccines depends on their safety and efficacy. The information gathered in the current pandemic is growing at an accelerated pace. Both the key vital protein DNA/RNA messengers and the delivery carriers are the elements of a puzzle including their interactions with the immune system to suppress SARS-CoV-2 infection. A new nano-era is beginning in the vaccine development field and an array of side applications for diagnostic and antiviral tools will likely emerge. This review focuses on the evolution of vaccine carriers up to COVID-19-aimed nanoparticles and the immune-related adverse effects imposed by these nanocarriers.
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Affiliation(s)
- Carolina Constantin
- “Victor Babeş” National Institute of Pathology, 99-101 Spl Independentei, Bucharest, 050096, Romania
- Colentina Clinical Hospital, 19-21, Sos. Stefan cel Mare, Bucharest, Romania
| | - Anissa Pisani
- Nanobiointeractions & Nanodiagnostics, Istituto Italiano di Tecnologia, Via Morego 30, Genova, 16163, Italy
- Department of Chemistry & Industrial Chemistry, University of Genova, Via Dodecaneso 31, Genova, 16146, Italy
| | - Giuseppe Bardi
- Nanobiointeractions & Nanodiagnostics, Istituto Italiano di Tecnologia, Via Morego 30, Genova, 16163, Italy
| | - Monica Neagu
- “Victor Babeş” National Institute of Pathology, 99-101 Spl Independentei, Bucharest, 050096, Romania
- Colentina Clinical Hospital, 19-21, Sos. Stefan cel Mare, Bucharest, Romania
- University of Bucharest, 93–95 Spl Independentei, Bucharest, Romania
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Borras E, McCartney MM, Thompson CH, Meagher RJ, Kenyon NJ, Schivo M, Davis CE. Exhaled breath biomarkers of influenza infection and influenza vaccination. J Breath Res 2021; 15. [PMID: 34343985 DOI: 10.1088/1752-7163/ac1a61] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/03/2021] [Indexed: 11/12/2022]
Abstract
Respiratory viral infections are considered a major public health threat, and breath metabolomics can provide new ways to detect and understand how specific viruses affect the human pulmonary system. In this pilot study, we characterized the metabolic composition of human breath for an early diagnosis and differentiation of influenza viral infection, as well as other types of upper respiratory viral infections. We first studied the non-specific effects of planned seasonal influenza vaccines on breath metabolites in healthy subjects after receiving the immunization. We then investigated changes in breath content from hospitalized patients with flu-like symptoms and confirmed upper respiratory viral infection. The exhaled breath was sampled using a custom-made breath condenser, and exhaled breath condensate (EBC) samples were analysed using liquid chromatography coupled to quadruplole-time-of-flight mass spectrometer (LC-qTOF). All metabolomic data was analysed using both targeted and untargeted approaches to detect specific known biomarkers from inflammatory and oxidative stress biomarkers, as well as new molecules associated with specific infections. We were able to find clear differences between breath samples collected before and after flu vaccine administration, together with potential biomarkers that are related to inflammatory processes and oxidative stress. Moreover, we were also able to discriminate samples from patients with flu-related symptoms that were diagnosed with confirmatory respiratory viral panels (RVP). RVP positive and negative differences were identified, as well as differences between specific viruses defined. These results provide very promising information for the further study of the effect of influenza A and other viruses in human systems by using a simple and non-invasive specimen like breath.
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Affiliation(s)
- Eva Borras
- Department of Mechanical and Aerospace Engineering, University of California, Davis, Mechanical and Aerospace Engineering, Davis, California, 95616, UNITED STATES
| | - Mitchell M McCartney
- Mechanical and Aerospace Engineering, University of California - Davis, Mechanical and Aerospace Engineering, Davis, California, 95616, UNITED STATES
| | - Cai Hugo Thompson
- Mechanical and Aerospace Engineering, UC Davis, 1 Shields Avenue, Davis, California, 95616, UNITED STATES
| | - Robert J Meagher
- Sandia National Laboratories California, 7011 East Avenue, Livermore, California, 94551-0969, UNITED STATES
| | - Nicholas J Kenyon
- Sacramento Medical Center, UC Davis Health System, Sacramento, CA 795187, USA, Sacramento, California, 95616, UNITED STATES
| | - Michael Schivo
- Department of Internal Medicine, UC Davis Health System, 4150 V Street, Suite 3100, Sacramento, CA 95817, USA, Sacramento, 95616, UNITED STATES
| | - Cristina E Davis
- Department of Mechanical and Aerospace Engineering, University of California - Davis, Davis, USA, Davis, California, 95616, UNITED STATES
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Leibinger EA, Pauler G, Benedek N, Berki T, Jankovics I, McNally R, Ottóffy G. Baseline CD3+CD56+ (NKT-like) Cells and the Outcome of Influenza Vaccination in Children Undergoing Chemotherapy. Front Immunol 2021; 12:690940. [PMID: 34267757 PMCID: PMC8276261 DOI: 10.3389/fimmu.2021.690940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/15/2021] [Indexed: 11/16/2022] Open
Abstract
Background In children undergoing chemotherapy yearly influenza vaccination is recommended by treatment protocols. We investigated the relationship between cellular immunity and the antibody response to inactivated influenza vaccines. Methods 25 patients (age: 2-18 years) undergoing chemotherapy for different malignancies participated in our study. Flow cytometric detection of peripheral blood lymphocyte subpopulations together with hemagglutination inhibition antibody titers were measured before and 21-28 days after vaccination. We examined the ratio and total numbers of CD3+, CD4+, CD8+ T cells, activated helper (CD3+CD4+CD25low), regulatory (CD3+CD4+CD25high), naive (CD3+CD45RA+) and memory (CD3+CD45RO+) T cells, CD56+NK, and CD3+CD56+ (NKT-like) cells. Relationships between specific antibody responses (seroprotection, seroconversion, geometric mean titer (GMT), geometric mean fold increase (GMFI)) and the ratios and counts of lymphocyte subpopulations were evaluated using one-way ANOVA and the paired sample t test after dichotomization according to age-related reference values. Results Patients with CD4+ lymphocyte levels in the normal age-specific range showed significantly better response regarding postvaccination GMT elevation for H1N1 and H3N2 strains (97.52 vs. 19.2, p=0.019, 80 vs. 14.43, p=0.021, respectively). GMFI results were significant only against B strain (2.69-fold vs. 1.23-fold, p=0.046). Prevaccination CD3+CD56+ (NKT-like) cells above predicted values according to age showed significant associations both in postvaccination GMT elevation (H1N1: 75.11 vs. 14.14, p=0.010; H3N2: 62.18 vs. 11.22, p=0.012; B: 22.69 vs. 6.67, p=0.043) and GMFI against all three strains (H1N1: 3.76-fold vs. 1.06-fold, p=0.015; H3N2: 2.74-fold vs. 1, p=0.013; B: 2.57-fold vs. 1, p=0.008). By one-way ANOVA, we found a positive relation between absolute lymphocyte cell count above 1000/µl and the postvaccination GMT elevation against H3N2 (12.81 vs. 56.56, p=0.032), and GMFI regarding H1N1 (1.22-fold vs. 3.48-fold, p=0.044). Conclusions In addition to verifying the predictive value of absolute lymphocyte count above 1000/µl, our results suggest an association between NKT-like cell counts and the specific antibody response against all three investigated influenza strains in highly immunosuppressed patients. Furthermore, prevaccination CD4+ lymphocyte levels in the normal age-specific range may influence seroresponse.
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Affiliation(s)
- Evelin A Leibinger
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Pécs Medical School, Pécs, Hungary
| | - Gábor Pauler
- Institute of Mathematics and Informatics, University of Pécs, Pécs, Hungary
| | - Noémi Benedek
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Pécs Medical School, Pécs, Hungary
| | - Tímea Berki
- Department of Immunology and Biotechnology, University of Pécs Medical School, Pécs, Hungary
| | - István Jankovics
- Department of Virology, National Center for Epidemiology, Budapest, Hungary
| | - Richard McNally
- Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Gábor Ottóffy
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Pécs Medical School, Pécs, Hungary
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Lewis NS, Banyard AC, Essen S, Whittard E, Coggon A, Hansen R, Reid S, Brown IH. Antigenic evolution of contemporary clade 2.3.4.4 HPAI H5 influenza A viruses and impact on vaccine use for mitigation and control. Vaccine 2021; 39:3794-3798. [PMID: 34074548 DOI: 10.1016/j.vaccine.2021.05.060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 12/23/2022]
Abstract
Since 2003, highly pathogenic avian influenza (HPAI) viruses of the H5 subtype have been maintained in poultry, periodically spilling back into wild migratory birds and spread to other geographic regions, with re-introduction to domestic birds causing severe impacts for poultry health, production and food sustainability. Successive waves of infection have also resulted in substantial genetic evolution and reassortment, enabling the emergence of multiple clades and subtypes within the H5 2.3.4.4 HPAI viruses. Control of AI is principally through either culling or through vaccination using conventional vaccines. Here, we antigenically and genetically characterise the emerging 2020/21 H5NX clade 2.3.4.4 strains and assess cross-reactivity to putative vaccine strains using chicken antisera. We demonstrate significant antigenic differences between commercially available poultry vaccines and currently circulating viruses suggesting that vaccination options might be suboptimal in the current outbreaks.
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Affiliation(s)
- Nicola S Lewis
- Animal and Plant Health Agency-Weybridge, OIE/FAO International Reference Laboratory for Avian Influenza, Swine Influenza and Newcastle Disease Virus, Department of Virology, Woodham Lane, Addlestone, Surrey KT15 3NB, United Kingdom; Royal Veterinary College, Department of Pathobiology and Population Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA, United Kingdom.
| | - Ashley C Banyard
- Animal and Plant Health Agency-Weybridge, OIE/FAO International Reference Laboratory for Avian Influenza, Swine Influenza and Newcastle Disease Virus, Department of Virology, Woodham Lane, Addlestone, Surrey KT15 3NB, United Kingdom
| | - Steve Essen
- Animal and Plant Health Agency-Weybridge, OIE/FAO International Reference Laboratory for Avian Influenza, Swine Influenza and Newcastle Disease Virus, Department of Virology, Woodham Lane, Addlestone, Surrey KT15 3NB, United Kingdom
| | - Elliot Whittard
- Animal and Plant Health Agency-Weybridge, OIE/FAO International Reference Laboratory for Avian Influenza, Swine Influenza and Newcastle Disease Virus, Department of Virology, Woodham Lane, Addlestone, Surrey KT15 3NB, United Kingdom
| | - Amelia Coggon
- Royal Veterinary College, Department of Pathobiology and Population Sciences, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA, United Kingdom
| | - Rowena Hansen
- Animal and Plant Health Agency-Weybridge, OIE/FAO International Reference Laboratory for Avian Influenza, Swine Influenza and Newcastle Disease Virus, Department of Virology, Woodham Lane, Addlestone, Surrey KT15 3NB, United Kingdom
| | - Scott Reid
- Animal and Plant Health Agency-Weybridge, OIE/FAO International Reference Laboratory for Avian Influenza, Swine Influenza and Newcastle Disease Virus, Department of Virology, Woodham Lane, Addlestone, Surrey KT15 3NB, United Kingdom
| | - Ian H Brown
- Animal and Plant Health Agency-Weybridge, OIE/FAO International Reference Laboratory for Avian Influenza, Swine Influenza and Newcastle Disease Virus, Department of Virology, Woodham Lane, Addlestone, Surrey KT15 3NB, United Kingdom
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13
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Gilroy DW, De Maeyer RP, Tepper M, O’Brien A, Uddin M, Chen J, Goldstein DR, Akbar AN. Treating exuberant, non-resolving inflammation in the lung; Implications for acute respiratory distress syndrome and COVID-19. Pharmacol Ther 2021; 221:107745. [PMID: 33188794 PMCID: PMC7657264 DOI: 10.1016/j.pharmthera.2020.107745] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/30/2020] [Indexed: 01/26/2023]
Abstract
While COVID-19, the disease driven by SARS-CoV-2 has ignited interest in the host immune response to this infection, it has also highlighted the lack of treatment options for the damaging inflammatory responses driven by pathogens that precipitate the acute respiratory distress syndrome (ARDS). With the global prevalence of SARS-CoV-2 and the likelihood of a second winter spike alongside seasonal flu, the need for effective and targeted anti-inflammatory agents is even more pressing. Here we discuss the aetiology of COVID-19 and the common signalling pathways driven by SARS-CoV-2, namely p38 MAP kinase. We highlight that p38 MAP kinase becomes elevated with increasing age, thereby driving many of the inflammatory pathways that precipitate death in old people with the added drawback of impairing vaccine efficacy in this susceptible age group. Finally, we review drugs available to inhibit p38 MAP kinase, their risks-versus-benefits as well as suggested dosing regimen to combat over-exuberant innate immune responses and potentially reverse vaccine inefficacy in older patients.
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Affiliation(s)
- Derek W. Gilroy
- Division of Medicine, University College London, London, UK,Corresponding author
| | | | - Mark Tepper
- Senex Therapeutics Inc., Newton, Center, MA, USA
| | | | - Mohib Uddin
- Late Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Sweden
| | - Judy Chen
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Daniel R. Goldstein
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Arne N. Akbar
- Division of Medicine, University College London, London, UK
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14
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Mezhenskaya D, Isakova-Sivak I, Kotomina T, Matyushenko V, Kim MC, Bhatnagar N, Kim KH, Kang SM, Rudenko L. A Strategy to Elicit M2e-Specific Antibodies Using a Recombinant H7N9 Live Attenuated Influenza Vaccine Expressing Multiple M2e Tandem Repeats. Biomedicines 2021; 9:biomedicines9020133. [PMID: 33535408 PMCID: PMC7912525 DOI: 10.3390/biomedicines9020133] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/21/2022] Open
Abstract
Influenza viruses remain a serious public health problem. Vaccination is the most effective way to prevent the disease; however, seasonal influenza vaccines demonstrate low or no effectiveness against antigenically drifted and newly emerged influenza viruses. Different strategies of eliciting immune responses against conserved parts of various influenza virus proteins are being developed worldwide. We constructed a universal live attenuated influenza vaccine (LAIV) candidate with enhanced breadth of protection by modifying H7N9 LAIV by incorporating four epitopes of M2 protein extracellular part into its hemagglutinin molecule. The new recombinant H7N9+4M2e vaccine induced anti-M2e antibody responses and demonstrated increased protection against heterosubtypic challenge viruses in direct and serum passive protection studies, compared to the classical H7N9 LAIV. The results of our study suggest that the H7N9+4M2e warrants further investigation in pre-clinical and phase 1 clinical trials.
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Affiliation(s)
- Daria Mezhenskaya
- Department of Virology, Institute of Experimental Medicine, 197376 Saint Petersburg, Russia; (D.M.); (T.K.); (V.M.); (L.R.)
| | - Irina Isakova-Sivak
- Department of Virology, Institute of Experimental Medicine, 197376 Saint Petersburg, Russia; (D.M.); (T.K.); (V.M.); (L.R.)
- Correspondence:
| | - Tatiana Kotomina
- Department of Virology, Institute of Experimental Medicine, 197376 Saint Petersburg, Russia; (D.M.); (T.K.); (V.M.); (L.R.)
| | - Victoria Matyushenko
- Department of Virology, Institute of Experimental Medicine, 197376 Saint Petersburg, Russia; (D.M.); (T.K.); (V.M.); (L.R.)
| | - Min-Chul Kim
- Center for Inflammation, Immunity and Infection, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA 30303, USA; (M.-C.K.); (N.B.); (K.-H.K.); (S.-M.K.)
| | - Noopur Bhatnagar
- Center for Inflammation, Immunity and Infection, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA 30303, USA; (M.-C.K.); (N.B.); (K.-H.K.); (S.-M.K.)
| | - Ki-Hye Kim
- Center for Inflammation, Immunity and Infection, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA 30303, USA; (M.-C.K.); (N.B.); (K.-H.K.); (S.-M.K.)
| | - Sang-Moo Kang
- Center for Inflammation, Immunity and Infection, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA 30303, USA; (M.-C.K.); (N.B.); (K.-H.K.); (S.-M.K.)
| | - Larisa Rudenko
- Department of Virology, Institute of Experimental Medicine, 197376 Saint Petersburg, Russia; (D.M.); (T.K.); (V.M.); (L.R.)
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