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Salisch NC, Stephenson KE, Williams K, Cox F, van der Fits L, Heerwegh D, Truyers C, Habets MN, Kanjilal DG, Larocca RA, Abbink P, Liu J, Peter L, Fierro C, De La Barrera RA, Modjarrad K, Zahn RC, Hendriks J, Cahill CP, Leyssen M, Douoguih M, van Hoof J, Schuitemaker H, Barouch DH. A Double-Blind, Randomized, Placebo-Controlled Phase 1 Study of Ad26.ZIKV.001, an Ad26-Vectored Anti-Zika Virus Vaccine. Ann Intern Med 2021; 174:585-594. [PMID: 33587687 DOI: 10.7326/m20-5306] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Zika virus (ZIKV) may cause severe congenital disease after maternal-fetal transmission. No vaccine is currently available. OBJECTIVE To assess the safety and immunogenicity of Ad26.ZIKV.001, a prophylactic ZIKV vaccine candidate. DESIGN Phase 1 randomized, double-blind, placebo-controlled clinical study. (ClinicalTrials.gov: NCT03356561). SETTING United States. PARTICIPANTS 100 healthy adult volunteers. INTERVENTION Ad26.ZIKV.001, an adenovirus serotype 26 vector encoding ZIKV M-Env, administered in 1- or 2-dose regimens of 5 × 1010 or 1 × 1011 viral particles (vp), or placebo. MEASUREMENTS Local and systemic adverse events; neutralization titers by microneutralization assay (MN50) and T-cell responses by interferon-γ enzyme-linked immunospot and intracellular cytokine staining; and protectivity of vaccine-induced antibodies in a subset of participants through transfer in an exploratory mouse ZIKV challenge model. RESULTS All regimens were well tolerated, with no safety concerns identified. In both 2-dose regimens, ZIKV neutralizing titers peaked 14 days after the second vaccination, with geometric mean MN50 titers (GMTs) of 1065.6 (95% CI, 494.9 to 2294.5) for 5 × 1010 vp and 956.6 (595.8 to 1535.8) for 1 × 1011 vp. Titers persisted for at least 1 year at a GMT of 68.7 (CI, 26.4-178.9) for 5 × 1010 vp and 87.0 (CI, 29.3 to 258.6) for 1 × 1011 vp. A 1-dose regimen of 1 × 1011 vp Ad26.ZIKV.001 induced seroconversion in all participants 56 days after the first vaccination (GMT, 103.4 [CI, 52.7 to 202.9]), with titers persisting for at least 1 year (GMT, 90.2 [CI, 38.4 to 212.2]). Env-specific cellular responses were induced. Protection against ZIKV challenge was observed after antibody transfer from participants into mice, and MN50 titers correlated with protection in this model. LIMITATION The study was conducted in a nonendemic area, so it did not assess safety and immunogenicity in a flavivirus-exposed population. CONCLUSION The safety and immunogenicity profile makes Ad26.ZIKV.001 a promising candidate for further development if the need reemerges. PRIMARY FUNDING SOURCE Janssen Vaccines and Infectious Diseases.
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Affiliation(s)
- Nadine C Salisch
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Kathryn E Stephenson
- Beth Israel Deaconess Medical Center, Boston, Massachusetts (K.E.S., D.G.K., R.A.L., P.A., J.L., L.P., D.H.B.)
| | - Kristi Williams
- Janssen Research and Development, Spring House, Pennsylvania (K.W.)
| | - Freek Cox
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Leslie van der Fits
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Dirk Heerwegh
- Janssen Research and Development, Beerse, Belgium (D.H., C.T.)
| | - Carla Truyers
- Janssen Research and Development, Beerse, Belgium (D.H., C.T.)
| | - Marrit N Habets
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Diane G Kanjilal
- Beth Israel Deaconess Medical Center, Boston, Massachusetts (K.E.S., D.G.K., R.A.L., P.A., J.L., L.P., D.H.B.)
| | - Rafael A Larocca
- Beth Israel Deaconess Medical Center, Boston, Massachusetts (K.E.S., D.G.K., R.A.L., P.A., J.L., L.P., D.H.B.)
| | - Peter Abbink
- Beth Israel Deaconess Medical Center, Boston, Massachusetts (K.E.S., D.G.K., R.A.L., P.A., J.L., L.P., D.H.B.)
| | - Jinyan Liu
- Beth Israel Deaconess Medical Center, Boston, Massachusetts (K.E.S., D.G.K., R.A.L., P.A., J.L., L.P., D.H.B.)
| | - Lauren Peter
- Beth Israel Deaconess Medical Center, Boston, Massachusetts (K.E.S., D.G.K., R.A.L., P.A., J.L., L.P., D.H.B.)
| | | | | | - Kayvon Modjarrad
- Walter Reed Army Institute of Research, Silver Spring, Maryland (R.A.D., K.M.)
| | - Roland C Zahn
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Jenny Hendriks
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Conor P Cahill
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Maarten Leyssen
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Macaya Douoguih
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Johan van Hoof
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Hanneke Schuitemaker
- Janssen Vaccines and Prevention, Leiden, the Netherlands (N.C.S., F.C., L.V., M.N.H., R.C.Z., J.H., C.P.C., M.L., M.D., J.V., H.S.)
| | - Dan H Barouch
- Beth Israel Deaconess Medical Center, Boston, Massachusetts (K.E.S., D.G.K., R.A.L., P.A., J.L., L.P., D.H.B.)
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Habets MN, van Selm S, van der Gaast-de Jongh CE, Diavatopoulos DA, de Jonge MI. A novel flow cytometry-based assay for the quantification of antibody-dependent pneumococcal agglutination. PLoS One 2017; 12:e0170884. [PMID: 28288168 PMCID: PMC5347990 DOI: 10.1371/journal.pone.0170884] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 01/12/2017] [Indexed: 11/18/2022] Open
Abstract
The respiratory pathogen Streptococcus pneumoniae is a major cause of diseases such as otitis media, pneumonia, sepsis and meningitis. The first step towards infection is colonization of the nasopharynx. Recently, it was shown that agglutinating antibodies play an important role in the prevention of mucosal colonization with S. pneumoniae. Here, we present a novel method to quantify antibody-dependent pneumococcal agglutination in a high-throughput manner using flow cytometry. We found that the concentration of agglutinating antibodies against pneumococcal capsule are directly correlated with changes in the size and complexity of bacterial aggregates, as measured by flow cytometry and confirmed by light microscopy. Using the increase in size, we determined the agglutination index. The cutoff value was set by measuring a series of non-agglutinating antibodies. With this method, we show that not only anti-polysaccharide capsule antibodies are able to induce agglutination but that also anti-PspA protein antibodies have agglutinating capabilities. In conclusion, we have described and validated a novel method to quantify pneumococcal agglutination, which can be used to screen sera from murine or human vaccination studies, in a high-throughput manner.
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Affiliation(s)
- Marrit N Habets
- Laboratory of Pediatric Infectious Diseases, Department of Pediatrics, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Saskia van Selm
- Laboratory of Pediatric Infectious Diseases, Department of Pediatrics, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Christa E van der Gaast-de Jongh
- Laboratory of Pediatric Infectious Diseases, Department of Pediatrics, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Dimitri A Diavatopoulos
- Laboratory of Pediatric Infectious Diseases, Department of Pediatrics, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Marien I de Jonge
- Laboratory of Pediatric Infectious Diseases, Department of Pediatrics, Radboud Institute for Molecular Life Sciences, Radboud university medical center, Nijmegen, The Netherlands
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Habets MN, van Selm S, van Opzeeland FJ, Simonetti E, Hermans PWM, de Jonge MI, Diavatopoulos DA. Role of antibodies and IL17-mediated immunity in protection against pneumococcal otitis media. Vaccine 2016; 34:5968-5974. [PMID: 27771185 DOI: 10.1016/j.vaccine.2016.09.057] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 09/12/2016] [Accepted: 09/29/2016] [Indexed: 11/19/2022]
Abstract
Widespread vaccination against Streptococcus pneumoniae (the pneumococcus) has significantly reduced pneumococcal disease caused by vaccine serotypes. Despite vaccination, overall pneumococcal colonization rates in children have not reduced and otitis media (OM) by non-vaccine serotypes remains one of the most common childhood infections. Pneumococcal surface protein A (PspA) has been shown to be a promising protein antigen to induce broad protection against pneumococcal colonization. However, its ability to protect against OM remains unclear. Using our previously established mouse model of influenza-virus induced pneumococcal OM, we here show that intranasal vaccination of mice with PspA together with the mucosal adjuvant CTB results in a decrease in pneumococcal load in the middle ears. This decrease correlated with the induction of PspA-specific IgA, a balanced IgG1:IgG2a antibody response and the induction of a mucosal Th17 response. Our data suggests that the IL-17 response to PspA is more important for protection against OM, whilst the presence of antibodies may be less important, as determined in mice deficient in IL-17 signaling or antibody production. Together, these results suggest that mucosal vaccination with PspA may not only protect against colonization, but also against the development of virus-induced pneumococcal OM.
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Affiliation(s)
- Marrit N Habets
- Laboratory of Pediatric Infectious Diseases, Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein 10 (Route 412), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Saskia van Selm
- Laboratory of Pediatric Infectious Diseases, Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein 10 (Route 412), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Fred J van Opzeeland
- Laboratory of Pediatric Infectious Diseases, Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein 10 (Route 412), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Elles Simonetti
- Laboratory of Pediatric Infectious Diseases, Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein 10 (Route 412), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Peter W M Hermans
- Laboratory of Pediatric Infectious Diseases, Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein 10 (Route 412), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Marien I de Jonge
- Laboratory of Pediatric Infectious Diseases, Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein 10 (Route 412), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Dimitri A Diavatopoulos
- Laboratory of Pediatric Infectious Diseases, Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein 10 (Route 412), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
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Habets MN, Cremers AJH, Bos MP, Savelkoul P, Eleveld MJ, Meis JF, Hermans PWM, Melchers WJ, de Jonge MI, Diavatopoulos DA. A novel quantitative PCR assay for the detection of Streptococcus pneumoniae using the competence regulator gene target comX. J Med Microbiol 2015; 65:129-136. [PMID: 26628261 DOI: 10.1099/jmm.0.000204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Streptococcus pneumoniae is responsible for an estimated 1.6 million deaths worldwide every year. While rapid detection and timely treatment with appropriate antibiotics is preferred, this is often difficult due to the amount of time that detection with blood cultures takes. In this study, a novel quantitative PCR assay for the detection of Streptococcus pneumoniae was developed. To identify novel targets, we analysed the pneumococcal genome for unique, repetitive DNA sequences. This approach identified comX, which is conserved and present in duplicate copies in Streptococcus pneumoniae but not in other bacterial species. Comparison with lytA, the current 'gold standard' for detection by quantitative PCR, demonstrated an analytic specificity of 100% for both assays on a panel of 10 pneumococcal and 18 non-pneumococcal isolates, but a reduction of 3.5 quantitation cycle values (± 0.23 sem), resulting in an increased analytical detection rate of comX. We validated our assay on DNA extracted from the serum of 30 bacteraemic patients who were blood culture positive for Streptococcus pneumoniae and 51 serum samples that were culture positive for other bacteria. This resulted in a similar clinical sensitivity between the comX and lytA assays (47%) and in a diagnostic specificity of 98.2 and 100% for the lytA and comX assays, respectively. In conclusion, we have developed a novel quantitative PCR assay with increased analytical sensitivity for the detection of Streptococcus pneumoniae, which may be used to develop a rapid bedside test for the direct detection of Streptococcus pneumoniae in clinical specimens.
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Affiliation(s)
- Marrit N Habets
- Laboratory of Pediatric Infectious Diseases, Department of Pediatrics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Amelieke J H Cremers
- Laboratory of Pediatric Infectious Diseases, Department of Pediatrics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Paul Savelkoul
- Microbiome, Amsterdam, The Netherlands
- Department of Medical Microbiology and Infection Control, VU University Medical Center, The Netherlands
- Department of Medical Microbiology, Maastricht University Medical Center, The Netherlands
| | - Marc J Eleveld
- Laboratory of Pediatric Infectious Diseases, Department of Pediatrics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter W M Hermans
- Laboratory of Pediatric Infectious Diseases, Department of Pediatrics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Willem J Melchers
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marien I de Jonge
- Laboratory of Pediatric Infectious Diseases, Department of Pediatrics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dimitri A Diavatopoulos
- Laboratory of Pediatric Infectious Diseases, Department of Pediatrics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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