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Ezzemani W, Ouladlahsen A, Altawalah H, Saile R, Sarih M, Kettani A, Ezzikouri S. Identification of novel T-cell epitopes on monkeypox virus and development of multi-epitopes vaccine using immunoinformatics approaches. J Biomol Struct Dyn 2024; 42:5349-5364. [PMID: 37354141 DOI: 10.1080/07391102.2023.2226733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/25/2022] [Accepted: 06/10/2023] [Indexed: 06/26/2023]
Abstract
Monkeypox virus (MPV) is closely related to the smallpox virus, and previous data from Africa suggest that the smallpox vaccine (VARV) is at least 85% effective in preventing MPV. No multi-epitope vaccine has yet been developed to prevent MPV infection. In this work, we used in silico structural biology and advanced immunoinformatic strategies to design a multi-epitope subunit vaccine against MPV infection. The designed vaccine sequence is adjuvanted with CpG-ODN and includes HTL/CTL epitopes for similar proteins between vaccinia virus (VACV) that induced T-cell production in vaccinated volunteers and the first draft sequence of the MPV genome associated with the suspected outbreak in several countries, May 2022. In addition, the specific binding of the modified vaccine and the immune Toll-like receptor 9 (TLR9) was estimated by molecular interaction studies. Strong interaction in the binding groove as well as good docking scores confirmed the stringency of the modified vaccine. The stability of the interaction was confirmed by a classical molecular dynamics simulation and normal mode analysis. Then, the immune simulation also indicated the ability of this vaccine to induce an effective immune response against MPV. Codon optimization and in silico cloning of the vaccine into the pET-28a (+) vector also showed its expression potential in the E. coli K12 system. The promising data obtained from the various in silico studies indicate that this vaccine is effective against MPV. However, additional in vitro and in vivo studies are still needed to confirm its efficacy.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Wahiba Ezzemani
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
- Laboratoire de Biologie et Santé (URAC34), Départment de Biologie, Faculté des Sciences Ben Msik, Hassan II University of Casablanca, Casablanca, Morocco
| | - Ahd Ouladlahsen
- Faculté de médecine et de pharmacie, Université Hassan II, Casablanca, Morocco
- Service des maladies infectieuses, CHU Ibn Rochd, Casablanca, Morocco
| | - Haya Altawalah
- Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
- Virology Unit, Yacoub Behbehani Center, Sabah Hospital, Ministry of Health, Kuwait City, Kuwait
| | - Rachid Saile
- Laboratoire de Biologie et Santé (URAC34), Départment de Biologie, Faculté des Sciences Ben Msik, Hassan II University of Casablanca, Casablanca, Morocco
| | - M'hammed Sarih
- Service de Parasitologie et des Maladies Vectorielles, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Anass Kettani
- Laboratoire de Biologie et Santé (URAC34), Départment de Biologie, Faculté des Sciences Ben Msik, Hassan II University of Casablanca, Casablanca, Morocco
| | - Sayeh Ezzikouri
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
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Berry MT, Khan SR, Schlub TE, Notaras A, Kunasekaran M, Grulich AE, MacIntyre CR, Davenport MP, Khoury DS. Predicting vaccine effectiveness for mpox. Nat Commun 2024; 15:3856. [PMID: 38719852 PMCID: PMC11078999 DOI: 10.1038/s41467-024-48180-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/22/2024] [Indexed: 05/12/2024] Open
Abstract
The Modified Vaccinia Ankara vaccine developed by Bavarian Nordic (MVA-BN) was widely deployed to prevent mpox during the 2022 global outbreak. This vaccine was initially approved for mpox based on its reported immunogenicity (from phase I/II trials) and effectiveness in animal models, rather than evidence of clinical efficacy. However, no validated correlate of protection after vaccination has been identified. Here we performed a systematic search and meta-analysis of the available data to test whether vaccinia-binding ELISA endpoint titer is predictive of vaccine effectiveness against mpox. We observe a significant correlation between vaccine effectiveness and vaccinia-binding antibody titers, consistent with the existing assumption that antibody levels may be a correlate of protection. Combining this data with analysis of antibody kinetics after vaccination, we predict the durability of protection after vaccination and the impact of dose spacing. We find that delaying the second dose of MVA-BN vaccination will provide more durable protection and may be optimal in an outbreak with limited vaccine stock. Although further work is required to validate this correlate, this study provides a quantitative evidence-based approach for using antibody measurements to predict the effectiveness of mpox vaccination.
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Affiliation(s)
- Matthew T Berry
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Shanchita R Khan
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Timothy E Schlub
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Adriana Notaras
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | | | - Andrew E Grulich
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - C Raina MacIntyre
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
- College of Public Service and Community Solutions, and College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Miles P Davenport
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
| | - David S Khoury
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
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Mariotti S, Venturi G, Chiantore MV, Teloni R, De Santis R, Amendola A, Fortuna C, Marsili G, Grilli G, Lia MS, Kiros ST, Lagi F, Bartoloni A, Iacobino A, Cresta R, Lastilla M, Biselli R, Di Bonito P, Lista F, Nisini R. Antibodies Induced by Smallpox Vaccination after at Least 45 Years Cross-React with and In Vitro Neutralize Mpox Virus: A Role for Polyclonal B Cell Activation? Viruses 2024; 16:620. [PMID: 38675961 PMCID: PMC11054675 DOI: 10.3390/v16040620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/04/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
AIMS To evaluate whether antibodies specific for the vaccinia virus (VV) are still detectable after at least 45 years from immunization. To confirm that VV-specific antibodies are endowed with the capacity to neutralize Mpox virus (MPXV) in vitro. To test a possible role of polyclonal non-specific activation in the maintenance of immunologic memory. METHODS Sera were collected from the following groups: smallpox-vaccinated individuals with or without latent tuberculosis infection (LTBI), unvaccinated donors, and convalescent individuals after MPXV infection. Supernatant of VV- or MPXV-infected Vero cells were inactivated and used as antigens in ELISA or in Western blot (WB) analyses. An MPXV plaque reduction neutralization test (PRNT) was optimized and performed on study samples. VV- and PPD-specific memory T cells were measured by flow cytometry. RESULTS None of the smallpox unvaccinated donors tested positive in ELISA or WB analysis and their sera were unable to neutralize MPXV in vitro. Sera from all the individuals convalescing from an MPXV infection tested positive for anti-VV or MPXV IgG with high titers and showed MPXV in vitro neutralization capacity. Sera from most of the vaccinated individuals showed IgG anti-VV and anti-MPXV at high titers. WB analyses showed that positive sera from vaccinated or convalescent individuals recognized both VV and MPXV antigens. Higher VV-specific IgG titer and specific T cells were observed in LTBI individuals. CONCLUSIONS ELISA and WB performed using supernatant of VV- or MPXV-infected cells are suitable to identify individuals vaccinated against smallpox at more than 45 years from immunization and individuals convalescing from a recent MPXV infection. ELISA and WB results show a good correlation with PRNT. Data confirm that a smallpox vaccination induces a long-lasting memory in terms of specific IgG and that antibodies raised against VV may neutralize MPXV in vitro. Finally, higher titers of VV-specific antibodies and higher frequency of VV-specific memory T cells in LTBI individuals suggest a role of polyclonal non-specific activation in the maintenance of immunologic memory.
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Affiliation(s)
- Sabrina Mariotti
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy; (S.M.); (G.V.); (M.V.C.); (R.T.); (A.A.); (C.F.); (G.M.); (A.I.); (P.D.B.)
| | - Giulietta Venturi
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy; (S.M.); (G.V.); (M.V.C.); (R.T.); (A.A.); (C.F.); (G.M.); (A.I.); (P.D.B.)
| | - Maria Vincenza Chiantore
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy; (S.M.); (G.V.); (M.V.C.); (R.T.); (A.A.); (C.F.); (G.M.); (A.I.); (P.D.B.)
| | - Raffaela Teloni
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy; (S.M.); (G.V.); (M.V.C.); (R.T.); (A.A.); (C.F.); (G.M.); (A.I.); (P.D.B.)
| | - Riccardo De Santis
- Defense Institute for Biomedical Sciences, 00184 Roma, Italy; (R.D.S.); (G.G.); (M.S.L.); (F.L.)
| | - Antonello Amendola
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy; (S.M.); (G.V.); (M.V.C.); (R.T.); (A.A.); (C.F.); (G.M.); (A.I.); (P.D.B.)
| | - Claudia Fortuna
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy; (S.M.); (G.V.); (M.V.C.); (R.T.); (A.A.); (C.F.); (G.M.); (A.I.); (P.D.B.)
| | - Giulia Marsili
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy; (S.M.); (G.V.); (M.V.C.); (R.T.); (A.A.); (C.F.); (G.M.); (A.I.); (P.D.B.)
| | - Giorgia Grilli
- Defense Institute for Biomedical Sciences, 00184 Roma, Italy; (R.D.S.); (G.G.); (M.S.L.); (F.L.)
| | - Maria Stella Lia
- Defense Institute for Biomedical Sciences, 00184 Roma, Italy; (R.D.S.); (G.G.); (M.S.L.); (F.L.)
| | - Seble Tekle Kiros
- University Hospital Careggi, 50134 Firenze, Italy; (S.T.K.); (F.L.); (A.B.)
| | - Filippo Lagi
- University Hospital Careggi, 50134 Firenze, Italy; (S.T.K.); (F.L.); (A.B.)
| | | | - Angelo Iacobino
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy; (S.M.); (G.V.); (M.V.C.); (R.T.); (A.A.); (C.F.); (G.M.); (A.I.); (P.D.B.)
| | - Raffaele Cresta
- Aeronautica Militare, Comando Logistico, Servizio Sanitario, 00185 Roma, Italy; (R.C.); (M.L.); (R.B.)
| | - Marco Lastilla
- Aeronautica Militare, Comando Logistico, Servizio Sanitario, 00185 Roma, Italy; (R.C.); (M.L.); (R.B.)
| | - Roberto Biselli
- Aeronautica Militare, Comando Logistico, Servizio Sanitario, 00185 Roma, Italy; (R.C.); (M.L.); (R.B.)
| | - Paola Di Bonito
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy; (S.M.); (G.V.); (M.V.C.); (R.T.); (A.A.); (C.F.); (G.M.); (A.I.); (P.D.B.)
| | - Florigio Lista
- Defense Institute for Biomedical Sciences, 00184 Roma, Italy; (R.D.S.); (G.G.); (M.S.L.); (F.L.)
| | - Roberto Nisini
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy; (S.M.); (G.V.); (M.V.C.); (R.T.); (A.A.); (C.F.); (G.M.); (A.I.); (P.D.B.)
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Nitido AN, Balazs AB. mRNA-based monkeypox virus vaccine prevents disease in non-human primates. Cell 2024; 187:1360-1362. [PMID: 38490180 DOI: 10.1016/j.cell.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 02/09/2024] [Accepted: 02/09/2024] [Indexed: 03/17/2024]
Abstract
The mpox outbreak in 2022 launched a vaccination campaign employing an existing vaccine with moderate protection, highlighting the lack of scalable Orthopoxvirus vaccines with optimal protection. In this issue of Cell, Zuiani et al. report pre-clinical findings of an mRNA-based mpox vaccine, paving the way for Phase I/II clinical trials.
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Affiliation(s)
- Adam N Nitido
- Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA 02139, USA
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Matusali G, Mazzotta V, Piselli P, Bettini A, Colavita F, Coen S, Vaia F, Girardi E, Antinori A, Maggi F. Asymptomatic Mpox Virus Infection in Subjects Presenting for MVA-BN Vaccine. Clin Infect Dis 2023; 77:1483-1484. [PMID: 37417243 PMCID: PMC10654850 DOI: 10.1093/cid/ciad414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/05/2023] [Indexed: 07/08/2023] Open
Affiliation(s)
- Giulia Matusali
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS (Istituto di Ricovero e Cura a carattere Scientifico), Rome, Italy
| | - Valentina Mazzotta
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS (Istituto di Ricovero e Cura a carattere Scientifico), Rome, Italy
| | - Pierluca Piselli
- Epidemiology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS (Istituto di Ricovero e Cura a carattere Scientifico), Rome, Italy
| | - Aurora Bettini
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS (Istituto di Ricovero e Cura a carattere Scientifico), Rome, Italy
| | - Francesca Colavita
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS (Istituto di Ricovero e Cura a carattere Scientifico), Rome, Italy
| | - Sabrina Coen
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS (Istituto di Ricovero e Cura a carattere Scientifico), Rome, Italy
| | - Francesco Vaia
- General Direction, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS (Istituto di Ricovero e Cura a carattere Scientifico), Rome, Italy
| | - Enrico Girardi
- Scientific Direction, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS (Istituto di Ricovero e Cura a carattere Scientifico), Rome, Italy
| | - Andrea Antinori
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS (Istituto di Ricovero e Cura a carattere Scientifico), Rome, Italy
| | - Fabrizio Maggi
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS (Istituto di Ricovero e Cura a carattere Scientifico), Rome, Italy
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Xia A, Wang X, He J, Wu W, Jiang W, Xue S, Zhang Q, Gao Y, Han Y, Li Y, Peng X, Xie M, Mayer CT, Liu J, Hua C, Sha Y, Xu W, Huang J, Ying T, Jiang S, Xie Y, Cai Q, Lu L, Silva IT, Yuan Z, Zhang Y, Wang Q. Cross-reactive antibody response to Monkeypox virus surface proteins in a small proportion of individuals with and without Chinese smallpox vaccination history. BMC Biol 2023; 21:205. [PMID: 37784185 PMCID: PMC10546712 DOI: 10.1186/s12915-023-01699-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 09/11/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND After the eradication of smallpox in China in 1979, vaccination with the vaccinia virus (VACV) Tiantan strain for the general population was stopped in 1980. As the monkeypox virus (MPXV) is rapidly spreading in the world, we would like to investigate whether the individuals with historic VACV Tiantan strain vaccination, even after more than 40 years, could still provide ELISA reactivity and neutralizing protection; and whether the unvaccinated individuals have no antibody reactivity against MPXV at all. RESULTS We established serologic ELISA to measure the serum anti-MPXV titer by using immunodominant MPXV surface proteins, A35R, B6R, A29L, and M1R. A small proportion of individuals (born before 1980) with historic VACV Tiantan strain vaccination exhibited serum ELISA cross-reactivity against these MPXV surface proteins. Consistently, these donors also showed ELISA seropositivity and serum neutralization against VACV Tiantan strain. However, surprisingly, some unvaccinated young adults (born after 1980) also showed potent serum ELISA activity against MPXV proteins, possibly due to their past infection by some self-limiting Orthopoxvirus (OPXV). CONCLUSIONS We report the serum ELISA cross-reactivity against MPXV surface protein in a small proportion of individuals both with and without VACV Tiantan strain vaccination history. Combined with our serum neutralization assay against VACV and the recent literature about mice vaccinated with VACV Tiantan strain, our study confirmed the anti-MPXV cross-reactivity and cross-neutralization of smallpox vaccine using VACV Tiantan strain. Therefore, it is necessary to restart the smallpox vaccination program in high risk populations.
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Affiliation(s)
- Anqi Xia
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Xiaojie Wang
- The Interdisciplinary Research Center on Biology and Chemistry, Chinese Academy of Sciences, Shanghai, China
| | - Jiaying He
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Wei Wu
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Weiyu Jiang
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Song Xue
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Qianqian Zhang
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yidan Gao
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yuru Han
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yaming Li
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Xiaofang Peng
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Minxiang Xie
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Christian T Mayer
- Experimental Immunology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Jie Liu
- Department of Respiratory and Critical Care Medicine, Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, 214023, Jiangsu, China
| | - Chen Hua
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yiou Sha
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Wei Xu
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Jinghe Huang
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Tianlei Ying
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Shibo Jiang
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Youhua Xie
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Qiliang Cai
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Lu Lu
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
| | - Israel T Silva
- Laboratory of Bioinformatics and Computational Biology, A. C. Camargo Cancer Center, São Paulo, SP, 01509-010, Brazil.
| | - Zhenghong Yuan
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
| | - Yixiao Zhang
- The Interdisciplinary Research Center on Biology and Chemistry, Chinese Academy of Sciences, Shanghai, China.
| | - Qiao Wang
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Institute of Infectious Disease and Biosecurity, Shanghai Frontiers Science Center of Pathogenic Microbes and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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Li E, Guo X, Hong D, Gong Q, Xie W, Li T, Wang J, Chuai X, Chiu S. Duration of humoral immunity from smallpox vaccination and its cross-reaction with Mpox virus. Signal Transduct Target Ther 2023; 8:350. [PMID: 37709783 PMCID: PMC10502045 DOI: 10.1038/s41392-023-01574-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/13/2023] [Revised: 06/11/2023] [Accepted: 07/26/2023] [Indexed: 09/16/2023] Open
Abstract
The ongoing pandemic caused by mpox virus (MPXV) has become an international public health emergency that poses a significant threat to global health. The vaccinia virus Tiantan strain (VTT) was used to vaccinate against smallpox in China 42 years ago. It is urgent to assess the level of immunity to smallpox in individuals vaccinated 43 or more years ago and evaluate their immunological susceptibility to MPXV. Here, we recruited 294 volunteers and detected the level of residual humoral immunity, including the vaccinia-specific IgG level and neutralizing antibody titer, and the cross-antibodies of MPXV A29L, B6R, A35R, and M1R. Our results showed that the humoral immunity from the smallpox vaccine in the population still remains, and VTT-specific NAb levels wane with age. The majority of the population pre-1981 who should be immunized with VTT still maintains certain levels of MPXV-specific antibodies, in particular, targeting A35R and B6R antigens. Furthermore, we separately analyzed the correlations between the OD450 values of VTT-specific IgG and A35R-specific IgG, B6R-specific IgG, and A29L-specific IgG with plasma samples diluted 1:40, showing a linear correlation (p < 0.0001). Our findings suggest that most Chinese populations still maintain VTT-specific IgG antibodies for 42 or more years after smallpox vaccination and could provide some level of protection against MPXV.
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Affiliation(s)
- Entao Li
- Department of Laboratory Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Xiaoping Guo
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Dongxiang Hong
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Qizan Gong
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Wenyu Xie
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Tingting Li
- Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jian Wang
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
| | - Xia Chuai
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega Science, Chinese Academy of Sciences, Wuhan, Hubei, China.
| | - Sandra Chiu
- Department of Laboratory Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
- Core Unit of National Clinical Research Center for Laboratory Medicine, Hefei, Anhui, China.
- Key Laboratory of Anhui Province for Emerging and Reemerging Infectious Diseases, Hefei, Anhui, China.
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8
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Sanz-Muñoz I, Sánchez-dePrada L, Sánchez-Martínez J, Rojo-Rello S, Domínguez-Gil M, Hernán-García C, Fernández-Espinilla V, de Lejarazu-Leonardo RO, Castrodeza-Sanz J, Eiros JM. Possible Mpox Protection from Smallpox Vaccine-Generated Antibodies among Older Adults. Emerg Infect Dis 2023; 29:656-658. [PMID: 36732061 PMCID: PMC9973709 DOI: 10.3201/eid2903.221231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Smallpox vaccination may confer cross-protection to mpox. We evaluated vaccinia virus antibodies in 162 persons ≥50 years of age in Spain; 68.5% had detectable antibodies. Highest coverage (78%) was among persons 71-80 years of age. Low antibody levels in 31.5% of this population indicates that addressing their vaccination should be a priority.
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9
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Abstract
Favored shot is a seemingly safer smallpox vaccine, but researchers debate how best to use it.
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10
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Thomas A, Hammarlund E, Gao L, Holman S, Michel KG, Glesby M, Villacres MC, Golub ET, Roan NR, French AL, Augenbraun MH, Slifka MK. Loss of Preexisting Immunological Memory Among Human Immunodeficiency Virus-Infected Women Despite Immune Reconstitution With Antiretroviral Therapy. J Infect Dis 2020; 222:243-251. [PMID: 31867597 PMCID: PMC7323495 DOI: 10.1093/infdis/jiz678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 12/19/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND It is unclear whether human immunodeficiency virus (HIV) infection results in permanent loss of T-cell memory or if it affects preexisting antibodies to childhood vaccinations or infections. METHODS We conducted a matched cohort study involving 50 pairs of HIV-infected and HIV-uninfected women. Total memory T-cell responses were measured after anti-CD3 or vaccinia virus (VV) stimulation to measure T cells elicited after childhood smallpox vaccination. VV-specific antibodies were measured by means of enzyme-linked immunosorbent assay (ELISA). RESULTS There was no difference between HIV-infected and HIV-uninfected study participants in terms of CD4+ T-cell responses after anti-CD3 stimulation (P = .19) although HIV-infected participants had significantly higher CD8+ T-cell responses (P = .03). In contrast, there was a significant loss in VV-specific CD4+ T-cell memory among HIV-infected participants (P = .04) whereas antiviral CD8+ T-cell memory remained intact (P > .99). VV-specific antibodies were maintained indefinitely among HIV-uninfected participants (half-life, infinity; 95% confidence interval, 309 years to infinity) but declined rapidly among HIV-infected participants (half-life; 39 years; 24-108 years; P = .001). CONCLUSIONS Despite antiretroviral therapy-associated improvement in CD4+ T-cell counts (nadir, <200/μL; >350/μL after antiretroviral therapy), antigen-specific CD4+ T-cell memory to vaccinations or infections that occurred before HIV infection did not recover after immune reconstitution, and a previously unrealized decline in preexisting antibody responses was observed.
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Affiliation(s)
- Archana Thomas
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon, USA
| | - Erika Hammarlund
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon, USA
| | - Lina Gao
- Biostatistics Shared Resource, Knight Cancer Institute, Biostatistics & Bioinformatics Core, Oregon National Primate Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Susan Holman
- Division of Infectious Diseases, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Katherine G Michel
- Department of Medicine, Georgetown University Medical Center, Washington, DC, USA
| | - Marshall Glesby
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Maria C Villacres
- Department of Pediatrics, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Elizabeth T Golub
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nadia R Roan
- Department of Urology, University of California, San Francisco, San Francisco, California, USA
| | - Audrey L French
- Department of Medicine, Cook County Health and Hospitals System, Chicago, Illinois, USA
| | - Michael H Augenbraun
- Division of Infectious Diseases, Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Mark K Slifka
- Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon, USA
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11
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Costantino V, Trent MJ, Sullivan JS, Kunasekaran MP, Gray R, MacIntyre R. Serological Immunity to Smallpox in New South Wales, Australia. Viruses 2020; 12:v12050554. [PMID: 32443405 PMCID: PMC7291091 DOI: 10.3390/v12050554] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 11/27/2022] Open
Abstract
The re-emergence of smallpox is an increasing and legitimate concern due to advances in synthetic biology. Vaccination programs against smallpox using the vaccinia virus vaccine ceased with the eradication of smallpox and, unlike many other countries, Australia did not use mass vaccinations. However, vaccinated migrants contribute to population immunity. Testing for vaccinia antibodies is not routinely performed in Australia, and few opportunities exist to estimate the level of residual population immunity against smallpox. Serological data on population immunity in Australia could inform management plans against a smallpox outbreak. Vaccinia antibodies were measured in 2003 in regular plasmapheresis donors at the Australian Red Cross Blood Service from New South Wales (NSW). The data were analysed to estimate the proportion of Australians in NSW with detectable serological immunity to vaccinia. The primary object of this study was to measure neutralising antibody titres against vaccinia virus. Titre levels in donor samples were determined by plaque reduction assay. To estimate current levels of immunity to smallpox infection, the decline in geometric mean titres (GMT) over time was projected using two values for the antibody levels estimated on the basis of different times since vaccination. The results of this study suggest that there is minimal residual immunity to the vaccinia virus in the Australian population. Although humoral immunity is protective against orthopoxvirus infections, cell-mediated immunity and immunological memory likely also play roles, which are not quantified by antibody levels. These data provide an immunological snapshot of the NSW population, which could inform emergency preparedness planning and outbreak control, especially concerning the stockpiling of vaccinia vaccine.
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Affiliation(s)
- Valentina Costantino
- Biosecurity Program, Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; (M.J.T.); (M.P.K.); (R.M.)
- Correspondence:
| | - Mallory J. Trent
- Biosecurity Program, Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; (M.J.T.); (M.P.K.); (R.M.)
| | - John S. Sullivan
- Central Clinical School, University of Sydney, Sydney, NSW 2052, Australia;
- School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - Mohana P. Kunasekaran
- Biosecurity Program, Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; (M.J.T.); (M.P.K.); (R.M.)
| | - Richard Gray
- Surveillance Evaluation and Research Program, Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia;
| | - Raina MacIntyre
- Biosecurity Program, Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia; (M.J.T.); (M.P.K.); (R.M.)
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12
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Overton ET, Lawrence SJ, Stapleton JT, Weidenthaler H, Schmidt D, Koenen B, Silbernagl G, Nopora K, Chaplin P. A randomized phase II trial to compare safety and immunogenicity of the MVA-BN smallpox vaccine at various doses in adults with a history of AIDS. Vaccine 2020; 38:2600-2607. [PMID: 32057574 DOI: 10.1016/j.vaccine.2020.01.058] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [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: 10/16/2019] [Revised: 01/17/2020] [Accepted: 01/21/2020] [Indexed: 01/04/2023]
Abstract
Traditional replicating smallpox vaccines are associated with serious safety concerns in the general population and are contraindicated in immunocompromised individuals. However, this very population remains at greatest risk for severe complications following viral infections, making vaccine prevention particularly relevant. MVA-BN was developed as a non-replicating smallpox vaccine that is potentially safer for people who are immunocompromised. In this phase II trial, 3 MVA-BN dosing regimens were evaluated for safety, tolerability, and immunogenicity in persons with HIV (PWH) who had a history of AIDS. Following randomization, 87 participants who were predominately male and African American received either 2 standard doses on weeks 0 and 4 in the standard dose (SD) group (N = 27), 2 double-standard doses on the same schedule in the double dose (DD) group (N = 29), or 3 standard doses on weeks 0, 4 and 12 in the booster dose (BD) group (N = 31). No safety concerns were identified, and injection site pain was the most commonly reported solicited adverse event (AE) in all groups (66.7%), with no meaningful differences between groups. The incidence of severe (Grade 3) AEs was low across groups and no serious AEs or AEs of special interest considered related to study vaccine were reported. Doubling the standard MVA-BN dose had no significant effect on induction of neutralizing antibodies, with 100% seroconversion and comparable GMTs at week 6 in the SD and DD groups (78.9 and 100.3, respectively). A booster dose significantly increased peak neutralizing titers in the BD group (GMT: 281.1), which remained elevated at 12 months (GMT: 45.3) compared to the SD (GMT: 6.2) and DD (GMT: 10.6) groups. However, based on the immune response previously reported for healthy participants, a third dose (booster) does not appear necessary, even for immunocompromised participants. Clinical Trial Registry Number: NCT02038881.
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Affiliation(s)
- Edgar Turner Overton
- Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Steven J Lawrence
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Jack T Stapleton
- Division of Infectious Diseases, Departments of Internal Medicine, Microbiology & Immunology, University of Iowa Carver College of Medicine and Iowa City Veterans Administration Healthcare, Iowa City, IA, USA
| | | | - Darja Schmidt
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, 82152 Martinsried, Germany
| | - Brigitte Koenen
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, 82152 Martinsried, Germany
| | - Günter Silbernagl
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, 82152 Martinsried, Germany
| | - Katrin Nopora
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, 82152 Martinsried, Germany
| | - Paul Chaplin
- Bavarian Nordic A/S, Hejreskovvej 10A, DK-3490 Kvistgård, Denmark
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13
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Abstract
Widespread vaccination programmes led to the global eradication of smallpox, which was certified by the World Health Organisation (WHO), and, since 1978, there has been no case of smallpox anywhere in the world. However, the viable variola virus (VARV), the causative agent of smallpox, is still kept in two maximum security laboratories in Russia and the USA. Despite the eradication of the disease smallpox, clandestine stocks of VARV may exist. In a rapidly changing world, the impact of an intentional VARV release in the human population would nowadays result in a public health emergency of global concern: vaccination programmes were abolished, the percentage of immunosuppressed individuals in the human population is higher, and an increased intercontinental air travel allows for the rapid viral spread of diseases around the world. The WHO has authorised the temporary retention of VARV to enable essential research for public health benefit to take place. This work aims to develop diagnostic tests, antiviral drugs, and safer vaccines. Advances in synthetic biology have made it possible to produce infectious poxvirus particles from chemicals in vitro so that it is now possible to reconstruct VARV. The status of smallpox in the post-eradication era is reviewed.
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Affiliation(s)
- Hermann Meyer
- Bundeswehr Institute of Microbiology, 80937 Munich, Germany
| | - Rosina Ehmann
- Bundeswehr Institute of Microbiology, 80937 Munich, Germany
| | - Geoffrey L. Smith
- Department of Pathology, University of Cambridge, Cambridge CB2 1QP, UK;
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14
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Russo AT, Berhanu A, Bigger CB, Prigge J, Silvera PM, Grosenbach DW, Hruby D. Co-administration of tecovirimat and ACAM2000™ in non-human primates: Effect of tecovirimat treatment on ACAM2000 immunogenicity and efficacy versus lethal monkeypox virus challenge. Vaccine 2020; 38:644-654. [PMID: 31677948 PMCID: PMC6954297 DOI: 10.1016/j.vaccine.2019.10.049] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 10/08/2019] [Accepted: 10/17/2019] [Indexed: 02/06/2023]
Abstract
Naturally occurring smallpox has been eradicated but research stocks of variola virus (VARV), the causative agent of smallpox, still exist in secure laboratories. Clandestine stores of the virus or resurrection of VARV via synthetic biology are possible and have led to concerns that VARV could be used as a biological weapon. The US government has prepared for such an event by stockpiling smallpox vaccines and TPOXX®, SIGA Technologies' smallpox antiviral drug. While vaccination is effective as a pre-exposure prophylaxis, protection is limited when administered following exposure. Safety concerns preclude general use of the vaccine unless there is a smallpox outbreak. TPOXX is approved by the FDA for use after confirmed diagnosis of smallpox disease. Tecovirimat, the active pharmaceutical ingredient in TPOXX, targets a highly conserved orthopoxviral protein, inhibiting long-range dissemination of virus. Although indications for use of the vaccine and TPOXX do not overlap, concomitant use is possible, especially if the TPOXX indication is expanded to include post-exposure prophylaxis. It is therefore important to understand how vaccine and TPOXX may interact. In studies presented here, monkeys were vaccinated with the ACAM2000TM live attenuated smallpox vaccine and concomitantly treated with tecovirimat or placebo. Immune responses to the vaccine and protective efficacy versus a lethal monkeypox virus (MPXV) challenge were evaluated. In two studies, primary and anamnestic humoral immune responses were similar regardless of tecovirimat treatment while the third study showed reduction in vaccine elicited humoral immunity. Following lethal MPXV challenge, all (12 of 12) vaccinated/placebo treated animals survived, and 12 of 13 vaccinated/tecovirimat treated animals survived. Clinical signs of disease were elevated in tecovirimat treated animals compared to placebo treated animals. This suggests that TPOXX may affect the immunogenicity of ACAM2000 if administered concomitantly. These studies may inform on how vaccine and TPOXX are used during a smallpox outbreak.
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Affiliation(s)
- Andrew T Russo
- Poxvirus Research Group, SIGA Technologies Inc., Corvallis, OR, United States.
| | | | | | - Jon Prigge
- Southern Research Institute, Frederick, MD, United States
| | | | - Douglas W Grosenbach
- Poxvirus Research Group, SIGA Technologies, Inc., Corvallis, OR 97333, United States.
| | - Dennis Hruby
- SIGA Technologies, Inc., Corvallis, OR 97333, United States
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15
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Pittman PR, Hahn M, Lee HS, Koca C, Samy N, Schmidt D, Hornung J, Weidenthaler H, Heery CR, Meyer TPH, Silbernagl G, Maclennan J, Chaplin P. Phase 3 Efficacy Trial of Modified Vaccinia Ankara as a Vaccine against Smallpox. N Engl J Med 2019; 381:1897-1908. [PMID: 31722150 DOI: 10.1056/nejmoa1817307] [Citation(s) in RCA: 122] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Many countries have stockpiled vaccines because of concerns about the reemergence of smallpox. Traditional smallpox vaccines are based on replicating vaccinia viruses; these vaccines have considerable side effects. METHODS To evaluate the efficacy of modified vaccinia Ankara (MVA) as a potential smallpox vaccine, we randomly assigned 440 participants to receive two doses of MVA followed by one dose of the established replicating-vaccinia vaccine ACAM2000 (the MVA group) or to receive one dose of ACAM2000 (the ACAM2000-only group). The two primary end points were noninferiority of the MVA vaccine to ACAM2000 with respect to the peak serum neutralizing antibody titers and attenuation of the ACAM2000-associated major cutaneous reaction by previous MVA vaccination, measured according to the maximum lesion area and the derived area attenuation ratio. RESULTS A total of 220 and 213 participants were randomly assigned and vaccinated in the MVA group and ACAM2000-only group, respectively, and 208 participants received two MVA vaccinations. At peak visits, MVA vaccination induced a geometric mean titer of neutralizing antibodies of 153.5 at week 6, as compared with 79.3 at week 4 with ACAM2000 (a ratio of 1.94 [95% confidence interval {CI}, 1.56 to 2.40]). At day 14, the geometric mean titer of neutralizing antibodies induced by a single MVA vaccination (16.2) was equal to that induced by ACAM2000 (16.2), and the percentages of participants with seroconversion were similar (90.8% and 91.8%, respectively). The median lesion areas of the major cutaneous reaction were 0 mm2 in the MVA group and 76.0 mm2 in the ACAM2000-only group, resulting in an area attenuation ratio of 97.9% (95% CI, 96.6 to 98.3). There were fewer adverse events or adverse events of grade 3 or higher after both MVA vaccination periods in the MVA group than in the ACAM2000-only group (17 vs. 64 participants with adverse events of grade 3 or higher, P<0.001). CONCLUSIONS No safety concerns associated with the MVA vaccine were identified. Immune responses and attenuation of the major cutaneous reaction suggest that this MVA vaccine protected against variola infection. (Funded by the Office of the Assistant Secretary for Preparedness and Response Biomedical Advanced Research and Development Authority of the Department of Health and Human Services and Bavarian Nordic; ClinicalTrials.gov number, NCT01913353.).
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Affiliation(s)
- Phillip R Pittman
- From the U.S. Army Medical Research Institute of Infectious Diseases, Medical Research and Materiel Command, Fort Detrick, Frederick, MD (P.R.P., C.K.); Brian Allgood Army Community Hospital, 121st Combat Support Hospital, Yongsan, South Korea (P.R.P., M.H., H.S.L., C.K.); Bavarian Nordic, Martinsried, Germany (N.S., D.S., J.H., H.W., T.P.H.M., G.S., J.M.); Bavarian Nordic, Morrisville NC (C.R.H.); and Bavarian Nordic, Kvistgård, Denmark (P.C.)
| | - Matthew Hahn
- From the U.S. Army Medical Research Institute of Infectious Diseases, Medical Research and Materiel Command, Fort Detrick, Frederick, MD (P.R.P., C.K.); Brian Allgood Army Community Hospital, 121st Combat Support Hospital, Yongsan, South Korea (P.R.P., M.H., H.S.L., C.K.); Bavarian Nordic, Martinsried, Germany (N.S., D.S., J.H., H.W., T.P.H.M., G.S., J.M.); Bavarian Nordic, Morrisville NC (C.R.H.); and Bavarian Nordic, Kvistgård, Denmark (P.C.)
| | - HeeChoon S Lee
- From the U.S. Army Medical Research Institute of Infectious Diseases, Medical Research and Materiel Command, Fort Detrick, Frederick, MD (P.R.P., C.K.); Brian Allgood Army Community Hospital, 121st Combat Support Hospital, Yongsan, South Korea (P.R.P., M.H., H.S.L., C.K.); Bavarian Nordic, Martinsried, Germany (N.S., D.S., J.H., H.W., T.P.H.M., G.S., J.M.); Bavarian Nordic, Morrisville NC (C.R.H.); and Bavarian Nordic, Kvistgård, Denmark (P.C.)
| | - Craig Koca
- From the U.S. Army Medical Research Institute of Infectious Diseases, Medical Research and Materiel Command, Fort Detrick, Frederick, MD (P.R.P., C.K.); Brian Allgood Army Community Hospital, 121st Combat Support Hospital, Yongsan, South Korea (P.R.P., M.H., H.S.L., C.K.); Bavarian Nordic, Martinsried, Germany (N.S., D.S., J.H., H.W., T.P.H.M., G.S., J.M.); Bavarian Nordic, Morrisville NC (C.R.H.); and Bavarian Nordic, Kvistgård, Denmark (P.C.)
| | - Nathaly Samy
- From the U.S. Army Medical Research Institute of Infectious Diseases, Medical Research and Materiel Command, Fort Detrick, Frederick, MD (P.R.P., C.K.); Brian Allgood Army Community Hospital, 121st Combat Support Hospital, Yongsan, South Korea (P.R.P., M.H., H.S.L., C.K.); Bavarian Nordic, Martinsried, Germany (N.S., D.S., J.H., H.W., T.P.H.M., G.S., J.M.); Bavarian Nordic, Morrisville NC (C.R.H.); and Bavarian Nordic, Kvistgård, Denmark (P.C.)
| | - Darja Schmidt
- From the U.S. Army Medical Research Institute of Infectious Diseases, Medical Research and Materiel Command, Fort Detrick, Frederick, MD (P.R.P., C.K.); Brian Allgood Army Community Hospital, 121st Combat Support Hospital, Yongsan, South Korea (P.R.P., M.H., H.S.L., C.K.); Bavarian Nordic, Martinsried, Germany (N.S., D.S., J.H., H.W., T.P.H.M., G.S., J.M.); Bavarian Nordic, Morrisville NC (C.R.H.); and Bavarian Nordic, Kvistgård, Denmark (P.C.)
| | - Joachim Hornung
- From the U.S. Army Medical Research Institute of Infectious Diseases, Medical Research and Materiel Command, Fort Detrick, Frederick, MD (P.R.P., C.K.); Brian Allgood Army Community Hospital, 121st Combat Support Hospital, Yongsan, South Korea (P.R.P., M.H., H.S.L., C.K.); Bavarian Nordic, Martinsried, Germany (N.S., D.S., J.H., H.W., T.P.H.M., G.S., J.M.); Bavarian Nordic, Morrisville NC (C.R.H.); and Bavarian Nordic, Kvistgård, Denmark (P.C.)
| | - Heinz Weidenthaler
- From the U.S. Army Medical Research Institute of Infectious Diseases, Medical Research and Materiel Command, Fort Detrick, Frederick, MD (P.R.P., C.K.); Brian Allgood Army Community Hospital, 121st Combat Support Hospital, Yongsan, South Korea (P.R.P., M.H., H.S.L., C.K.); Bavarian Nordic, Martinsried, Germany (N.S., D.S., J.H., H.W., T.P.H.M., G.S., J.M.); Bavarian Nordic, Morrisville NC (C.R.H.); and Bavarian Nordic, Kvistgård, Denmark (P.C.)
| | - Christopher R Heery
- From the U.S. Army Medical Research Institute of Infectious Diseases, Medical Research and Materiel Command, Fort Detrick, Frederick, MD (P.R.P., C.K.); Brian Allgood Army Community Hospital, 121st Combat Support Hospital, Yongsan, South Korea (P.R.P., M.H., H.S.L., C.K.); Bavarian Nordic, Martinsried, Germany (N.S., D.S., J.H., H.W., T.P.H.M., G.S., J.M.); Bavarian Nordic, Morrisville NC (C.R.H.); and Bavarian Nordic, Kvistgård, Denmark (P.C.)
| | - Thomas P H Meyer
- From the U.S. Army Medical Research Institute of Infectious Diseases, Medical Research and Materiel Command, Fort Detrick, Frederick, MD (P.R.P., C.K.); Brian Allgood Army Community Hospital, 121st Combat Support Hospital, Yongsan, South Korea (P.R.P., M.H., H.S.L., C.K.); Bavarian Nordic, Martinsried, Germany (N.S., D.S., J.H., H.W., T.P.H.M., G.S., J.M.); Bavarian Nordic, Morrisville NC (C.R.H.); and Bavarian Nordic, Kvistgård, Denmark (P.C.)
| | - Günter Silbernagl
- From the U.S. Army Medical Research Institute of Infectious Diseases, Medical Research and Materiel Command, Fort Detrick, Frederick, MD (P.R.P., C.K.); Brian Allgood Army Community Hospital, 121st Combat Support Hospital, Yongsan, South Korea (P.R.P., M.H., H.S.L., C.K.); Bavarian Nordic, Martinsried, Germany (N.S., D.S., J.H., H.W., T.P.H.M., G.S., J.M.); Bavarian Nordic, Morrisville NC (C.R.H.); and Bavarian Nordic, Kvistgård, Denmark (P.C.)
| | - Jane Maclennan
- From the U.S. Army Medical Research Institute of Infectious Diseases, Medical Research and Materiel Command, Fort Detrick, Frederick, MD (P.R.P., C.K.); Brian Allgood Army Community Hospital, 121st Combat Support Hospital, Yongsan, South Korea (P.R.P., M.H., H.S.L., C.K.); Bavarian Nordic, Martinsried, Germany (N.S., D.S., J.H., H.W., T.P.H.M., G.S., J.M.); Bavarian Nordic, Morrisville NC (C.R.H.); and Bavarian Nordic, Kvistgård, Denmark (P.C.)
| | - Paul Chaplin
- From the U.S. Army Medical Research Institute of Infectious Diseases, Medical Research and Materiel Command, Fort Detrick, Frederick, MD (P.R.P., C.K.); Brian Allgood Army Community Hospital, 121st Combat Support Hospital, Yongsan, South Korea (P.R.P., M.H., H.S.L., C.K.); Bavarian Nordic, Martinsried, Germany (N.S., D.S., J.H., H.W., T.P.H.M., G.S., J.M.); Bavarian Nordic, Morrisville NC (C.R.H.); and Bavarian Nordic, Kvistgård, Denmark (P.C.)
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16
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Rieckmann A, Villumsen M, Hønge BL, Sørup S, Rodrigues A, da Silva ZJ, Whittle H, Benn C, Aaby P. Phase-out of smallpox vaccination and the female/male HIV-1 prevalence ratio: an ecological study from Guinea-Bissau. BMJ Open 2019; 9:e031415. [PMID: 31666269 PMCID: PMC6830606 DOI: 10.1136/bmjopen-2019-031415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE In Guinea-Bissau, West Africa, we observed that having a smallpox vaccination scar was associated with lower HIV-1 prevalence, more strongly for women than men. If this represents a causal effect, the female/male HIV-1 prevalence ratio would increase for birth cohorts no longer receiving smallpox vaccination due to the phase-out of this vaccine. DESIGN An ecological design using HIV surveys and information about smallpox vaccination coverage. SETTING Urban and rural Guinea-Bissau. PARTICIPANTS Participants in HIV surveys were grouped into an age group with decreasing smallpox vaccination coverage (15-34 years) and an age group with steady smallpox vaccination coverage (≥35 years). INTERVENTIONS The exposure of interest was the phase-out of the smallpox vaccine in Guinea-Bissau. PRIMARY AND SECONDARY OUTCOME MEASURES HIV-1 prevalence. RESULTS At both sites, the female/male HIV-1 prevalence ratio increased by calendar time for the age group with decreasing smallpox vaccination coverage; the combined female/male HIV-1 prevalence ratio among people aged 15-34 years was 1.00 (95% CI 0.17 to 5.99) in 1987-1990, 1.16 (95% CI 0.69 to 1.93) in 1996-1997, 2.32 (95% CI 1.51 to 3.56) in 2006-2007 (p value for no trend=0.04). There was no increase in the female-to-male HIV-1 prevalence ratio for the age group >35 years with steady smallpox vaccination coverage; 1.93 (95% CI 0.40 to 9.25) in 1987-1990, 1.32 (95% CI 0.83 to 2.10) in 1996-1997, 0.81 (95% CI 0.56 to 1.16) in 2006-2007 (p value for no trend=0.07). CONCLUSIONS Thus, data was compatible with the deduction that the phase-out of smallpox vaccination may have increased the susceptibility to HIV-1 relatively more for women than men. Hence, phasing out smallpox vaccination may have contributed to the global increase in the female/male HIV-1 prevalence ratio among young individuals. Due to the potential fallacies of ecological studies, the results should be interpreted carefully, and this hypothesis needs further assessment. If the hypothesis is true, studies of smallpox vaccination could inform HIV-1 vaccine research.
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Affiliation(s)
- Andreas Rieckmann
- Bandim Health Project, OPEN, Department of Clinical Research, University of Southern Denmark/Odense University Hospital, Odense, Denmark
- Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marie Villumsen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region, Copenhagen, Denmark
| | - Bo Langhoff Hønge
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau
| | - Signe Sørup
- Bandim Health Project, OPEN, Department of Clinical Research, University of Southern Denmark/Odense University Hospital, Odense, Denmark
- Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | | | | | - Hilton Whittle
- London School of Hygiene and Tropical Medicine, London, UK
| | - Christine Benn
- Bandim Health Project, OPEN, Department of Clinical Research, University of Southern Denmark/Odense University Hospital, Odense, Denmark
- Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark
| | - Peter Aaby
- Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau
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Rieckmann A, Meyle KD, Rod NH, Baker JL, Benn CS, Aaby P, Sørup S. Smallpox and BCG vaccination in childhood and cutaneous malignant melanoma in Danish adults followed from 18 to 49 years. Vaccine 2019; 37:6730-6736. [PMID: 31537447 DOI: 10.1016/j.vaccine.2019.09.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/30/2019] [Accepted: 09/06/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Early smallpox and Bacillus Calmette-Guérin (BCG) vaccinations have been associated with reduced risk of cutaneous malignant melanoma (CMM). We assessed the association between pre-school smallpox vaccination and early-school BCG vaccination and CMM in a young Danish population. METHODS We conducted a register-based case-cohort study of individuals growing up during the phase-out period of smallpox and BCG vaccination in Denmark (born 1965-1976) utilising the decrease in vaccination during this period. Information on childhood vaccinations and potential confounders from Copenhagen school health records were linked with nationwide registers on cancer (CMM diagnoses), migrations and deaths by personal identification numbers. RESULTS The individuals were followed from age 18 until 31/12/2014 (maximum age at end of follow-up, 49 years). 188 cases of CMM occurred in the background population of 46,239 individuals; 172 CMM cases (91%) had full information and were analysed. The adjusted hazard ratio (HR) for CMM by BCG and/or smallpox vaccination compared with neither vaccine was 1.29 (95% confidence interval (CI) 0.72-2.31). For smallpox vaccination only, HR = 1.23 (95% CI 0.53-2.86) for BCG vaccination only, HR = 1.13 (95% CI 0.61-2.09) and for both smallpox and BCG vaccination, HR = 1.75 (95% CI 0.87-3.48) compared with none of these. Vaccination below the age of one year gave similar results. CONCLUSIONS We found no strong beneficial effect of smallpox and BCG vaccination against CMM among young adult Danes and with broad confidence intervals our data alone could be compatible with both modest preventive effects, no effects, and modest harmful effects. Our estimates do not contradict a potential modest beneficial effect of neonatal vaccination.
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Affiliation(s)
- Andreas Rieckmann
- Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark; OPEN, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Kathrine Damm Meyle
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | - Naja Hulvej Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jennifer Lyn Baker
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Section on Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Christine Stabell Benn
- OPEN, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Peter Aaby
- Bandim Health Project, Indepth Network, Apartado 861, Bissau, Guinea-Bissau
| | - Signe Sørup
- Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark; Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
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Eto A, Fujita M, Nishiyama Y, Saito T, Molina DM, Morikawa S, Saijo M, Shinmura Y, Kanatani Y. Profiling of the antibody response to attenuated LC16m8 smallpox vaccine using protein array analysis. Vaccine 2019; 37:6588-6593. [PMID: 31540810 DOI: 10.1016/j.vaccine.2019.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 05/07/2019] [Revised: 08/15/2019] [Accepted: 09/02/2019] [Indexed: 11/18/2022]
Abstract
Concerns about bioterrorism and outbreaks of zoonotic orthopoxvirus require safe and efficacious smallpox vaccines. We previously reported the clinical efficacy and safety profiles of LC16m8, a live, attenuated, cell culture-derived, smallpox vaccine, examined in over 3000 healthy Japanese adults with various vaccination histories. In this study, serum of approximately 200 subjects pre and post LC16m8 vaccination were subjected to a vaccinia virus-specific protein array to evaluate the proteome-wide immunogenicity. The relationships between antigen-specific antibodies and plaque reduction neutralization titers were analyzed. LC16m8 induced antibodies to multiple vaccinia antigens in primary-vaccinated individuals and yielded effective booster responses in previously vaccinated individuals, demonstrating similar antibody profiles to those reported for other vaccinia virus strains. Several immunodominant antigens were indicated to be important for neutralization of the intracellular mature virion. The similarity of antibody profiles between LC16m8 and other smallpox vaccine strains supports the immunogenicity and protective efficacy of LC16m8.
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Affiliation(s)
- Akiko Eto
- Department of Health Crisis Management, National Institute of Public Health, 2-3-6 Minami, Wako-shi, Saitama 351-0197, Japan
| | - Masanori Fujita
- Division of Environmental Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama 359-8513, Japan
| | - Yasumasa Nishiyama
- Health Care Center, Japan Self-Defense Forces Central Hospital, 1-2-24 Ikeziri, Setagaya-ku, Tokyo 154-8532, Japan
| | - Tomoya Saito
- Department of Health Crisis Management, National Institute of Public Health, 2-3-6 Minami, Wako-shi, Saitama 351-0197, Japan
| | | | - Shigeru Morikawa
- Department of Veterinary Science, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Masayuki Saijo
- Department of Virology I, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo 162-8640, Japan
| | | | - Yasuhiro Kanatani
- Department of Health Crisis Management, National Institute of Public Health, 2-3-6 Minami, Wako-shi, Saitama 351-0197, Japan.
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Andreani J, Arnault JP, Bou Khalil JY, Abrahão J, Tomei E, Vial E, Le Bideau M, Raoult D, La Scola B. Atypical Cowpox Virus Infection in Smallpox-Vaccinated Patient, France. Emerg Infect Dis 2019; 25:212-219. [PMID: 30666929 PMCID: PMC6346447 DOI: 10.3201/eid2502.171433] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We report a case of atypical cowpox virus infection in France in 2016. The patient sought care for thoracic lesions after injury from the sharp end of a metallic guardrail previously stored in the ground. We isolated a cowpox virus from the lesions and sequenced its whole genome. The patient reported that he had been previously vaccinated against smallpox. We describe an alternative route of cowpox virus infection and raise questions about the immunological status of smallpox-vaccinated patients for circulating orthopoxviruses.
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20
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MacIntyre CR, Costantino V, Chen X, Segelov E, Chughtai AA, Kelleher A, Kunasekaran M, Lane JM. Influence of Population Immunosuppression and Past Vaccination on Smallpox Reemergence. Emerg Infect Dis 2019; 24:646-653. [PMID: 29553311 PMCID: PMC5875263 DOI: 10.3201/eid2404.171233] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We built a SEIR (susceptible, exposed, infected, recovered) model of smallpox transmission for New York, New York, USA, and Sydney, New South Wales, Australia, that accounted for age-specific population immunosuppression and residual vaccine immunity and conducted sensitivity analyses to estimate the effect these parameters might have on smallpox reemergence. At least 19% of New York’s and 17% of Sydney’s population are immunosuppressed. The highest smallpox infection rates were in persons 0–19 years of age, but the highest death rates were in those >45 years of age. Because of the low level of residual vaccine immunity, immunosuppression was more influential than vaccination on death and infection rates in our model. Despite widespread smallpox vaccination until 1980 in New York, smallpox outbreak severity appeared worse in New York than in Sydney. Immunosuppression is highly prevalent and should be considered in future smallpox outbreak models because excluding this factor probably underestimates death and infection rates.
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21
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Petersen BW, Kabamba J, McCollum AM, Lushima RS, Wemakoy EO, Muyembe Tamfum JJ, Nguete B, Hughes CM, Monroe BP, Reynolds MG. Vaccinating against monkeypox in the Democratic Republic of the Congo. Antiviral Res 2019; 162:171-177. [PMID: 30445121 PMCID: PMC6438175 DOI: 10.1016/j.antiviral.2018.11.004] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/09/2018] [Accepted: 11/12/2018] [Indexed: 01/02/2023]
Abstract
Healthcare-associated transmission of monkeypox has been observed on multiple occasions in areas where the disease is endemic. Data collected by the US Centers for Disease Control and Prevention (CDC) from an ongoing CDC-supported program of enhanced surveillance in the Tshuapa Province of the Democratic Republic of the Congo, where the annual incidence of human monkeypox is estimated to be 3.5-5/10,000, suggests that there is approximately one healthcare worker infection for every 100 confirmed monkeypox cases. Herein, we describe a study that commenced in February 2017, the intent of which is to evaluate the effectiveness, immunogenicity, and safety of a third-generation smallpox vaccine, IMVAMUNE®, in healthcare personnel at risk of monkeypox virus (MPXV) infection. We describe procedures for documenting exposures to monkeypox virus infection in study participants, and outline lessons learned that may be of relevance for studies of other investigational medical countermeasures in hard to reach, under-resourced populations.
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Affiliation(s)
| | - Joelle Kabamba
- U.S. Centers for Disease Control and Prevention, Kinshasa, Democratic Republic of the Congo
| | | | - Robert Shongo Lushima
- Hemorrhagic Fever and Monkeypox Program, Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | | | | | - Beatrice Nguete
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | | | | | - Mary G Reynolds
- U.S. Centers for Disease Control and Prevention, Atlanta, USA
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22
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Affiliation(s)
- José Esparza
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Andreas Nitsche
- Centre for Biological Threats and Special Pathogens 1 –Highly Pathogenic Viruses & German Consultant Laboratory for Poxviruses & WHO Collaborating Centre for Emerging Infections and Biological Threats, Robert Koch Institute, Berlin, Germany
| | - Clarissa R. Damaso
- Laboratório de Biologia Molecular de Virus, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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23
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24
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Overton ET, Lawrence SJ, Wagner E, Nopora K, Rösch S, Young P, Schmidt D, Kreusel C, De Carli S, Meyer TP, Weidenthaler H, Samy N, Chaplin P. Immunogenicity and safety of three consecutive production lots of the non replicating smallpox vaccine MVA: A randomised, double blind, placebo controlled phase III trial. PLoS One 2018; 13:e0195897. [PMID: 29652929 PMCID: PMC5898760 DOI: 10.1371/journal.pone.0195897] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 03/30/2018] [Indexed: 12/18/2022] Open
Abstract
Background Modified Vaccinia Ankara (MVA) is a live, viral vaccine under advanced development as a non-replicating smallpox vaccine. A randomised, double-blind, placebo-controlled phase III clinical trial was conducted to demonstrate the humoral immunogenic equivalence of three consecutively manufactured MVA production lots, and to confirm the safety and tolerability of MVA focusing on cardiac readouts. Methods The trial was conducted at 34 sites in the US. Vaccinia-naïve adults aged 18-40 years were randomly allocated to one of four groups using a 1:1:1:1 randomization scheme. Subjects received either two MVA injections from three consecutive lots (Groups 1-3), or two placebo injections (Group 4), four weeks apart. Everyone except personnel involved in vaccine handling and administration was blinded to treatment. Safety assessment focused on cardiac monitoring throughout the trial. Vaccinia-specific antibody titers were measured using a Plaque Reduction Neutralization Test (PRNT) and an Enzyme-Linked Immunosorbent Assay (ELISA). The primary immunogenicity endpoint was Geometric Mean Titers (GMTs) after two MVA vaccinations measured by PRNT at trial visit 4. This trial is registered with ClinicalTrials.gov, number NCT01144637. Results Between March 2013 and May 2014, 4005 subjects were enrolled and received at least one injection of MVA (n = 3003) or placebo (n = 1002). The three MVA lots induced equivalent antibody titers two weeks after the second vaccination, with seroconversion rates of 99·8% (PRNT) and 99·7% (ELISA). Overall, 180 (6·0%) subjects receiving MVA and 29 (2·9%) subjects in the placebo group reported at least one unsolicited Adverse Event (AE) that was considered trial-related. Vaccination was well tolerated without significant safety concerns, particularly regarding cardiac assessment. Conclusions The neutralizing and total antibody titers induced by each of the three lots were equivalent. No significant safety concerns emerged in this healthy trial population, especially regarding cardiac safety, thus confirming the excellent safety and tolerability profile of MVA. Trial registration ClinicalTrials.gov NCT01144637
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Affiliation(s)
- Edgar Turner Overton
- Division of Infectious Diseases, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, United States of America
| | - Steven J. Lawrence
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Eva Wagner
- Bavarian Nordic GmbH, Martinsried, Germany
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25
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Emergence of monkeypox in West Africa and Central Africa, 1970–2017. Wkly Epidemiol Rec 2018; 93:125-32. [PMID: 29546750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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26
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Albarnaz JD, Torres AA, Smith GL. Modulating Vaccinia Virus Immunomodulators to Improve Immunological Memory. Viruses 2018; 10:E101. [PMID: 29495547 PMCID: PMC5869494 DOI: 10.3390/v10030101] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 02/21/2018] [Accepted: 02/22/2018] [Indexed: 12/14/2022] Open
Abstract
The increasing frequency of monkeypox virus infections, new outbreaks of other zoonotic orthopoxviruses and concern about the re-emergence of smallpox have prompted research into developing antiviral drugs and better vaccines against these viruses. This article considers the genetic engineering of vaccinia virus (VACV) to enhance vaccine immunogenicity and safety. The virulence, immunogenicity and protective efficacy of VACV strains engineered to lack specific immunomodulatory or host range proteins are described. The ultimate goal is to develop safer and more immunogenic VACV vaccines that induce long-lasting immunological memory.
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Affiliation(s)
- Jonas D Albarnaz
- Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QP, UK.
| | - Alice A Torres
- Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QP, UK.
| | - Geoffrey L Smith
- Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QP, UK.
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27
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Robertson J, Susong J, Wong EB. Smallpox vaccine complications: the dermatologist's role in diagnosis and management. Cutis 2018; 101:87-90. [PMID: 29554163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In 2002, the United States implemented a new program for smallpox vaccinations among military personnel using a live vaccinia virus product. Approximately 2.4 million US military service members and health care workers have since been inoculated, with considerable numbers experiencing adverse reactions. Military dermatologists are at the forefront of describing and treating these reactions, from relatively benign generalized vaccinia (GV) and erythema multiforme (EM) to more severe progressive vaccinia (PV) and eczema vaccinatum (EV). A wide range of providers, including civilian dermatologists and primary care providers, also may see such reactions and must be aware of the spectrum of vaccine reactions. Given current world instability (eg, threats of nuclear war, rise of authoritarian regimes) and concerns for bioterrorism attacks, the smallpox vaccine program likely will continue indefinitely. As the brisk military deployment tempo continues, a larger population of new vaccinees will yield more cutaneous reactions and diagnostic challenges.
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Volz A, Jany S, Freudenstein A, Lantermann M, Ludwig H, Sutter G. E3L and F1L Gene Functions Modulate the Protective Capacity of Modified Vaccinia Virus Ankara Immunization in Murine Model of Human Smallpox. Viruses 2018; 10:v10010021. [PMID: 29300297 PMCID: PMC5795434 DOI: 10.3390/v10010021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 12/17/2017] [Accepted: 12/28/2017] [Indexed: 12/15/2022] Open
Abstract
The highly attenuated Modified Vaccinia virus Ankara (MVA) lacks most of the known vaccinia virus (VACV) virulence and immune evasion genes. Today MVA can serve as a safety-tested next-generation smallpox vaccine. Yet, we still need to learn about regulatory gene functions preserved in the MVA genome, such as the apoptosis inhibitor genes F1L and E3L. Here, we tested MVA vaccine preparations on the basis of the deletion mutant viruses MVA-ΔF1L and MVA-ΔE3L for efficacy against ectromelia virus (ECTV) challenge infections in mice. In non-permissive human tissue culture the MVA deletion mutant viruses produced reduced levels of the VACV envelope antigen B5. Upon mousepox challenge at three weeks after vaccination, MVA-ΔF1L and MVA-ΔE3L exhibited reduced protective capacity in comparison to wildtype MVA. Surprisingly, however, all vaccines proved equally protective against a lethal ECTV infection at two days after vaccination. Accordingly, the deletion mutant MVA vaccines induced high levels of virus-specific CD8+ T cells previously shown to be essential for rapidly protective MVA vaccination. These results suggest that inactivation of the anti-apoptotic genes F1L or E3L modulates the protective capacity of MVA vaccination most likely through the induction of distinct orthopoxvirus specific immunity in the absence of these viral regulatory proteins.
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Affiliation(s)
- Asisa Volz
- Lehrstuhl für Virologie, Institut für Infektionsmedizin und Zoonosen, Ludwig-Maximilians-Universität München, 80539 Munich, Germany.
- Deutsches Zentrum für Infektionsforschung (DZIF), 80539 Munich, Germany.
| | - Sylvia Jany
- Lehrstuhl für Virologie, Institut für Infektionsmedizin und Zoonosen, Ludwig-Maximilians-Universität München, 80539 Munich, Germany.
| | - Astrid Freudenstein
- Lehrstuhl für Virologie, Institut für Infektionsmedizin und Zoonosen, Ludwig-Maximilians-Universität München, 80539 Munich, Germany.
| | | | - Holger Ludwig
- Division of Virology, Paul-Ehrlich-Institut, 63225 Langen, Germany.
| | - Gerd Sutter
- Lehrstuhl für Virologie, Institut für Infektionsmedizin und Zoonosen, Ludwig-Maximilians-Universität München, 80539 Munich, Germany.
- Deutsches Zentrum für Infektionsforschung (DZIF), 80539 Munich, Germany.
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Leendertz SAJ, Stern D, Theophil D, Anoh E, Mossoun A, Schubert G, Wiersma L, Akoua-Koffi C, Couacy-Hymann E, Muyembe-Tamfum JJ, Karhemere S, Pauly M, Schrick L, Leendertz FH, Nitsche A. A Cross-Sectional Serosurvey of Anti-Orthopoxvirus Antibodies in Central and Western Africa. Viruses 2017; 9:v9100278. [PMID: 28961172 PMCID: PMC5691630 DOI: 10.3390/v9100278] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 09/26/2017] [Accepted: 09/27/2017] [Indexed: 12/17/2022] Open
Abstract
Since the eradication of smallpox and the subsequent discontinuation of the worldwide smallpox vaccination program, other Orthopoxviruses beside Variola virus have been increasingly representing a risk to human health. To investigate the extent of natural contact with Orthopoxviruses and possible demographic risk factors for such an exposure, we performed a cross-sectional serosurvey of anti-Orthopoxvirus IgG antibodies in West and Central Africa. To this end, people living in forest regions in Côte d’Ivoire (CIV, n = 737) and the Democratic Republic of the Congo (COD, n = 267) were assigned into groups according to their likely smallpox vaccination status. The overall prevalence of anti-Orthopoxvirus antibodies was 51% in CIV and 60% in COD. High rates of seropositivity among the vaccinated part of the population (80% in CIV; 96% COD) indicated a long-lasting post vaccination immune response. In non-vaccinated participants, seroprevalences of 19% (CIV) and 26% (COD) indicated regular contact with Orthopoxviruses. Multivariate logistic regression revealed that the antibody level in the vaccinated part of the population was higher in COD than in CIV, increased with age and was slightly higher in females than males. In the unvaccinated part of the population none of these factors influenced antibody level significantly. In conclusion, our results confirm expectedly high anti-Orthopoxvirus seroprevalences in previously smallpox-vaccinated people living in CIV and the COD but more unexpectedly imply regular contact with Orthopoxviruses both in Western and Central Africa, even in the absence of recognized outbreaks.
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Affiliation(s)
- Siv Aina J Leendertz
- Epidemiology of Highly Pathogenic Microorganisms, Robert Koch Institute, 13353 Berlin, Germany.
- Department of Infectious Disease Epidemiology, Robert Koch Institute, 13353 Berlin, Germany.
| | - Daniel Stern
- Centre for Biological Threats and Special Pathogens ZBS 1, Highly Pathogenic Viruses Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353 Berlin, Germany.
| | - Dennis Theophil
- Centre for Biological Threats and Special Pathogens ZBS 1, Highly Pathogenic Viruses Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353 Berlin, Germany.
| | - Etile Anoh
- Université Felix Houphouët Boigny, Abidjan BP 1174, Cote D'Ivoire.
- Centre de Recherche pour le Développement, Université Alassane Ouattara, Bouaké BP 1174, Cote D'Ivoire.
| | - Arsène Mossoun
- Université Felix Houphouët Boigny, Abidjan BP 1174, Cote D'Ivoire.
- Laboratoire National D'appui au Développement Agricole/Laboratoire Central de Pathologie Animale, Bingerville BP 206, Cote D'Ivoire.
| | - Grit Schubert
- Epidemiology of Highly Pathogenic Microorganisms, Robert Koch Institute, 13353 Berlin, Germany.
| | - Lidewij Wiersma
- Epidemiology of Highly Pathogenic Microorganisms, Robert Koch Institute, 13353 Berlin, Germany.
| | - Chantal Akoua-Koffi
- Centre de Recherche pour le Développement, Université Alassane Ouattara, Bouaké BP 1174, Cote D'Ivoire.
| | - Emmanuel Couacy-Hymann
- Laboratoire National D'appui au Développement Agricole/Laboratoire Central de Pathologie Animale, Bingerville BP 206, Cote D'Ivoire.
| | | | - Stomy Karhemere
- Institut National de Recherche Biomédicale, Kinshasa BP 1197, Democratic Republic of the Congo.
| | - Maude Pauly
- Epidemiology of Highly Pathogenic Microorganisms, Robert Koch Institute, 13353 Berlin, Germany.
- Department of Infection and Immunity, Luxembourg Institute of Health, 4354 Esch-sur-Alzette, Luxembourg.
| | - Livia Schrick
- Centre for Biological Threats and Special Pathogens ZBS 1, Highly Pathogenic Viruses Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353 Berlin, Germany.
| | - Fabian H Leendertz
- Epidemiology of Highly Pathogenic Microorganisms, Robert Koch Institute, 13353 Berlin, Germany.
| | - Andreas Nitsche
- Centre for Biological Threats and Special Pathogens ZBS 1, Highly Pathogenic Viruses Centre for Biological Threats and Special Pathogens, Robert Koch Institute, 13353 Berlin, Germany.
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Iizuka I, Ami Y, Suzaki Y, Nagata N, Fukushi S, Ogata M, Morikawa S, Hasegawa H, Mizuguchi M, Kurane I, Saijo M. A Single Vaccination of Nonhuman Primates with Highly Attenuated Smallpox Vaccine, LC16m8, Provides Long-term Protection against Monkeypox. Jpn J Infect Dis 2017; 70:408-415. [PMID: 28003603 DOI: 10.7883/yoken.jjid.2016.417] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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] [Indexed: 11/17/2022]
Abstract
Monkeypox virus (MPXV) causes human monkeypox (human MPX), which is a similar disease to smallpox in humans. A previous study showed that a single vaccination of monkeys with LC16m8, a highly attenuated smallpox vaccine, protected them from MPX from 4-5 weeks post-vaccination. In this study, we evaluated the long-term efficacy of a single vaccination with LC16m8 in a nonhuman primate model of MPXV infection. The monkeys were inoculated with either LC16m8, Lister (parental strain of LC16m8), or a mock-up vaccine, and then challenged with MPXV via a subcutaneous route, at 6 and 12 months after vaccination, which we compared with either Lister or the mock-up vaccination. The LC16m8 monkeys exhibited almost no MPX-associated symptoms, whereas most of the naïve monkeys died. LC16m8 generated the protective memory immune response against MPXV, as suggested by the immediate viremia reduction and the response of the IgG antibody. The results demonstrated that the vaccination of monkeys with a single dose of LC16m8 provided durable protection against MPXV for longer than one year after immunization. The results suggest that the vaccination of humans with LC16m8 could induce long-term protection against MPXV infection.
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Affiliation(s)
- Itoe Iizuka
- Laboratory of Special Pathogens, Department of Virology 1, National Institute of Infectious Diseases
- Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo
| | - Yasushi Ami
- Department of Experimental Animals Research, National Institute of Infectious Diseases
| | - Yuriko Suzaki
- Department of Experimental Animals Research, National Institute of Infectious Diseases
| | - Noriyo Nagata
- Department of Pathology, National Institute of Infectious Diseases
| | - Shuetsu Fukushi
- Laboratory of Special Pathogens, Department of Virology 1, National Institute of Infectious Diseases
| | - Momoko Ogata
- Laboratory of Special Pathogens, Department of Virology 1, National Institute of Infectious Diseases
| | - Shigeru Morikawa
- Department of Veterinary Science, National Institute of Infectious Diseases
| | - Hideki Hasegawa
- Department of Pathology, National Institute of Infectious Diseases
| | - Masashi Mizuguchi
- Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo
| | | | - Masayuki Saijo
- Laboratory of Special Pathogens, Department of Virology 1, National Institute of Infectious Diseases
- Department of Developmental Medical Sciences, Graduate School of Medicine, The University of Tokyo
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31
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Jackson LA, Frey SE, El Sahly HM, Mulligan MJ, Winokur PL, Kotloff KL, Campbell JD, Atmar RL, Graham I, Anderson EJ, Anderson EL, Patel SM, Fields C, Keitel W, Rouphael N, Hill H, Goll JB. Safety and immunogenicity of a modified vaccinia Ankara vaccine using three immunization schedules and two modes of delivery: A randomized clinical non-inferiority trial. Vaccine 2017; 35:1675-1682. [PMID: 28256358 DOI: 10.1016/j.vaccine.2017.02.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 02/14/2017] [Accepted: 02/15/2017] [Indexed: 01/17/2023]
Abstract
INTRODUCTION To guide the use of modified vaccinia Ankara (MVA) vaccine in response to a release of smallpox virus, the immunogenicity and safety of shorter vaccination intervals, and administration by jet injector (JI), were compared to the standard schedule of administration on Days 1 and 29 by syringe and needle (S&N). METHODS Healthy adults 18-40years of age were randomly assigned to receive MVA vaccine subcutaneously by S&N on Days 1 and 29 (standard), Days 1 and 15, or Days 1 and 22, or to receive the vaccine subcutaneously by JI on Days 1 and 29. Blood was collected at four time points after the second vaccination for plaque reduction neutralization test (PRNT) (primary endpoint) and ELISA (secondary endpoint) antibody assays. For each subject, the peak PRNT (or ELISA) titer was defined by the highest PRNT (or ELISA) titer among all available measurements post second vaccination. Non-inferiority of a non-standard arm compared to the standard arm was met if the upper limit of the 98.33% confidence interval of the difference in the mean log2 peak titers between the standard and non-standard arm was less than 1. RESULTS Non-inferiority of the PRNT antibody response was not established for any of the three non-standard study arms. Non-inferiority of the ELISA antibody response was established for the Day 1 and 22 compressed schedule and for administration by JI. Solicited local reactions, such as redness and swelling, tended to be more commonly reported with JI administration. Four post-vaccination hypersensitivity reactions were observed. CONCLUSIONS Evaluations of the primary endpoint of PRNT antibody responses do not support alternative strategies of administering MVA vaccine by S&N on compressed schedules or administration by JI on the standard schedule. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01827371.
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Affiliation(s)
- Lisa A Jackson
- Group Health Research Institute, Seattle, WA, United States.
| | - Sharon E Frey
- Division of Infectious Diseases, Allergy, & Immunology, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Hana M El Sahly
- Departments of Molecular Virology & Microbiology and Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Mark J Mulligan
- The Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Decatur, GA, United States
| | - Patricia L Winokur
- University of Iowa and Iowa City VA Medical Center, Iowa City, IA, United States
| | - Karen L Kotloff
- Division of Infectious Disease and Tropical Pediatrics, Department of Pediatrics, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, United States
| | - James D Campbell
- Division of Infectious Disease and Tropical Pediatrics, Department of Pediatrics, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Robert L Atmar
- Departments of Molecular Virology & Microbiology and Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Irene Graham
- Division of Infectious Diseases, Allergy, & Immunology, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Evan J Anderson
- Emory Children's Center, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, United States
| | - Edwin L Anderson
- Division of Infectious Diseases, Allergy, & Immunology, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Shital M Patel
- Departments of Molecular Virology & Microbiology and Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Colin Fields
- Group Health Research Institute, Seattle, WA, United States
| | - Wendy Keitel
- Departments of Molecular Virology & Microbiology and Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Nadine Rouphael
- The Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Decatur, GA, United States
| | - Heather Hill
- The Emmes Corporation, Rockville, MD, United States
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Slike BM, Creegan M, Marovich M, Ngauy V. Humoral Immunity to Primary Smallpox Vaccination: Impact of Childhood versus Adult Immunization on Vaccinia Vector Vaccine Development in Military Populations. PLoS One 2017; 12:e0169247. [PMID: 28046039 PMCID: PMC5207489 DOI: 10.1371/journal.pone.0169247] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 12/14/2016] [Indexed: 11/20/2022] Open
Abstract
Modified Vaccinia virus has been shown to be a safe and immunogenic vector platform for delivery of HIV vaccines. Use of this vector is of particular importance to the military, with the implementation of a large scale smallpox vaccination campaign in 2002 in active duty and key civilian personnel in response to potential bioterrorist activities. Humoral immunity to smallpox vaccination was previously shown to be long lasting (up to 75 years) and protective. However, using vaccinia-vectored vaccine delivery for other diseases on a background of anti-vector antibodies (i.e. pre-existing immunity) may limit their use as a vaccine platform, especially in the military. In this pilot study, we examined the durability of vaccinia antibody responses in adult primary vaccinees in a healthy military population using a standard ELISA assay and a novel dendritic cell neutralization assay. We found binding and neutralizing antibody (NAb) responses to vaccinia waned after 5–10 years in a group of 475 active duty military, born after 1972, who were vaccinated as adults with Dryvax®. These responses decreased from a geometric mean titer (GMT) of 250 to baseline (<20) after 10–20 years post vaccination. This contrasted with a comparator group of adults, ages 35–49, who were vaccinated with Dryvax® as children. In the childhood vaccinees, titers persisted for >30 years with a GMT of 210 (range 112–3234). This data suggests limited durability of antibody responses in adult vaccinees compared to those vaccinated in childhood and further that adult vaccinia recipients may benefit similarly from receipt of a vaccinia based vaccine as those who are vaccinia naïve. Our findings may have implications for the smallpox vaccination schedule and support the ongoing development of this promising viral vector in a military vaccination program.
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Affiliation(s)
- Bonnie M. Slike
- U.S. Military HIV Research Program, Silver Spring, Maryland, United States of America
- The Henry M. Jackson for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Matthew Creegan
- U.S. Military HIV Research Program, Silver Spring, Maryland, United States of America
- The Henry M. Jackson for the Advancement of Military Medicine, Bethesda, Maryland, United States of America
| | - Mary Marovich
- Division of AIDS, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - Viseth Ngauy
- Tripler Army Medical Center, Honolulu, Hawaii, United States of America
- * E-mail:
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Abstract
Vaccinia Virus (VACV) is an enveloped double stranded DNA virus and the active ingredient of the smallpox vaccine. The systematic administration of this vaccine led to the eradication of circulating smallpox (variola virus, VARV) from the human population. As a tribute to its success, global immunization was ended in the late 1970s. The efficacy of the vaccine is attributed to a robust production of protective antibodies against several envelope proteins of VACV, which cross-protect against infection with pathogenic VARV. Since global vaccination was ended, most children and young adults do not possess immunity against smallpox. This is a concern, since smallpox is considered a potential bioweapon. Although the smallpox vaccine is considered the gold standard of all vaccines and the targeted antigens have been widely studied, the epitopes that are targeted by the protective antibodies and their mechanism of binding had been, until recently, poorly characterized. Understanding the precise interaction between the antibodies and their epitopes will be helpful in the design of better vaccines against other diseases. In this review we will discuss the structural basis of recognition of the immunodominant VACV antigens A27, A33, D8, and L1 by protective antibodies and discuss potential implications regarding their protective capacity.
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Affiliation(s)
- Dirk M Zajonc
- Division of Cell Biology, La Jolla Institute for Allergy and Immunology (LJI), La Jolla, CA, 92037, USA.
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, 9000, Belgium.
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Bissa M, Quaglino E, Zanotto C, Illiano E, Rolih V, Pacchioni S, Cavallo F, De Giuli Morghen C, Radaelli A. Protection of mice against the highly pathogenic VV IHD-J by DNA and fowlpox recombinant vaccines, administered by electroporation and intranasal routes, correlates with serum neutralizing activity. Antiviral Res 2016; 134:182-191. [PMID: 27637905 PMCID: PMC9533953 DOI: 10.1016/j.antiviral.2016.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/05/2016] [Accepted: 09/09/2016] [Indexed: 11/06/2022]
Abstract
The control of smallpox was achieved using live vaccinia virus (VV) vaccine, which successfully eradicated the disease worldwide. As the variola virus no longer exists as a natural infection agent, mass vaccination was discontinued after 1980. However, emergence of smallpox outbreaks caused by accidental or deliberate release of variola virus has stimulated new research for second-generation vaccine development based on attenuated VV strains. Considering the closely related animal poxviruses that also arise as zoonoses, and the increasing number of unvaccinated or immunocompromised people, a safer and more effective vaccine is still required. With this aim, new vectors based on avian poxviruses that cannot replicate in mammals should improve the safety of conventional vaccines, and protect from zoonotic orthopoxvirus diseases, such as cowpox and monkeypox. In this study, DNA and fowlpox (FP) recombinants that expressed the VV L1R, A27L, A33R, and B5R genes were generated (4DNAmix, 4FPmix, respectively) and tested in mice using novel administration routes. Mice were primed with 4DNAmix by electroporation, and boosted with 4FPmix applied intranasally. The lethal VVIHD-J strain was then administered by intranasal challenge. All of the mice receiving 4DNAmix followed by 4FPmix, and 20% of the mice immunized only with 4FPmix, were protected. The induction of specific humoral and cellular immune responses directly correlated with this protection. In particular, higher anti-A27 antibodies and IFNγ-producing T lymphocytes were measured in the blood and spleen of the protected mice, as compared to controls. VVIHD-J neutralizing antibodies in sera from the protected mice suggest that the prime/boost vaccination regimen with 4DNAmix plus 4FPmix may be an effective and safe mode to induce protection against smallpox and poxvirus zoonotic infections. The electroporation/intranasal administration routes contributed to effective immune responses and mouse survival.
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Affiliation(s)
- Massimiliano Bissa
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti, 9, 20133 Milano, Italy.
| | - Elena Quaglino
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Turin, Via Nizza 52, 10126 Torino, Italy.
| | - Carlo Zanotto
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, Via Vanvitelli, 32, 20129 Milano, Italy.
| | - Elena Illiano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti, 9, 20133 Milano, Italy.
| | - Valeria Rolih
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Turin, Via Nizza 52, 10126 Torino, Italy.
| | - Sole Pacchioni
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti, 9, 20133 Milano, Italy.
| | - Federica Cavallo
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Turin, Via Nizza 52, 10126 Torino, Italy.
| | - Carlo De Giuli Morghen
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, Via Vanvitelli, 32, 20129 Milano, Italy; Catholic University "Our Lady of Good Counsel", Rr. Dritan Hoxha, Tirana, Albania.
| | - Antonia Radaelli
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti, 9, 20133 Milano, Italy; Cellular and Molecular Pharmacology Section, National Research Council (CNR), Institute of Neurosciences, University of Milan, Via Vanvitelli, 32, 20129 Milano, Italy.
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McKinney BA, Lareau C, Oberg AL, Kennedy RB, Ovsyannikova IG, Poland GA. The Integration of Epistasis Network and Functional Interactions in a GWAS Implicates RXR Pathway Genes in the Immune Response to Smallpox Vaccine. PLoS One 2016; 11:e0158016. [PMID: 27513748 PMCID: PMC4981436 DOI: 10.1371/journal.pone.0158016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 06/08/2016] [Indexed: 11/24/2022] Open
Abstract
Although many diseases and traits show large heritability, few genetic variants have been found to strongly separate phenotype groups by genotype. Complex regulatory networks of variants and expression of multiple genes lead to small individual-variant effects and difficulty replicating the effect of any single variant in an affected pathway. Interaction network modeling of GWAS identifies effects ignored by univariate models, but population differences may still cause specific genes to not replicate. Integrative network models may help detect indirect effects of variants in the underlying biological pathway. In this study, we used gene-level functional interaction information from the Integrative Multi-species Prediction (IMP) tool to reveal important genes associated with a complex phenotype through evidence from epistasis networks and pathway enrichment. We test this method for augmenting variant-based network analyses with functional interactions by applying it to a smallpox vaccine immune response GWAS. The integrative analysis spotlights the role of genes related to retinoid X receptor alpha (RXRA), which has been implicated in a previous epistasis network analysis of smallpox vaccine.
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Affiliation(s)
- Brett A. McKinney
- Tandy School of Computer Science and Department of Mathematics, University of Tulsa, Tulsa, OK, United States of America
| | - Caleb Lareau
- Tandy School of Computer Science and Department of Mathematics, University of Tulsa, Tulsa, OK, United States of America
| | - Ann L. Oberg
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States of America
| | - Richard B. Kennedy
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, United States of America
| | - Inna G. Ovsyannikova
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, United States of America
| | - Gregory A. Poland
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN, United States of America
- * E-mail:
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36
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Greenberg RN, Hay CM, Stapleton JT, Marbury TC, Wagner E, Kreitmeir E, Röesch S, von Krempelhuber A, Young P, Nichols R, Meyer TP, Schmidt D, Weigl J, Virgin G, Arndtz-Wiedemann N, Chaplin P. A Randomized, Double-Blind, Placebo-Controlled Phase II Trial Investigating the Safety and Immunogenicity of Modified Vaccinia Ankara Smallpox Vaccine (MVA-BN®) in 56-80-Year-Old Subjects. PLoS One 2016; 11:e0157335. [PMID: 27327616 PMCID: PMC4915701 DOI: 10.1371/journal.pone.0157335] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 05/27/2016] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Modified Vaccinia Ankara MVA-BN® is a live, highly attenuated, viral vaccine under advanced development as a non-replicating smallpox vaccine. In this Phase II trial, the safety and immunogenicity of Modified Vaccinia Ankara MVA-BN® (MVA) was assessed in a 56-80 years old population. METHODS MVA with a virus titer of 1 x 108 TCID50/dose was administered via subcutaneous injection to 56-80 year old vaccinia-experienced subjects (N = 120). Subjects received either two injections of MVA (MM group) or one injection of Placebo and one injection of MVA (PM group) four weeks apart. Safety was evaluated by assessment of adverse events (AE), focused physical exams, electrocardiogram recordings and safety laboratories. Solicited AEs consisted of a set of pre-defined expected local reactions (erythema, swelling, pain, pruritus, and induration) and systemic symptoms (body temperature, headache, myalgia, nausea and fatigue) and were recorded on a memory aid for an 8-day period following each injection. The immunogenicity of the vaccine was evaluated in terms of humoral immune responses measured with a vaccinia-specific enzyme-linked immunosorbent assay (ELISA) and a plaque reduction neutralization test (PRNT) before and at different time points after vaccination. RESULTS Vaccinations were well tolerated by all subjects. No serious adverse event related to MVA and no case of myopericarditis was reported. The overall incidence of unsolicited AEs was similar in both groups. For both groups immunogenicity responses two weeks after the final vaccination (i.e. Visit 4) were as follows: Seroconversion (SC) rates (doubling of titers from baseline) in vaccine specific antibody titers measured by ELISA were 83.3% in Group MM and 82.8% in Group PM (difference 0.6% with 95% exact CI [-13.8%, 15.0%]), and 90.0% for Group MM and 77.6% for Group PM measured by PRNT (difference 12.4% with 95% CI of [-1.1%, 27.0%]). Geometric mean titers (GMT) measured by ELISA two weeks after the final vaccination for Group MM were 804.1 and 605.8 for Group PM (with ratio of GMTs of 1.33 with 95% CI of [0.96, 1.84]). Similarly, GMTs measured by PRNT were 210.3 for Group MM and 126.7 for Group PM (with ratio 1.66 and 95% CI [0.95, 2.90]). CONCLUSIONS One or two doses of MVA were safe and immunogenic in a 56-80 years old vaccinia-experienced population. No cases of myopericarditis were observed following vaccinations with MVA. The safety, reactogenicity and immunogenicity were similar to that seen in younger (18-55 year old) healthy populations as investigated in other MVA trials. The results suggest that a single dose of MVA in a 56-80 years old population was well tolerated and sufficient to rapidly boost the long-term B cell memory response induced by a prior vaccination with a traditional smallpox vaccine. TRIAL REGISTRATION ClinicalTrials.gov NCT00857493.
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Affiliation(s)
- Richard N. Greenberg
- University of Kentucky School of Medicine, MN663 Medical Science Bldg., 800 Rose Street, Lexington, KY, 40536, United States of America
| | - Christine M. Hay
- University of Iowa, SW54, GH, 200 Hawkins Drive, UHC, Iowa City, IA, 52242, United States of America
| | - Jack T. Stapleton
- University of Rochester Medical Center School of Medicine and Dentistry, 601 Elmwood Avenue, Box 689, Rochester, NY, 14642, United States of America
| | - Thomas C. Marbury
- Orlando Clinical Research Center, 5055 South Orange Avenue, Orlando, FL, 32809, United States of America
| | - Eva Wagner
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, 82152 Martinsried, Germany
| | - Eva Kreitmeir
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, 82152 Martinsried, Germany
| | - Siegfried Röesch
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, 82152 Martinsried, Germany
| | | | - Philip Young
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, 82152 Martinsried, Germany
| | - Richard Nichols
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, 82152 Martinsried, Germany
| | - Thomas P. Meyer
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, 82152 Martinsried, Germany
| | - Darja Schmidt
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, 82152 Martinsried, Germany
| | - Josef Weigl
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, 82152 Martinsried, Germany
| | - Garth Virgin
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, 82152 Martinsried, Germany
| | | | - Paul Chaplin
- Bavarian Nordic GmbH, Fraunhoferstrasse 13, 82152 Martinsried, Germany
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Kennedy RB, Poland GA, Ovsyannikova IG, Oberg AL, Asmann YW, Grill DE, Vierkant RA, Jacobson RM. Impaired innate, humoral, and cellular immunity despite a take in smallpox vaccine recipients. Vaccine 2016; 34:3283-90. [PMID: 27177944 PMCID: PMC5528000 DOI: 10.1016/j.vaccine.2016.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 04/26/2016] [Accepted: 05/02/2016] [Indexed: 11/29/2022]
Abstract
Smallpox vaccine is highly effective, inducing protective immunity to smallpox and diseases caused by related orthopoxviruses. Smallpox vaccine efficacy was historically defined by the appearance of a lesion or "take" at the vaccine site, which leaves behind a characteristic scar. Both the take and scar are readily recognizable and were used during the eradication effort to indicate successful vaccination and to categorize individuals as "protected." However, the development of a typical vaccine take may not equate to the successful development of a robust, protective immune response. In this report, we examined two large (>1000) cohorts of recipients of either Dryvax(®) or ACAM2000 using a testing and replication study design and identified subgroups of individuals who had documented vaccine takes, but who failed to develop robust neutralizing antibody titers. Examination of these individuals revealed that they had suboptimal cellular immune responses as well. Further testing indicated these low responders had a diminished innate antiviral gene expression pattern (IFNA1, CXCL10, CXCL11, OASL) upon in vitro stimulation with vaccinia virus, perhaps indicative of a dysregulated innate response. Our results suggest that poor activation of innate antiviral pathways may result in suboptimal immune responses to the smallpox vaccine. These genes and pathways may serve as suitable targets for adjuvants in new attenuated smallpox vaccines and/or effective antiviral therapy targets against poxvirus infections.
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Affiliation(s)
- Richard B Kennedy
- Mayo Vaccine Research Group, Mayo Clinic, Rochester, MN, USA; Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Gregory A Poland
- Mayo Vaccine Research Group, Mayo Clinic, Rochester, MN, USA; Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Inna G Ovsyannikova
- Mayo Vaccine Research Group, Mayo Clinic, Rochester, MN, USA; Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ann L Oberg
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Yan W Asmann
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Diane E Grill
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Robert A Vierkant
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Robert M Jacobson
- Mayo Vaccine Research Group, Mayo Clinic, Rochester, MN, USA; Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA; Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
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38
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Eto A, Saito T, Yokote H, Kurane I, Kanatani Y. Recent advances in the study of live attenuated cell-cultured smallpox vaccine LC16m8. Vaccine 2015; 33:6106-11. [PMID: 26319072 PMCID: PMC9533910 DOI: 10.1016/j.vaccine.2015.07.111] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 07/20/2015] [Accepted: 07/29/2015] [Indexed: 12/02/2022]
Abstract
LC16m8 is a live, attenuated, cell-cultured smallpox vaccine that was developed and licensed in Japan in the 1970s, but was not used in the campaign to eradicate smallpox. In the early 2000s, the potential threat of bioterrorism led to reconsideration of the need for a smallpox vaccine. Subsequently, LC16m8 production was restarted in Japan in 2002, requiring re-evaluation of its safety and efficacy. Approximately 50,000 children in the 1970s and about 3500 healthy adults in the 2000s were vaccinated with LC16m8 in Japan, and 153 adults have been vaccinated with LC16m8 or Dryvax in phase I/II clinical trials in the USA. These studies confirmed the safety and efficacy of LC16m8, while several studies in animal models have shown that LC16m8 protects the host against viral challenge. The World Health Organization Strategic Advisory Group of Experts on Immunization recommended LC16m8, together with ACAM2000, as a stockpile vaccine in 2013. In addition, LC16m8 is expected to be a viable alternative to first-generation smallpox vaccines to prevent human monkeypox.
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Affiliation(s)
- Akiko Eto
- Department of Health Crisis Management, National Institute of Public Health, 2-3-6 Minami, Wako-shi, 351-0197, Saitama, Japan
| | - Tomoya Saito
- Department of Health Crisis Management, National Institute of Public Health, 2-3-6 Minami, Wako-shi, 351-0197, Saitama, Japan
| | - Hiroyuki Yokote
- Chemo-Sero-Therapeutic Research Institute (Kaketsuken), 1-6-1 Okubo, Kita-ku, Kumamoto-shi, 860-8568, Kumamoto, Japan
| | - Ichiro Kurane
- National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, 162-8640, Tokyo, Japan
| | - Yasuhiro Kanatani
- Department of Health Crisis Management, National Institute of Public Health, 2-3-6 Minami, Wako-shi, 351-0197, Saitama, Japan.
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Medcalf S, Bilek L, Hartman T, Iwen PC, Leuschen P, Miller H, O'Keefe A, Sayles H, Smith PW. Smallpox Vaccination of Laboratory Workers at US Variola Testing Sites. Emerg Infect Dis 2015. [PMID: 26196153 PMCID: PMC4517736 DOI: 10.3201/eid2108.140956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To evaluate the need to revaccinate laboratory workers against smallpox, we assessed regular revaccination at the US Laboratory Response Network’s variola testing sites by examining barriers to revaccination and the potential for persistence of immunity. Our data do not provide evidence to suggest prolonging the recommended interval for revaccination.
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Martínez O, Miranda E, Ramírez M, Santos S, Rivera C, Vázquez L, Sánchez T, Tremblay RL, Ríos-Olivares E, Otero M. Immunomodulator-based enhancement of anti smallpox immune responses. PLoS One 2015; 10:e0123113. [PMID: 25875833 PMCID: PMC4395221 DOI: 10.1371/journal.pone.0123113] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 02/27/2015] [Indexed: 12/23/2022] Open
Abstract
Background The current live vaccinia virus vaccine used in the prevention of smallpox is contraindicated for millions of immune-compromised individuals. Although vaccination with the current smallpox vaccine produces protective immunity, it might result in mild to serious health complications for some vaccinees. Thus, there is a critical need for the production of a safe virus-free vaccine against smallpox that is available to everyone. For that reason, we investigated the impact of imiquimod and resiquimod (Toll-like receptors agonists), and the codon-usage optimization of the vaccinia virus A27L gene in the enhancement of the immune response, with intent of producing a safe, virus-free DNA vaccine coding for the A27 vaccinia virus protein. Methods We analyzed the cellular-immune response by measuring the IFN-γ production of splenocytes by ELISPOT, the humoral-immune responses measuring total IgG and IgG2a/IgG1 ratios by ELISA, and the TH1 and TH2 cytokine profiles by ELISA, in mice immunized with our vaccine formulation. Results The proposed vaccine formulation enhanced the A27L vaccine-mediated production of IFN-γ on mouse spleens, and increased the humoral immunity with a TH1-biased response. Also, our vaccine induced a TH1 cytokine milieu, which is important against viral infections. Conclusion These results support the efforts to find a new mechanism to enhance an immune response against smallpox, through the implementation of a safe, virus-free DNA vaccination platform.
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Affiliation(s)
- Osmarie Martínez
- Department of Microbiology, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Eric Miranda
- Department of Microbiology, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
- Department of Microbiology Universidad Central del Caribe School of Medicine, Bayamón, Puerto Rico
| | - Maite Ramírez
- Department of Microbiology, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Saritza Santos
- Department of Microbiology, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Carlos Rivera
- Department Biology, University of Puerto Rico, Rio Piedras Campus, San Juan, Puerto Rico
| | - Luis Vázquez
- Department Biology, University of Puerto Rico, Rio Piedras Campus, San Juan, Puerto Rico
| | - Tomás Sánchez
- Department Biology, University of Puerto Rico, Rio Piedras Campus, San Juan, Puerto Rico
| | - Raymond L. Tremblay
- Department of Biology, University of Puerto Rico, Humacao, Puerto Rico
- Department of Biology, University of Puerto Rico, Rio Piedras Campus, San Juan, Puerto Rico
- Center for Applied Tropical Ecology and Conservation, University of Puerto Rico, Rio Piedras campus, San Juan, Puerto Rico
| | - Eddy Ríos-Olivares
- Department of Microbiology Universidad Central del Caribe School of Medicine, Bayamón, Puerto Rico
| | - Miguel Otero
- Department of Microbiology, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
- * E-mail:
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Sánchez-Sampedro L, Perdiguero B, Mejías-Pérez E, García-Arriaza J, Di Pilato M, Esteban M. The evolution of poxvirus vaccines. Viruses 2015; 7:1726-803. [PMID: 25853483 PMCID: PMC4411676 DOI: 10.3390/v7041726] [Citation(s) in RCA: 133] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 03/16/2015] [Accepted: 03/27/2015] [Indexed: 02/07/2023] Open
Abstract
After Edward Jenner established human vaccination over 200 years ago, attenuated poxviruses became key players to contain the deadliest virus of its own family: Variola virus (VARV), the causative agent of smallpox. Cowpox virus (CPXV) and horsepox virus (HSPV) were extensively used to this end, passaged in cattle and humans until the appearance of vaccinia virus (VACV), which was used in the final campaigns aimed to eradicate the disease, an endeavor that was accomplished by the World Health Organization (WHO) in 1980. Ever since, naturally evolved strains used for vaccination were introduced into research laboratories where VACV and other poxviruses with improved safety profiles were generated. Recombinant DNA technology along with the DNA genome features of this virus family allowed the generation of vaccines against heterologous diseases, and the specific insertion and deletion of poxvirus genes generated an even broader spectrum of modified viruses with new properties that increase their immunogenicity and safety profile as vaccine vectors. In this review, we highlight the evolution of poxvirus vaccines, from first generation to the current status, pointing out how different vaccines have emerged and approaches that are being followed up in the development of more rational vaccines against a wide range of diseases.
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MESH Headings
- Animals
- History, 18th Century
- History, 19th Century
- History, 20th Century
- History, 21st Century
- Humans
- Poxviridae/immunology
- Poxviridae/isolation & purification
- Smallpox/prevention & control
- Smallpox Vaccine/history
- Smallpox Vaccine/immunology
- Smallpox Vaccine/isolation & purification
- Vaccines, Attenuated/history
- Vaccines, Attenuated/immunology
- Vaccines, Attenuated/isolation & purification
- Vaccines, Synthetic/history
- Vaccines, Synthetic/immunology
- Vaccines, Synthetic/isolation & purification
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Affiliation(s)
- Lucas Sánchez-Sampedro
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CSIC), Madrid-28049, Spain.
| | - Beatriz Perdiguero
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CSIC), Madrid-28049, Spain.
| | - Ernesto Mejías-Pérez
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CSIC), Madrid-28049, Spain
| | - Juan García-Arriaza
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CSIC), Madrid-28049, Spain
| | - Mauro Di Pilato
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CSIC), Madrid-28049, Spain.
| | - Mariano Esteban
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas (CSIC), Madrid-28049, Spain.
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Knitlova J, Hajkova V, Voska L, Elsterova J, Obrova B, Melkova Z. Development of eczema vaccinatum in atopic mouse models and efficacy of MVA vaccination against lethal poxviral infection. PLoS One 2014; 9:e114374. [PMID: 25486419 PMCID: PMC4259321 DOI: 10.1371/journal.pone.0114374] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 11/06/2014] [Indexed: 01/08/2023] Open
Abstract
Smallpox vaccine based on live, replicating vaccinia virus (VACV) is associated with several potentially serious and deadly complications. Consequently, a new generation of vaccine based on non-replicating Modified vaccinia virus Ankara (MVA) has been under clinical development. MVA seems to induce good immune responses in blood tests, but it is impossible to test its efficacy in vivo in human. One of the serious complications of the replicating vaccine is eczema vaccinatum (EV) occurring in individuals with atopic dermatitis (AD), thus excluding them from all preventive vaccination schemes. In this study, we first characterized and compared development of eczema vaccinatum in different mouse strains. Nc/Nga, Balb/c and C57Bl/6J mice were epicutaneously sensitized with ovalbumin (OVA) or saline control to induce signs of atopic dermatitis and subsequently trans-dermally (t.d.) immunized with VACV strain Western Reserve (WR). Large primary lesions occurred in both mock- and OVA-sensitized Nc/Nga mice, while they remained small in Balb/c and C57Bl/6J mice. Satellite lesions developed in both mock- and OVA-sensitized Nc/Nga and in OVA-sensitized Balb/c mice with the rate 40–50%. Presence of mastocytes and eosinophils was the highest in Nc/Nga mice. Consequently, we have chosen Nc/Nga mice as a model of AD/EV and tested efficacy of MVA and Dryvax vaccinations against a lethal intra-nasal (i.n.) challenge with WR, the surrogate of smallpox. Inoculation of MVA intra-muscularly (i.m.) or t.d. resulted in no lesions, while inoculation of Dryvax t.d. yielded large primary and many satellite lesions similar to WR. Eighty three and 92% of mice vaccinated with a single dose of MVA i.m. or t.d., respectively, survived a lethal i.n. challenge with WR without any serious illness, while all Dryvax-vaccinated animals survived. This is the first formal prove of protective immunity against a lethal poxvirus challenge induced by vaccination with MVA in an atopic organism.
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Affiliation(s)
- Jarmila Knitlova
- Department of Immunology and Microbiology, 1st Medical Faculty, Charles University, Studnickova 7, 128 00, Prague 2, Czech Republic
| | - Vera Hajkova
- Department of Immunology and Microbiology, 1st Medical Faculty, Charles University, Studnickova 7, 128 00, Prague 2, Czech Republic
| | - Ludek Voska
- Department of Clinical and Transplant Pathology, Institute for Clinical and Experimental Medicine, Videnska 9, 140 21, Prague 4, Czech Republic
| | - Jana Elsterova
- Department of Immunology and Microbiology, 1st Medical Faculty, Charles University, Studnickova 7, 128 00, Prague 2, Czech Republic
| | - Barbora Obrova
- Department of Immunology and Microbiology, 1st Medical Faculty, Charles University, Studnickova 7, 128 00, Prague 2, Czech Republic
| | - Zora Melkova
- Department of Immunology and Microbiology, 1st Medical Faculty, Charles University, Studnickova 7, 128 00, Prague 2, Czech Republic
- * E-mail:
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Israely T, Melamed S, Achdout H, Erez N, Politi B, Waner T, Lustig S, Paran N. TLR3 and TLR9 agonists improve postexposure vaccination efficacy of live smallpox vaccines. PLoS One 2014; 9:e110545. [PMID: 25350003 PMCID: PMC4211728 DOI: 10.1371/journal.pone.0110545] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 09/14/2014] [Indexed: 12/14/2022] Open
Abstract
Eradication of smallpox and discontinuation of the vaccination campaign resulted in an increase in the percentage of unvaccinated individuals, highlighting the need for postexposure efficient countermeasures in case of accidental or deliberate viral release. Intranasal infection of mice with ectromelia virus (ECTV), a model for human smallpox, is curable by vaccination with a high vaccine dose given up to 3 days postexposure. To further extend this protective window and to reduce morbidity, mice were vaccinated postexposure with Vaccinia-Lister, the conventional smallpox vaccine or Modified Vaccinia Ankara, a highly attenuated vaccine in conjunction with TLR3 or TLR9 agonists. We show that co-administration of the TLR3 agonist poly(I:C) even 5 days postexposure conferred protection, avoiding the need to increase the vaccination dose. Efficacious treatments prevented death, ameliorated disease symptoms, reduced viral load and maintained tissue integrity of target organs. Protection was associated with significant elevation of serum IFNα and anti-vaccinia IgM antibodies, modulation of IFNγ response, and balanced activation of NK and T cells. TLR9 agonists (CpG ODNs) were less protective than the TLR3 agonist poly(I:C). We show that activation of type 1 IFN by poly(I:C) and protection is achievable even without co-vaccination, requiring sufficient amount of the viral antigens of the infective agent or the vaccine. This study demonstrated the therapeutic potential of postexposure immune modulation by TLR activation, allowing to alleviate the disease symptoms and to further extend the protective window of postexposure vaccination.
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Affiliation(s)
- Tomer Israely
- Department of Infectious diseases, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Sharon Melamed
- Department of Infectious diseases, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Hagit Achdout
- Department of Infectious diseases, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Noam Erez
- Department of Infectious diseases, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Boaz Politi
- Department of Infectious diseases, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Trevor Waner
- Department of Infectious diseases, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Shlomo Lustig
- Department of Infectious diseases, Israel Institute for Biological Research, Ness-Ziona, Israel
| | - Nir Paran
- Department of Infectious diseases, Israel Institute for Biological Research, Ness-Ziona, Israel
- * E-mail:
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Balicer RD, Grotto I, Huerta M, Leventhal A, Zach R, Yahalom V, Cohen D. Beveled Needle Technique is Not Associated with Low Take Rates in Israeli Smallpox Revaccination Campaign. Human Vaccines 2014; 1:224-7. [PMID: 17012858 DOI: 10.4161/hv.1.6.2279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND In its first large-scale smallpox vaccination campaign in the 20(th) century, Israel has experienced an exceptionally high rate of failure to achieve clinical take following vaccination. It was hypothesized that this failure rates might be attributed to the unique vaccination technique adopted in Israel, of using beveled needles rather than bifurcated needles. MATERIALS AND METHODS We retrospectively identified two cohorts vaccinated in the defined dates during the Israeli revaccination campaign, in which beveled needles and bifurcated needles were used alternately, and studied the impact of different covariates on clinical vaccination outcome measures. RESULTS Of 116 subjects that were vaccinated within the defined dates, 46 were vaccinated using bifurcated needles, and 70 by beveled needles. 'Take' rates in subjects vaccinated up to 20 years earlier was 77.5%, compared with 97.2% among those vaccinated in the more distant past (p = 0.001). In multivariate analyses, vaccination 'take' was independently associated with a shorter time from previous vaccination (p = 0.013), but not with gender, birth country, vaccinator or the vaccination technique used. CONCLUSIONS The low take rates observed in the Israeli smallpox revaccination campaign could not be attributed to the unique local vaccination technique, and was most likely induced by a higher rate of residual immunity among vaccinees, compared with the US, as well as by the lower vaccine concentrations used in Israel. In countries and circumstances when bifurcated needles are not sufficiently available, the beveled needle technique may be considered an appropriate alternative.
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Affiliation(s)
- Ran D Balicer
- Army Health Branch, Medical Corps, Israeli Defense Forces, Be'er-Sheva, Israel.
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45
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Abstract
Although it has been >30 years since the eradication of smallpox, the unearthing of well-preserved tissue material in which the virus may reside has called into question the viability of variola virus decades or centuries after its original occurrence. Experimental data to address the long-term stability and viability of the virus are limited. There are several instances of well-preserved corpses and tissues that have been examined for poxvirus viability and viral DNA. These historical specimens cause concern for potential exposures, and each situation should be approached cautiously and independently with the available information. Nevertheless, these specimens provide information on the history of a major disease and vaccination against it.
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46
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McCollum AM, Li Y, Wilkins K, Karem KL, Davidson WB, Paddock CD, Reynolds MG, Damon IK. Poxvirus viability and signatures in historical relics. Emerg Infect Dis 2014; 20:177-84. [PMID: 24447382 DOI: 10.3201/eid2002/131098] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Although it has been >30 years since the eradication of smallpox, the unearthing of well-preserved tissue material in which the virus may reside has called into question the viability of variola virus decades or centuries after its original occurrence. Experimental data to address the long-term stability and viability of the virus are limited. There are several instances of well-preserved corpses and tissues that have been examined for poxvirus viability and viral DNA. These historical specimens cause concern for potential exposures, and each situation should be approached cautiously and independently with the available information. Nevertheless, these specimens provide information on the history of a major disease and vaccination against it.
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47
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Ovsyannikova IG, Pankratz VS, Salk HM, Kennedy RB, Poland GA. HLA alleles associated with the adaptive immune response to smallpox vaccine: a replication study. Hum Genet 2014; 133:1083-92. [PMID: 24880604 PMCID: PMC4127812 DOI: 10.1007/s00439-014-1449-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 05/13/2014] [Indexed: 11/28/2022]
Abstract
We previously reported HLA allelic associations with vaccinia virus (VACV)-induced adaptive immune responses in a cohort of healthy individuals (n = 1,071 subjects) after a single dose of the licensed smallpox (Dryvax) vaccine. This study demonstrated that specific HLA alleles were significantly associated with VACV-induced neutralizing antibody (NA) titers (HLA-B*13:02, *38:02, *44:03, *48:01, and HLA-DQB1*03:02, *06:04) and cytokine (HLA-DRB1*01:03, *03:01, *10:01, *13:01, *15:01) immune responses. We undertook an independent study of 1,053 healthy individuals and examined associations between HLA alleles and measures of adaptive immunity after a single dose of Dryvax-derived ACAM2000 vaccine to evaluate previously discovered HLA allelic associations from the Dryvax study and determine if these associations are replicated with ACAM2000. Females had significantly higher NA titers than male subjects in both study cohorts [median ID50 discovery cohort 159 (93, 256) vs. 125 (75, 186), p < 0.001; replication cohort 144 (82, 204) vs. 110 (61, 189), p = 0.024]. The association between the DQB1*03:02 allele (median ID50 discovery cohort 152, p = 0.015; replication cohort 134, p = 0.010) and higher NA titers was replicated. Two HLA associations of comparable magnitudes were consistently found between DRB1*04:03 and DRB1*08:01 alleles and IFN-γ ELISPOT responses. The association between the DRB1*15:01 allele with IFN-γ secretion was also replicated (median pg/mL discovery cohort 182, p = 0.052; replication cohort 203, p = 0.014). Our results suggest that smallpox vaccine-induced adaptive immune responses are significantly influenced by HLA gene polymorphisms. These data provide information for functional studies and design of novel candidate smallpox vaccines.
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Affiliation(s)
- Inna G. Ovsyannikova
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA
- Program in Translational Immunovirology and Biodefense, Mayo Clinic, Rochester, MN 55905, USA
| | - V. Shane Pankratz
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Hannah M. Salk
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA
| | - Richard B. Kennedy
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA
- Program in Translational Immunovirology and Biodefense, Mayo Clinic, Rochester, MN 55905, USA
| | - Gregory A. Poland
- Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA
- Program in Translational Immunovirology and Biodefense, Mayo Clinic, Rochester, MN 55905, USA
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Frey SE, Winokur PL, Hill H, Goll JB, Chaplin P, Belshe RB. Phase II randomized, double-blinded comparison of a single high dose (5×10(8) TCID50) of modified vaccinia Ankara compared to a standard dose (1×10(8) TCID50) in healthy vaccinia-naïve individuals. Vaccine 2014; 32:2732-9. [PMID: 24607004 DOI: 10.1016/j.vaccine.2014.02.043] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 12/20/2013] [Accepted: 02/12/2014] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Reintroduction of Variola major as an agent of bioterrorism remains a concern. Time to seroconversion and plaque reduction neutralizing antibody titers (PRNT) of 1 or 2 standard doses (SD) were compared to a single high dose (HD) of modified vaccinia Ankara (MVA). METHODS Ninety subjects were randomized 1:1 to receive 1 HD or 2 SD of MVA subcutaneously on Days 0 and 28 in a placebo-controlled trial. Serum was collected for PRNT and ELISA. Subjects were followed for safety for the entire study. RESULTS The HD was well-tolerated. Using Bavarian Nordic's ELISA, subjects in both groups achieved seroconversion by Study Day 15 (HD) and Day 28 (SD). Before second vaccination, the hazard rate of seroconverting for the HD group was 1.7 times the SD group with a median time for seroconversion of 14 days for both groups. The peak titer of one HD vaccine was superior to one dose of SD vaccine but inferior to the peak titer after the second dose of the SD vaccination regimen. Using Saint Louis University's PRNT, peak titers were 95.8 and 65.2 for the HD and SD groups, respectively, prior to second vaccination. Non-inferiority of the SD group was not established. The proportions of positives were 93.3% (42/45) and 82.2% (37/45) for the HD and SD groups, respectively. The peak titer after two standard doses was superior to that of the HD. CONCLUSIONS HD MVA was safe and well-tolerated. While the hazard rate for seroconverting was significantly higher in the HD group before second dose, the effect was small as the median time to seroconversion was identical. When comparing PRNT, non-inferiority of one SD was not established and the peak titers were low for both groups. The HD peak response was inferior to the standard two-dose regimen response based on ELISA and PRNT.
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Affiliation(s)
- Sharon E Frey
- Saint Louis University Medical School, Department of Internal Medicine, United States.
| | - Patricia L Winokur
- University of Iowa and Iowa City VA Medical Center Health Care System, Department of Internal Medicine, United States
| | | | | | | | - Robert B Belshe
- Saint Louis University Medical School, Department of Internal Medicine, United States
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Borisevich SV, Marennikova SS, Stovba LF, Makhlaĭ AA, Loginova SI, Terent'ev AI, Krotkov VT, Perekrest VV, Krasnianskiĭ VP. [Vaccine-like viruses: peculiarities of circulation in the South America]. Vopr Virusol 2014; 59:10-14. [PMID: 25069279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The peculiarities of the spread of vaccine-like viruses first revealed more than 50 years ago in the area of the South America was discussed. These viruses cause infective episodes among milk cattle and caretaking personnel. Cancellation of the smallpox vaccination in 1980 resulted in a decrease in the community immunity and increased the risks of human infection. This circumstance makes it necessary to activate monitoring of the properties of the vaccine-like viruses, the circle of hosts and possible changes in the pathogenicity for humans.
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50
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Bissa M, Pacchioni SM, Zanotto C, De Giuli Morghen C, Illiano E, Granucci F, Zanoni I, Broggi A, Radaelli A. Systemically administered DNA and fowlpox recombinants expressing four vaccinia virus genes although immunogenic do not protect mice against the highly pathogenic IHD-J vaccinia strain. Virus Res 2013; 178:374-82. [PMID: 24050999 PMCID: PMC9533858 DOI: 10.1016/j.virusres.2013.09.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 09/05/2013] [Accepted: 09/09/2013] [Indexed: 11/30/2022]
Abstract
The first-generation smallpox vaccine was based on live vaccinia virus (VV) and it successfully eradicated the disease worldwide. Therefore, it was not administered any more after 1980, as smallpox no longer existed as a natural infection. However, emerging threats by terrorist organisations has prompted new programmes for second-generation vaccine development based on attenuated VV strains, which have been shown to cause rare but serious adverse events in immunocompromised patients. Considering the closely related animal poxviruses that might also be used as bioweapons, and the increasing number of unvaccinated young people and AIDS-affected immunocompromised subjects, a safer and more effective smallpox vaccine is still required. New avipoxvirus-based vectors should improve the safety of conventional vaccines, and protect from newly emerging zoonotic orthopoxvirus diseases and from the threat of deliberate release of variola or monkeypox virus in a bioterrorist attack. In this study, DNA and fowlpox recombinants expressing the L1R, A27L, A33R and B5R genes were constructed and evaluated in a pre-clinical trial in mouse, following six prime/boost immunisation regimens, to compare their immunogenicity and protective efficacy against a challenge with the lethal VV IHD-J strain. Although higher numbers of VV-specific IFNγ-producing T lymphocytes were observed in the protected mice, the cytotoxic T-lymphocyte response and the presence of neutralising antibodies did not always correlate with protection. In spite of previous successful results in mice, rabbits and monkeys, where SIV/HIV transgenes were expressed by the fowlpox vector, the immune response elicited by these recombinants was low, and most of the mice were not protected.
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Affiliation(s)
- Massimiliano Bissa
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, via Vanvitelli, 32, 20129 Milan, Italy.
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