Development of a mucosal vaccine for influenza viruses: preparation for a potential influenza pandemic

Highly pathogenic avian H5N1 influenza A virus has caused influenza outbreaks in poultry and migratory birds in Southeast Asia, Africa and Europe, and there is concern that it could cause a new pandemic. This fear of an emerging pandemic of a new influenza strain underscores the urgency of preparing effective vaccines to meet the pandemic. One way to mitigate current concerns is to develop an influenza vaccine that is fully functional against drift influenza viruses. In our current situation, in which we cannot predict which strain will cause a pandemic, cross-protective immunity using potential and novel mucosal vaccines plays a particularly important role in preventing the spread of highly pathogenic influenza virus.     

Virus-like particle (VLP)-based vaccines for pandemic influenza: Performance of a VLP vaccine during the 2009 influenza pandemic

The influenza pandemic of 2009 demonstrated the inability of the established global capacity for egg-based vaccine production technology to provide sufficient vaccine for the population in a timely fashion. Several alternative technologies for developing influenza vaccines have been proposed, among which non-replicating virus-like particles (VLPs) represent an attractive option because of their safety and immunogenic characteristics. VLP vaccines against pandemic influenza have been developed in tobacco plant cells and in Sf9 insect cells infected with baculovirus that expresses protein genes from pandemic influenza strains. These technologies allow rapid and large-scale production of vaccines (3-12 weeks). The 2009 influenza outbreak provided an opportunity for clinical testing of a pandemic influenza VLP vaccine in the midst of the outbreak at its epicenter in Mexico. An influenza A(H1N1)2009 VLP pandemic vaccine (produced in insect cells) was tested in a phase II clinical trial involving 4,563 healthy adults. Results showed that the vaccine is safe and immunogenic despite high preexisting anti-A(H1N1)2009 antibody titers present in the population. The safety and immunogenicity profile presented by this pandemic VLP vaccine during the outbreak in Mexico suggests that VLP technology is a suitable alternative to current influenza vaccine technologies for producing pandemic and seasonal vaccines.     

Immunogenicity of a monovalent, aluminum-adjuvanted influenza whole virus vaccine for pandemic use

In the case of an influenza pandemic a significant gap between influenza vaccine manufacturing capacities and vaccine demands must be expected on a global scale. This study explores the possibility to increase the number of vaccine doses that can be provided with the existing resources by using a lower amount of antigen per dose in an aluminum-adjuvanted whole virus vaccine formulation, instead of the standard dosage of 15 microg hemagglutinin (HA). The study was performed as an open, non-controlled, randomized, multicentric study in 200 volunteers (18-30 years of age). Three monovalent aluminum-adjuvanted whole virus formulations with different antigen concentrations (1.9, 3.75 and 7.5 microg HA per dose) were compared to a split virus vaccine (15 microg HA per dose) without aluminum adjuvantation. The sera were tested for hemagglutination inhibition (HI) antibodies, neuraminidase inhibition (NI) antibodies and virus neutralizing (VN) antibodies. Nasal swab samples were tested for influenza-specific IgA antibodies. All volunteers were immunologically na?ve to the vaccine strain influenza A/Singapore/1/57 (H2N2). The vaccine was well tolerated. HI titers reached protective levels (geometric mean titer (GMT) >1:40) after two vaccine doses. In the group immunized with the lowest antigen dose the seroprotection rate was 82%. Although the immune response tends to be lower for vaccine formulations with reduced antigen content, the immunogenicity criteria as defined by the European Agency for the Evaluation of Medicinal Products (EMEA) were met with all antigen formulations after two vaccine doses. Significant increases in HI, NI and VN titers were observed, however, no significant local immune response was detected. The use of a low-dose whole virus influenza vaccine, adjuvanted with aluminum appears to be a viable approach to increase vaccine supplies in a pandemic situation.     

The formation of an immune response in volunteers inoculated with a live recombinant influenza vaccine]

The capacity of a live influenza vaccine (LIV) to stimulate cytotoxic cells (ADCMC and NK) was studied in 49 volunteers and 56 patients with influenza. Experimental batches of LIV from influenza A and B viruses prepared by genetic recombination on the basis of cold-adapted attenuation donors were used. Type A and B LIV were shown to stimulate the cytotoxic cell-mediated and humoral immunity; the intensity of immune response, however, depended on the molecular genetic characteristics of the vaccine (genome structure, properties of the donor of attenuation), its biological activity and capacity of reproduction in tissues.     

Genome composition analysis of reassortant influenza viruses used in seasonal and pandemic live attenuated influenza vaccine

The cold-adapted, temperature sensitive and attenuated influenza master donor viruses A/Leningrad/134/17/57 (H2N2) and B/USSR/60/69 were used to generate vaccine viruses to be included in live attenuated influenza vaccine. These vaccine viruses typically are 6: 2 reassortant viruses containing the gene segments of the surface antigens haemagglutinin and neuraminidase of current wild type influenza A and influenza B viruses with the gene segments encoding the internal viral proteins, conferring the cold-adapted, temperature sensitive and attenuated phenotype, being inherited from the master donor viruses. The 6: 2 reassortant viruses are selected from co-infections between master donor virus and wild type viruses that theoretically may yield as many as 256 combinations of gene segments and thus 256 genetically different viruses. As the time to generate and isolate vaccine viruses is limited and because only 6: 2 reassortant viruses are allowed as vaccine viruses, sboth selection and creening needs to be both rapid and unambiguous. The screening of reassortant viruses by RT-PCRs using master donor virus and wild type virus specific primer sets is described to select both influenza A and influenza B 6: 2 reassortant viruses to be used in seasonal and pandemic live attenuated vaccine, unambigously.     

Live cold-adapted influenza A vaccine produced in Vero cell line

The African green monkey kidney (Vero) cell line was used as a substrate for the development of a live cold-adapted (ca) reassortant influenza vaccine. For that purpose, a new master strain was generated by an adaptation of the wild type (wt) A/Singapore/1/57 virus to growth at 25 degrees C in a Vero cell line. The resulting cold-adapted (ca) muster strain A/Singapore/1/57ca showed temperature sensitive (ts) phenotype and was attenuated in animal models and protective in the challenge experiments in ferrets. Two vaccine candidates of influenza A(H1N1) and A(H3N2) subtypes (6/2 reassortants) inheriting six genes coding internal proteins from the new master strain and the surface antigens hemagglutinin (HA) and neuraminidase (NA) from the epidemic viruses were obtained by a standard method of genetic reassortment. All steps of the vaccine preparation were done exclusively in Vero cells, including the isolation of the epidemic viruses. Both vaccine strains were used for immunization of young adult volunteers in a limited clinical trial and appeared to be safe, well tolerated and immunogenic after intranasal administration.     

Containing the accidental laboratory escape of potential pandemic influenza viruses

Background

The recent work on the modified H5N1 has stirred an intense debate on the risk associated with the accidental release from biosafety laboratory of potential pandemic pathogens. Here, we assess the risk that the accidental escape of a novel transmissible influenza strain would not be contained in the local community.

Methods

We develop here a detailed agent-based model that specifically considers laboratory workers and their contacts in microsimulations of the epidemic onset. We consider the following non-pharmaceutical interventions: isolation of the laboratory, laboratory workers’ household quarantine, contact tracing of cases and subsequent household quarantine of identified secondary cases, and school and workplace closure both preventive and reactive.

Results

Model simulations suggest that there is a non-negligible probability (5% to 15%), strongly dependent on reproduction number and probability of developing clinical symptoms, that the escape event is not detected at all. We find that the containment depends on the timely implementation of non-pharmaceutical interventions and contact tracing and it may be effective (>90% probability per event) only for pathogens with moderate transmissibility (reproductive number no larger than R₀?=?1.5). Containment depends on population density and structure as well, with a probability of giving rise to a global event that is three to five times lower in rural areas.

Conclusions

Results suggest that controllability of escape events is not guaranteed and, given the rapid increase of biosafety laboratories worldwide, this poses a serious threat to human health. Our findings may be relevant to policy makers when designing adequate preparedness plans and may have important implications for determining the location of new biosafety laboratories worldwide.

     

Evaluation of a live, attenuated recombinant influenza vaccine in high school children.

A live, attenuated, recombinant influenza vaccine (Alice strain) administered intranasally was evaluated in high school students and compared with intranasal placebo and subcutaneous, inactivated, bivalent influenza vaccine. The Alice strain was antigenic, increasing the geometric mean titer (GMT) from a prestudy level of 30.2 to a postvaccine level of 189.6. The inactivated vaccine increased the GMT from 32.9 to 361.8. There was no increase in the GMT among the placebo recipients. The Alice strain produced little reaction. With an antigenic, safe, acceptable, live, attenuated influenza vaccine available, immunization on a widespread basis should be considered.     

Characterization and vaccine potential of a novel recombinant coccidial antigen.

A cDNA clone derived from sporulated oocysts of Eimeria tenella and encoding the expression product GX3262 was identified using a monoclonal antibody raised against Eimeria acervulina sporozoites. The cDNA fragment containing the coccidial antigen gene was cloned in bacteriophage lambda gt11, transferred to a plasmid, and introduced into Escherichia coli for analysis of the gene products. The strain carrying the plasmid produced GX3262 as part of a fusion protein consisting of the first 1,006 amino acids of E. coli beta-galactosidase and 112 amino acids of the E. tenella protein of approximately 12 kilodaltons. Partially purified antigen, heat-killed recombinant bacterin, and live E. coli containing the recombinant coccidial antigen were used to immunize 1-week-old or newly hatched broiler chicks. Several immunization protocols were utilized, including boosts with partially purified beta-galactosidase-GX3262, bacterin, or small numbers of live E. tenella oocysts. After challenge with an experimental E. tenella infection, the birds were evaluated by scoring cecal lesions to determine the level of protection. The greatest degree of protection was seen after only a single immunization of 2-day-old birds with a live recombinant E. coli preparation. The results presented here identify GX3262 as a potential candidate coccidial vaccine antigen and provide evidence for the first time that newly hatched chickens can be successfully vaccinated with a recombinant antigen.     

In vitro assessment of the allergenicity of novel MF59-adjuvanted pandemic H1N1 influenza vaccine produced in dog kidney cells

A licensed inactivated MF59-adjuvanted seasonal influenza vaccine (Optaflu) produced in canine kidney cells (MDCK 33016-PF) contained no egg proteins and did not trigger degranulation in rat basophilic leukemia (RBL) cells passively sensitized with human anti-dog IgE, supporting its safe use in dog-allergic individuals. The cell-derived pandemic H1N1 influenza vaccine was also adjuvanted with the emulsion adjuvant MF59, and support for its similar safe use was sought. We sought to evaluate in vitro allergenicity of the MF59-adjuvanted cell-derived pandemic H1N1 influenza vaccine in subjects with dog allergy, with a mediator release assay. RBL-2H3 cells transfected with human Fcε receptor type 1 were sensitized with sera from adult dog-allergic subjects and stimulated with serial dilutions of pandemic H1N1 influenza vaccine and dog dander extract. β-N-hexosaminidase release (NHR) was used as a marker of RBL degranulation.. Median dog dander-specific IgE in 30 dog-allergic subjects was 27.7 kUA/L (range 10.1; > 100); and in 5 dog non-allergic subjects was < 0.35 kUA/L (UniCAP system). Median (range) maximum NHR in dog-allergic subjects was: pandemic H1N1 influenza vaccine 1.1% (0; 4.4) and dog dander 6.9% (0.7; 37.3), P < 0.001. In conclusion, MF59-adjuvanted pandemic H1N1 influenza vaccine produced in continuous canine kidney cells did not trigger degranulation in RBL cells passively sensitized with human anti-dog IgE, supporting its safe use in dog-allergic individuals.     

Electrophoretic migration rate differences of polypeptides of human influenza A viruses: Partial analysis of the genome of influenza vaccine recombinant viruses

Summary Electrophoretic migration rate differences were detected in high resolution SDS polyacrylamide gels for nucleoprotein (NP), matrix protein (M), non structural protein (NS1), haemagglutinin (HA) and, less regularly, for the polymerase polypeptides P1, P2 and P3 induced by different influenza A viruses. The technique allowed parental assignation of the corresponding genes in certain recombinant viruses including A/PR/8/34 (H0N1)—A/HK/117/77 (H1N1), A/Okuda/57 (H2N2)—A/HK/119/77 (H1N1) and A/Leningrad/76 (H3N2)—A/Leningrad/46 (H0N1) recombinants, thus considerably extending the technique which had been applied previously to A/PR/8/34—A/HK/68 (H3N2) only. Agreement in gene assignment between three recombinants of the former group and 11 of 17 recombinants in the A/Okuda/57—A/HK/119/77 group was noted when the data obtained using the polypeptide method was correlated with a direct genetic analysis by others using RNA:RNA hybridisation techniques. The polypeptide method appears to have wide application for the initial rapid analysis of influenza A virus recombinants obtained using parents of different influenza subtypes although complete analysis of the total genome requires the use of RNA hybridisation techniques. Two additional virus induced proteins are described, a phosphorylated form of NS 1 and a non structual polypeptide with a molecular weight of 16 K daltons.With 6 Figures     

Highly immunogenic and protective recombinant vaccine candidate expressed in transgenic plants

Vaccine development has been hampered by difficulties in developing new and safe adjuvants, so alternative technologies that offer new avenues forward are urgently needed. The goal of this study was to express a monoclonal recombinant immune complex in a transgenic plant. A recombinant protein consisting of a tetanus toxin C fragment-specific monoclonal antibody fused with the tetanus toxin C fragment was designed and expressed. Immune complex formation occurred between individual fusion proteins to form immune complex-like aggregates that bound C1q and FcgammaRIIa receptor and could be targeted to antigen-presenting cells. Unlike antigen alone, the recombinant immune fusion complexes were highly immunogenic in mice and did not require coadministration of an adjuvant (when injected subcutaneously). Indeed, these complexes elicited antibody titers that were more than 10,000 times higher than those observed in animals immunized with the antigen alone. Furthermore, animals immunized with only 1 mug of recombinant immune complex without adjuvant were fully protected against lethal challenge. This the first report on the use of a genetic fusion between antigen and antibody to ensure an optimal expression ratio between the two moieties and to obtain fully functional recombinant immune complexes as a new vaccine model.     

A pandemic H1N1 influenza virus-like particle vaccine induces cross-protection in mice

Influenza virus-like particles (VLPs) represent promising alternative vaccines. However, it is necessary to demonstrate that influenza VLPs confer cross-protection against antigenically distinct viruses. In this study, a VLP vaccine comprising hemagglutinin (HA) and M1 from the A/California/04/2009 (H1N1) were used and its ability to induce cross-protective efficacy against heterologous viruses A/PR/8/34 (H1N1) and A/New Caledonia/20/99 (H1N1) in mice was assessed. Vaccination with 2009 H1 VLPs induced significantly higher levels of IgG cross-reactive with these heterologous viruses after the second boost compared to after the prime or first boost. Lung virus titers also decreased significantly and the lung cross-reactive IgG response after lethal virus challenge was significantly greater in immunized mice compared to naïve mice. Vaccinated mice showed 100% protection against A/PR/8/34 and A/Caledonia/20/99 viruses with only moderate body weight loss and induction of cross-reactive recall, IgG antibody-secreting cell responses. The variations in HA amino acid sequences and antigenic sites were determined and correlated with induction of cross-protective immunity. These results indicate that VLPs can be used as an effective vaccine that confers cross-protection against antigenically distinct viruses.     

The epidemiology of seasonal influenza after the 2009 influenza pandemic in Africa: a systematic review

BackgroundInfluenza infection is a serious public health problem that causes an estimated 3 to 5 million cases and 250,000 deaths worldwide every year. The epidemiology of influenza is well-documented in high- and middle-income countries, however minimal effort had been made to understand the epidemiology, burden and seasonality of influenza in Africa. This study aims to assess the state of knowledge of seasonal influenza epidemiology in Africa and identify potential data gaps for policy formulation following the 2009 pandemic.MethodWe reviewed articles from Africa published into four databases namely: MEDLINE (PubMed), Google Scholar, Cochrane Library and Scientific Research Publishing from 2010 to 2019.ResultsWe screened titles and abstracts of 2070 studies of which 311 were selected for full content evaluation and 199 studies were considered. Selected articles varied substantially on the basis of the topics they addressed covering the field of influenza surveillance (n=80); influenza risk factors and co-morbidities (n=15); influenza burden (n=37); influenza vaccination (n=40); influenza and other respiratory pathogens (n=22) and influenza diagnosis (n=5).ConclusionSignificant progress has been made since the last pandemic in understanding the influenza epidemiology in Africa. However, efforts still remain for most countries to have sufficient data to allow countries to prioritize strategies for influenza prevention and control.