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B族链球菌结合疫苗的抗体和疫苗本身对兔子均无致畸性。

Neither antibody to a group B streptococcal conjugate vaccine nor the vaccine itself is teratogenic in rabbits.

作者信息

Paoletti Lawrence C, Guttormsen Hilde-Kari, Christian Mildred S, Hoberman Alan M, McInnes Pamela

机构信息

Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.

出版信息

Hum Vaccin. 2008 Nov-Dec;4(6):435-43. doi: 10.4161/hv.4.6.6178. Epub 2008 Nov 21.

Abstract

Group B Streptococcus (GBS) is a leading cause of human neonatal bacterial disease, resulting in pneumonia, sepsis, meningitis and sometimes, death. Supportive preclinical studies of GBS capsular polysaccharide (CPS)-protein conjugate vaccines have led to several phase 1 and phase 2 trials in healthy, non-pregnant adults, which demonstrated that the vaccines, produced at the Channing Laboratory, were safe and immunogenic. However, evaluation of the safety and immunogenicity of a GBS conjugate vaccine administered to pregnant women demanded that it be manufactured under current good manufacturing practices (cGMP) and that it undergo developmental toxicity evaluation. In this report, we describe a GBS type III CPS-tetanus toxoid (III-TT) vaccine lot 3-1-96 manufactured and vialed under cGMP and our evaluation of the effect of this vaccine and of GBS type III CPS-specific antibody on conception and early- and late-stage fetal development in rabbits. III-TT lot 3-1-96 was compositionally similar to prototype III-TT lot 91-1, produced under non-GMP, and was potent in a mouse maternal vaccination-neonatal pup challenge model of GBS disease. Four groups of 30 female rabbits each were randomized to receive III-TT lot 3-1-96 vaccine, saline-alum, or combinations of these treatments before and after insemination. The dose of conjugated CPS on a weight basis was 1 microg/kg, mimicking the anticipated actual human dose. Based on the weight of the rabbits, this was 20- to 100-fold greater than the expected human dose. Does were pre-assigned to deliver litters naturally or have their kits delivered by Caesarean-section at gestation day 29, to assess late fetal development. Sera from does and kits were collected, and the presence of type III CPS-specific IgG was confirmed by quantitative ELISA. Based on all assessments, GBS type III-TT lot 3-1-96, nor antibody to it did not affect embryo fetal viability, sex ratio, growth or cause malformations (i.e., it was non-teratogenic). In addition, that III-TT lot 3-1-96 was found to be safe and immunogenic in two clinical studies involving healthy non-pregnant adults supports a clinical evaluation of this vaccine in pregnant women.

摘要

B族链球菌(GBS)是人类新生儿细菌性疾病的主要病因,可导致肺炎、败血症、脑膜炎,有时还会导致死亡。对GBS荚膜多糖(CPS)-蛋白结合疫苗的支持性临床前研究已在健康的非妊娠成人中开展了多项1期和2期试验,结果表明在钱宁实验室生产的这些疫苗是安全且具有免疫原性的。然而,评估给孕妇接种GBS结合疫苗的安全性和免疫原性要求该疫苗按照现行药品生产质量管理规范(cGMP)进行生产,并进行发育毒性评估。在本报告中,我们描述了一批按照cGMP生产并装瓶的GBS III型CPS-破伤风类毒素(III-TT)疫苗(批次3-1-96),以及我们对该疫苗和GBS III型CPS特异性抗体对兔受孕及胎儿早期和晚期发育影响的评估。III-TT批次3-1-96在成分上与非cGMP条件下生产的原型III-TT批次91-1相似,并且在GBS疾病的小鼠母体疫苗接种-新生幼崽攻毒模型中具有效力。四组,每组30只雌性兔被随机分配在授精前后接受III-TT批次3-1-96疫苗、生理盐水-明矾或这些处理的组合。基于体重的结合CPS剂量为1微克/千克,模拟预期的实际人类剂量。基于兔的体重,这比预期的人类剂量高20至100倍。预先安排在妊娠第29天自然分娩或通过剖腹产取出幼崽,以评估胎儿后期发育。收集母兔和幼崽的血清,并通过定量ELISA确认III型CPS特异性IgG的存在。基于所有评估,GBS III型-TT批次3-1-96及其抗体均未影响胚胎-胎儿活力、性别比例、生长或导致畸形(即它是非致畸性的)。此外,在两项涉及健康非妊娠成人的临床研究中发现III-TT批次3-1-96是安全且具有免疫原性的,这支持了对该疫苗在孕妇中进行临床评估。

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