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基于微针的疫苗。

Microneedle-based vaccines.

作者信息

Prausnitz Mark R, Mikszta John A, Cormier Michel, Andrianov Alexander K

机构信息

School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, 311 Ferst Drive, Atlanta, GA 30332-0100, USA.

出版信息

Curr Top Microbiol Immunol. 2009;333:369-93. doi: 10.1007/978-3-540-92165-3_18.

Abstract

The threat of pandemic influenza and other public health needs motivate the development of better vaccine delivery systems. To address this need, microneedles have been developed as micron-scale needles fabricated using low-cost manufacturing methods that administer vaccine into the skin using a simple device that may be suitable for self-administration. Delivery using solid or hollow microneedles can be accomplished by (1) piercing the skin and then applying a vaccine formulation or patch onto the permeabilized skin, (2) coating or encapsulating vaccine onto or within microneedles for rapid, or delayed, dissolution and release in the skin, and (3) injection into the skin using a modified syringe or pump. Extensive clinical experience with smallpox, TB, and other vaccines has shown that vaccine delivery into the skin using conventional intradermal injection is generally safe and effective and often elicits the same immune responses at lower doses compared to intramuscular injection. Animal experiments using microneedles have shown similar benefits. Microneedles have been used to deliver whole, inactivated virus; trivalent split antigen vaccines; and DNA plasmids encoding the influenza hemagglutinin to rodents, and strong antibody responses were elicited. In addition, ChimeriVax-JE against yellow fever was administered to nonhuman primates by microneedles and generated protective levels of neutralizing antibodies that were more than seven times greater than those obtained with subcutaneous delivery; DNA plasmids encoding hepatitis B surface antigen were administered to mice and antibody and T cell responses at least as strong as hypodermic injections were generated; recombinant protective antigen of Bacillus anthracis was administered to rabbits and provided complete protection from lethal aerosol anthrax spore challenge at a lower dose than intramuscular injection; and DNA plasmids encoding four vaccinia virus genes administered to mice in combination with electroporation generated neutralizing antibodies that apparently included both Th1 and Th2 responses. Dose sparing with microneedles was specifically studied in mice with the model vaccine ovalbumin. At low dose (1 microg), specific antibody titers from microneedles were one order of magnitude greater than subcutaneous injection and two orders of magnitude greater than intramuscular injection. At higher doses, antibody responses increased for all delivery methods. At the highest levels (20-80 microg), the route of administration had no significant effect on the immune response. Concerning safety, no infections or other serious adverse events have been observed in well over 1,000 microneedle insertions in human and animal subjects. Bleeding generally does not occur for short microneedles (<1 mm). Highly localized, mild, and transient erythema is often observed. Microneedle pain has been reported as nonexistent to mild, and always much less than a hypodermic needle control. Overall, these studies suggest that microneedles may provide a safe and effective method of delivering vaccines with the possible added attributes of requiring lower vaccine doses, permitting low-cost manufacturing, and enabling simple distribution and administration.

摘要

大流行性流感的威胁和其他公共卫生需求推动了更好的疫苗递送系统的开发。为满足这一需求,微针已被开发出来,它是使用低成本制造方法制造的微米级针头,通过一种可能适合自我给药的简单装置将疫苗注入皮肤。使用实心或空心微针进行递送可通过以下方式实现:(1) 刺穿皮肤,然后将疫苗制剂或贴片应用于通透性增强的皮肤上;(2) 将疫苗包被或封装在微针上或微针内,以便在皮肤中快速或延迟溶解和释放;(3) 使用改良的注射器或泵注入皮肤。天花、结核病和其他疫苗的广泛临床经验表明,使用传统皮内注射将疫苗递送至皮肤通常是安全有效的,并且与肌肉注射相比,通常在较低剂量下就能引发相同的免疫反应。使用微针的动物实验也显示出类似的益处。微针已被用于将完整的灭活病毒、三价裂解抗原疫苗以及编码流感血凝素的DNA质粒递送至啮齿动物体内,并引发了强烈的抗体反应。此外, 通过微针将抗黄热病的嵌合疫苗ChimeriVax-JE施用于非人灵长类动物,产生的中和抗体保护水平比皮下给药获得的水平高出七倍多;将编码乙型肝炎表面抗原的DNA质粒施用于小鼠,产生的抗体和T细胞反应至少与皮下注射一样强烈;将炭疽芽孢杆菌的重组保护性抗原施用于兔子,以低于肌肉注射的剂量提供了对致死性气溶胶炭疽芽孢攻击的完全保护;将编码四个痘苗病毒基因的DNA质粒与电穿孔联合施用于小鼠,产生的中和抗体显然包括Th1和Th2反应。使用模型疫苗卵清蛋白在小鼠中专门研究了微针的剂量节省情况。在低剂量 (1微克) 时,微针产生的特异性抗体滴度比皮下注射高一个数量级,比肌肉注射高两个数量级。在较高剂量时,所有递送方法的抗体反应均增加。在最高水平 (20 - 80微克) 时,给药途径对免疫反应没有显著影响。关于安全性,在超过1000次人体和动物受试者的微针插入操作中,未观察到感染或其他严重不良事件。短微针 (<1毫米) 通常不会引起出血。经常观察到高度局部化、轻微且短暂的红斑。据报道,微针疼痛不存在或很轻微,而且总是比皮下注射对照轻得多。总体而言,这些研究表明,微针可能提供一种安全有效的疫苗递送方法,可能还具有需要更低疫苗剂量、允许低成本制造以及便于简单分发和给药等附加特性。

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