Programa de Estudio y Control de Enfermedades Tropicales, PECET, Universidad de Antioquia, Medellín, Colombia.
Vaccine. 2009 Dec 11;28(2):329-37. doi: 10.1016/j.vaccine.2009.10.045. Epub 2009 Oct 30.
Healthy Colombian adult volunteers with no history of leishmaniasis were evaluated for evidence of previous subclinical infection with Leishmania based on the Montenegro skin test (MST). Twelve MST-positive subjects were enrolled in an open-label, uncontrolled clinical trial (the "MST-positive trial") and received three injections of the LEISH-F1+MPL-SE vaccine (consisting of 10 microg recombinant Leishmania polyprotein LEISH-F1 antigen [TSA+LmSTI1+LeIF]+25 microg MPL-SE adjuvant). Sixty-eight MST-negative subjects were enrolled in a randomized, double-blind, controlled trial (the "MST-negative trial") and were randomly assigned to receive three injections of either the vaccine (n=34), 10 microg LEISH-F1 protein alone (n=17), or saline placebo (n=17). In both trials, the study injections were given subcutaneously on Days 0, 28, and 56, and subjects were followed for safety and immunological endpoints. The LEISH-F1+MPL-SE vaccine was safe and well tolerated in MST-positive and MST-negative subjects. In both trials, an IFN-gamma response to the LEISH-F1 antigen at Day 84 was observed in more than half of the vaccine recipients. In the MST-negative trial, the IFN-gamma response was significantly more frequent and of greater magnitude in vaccine recipients than in protein-alone or placebo recipients. An IgG antibody response to LEISH-F1 was observed in all vaccine recipients. In both trials, delayed-type hypersensitivity (DTH) to LEISH-F1 was observed in most of the vaccine recipients. In the MST-negative trial, DTH was significantly higher in vaccine than placebo recipients. These clinical trials of the first defined vaccine for leishmaniasis show that the LEISH-F1+MPL-SE vaccine is safe and immunogenic in healthy subjects with and without evidence of previous subclinical infection with Leishmania.
健康的哥伦比亚成年志愿者无利什曼病病史,采用曼托黑诺皮肤试验(MST)评估有无利什曼原虫既往亚临床感染的证据。12 例 MST 阳性者入组开放性、非对照临床试验(“MST 阳性试验”),并接受 LEISH-F1+MPL-SE 疫苗 3 次注射(由 10μg 重组利什曼多蛋白 LEISH-F1 抗原[TSA+LmSTI1+LeIF]+25μg MPL-SE 佐剂组成)。68 例 MST 阴性者入组随机、双盲、对照临床试验(“MST 阴性试验”),并随机接受疫苗(n=34)、LEISH-F1 蛋白单独(n=17)或盐水安慰剂(n=17)3 次注射。在两项试验中,研究注射均于第 0、28 和 56 天皮下给予,对受试者进行安全性和免疫学终点随访。LEISH-F1+MPL-SE 疫苗在 MST 阳性和 MST 阴性受试者中安全且耐受良好。在两项试验中,84 天时超过一半的疫苗接种者对 LEISH-F1 抗原产生 IFN-γ应答。在 MST 阴性试验中,疫苗接种者 IFN-γ应答的频率和强度显著高于蛋白单独或安慰剂接种者。所有疫苗接种者均观察到针对 LEISH-F1 的 IgG 抗体应答。在两项试验中,大多数疫苗接种者均观察到 LEISH-F1 的迟发型超敏反应(DTH)。在 MST 阴性试验中,疫苗接种者 DTH 显著高于安慰剂接种者。这些首例利什曼病定义性疫苗的临床试验显示,LEISH-F1+MPL-SE 疫苗在有和无既往利什曼原虫亚临床感染证据的健康受试者中安全且具有免疫原性。