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鼻腔内接种季节性流感疫苗和 TLR-3 激动剂瑞替莫德可诱导人体针对禽流感 H5N1 和 H7N9 流感 HA 产生交叉反应性 IgA 抗体。

Intranasal seasonal influenza vaccine and a TLR-3 agonist, rintatolimod, induced cross-reactive IgA antibody formation against avian H5N1 and H7N9 influenza HA in humans.

机构信息

University of Alabama at Birmingham, 908 20th Street South, Birmingham, AL 35294, United States.

Hemispherx Biopharma, Inc., One Penn Center, 1617 JFK Boulevard, Suite 500, Philadelphia, PA 19103, United States.

出版信息

Vaccine. 2014 Sep 22;32(42):5490-5. doi: 10.1016/j.vaccine.2014.07.078. Epub 2014 Aug 13.


DOI:10.1016/j.vaccine.2014.07.078
PMID:25128802
Abstract

The intranasal use of rintatolimod, a specific TLR-3 agonist, combined with trivalent seasonal influenza vaccine generated cross-protection against highly pathogenic H5N1 avian influenza in mice. The purpose of this clinical trial is to assess the safety and impact of rintatolimod on intranasal influenza vaccine in healthy adults. During Stage I of this Phase I/II clinical trial, 12 volunteers were immunized intranasally with 3 doses of FluMist seasonal influenza vaccine on Days 0, 28, and 56 followed by intranasal rintatolimod (50 μg, 200 μg, or 500 μg) 3 days later. Parotid saliva and nasal wash samples were collected at baseline and on Days 25, 53, 84, and 417. The samples were tested for IgA and IgG specific antibodies (Ab) directed against the homologous FluMist viral hemagglutinins (HAs). In addition, viral specific responses against influenza A HAs were tested for IgA Ab cross-reactivity against 3 H5 clades: HA (H5N1) A/Indonesia/5/2005, HA (H5N1) A/Hong Kong/483/97 and HA (H5N1) A/Vietnam/1194/2004, as well as, two H7 strains, HA (H7N9) A/Shanghai/2/2013 and HA (H7N3) A/chicken/Jalisco/CPA1. The combination of the intranasal FluMist along with the rintatolimod generated specific secretory IgA responses of at least 4-fold over baseline against at least one of the homologous vaccine strains included in the vaccine in 92% of the vaccinees. Additionally, this vaccination strategy induced cross-reactive secretory IgA against highly pathogenic avian influenza virus strains H5N1, H7N9, and H7N3 with pandemic potential for humans. The combination of rintatolimod and FluMist was well-tolerated.

摘要

鼻腔内使用特定的 TLR-3 激动剂利纳托利莫德(rintatolimod)与三价季节性流感疫苗联合使用,可在小鼠中产生针对高致病性 H5N1 禽流感的交叉保护作用。本临床试验的目的是评估利纳托利莫德对健康成年人鼻腔内流感疫苗的安全性和影响。在这项 I 期/II 期临床试验的 I 期阶段,12 名志愿者在第 0、28 和 56 天接受 3 剂 FluMist 季节性流感疫苗鼻腔内免疫接种,随后在第 3 天鼻腔内给予利纳托利莫德(50μg、200μg 或 500μg)。在基线和第 25、53、84 和 417 天收集腮腺唾液和鼻洗液样本。测试针对同源 FluMist 病毒血凝素(HA)的 IgA 和 IgG 特异性抗体(Ab)。此外,还测试了针对流感 A HAs 的病毒特异性反应,以检测针对 3 个 H5 谱系的 IgA Ab 交叉反应性:HA(H5N1)A/印度尼西亚/5/2005、HA(H5N1)A/香港/483/97 和 HA(H5N1)A/越南/1194/2004,以及两种 H7 株,HA(H7N9)A/上海/2/2013 和 HA(H7N3)A/鸡/墨西哥/CPA1。鼻腔内 FluMist 与利纳托利莫德联合使用,在 92%的疫苗接种者中,针对疫苗中包含的至少一种同源疫苗株,产生了至少 4 倍基线的特异性分泌型 IgA 反应。此外,这种疫苗接种策略诱导了针对具有大流行潜力的高致病性禽流感病毒株 H5N1、H7N9 和 H7N3 的交叉反应性分泌型 IgA。利纳托利莫德和 FluMist 的联合使用具有良好的耐受性。

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