Hokey David A, Wachholder Robert, Darrah Patricia A, Bolton Diane L, Barouch Dan H, Hill Krystal, Dheenadhayalan Veerabadran, Schwander Stephan, Godin C Steven, Douoguih Macaya, Pau Maria Grazia, Seder Robert A, Roederer Mario, Sadoff Jerald C, Sizemore Donata
a Aeras; Rockville, MD USA.
Hum Vaccin Immunother. 2014;10(8):2199-210. doi: 10.4161/hv.29108.
Bacille Calmette-Guérin (BCG), the only licensed vaccine for the prevention of tuberculosis (TB), provides only limited protection against certain forms of Mycobacterium tuberculosis (Mtb) infection. While infection with Mtb can be treated with antibiotics, the therapy is expensive, toxic, and requires several months for treatment. In addition, the emergence of drug resistant strains limits the impact of antibiotics and underlines the importance of developing a more effective vaccine to control this disease. Given that pulmonary TB is the most common form of the disease, a vaccine capable of inducing lung-resident immunity may be advantageous for combating this infection. New advances in pulmonary delivery make this route of vaccination feasible and affordable. Here, we evaluate the safety and immunogenicity of an aerosolized Ad35-based vaccine, AERAS-402, delivered to the lungs in nonhuman primates as part of a GLP acute and chronic toxicology and safety study. In this study, animals received three high doses (1 x 10(11) vp) of AERAS-402 by inhalation via a nebulizer at 1-week intervals. Aerosol delivery of AERAS-402 resulted in an increase in relative lung weights as well as microscopic findings in the lungs, mediastinal lymph nodes, bronchus-associated lymphatic tissue, and the naso-oropharynx that were consistent with the induction of an immune response during the acute phase. These findings resolved by the chronic phase and were considered to be non-adverse. Furthermore, we observed transient vaccine-specific immune responses in the peripheral blood as well as sustained high-level polyfunctional CD4(+) and CD8(+) T cell responses in the bronchoalveolar lavage fluid of vaccinated nonhuman primates. The data suggest that pulmonary delivery of Ad35-based vaccines can be safe and can induce potent lung-resident immunity.
卡介苗(BCG)是唯一获得许可用于预防结核病(TB)的疫苗,对某些形式的结核分枝杆菌(Mtb)感染仅提供有限的保护。虽然Mtb感染可用抗生素治疗,但该疗法昂贵、有毒,且需要数月的治疗时间。此外,耐药菌株的出现限制了抗生素的作用,并凸显了开发更有效疫苗以控制这种疾病的重要性。鉴于肺结核是该疾病最常见的形式,一种能够诱导肺部驻留免疫的疫苗可能有利于对抗这种感染。肺部给药的新进展使这种疫苗接种途径可行且经济实惠。在这里,作为GLP急性和慢性毒理学及安全性研究的一部分,我们评估了雾化的基于Ad35的疫苗AERAS-402在非人灵长类动物肺部给药后的安全性和免疫原性。在这项研究中,动物每隔1周通过雾化器吸入三次高剂量(1×10¹¹ vp)的AERAS-402。AERAS-402的雾化给药导致相对肺重量增加,以及在肺部、纵隔淋巴结、支气管相关淋巴组织和鼻-口咽部出现微观变化,这些变化与急性期免疫反应的诱导一致。这些发现到慢性期时消失,被认为是无不良影响的。此外,我们在接种疫苗的非人灵长类动物的外周血中观察到短暂的疫苗特异性免疫反应,以及在支气管肺泡灌洗液中持续的高水平多功能CD4⁺和CD8⁺ T细胞反应。数据表明,基于Ad35的疫苗经肺部给药是安全的,并且可以诱导强大的肺部驻留免疫。