Leroux-Roels Geert, Leroux-Roels Isabel, Clement Frédéric, Ofori-Anyinam Opokua, Lievens Marc, Jongert Erik, Moris Philippe, Ballou W Ripley, Cohen Joe
a Centre for Vaccinology (CEVAC); Ghent University and Ghent University Hospital; Ghent, Belgium.
Hum Vaccin Immunother. 2014;10(8):2211-9. doi: 10.4161/hv.29375.
This phase II, randomized, double-blind study evaluated the immunogenicity of RTS,S vaccines containing Adjuvant System AS01 or AS02 as compared with non-adjuvanted RTS,S in healthy, malaria-naïve adults (NCT00443131). Thirty-six subjects were randomized (1:1:1) to receive RTS,S/AS01, RTS,S/AS02, or RTS,S/saline at months 0, 1, and 2. Antibody responses to Plasmodium falciparum circumsporozoite (CS) and hepatitis B surface (HBs) antigens were assessed and cell-mediated immune responses evaluated by flow cytometry using intracellular cytokine staining on peripheral blood mononuclear cells. Anti-CS antibody avidity was also characterized. Safety and reactogenicity after each vaccine dose were monitored. One month after the third vaccine dose, RTS,S/AS01 (160.3 EU/mL [95%CI: 114.1-225.4]) and RTS,S/AS02 (77.4 EU/mL (95%CI: 47.3-126.7)) recipients had significantly higher anti-CS antibody geometric mean titers (GMTs) than recipients of RTS,S/saline (12.2 EU/mL (95%CI: 4.8-30.7); P < 0.0001 and P = 0.0011, respectively). The anti-CS antibody GMT was significantly higher with RTS,S/AS01 than with RTS,S/AS02 (P = 0.0135). Anti-CS antibody avidity was in the same range in all groups. CS- and HBs-specific CD4(+) T cell responses were greater for both RTS,S/AS groups than for the RTS,S/saline group. Reactogenicity was in general higher for RTS,S/AS compared with RTS,S/saline. Most grade 3 solicited adverse events (AEs) were of short duration and grade 3 solicited general AEs were infrequent in the 3 groups. No serious adverse events were reported. In conclusion, in comparison with non-adjuvanted RTS,S, both RTS,S/AS vaccines exhibited better CS-specific immune responses. The anti-CS antibody response was significantly higher with RTS,S/AS01 than with RTS,S/AS02. The adjuvanted vaccines had acceptable safety profiles.
这项II期随机双盲研究评估了含有佐剂系统AS01或AS02的RTS,S疫苗与未加佐剂的RTS,S疫苗相比,在未感染过疟疾的健康成年人中的免疫原性(NCT00443131)。36名受试者按1:1:1随机分组,在第0、1和2个月分别接受RTS,S/AS01、RTS,S/AS02或RTS,S/生理盐水。评估了对恶性疟原虫环子孢子(CS)和乙肝表面(HBs)抗原的抗体反应,并通过对外周血单核细胞进行细胞内细胞因子染色的流式细胞术评估细胞介导的免疫反应。还对抗CS抗体亲和力进行了表征。监测每次疫苗接种后的安全性和反应原性。在第三次疫苗接种后1个月,接受RTS,S/AS01(160.3 EU/mL [95%CI: 114.1 - 225.4])和RTS,S/AS02(77.4 EU/mL [95%CI: 47.3 - 126.7])的受试者的抗CS抗体几何平均滴度(GMT)显著高于接受RTS,S/生理盐水的受试者(12.2 EU/mL [95%CI: 4.8 - 30.7];P分别<0.0001和P = 0.0011)。RTS,S/AS01的抗CS抗体GMT显著高于RTS,S/AS02(P = 0.0135)。所有组的抗CS抗体亲和力处于相同范围。RTS,S/AS两组的CS特异性和HBs特异性CD4(+) T细胞反应均高于RTS,S/生理盐水组。与RTS,S/生理盐水相比,RTS,S/AS的反应原性总体上更高。大多数3级诱发不良事件(AE)持续时间短,3级诱发的一般AE在3组中很少见。未报告严重不良事件。总之,与未加佐剂的RTS,S相比,两种RTS,S/AS疫苗均表现出更好的CS特异性免疫反应。RTS,S/AS01的抗CS抗体反应显著高于RTS,S/AS02。佐剂疫苗具有可接受的安全性。