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2型糖尿病患者白细胞介素-1β疫苗的研发

Development of an Interleukin-1β Vaccine in Patients with Type 2 Diabetes.

作者信息

Cavelti-Weder Claudia, Timper Katharina, Seelig Eleonora, Keller Cornelia, Osranek Martin, Lässing Ute, Spohn Gunther, Maurer Patrik, Müller Philipp, Jennings Gary T, Willers Joerg, Saudan Philippe, Donath Marc Y, Bachmann Martin F

机构信息

Department of Endocrinology, Diabetes, and Metabolism, University Hospital of Basel, Basel, Switzerland.

Department of Endocrinology, Diabetes, and Metabolism, University Hospital of Zurich, Zurich, Switzerland.

出版信息

Mol Ther. 2016 May;24(5):1003-12. doi: 10.1038/mt.2015.227. Epub 2015 Dec 21.

Abstract

Interleukin-1β (IL-1β) is a key cytokine involved in inflammatory illnesses including rare hereditary diseases and common chronic inflammatory conditions as gout, rheumatoid arthritis, and type 2 diabetes mellitus, suggesting reduction of IL-1β activity as new treatment strategy. The objective of our study was to assess safety, antibody response, and preliminary efficacy of a novel vaccine against IL-1β. The vaccine hIL1bQb consisting of full-length, recombinant IL-1β coupled to virus-like particles was tested in a preclinical and clinical, randomized, placebo-controlled, double-blind study in patients with type 2 diabetes. The preclinical simian study showed prompt induction of IL-1β-specific antibodies upon vaccination, while neutralizing antibodies appeared with delay. In the clinical study with 48 type 2 diabetic patients, neutralizing IL-1β-specific antibody responses were detectable after six injections with doses of 900 µg. The development of neutralizing antibodies was associated with higher number of study drug injections, lower baseline body mass index, improvement of glycemia, and C-reactive protein (CRP). The vaccine hIL1bQb was safe and well-tolerated with no differences regarding adverse events between patients receiving hIL1bQb compared to placebo. This is the first description of a vaccine against IL-1β and represents a new treatment option for IL-1β-dependent diseases such as type 2 diabetes mellitus (ClinicalTrials.gov NCT00924105).

摘要

白细胞介素-1β(IL-1β)是一种关键细胞因子,参与包括罕见遗传性疾病以及痛风、类风湿性关节炎和2型糖尿病等常见慢性炎症性疾病在内的炎症性疾病,这表明降低IL-1β活性可作为一种新的治疗策略。我们研究的目的是评估一种新型抗IL-1β疫苗的安全性、抗体反应和初步疗效。由与病毒样颗粒偶联的全长重组IL-1β组成的疫苗hIL1bQb,在一项针对2型糖尿病患者的临床前和临床随机、安慰剂对照、双盲研究中进行了测试。临床前的猴类研究表明,接种疫苗后可迅速诱导产生IL-1β特异性抗体,而中和抗体出现较晚。在一项有48名2型糖尿病患者参与的临床研究中,注射6次900μg剂量后可检测到中和性IL-1β特异性抗体反应。中和抗体的产生与研究药物注射次数增加、基线体重指数较低、血糖改善以及C反应蛋白(CRP)有关。疫苗hIL1bQb安全且耐受性良好,接受hIL1bQb的患者与接受安慰剂的患者在不良事件方面没有差异。这是关于抗IL-1β疫苗的首次描述,代表了针对2型糖尿病等IL-1β依赖性疾病的一种新的治疗选择(ClinicalTrials.gov NCT00924105)。

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