Sivko G S, Stark G V, Tordoff K P, Taylor K L, Glaze E, VanRaden M, Schiffer J M, Hewitt J A, Quinn C P, Nuzum E O
Battelle Memorial Institute, Columbus, OH 43201, USA.
Battelle Memorial Institute, Columbus, OH 43201, USA.
Vaccine. 2016 Dec 12;34(51):6518-6528. doi: 10.1016/j.vaccine.2016.04.048. Epub 2016 May 4.
Anthrax Vaccine Adsorbed (AVA, BioThrax) is approved by the US Food and Drug Administration for post-exposure prophylaxis (PEP) of anthrax in adults. The PEP schedule is 3 subcutaneous (SC) doses (0, 14 and 28 days), in conjunction with a 60 day course of antimicrobials. The objectives of this study were to understand the onset of protection from AVA PEP vaccination and to assess the potential for shortening the duration of antimicrobial treatment (http://www.phe.gov/Preparedness/mcm/phemce/Documents/2014-phemce-sip.pdf). We determined the efficacy against inhalation anthrax in nonhuman primates (NHP) of the first two doses of the PEP schedule by infectious challenge at the time scheduled for receipt of the third PEP dose (Day 28). Forty-eight cynomolgus macaques were randomized to five groups and vaccinated with serial dilutions of AVA on Days 0 and 14. NHP were exposed to Bacillus anthracis Ames spores on Day 28 (target dose 200 LD equivalents). Anti-protective antigen (PA) IgG and toxin neutralizing antibody (TNA) responses to vaccination and in post-challenge survivors were determined. Post-challenge blood and selected tissue samples were assessed for B. anthracis at necropsy or end of study (Day 56). Pre-challenge humoral immune responses correlated with survival, which ranged from 24 to 100% survival depending on vaccination group. Surviving, vaccinated animals had elevated anti-PA IgG and TNA levels for the duration of the study, were abacteremic, exhibited no apparent signs of infection, and had no gross or microscopic lesions. However, survivors had residual spores in lung tissues. We conclude that the first two doses of the PEP schedule provide high levels of protection by the scheduled timing of the third dose. These data may also support consideration of a shorter duration PEP antimicrobial regimen.
吸附炭疽疫苗(AVA,BioThrax)已获美国食品药品监督管理局批准,用于成人炭疽暴露后预防(PEP)。PEP接种程序为3剂皮下注射(SC)(分别在0、14和28天),同时进行为期60天的抗菌药物治疗。本研究的目的是了解AVA PEP疫苗接种产生保护作用的起始时间,并评估缩短抗菌治疗疗程的可能性(http://www.phe.gov/Preparedness/mcm/phemce/Documents/2014 - phemce - sip.pdf)。我们通过在预定接种第三剂PEP疫苗的时间(第28天)进行感染攻击,确定了PEP接种程序前两剂在非人类灵长类动物(NHP)中对吸入性炭疽的效力。48只食蟹猴被随机分为五组,并在第0天和第14天接种不同稀释度的AVA。在第28天,NHP暴露于炭疽芽孢杆菌埃姆斯菌株孢子(目标剂量为200个致死剂量当量)。测定了接种疫苗后以及攻击后存活动物体内抗保护性抗原(PA)IgG和毒素中和抗体(TNA)的反应。在尸检或研究结束时(第56天),对攻击后采集的血液和选定组织样本进行炭疽芽孢杆菌检测。攻击前的体液免疫反应与存活率相关,不同疫苗接种组的存活率在24%至100%之间。存活的接种疫苗动物在研究期间抗PA IgG和TNA水平升高,无菌血症,未表现出明显感染迹象,也没有肉眼可见或显微镜下的病变。然而,存活动物的肺组织中仍有残留孢子。我们得出结论,PEP接种程序的前两剂在第三剂预定接种时间时可提供高水平的保护。这些数据也可能支持考虑缩短PEP抗菌治疗方案的疗程。