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免疫原性:脑膜炎球菌 ABCWY 疫苗加强免疫对原发性接种研究性或已上市疫苗的影响:一项 2 期随机研究。

Immune Responses to Booster Vaccination With Meningococcal ABCWY Vaccine After Primary Vaccination With Either Investigational or Licensed Vaccines: A Phase 2 Randomized Study.

机构信息

From the Department of Pediatric Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland.

Kentucky Pediatric and Adult Research Inc, Bardstown, Kentucky.

出版信息

Pediatr Infect Dis J. 2018 May;37(5):475-482. doi: 10.1097/INF.0000000000001896.

DOI:10.1097/INF.0000000000001896
PMID:29329168
Abstract

BACKGROUND

Current meningococcal prime-boost vaccination schedules include separate vaccines for serogroups ACWY and B. An investigational combined serogroups ABCWY vaccine (MenABCWY) was developed to protect against clinically important Neisseria meningitidis serogroups.

METHODS

In this phase 2, randomized, observer-blind, extension study (NCT01272180), participants 10-25 years of age received 1 booster dose of MenABCWY vaccine at 24 months (M) postprimary series of MenABCWY (2 doses), 4CMenB (2 doses) or MenACWY-CRM vaccine (1 dose). Immune responses to booster dose (1M postbooster) and antibody persistence (24M, 36M postprimary series) were assessed using bactericidal assay with human complement (hSBA). Reactogenicity and safety were evaluated.

RESULTS

One hundred ninety participants were vaccinated. At 1M after the MenABCWY booster dose, seroresponse rates against serogroups ACWY ranged between 85% and 96%, 73% and 100% and 83% and 95% for participants previously receiving MenABCWY, 4CMenB and MenACWY-CRM, respectively. At 12M postbooster dose, ≥67% of participants across all groups had hSBA titers ≥8 for serogroups ACWY, except in 4CMenB-primed individuals for serogroup Y (45%). Across MenABCWY and 4CMenB-primed groups, hSBA titers ≥5 across serogroup B test strains were observed in 82%-100% and 29%-100% of participants at 1M and 12M postbooster, respectively. Geometric mean titers against serogroups ACWY increased from pre- to 1M postboosting with MenABCWY and persisted at 12M. The reactogenicity and safety profile of MenABCWY was similar to that of 4CMenB.

CONCLUSIONS

MenABCWY may be suitable for prime-boost schedules against meningococcal disease, including regimens involving a primary series of either 4CMenB or MenACWY-CRM licensed vaccines.

摘要

背景

目前的脑膜炎球菌初免-加强免疫接种计划包括针对血清群 ACWY 和 B 的单独疫苗。一种研究性的联合血清群 ABCWY 疫苗(MenABCWY)被开发出来,以预防临床上重要的脑膜炎奈瑟菌血清群。

方法

在这项 2 期、随机、观察者盲法、扩展研究(NCT01272180)中,年龄在 10-25 岁的参与者在初免系列(MenABCWY 两剂、4CMenB 两剂)后 24 个月(M)接受 1 剂 MenABCWY 疫苗加强剂,或 MenACWY-CRM 疫苗(1 剂)。使用人补体杀菌试验(hSBA)评估加强剂量(加强后 1M)和抗体持久性(初免系列后 24M、36M)的免疫应答。评估了反应原性和安全性。

结果

190 名参与者接种了疫苗。在接受 MenABCWY 加强剂量后 1M,以前接受过 MenABCWY、4CMenB 和 MenACWY-CRM 疫苗接种的参与者针对血清群 ACWY 的血清反应率分别为 85%至 96%、73%至 100%和 83%至 95%。在加强后 12M,所有组中≥67%的参与者针对血清群 ACWY 的 hSBA 滴度≥8,除了 4CMenB 初免组的血清群 Y(45%)外。在 MenABCWY 和 4CMenB 初免组中,在加强后 1M 和 12M,针对血清群 B 测试菌株的 hSBA 滴度≥5 的参与者分别为 82%-100%和 29%-100%。针对血清群 ACWY 的几何平均滴度在 MenABCWY 从初免前到加强后 1M 增加,并在 12M 时持续存在。MenABCWY 的反应原性和安全性与 4CMenB 相似。

结论

MenABCWY 可能适合用于脑膜炎球菌疾病的初免-加强免疫接种计划,包括使用已许可的 4CMenB 或 MenACWY-CRM 疫苗进行初免系列的方案。

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