Department of Dermatology, University Hospital Zurich, Schlieren, Switzerland; Evax AG, Münchwilen, Switzerland.
Department of Dermatology, University Hospital Zurich, Schlieren, Switzerland; Evax AG, Münchwilen, Switzerland.
J Allergy Clin Immunol. 2018 Oct;142(4):1194-1205.e3. doi: 10.1016/j.jaci.2018.01.041. Epub 2018 Apr 4.
Insect-bite hypersensitivity is the most common allergic dermatitis in horses. Excoriated skin lesions are typical symptoms of this seasonal and refractory chronic disease. On a cellular level, the skin lesions are characterized by massive eosinophil infiltration caused by an underlying allergic response.
To target these cells and treat disease, we developed a therapeutic vaccine against equine IL-5 (eIL-5), the master regulator of eosinophils.
The vaccine consisted of eIL-5 covalently linked to a virus-like particle derived from cucumber mosaic virus containing the tetanus toxoid universal T-cell epitope tt830-843 (CMV). Thirty-four Icelandic horses were recruited and immunized with 400 μg of eIL-5-CMV formulated in PBS without adjuvant (19 horses) or PBS alone (15 horses).
The vaccine was well tolerated and did not reveal any safety concerns but was able to induce anti-eIL-5 autoantibody titers in 17 of 19 horses. This resulted in a statistically significant reduction in clinical lesion scores when compared with previous season levels, as well as levels in placebo-treated horses. Protection required a minimal threshold of anti-eIL-5 antibodies. Clinical improvement by disease scoring showed that 47% and 21% of vaccinated horses reached 50% and 75% improvement, respectively. In the placebo group no horse reached 75% improvement, and only 13% reached 50% improvement.
Our therapeutic vaccine inducing autoantibodies against self IL-5 brings biologics to horses, is the first successful immunotherapeutic approach targeting a chronic disease in horses, and might facilitate development of a similar vaccine against IL-5 in human subjects.
昆虫叮咬过敏是马最常见的过敏性皮炎。搔抓后的皮肤损伤是这种季节性和难治性慢性疾病的典型症状。在细胞水平上,皮肤损伤的特征是大量嗜酸性粒细胞浸润,这是过敏反应的基础。
为了靶向这些细胞并治疗疾病,我们开发了一种针对马白细胞介素 5(eIL-5)的治疗性疫苗,eIL-5 是嗜酸性粒细胞的主要调节因子。
该疫苗由与黄瓜花叶病毒衍生的类病毒颗粒共价连接的 eIL-5 组成,该颗粒含有破伤风类毒素通用 T 细胞表位 tt830-843(CMV)。34 匹冰岛马被招募并接受 400μg 的 PBS 中无佐剂的 eIL-5-CMV(19 匹马)或 PBS 单独免疫(15 匹马)。
该疫苗耐受性良好,没有任何安全问题,但能够在 19 匹马中的 17 匹马中诱导抗 eIL-5 自身抗体滴度。与前一个季节的水平以及安慰剂治疗的马相比,这导致临床病变评分显著降低。保护需要抗 eIL-5 抗体的最小阈值。通过疾病评分的临床改善表明,47%和 21%的接种马分别达到 50%和 75%的改善。在安慰剂组中,没有马达到 75%的改善,只有 13%的马达到 50%的改善。
我们的治疗性疫苗诱导针对自身 IL-5 的自身抗体为马带来了生物制剂,是针对马慢性疾病的首次成功免疫治疗方法,并且可能促进针对人类 IL-5 的类似疫苗的开发。