Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Moderna, Cambridge, MA, USA.
Nat Med. 2021 Jan;27(1):106-114. doi: 10.1038/s41591-020-1118-7. Epub 2020 Dec 7.
Seasonal influenza viruses constantly change through antigenic drift and the emergence of pandemic influenza viruses through antigenic shift is unpredictable. Conventional influenza virus vaccines induce strain-specific neutralizing antibodies against the variable immunodominant globular head domain of the viral hemagglutinin protein. This necessitates frequent re-formulation of vaccines and handicaps pandemic preparedness. In this completed, observer-blind, randomized, placebo-controlled phase I trial (NCT03300050), safety and immunogenicity of chimeric hemagglutinin-based vaccines were tested in healthy, 18-39-year-old US adults. The study aimed to test the safety and ability of the vaccines to elicit broadly cross-reactive antibodies against the hemagglutinin stalk domain. Participants were enrolled into five groups to receive vaccinations with live-attenuated followed by AS03-adjuvanted inactivated vaccine (n = 20), live-attenuated followed by inactivated vaccine (n = 15), twice AS03-adjuvanted inactivated vaccine (n = 16) or placebo (n = 5, intranasal followed by intramuscular; n = 10, twice intramuscular) 3 months apart. Vaccination was found to be safe and induced a broad, strong, durable and functional immune response targeting the conserved, immunosubdominant stalk of the hemagglutinin. The results suggest that chimeric hemagglutinins have the potential to be developed as universal vaccines that protect broadly against influenza viruses.
季节性流感病毒通过抗原漂移不断变化,而通过抗原转变出现大流行性流感病毒是不可预测的。传统的流感病毒疫苗诱导针对病毒血凝素蛋白可变免疫显性球状头部域的株特异性中和抗体。这需要频繁地重新制定疫苗配方,从而阻碍了大流行的准备工作。在这项已完成的、观察者盲法、随机、安慰剂对照的 I 期临床试验(NCT03300050)中,在健康的 18-39 岁美国成年人中测试了嵌合血凝素基疫苗的安全性和免疫原性。该研究旨在测试疫苗的安全性和能力,以诱导针对血凝素茎域的广泛交叉反应性抗体。参与者被招募到五组中,接受活减毒疫苗接种,随后接种含 AS03 佐剂的灭活疫苗(n=20)、活减毒疫苗接种,随后接种灭活疫苗(n=15)、两次接种含 AS03 佐剂的灭活疫苗(n=16)或安慰剂(n=5,鼻内接种后肌内接种;n=10,两次肌内接种),间隔 3 个月。接种疫苗被发现是安全的,并诱导了广泛、强烈、持久和功能性的免疫反应,针对血凝素的保守、免疫亚结构域。结果表明,嵌合血凝素有可能被开发为通用疫苗,广泛保护免受流感病毒的侵害。
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