Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
Biostatistics Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
Sci Transl Med. 2023 Apr 19;15(692):eade4790. doi: 10.1126/scitranslmed.ade4790.
Influenza vaccines could be improved by platforms inducing cross-reactive immunity. Immunodominance of the influenza hemagglutinin (HA) head in currently licensed vaccines impedes induction of cross-reactive neutralizing stem-directed antibodies. A vaccine without the variable HA head domain has the potential to focus the immune response on the conserved HA stem. This first-in-human dose-escalation open-label phase 1 clinical trial (NCT03814720) tested an HA stabilized stem ferritin nanoparticle vaccine (H1ssF) based on the H1 HA stem of A/New Caledonia/20/1999. Fifty-two healthy adults aged 18 to 70 years old enrolled to receive either 20 μg of H1ssF once ( = 5) or 60 μg of H1ssF twice ( = 47) with a prime-boost interval of 16 weeks. Thirty-five (74%) 60-μg dose participants received the boost, whereas 11 (23%) boost vaccinations were missed because of public health restrictions in the early stages of the COVID-19 pandemic. The primary objective of this trial was to evaluate the safety and tolerability of H1ssF, and the secondary objective was to evaluate antibody responses after vaccination. H1ssF was safe and well tolerated, with mild solicited local and systemic reactogenicity. The most common symptoms included pain or tenderness at the injection site ( = 10, 19%), headache ( = 10, 19%), and malaise ( = 6, 12%). We found that H1ssF elicited cross-reactive neutralizing antibodies against the conserved HA stem of group 1 influenza viruses, despite previous H1 subtype head-specific immunity. These responses were durable, with neutralizing antibodies observed more than 1 year after vaccination. Our results support this platform as a step forward in the development of a universal influenza vaccine.
流感疫苗可以通过诱导交叉反应性免疫的平台得到改善。目前许可疫苗中流感血凝素(HA)头部的免疫优势阻碍了交叉反应性中和茎定向抗体的诱导。不含可变 HA 头部结构域的疫苗有可能使免疫反应集中在保守的 HA 茎上。这是一项首次在人体中进行的递增剂量、开放性标签的 1 期临床试验(NCT03814720),测试了一种基于 A/New Caledonia/20/1999 株的 HA 稳定茎铁蛋白纳米颗粒疫苗(H1ssF)。52 名年龄在 18 至 70 岁的健康成年人入组,接受单次 20 μg H1ssF(n = 5)或 60 μg H1ssF 两次(n = 47),间隔 16 周进行初免-加强免疫。35 名(74%)接受 60 μg 剂量的参与者接受了加强免疫,而 11 名(23%)因 COVID-19 大流行早期的公共卫生限制而错过了加强免疫。该试验的主要目的是评估 H1ssF 的安全性和耐受性,次要目的是评估接种后的抗体反应。H1ssF 安全且耐受性良好,轻度局部和全身反应。最常见的症状包括注射部位疼痛或压痛(n = 10,19%)、头痛(n = 10,19%)和不适(n = 6,12%)。我们发现,尽管先前存在 H1 亚型头特异性免疫,H1ssF 仍能诱导针对组 1 流感病毒保守 HA 茎的交叉反应性中和抗体。这些反应具有持久性,接种后 1 年以上仍可观察到中和抗体。我们的结果支持该平台在开发通用流感疫苗方面向前迈进了一步。