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基于 Advax-CpG55.2 佐剂的重组 SARS-CoV-2 刺突蛋白胞外域疫苗保护效力的潜在相关性的事后分析。

Post-Hoc Analysis of Potential Correlates of Protection of a Recombinant SARS-CoV-2 Spike Protein Extracellular Domain Vaccine Formulated with Advax-CpG55.2-Adjuvant.

机构信息

Vaxine Pty Ltd., Warradale, Adelaide 5046, Australia.

Australian Respiratory and Sleep Medicine Institute, Adelaide 5042, Australia.

出版信息

Int J Mol Sci. 2024 Aug 30;25(17):9459. doi: 10.3390/ijms25179459.

Abstract

SpikoGen vaccine is a subunit COVID-19 vaccine composed of an insect cell expressed recombinant spike protein extracellular domain formulated with Advax-CpG55.2™ adjuvant. A randomized double-blind, placebo-controlled Phase II clinical trial was conducted in 400 adult subjects who were randomized 3:1 to receive two intramuscular doses three weeks apart of either SpikoGen vaccine 25 μg or saline placebo, as previously reported. This study reports a post hoc analysis of the trial data to explore potential immune correlates of SpikoGen vaccine protection. A range of humoral markers collected pre- and post-vaccination, including spike- and RBD-binding IgG and IgA, surrogate (sVNT), and conventional (cVNT) virus neutralization tests were compared between participants who remained infection-free or got infected over three months of follow-up. From 2 weeks after the second vaccine dose, 21 participants were diagnosed with SARS-CoV-2 infection, 13 (4.2%) in the SpikoGen group and 8 (9%) in the placebo group. Those in the vaccinated group who experienced breakthrough infections had significantly lower sVNT titers (GMT 5.75 μg/mL, 95% CI; 3.72-8.91) two weeks after the second dose (day 35) than those who did not get infected (GMT 21.06 μg/mL, 95% CI; 16.57-26.76). Conversely, those who did not develop SARS-CoV-2 infection during follow-up had significantly higher baseline sVNT, cVNT, spike-binding IgG and IgA, and RBD-binding IgG, consistent with a past SARS-CoV-2 infection. SpikoGen further reduced the risk of re-infection (OR 0.29) in baseline seropositive (previously infected) as well as baseline seronegative participants. This indicates that while SpikoGen vaccine is protective in seronegative individuals, those with hybrid immunity have the most robust protection.

摘要

斯皮科根疫苗是一种基于昆虫细胞表达的重组刺突蛋白胞外域的亚单位 COVID-19 疫苗,与 Advax-CpG55.2™佐剂联合使用。一项随机、双盲、安慰剂对照的 II 期临床试验在 400 名成年受试者中进行,这些受试者按照 3:1 的比例随机接受两次肌肉内注射,间隔 3 周,分别接受斯皮科根疫苗 25μg 或生理盐水安慰剂,如前所述。本研究报告了该试验数据的事后分析,以探索斯皮科根疫苗保护的潜在免疫相关性。在接种前后收集了一系列体液标志物,包括刺突蛋白和 RBD 结合 IgG 和 IgA、替代(sVNT)和常规(cVNT)病毒中和试验,比较了在三个月随访期间保持无感染或感染的参与者之间的差异。在第二次疫苗接种后 2 周,21 名参与者被诊断出感染了 SARS-CoV-2,斯皮科根组 13 名(4.2%),安慰剂组 8 名(9%)。在接种组中,发生突破性感染的参与者在第二次剂量后两周(第 35 天)的 sVNT 滴度明显较低(GMT 5.75μg/mL,95%CI;3.72-8.91),而未感染的参与者的 sVNT 滴度较高(GMT 21.06μg/mL,95%CI;16.57-26.76)。相反,在随访期间未发生 SARS-CoV-2 感染的参与者的基线 sVNT、cVNT、刺突蛋白结合 IgG 和 IgA 以及 RBD 结合 IgG 明显较高,这与过去感染过 SARS-CoV-2 相符。斯皮科根疫苗进一步降低了基线血清阳性(既往感染)和基线血清阴性参与者再次感染的风险(OR 0.29)。这表明,尽管斯皮科根疫苗对血清阴性个体具有保护作用,但具有混合免疫的个体具有最强大的保护作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a9f/11395249/482c8c77c2f2/ijms-25-09459-g001.jpg

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