RESUMO
Finlay Vaccine Institute is developing a new heptavalent conjugate vaccine against Streptococcus pneumoniae. As infants are the target population, PCV7-TT will be necessarily co-administered with other vaccines, and then, the interactions represent a concern. The aim of this work is to evaluate the possible immunological interferences in rabbits as animal experimental model. Rabbits were immunized with Heberpenta®-L, VA-MENGOC-BC®, and PCV7-TT. Blood samples were taken fourteen days after final immunization for obtaining sera. Antibody responses to all antigens were evaluated by indirect ELISA. Functional responses against diphtheria and tetanus toxoid were done by in vivo seroneutralization assay. No interference was observed by PCV7-TT over the humoral response against diphtheria toxoid and meningococcal antigens (p > 0.05). A nonstatistically significant reduction (p > 0.05) was observed in the case of the humoral response against Haemophilus influenzae type b oligosaccharide. Concomitant administration of Heberpenta®-L and PCV7-TT increased twice the antibody titers as well as the protective activity against tetanus toxoid, but no statistical differences were found. The co-administration did not induce a reduction in the percent of responders against pneumococcal polysaccharides contained in PCV7-TT vaccine. Concomitant administration of PCV7-TT did not induce interferences over the evaluated antigens of Heberpenta®-L and VA-MENGOC-BC®. Also, no interference was observed on the immune response elicited by PCV7-TT. These preclinical results suggest that PCV7-TT will not result in a serious problem over the immune response elicited by the licensed vaccines Heberpenta®-L and VA-MENGOC-BC®. However, the clinical interference could be strictly studied during clinical trials in infants.
Assuntos
Anticorpos Antibacterianos/sangue , Vacina Pneumocócica Conjugada Heptavalente/imunologia , Imunidade Heteróloga , Infecções Pneumocócicas/imunologia , Streptococcus pneumoniae/imunologia , Animais , Antígenos de Bactérias/imunologia , Toxoide Diftérico/imunologia , Feminino , Vacinas Anti-Haemophilus/imunologia , Humanos , Lactente , Vacinas Meningocócicas/imunologia , Polissacarídeos Bacterianos/imunologia , Coelhos , Vacinação , Vacinas Virais/imunologiaRESUMO
INTRODUCTION Pneumococcal infections are a major cause of morbidity and mortality and are associated with considerable economic burden on health systems. To prevent pneumococcal infections, 7-valent conjugate vaccines have been available for over a decade; more recently, 10- and 13-valent conjugate vaccines have been formulated, which are more immunogenic than vaccines with capsular polysaccharides only. In Cuba, a new vaccine candidate has been developed, PCV7-TT, a conjugate of tetanus toxoid with antigens of seven of the serotypes of Streptococcus pneumoniae with highest circulation in Cuba and in the world: 1, 5, 6B, 14, 18C, 19F and 23F. OBJECTIVE Assess the safety of the vaccine candidate PCV7-TT in healthy adults and conduct a preliminary assessment of its immunogenicity. METHODS A phase I, double-blind clinical trial was performed at the National Toxicology Center in Havana, Cuba. Healthy male volunteers aged 18-35 years were randomly assigned to two groups: 20 received the vaccine candidate PCV7-TT and 20 the polyvalent antipneumococcal vaccine PNEUMO-23 used as control, each in a single intramuscular dose. To assess safety, the occurrence of adverse events was monitored for 30 days following inoculation. To explore immunogenicity, concentrations of serotype-specific antibodies was quantified before and 30 days after inoculation, as well titers of opsonophagocytic antibodies. (National Clinical Trial Registry RPCEC00000133) RESULTS Local adverse events were pain, redness, induration, increased sensitivity to touch, and warmth in the injection area. Pain was registered in 70% of individuals who received PCV7-TT and in 75% of those vaccinated with PNEUMO-23. Reported systemic adverse events were general malaise, headache and drowsiness. All adverse events appeared in the first 72 hours post inoculation and lasted no longer than 3 days. One event was reported that was classified as severe in intensity and serious in consequences, but it was unrelated to vaccination appendicitis in one individual inoculated with the control vaccine. Before vaccination, all participants but one had antibody concentrations =0.20 µg/ml against the vaccine strains; after vaccination 100% of individuals were positive and the concentrations of antibodies increased in previously positive volunteers. Some individuals had opsonophagocytic antibodies against serotypes 1, 14, 19F and 23F before vaccination, with highest concentrations against serotypes 14 and 19F. After vaccination, the percent of individuals with opsonophagocytic titers >1:8 for all serotypes in the vaccine was >50% in both groups. CONCLUSIONS A single dose of candidate vaccine PCV7-TT was safe when used in healthy adults. Preliminary results showed that it was able to activate an immune response against the serotypes of Streptococcus pneumoniae used. KEYWORDS Invasive pneumococcal diseases, pneumococcal vaccines, conjugate vaccines, immunization, randomized clinical trial, safety, Cuba.
Assuntos
Vacina Pneumocócica Conjugada Heptavalente/imunologia , Infecções Pneumocócicas/prevenção & controle , Toxoide Tetânico/imunologia , Adolescente , Adulto , Cuba/epidemiologia , Método Duplo-Cego , Humanos , Masculino , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/imunologiaRESUMO
A new heptavalent conjugate vaccine (PCV7-TT) is under development in Cuba. PCV7-TT contains 2 µg of serotypes 1, 5, 14, 18C, 19F, 23F and 4 µg of 6B, each one conjugated to tetanus toxoid (TT). This vaccine was designed with the serotypes that cause most invasive pneumococcal diseases (IPD) worldwide. In the present study, we investigated the safety and explored the immunogenicity of PCV7-TT during a controlled, randomized and double blind clinical trial phase I in 4-5-year-old children. PCV7-TT was well tolerated and as safe as Synflorix used as control vaccine. Following a single-dose vaccination, all individual serotypes included in PCV7-TT induced statistically significant increase of IgG GMC and OPA GMT. These are the first clinical results of PCV7-TT in children and they pave the way toward next clinical trials in children and infants. This clinical trial was published in the Cuban Public Register of Clinical Trials with code RPCEC00000173.
Assuntos
Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/uso terapêutico , Anticorpos Antibacterianos/sangue , Formação de Anticorpos , Pré-Escolar , Cuba , Método Duplo-Cego , Vacina Pneumocócica Conjugada Heptavalente , Humanos , Imunoglobulina G/sangue , Vacinas Pneumocócicas/efeitos adversosRESUMO
Capsular polysaccharides are important virulence factors of Streptococcus pneumoniae. The polysaccharide has been used as a component of vaccines against pneumococcal diseases either as plain polysaccharide or better conjugated to a protein. The last one is the vaccine of choice to target child protection. The immune responses depend on several polysaccharide physicochemical properties that can be affected during either purification or modification in the case of conjugate vaccines. In serotype 18C, the repeating unit has a complex structure having a branched pentasaccharide with two apparently labile subtituents: glycerol-phosphate and O-acetyl group. The loss of these groups may potentially reduce the ability of the 18C polysaccharide to induce the desired immune response. Therefore, the relationship of both groups with the antigenicity and immunogenicity of 18C capsular polysaccharide is explored. It is shown that glycerol-phosphate must be preserved for conserving adequate antigenicity of the 18C capsular polysaccharide. At the same time, it was proved that O-acetyl groups do not play any role for the antigenicity and immunogenicity.
Assuntos
Antígenos de Bactérias/química , Antígenos de Bactérias/imunologia , Polissacarídeos Bacterianos/química , Polissacarídeos Bacterianos/imunologia , Streptococcus pneumoniae/química , Streptococcus pneumoniae/imunologia , Animais , Humanos , Éteres Fosfolipídicos/química , Éteres Fosfolipídicos/imunologia , CoelhosRESUMO
Neisseria meningitidis constitutes the main cause of meningococcal disease in infants. Serogroups A, B, C, W135, Y, and X have the higher incidence in young children and teenagers. The use of polyvalent conjugate carbohydrate-based vaccines has decreased the meningococcal infection around the world. Recently, the serogroup X has been found to be responsible of different outbreaks of meningococcal diseases, mainly in "Meningitis Belt" of Africa and the structure of the repetitive unit of the capsular polysaccharide has been confirmed through a monodimensional (13)C NMR study. No further characterization studies have been carried out, especially with the use of other nuclei. In this paper a novel method for quantification of the N. meningitidis serogroup X by proton qNMR is reported. Deep characterization of the serogroup X polysaccharide was also carried out by combination of correlation experiments involving (13)C, (1)H, and (31)P nuclei.
Assuntos
Cápsulas Bacterianas/química , Neisseria meningitidis/química , Ressonância Magnética Nuclear Biomolecular/métodos , Polissacarídeos Bacterianos/química , Cápsulas Bacterianas/imunologia , Configuração de Carboidratos , Isótopos de Carbono , Modelos Lineares , Estrutura Molecular , Neisseria meningitidis/imunologia , Isótopos de Fósforo , Polissacarídeos Bacterianos/imunologia , Prótons , Reprodutibilidade dos TestesRESUMO
A methods using high-performance reverse phase (RP) chromatography with fluorescence detection, has been developed to determine the composition and identity of Streptococcus pneumoniae capsular polysaccharide used in formulating conjugate vaccine for prevention of pneumococcal infection. For the monosaccharide composition, the polysaccharides were subjected to hydrofluoric acid (HF) hydrolysis followed by trifluoroacetic acid (TFA). After acid hydrolysis, the released monosaccharides were re-N-acetylated and labeled with 2-aminobenzamide (2AB) by reductive amination reaction. High-performance RP chromatography was performed on C18 TSKODS 120T column. Nuclear magnetic resonance was used to confirm chemical structure and purity of pneumococcal capsular polysaccharides.