EP0835318A2 - Vaccines against hepatitis c - Google Patents

Vaccines against hepatitis c

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Publication number
EP0835318A2
EP0835318A2 EP96922029A EP96922029A EP0835318A2 EP 0835318 A2 EP0835318 A2 EP 0835318A2 EP 96922029 A EP96922029 A EP 96922029A EP 96922029 A EP96922029 A EP 96922029A EP 0835318 A2 EP0835318 A2 EP 0835318A2
Authority
EP
European Patent Office
Prior art keywords
protein
immunogenic derivative
composition according
oil
dna
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP96922029A
Other languages
German (de)
English (en)
French (fr)
Inventor
Teresa SmithKline Beecham CABEZON SILVA
Patricia Marie SmithKline Beecham MOMIN
Nathalie Marie-Josephe Claude SmithKline GARçON
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
GlaxoSmithKline Biologicals SA
Original Assignee
SmithKline Beecham Biologicals SA
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by SmithKline Beecham Biologicals SA filed Critical SmithKline Beecham Biologicals SA
Publication of EP0835318A2 publication Critical patent/EP0835318A2/en
Withdrawn legal-status Critical Current

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Classifications

    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K14/00—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • C07K14/005—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from viruses
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N15/00—Mutation or genetic engineering; DNA or RNA concerning genetic engineering, vectors, e.g. plasmids, or their isolation, preparation or purification; Use of hosts therefor
    • C12N15/09—Recombinant DNA-technology
    • C12N15/11—DNA or RNA fragments; Modified forms thereof; Non-coding nucleic acids having a biological activity
    • C12N15/62—DNA sequences coding for fusion proteins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K39/12—Viral antigens
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K39/12—Viral antigens
    • A61K39/29—Hepatitis virus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/16—Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/12—Antivirals
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07K—PEPTIDES
    • C07K14/00—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • C07K14/005—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from viruses
    • C07K14/08—RNA viruses
    • C07K14/18—Togaviridae; Flaviviridae
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K2039/555—Medicinal preparations containing antigens or antibodies characterised by a specific combination antigen/adjuvant
    • A61K2039/55511—Organic adjuvants
    • A61K2039/55566—Emulsions, e.g. Freund's adjuvant, MF59
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K2039/555—Medicinal preparations containing antigens or antibodies characterised by a specific combination antigen/adjuvant
    • A61K2039/55511—Organic adjuvants
    • A61K2039/55572—Lipopolysaccharides; Lipid A; Monophosphoryl lipid A
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K2039/555—Medicinal preparations containing antigens or antibodies characterised by a specific combination antigen/adjuvant
    • A61K2039/55511—Organic adjuvants
    • A61K2039/55577—Saponins; Quil A; QS21; ISCOMS
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K2039/60—Medicinal preparations containing antigens or antibodies characteristics by the carrier linked to the antigen
    • A61K2039/6031—Proteins
    • A61K2039/6075—Viral proteins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N2770/00—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA ssRNA viruses positive-sense
    • C12N2770/00011—Details
    • C12N2770/24011—Flaviviridae
    • C12N2770/24211—Hepacivirus, e.g. hepatitis C virus, hepatitis G virus
    • C12N2770/24222—New viral proteins or individual genes, new structural or functional aspects of known viral proteins or genes

Definitions

  • the present invention relates to novel vaccine formulations, to methods of their production and to their use in medicine.
  • 3 De-O-acylated monophosphoryl lipid A is known from GB2220 211 (Ribi).
  • Hepatitis C virus is described in EP-A-0 318 216.
  • a particular antigenic protein of hepatitis C virus has been designated the core protein and is described by, for example, Delisse et al., J. Hepatology, 1991;13 (Suppl. 4): S20-S23 (for genotype lb).
  • Particular envelope proteins of hepatitis C virus have been designated El and E2 and are described by, for example, Grakoui et al., 1993, J.
  • the present invention provides a vaccine composition
  • a vaccine composition comprising QS21, 3 De-O-acylated monophosphoryl lipid A (3D-MPL), an oil in water emulsion, wherein the oil in water emulsion has the following composition: a metabolisible oil, such as squalene, alpha tocopherol and tween 80, and at least one immunogen selected from the group consisting of (a) a hepatitis C virus core protein or an immunogenic derivative thereof, and (b) a hepatitis C virus envelope protein or an immunogenic derivative thereof.
  • a metabolisible oil such as squalene, alpha tocopherol and tween 80
  • an immunogen selected from the group consisting of (a) a hepatitis C virus core protein or an immunogenic derivative thereof, and (b) a hepatitis C virus envelope protein or an immunogenic derivative thereof.
  • immunogenic derivative encompasses any molecule such as a truncated or other derivative of the protein which retains the ability to induce an immune response to the protein following internal administration to a human.
  • Such other derivatives can be prepared by the addition, deletion, substitution, or rearrangement of amino acids or by chemical modifications thereof.
  • Immunogenic fragments of the protein which may be useful in the preparation of subunit vaccines, may be prepared by expression of the appropriate gene fragments or by peptide synthesis, for example using the Merrifield synthesis (The Peptides, Vol 2., Academic Press, NY, page 3).
  • the immunogenic derivative of the invention can be a hybrid, that is, a fusion polypeptide containing additional sequences which can carry one or more epitopes for other immunogens.
  • the immunogenic derivative of the invention can be fused to a carrier polypeptide or to another carrier which has immunostimulating properties, as in the case of an adjuvant, or which otherwise enhances the immune response to the protein or derivative thereof, or which is useful in expressing, purifying or formulating the protein or derivative thereof.
  • the invention also extends to the HCV protein or immunogenic derivative thereof when chemically conjugated to a macromolecule using a conventional linking agent such as glutaraldehyde (Geerlings et al, (1988) J, Immunol. Methods, ___, 239-244).
  • a conventional linking agent such as glutaraldehyde (Geerlings et al, (1988) J, Immunol. Methods, ___, 239-244).
  • Proteins and their immunogenic derivatives suitable for use in the present invention can be prepared by expressing DNA encoding said protein or derivative thereof in a recombinant host cell and recovering the product, and thereafter, optionally, preparing a derivative thereof.
  • a DNA molecule comprising such coding sequence can be synthesized by standard DNA synthesis techniques, such as by enzymatic ligation as described by D.M. Roberts _i _l in Biochemistry 1985, 24, 5090-5098, by chemical synthesis, by in vitro enzymatic polymerization, or by a combination of these techniques.
  • Enzymatic polymerisation of DNA may be carried out in vitro using a DNA polymerase such as DNA polymerase I (Klenow fragment) in an appropriate buffer containing the nucleoside triphosphates dATP, dCTP, dGTP and dTTP as required at a temperature of 10°-37°C, generally in a volume of 50ml or less.
  • Enzymatic ligation of DNA fragments may be carried out using a DNA ligase such as T4 DNA ligase in an appropriate buffer, such as 0.05M Tris (pH 7.4), 0.01M MgCl2, 0.01M dithiothreitol, lmM spermidine, lmM ATP and 0.
  • lmg ml bovine serum albumin at a temperature of 4°C to ambient, generally in a volume of 50ml or less.
  • the chemical synthesis of the DNA polymer or fragments may be carried out by conventional phosphotriester, phosphite or phosphoramidite chemistry, using solid phase techniques such as those described in 'Chemical and Enzymatic Synthesis of Gene Fragments - A Laboratory Manual' (ed. H.G. Gassen and A. Lang), Verlag Chemie, Weinheim (1982),or in other scientific publications, for example M.J. Gait, H.W.D. Matthes, M. Singh, B.S. Sproat, and R.C.
  • DNA polymers which encode mutants may be prepared by site-directed mutagenesis by conventional methods such as those described by G. Winter £ al in Nature 1982, 2__, 756-758 or by Zoller and Smith 1982; Nucl. Acids Res., __, 6487-6500, or deletion mutagenesis such as described by Chan and Smith in Nucl. Acids Res., 1984, 12, 2407-2419 or by G. Winter ei ai in Biochem. Soc. Trans., 1984, 2, 224-225.
  • a protein or immunogenic derivative for use in the present invention can be prepared using the following steps: i) preparing a replicable or integrating expression vector capable, in a host cell, of expressing a DNA polymer comprising a nucleotide sequence that encodes said protein or an immunogenic derivative thereof;
  • transformation is used herein to mean the introduction of foreign DNA into a host cell by transformation, transfection or infection with an appropriate plasmid or viral vector using e.g. conventional techniques as described in Genetic Engineering; Eds. S.M. Kingsman and AJ. Kingsman; Blackwell Scientific Publications; Oxford, England, 1988.
  • conventional techniques as described in Genetic Engineering; Eds. S.M. Kingsman and AJ. Kingsman; Blackwell Scientific Publications; Oxford, England, 1988.
  • the replicable expression vector may be prepared by cleaving a vector compatible with the host cell to provide a linear DNA segment having an intact replicon, and combining said linear segment with one or more DNA molecules which, together with said linear segment encode the desired product, under ligating conditions.
  • the DNA polymer may be preformed or formed during the construction of the vector, as desired.
  • the preparation of the replicable expression vector may be carried out conventionally with appropriate enzymes for restriction, polymerisation and ligation of the DNA, by procedures described in, for example, Maniatis ei al cited above.
  • the recombinant host cell is prepared by transforming a host cell with a replicable expression vector under transforming conditions. Suitable transforming conditions are conventional and are described in, for example,
  • the choice of transforming conditions is determined by the host cell.
  • a bacterial host such as E. ___ may be treated with a solution of CaCl2 (Cohen ei aL Proc. Nat. Acad. Sci., 1973, _9, 2110) or with a solution comprising a mixture of RbCl, MnC-2, potassium acetate and glycerol, and then with 3- [N-morpholino] -propane-sulphonic acid, RbCl and glycerol.
  • Mammalian cells in culture may be transformed by calcium co-precipitation of the vector DNA onto the cells. Culturing the transformed host cell under conditions permitting expression of the DNA polymer is carried out conventionally, as described in, for example, Maniatis ei al and "DNA Cloning" cited above. Thus, preferably the cell is supplied with nutrient and cultured at a temperature below 45°C. The product is recovered by conventional methods according to the host cell. Thus, where the host cell is bacterial, such as E. _ ⁇ _i it may be lysed physically, chemically or enzymatically and the protein product isolated from the resulting lysate. Where the host cell is mammalian, the product may generally be isolated from the nutrient medium or from cell free extracts. Conventional protein isolation techniques include selective precipitation, absorption chromatography, and affinity chromatography including a monoclonal antibody affinity column.
  • the host cell is E. coli.
  • a particular aspect of the present invention provides a novel compound which comprises an HCV core protein, or an immunogenic derivative thereof, fused to a polypeptide containing foreign epitopes.
  • the polypeptide is preferably an influenza protein, such as the NS1 protein, or an immunogenic derivative thereof.
  • the vaccines of the present invention are preferential stimulators of IgG2a production and THl cell response. This is advantageous, because of the known implication of THj response in cell mediated response. Indeed in mice induction of IgG2a is correlated with such an immune response.
  • the vaccines of the invention enhance induction of cytolytic T lymphocyte responses. Induction of CTL is easily seen when the target antigen is synthesised intracellularly, ie during infection by the virus, because peptides generated by proteolytic breakdown of the antigen can enter the appropriate processing pathway, leading to presentation in association with class I molecules on the cell membrane. However, in general, pre-formed soluble antigen does not reach this processing and presentation pathway, and does not elicit class I restricted CTL.
  • the combination of 3D-MPL and QS21 together with an oil in water emulsion have been able to synergistically enhance interferon ⁇ production.
  • the oil in water emulsion may contain span 85 and/or lecithin.
  • a preferred form of 3 De-O-acylated monophosphoryl lipid A is disclosed in
  • a vaccine as herein described for use in medicine.
  • the ratio of QS21 : 3D-MPL will typically be in the order of 1 : 10 to 10 : 1; preferably 1 : 5 to 5 : 1 and often substantially 1 : 1.
  • the preferred range for optimal synergy is 2.5:1 to 1:1 3D MPL: QS21.
  • QS21 and 3D MPL will be present in a vaccine in the range 1 ⁇ g - 100 ⁇ g, preferably 10 ⁇ g - 50 ⁇ g per dose.
  • the oil in water will comprise from 2 to 10% squalene, from 2 to 10% alpha tocopherol and from 0.3 to 3% tween 80.
  • the ratio of squalene: alpha tocopherol is equal or less than 1 as this provides a more stable emulsion.
  • Span 85 may also be present at a level of 1%.
  • the vaccines of the present invention will further contain a stabiliser.
  • Vaccine preparation is generally described in New Trends and Developments in Vaccines, edited by Voller et al., University Park Press, Baltimore, Maryland,
  • each vaccine dose is selected as an amount which induces an immunoprotective response without significant, adverse side effects in typical vaccinees. Generally, it is expected that each dose will comprise 1-1000 ⁇ g of protein, preferably 2-100 ⁇ g. An optimal amount for a particular vaccine can be ascertained by standard studies involving observation of appropriate immune responses in subjects. Following an initial vaccination, subjects may receive one or several booster immunisation adequately spaced.
  • formulations of the present invention may be used for both prophylatic and therapeutic purposes.
  • the invention provides a method of treatment comprising administering an effective amount of a vaccine of the present invention to a patient.
  • Plasmid pMG81 a derivative of pMG27 (Gross et al 1985, Mol.Cell. Biol. 5: 1015) in which: (i) the 81 first codons of the NS1 coding region from influenza strain A/PR/8/34 cleaved from plasmid pASlEH/801 (Young et al. 1983, Proc. Natl. Acad. Sci. 80: 6105) have been inserted downstream of the pL promoter and ii) the ampicillin resistance gene has been replaced by the kanamycin resistance gene from transposon Tn902, was used to express the fusion protein NSl-Core.
  • HCV genomic sequences of hepatitis C virus genotype lb (Delisse et al, 1991 J. Hepathology 13, suppl. 4:S20-23) were PCR amplified and cloned into pUC12 plasmid to give plasmid TCM 128-2.
  • nucleotides sequences corresponding to amino acids 2-166 of the core protein were amplified from TCM 128-2.
  • Ncol and Xbal restriction sites have been generated at the 5' and 3' ends of the core sequences allowing insertion into the same sites of plasmid pMG81 to give pRTT 14129.
  • pRJT 14129 contains the coding sequence for the fusion protein NS1 (flu)-core(HCV) and expresses the polypeptide described in SEQ ID NO. 1.
  • the coding sequence for the fusion protein NS1 (flu)-core(HCV) is contained in SEQ ID NO 2.
  • SEQ ID NO 3 shows the amino acid sequence 1-1006 of HCV genome type la (H).
  • Plasmid pRIT14129 was introduced into E. coli AR 58 (Mott et al, 1985, Proc, Natl. Acad. Sci., 82:88) containing the thermosensitive repressor of the ⁇ pL promoter.
  • the recombinant bacteria were grown in a 20 Litters fermentor under fed-batch conditions at 30°.
  • the expression of the NSl-Core protein was induced by raising the temperature to 38-42°C.
  • the cells were then harvested and mechanically disrupted.
  • Step 1 Bacterial cells were broken (Rannie-2 x 14,500 pi) in a 20 mM phosphate buffer pH7 containing protease inhibitors (lmM pefabloc, 0.5mg leupeptin, 0.1% aprotinin).
  • Step 2 Lysate was centrifuged for 25 minutes, at 17,000g. At this stage the recombinant protein was insoluble and was recovered in the pellet The pellet was washed two times with lOmM phosphate pH6.8, 2M NaCl, 4M urea; three times with lOmM phosphate pH 6.8, 0.15M NaCl, and centrifuged at 17,000g for 25 minutes after each wash step. These steps were introduced in order to lower the endotoxin content of the purified product.
  • Step 3 The washed pellets re suspended in SDS-PAGE reducing sample buffer, boiled for 5 minutes, centrifuged again at 27,000g for 25 minutes and then applied on a 12% polyacrylamide gel for separation of the remaining proteins (Prep Cell equipment Biorad).
  • Step 4 The protein was electroluted from the gels in 25mM Tris pH8, 200mM glycine, 0.1% SDS; precipitated by 10% TCA at 0° and finally resuspended in lOmM phosphate pH 6.8, 150mM NaCl, 50mM sarcosyl.
  • the purified antigen appears as a doublet, in the 27-30 kD range, both bands are recognised by an anti-NSl monoclonal antibody as well as by anti-core specific human monoclonal and rabbit polyclonal antibodies.
  • the two adjuvant formulations were made each comprising the following oil in water emulsion component
  • SB26 5% squalene 5% tocopherol 0.4% tween 80; the particle size was 500 nm size SB62: 5% Squalene 5% tocopherol 2.0% tween 80; the particle size was 180 nm
  • Tween 80 is dissolved in phosphate buffered saline (PBS) to give a 2% solution in the PBS.
  • PBS phosphate buffered saline
  • 5g of DL alpha tocopherol and 5ml of squalene are vortexed to mix thoroughly.
  • 90ml of PBS Tween solution is added and mixed thoroughly.
  • the resulting emulsion is then passed through a syringe and finally microfluidised by using an Ml 10S microfluidics machine.
  • the resulting oil droplets have a size of approximately 180 nm.
  • This emulsion was prepared in an analogous manner utilising 0.4% tween 80.
  • Oligomeric forms of E1-E2 HCV envelope proteins can be prepared form mammalian cells infected with recombinant vaccinia virus expressing HCV envelope sequences as a polyprotein.
  • the coding sequences for a polyprotein covering the amino acids 167- 1006 of HCV genome of type la (H) can be inserted in vaccinia virus vectors using procedures known in the art and the resulting plasmid used to prepared vaccinia recombinant virus that will lead to expression of the polyprotein in infected cells.
  • the expressed polyprotein is processed and retained intracellularly.
  • E1-E2 oligomeric form can be purified from cell extracts in which the E1/E2 protein complex has been solubilized using specific detergent (Ralston et al, 1993, J. Virology 67:6753) (Dubuisson et al 1994, J. Virology 68:6147).
  • Formulations of oligomeric E1E2 are prepared analagously to the formulations of Example 1.
  • Example 3 Formulations of oligomeric E1E2 are prepared analagously to the formulations of Example 1.
  • Formulations containing both the fusion protein of Example 1 and the E1E2 oligomer of Example 2 are prepared analagously to the formulations of Example 1, each formulation containing between 50 and lOO ⁇ g of each protein.
  • SEQ ID NO 2 1 GAATTCGTAC CTAGATCTCT CACCTACCAA ACAATGCCCC CCTGCAAAAA
  • ATCCGCCTCC ATCCAGTCTA TTAATTGTTG CCGGGAAGCT AGAGTAAGTA 4501 GTTCGCCAGT TAATAGTTTG CGCAACGTTG TTGCCATTGC TGCAGGTCGA

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EP96922029A 1995-06-29 1996-06-20 Vaccines against hepatitis c Withdrawn EP0835318A2 (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
GBGB9513261.9A GB9513261D0 (en) 1995-06-29 1995-06-29 Vaccines
GB9513261 1995-06-29
PCT/EP1996/002764 WO1997001640A2 (en) 1995-06-29 1996-06-20 Vaccines against hepatitis c

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EP0835318A2 true EP0835318A2 (en) 1998-04-15

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EP (1) EP0835318A2 (no)
JP (1) JPH11508769A (no)
KR (1) KR19990028505A (no)
AU (1) AU6304996A (no)
BR (1) BR9609258A (no)
CA (1) CA2222456A1 (no)
CZ (1) CZ422397A3 (no)
GB (1) GB9513261D0 (no)
HU (1) HUP9901901A3 (no)
IL (1) IL122589A0 (no)
NO (1) NO976060L (no)
PL (1) PL324906A1 (no)
TR (1) TR199701713T1 (no)
WO (1) WO1997001640A2 (no)
ZA (1) ZA965459B (no)

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EP2258389A1 (en) 2002-08-30 2010-12-08 Novartis Vaccines and Diagnostics S.r.l. Improved bacterial outer membrane vesicles
EP2263688A1 (en) 2001-06-20 2010-12-22 Novartis AG Neisseria meningitidis combination vaccines
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