Classifications

• • 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
  • A61K39/39—Medicinal preparations containing antigens or antibodies characterised by the immunostimulating additives, e.g. chemical adjuvants
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P37/00—Drugs for immunological or allergic disorders
  • A61P37/02—Immunomodulators
  • A61P37/04—Immunostimulants
• • 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

Definitions

• This invention relates to compositions comprising a vaccine and a vaccine adjuvant. In another aspect this invention relates to vaccine adjuvants.
• vaccines possessing antigenic epitopes that were previously impossible to produce.
• vaccine candidates include synthetic peptides mimicking streptococcal, gonococcal, and malarial antigens. These purified antigens are generally weak immunogens, however, that require adjuvants in order to evoke protective immunity.
• conventional vaccine adjuvants possess a number of drawbacks which limit their overall use and effectiveness.
• Staphylococcus enterotoxin B has not been found to be immunoenhancing for either cell- mediated (e.g., cytotoxic T-cell lymphocytes) or humoral immune responses (i.e., specific antibody production) even though the enterotoxin has been shown to increase the level of production of various cytokines such as IL-2, TNF, gamma-interferon, etc. (see, e.g., J. Immunol.. 1975, 115. 575 (Smith et al.) and Infection and Immunity.
• cell- mediated e.g., cytotoxic T-cell lymphocytes
• humoral immune responses i.e., specific antibody production
• This invention provides an immunogen/vaccine adjuvant composition
• an immunogen/vaccine adjuvant composition comprising an immunogen in an amount effective to stimulate an immune response and as a vaccine adjuvant a lH-imidazo[4,5-c]quinolin-4-amine in an amount effective to increase the immune response to the immunogen.
• This invention also provides a method of increasing the immune response to an immunogen, comprising the step of administering (i) the immunogen in an amount effective to stimulate an immune response, and (ii) as a vaccine adjuvant a lH-imidazo[4,5-c]quinolin-4-amine in an amount effective to increase the immune response.
• Certain lH-imidazo[4,5-c]quinolin-4-amines have been disclosed as antiviral agents (see, e.g., U.S. Pat. Nos. 4,689,338 (Gerster) and 4,929,624 (Gerster et al.), European Patent Application 90.301776.3 (Gerster) and commonly assigned copending U.S.
• immunogen/vaccine adjuvant composition refers to a combination of an immunogen and a lH-imidazo[4,5-c]quinolin-4-amine, whether that combination is in the form of an admixture of the two components in a pharmaceutically acceptable carrier or in the form of separate, individual components, for example in the form of a kit comprising an immunogen as one component and the lH-imidazo[4,5- c]quinolin-4-amine as another component.
• the vaccine adjuvant component of a composition of the invention is a lH-imidazo[4,5-c]quinolin-4-amine. It has been found that compounds of this class induce biosynthesis of a variety of cytokines in human and murine cells. While the particular profile of cytokine induction varies to some extent from compound to compound within this class, it is thought that the general profile of cytokine induction common to the compounds of the class is responsible for the vaccine adjuvant activity of the compounds. Also, some compounds of this class have been shown to be potent stimulants of ⁇ -lymphocytes and therefore capable of increasing humoral immune response.
• lH-imidazo[4,5-c]quinolin-4-amine is a compound defined by one of Formulas I-V below:
• R n is selected from the group consisting of alkyl, hydroxyalkyl, acyloxyalkyl, benzyl, (phenyl)ethyl and phenyl, said benzyl, (phenyl)ethyl or phenyl substituent being optionally substituted on the benzene ring by one or two moieties independently selected from the group consisting of alkyl of one to about four carbon atoms, alkoxy of one to about four carbon atoms and halogen, with the proviso that if said benzene ring is substituted by two of said moieties, then said moieties together contain no more than 6 carbon atoms;
• R 21 is selected from the group consisting of hydrogen, alkyl of one to about eight carbon atoms, benzyl, (phenyl)ethyl and phenyl, the benzyl, (phenyl)ethyl or phenyl substituent being optionally substituted on the benzene ring by
• R 12 is selected from the group consisting of straight chain or branched chain alkenyl containing 2 to about 10 carbon atoms and substituted straight chain or branched chain alkenyl containing 2 to about 10 carbon atoms, wherein the substituent is selected from the group consisting of straight chain or branched chain alkyl containing 1 to about 4 carbon atoms and cycloalkyl containing 3 to about 6 carbon atoms; and cycloalkyl containing 3 to about 6 carbon atoms substituted by straight chain or branched chain alkyl containing 1 to about 4 carbon atoms; and R 22 is selected from the group consisting of hydrogen, straight chain or branched chain alkyl containing one to about eight carbon atoms, benzyl, (phenyl)ethyl and phenyl, the benzyl, (phenyl)ethyl or phenyl substituent being optionally substituted on the benzene ring by one or two moieties independently selected from the group consisting of straight chain
• 23 is selected from the group consisting of hydrogen, straight chain or branched chain alkyl of one to about eight carbon atoms, benzyl, (phenyl)ethyl and phenyl, the benzyl, (phenyl) thyl or phenyl substituent being optionally substituted on the benzene ring by one or two moieties independently selected from the group consisting of straight chain or branched chain alkyl of one to about four carbon atoms, straight chain or branched chain alkoxy of one to about four carbon atoms, and halogen, with the proviso that when the benzene ring is substituted by two such moieties, then the moieties together contain no more than 6 carbon atoms; and each R 3 is independently selected from the group consisting of straight chain or branched chain alkoxy of one to about four carbon atoms, halogen, and straight chain or branched chain alkyl of one to about four carbon atoms, and n is an integer from zero to
• R 14 is -CHR A R B wherein R B is hydrogen or a carbon-carbon bond, with the proviso that when R B is hydrogen R A is alkoxy of one to about four carbon atoms, hydroxyalkoxy of one to about four carbon atoms, 1-alkynyl of two to about ten carbon atoms, tetrahydropyranyl, alkoxyalkyl wherein the alkoxy moiety contains one to about four carbon atoms and the alkyl moiety contains one to about four carbon atoms, 2-, 3-, or 4-pyridyl, and with the further proviso that when R B is a carbon-carbon bond R B and R A together form a tetrahydrofuranyl group optionally substituted with one or more substituents independently selected from the group consisting of hydroxy and hydroxyalkyl of one to about four carbon atoms;
• R 24 is selected from the group consisting of hydrogen, alkyl of one to about four carbon atoms, phenyl, and substituted phenyl wherein the substituent is selected from the group consisting of alkyl of one to about four carbon atoms, alkoxy of one to about four carbon atoms, and halogen; and
• R 4 is selected from the group consisting of hydrogen, straight chain or branched chain alkoxy containing one to about four carbon atoms, halogen, and straight chain or branched chain alkyl containing one to about four carbon atoms;
• R 15 is selected from the group consisting of: hydrogen; straight chain or branched chain alkyl containing one to about ten carbon atoms and substituted straight chain or branched chain alkyl containing one to about ten carbon atoms, wherein the substituent is selected from the group consisting of cycloalkyl containing three to about six carbon atoms and cycloalkyl containing three to about six carbon atoms substituted by straight chain or branched chain alkyl containing one to about four carbon atoms; straight chain or branched chain alkenyl containing two to about ten carbon atoms and substituted straight chain or branched chain alkenyl containing two to about ten carbon atoms, wherein the substituent is selected from the group consisting of cycloalkyl containing three to about six carbon atoms and cycloalkyl containing three to about six carbon atoms substituted by straight chain or branched chain alkyl containing one to about four carbon atoms; hydroxyalkyl of one
• R x and R y are independently selected from the group consisting of hydrogen, alkyl of one to about four carbon atoms, phenyl, and substituted phenyl wherein the substituent is elected from the group consisting of alkyl of one to about four carbon atoms, alkoxy of one to about four carbon atoms, and halogen;
• X is selected from the group consisting of alkoxy containing one to about four carbon atoms, alkoxyalkyl wherein the alkoxy moiety contains one to about four carbon atoms and the alkyl moiety contains one to about four carbon atoms, haloalkyl of one to about four carbon atoms, alkylamido wherein the alkyl group contains one to about four carbon atoms, amino, substituted amino wherein the substituent is alkyl or hydroxyalkyl of one to about four carbon atoms, azido, alkylthio of one to about four carbon atoms; and R 5 is selected from the group consisting of hydrogen, straight chain or branched chain alkoxy containing one to about four carbon atoms, halogen, and straight chain or branched chain alkyl containing one to about four carbon atoms; or a pharmaceutically acceptable salt of any of the foregoing.
• n can be zero, one, or two, n is preferably zero or one.
• the substituents R ⁇ s above are generally designated "benzo substituents" herein.
• the preferred benzo substituent is hydrogen.
• the substituents ⁇ -R ⁇ 5 above are generally designated "1-substituents" herein.
• the preferred 1- substituent is 2-methylpropyl or 2-hydroxy-2-methylpropy1.
• the substituents R 2 ⁇ -R 25 above are generally designated “2-substituents” herein.
• the preferred 2- substituents are hydrogen, alkyl of one to about six carbon atoms , alkoxyalkyl wherein the alkoxy moiety contains one to about four carbon atoms and the alkyl moiety contains one to about four carbon atoms. Most preferably the 2-substituent is hydrogen, methyl, or ethoxymethyl.
• Preferred compounds lH-imidazo[4,5-c] quinolin-4- amines include: l-(2-methylpropyl)-lH-imidazo[4,5-c]quinolin-4- amine;
• the lH-imidazo[4,5-c]quinolin-4-amine is present (or administered, as appropriate to the form of the immunogen/vaccine adjuvant composition) in an amount effective to increase the immune response to a particular immunogen.
• the compound is administered independent of the immunogen, e.g., by separate injection, the compound is generally administered in an amount of about 0.003 to about 5 mg/kg.
• the particular amount that constitutes an effective amount depends to some extent upon certain factors, including the particular lH-imidazo[4,5-c]quinolin-4-amine, the particular immunogen being administered and the amount thereof, the immune response that is to be enhanced (humoral or cell mediated), the state of the immune system (e.g., suppressed, compromised, stimulated) , the method and order of administration of the compound and the immunogen, the species, and the desired therapeutic result. Accordingly it is not practical to set forth generally the amount that constitutes an effective amount of the lH-imidazo[4,5-c]quinolin-4-amine. Those of ordinary skill in the art, however, can readily determine the appropriate amount with due consideration of such factors.
• the immunogen can be any material that raises either humoral or cell mediated immune response, or both.
• Suitable immunogens include live viral and bacterial immunogens and inactivated viral, tumor-derived, protozoal, organism-derived, fungal, and bacterial immunogens, toxoids, toxins, polysaccharides, proteins, glycoproteins, peptides, and the like.
• vaccine preparations such as those used in connection with BCG (live bacteria) , cholera, plague, and typhoid (killed bacteria) , hepatitis B, influenza, inactivated polio, and rabies (inactivated virus) , measles, mumps, rubella, oral polio and yellow fever (live virus) , tetanus and diphtheria (toxoids) , hemophilus influenzae b, meningococcal, and pneumococcal (bacterial polysaccharides) can be used as the immunogen.
• BCG live bacteria
• cholera cholera
• plague plague
• typhoid killed bacteria
• hepatitis B influenza
• influenza inactivated polio
• rabies inactivated virus
• measles measles
• mumps rubella
• oral polio and yellow fever live virus
• tetanus and diphtheria toxoids
• the lH-imidazo[4,5-c]quinolin- 4-amine compounds induce biosynthesis of antiviral cytokines, in the instance of a live viral immunogen it is preferred to administer the virus prior to administration of the adjuvant compound in order that the viral infection can be established.
• Exemplary experimental subunit immunogens include those related to viral disease such as adenovirus, AIDS, chicken pox, cytomegalovirus, dengue, feline leukemia, fowl plague, hepatitis A, hepatitis B, HSV-1, HSV-2, hog cholera, influenza A, influenza B, Japanese encephalitis, measles, parainfluenza, rabies, respiratory syncytial virus, rotavirus, wart, and yellow fever.
• viral disease such as adenovirus, AIDS, chicken pox, cytomegalovirus, dengue, feline leukemia, fowl plague, hepatitis A, hepatitis B, HSV-1, HSV-2, hog cholera, influenza A, influenza B, Japanese encephalitis, measles, parainfluenza, rabies, respiratory syncytial virus, rotavirus, wart, and yellow fever.
• Preferred immunogens for use in this invention include T-dependent immunogens such as viral pathogens and tumor-derived immunogens.
• a particular preferred immunogen for use in this invention is a herpes simplex II (HSV-2) glycoprotein subunit preparation prepared as described in J. Infect. Pis. 1987, 155, 914 (Stanberry et al.).
• the immunogen is administered in an amount effective to stimulate an immune response.
• the amount that constitutes an effective amount depends to some extent upon certain factors, including the particular immunogen, the particular adjuvant being administered and the amount thereof, the immune response that is to be enhanced (humoral or cell mediated) , the state of the immune system (e.g., suppressed, compromised, stimulated), the method and order of administration of the compound and the immunogen, and the desired therapeutic result. Accordingly it is not practical to set forth generally the amount that constitutes an effective amount of immunogen. Those of ordinary skill in the art, however, can readily determine the appropriate amount with due consideration of such factors.
• immunogen/vaccine adjuvant compositions of the invention can contain further pharmaceutically acceptable ingredients, excipients, carriers, and the like well known to those skilled in the art.
• the immunogen/vaccine adjuvant composition of the invention can be administered to animals, e.g., mammals (human and non-human) , fowl, and the like according to conventional methods well known to those skilled in the art (e.g., orally, subcutaneously, nasally, topically). It is preferred to administer the lH-imidazo[4,5-c]quinolin-4-amine simultaneously with the immunogen (together in admixture or separately, e.g., orally or by separate injection) or subsequent to challenge with the immunogen. As seen in the Examples that follow (and as is common in the art) administration of the vaccine adjuvant prior to challenge with the immunogen can result in immunosuppression rather than stimulation.
• Compound A designates l-(2- methylpropyl)-lH-imidazo[4,5-c]quinolin-4-amine.
• Compound B designates l-(2-hydroxy-2-methylpropyl)- lH-imidazo[4,5-c]quinolin-4-amine.
• Compound C designates 1-(2-hydroxy-2-methylpropyl)-2-methyl-1H- imidazo[4,5-c]quinolin-4-amine.
• Compound D designates 1-(2-hydroxy-2-methylpropyl)-2-ethoxymethyl- lH-imidazo[4,5-c]quinolin-4-amine.
• PBMC Peripheral blood mononuclear cells
• Ficoll-Paque® solution available from Pharmacia LKB Biotechnology Inc. , Piscataway, NJ
• the PBMC are washed with Hank's Balanced Salts Solution then diluted with RPMI 1640 medium containing 2.0 Mm L-glutamine, 10% fetal calf serum and 1% penicillin/streptomycin to obtain a concentration of 2 X 10 6 cells/mL.
• Incubation A 0.1 mL portion of compound solution is added to the wells (3 wells for each treatment) of a 96 well round bottom tissue culture plate. Control wells receive 0.1 mL portions of medium. A 0.1 mL portion of cell suspension (I X IO 5 cells) is added to each well and the plates are incubated for 48 hours at 37°C in the presence of 5% carbon dioxide. During the last 4 to 6 hour of culture 1 Ci of 3 H-thymidine (having a specific activity of 6.7 Ci/mmole; available from New England Nuclear) is added to each well.
• Cultures are harvested and collected on glass fiber filter strips. Each strip is placed in a scintillation vial. A 1 to 2 mL portion of Aquasol®-2 Universal LSC Cocktail (available from DuPont) is added to each well. After 15 minutes the radioactivity is counted for 1 minute in a scintillation counter. A stimulation index (SI) is calculated by dividing the counts per minute from the treatment wells by the counts per minute from the control wells. Results are shown in the table below.
• SI stimulation index
• Concentrations are the final concentrations found in the well after the addition of the cell suspension.
• the CPM value is the mean CPM of the three wells for each treatment.
• Phytohemagglutinin (PHA) and lipopolysaccharide (LPS) are included as reference agents.
• Spleen Cell Preparation for Culture Spleens are aseptically removed from male CFW mice 4 to 8 weeks of age and placed in 10 mL of Hank's Balanced Salts Solution (HBSS) .
• a scalpel is used to remove the cells from the capsule.
• a single cell suspension is prepared by pipetting the suspension several times using a 5.0 mL syringe equipped with a 19 gauge needle. The suspension is transferred to a 15 mL centrifuge tube and allowed to stand on ice for 4 minutes. The supernatant is removed with a 10 mL pipet, transferred to a clean 15 mL centrifuge tube and centrifuged at 1200 rpm for 5 to 10 minutes. The supernatant is discarded.
• the pellet is resuspended in 5 mL of 0.15M ammonium chloride, let stand at room temperature for 5 minutes and then centrifuged at 1200 rpm for 5 to 10 minutes. The supernatant is discarded.
• the pellet is twice resuspended in 10 mL HBSS then centrifuged at 1200 rpm for 5 to 10 minutes. The supernatant is discarded.
• the pellet is resuspended in RPMI 1640 medium containing 2.0 mM L-glutamine, 10% fetal calf serum, 1% penicillin/streptomycin and 5 X lO' 2- mercaptoethanol. The cells are counted then diluted with medium to give a concentration of 2 X IO 6 cells/mL.
• Concanavalin A ConA
• lipopolysaccharide LPS
• staphylococcal enterotoxin B SEB
• polyriboinosinic acid-polyribocytidylic acid Poly IC
• the spleen cells are prepared as described above except that they are diluted in 6 well tissue culture plates to give a final concentration of 1 X IO 7 cells/mL.
• the compounds are dissolved in water then diluted with medium to give the desired concentration.
• a 0.1 mL portion of compound solution is added to each well (2 wells for each treatment) .
• Control wells receive medium.
• the final volume in the well is adjusted to 1 mL with medium.
• the plates are incubated for 72 hours at 37°C in the presence of 5% carbon dioxide.
• Antibody production is measured by utilizing a modified Jerne Plaque Assay. Briefly stated, the method is as follows. Plastic culture dishes are coated with 2 mL of poly-L-lysine (50 ⁇ g/mL) . After 15 minutes the plates are washed with phosphate buffered saline (PBS) and 2 mL of washed sheep red blood cells (SRBC) diluted 1:20 in PBS is added. After 15 minutes the plates are swirled, allowed to settle for another 15 minutes and rinsed with buffered saline. Finally, 1.5 mL of phosphate-buffered saline, pH 7.2, is added to each plate along with 2.5 X 10 5 spleen cells.
• PBS phosphate buffered saline
• SRBC washed sheep red blood cells
• a stimulation index (SI) is calculated by dividing the PFC from the treatment wells by the PFC from the control (medium) wells.
• Spleen Cell Preparation for Culture Spleen cells are prepared as described above in connection with the uptake of 3 H-thymidine.
• the compounds are dissolved in water then diluted with medium to give the desired concentration. Incubation
• a 0.9 mL portion of cell suspension is added to each well of a 12 well tissue culture plate.
• a 0.1 mL portion of compound solution is added to the wells (2 wells for each treatment) .
• Control wells receive 0.1 mL portions of medium. The plates are incubated for 72 hours at 37°C in the presence of 5% carbon dioxide.
• the cell culture is removed from the well, combined with the culture from the second well, and washed twice with Hanks Balanced Salts Solution.
• the cells are diluted with phosphate buffered saline (PBS) supplemented with 1% fetal calf serum (FCS) to give a concentration of 1 X 10 6 cells/100 ⁇ L.
• the cells are stained with antibody for 30 minutes at 4°C.
• Fluorescein isothiocyanate labeled goat anti-mouse immunoglobulin antibody (FITC ⁇ I G ) functions as the B cell marker.
• Fluorescein isothiocyanate labeled anti mouse Thy 1.2 antibody functions as the T cell marker.
• the cells are then washed twice with PBS supplemented with 1% FCS then analyzed for fluorescence using a Becton Dickinson FACSCAN. The results are reported as the percentage of the total cells, both the whole (unseparated) cells and the blast-like cells, that are positive for the marker.
• the concentrations are the final concentrations in the well after both the cell suspension and the compound solution have been added. Lipopolysaccharide is included as a reference agent.
• mice 4 to 8 weeks of age are injected intraperitoneally with sheep red blood cells (1 X 10 7 in phosphate buffered saline). Also on day 0, test compounds are dissolved in sterile water then injected intraperitoneally (3 mice for each treatment) . On day 4 the mice are sacrificed and the spleens are removed. Single cell suspensions are prepared in phosphate buffered saline to give a final concentration of 5 X 10 5 cells/mL for use in a modified Jerne Plaque Assay. The assay is performed as described above in connection with antibody formation in spleen cell cultures. The results are reported as plaque forming cells (PFC) per 10° cells and per spleen. A stimulation index (SI) is calculated by dividing the PFC value for the treatment group by the PFC value for the control (SRBC but no compound) group.
• SI stimulation index
• Results are shown in the table below. Values are the average number of plaque forming cells (PFC) 1 SEM. Each data point is the average of three mice pooled. Lipopolysaccharide (LPS) and polyriboinosinic acid- polyribocytidylic acid (Poly IC) are included as reference agents.
• LPS Lipopolysaccharide
• Poly IC polyriboinosinic acid- polyribocytidylic acid
• HSV-2 (strain MS) infected Vero cells were solubilized and the glycoproteins were purified by lentil-lectin sepharose chromatography. The final preparation contained all three HSV-2 glycoproteins, gB, gD, and gG, that were evaluated. The glycoprotein preparation was diluted to contain 35 ⁇ g/0.1 mL total glycoprotein. Glycoprotein administration is described below in connection with the experimental design. Treatment Groups
• 1-(2-methylpropyl)-lH-imidazo[4,5-c]quinolin-4- amine one percent by weight in a cream containing water (76.5%), isosteric acid (10%), stearyl alcohol (3.1%), polysorbate 60 (2.55%), cetyl alcohol (2.2%), benzyl alcohol (2%) , glycerin (2%) , sorbitan onostearate (0.45%), methylparaben (0.2%), and propylparaben (0.02%) was administered to guinea pigs as described below intravaginally at a concentration of 5 mg/kg/day for 5 days beginning either simultaneously with glycoprotein administration ("S group”) , or after a delay of 48h after glycoprotein administration (“D group”) .
• S group glycoprotein administration
• D group glycoprotein administration
• hydrochloride salt was administered in water subcutaneously at a dose of 3 mg/kg/day for 5 days beginning simultaneously with glycoprotein administration ("subQ s group”).
• Complete Freund's adjuvant (“CFA”, Sigma) was administered as a 1:1 mixture of the adjuvant and the glycoprotein (“CFA Group”) .
• An unimmunized infected control group was maintained. Also one group was given the glycoprotein alone (“glycoprotein group”) .
• Hartley female guinea pigs (Charles River Breeding Laboratory, Wilmington, Mass.) weighing 200-300 g were immunized with 35 ⁇ g of HSV-2 glycoproteins in the hind footpads, first 35 days prior to vaginal inoculation with HSV-2 and again 14 days prior to inoculation.
• Enzyme-linked immunosorbent assay for HSV-2 antibodies HSV-2 antibodies were quantified by an ELISA assay. Lectin purified HSV-2 glycoproteins were used as the solid phase and peroxidase-conjugated rabbit anti- guinea pig immunoglobulins (Accurate Chemical, Westbury, N.Y.) were used for detection of guinea pig antibody. Absorbances were compared to a standardized control serum arbitrarily assigned a value of 10,000 ELISA units.
• the recurrence pattern was similar for the unimmunized control group and glycoprotein group (4.9 i 0.9 vs. 4.3 1 0.9 recurrent lesion days, respectively).
• the use of 1-(2-methylpropyl)-1H- imidazo[4,5-c3quinolin-4-amine as an adjuvant significantly reduced recurrent lesion days to 0.8 1 0.3 and 0.11 0.1, respectively, for the S Group and D Group (p ⁇ .01 for each compared to the glycoprotein group) .
• Only one of ten animals in the S Group developed a recurrence, while eight of nine recipients of glycoprotein alone (p ⁇ .002) developed a recurrence.
• Three of ten animals in the CFA Group developed recurrent lesions.
• the only groups to develop lesions acutely were the unimmunized groups (Compound Group, 9 of 9; unimmunized control group, 11 of 11) and the glycoprotein group (6 of 11) . Again, because of the significant effect of immunization with glycoprotein alone, only small adjuvant effects of l-(2- methylpropyl)-lH-imidazo[4,5-c]quinolin-4-amine on the severity of the acute disease could be demonstrated (differences in total lesion score (p ⁇ .05) for each compared to glycoprotein alone) .
• Vaginal viral shedding was also decreased by immunization with glycoprotein alone.
• viral shedding was decreased tenfold in the D Group, by another tenfold in the S Group (p ⁇ .05), and by yet another tenfold in the SubQ s Group (p ⁇ .00i) on day one.
• there was >99.9% reduction in the SubQ S Group compared to the glycoprotein group and a >99.9% reduction compared to the unimmunized control group.
• No virus was detected in the CFA group.
• Treatment with 1-(2-methylpropyl)-1H- imidazo[4,5-c]quinolin-4-amine alone had no significant effect on vaginal viral shedding.
• Antibody titers in the CFA group were again over tenfold higher than the glycoprotein group (p ⁇ .001) and the D Group, S Group, and SubQ S Group (p ⁇ .01). Groups that received l-(2-methylpropyl)-lH-imidazo[4,5- c]quinolin-4-amine as an adjuvant did not, however, develop higher titers of HSV-2 antibody than the glycoprotein group. The Compound Group developed higher antibody titers than the unimmunized control group (p ⁇ .05) .
• the most effective regimen involved subcutaneous administration for 5 doses beginning at the time of immunization. The results were comparable to using CFA as an adjuvant. Animals that received intravaginal administration had decreased viral titers and fewer recurrent lesion days. The addition of 1-(2-methylpropyl)-lH-imidazo[4,5- c]guinolin-4-amine to glycoprotein immunization had little effect on antibody titers but significantly increased the protection provided by the glycoprotein preparation especially against recurrent disease.

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