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
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
  • A61K47/28—Steroids, e.g. cholesterol, bile acids or glycyrrhetinic acid
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
• • 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
  • A61P31/20—Antivirals for DNA viruses
  • A61P31/22—Antivirals for DNA viruses for herpes viruses
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P33/00—Antiparasitic agents
  • A61P33/02—Antiprotozoals, e.g. for leishmaniasis, trichomoniasis, toxoplasmosis
  • A61P33/06—Antimalarials
• • 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
• • 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
  • A61K2039/55577—Saponins; Quil A; QS21; ISCOMS
• • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
  • Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
  • Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
  • Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
  • Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

Definitions

• the present invention relates to an oil in water emulsion compositions, their use in medicine, in particular to their use in augmenting immune responses to a wide range of antigens, and to methods of their manufacture; the oil in water emulsion comprising a metabolisable oil, a saponin and a sterol.
• cytotoxic T-cell occurs naturally during infection of a target cell, or uncontrolled synthesis of a tumour antigen, wherein enzymatic degradation of the target antigen takes place in the cell cytoplasm.
• This phenomenon allows cytoplasmic peptides derived from the pathogen, or tumour specific antigen, to enter the Thl (endogenous antigen processing) pathway and be presented on the surface of the cell associated with an MHC class 1 molecule.
• Thl endogenous antigen processing
• a vaccine antigen does not enter into the cytoplasm of the host cell, then it might be taken up by the cell and enter the exogenous antigen processing pathway and ultimately be presented on the surface of the cell associated with a MHC class II molecule.
• This alternative route generally results in T- helper responses and antigen specific antibody responses.
• antigen After conventional vaccination with subunit or non-living vaccines, antigen generally does not enter the cytoplasm of a host cell, and therefore will not enter the endogenous antigen processing pathway and ultimately will not induce a CTL response.
• CTL induction is believed to correlate with Th-1 cytokine profile responses, specifically with IFN- ⁇ and IL-2 secretion.
• IFN- ⁇ secretion is associated with protective responses against intracellular pathogens, including parasites, bacteria and viruses.
• Activation of leucocytes by IFN- ⁇ enhances killing of intracellular pathogens and increases expression of Fc receptors. Direct cytotoxicity may also occur, especially in synergy with lymphotoxin (another product of TH1 cells).
• IFN- ⁇ is also both an inducer and a product of NK cells, which are major innate effectors of protection.
• TH1 type responses either through IFN- ⁇ or other mechanisms, provide preferential help for murine IgG2a and human IgGl immunoglobulin isotypes.
• WO 95/17210 discloses an adjuvant emulsion system based ori squalene, ⁇ -tocopherol, and polyoxyethylene sorbitan monooleate (TWEEN 80), optionally formulated with the immunostimulants QS21 and/or 3D-MPL.
• This adjuvant formulation is a very potent inducer of a wide range of immune responses.
• this system when associated with antigen preferentially stimulate the sub- isotype of IgG associated with Thl responses (for example, murine IgG2a and human IgGl) and also will induce significant levels of IFN- ⁇ production and antigen specific CTL responses.
• Thl responses for example, murine IgG2a and human IgGl
• IFN- ⁇ production and antigen specific CTL responses The observation that the basic oil in water/QS21/3D-MPL formulation can induce strong CTL responses is significant, as these responses in certain animal models have been shown to induce protection against disease.
• Immunologically active saponin fractions e.g. Quil A having adjuvant activity derived from the bark of the South American tree Quillaja Saponaria Molina are known in the art.
• Derivatives of Quil A for example QS21 (an HPLC purified fraction derivative of Quil A), and the method of its production is disclosed in US Patent No.5,057,540.
• QS21 an HPLC purified fraction derivative of Quil A
• QA21 other fractions such as QA17 are also disclosed.
• the use of such saponins in isolation is accompanied with disadvantage in that local necrosis, that is to say, localised tissue death, occurs at the injection site, thereby leading to pain.
• 3 De-O-acylated monophosphoryl lipid A is a well known adjuvant manufactured by Ribi Immunochem, Montana. Chemically it is often supplied as a mixture of 3 De-O- acylated monophosphoryl lipid A with either 4, 5, or 6 acylated chains. It can be prepared by the methods taught in GB 2122204B.
• a preferred form of 3 De-O-acylated monophosphoryl lipid A is in in the form of an emulsion having a small particle size less than 0.2 ⁇ m in diameter, and its method of manufacture is disclosed in European Patent NO. EP 0 671 948 B1.
• the oil phase of the emulsion system has to comprise a metabolisable oil.
• metabolisable oil is well known in the art. Metabolisable can be defined as "being capable of being transformed by metabolism” (Dorland's Illustrated Medical Dictionary, W.B. Sanders Company, 25th edition (1974)).
• the oil may be any vegetable oil, fish oil, animal oil or synthetic oil, which is not toxic to the recipient and is capable of being transformed by metabolism. Nuts, seeds, and grains are common sources of vegetable oils. Synthetic oils are also part of this invention and can include commercially available oils such as NEOBEE® and others.
• Squalene (2,6,10,15,19,23-Hexamethyl- 2,6,10,14,18,22-tetracosahexaene) is an unsaturated oil which is found in large quantities in shark-liver oil, and in lower quantities in olive oil, wheat germ oil, rice bran oil, and yeast, and is a particularly preferred oil for use in this invention.
• Squalene is a metabolisable oil virtue of the fact that it is an intermediate in the biosynthesis of cholesterol (Merck index, 10th Edition, entry no.8619).
• Oil in water emulsions per se are well known in the art, and have been suggested to be useful as adjuvant compositions (EPO 399843).
• Formulations comprising QS21 with a sterol are known from International Patent Application No. PCT/EP96/01464, No oil in water emulsions disclosed in this document.
• Sterols are well known in the art, for example cholesterol is well known and is, for example, disclosed in the Merck Index, 11th Edn., page 341, as a naturally occurring sterol found in animal fat.
• one preferred embodiment of the present invention provides a composition comprising a saponin, an oil in water emulsion, and a sterol.
• a composition comprising a saponin, an oil in water emulsion, and a sterol.
• this include compositions wherein the saponin is the non-toxic fraction of Quil A known as QS21, the oil in water emulsion comprises a metabolisible oil, such as squalene, and wherein the sterol is cholesterol.
• Such a composition may further comprise other immunomodulators including: ⁇ -tocopherol and polyoxyethylene sorbitan monooleate (TWEEN 80), and 3D-MPL.
• TWEEN 80 polyoxyethylene sorbitan monooleate
• 3D-MPL 3D-MPL.
• the inclusion of cholesterol in the formulation much reduces the local reactogenicity of the composition once injected into a recipient.
• Other sterols that can easily act as alternatives for cholesterol include ⁇ - sitoste
• Embodiments of the present invention are used as vaccine adjuvant systems, and once combined with antigen form potent vaccines. Advantageously they preferentially induce a Thl response.
• Embodiments of the present invention include composition comprising an oil in water emulsion, a saponin and a sterol, characterised in that a reduced reatogenicity profile is induced upon administration to a host in comparison to the reactogenicity profile observed after administration of the same composition from which the sterol has been omitted.
• the adjuvant system of the present invention typically comprises a ratio of squalene: saponin (w/w) in the range of 200: 1 to 300: 1
• the present invention can be used in a "low oil" form the preferred range of which is 1 :1 to 200:1, preferably 20:1 to 100:1, and most preferably substantially 48:1, this vaccine retains the beneficial adjuvant properties of all of the components, with a much reduced reactogenicity profile.
• the particularly preferred embodiments have a ratio of squalene:QS21 (w/w) in the range of 1 : 1 to 250: 1 , also a preferred range is 20: 1 to 200:1, preferably 20:1 to 100:1, and most preferably substantially 48:1.
• the emulsion systems of the present invention have a small oil droplet size in the sub- micron range.
• the oil droplet sizes will be in the range 120 to 750 run, and most preferably from 120-600nm in diameter.
• the formulations of the invention are suitable for a broad range of monovalent or polyvalent vaccines, once combined with an antigen or antigenic composition/combination.
• the oil in water emulsion may contain 3 de-O- acylated monophosphoryl lipid A (3D-MPL) and/or polyoxyethylene sorbitan trioleate (such as SPAN 85).
• 3D-MPL 3 de-O- acylated monophosphoryl lipid A
• SPAN 85 polyoxyethylene sorbitan trioleate
• SPAN 85 polyoxyethylene sorbitan trioleate
• the preferred form of 3 De-O-acylated monophosphoryl lipid A is disclosed in International patent application published under No. 92116556 - SmithKline Beecham Biologicals s.a.
• the vaccine formulations of the present invention contain an antigen or antigenic composition capable of eliciting an immune response against a human pathogen, which antigen or antigenic composition is derived from HIV-1, (such as tat, nef, gpl20 or gpl60), human herpes viruses, such as gD or derivatives thereof or Immediate Early protein such as ICP27 from HSNl or HSV2, cytomegalovirus ((esp), HIV-1, (such as tat, nef, gpl20 or gpl60), human herpes viruses, such as gD or derivatives thereof or Immediate Early protein such as ICP27 from HSNl or HSV2, cytomegalovirus ((esp), cytomegalovirus ((esp), cytomegalovirus ((esp)
• HIV-1 such as tat, nef, gpl20 or gpl60
• human herpes viruses such as gD or derivatives
• hepatitis virus such as hepatitis B virus (for example Hepatitis B Surface antigen or a derivative thereof), hepatitis A virus, hepatitis C virus and hepatitis E virus, or from other viral pathogens, such as paramyxo viruses: Respiratory Syncytial virus (such as F and G proteins or derivatives thereof), parainfluenza virus, measles virus, mumps virus, human papilloma viruses (for example HPV6, 11, 16, 18, ..), flaviviruses (e.g.
• Neisseria spp including N. gonorrhea and N. meningitidis (for example capsular polysaccharides and conjugates thereof, transferrin-binding proteins, lactoferrin binding proteins, PilC, adhesins); Streptococcus spp, including S. pneumoniae (for example capsular polysaccharides and conjugates thereof, PsaA, PspA, streptolysin, choline-binding proteins), S.
• Neisseria spp including N. gonorrhea and N. meningitidis (for example capsular polysaccharides and conjugates thereof, transferrin-binding proteins, lactoferrin binding proteins, PilC, adhesins); Streptococcus spp, including S. pneumoniae (for example capsular polysaccharides and conjugates thereof, PsaA, PspA, streptolysin, choline-binding proteins), S.
• pyogenes for example M proteins or fragments thereof, C5 A protease, lipoteichoic acids), S. agalactiae, S. mutans; Haemophilus spp, including H. influenzae type B (for example PRP and conjugates thereof), non typeable H. influenzae (for example OMP26, high molecular weight adhesins, P5, P6, lipoprotein D), H. ducreyi; Moraxella spp, including M catarrhalis, also known as Branhamella catarrhalis (for example high and low molecular weight adhesins and invasinsj; Bordetella spp, including B.
• H. influenzae type B for example PRP and conjugates thereof
• non typeable H. influenzae for example OMP26, high molecular weight adhesins, P5, P6, lipoprotein D
• Moraxella spp including M catarrhalis, also known as Branhamella catarrhalis (for example
• pertussis for example pertactin, pertussis toxin or derivatives thereof, filamenteous hemagglutinin, adenylate cyclase, fimbriae), B. parapertussis and B. bronchiseptica; Mycobacterium spp., including M. tuberculosis ( or example ESAT6, Antigen 85A, -B or -C), M. bovis, M. leprae, M. avium, M. paratuberculosis, M. smegmatis; Legionella spp, including L. pneumophila; Escherichia spp, including enterotoxic E.
• M. tuberculosis or example ESAT6, Antigen 85A, -B or -C
• M. bovis M. leprae, M. avium, M. paratuberculosis, M. smegmatis
• Legionella spp including L. pneumophila
• coli for example colonization factors, heat-labile toxin or derivatives thereof, heat-stable toxin or derivatives thereof), enterohemorragic E. coli, enteropathogenic E. coli (for example shiga toxin-like toxin or derivatives thereof); Vibrio spp, including V. cholera (for example cholera toxin or derivatives thereof); Shigella spp, including S. sonnei, S. dysenteriae, S. flexnerii; Yersinia spp, including Y. enterocolitica (for example a Yop protein) , Y. pestis, Y. pseudotuberculosis; Campylobacter spp, including C.
• V. cholera for example cholera toxin or derivatives thereof
• Shigella spp including S. sonnei, S. dysenteriae, S. flexnerii
• Yersinia spp including Y. enterocolitica (for example
• jejuni for example toxins, adhesins and invasins
• C. coli Salmonella spp, including S. typhi, S. paratyphi, S. choleraesuis, S. enteritidis
• Listeria spp. including L. monocytogenes
• Helicobacter spp including H pylori (for example urease, catalase, vacuolating toxin); Pseudomonas spp, including P. aeruginosa; Staphylococcus spp., including S. aureus, S.
• Clostridium spp. including C. tetani (for example tetanus toxin and derivative thereof), C. botulinum (for example botulinum toxin and derivative thereof), C. difficile (for example clostridium toxins A or B and derivatives thereof); Bacillus spp., including B. anthracis (for example botulinum toxin and derivatives thereof); Corynebacterium spp., including C. diphtheriae (for example diphtheria toxin and derivatives thereof); Borrelia spp., including B.
• burgdorferi for example OspA, OspC, DbpA, DbpB
• B. garinii for example OspA, OspC, DbpA, DbpB
• B. afzelii for example OspA, OspC, DbpA, DbpB,
• B. andersonii for example OspA, OspC, DbpA, DbpB
• B. hermsii; Ehrlichia spp. including E. equi and the agent of the Human Granulocytic Ehrlichiosis; Rickettsia spp, including R.
• Chlamydia spp. including C. trachomatis (for example MOMP, heparin-binding proteins), C. pneumoniae (for example MOMP, heparin-binding proteins), C. psittaci; Leptospira spp., including L. interrogans; Treponema spp., including T. pallidum (for example the rare outer membrane proteins), T. denticola, T. hyodysenteriae; or derived from parasites such as Plasmodium spp., including P. falciparum; Toxoplasma spp., including T.
• C. trachomatis for example MOMP, heparin-binding proteins
• C. pneumoniae for example MOMP, heparin-binding proteins
• C. psittaci Leptospira spp., including L. interrogans
• Treponema spp. including T. pallidum (for example the rare outer membrane proteins),
• gondii for example SAG2, SAG3, Tg34
• Entamoeba spp. including E. histolytica
• Babesia spp. including B. microti
• Trypanosoma spp. including T. cruzi
• Giardia spp. including G lamblia
• Leshmania spp. including L. major
• Pneumocystis spp. including P. carinii
• Trichomonas spp. including T. vaginalis
• Schisostoma spp. including S. mansoni, or derived from yeast such as Candida spp., including C. albicans
• Cryptococcus spp. including C. neoformans.
• the vaccine formulation of the invention comprises the HIV-1 antigen, gpl20, especially when expressed in CHO cells.
• the vaccine formulation of the invention comprises gD2t as hereinabove defined.
• vaccines containing the claimed adjuvant comprise the HPV viruses considered to be responsible for genital warts, ( ⁇ PV 6 or HPV 11 and others , ), and the HPV viruses responsible for cervical cancer (HPV 16, HPV 18 and others).
• Particularly preferred forms' of vaccine comprise LI particles or capsomers, and fusion proteins comprising one or more antigens selected from the HPV 6 and HPV 11 proteins E6, E7, LI, and L2.
• the most preferred forms of fusion protein are: L2E7 as disclosed in GB 95 15478.7, and proteinD(l/3)-E7 disclosed in GB 9717953.5.
• Vaccines of the present invention further comprise antigens derived from parasites that cause Malaria.
• preferred antigens from Plasmodia falciparum include RTS,S and TRAP.
• RTS is a hybrid protein comprising substantially all the C-terminal portion of the circumsporozoite (CS) protein of P. falciparum linked via four amino acids of the preS2 portion of Hepatitis B surface antigen to the surface (S) antigen of hepatitis B virus. It's full structure is disclosed in the International Patent Application No. PCT/EP92/02591, published under Number WO 93/10152 claiming priority from UK patent application No.9124390.7.
• RTS When expressed in yeast RTS is produced as a lipoprotein particle, and when it is co-expressed with the S antigen from HBV it produces a mixed particle known as RTS,S.
• TRAP antigens are described in the International Patent Application No. PCT/GB89/00895, published under WO 90/01496.
• a preferred embodiment of the present invention is a Malaria vaccine wherein the antigenic preparation comprises a combination of the RTS,S and TRAP antigens.
• Other plasmodia antigens that are likely candidates to be components of a multistage Malaria vaccine are P.
• the formulations may also contain an anti-tumour antigen and be useful for the immunotherapeutic treatment cancers.
• the adjuvant formulation finds utility with tumour rejection antigens such as those for prostrate, breast, colorectal, lung, pancreatic, renal or melanoma cancers.
• Exemplary antigens include MAGE 1 and MAGE 3 or other MAGE antigens for the treatment of melanoma, PRAME, BAGE or GAGE (Robbins and Kawakami, 1996, Current Opinions in Immunology 8, pps 628- 636; Van den Eynde et al., International Journal of Clinical & Laboratory Research (submitted 1997); Correale et al. (1997), Journal of the National Cancer Institute 89, p293.
• Tumor-Specific antigens are suitable for use with adjuvant of the present invention and include, but are not restricted to Prostate specific antigen (PSA) or Her-2/neu, KSA (GA733), MUC-1 and carcinoembryonic antigen (CEA). Accordingly in one aspect of the present invention there is provided a vaccine comprising an adjuvant composition according to the invention and a tumour rejection antigen. It is foreseen that compositions of the present invention will be used to formulate vaccines containing antigens derived from Borrelia sp..
• antigens may include nucleic acid, pathogen derived antigen or antigenic preparations, recombinantly produced protein or peptides, and chimeric fusion proteins.
• the antigen is OspA.
• the OspA may be a full mature protein in a lipidated form virtue of the host cell (E.Coli) termed (Lipo-OspA) or a non-lipidated derivative.
• non-lipidated derivatives include the non-lipidated NSl-OspA fusion protein which has the first 81 N- terminal amino acids of the non-structural protein (NS1) of the influenza virus, and the complete OspA protein, and another, MDP-OspA is a non-lipidated form of OspA carrying 3 additional N-terminal amino acids.
• NS1 non-structural protein
• MDP-OspA is a non-lipidated form of OspA carrying 3 additional N-terminal amino acids.
• Vaccines of the present invention may be used for the prophylaxis or therapy of allergy.
• Such vaccines would comprise allergen specific (for example Der pi) and allergen non- specific antigens (for example the stanworth decapeptide).
• the ratio of the QS21 to cholesterol (w/w), present in a preferred embodiment of the present invention, is envisaged to be in the range of 1 : 1 to 1 :20, substantially 1:10.
• the ratio of QS21 : 3D-MPL (w/w) 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%) ⁇ -tocopherol and from 0.4 to 2% polyoxyethylene sorbitan monooleate (TWEEN 80).
• the ratio of squalene: ⁇ -tocopherol is equal or less than 1 as this provides a more stable emulsion.
• Sorbitan trioleate (SPAN 85) may also be present at a level of 0.5 to 1%.
• the vaccines of the present invention will further contain a stabiliser, for example other emulsifyers/surfactants, including Caprylic acid (merck index 10th Edition, entry no.1739), of which Tricaprylin is a particularly preferred embodiment.
• Vaccine preparation is generally described in New Trends and Developments in Vaccines, edited by Voller et al, University Park Press, Baltimore, Maryland, U.S.A. 1978. Conjugation of proteins to macromolecules is disclosed by Likhite, U.S. Patent 4,372,945 and by Armor et al., U.S. Patent 4,474,757.
• each vaccine dose is selected as an amount which induces an immunoprotective response without significant, adverse side effects in typical vaccinees. Such amount will vary depending upon which specific immunogen is employed and how it is presented. Generally, it is expected that each dose will comprise 1-1000 ⁇ g of protein, preferably 1-500 ⁇ g, preferably 1-100 ⁇ g, of which 1 to 50 ⁇ g is the most preferable range. 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 immunisations adequately spaced.
• compositions of the present invention can be used to formulate vaccines containing antigens derived from a wide variety of sources.
• antigens may include human, bacterial, or viral nucleic acid, pathogen derived antigen or antigenic preparations, tumour derived antigen or antigenic preparations, host-derived antigens, including the histamine releasing decapeptide of IgE (known as the Stanworth decapeptide), recombinantly produced protein and peptides, and chimeric fusion proteins.
• a vaccine as herein described for use in medicine.
• QS21 in aqueous solution is known to degenerate over time into an adjuvant- inactive form, QS21-H, which degeneration is mediated by OH hydrolysis by the aqueous medium. Such degeneration may occur when the QS21 is present in the aqueous phase of an oil in water adjuvant.
• the addition of cholesterol to the oil phase of the oil in water emulsion has the effect of maintaining the QS21 in its active form, with obvious benefits to the shelf-life of the adjuvant/vaccine formulation.
• the present invention provides a method of stablilising a preparation of a saponin, preferably QS21, in its non-hydro lysed adjuvant-active form, when the QS21 is present in an oil in water emulsion based adjuvant.
• This method comprises the addition of a sterol, preferably cholesterol, into the oil phase of an oil in water emulsion.
• Also provided by the present invention is the process for the production of an adjuvant or vaccine preparation comprising the addition of cholesterol to a metabolisable oil, followed by emulsification of the oil phase; into which emulsion is added QS21, and optionally 3D-MPL, ⁇ -tocopherol, and antigen.
• the vaccine preparation of the present invention may be used to protect or treat a mammal susceptible to, or suffering from a disease, by means of administering said vaccine via systemic or mucosal route.
• administrations may include injection via the intramuscular, intraperitoneal, intradermal or subcutaneous routes; or via mucosal administration to the oral/alimentary, respiratory, genitourinary tracts.
• oil in water emulsion adjuvants used in the subsequent examples were each made comprising the following oil in water emulsion component: 5% Squalene, 5% ⁇ -tocopherol, 2.0% polyoxyethylene sorbitan monooleate (TWEEN 80).
• the emulsion was prepared as follows as a 2 fold concentrate. All examples used in the immunological experiments are diluted with the addition of extra components and diluents to give either a lx concentration (equating to a squalene:QS21 ratio (w/w) of 240:1) or further dilutions thereof.
• the TWEEN 80 is dissolved in phosphate buffered saline (PBS) to give a 2% solution in the PBS.
• PBS phosphate buffered saline
• 5ml of DL alpha tocopherol and 5ml of squalene are vortexed to mix thoroughly.
• 95ml of PBS/Tween solution is added to the oil and are mixed thoroughly.
• the resulting emulsion is then passed through a syringe needle and finally microfluidised by using an MHOS Microfluidics machine.
• the resulting oil droplets have a size of approximately 145-180 nm (expressed as z av. measured by PCS) and is termed "full dose" SB62.
• formulations can be sterile filtered through a 0.2 ⁇ m filter.
• the other adjuvant/vaccine components QS21, 3D-MPL or antigen are added to the emulsion in simple admixture.
• the antigen containing vaccines used herein are formulated either with full dose SB62 adjuvant to give a high squalene:QS21 ratio (240:1) or with a lower amount of emulsion to give a low ratio formulation (48:1), these adjuvant formulations are called SB62 and SB62' respectively.
• Other vaccines were formulated with the addition of cholesterol to the oil phase of the emulsion prior to the emulsifying process, wherein the QS21 cholesterol ratio of 1 :10 (denoted by the addition of the letter "c").
• the vaccine preparation in group 1 the SB62 stock preparation is diluted with the addition of extra components and diluents to give a lx concentration (1/1).
• the SB62 final dilution varies between 1/2 to 1/5.
• Groups 1 to 5 have a squalene:QS21 ratio (w/w) of 240:1, 120:1, 80:1, 60:1 and 48:1 respectively.
• the antigen used in this study is a truncated HSV-2 glycoprotein D of 308 amino acids, which comprises amino acids 1 through 306 naturally occurring glycoprotein with the addition Asparagine and Glutamine at the C terminal end of the truncated protein devoid of its membrane anchor region.
• This form of the protein includes the signal peptide which is cleaved to yield a mature 283 amino acid protein.
• the production of such a protein in Chinese Hamster ovary cells has been described in Genentech's European patent EP-B-139 417.
• the antigen is used in the vaccine formulations of the present invention as is designated gD2t.
• CPK levels in units per litre (U/L), were determined from serum at various time points throughout the experiment, using commercially available reagents (Abbot) and a Abbot Vision System analyser. Levels of PMN in blood samples were determined concurrently using a Sysmex K-1000 Haematology analyser (Toa Medical Electronics Co.).
• CPK levels were substantially the same as, or lower than, those seen before vaccination or after vaccination with PBS. Vaccine preparations not containing cholesterol induced a significant increases in blood CPK levels on day 1. These CPK levels were independent of SB62 dilution.
• the results relating to the %PMN observed after vaccination can be summarised by the following. A transient PMN burst was observed on day 1 in all animals injected, independent of SB62 dilution and presence of cholesterol.
• mice were immunised in the rear footpads (50 ⁇ l per footpad) with the following formulations, at days 0 and 28:
• the vaccines were prepared using the SB62 oil in water emulsion adjuvants as described in example 1.
• the antigen used in this study is a truncated HSV-2 glycoprotein D of 308 amino acids, which comprises amino acids 1 through 306 naturally occurring glycoprotein with the addition Asparagine and Glutamine at the C terminal end of the truncated protein devoid of its membrane anchor region.
• This form of the protein includes the signal peptide which is cleaved to yield a mature 283 amino acid protein.
• the production of such a protein in Chinese Hamster ovary cells has been described in Genentech's European patent EP-B-139 417.
• the antigen is used in the vaccine formulations of the present invention as is designated gD2t.
• Sera was obtained from 5 mice from each group at 14 days after the second immunisation, and again from the 5 remaining mice 28 days after the second immunization. Each serum sample was tested in ELISA for anti-gD2t Ig titers and the isotype distribution using pooled sera was measured.
• mice immunised with the gD2t vaccines are summarised in the following table.
• the magnitude of the response with respect to each parameter measured is indicated by the number of "+” signs.
• Table 4 Summary table showing the anti-gD2t immune responses in mice (example 3).
• the vaccines were prepared using the SB62 emulsion adjuvants as described in example 1.
• the antigen used in this study is a truncated HSV-2 glycoprotein D of 308 amino acids, which comprises amino acids 1 through 306 naturally occurring glycoprotein with the addition Asparagine and Glutamine at the C terminal end of the truncated protein devoid of its membrane anchor region.
• This form of the protein includes the signal peptide which is cleaved to yield a mature 283 amino acid protein.
• the production of such a protein in Chinese Hamster ovary cells has been described in Genentech's European patent EP-B-139 417.
• the antigen is used in the vaccine formulations of the present invention as is designated gD2t.
• the monkeys were vaccinated on days 0, 28 and 84. Serum was taken from each monkey at 14, 28, and 42 days after the third vaccination. Each serum was tested in ELISA for anti-gD2t Ig titres. Results were expressed as ELISA units (EU). Neutralisation assays were also performed, which evaluated the ability of serial dilutions of the sera to neutralise in vitro the infectivity of HSV-2 (strain HG-52). Results were expressed as mid-point titres after regression analysis.
• a DTH test was performed at 42 days after the third vaccination. 28 ⁇ g gD2t diluted in PBS (total volume of lOO ⁇ l) was injected intradermally in duplicate. Controls consisted of PBS alone. Skin thickness was measured prior to, and 24 hours after, injection. Data was expressed as specific increase of skin thickness (difference between the site injected with gD2t and the site injected with PBS).
• the oil in water emulsions tested were produced using techniques described in example 1.
• Groups of 5 SPF bred New Zealand White albino rabbits were inoculated by intramuscular injection into the right hind leg muscle (gastrocnemius), with 0.5ml of the adjuvant preparations.
• Samples were taken before and after vaccination to assay the percentage blood polymorpho-neutrophils (as a measure of inflammation, %>PMN), and Creatine phosphokinase (as a measure of muscle damage, CPK).
• the animals were sacrificed 3 days after vaccination for histological examination of the injection site.
• SB62 full dose oil in water emulsion
• SB62' l/5th dose
• SB62 SB62'c SB62' containing cholesterol in the oil phase
• PBS Phosphate Buffered Saline
• CPK levels in units per litre (U/L), were determined from serum at various time points throughout the experiment, using commercially available reagents (Abbot) and a Abbot Vision Systems analyser. %> PMN in blood samples were determined concurrently using a Sysmex K-1000 Haematology analyser (Toa Medical Electronics Co.). Three days after injection post-mortem inspection of the rabbits determined lesion size at injection site, and local histopathology.
• the percentage of blood PMN is taken to be a readout of the magnitude of the local inflammation reaction in response to vaccination.
• the addition of cholesterol to the QS21 containing adjuvant formulation does not significantly affect the inflammatory process at day 1 post- vaccination, despite the absence of muscle damage as indicated in table 8 .
• the addition of cholesterol does not affect the inflammatory process induced by SB62.
• RTS is a hybrid protein comprising substantially all the C-terminal portion of the circumsporozoite (CS) protein of P. falciparum linked via four amino acids of the preS2 portion of Hepatitis B surface antigen to the surface (S) antigen of hepatitis B virus. It's full structure is disclosed in the International Patent Application No. PCT/EP92/02591, published under Number WO 93/10152 claiming priority from UK patent application No.9124390.7. When expressed in yeast RTS is produced as a lipoprotein particle, and when it is co-expressed with the S antigen from HBV it produces a mixed particle known as RTS,S.
• TRAP antigens are described in the International Patent Application No. PCT/GB89/00895, published under WO 90/01496.
• TRAP antigens are polypeptides, so called Thrombospondin Related Anonymous Proteins, which share homology with various P. falciparum proteins.
• mice Groups of 5 mice (six weeks old female mice, strain C57/BL6 x CBA/J [H-2k]) were immunised twice (in 2 ⁇ 50 ⁇ l volumes) in the hind foot-pad, 14 days apart, with either lO ⁇ g RTS,S or 4 ⁇ g TRAP combined with various oil in water emulsion systems (SB62). 14 days following the second immunisation the production of cytokines (IL5 and IFN- ⁇ ) and T-cell proliferation was analysed after in vitro restimulation of spleen and lymph nodes cells with the malaria antigens. Antibody response to RTS,S and TRAP and the isotypic profile that was induced was investigated by ELISA.
• SB62'-oil in water emulsion exemplified in the figures as SB62 l/5th dose SB62c or SB62'c - oil in water emulsion (either dose) plus cholesterol in the oil phase.
• VacNir. 3D7 a recombinant vaccinia virus construct expressing CS protein and administered at 10 PFU per mouse.
• Spleen or popliteal lymph node cells were aseptically removed and washed. 100 ⁇ l of cells in RPMI medium (1% heat-inactivated normal mouse serum, ⁇ MS) containing 2x10 /ml of cells were cultured in round bottomed plates in the presence of RTS,S or TRAP antigens. Following stimulation for 96 hours with 0.1, 0.5, and 2.5 ⁇ g of antigen, or 48 hours with 2 ⁇ g/ml ConA, the cells were labelled with ⁇ -Thymidine (l ⁇ Ci/well) for 16 hours before harvesting and counting in a ⁇ -counter.
• RPMI medium 1% heat-inactivated normal mouse serum, ⁇ MS
• Spleen or popliteal lymph node cells were aseptically removed and. 1000 ⁇ l of cells in RPMI medium (5% heat-inactivated fetal calf serum, FCS) containing 5 l0 6 /ml of cells were cultured in 24 well flat bottomed plates in the presence of RTS, S or TRAP antigens. The plates were then incubated (37°C, 5% CO 2 ) for a number of hours with 0.5, and 2.5 ⁇ g of antigen, or 4 ⁇ g/ml final of ConA.
• RPMI medium 5% heat-inactivated fetal calf serum, FCS
• FCS heat-inactivated fetal calf serum
• IL-2 was stimulated for 72 hours
• IL-5 was 72 or 96 hours
• IFN- ⁇ was 96 hours.
• Each cytokine was detected using commercially available ELISA kits (IL-2 and IFN- ⁇ , Duoset Genzyme No.80-3573-00 and 80-3931-00 respectively; IL-5 was detected using the Pharmingen kit).
• Antibodies directed against TRAP were analysed using a sandwich ELISA.
• a sheep anti- TRAP antiserum was coated onto ELISA plates which was used to capture TRAP antigen added at 0.5 ⁇ g/ml. Titrations of pooled serum from the experimental groups were added and incubated. Finally, biotinylated anti-mouse isotype-specific antibodies followed by streptavidin-peroxidase, were used to detect bound TRAP-specific antibodies.
• Anti HBV humoral responses were analysed by a direct ELISA, HBsAg was coated onto the ELISA plate at 1 ⁇ g/ml. Pooled serum from the different experimental groups were titrated and bound antibodies were detected as described above.
• All vaccine preparations were capable of stimulating splenic cells which proliferated in vitro in response to antigen.
• the preparations which elicited the highest responses in the spleen were the ones containing cholesterol and those having the low ratio squalene:QS21 ( 1 /5th dose SB62).
• Figure 1 shows the proliferative responses of popliteal lymph node cells (in raw counts per minute (CPM) form) derived from the experimental groups after stimulation with TRAP and RTS,S antigens.
• CPM raw counts per minute
• Figure 2 shows the proliferative responses of splenic cells (in raw counts per minute (CPM) form) derived from the experimental groups after stimulation with TRAP and RTS,S antigens.
• Figure 3 shows the proliferative responses of popliteal lymph node cells (Stimulation index) derived from the experimental groups after stimulation with TRAP and RTS,S antigens.
• FIG 4 shows the proliferative responses of splenic cells (Stimulation index) derived from the experimental groups after stimulation with TRAP and RTS,S antigens.
• FIGS 1 and 2 clearly show that all of the vaccine formulations stimulate lymphoid cells which are capable of proliferating in vitro in the presence of antigen in a dose dependent manner.
• the raw cpm data suggests that the inclusion of cholesterol in the adjuvant formulations has no effect on the magnitude of the proliferative responses (for example a comparison between groups 26 and 31, termed RTS,S/MPL/QS21/SB62 and RTS,S/MPL/QS21/SB62c respectively).
• Cytokine production measured in vitro in response to antigen, can be both a quantitative and qualitative measure of the induction of immune responses in vivo.
• high levels of IFN- ⁇ and IL-2 are taken to be a measure of Thl -type immune responses and IL-5 is considered to be a Th2-type cytokine.
• the following figures demonstrate evidence that the addition of cholesterol has no qualitative or quantitative effects on the cytokine profile produced in vitro in response to antigen.
• the use of SB62' containing a reduced ratio of squalene:QS21 (termed SB62 1/5 th dose) had a marked effect in enhancing the production of IFN- ⁇ (figure 6).
• Figure 5 shows the IL-2 production of spleen cells after stimulation with TRAP or RTS,S antigen 14 days after VII.
• Figure 6 shows the IFN- ⁇ production by spleen cells after stimulation with TRAP or RTS,S antigen 14 days after VII.
• Figure 7 shows the IL-5 production by spleen cells after stimulation with TRAP or RTS,S antigen 14 days after VII.
• IgG sub-isotype Another measure of immunity that can correlate to a Thl -type, or alternatively a Th2- type, immune response is the IgG sub-isotype which is elicited.
• a preferential stimulation of the IgGl sub-isotype is generally taken to be a measure of the induction of a Th2-type immune response, and conversely IgG2a and IgG2b is taken to be a measure of a Thl type immune response.
• TRAP-specific antibodies exhibited a Th2-type isotype pattern.
• the only exceptions to this observation were groups 2, who received TRAP alone, and group 9, who received TRAP/RTS,S in a SB62' formulation (containing a low ratio of squalene:QS21, termed SB621/5th dose).
• S,L* is a composite antigen comprising a modified surface antigen L protein (L*) and an S -protein both derived from the Hepatitis B virus (HB.
• L* modified surface antigen L protein
• HB Hepatitis B virus
• mice were immunised intramuscularly 4 times at 3 weeks interval with 2 ⁇ g lyophilised S,L* combined with various oil in water emulsion systems (SB62). 14 days following the fourth immunisation the production of cytokines (IL5 and IFN- ⁇ ) and CTL activity was analysed after in vitro restimulation of spleen and lymph nodes cells with S,L* antigen. Antibody response to S,L* and the isotypic profile induced were monitored by ELISA at 21 days post II and 14 days post IV.
• cytokines IL5 and IFN- ⁇
• CTL activity was analysed after in vitro restimulation of spleen and lymph nodes cells with S,L* antigen.
• Antibody response to S,L* and the isotypic profile induced were monitored by ELISA at 21 days post II and 14 days post IV.
• mice were immunised intramuscularly with formulations described below. SB62 was formulated together with the antigen at a normal (240:1, SB62) or low (48:1, SB62') ratio of squalene:QS21, optionally with the addition of cholesterol (c). Table 13, Groups of mice described in example 7:
• Animals were immunised intramuscularly in the leg (50 ⁇ l for all groups except for group 5 where 100 ⁇ l was injected) at days 0, 21, 42 and 63. Blood was taken from the retroorbital sinus at various time points post immunisations. On day 77, animals from each group were sacrificed, spleens and lymph nodes draining the site of injection (iliac lymph nodes) were taken out for in vitro restimulation. Pools of 3 or 4 spleens and 1 pool of 10 LN were obtained for each group and treated separately in the in vitro assays.
• Antigen and antibody solutions were used at 50 ⁇ l per well. Antigen was diluted at a final concentration of 1 ⁇ g/ml in PBS and was adsorbed overnight at 4°c to the wells of 96 wells microtiter plates (Maxisorb Immuno-plate, Nunc, Denmark). The plates were then incubated for lhr at 37°C with PBS containing 1% bovine serum albumin and 0.1 % Tween 20 (saturation buffer).
• mice were killed, spleen and lymph nodes were removed aseptically in pools (3 or 4 organs per pool for splenic cells, 1 pool of 10 organs for LNC).
• Cell suspensions were prepared in RPMI 1640 medium (GIBCO) containing 2 mM L-glutamine, antibiotics, 5x10 " M 2-mercaptoethanol, and 1% syngeneic normal mouse serum.
• Cells were cultured at a final concentration of 2x10 cells/ml (for LNC or SPC) in 200 ⁇ l in round-bottomed 96 well-plates with different concentrations (10-0.03 ⁇ g/ml) of S,L* antigen (25D84). Each test was carried out in quadriplicate.
• mice were killed, spleen and lymph nodes were removed aseptically in pools (3 or 4 organs per pool for splenic cells, 1 pool of 10 organs for LNC).
• Cell suspensions were prepared in RPMI 1640 medium (GIBCO) containing 2 mM L-glutamine, antibiotics, 5x10 "5 M 2-mercaptoethanol, and 5% foetal calf serum.
• Cells were cultured at a final concentration of 2.5 to 5x10 6 cells/ml (respectively for LNC or SPC) in 1ml, in flat-bottomed 24 well- with different concentrations (1-0.01 ⁇ g/ml) of S,L* (25D84).
• Supernatants were harvested 96 hrs later and frozen until tested for the presence of IFNg and IL-5 by Elisa.
• IFN ⁇ IFN ⁇ Quantitation of IFN ⁇ was performed by Elisa using reagents from Genzyme. Samples and antibody solutions were used at 50 ⁇ l per well. 96-well microtiter plates (Maxisorb Immuno-plate, Nunc, Denmark) were coated overnight at 4°c with 50 ⁇ l of hamster anti- mouse IFNg diluted at 1.5 ⁇ g/ml in carbonate buffer pH 9.5. Plates were then incubated for lhr at 37°c with 100 ⁇ l of PBS containing 1% bovine serum albumin and 0.1%>
• Tween 20 saturated buffer
• Tween 20 Tween 20 (saturation buffer).Two-fold dilutions of supernatant from in vitro stimulation (starting at 1/2) in saturation buffer were added to the anti-IFNg-coated plates and incubated for 1 hr 30 at 37°C. The plates were washed 4 times with PBS Tween 0.1 % (wash buffer) and biotin-conjugated goat anti-mouse IFNg diluted in saturation buffer at a final concentration of 0.5 ⁇ g/ml was added to each well and incubated for 1 hr at 37°c. After a washing step, AMDEX conjugate (Amersham) diluted 1/10000 in saturation buffer was added for 30 min at 37°C.
• IL5 Quantitation of IL5 was performed by Elisa using reagents from Pharmingen. Samples and antibody solutions were used at 50 ⁇ l per well. 96-well microtiter plates (Maxisorb Immuno-plate, Nunc, Denmark) were coated overnight at 4°C with 50 ⁇ l of rat anti- mouse IL5 diluted at 1 ⁇ g/ml in carbonate buffer pH 9.5.
• mice were killed, spleens were removed aseptically in pools of 3 or 4 mice (2 pools of 3 and one pool of 4 mice per group).
• Cell suspensions were prepared in RPMI 1640 medium (GIBCO) containing 2 mM L- glutamine, antibiotics, 5x10 "5 M 2-mercaptoethanol, and 5% foetal calf serum.
• Cells were cultured at a final concentration of 2 x 10 cells/ml in 10 ml medium containing 2 ⁇ g/ml S,L* and 1.25% ConA sup (25 cm 2 Falcon flasks) and incubated for 8 days at 37°C under 5% CO 2 .
• CTL assay The day before the CTL assay (d7), target cells were prepared by incubation of P815 cells (10 cells/ml) with S,L* or peptide S 28 . 39 at 10 ⁇ g/ml. Following lhr incubation in 15 ml Falcon tubes in a small volume, cells are transferred to 24 well plates and incubated ON at 37°C. The day of the assay, 2 x 10 6 S,L* and S 28 . 39 pulsed P815 cells and P815-S are centrifugated, resuspended in 50 ⁇ l FCS and incubated with 75 ⁇ l 51 Cr (375 ⁇ Ci) for lhr at 37°C (shaking every 15').
• Cells are then washed 4 times with 10 ml complete medium and incubated for 30' at 4°c following the 4th wash. Cells are then centrifugated and resuspended at a concentration of 2x10 4 cells / ml. Effector cells are then centrifugated, counted and resuspended at 2 x 10 cells / ml. Three fold serial dilutions of effector cells are done in 96 V-bottomed plates, starting at a concentration of 2 X 10 5 cells /well/1 OO ⁇ l.
• target cells in lOO ⁇ l are added to effector cells in triplicate. Spontaneous and maximum release are assessed by incubating target cells respectively with medium or Triton XI 00 3%.
• Humoral responses (Ig and isotypes) were measured by Elisa using HB surface antigen as coating antigen. Only the time point: 21 days post II was analysed. The results are shown in figure 8 and 9.
• FIG 8 Shows the titres of anti-Hepatitis B virus antibody responses (Ig) expressed as both individual mouse sera and average (21 days post II).
• FIG. 9 Shows the sub-isotype distribution of Hbs specific IgG in the serum the vaccinated mice.
• SB62 related formulations induce much higher antibody titers than the S,L* Alum formulation. • Analysis of mean titres from individual sera suggest that higher antibody titers are obtained with SB62c and SB62'c formulations ( roughly 2 fold higher antibody titers than SB62 and SB62' respectively).
• Cytokine production (IFN- ⁇ and IL-5) has been measured following 96 h of in vitro restimulation of splenic cells and iliac lymph node cells with S,L*. The results are shown in figures 10 to 13.
• Figure 10 Shows the results of analysis of IFN- ⁇ production by splenic cells (mean of data obtained with three pools / group).
• Figure 11 Shows the results of analysis of IL-5 production by splenic cells (mean of data obtained with three pools / group).
• Figure 12 Shows the results of analysis of IFN- ⁇ production by Iliac lymph node cells (mean of data obtained with three pools / group).
• Figure 13 Shows the results of analysis of IL-5 production by Iliac lymph node cells (mean of data obtained with three pools / group).
• Figure 14 Shows the CTL activity of splenic T-cells stimulated in vitro for 7 days with S,L* antigen (mean %> specific lysis of three pools).
• the THl type profile of the immune response induced by all SB62 related formulations is further confirmed by the IFN- ⁇ / IL-5 ratio.
• Table 15 Summary table of the immune parameters induced by the vaccine formulation described in example 7.
• the antigen used in this study is a fusion protein comprising the L2 and E7 proteins from Human Papilloma virus.
• L2E7 fusion proteins are disclosed in GB 95/15478.7.
• CPK creatin phosphate kinase
• PMN polymorphonuclear neutrophils
• SB62 formulations with or without antigen induce a significant increase in CPK on day 1.
• SB62c formulations with or without antigen do not induce significant CPK release on day 1.
• QS21-H is hydrolysis product of QS21. that is no longer active as adjuvant. It is formed by cleavage of the QS21 molecule by OH " from the aqueous solution. This reaction occurs where the pH of the aqueous medium is above a value of 6.5, and is accelerated by higher temperature.
• the oil-in-water emulsions described in this patent application (for example SB62) are known to exhibit a stabilising effect such that the hydrolysis of QS21 into QS21-H is inhibited. Upon dilution of the oil in water emulsion in the presence of constant QS21, they lose this stabilising property and the QS21 degenerates into the inactive QS21-H form.
• emulsions containing additional Cholesterol who at 1/1 ratio do not show an improved QS21 stability, maintain the stabilising effect even at a 1/5 dilution.
• QS21 and QS21-H are assayed directly into the emulsion. This is achieved by chemically derivatising the complete formulation, and by performing a selective extraction step that dissolves the QS21, but leaves most interfering matrix compounds behind.
• the assay is HPLC based, and the compounds are dansylated.
• the dansylation is performed by drying down a sample of the emulsion, and adding 100 ⁇ l of 3.5 mg dansyl hydrazine/ml C/M 2/1 and 100 ⁇ l of 1 :4 Acetic acid : C/M 2/1 in that order. The mixture is well vortexed and incubated at 60°C for 2 hours. The reaction mixture is dried in the Speedvac.
• the HPLC assay is ran on a Vydac 218TP54 5 ⁇ particle size C18 RP column, 250*4.6 mm.
• Solvents are A:H20 + 0,05% TFA(trifluoracetic acid) and B:Acetonitrile + 0,05% TFA.
• the gradient table is:
• the Flow rate is lml/min. Detection is in fluorescence, with excitation at 345 nm and emission at 515 nm. 50 ⁇ l is injected of both the sample and the standards.
• the column heater is set to 37°C for this separation. Peaks for QS21, QS21-iso and QS21-H are distinguished on the chromatogram.
• the present invention encompasses an oil in water emulsion which preferentially induces a strong Thl-type immune responses.
• Embodiments of the present invention include composition comprising an oil in water emulsion, a saponin and a sterol, characterised in that a reduced reatogenicity profile is induced upon administration to a host in comparison to the reactogenicity profile observed after administration of the same composition from which the sterol has been omitted.
• the addition of cholesterol does not adversly affect quantitatively or qualitatively the immune responses thus induced.

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• 1997
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