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• • 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
• • 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
  • A61K39/002—Protozoa antigens
  • A61K39/015—Hemosporidia antigens, e.g. Plasmodium antigens
• • 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
• • 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
  • A61K2039/51—Medicinal preparations containing antigens or antibodies comprising whole cells, viruses or DNA/RNA
  • A61K2039/525—Virus
• • 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
  • A61K2039/51—Medicinal preparations containing antigens or antibodies comprising whole cells, viruses or DNA/RNA
  • A61K2039/525—Virus
  • A61K2039/5256—Virus expressing foreign 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
  • A61K2039/51—Medicinal preparations containing antigens or antibodies comprising whole cells, viruses or DNA/RNA
  • A61K2039/525—Virus
  • A61K2039/5258—Virus-like particles
• • 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
  • A61K2039/51—Medicinal preparations containing antigens or antibodies comprising whole cells, viruses or DNA/RNA
  • A61K2039/53—DNA (RNA) vaccination

Definitions

• the present invention relates to generation of a CD8+ T cell immune response against an antigen. More particularly, the present invention relates to "prime and boost" immunisation regimes in which the immune response induced by administration of a priming composition is boosted by administration of a boosting composition.
• the present invention is based on the inventors' experimental demonstration that effective boosting can be achieved using replication-defective adenovirus vectors, following priming with any of a variety of different types of priming compositions.
• T lymphocytes of the CD8+ type also known as cytotoxic T lymphocytes (CTL) .
• CTL cytotoxic T lymphocytes
• An important function of CD8+ cells is secretion of gamma interferon (IFN ⁇ ) , and this provides a measure of CD8+ T cell immune response.
• IFN ⁇ gamma interferon
• CD8+ T cell response is important in protection against a number of parasites, including protozoan parasites such as Toxoplasma and Trypanosoma , Plasmodi um falciparum (and in mice P. berghe ⁇ ) , viruses such as HIV, herpes simplex, herpes zoster, HBV, HCV influenza, EBV, measles, dengue and HTLV-1, bacteria such as Mycobacteri um tuberculosis and Listeria sp, and various cancers, such as melanoma and renal carcinoma.
• protozoan parasites such as Toxoplasma and Trypanosoma
• Plasmodi um falciparum and in mice P. berghe ⁇
• viruses such as HIV, herpes simplex, herpes zoster, HBV, HCV influenza, EBV, measles, dengue and HTLV-1
• bacteria such as Mycobacteri um tuberculosis and Listeria sp
• an immunogenic composition In order to protect against the pre-erythrocytic stage of Plasmodi um falciparum malaria, an immunogenic composition must induce a strong CD8+ T cell response.
• live attenuated vaccines capable of producing a short-lived infection that is harmless in a healthy individual are effective at inducing T cell responses.
• Irradiated Plasmodi um sporozoites which can infect hepatocytes but do not progress to a blood-stage infection have been shown to protect both mice and men against malaria by inducing T cell responses against pre-erythrocytic antigens [Nardin and Nussenzweig (1993) Annu . Rev. Immunol. 11: 687-727].
• berghei CS gene had only a weak CD8+ T cell response to the protective CD8+ T cell epitope pb9 [Romero et al . , (1989) Nature 341(6240): 323-6] and were not protected against challenge with infectious sporozoites even after repeated immunisations [Schneider et al . , (1998) Nat. Med. 4(4): 397-402].
• Ty virus-like particles consisting of a recombinant protein assembled into a 30nm particle, induce stronger CD8+ T cell responses, but do not protect against infection [Gilbert et al . , (1997) Nat. Biotechnol. 15(12): 1280-4] .
• Recombinant viruses can also be used as vaccines.
• Modified Vaccinia virus Ankara (MVA) does not replicate in human cells and is a very safe virus to use as a vaccine [Mayr et al . ,
• the present invention employs replication-deficient adenovirus which, as the experiments described below show, has been found to be an effective means for providing a boost to a CD8+ T cell immune response primed to antigen using any of a variety of different priming compositions.
• Adenoviruses are non-enveloped viruses containing a linear double stranded DNA genome of around 3600 bp .
• Recombinant viruses can be constructed by in vi tro recombination between an adenovirus genome plasmid and a shuttle vector containing the gene of interest together with a strong eukaryotic promoter, in a permissive cell line which allows viral replication. High viral titres can be obtained from the permissive cell line, but the resulting viruses, although capable of infecting a wide range of cell types, do not replicate in any cells other than the permissive line, and are therefore a safe antigen delivery system.
• Recombinant adenoviruses have been shown to elicit protective immune responses against a number of antigens including tick-borne encephalitis virus NS1 protein [Jacobs et al . , (1992) J. Virol.
• the experimental work described below demonstrates that use of embodiments of the present invention allows for recombinant replication-defective adenovirus expressing an antigen (specifically exemplified with the CS gene from Plasmodi um berghei ) to boost a CD8+ T cell immune response primed by a DNA vaccine, Ty-VLPs or recombinant modified Vaccinia virus Ankara (MVA) .
• the replication-defective adenovirus was found to induce a CD8+ T cell response after intradermal or intramuscular immunisation.
• prime/boost vaccination regimes the replication-defective adenovirus was also able to prime a response that could be boosted by MVA.
• mice immunised with the replication-defective adenovirus and boosted with the MVA were completely protected against P. berghei sporozoite challenge.
• Both recombinant replication- deficient adenovirus and recombinant MVA are vaccines that are safe for use in humans.
• the inventors found that a vaccination regime used intradermal immunisation for both prime and boost can be employed, constituting a general immunisation regime suitable for inducing CD8+ T cells, e.g. in humans .
• the present invention in various aspects and embodiments employs a replication-deficient adenovirus vector encoding an antigen for boosting a CD8+ T cell immune response to the antigen primed by previous administration of the antigen or nucleic acid encoding the antigen.
• a general aspect of the present invention provides for the use of a replication-deficient adenoviral vector for boosting a CD8+ T cell immune response to an antigen.
• One aspect of the present invention provides a method of boosting a CD8+ T cell immune response to an antigen in an individual, the me ' thod including provision in the individual of a replication-deficient adenoviral vector including nucleic acid encoding the antigen operably linked to regulatory sequences for production of antigen in the individual by expression from the nucleic acid, whereby a CD8+ T cell immune response to the antigen previously primed in the individual is boosted.
• An immune response to an antigen may be primed by immunisation, by infection with an infectious agent, or by development of a tumour or malignancy.
• a further aspect of the invention provides a method of inducing a CD8+ T cell immune response to an antigen in an individual, the method comprising administering to the individual a priming composition comprising the antigen or nucleic acid encoding the antigen and then administering a boosting composition which comprises a replication-deficient adenoviral vector including nucleic acid encoding the antigen operably linked to regulatory sequences for production of antigen in the individual by expression from the nucleic acid.
• a further aspect provides for use of a replication-deficient adenoviral vector, as disclosed, in the manufacture of a medicament for administration to a mammal to boost a CD8+ T cell immune response to an antigen.
• a medicament for administration to a mammal to boost a CD8+ T cell immune response to an antigen.
• Such a medicament is generally for administration following prior administration of a priming composition comprising the antigen.
• the priming composition may comprise any viral vector, although generally other than adenoviral, such as a vaccinia virus vector such as a replication-deficient strain such as modified virus ankara (MVA) (Mayr et al . , (1978) Primabl . Bakteriol. 167(5-6): 375-90; Sutter and Moss (1992) Proc. Natl. Acad. Sci. 89(22): 10847-51; Sutter et al . , (1994) Vaccine 12(11): 1032- 40) or NYVAC (Tartaglia et al .
• a viral vector although generally other than adenoviral, such as a vaccinia virus vector such as a replication-deficient strain such as modified virus ankara (MVA) (Mayr et al . , (1978) Monobl . Bakteriol. 167(5-6): 375-90; Sutter and Moss (1992) Proc. Natl
• the priming composition may comprise a recombinant bacterial vector, such as recombinant BCG or Salmonella .
• a priming composition comprising a recombinant fowlpox virus is among preferred embodiments for use in the present invention.
• the priming composition may comprise DNA encoding the antigen, such DNA preferably being in the form of a circular plasmid that is not capable of replicating in mammalian cells Any selectable marker should not be resistance to an antibiotic used clinically, so for example Kanamycin resistance is preferred to Ampicillin resistance.
• Antigen expression should be driven by a promoter which is active in mammalian cells, for instance the cytomegalovirus immediate early (CMV IE) promoter.
• CMV IE cytomegalovirus immediate early
• the priming composition may be a recombinant Ty-VLP.
• Ty-VLP protein particles consisting of a single protein species from the Tyl retrotransposon of S . cerevisiae which spontaneously assembles into particles.
• Recombinant Ty-VLP' s may be produced by fusing the coding sequence of the required epitope or antigen to the 3 ' end of the coding sequence for the TyA protein, and transforming S . cerevisiae with a vector including the coding sequence for expression of the fusion protein which then assembles into particles in the yeast cytoplasm from where they may be purified.
• the particulate nature of the Ty-VLP' s allows them to be taken up by antigen presenting cells and prime a CD8+ T cell response to epitopes contained within them.
• Suitable priming compositions include lipid-tailed peptides, fusion proteins, adjuvant compositions and so on.
• a priming composition is followed by boosting with first and second boosting compositions, the first and second boosting compositions being different from one another, e.g. as exemplified below.
• Still further boosting compositions may be employed without departing from the present invention.
• a triple immunisation regime employs DNA, then adenovirus as a first boosting composition, and then MVA as a second boosting composition, optionally followed by a further (third) boosting composition or subsequent boosting administration of one or other or both of the same or different vectors.
• DNA then MVA then Ad, optionally followed by subsequent boosting administration of one or other or both of the same or different vectors .
• the antigen to be included in respective priming and boosting compositions need not be identical, but should share at least one CD8+ T cell epitope.
• the antigen may correspond to a complete antigen in a target pathogen or cell , or a fragment thereof.
• Peptide epitopes or artificial strings of epitopes may be employed, more efficiently cutting out unnecessary protein sequence in the antigen and encoding sequence in the vector or vectors.
• One or more additional epitopes may be included, for instance epitopes which are recognised by T helper cells, especially epitopes recognised in indivuals of different HLA types (such as tetanus epitopes) .
• promoter is meant a sequence of nucleotides from which transcription may be initiated of DNA operably linked downstream (i.e. in the 3' direction on the sense strand of double-stranded DNA) .
• operably linke'd means joined as part of the same nucleic acid molecule, suitably positioned and oriented for transcription to be initiated from the promoter.
• DNA operably linked to a promoter is "under transcriptional initiation regulation" of the promoter.
• Terminator fragments including terminator fragments, polyadenylation sequences, enhancer sequences, marker genes and other sequences may be included as appropriate, in accordance with the knowledge and practice of the ordinary person skilled in the art: see, for example, Molecular Cloning: a Laboratory Manual: 2nd edition, Sambrook et al., 1989, Cold Spring Harbor Laboratory Press. Many known techniques and protocols for manipulation of nucleic acid, for example in preparation of nucleic acid constructs, mutagenesis, sequencing, introduction of DNA into cells and gene expression, and analysis of proteins, are described in detail in Current Protocols in Molecular Biology, Ausubel et al . eds . , John Wiley & Sons, 1994.
• Suitable promoters for use in aspects and embodiments of the present invention include the cytomegalovirus immediate early (CMV IE) promoter, with or without intron A, and any other promoter that is active in mammalian cells.
• CMV IE cytomegalovirus immediate early
• Either or both of the priming and boosting compositions may include an adjuvant, such as granulocyte macrophage-colony stimulating factor (GM-CSF) or encoding nucleic acid therefor.
• an adjuvant such as granulocyte macrophage-colony stimulating factor (GM-CSF) or encoding nucleic acid therefor.
• GM-CSF granulocyte macrophage-colony stimulating factor
• Administration of the boosting composition is generally about 10 days to 4 weeks after administration of the priming composition, preferably about 2-3 weeks.
• administration of priming composition, boosting composition, or both priming and boosting compositions is intradermal or intramuscular immunisation
• Intradermal administration of adenovirus and MVA vaccines may be achieved by using a needle to inject a suspension of the virus.
• An alternative is the use of a needleless injection device to administer a virus suspension (using e.g. BiojectorTM) or a freeze-dried powder containing the vaccine (e.g. in accordance with techniques and products of Powderject), providing for manufacturing individually prepared doses that do not need cold storage. This would be a great advantage for a vaccine that is needed in rural areas of Africa.
• Adenovirus and MVA are both viruses with an excellent safety record in human immunisations.
• the generation of recombinant viruses can be accomplished simply, and they can be manufactured reproducibly in large quantities.
• Intradermal administration of recombinant replication-deficient adenovirus followed by recombinant MVA is therefore highly suitable for prophylactic or therapeutic vaccination of humans against diseases which can be controlled by a CD8+ T cell response.
• the individual may have a disease or disorder such that delivery of the antigen and generation of a CD8+ T cell immune response to the antigen is of benefit or has a therapeutically beneficial effect.
• administration will have prophylactic aim to generate an immune response against a pathogen or disease before infection or development of symptoms.
• CD8+ T cell immune response may play a protective or therapeutic role.
• compositions may comprise a pharmaceutically acceptable excipient, carrier, buffer, stabiliser or other materials well known to those skilled in the art. Such materials should be non-toxic and should not interfere with the efficacy of the active ingredient.
• the precise nature of the carrier or other material may depend on the route of administration, e.g. intravenous, cutaneous or subcutaneous, nasal, intramuscular, intraperitoneal routes.
• administration is preferably intradermal, subcutaneous or intramuscular.
• Liquid pharmaceutical compositions generally include a liquid carrier such as water, petroleum, animal or vegetable oils, mineral oil or synthetic oil.
• a liquid carrier such as water, petroleum, animal or vegetable oils, mineral oil or synthetic oil.
• Physiological saline solution, dextrose or other saccharide solution or glycols such as ethylene glycol, propylene glycol or polyethylene glycol may be included.
• the active ingredient will be in the form of a parenterally acceptable aqueous solution which is pyrogen-free and has suitable pH, isotonicity and stability.
• a parenterally acceptable aqueous solution which is pyrogen-free and has suitable pH, isotonicity and stability.
• isotonic vehicles such as Sodium Chloride Injection, Ringer's Injection, Lactated Ringer's Injection.
• Preservatives, stabilisers, buffers, antioxidants and/or other additives may be included, as required.
• a slow-release formulation may be employed.
• the particles may be administered to an individual, particularly human or other primate.
• Administration may be to another mammal, e.g. rodent such as mouse, rat or hamster, guinea pig, rabbit, sheep, goat, pig, horse, cow, donkey, dog or cat.
• rodent such as mouse, rat or hamster, guinea pig, rabbit, sheep, goat, pig, horse, cow, donkey, dog or cat.
• Administration is preferably in a "prophylactically effective amount” or a " therapeutically effective amount” (as the case may be, although prophylaxis may be considered therapy) , this being sufficient to show benefit to the individual.
• the actual amount administered, and rate and time-course of administration will depend on the nature and severity of what is being treated. Prescription of treatment, e.g.
• DNA is administered (preferably intramuscularly) at a dose of 0.5 mg/injection, follwed by adenovirus (preferably intramuscularly or intradermally) at a dose of 5 x 10 7 - 5 x 10 8 virus particles/injection.
• a composition may be administered alone or in combination with other treatments, either simultaneously or sequentially dependent upon the condition to be treated. Delivery to a non-human mammal need not be for a therapeutic purpose, but may be for use in an experimental context, for instance in investigation of mechanisms of immune responses to an antigen of interest, e.g. protection against cancers, malaria, other pathogens and so on.
• Figure 1 shows results of experiments demonstrating peptide-specific IFN- ⁇ secreting T cells primed by a single
• Figure 2 shows results of prime/boost immunisations.
• DNA was injected i.m., adenovirus and MVA i.d.
• Elispots were performed on splenocytes isolated on day 28.
• the graph shows SFC per million splenocytes for each prime/bosst immunisation regime.
• adenovirus priming followed by MVA boosting resulted in complete protection.
• adenovirus was able to boost substantially a response primed by DNA, Ty-VLPs or MVA.
• This vector can be used to construct Adenovirus 5 recombinants with deletions in El. Thje recombinant shuttle vector was used to transfect the permissive cell line 293 along with the adenovirus genome plasmid pJM17 [Graham and Prevec (1995) Mol . Biotechnol. 3(3): 207-20].
• Virus from transfected cells was clonally purified by three successive limiting dilutions in 293 cells, and expression of P. berghei CS in cells infected with the isolated virus was confirmed by immunofluoresence . Large quantities of virus were prepared from infected 293 cells and purified by extraction with Arklone [Graham and Prevec (1995) Mol . Biotechnol. 3(3): 207-20] prior to immunisation.
• P. berghei challenge Sporozoites of P. berghei were obtained from laboratory reared female Anopheles s tephensi mosquitoes maintained at 18 °C for 20-25 days after feeding on infected mice. Salivary glands from the mosquitoes were collected by dissection and placed in a tissue homogeniser with RPMI 1640 (Sigma) to release the sporozoites, which were then counted using a haemocytometer . Mice were challenged by injection of 2000 sporozoites into the tail vein. Infection was determined by the presence of ring forms in Giemsa stained blood smears taken 7 and 9 days post challenge. If blood-stage parasitaemia was observed at two time points the mice were sacrificed.
• gene paint groups - simple administration of recombinant adenovirus onto the skin (known as gene painting) , previously shown to be able to induce an immune response against the antigen expressed by the virus [Tang et al., (1997) Nature 388(6644): 729-30].
• mice received a single immunisation of 10 7 pfu Ad-
• mice DNA/Ad/MVA and DNA/MVA/Ad.
• Groups of mice were immunised at 10 day intervals and splenocytes were tested 10 days after the final immunisation.
• IFN- ⁇ secreting T cells were detected after DNA/MVA, Ad/MVA,

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