WO2015010450A1 - 一种病毒免疫治疗药物复合物及其用途 - Google Patents
一种病毒免疫治疗药物复合物及其用途 Download PDFInfo
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Definitions
- hepatitis B eg liver cirrhosis, liver cancer, etc.
- the population infection rate is 60%
- the population carrying rate is 10%.
- HBsAg hepatitis B surface antigen
- GM-CSF is mainly produced by activated T cells, B cells, monocyte macrophages, mast cells, endothelial cells and fibroblasts. It not only promotes the proliferation, differentiation and maturation of hematopoietic precursor cells, but also for other cells, For example, antigen-presenting cells (APC), fibroblasts, keratinocytes, and skin mucosal cells have different degrees of stimulation.
- APC antigen-presenting cells
- fibroblasts fibroblasts
- keratinocytes keratinocytes
- skin mucosal cells have different degrees of stimulation.
- Dranoff et al. first used GM-CSF as an immunological adjuvant to enhance the immune response of anti-tumor vaccines.
- the immunopotentiating effect of GM-CSF may be related to its ability to enhance the antigen presentation of APC cells.
- the drug complex of the present invention can provide a new immunotherapeutic drug for the treatment of hepatitis B.
- the antiviral drug is selected from the group consisting of interferon or nucleic acid drugs, for example: common IFN- ⁇ 3 ⁇ 5 MU, polyethylene glycol IFN- ⁇ 2a, polyethylene glycol IFN- ⁇ 2b, and Lamy Lamivudine (LAM), adefovir dipivoxi l (ADV), entecavir (ETV), telbivudine (LdT), tenofovir di soproxi l fumarate , TDF);
- interferon or nucleic acid drugs for example: common IFN- ⁇ 3 ⁇ 5 MU, polyethylene glycol IFN- ⁇ 2a, polyethylene glycol IFN- ⁇ 2b, and Lamy Lamivudine (LAM), adefovir dipivoxi l (ADV), entecavir (ETV), telbivudine (LdT), tenofovir di soproxi l fumarate , TDF);
- the macrophage colony stimulating factor gene is expressed in the yeast system, and the protein is extracted and purified, and the immunomodulatory drug is made into rhGM-CSF (recombinant human granulocyte macrophage colony stimulating factor) by genetic engineering technology.
- the human hepatitis B antigen gene is expressed in a yeast system, extracted and purified, and then combined with an adjuvant to prepare a recombinant hepatitis B surface antigen vaccine.
- the amount of the antiviral drug is determined by the clinical routine dosage (refer to "Guidelines for Prevention and Treatment of Chronic Hepatitis B”); genetically engineered hepatitis B vaccine and recombinant human granulocyte macrophage colony stimulating factor
- the mass ratio is 1: 1 ⁇ 30.
- the amount and usage of antiviral drugs are referred to the "Guidelines for the Prevention and Treatment of Chronic Hepatitis B", for example,
- Polyethylene glycol IFN- ⁇ 2b 1. (Tl. 5 ⁇ g/kg, once a week, subcutaneously, for 1 year.
- TDF Tenofovir di soproxi l fumarate
- the present invention discloses:
- Antiviral drugs interferon, nucleic acid drugs, etc.
- immunomodulatory drugs recombinant human granulocyte macrophage colony stimulating factor
- recombinant hepatitis B vaccine for the preparation of drugs for treating hepatitis B; especially in the preparation of treatment for chronic B Use in hepatitis drugs;
- the antiviral drug is administered prior to administration of the genetically engineered hepatitis B vaccine
- the recombinant human granulocyte macrophage colony stimulating factor is administered prior to administration of the genetically engineered hepatitis B vaccine;
- the antiviral dosage refers to the "Guidelines for the Prevention and Treatment of Chronic Hepatitis B"; the mass ratio of genetically engineered hepatitis B vaccine to recombinant human granulocyte macrophage colony stimulating factor is 1: 1 ⁇ 30.
- the drug complex of the present invention is subjected to an anti-viral immunization experiment, and the results show that it is used for treating hepatitis B persistent viral infection, wherein ⁇ -IFN and nucleoside (acid) drugs reduce viral load in the body; GM-CSF, etc.
- the hepatitis B vaccine with an immunopotentiating cytokine as an adjuvant enables the body to establish an effective immune memory protection response, which can produce strong antibody protection and cellular immunity, eliminate viruses and prevent infection.
- an immunopotentiating cytokine as an adjuvant
- a large number of experiments have been carried out using different combinations of recombinant human granulocyte macrophage colony stimulating factor and genetically engineered hepatitis B vaccine, and the results show that in situ injection 3 days before the injection of hepatitis B vaccine.
- genetic engineering hepatitis B vaccine immunization can effectively promote the maturation of dendritic cells and significantly enhance the cellular immunity of animals. Increase antibody levels, promote TH1 type cytokines, store IgG2a antibody production, enhance T cell proliferation and cytotoxic T cell (CTL) function.
- CTL cytotoxic T cell
- recombinant human granulocyte macrophage colony stimulating factor (2 ⁇ 30ug/day/day) is injected in situ 3 days before the injection of hepatitis B vaccine in an animal model of chronic hepatitis B metastasis gene.
- genetic engineering hepatitis B vaccine immunization lug/only
- an antiviral drug (recombinant human interferon) is used in combination with recombinant human granulocyte macrophage colony stimulating factor and recombinant hepatitis B vaccine before hepatitis B vaccine injection (4 ⁇ 0 days) Injection of antiviral drugs, injecting recombinant human granulocyte macrophage colony stimulating factor (2 ⁇ 30ug/day/day) in situ 3 days before hepatitis B vaccine, and then genetically engineered hepatitis B vaccine (lug/only) It can also induce a higher cellular immune response and promote the proliferation of T cells.
- the present invention also provides a vaccine complex for treating hepatitis B and AIDS in a patient who has been infected with hepatitis B and HIV, the vaccine complex comprising an antiviral drug, an immunomodulator and a hepatitis B vaccine.
- Figure 1 shows the total IgG of recombinant human granulocyte macrophage stimulating factor combined with hepatitis B vaccine, and the detection of recombinant human granulocyte macrophage colony stimulating factor by quantitative ELISA, A.
- the proportion of IgG subtype immunized with hepatitis B vaccine, B shows the detection result of T lymphocyte expansion of recombinant human granulocyte macrophage colony stimulating factor combined with hepatitis B vaccine immune-enhanced immune reaction in Example 1, C, showing Example 1
- the in vivo CTL response of recombinant human granulocyte macrophage colony stimulating factor combined with hepatitis B vaccine immunoenhanced immune response was detected by flow cytometry.
- FIG. 1 Flow cytometry in Example 1 for detection of recombinant human granulocyte macrophage colony stimulating factor combined with hepatitis B vaccine immunization to enhance hepatitis B vaccine immune response in IFN- ⁇ , IL-4 in CD4 T cells, and IFN- ⁇ The results were expressed in CD8 T cells.
- Figure 4 showing the flow cytometry in Example 2 for detection of recombinant human granulocyte macrophage colony stimulating factor combined with hepatitis B vaccine immunization to break the hepatitis B surface antigen transgenic mice after immune tolerance IL-10, IFN- y in CD4 and Expression in CD8 T cells; B, showing the results of the detection of DTH in hepatitis B vaccine immune response after total recombinant human granulocyte macrophage colony stimulating factor combined with hepatitis B vaccine immunization in hepatitis B surface antigen transgenic mice in Example 2.
- FIG. 5 Flow cytometry analysis of recombinant human granulocyte macrophage colony stimulating factor combined with hepatitis B vaccine immunization in Example 2 to break the hepatitis B surface of liver surface of hepatitis B antigen transgenic mice after breaking the immune tolerance of hepatitis B surface antigen transgenic mice The histochemical staining of the antigen and the mean optical density of hepatocytes expressing hepatitis B antigen in the liver of the transgenic mice after treatment.
- Figure 6 showing the ELISA method for detecting the antiviral drug IFN-a2a in Example 3, recombinant human granulocyte macrophage colony stimulating factor combined with hepatitis B vaccine immunization enhanced hepatitis B vaccine immune response detection of recombinant human granulocyte macrophage colonies The total IgG of the stimulating factor combined with hepatitis B vaccine; B, showing the antiviral drug IFN_a2a in Example 3, recombinant human granulocyte macrophage colony stimulating factor combined with hepatitis B vaccine immunization The detection result of T lymphocyte expansion of strong immune reaction; showing the antiviral drug IFN_a2a detected by flow cytometry in Example 3, recombinant human granulocyte macrophage colony stimulating factor combined with hepatitis B vaccine to enhance the immune response of hepatitis B vaccine - Y, IL-17 expression in CD4 T cells.
- Figure 7 is a graph showing the decrease in HBsAg levels in Example 5, wherein the ordinate is HBsAg level, IU/ml; the abscissa is at each time point, May 2012-March 2013.
- the experimental data in the examples of the present invention are the average values obtained for each mouse in each group unless otherwise specified.
- Example 1 Immunization strategy of GM-CSF combined with recombinant hepatitis B vaccine Enhanced immune response of C57BL/6 to recombinant hepatitis B subunit vaccine
- HBsAg stock solution was provided by Huatan Pharmaceutical Group Jintan Biotechnology Co., Ltd.
- Glass wool column A glass wool column for separating T lymphocytes is prepared by placing glass wool in a disposable lmL syringe.
- MTT After the purchased MTT powder was dissolved in PBS (concentration: 5 mg/mL or 0.5% MTT), it was filtered and sterilized at -20 °C in the dark.
- ConA ConA powder was dissolved in serum-free RPMI 1640 medium at a concentration of 60 g/mL.
- Fluorescently labeled monoclonal antibodies Commonly used monoclonal antibodies with FITC, PE, APC labeling, purchased from BD, eBioscience, BioLegend; Blocking antibodies: Anti-Fc receptor antibodies. Immunocytes are generally expressed with Fc receptors, antibodies and antibodies.
- the Fc segment binds.
- the role of blocking antibody is to block the non-specific results of the binding of the Fc segment of the fluorescently labeled monoclonal antibody to the Fc receptor on the surface of the immune cell; Fixative: 4% paraformaldehyde in PBS solution; Breaking agent: 1 % Saponin; Hepatitis B surface antigen CD8 in vitro CTL stimulator polypeptide was synthesized by Shanghai Jill Biochemical Company. Hepatitis B surface antibody diagnostic kit and hepatitis B surface antibody standard were purchased from Beijing Jinhao Pharmaceutical Co., Ltd. Centrifuge: eppendorf product; flow cytometer: FACScal ibur, manufactured by BD Bioscience, USA.
- mice and immunization C57BL/6 mice, SPF grade, 6-8 weeks old female, weighing 16-18 g, purchased from Institute of Laboratory Animals, Chinese Academy of Medical Sciences. Divided into 4 groups of 6 mice per group, The experimental groups are shown in the table below. Each group of vaccine or GM-CSF was dissolved in physiological saline, and each mouse was injected with 100 ⁇ l, and each mouse was immunized subcutaneously in the neck, and boosted once every 14 days after the first immunization.
- HBV+GM-CSF 1 g HBV vaccine 1 g GM-CSF
- Mouse serum collection Sterilized capillary glass needle, collect the mouse fundus arterial blood sample about 200-300 ⁇ into a sterile microcentrifuge tube, let stand at room temperature for 30min, set at 4 °C for 2h, 5000rpm, After centrifugation for 10 min, the supernatant was collected and stored at -20 ° C until use.
- antigen coating 96-well microtiter plate coated with lug/ml antigen, 100 ⁇ l/well, overnight at 4 °C;
- PBST was washed 3 times, each time 5 min, the mouse serum was diluted 2 times, the unimmunized mouse serum was used as a control, ⁇ ⁇ / well, incubated at 37 ° C for 1 h;
- Termination Stop the color development by adding 0.2M sulfuric acid, 50 ⁇ 1 / hole;
- Reading Optical density value at 0D 450nm/620 nm. The 0D value of the experimental well was considered to be positive when it was twice the control well.
- Antigen coating A 96-well microtiter plate was coated with 2 ⁇ g/ml rabbit IgG and lug/ml VP1 antigen, 100 ⁇ l/well, overnight at 4 °C;
- Termination Stop the color development by adding 0.2M sulfuric acid, ⁇ ⁇ /well.
- mice were sacrificed by dislocation and soaked in 70% ethanol for 15 minutes.
- the antigen is filtered and sterilized. After dilution for a certain number of times, 20 ul of stimulating substance is added per well (the final concentration of stimulating substance is ConA 10 ug/ml, 5 ug/ml, BSA/0VA 2 ug/ml, and the antigen stimulant can be pressed. Dilute the samples at different concentrations. ), and set up control wells with only cells without sputum, and media holes with only medium.
- T cells were isolated from mice and diluted to 10 ⁇ 107/mL in 10% medium. Cells.
- Na'ive mice were taken, and spleen lymphocytes were isolated after breaking red blood cells.
- Target cells that were not incubated with small peptides were stained with low concentrations of CFSE (0.5 uM), and small peptide target cells were stained with high concentrations of CFSE (5 uM) and stained with 37 C for 15 minutes in the dark.
- mice Four hours after the injection, the experimental mice were sacrificed, and spleen cells were obtained in the dark.
- GM-CSF was injected in advance or simultaneously with HBV vaccine.
- serum anti-HBsAg total IgG antibody was detected, and only HBV was injected.
- the total IgG level of the group injected with GM-CSF was significantly enhanced (Fig. 1-A);
- the IgG2a level was significantly increased (p ⁇ 0.05); conversely, if GM-CSF was injected simultaneously with HBV, the IgG1 level was significantly increased (Fig. 2-1B); - Pretreatment of CSF can enhance the Th1 response, while simultaneous injection of GM-CSF with the vaccine enhances the Th2 response.
- GM-CSF affects the T cell response
- the mouse spleen cells were taken aseptically, the rHBsAg antigen was used to stimulate T cell proliferation, BSA was used as a non-specific antigen control, and ConA was used as a positive control.
- the results showed that the proliferative response was significantly increased in the pre-injected GM-CSF group, while the proliferative response level was low in the group injected simultaneously with GM-CSF and HBV (Fig. 1-B), indicating GM-CSF.
- Pretreatment can promote antigen-specific T cell responses.
- the CTL response was detected by flow cytometry 7 days after the second immunization.
- the GM-CSF pretreatment group was specific to the target cells.
- the killing rate was 30. 01%, which was significantly higher than the killing rate of 10.26%, and the killing rate of HBV and GM-CSF was 13.6%.
- the result was GM-CSF.
- the pretreatment group was able to enhance the level of CTL response in vivo, while there was no significant change in the HBV and GM-CSF simultaneous injection groups.
- Cytokines can regulate cell differentiation, proliferation and induce cells to play their respective functions, play an important role in regulating immune response.
- antigen-specific IL-4, IFN- ⁇ and CD4+ T cells were detected by intracellular cytokine staining.
- the expression level of antigen-specific IFN- ⁇ in CD8+ T cells, as shown in Figure 2 was higher in the GM-CSF pretreatment group than in the HBV-injected group, IL-4, IFN- ⁇ (in CD4 cells) and IFN- ⁇ ( In CD8 cells, the levels were significantly increased.
- Example 2 GM-CSF combined with recombinant hepatitis B vaccine immunization strategy breaks HBsAg transgenic mice immune tolerance induces anti-hepatitis B surface antigen humoral immune response in transgenic mice
- 35 HBsAg transgenic mice (C57BL / 6J-Tg (AlblHBV) 44Bri / Jf4J ) (initial serum HBsAg concentration of 5000-10000pg / ml), were randomly divided into 5 groups, each group of 7, the experimental group following the table immunoassay Group design; each group of vaccine or GM-CSF was dissolved in normal saline, and each mouse was injected with 100 Microliters, each mouse was immunized subcutaneously in the neck, each group of mice immunized 4 times, the first three times each time interval of 14 days, the fourth immunization and the third immunization interval of 8 weeks, every two weeks on the mice Blood was collected from the eyelids, and the concentration of hepatitis B surface antigen and anti-hepatitis B surface antigen antibody in the serum of the transgenic mice was detected by ELISA.
- Antigen standard (2mg/mL) Dilution Do a 2-fold gradient dilution from 10 ⁇ 6.
- GM-CSF Detect whether GM-CSF combined with recombinant hepatitis B vaccine immunization strategy can break the immune tolerance of HBsAg transgenic mice and induce anti-hepatitis B surface antigen humoral immune response in transgenic mice.
- GM-CSF is injected in advance or simultaneously with HBV vaccine, every two Week, the serum HBsAg concentration and anti-HBsAg total IgG antibody were detected, and the total IgG level of 3GM-CSF+HBV was significantly enhanced compared with the group injected with HBV only (as shown in Figure 3), in the fourth time.
- the group of GM-CSF (3GM-CSF+HBV) was injected for the first 3 days, and the level of hepatitis B virus surface antigen was significantly decreased (P ⁇ 0.05).
- the GM-CSF team can break the immune tolerance of transgenic mice and induce a humoral immune response against hepatitis B surface antigen in transgenic mice, thereby keeping the surface antigen level of hepatitis B virus low.
- the simple injection of HBV vaccine group and the simultaneous injection of GM-CSF and HBV vaccine did not promote a significant increase in anti-hepatitis B surface antigen antibody.
- HBsAg transgenic mice C57BL / 6J-Tg (AlblHBV) 44Bri / Jf 4J ) were purchased from the Shanghai Public Health Clinical Center affiliated to Fudan University. Hepatitis B surface S antigen immunohistochemical primary antibody and secondary antibody were purchased from Shanghai Changdao Biotechnology Co., Ltd. Other experimental materials, main reagents and instruments are the same as in Example 1.
- HBsAg transgenic mice C57BL / 6J-Tg (AlblHBV) 44Bri / Jf 4J ) 35 (initial serum HBsAg concentration of 5000-10000pg / ml), were randomly divided into 5 groups, 5 in each group, the experimental grouping is shown in the table below.
- Each group of vaccine or GM-CSF was dissolved in physiological saline, and each mouse was injected with 100 ⁇ l.
- Each mouse was subcutaneously injected into the neck for immunization.
- Each group of mice was immunized 3 times, each time interval of 14 days, the third time. Twelve days after immunization, a delayed type hypersensitivity test was performed, and the mice were sacrificed 15 days after the third immunization.
- the splenocytes were isolated and the liver was taken for immunohistochemistry.
- HBsAg transgenic mice were anesthetized 14 days after the last immunization, and liver tissue fixation, embedding and sectioning were performed, respectively, and H&E staining and immunohistochemistry experiments were performed.
- the antibody used in the immunohistochemistry experiment was an antibody with anti-HBsAg.
- Repairing the wax block Repairing the wax block into a trapezoidal shape is beneficial to the formation of the wax band;
- Slice The thickness of the slice is about 8-10 ⁇ ⁇ ;
- Tissue sections with better tissue morphology were rehydrated with gradient alcohol and soaked three times with PBS (0.01 M; pH 7.4) for 5 minutes each time;
- 1 ⁇ 2 drops of 1M hydrochloric acid can be returned to the blue treatment lmin, tap water for 3min. Eosin staining is carried out directly, and dyeing lmin can be completed;
- Delayed type hypersensitivity is an immune response mainly mediated by T cells, in order to further confirm the GM-CSF combination
- the recombinant hepatitis B vaccine immunization strategy induced strong cellular immunity in vivo, using delayed type hypersensitivity as an in vivo indicator, immunizing according to the experimental group, and immunizing HBsAg transgenic mice three times (C57BL/6J-Tg (AlblHBV) 44Bri / Jf4J) After 12 days, all the experimental group and the control group were injected with rHBsAg antigen in the right foot pad, and the left foot pad was injected with normal saline.
- the thickness of the foot pad was measured in 24 hours, 48 hours, and 72 hours, respectively.
- the DTH level of the immunized hepatitis B vaccine group was higher than that of the control group, while the DTH level of the GM-CSF combined with the recombinant hepatitis B vaccine immunization strategy group (3*GM-CSF+HBV and 30ug GM-CSF+HBV group) was higher than that of HBV alone.
- the vaccine should be significantly enhanced, indicating that GM-CSF combined with recombinant hepatitis B vaccine immunization strategy group (3*GM-CSF+HBV and 30ug GM-CSF+HBV group) induced strong cell excretion in vivo. Level.
- GM-CSF combined with recombinant hepatitis B vaccine immunization strategy enhances CD8+ T cell-mediated DTH, may increase the activity of killer CD8+ T cells, IFN- ⁇ secreting CD8+ T cells (Tel) and IL-17 secreting CD8+ T cells (Tcl7) are two key killer CD8+ T cells.
- IFN- ⁇ secreting CD8+ T cells Tel
- IL-17 secreting CD8+ T cells Tcl7
- the expression of IFN- ⁇ and IL-17 in mouse CD8+ T cells after immunization was further tested. The spleen was aseptically removed 15 days after three immunizations. A single cell suspension was prepared, and the hepatitis B surface antigen CD8+ T cell epitope polypeptide was incubated in vitro.
- Figure 5 is hepatitis B virus surface antigen transgenic mice liver hepatitis B virus Surface original immunohistochemistry photos and picture densitometry statistics, it can be seen
- Laboratory animals and immunization experimental animals and immunization: C57BL/6 mice, SPF grade, 6-8 weeks old females, weighing 16-18 g, purchased from the Institute of Laboratory Animals, Chinese Academy of Medical Sciences, divided into 8 groups, 6 mice per group, The experimental grouping is shown in Table 1. Each group of vaccine or GM-CSF was dissolved in physiological saline, and each mouse was injected with 100 ⁇ l. Each mouse was injected subcutaneously for immunization in the neck, and boosted 14 days after the first immunization. Once, according to the experiment group interferon subcutaneous injection of 5*104U per neck;
- mice were routinely treated and soaked in 75% ethanol for 5-10 min ;
- RBC lysis of red blood cells 700 ul of RBC lysed cells were added to each tube for 2 min (strictly controlled lysis time), 700 ul FBS was added to terminate lysis, centrifuged at 1500 rpm for 3 min, the supernatant was discarded, and the cells were resuspended in 1 ml of 1640 or PBS;
- the drug complex of the present invention temporarily inhibits virus replication by using an antiviral drug, and then immunizes by using an immunomodulator plus a vaccine, thereby effectively enhancing the immune response of the hepatitis B vaccine and avoiding the use of a single antibody.
- Viral drug resistance produces non-reactivity and provides new research directions for the treatment of chronic HBV infection;
- the antiviral drug combination of the present invention can activate the body fluid and cellular immunity level of the body more effectively than the existing antiviral therapy, and significantly enhance the immune effect;
- the drug complex of the invention has the advantages of convenient use, low cost, small side effect and easy promotion;
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EP3025730A1 (en) | 2016-06-01 |
JP2016525523A (ja) | 2016-08-25 |
CN104338132A (zh) | 2015-02-11 |
US10086067B2 (en) | 2018-10-02 |
KR102254955B1 (ko) | 2021-05-24 |
JP6629195B2 (ja) | 2020-01-15 |
EP3025730A4 (en) | 2017-04-19 |
US20160136265A1 (en) | 2016-05-19 |
KR20160042875A (ko) | 2016-04-20 |
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