Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
  • A61K31/715—Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
• • 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
  • A61K39/02—Bacterial antigens
  • A61K39/09—Lactobacillales, e.g. aerococcus, enterococcus, lactobacillus, lactococcus, streptococcus
  • A61K39/092—Streptococcus
• • 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
  • A61K39/02—Bacterial antigens
  • A61K39/09—Lactobacillales, e.g. aerococcus, enterococcus, lactobacillus, lactococcus, streptococcus
• • 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
  • A61K39/385—Haptens or antigens, bound to carriers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K39/39—Medicinal preparations containing antigens or antibodies characterised by the immunostimulating additives, e.g. chemical adjuvants
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P11/00—Drugs for disorders of the respiratory system
• • 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
  • A61P31/04—Antibacterial agents
• • C—CHEMISTRY; METALLURGY
  • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
  • C08B—POLYSACCHARIDES; DERIVATIVES THEREOF
  • C08B37/00—Preparation of polysaccharides not provided for in groups C08B1/00 - C08B35/00; Derivatives thereof
  • C08B37/0003—General processes for their isolation or fractionation, e.g. purification or extraction from biomass
• • C—CHEMISTRY; METALLURGY
  • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
  • C12P—FERMENTATION OR ENZYME-USING PROCESSES TO SYNTHESISE A DESIRED CHEMICAL COMPOUND OR COMPOSITION OR TO SEPARATE OPTICAL ISOMERS FROM A RACEMIC MIXTURE
  • C12P19/00—Preparation of compounds containing saccharide radicals
  • C12P19/04—Polysaccharides, i.e. compounds containing more than five saccharide radicals attached to each other by glycosidic bonds
• • 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
  • A61K2039/545—Medicinal preparations containing antigens or antibodies characterised by the dose, timing or administration schedule
• • 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
  • A61K2039/55505—Inorganic 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
  • A61K2039/57—Medicinal preparations containing antigens or antibodies characterised by the type of response, e.g. Th1, Th2
  • A61K2039/575—Medicinal preparations containing antigens or antibodies characterised by the type of response, e.g. Th1, Th2 humoral response
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K2039/60—Medicinal preparations containing antigens or antibodies characteristics by the carrier linked to the antigen
  • A61K2039/6031—Proteins
  • A61K2039/6037—Bacterial toxins, e.g. diphteria toxoid [DT], tetanus toxoid [TT]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K2039/60—Medicinal preparations containing antigens or antibodies characteristics by the carrier linked to the antigen
  • A61K2039/6031—Proteins
  • A61K2039/6068—Other bacterial proteins, e.g. OMP
• • 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
  • A61K2039/70—Multivalent vaccine

Definitions

• the invention relates to isolated Streptococcus pneumoniae serotype 15B capsular polysaccharide and processes for their preparation.
• the invention also relates to immunogenic conjugates comprising Streptococcus pneumoniae serotype 15B capsular polysaccharide covalently linked to a carrier protein, processes for their preparation and immunogenic compositions and vaccines comprising them.
• Streptococcus pneumoniae are Gram-positive, lancet shaped cocci that are usually seen in pairs (diplococci), but also in short chains or as single cells. They grow readily on blood agar plates with glistening colonies and display alpha hemolysis unless grown anaerobically where they show beta hemolysis.
• the cells of most pneumococcal serotypes have a capsule which is a polysaccharide coating surrounding each cell. This capsule is a determinant of virulence in humans, as it interferes with phagocytosis by preventing antibodies from attaching to the bacterial cells.
• pneumococcal capsular serotypes identified, with the 23 most common serotypes accounting for approximately 90% of invasive disease worldwide.
• the pneumococcal polysaccharide coat can confer a reasonable degree of immunity to Streptococcus pneumoniae in individuals with developed or unimpaired immune systems, but the capsular polysaccharide conjugated to a suitable carrier protein allows for an immune response in infants and elderly who are also at most risk for pneumococcal infections.
• the present disclosure provides an isolated Streptococcus pneumoniae serotype 15B capsular polysaccharide having a molecular weight between 5kDa and 500kDa.
• the present disclosure provides an isolated Streptococcus pneumoniae serotype 15B capsular polysaccharide comprising at least 0.1 , 0.2, 0.3, 0.4, 0.5, 0.6, 0.7 or 0.8, preferably at least 0.6 mM, acetate per mM of said Streptococcus pneumoniae serotype 15B capsular polysaccharide
• the present disclosure provides an isolated Streptococcus pneumoniae serotype 15B capsular polysaccharide comprising at least 0.1 , 0.2, 0.3, 0.4, 0.5, 0.6, 0.7 or 0.8, preferably at least 0.6 mM glycerol per mM of said Streptococcus pneumoniae serotype 15B capsular polysaccharide.
• the present disclosure provides an immunogenic conjugate comprising an isolated Streptococcus pneumoniae serotype 15B capsular polysaccharide disclosed herein covalently linked to a carrier protein.
• said carrier protein is CRM 197 .
• the present disclosure provides an immunogenic composition
• an immunogenic composition comprising an immunogenic conjugate disclosed herein and a physiologically acceptable vehicle.
• said immunogenic composition further comprises at least one additional antigen.
• said immunogenic composition further comprises an adjuvant.
• the present disclosure provides a vaccine comprising an immunogenic composition as disclosed herein.
• the present disclosure provides a process for producing an isolated serotype 15B polysaccharide as disclosed herein, the process comprising the steps of:
• the present disclosure provides a process for producing an activated Streptococcus pneumoniae serotype 15B capsular polysaccharide, said process comprising the step of reacting an isolated Streptococcus pneumoniae serotype 15B capsular polysaccharide as disclosed herein with an oxidizing agent.
• the present disclosure provides an activated serotype 15B capsular polysaccharide obtained or obtainable by the above process.
• the present disclosure provides a process for the preparation of an immunogenic conjugate comprising Streptococcus pneumoniae serotype 15B capsular polysaccharide covalently linked to a carrier protein, the process comprising the steps of: (a) compounding an activated polysaccharide as disclosed herein with a carrier protein;
• the present disclosure provides an immunogenic conjugate obtained or obtainable by the above process.
• the present disclosure provides a method of protecting a subject against an infection with serotype 15B Streptococcus pneumoniae, the method comprising administering to a subject an immunogenic amount of the immunogenic composition or the vaccine disclosed herein.
• the present disclosure provides a method of treating or preventing a Streptococcus pneumoniae infection, disease or condition associated with serotype 15A, 15B and/or 15C Streptococcus pneumoniae in a subject, the method comprising the step of administering a therapeutically or prophylactically effective amount of an immunogenic composition or a vaccine disclosed herein.
• the "molecular weight" of a polysaccharide or of a polysaccharide-carrier protein conjugate refers to molecular weight calculated by size exclusion chromatography (SEC) combined with multiangle laser light scattering detector (MALLS).
• free polysaccharide means a serotype 15B capsular polysaccharide that is not covalently conjugated to the carrier protein, but is nevertheless present in the serotype 15B capsular polysaccharide-carrier protein conjugate composition.
• the free polysaccharide may be non-covalently associated with (i.e., non-covalently bound to, adsorbed to, or entrapped in or with) the polysaccharide-carrier protein conjugate.
• the percentage of free polysaccharide is measured after the final purification of the serotype 15B capsular polysaccharide-carrier protein conjugate. Preferably it is measured within 4 weeks after the final purification. It is expressed as a percentage of the total polysaccharide in the sample.
• serotype 15B polysaccharide or "serotype 15B capsular polysaccharide” refers to a Streptococcus pneumoniae serotype 15B capsular polysaccharide.
• serotype 15B glycoconjugate or "serotype 15B conjugate” refers to an isolated serotype 15B polysaccharide covalently conjugated to a carrier protein.
• degree of oxidation refers to the number of sugar repeat units per aldehyde group generated when the isolated polysaccharide is activated with an oxidizing agent.
• degree of oxidation of a polysaccharide can be determined using routine methods known to the man skilled in the art.
• the term “subject” refers to a mammal, including a human, or to a bird, fish, reptile, amphibian or any other animal.
• the term “subject” also includes household pets or research animals. Non-limiting examples of household pets and research animals include: dogs, cats, pigs, rabbits, rats, mice, gerbils, hamsters, guinea pigs, ferrets, monkeys, birds, snakes, lizards, fish, turtles, and frogs.
• the term “subject” also includes livestock animals.
• Non-limiting examples of livestock animals include: alpaca, bison, camel, cattle, deer, pigs, horses, llamas, mules, donkeys, sheep, goats, rabbits, reindeer, yak, chickens, geese, and turkeys.
• the polysaccharide repeating unit of serotype 15B consists of a branched trisaccharide backbone (one N-acetylglucosamine (Glc p NAc), one galactopyranose (Gal p ) and one glucopyranose (Glc p )) with an aGal p -pGal p disaccharide branch linked to the C4 hydroxyl group of Glc p NAc.
• the phosphoglycerol is linked to the C3 hydroxyl group of the pGal p residue in the disaccharide branch.
• Serotype 15B capsular polysaccharide is O- acetylated and the total amount of O-acetylation is approximately 0.8 to 0.9 O-acetyl groups per polysaccharide repeating unit (see for example C. Jones et Al, Carbohydrate Research, 340 (2005) 403-409).
• Capsular polysaccharide from serotype 15C serotype has the identical backbone structure as serotype 15B but lacks the O-acetylation.
• the isolated serotype 15B polysaccharide of the invention can be obtained by a process comprising the steps of:
• Serotype 15B polysaccharides can be obtained directly from bacteria using isolation procedures known to one of ordinary skill in the art (see for example methods disclosed U.S. Patent App. Pub. Nos. 20060228380, 20060228381 , 20070184071 , 20070184072, 20070231340, and 20080102498 or WO2008118752). In addition, they can be produced using synthetic protocols.
• Serotype 15B Streptococcus pneumoniae strains may be obtained from established culture collections (such as for example ATCC deposit strain No ATCC10354 or strain available from the Streptococcal Reference Laboratory of the Center for disease control and prevention, Atlanta, GA)) or clinical specimens.
• the bacterial cells are preferably grown in a soy based medium. Following fermentation of bacterial cells that produce Streptococcus pneumoniae serotype 15B capsular polysaccharides, the bacterial cells are lysed to produce a cell lysate.
• the bacterial cells may be lysed using any lytic agent.
• a "lytic agent” is any agent that aids in cell wall breakdown and release of autolysin which causes cellular lysis including, for example, detergents.
• detergent refers to any anionic or cationic detergent capable of inducing lysis of bacterial cells.
• Representative examples of such detergents for use within the methods of the present invention include deoxycholate sodium (DOC), N-lauroyl sarcosine, chenodeoxycholic acid sodium, and saponins.
• DOC deoxycholate sodium
• N-lauroyl sarcosine N-lauroyl sarcosine
• chenodeoxycholic acid sodium and saponins.
• the lytic agent used for lysing bacterial cells is DOC.
• DOC is the sodium salt of the bile acid deoxycholic acid, which is commonly derived from biological sources such as cows or oxen.
• DOC activates the LytA protein, which is an autolysin that is involved in cell wall growth and division in Streptococcus pneumoniae.
• the LytA protein has choline binding domains in its C-terminal portion, and mutations of the lytA gene are known to produce LytA mutants that are resistant to lysis with DOC.
• the lytic agent used for lysing bacterial cells is a non-animal derived lytic agent.
• Non-animal derived lytic agents for use within the methods of the present invention include agents from non-animal sources with modes of action similar to that of DOC (i. e., that affect LytA function and result in lysis of Streptococcus pneumoniae cells).
• Such non-animal derived lytic agents include, but are not limited to, analogs of DOC, surfactants, detergents, and structural analogs of choline.
• the non- animal derived lytic agent is selected from the group consisting of decanesulfonic acid, tert- octylphenoxy poly(oxyethylene)ethanols (e.g. Igepal® CA-630, CAS #: 9002-93-1 , available from Sigma Aldrich, St. Louis, MO), octylphenol ethylene oxide condensates (e.g. Triton® X- 100, available from Sigma Aldrich, St.
• decanesulfonic acid tert- octylphenoxy poly(oxyethylene)ethanols
• octylphenol ethylene oxide condensates e.g. Triton® X- 100, available from Sigma Aldrich, St.
• N-lauroyl sarcosine N-lauroyl sarcosine sodium, lauryl iminodipropionate, sodium dodecyl sulfate, chenodeoxycholate, hyodeoxycholate, glycodeoxycholate, taurodeoxycholate, taurochenodeoxycholate, and cholate.
• the non-animal derived lytic agent is N-lauroyl sarcosine.
• the lytic agent is N-lauroyl sarcosine sodium.
• the serotype 15B polysaccharide may then be isolated from the cell lysate using purification techniques known in the art, including the use of centrifugation, depth filtration, precipitation, ultra-filtration, treatment with activate carbon, diafiltration and/or column chromatography (See, for example, U.S. Patent App. Pub. Nos. 20060228380, 20060228381 , 20070184071 , 20070184072, 20070231340, and 20080102498 or WO2008118752).
• the purified serotype 15B capsular polysaccharide can then be used for the preparation of immunogenic conjugates.
• sizing of the polysaccharide to a lower molecular weight (MW) range is performed prior to the conjugation to a carrier protein.
• the size of the purified serotype 15B polysaccharide is reduced while preserving critical features of the structure of the polysaccharide such as for example the presence of O-acetyl groups.
• the size of the purified serotype 15B polysaccharide is reduced by mechanical homogenization.
• the size of the purified serotype 15B polysaccharide is reduced by high pressure homogenization. High pressure homogenization achieves high shear rates by pumping the process stream through a flow path with sufficiently small dimensions. The shear rate is increased by using a larger applied homogenization pressure and exposure time can be increased by recirculating the feed stream through the homogenizer.
• the high pressure homogenization process is particularly appropriate for reducing the size of the purified serotype 15B polysaccharide while preserving the structural features of the polysaccharide such as the presence of O-acetyl groups.
• the isolated serotype 15B capsular polysaccharide obtained by purification of serotype 15B polysaccharide from the Streptococcus pneumoniae lysate and optionally sizing of the purified polysaccharide can be characterized by different parameters including for example the molecular weight, the mM of glycerol per mM of said serotype 15B capsular polysaccharide or the mM of acetate per mM of said serotype 15B capsular polysaccharide.
• the degree of O-acetylation of the polysaccharide can be determined by any method known in the art, for example, by proton NMR (see for example Lemercinier and Jones (1996) Carbohydrate Research 296; 83-96, Jones and Lemercinier (2002) J. Pharmaceutical and Biomedical Analysis 30; 1233-1247, WO 05/033148 or WO00/56357). Another commonly used method is described in Hestrin (1949) J. Biol. Chem. 180; 249-261. Preferably, the presence of O-acetyl groups is determined by ion-HPLC analysis.
• the presence of O-acetyl in a purified, isolated or activated serotype 15B capsular polysaccharide or in a serotype 15B polysaccharide-carrier protein conjugate is expressed as the number of mM of acetate per mM of said polysaccharide or as the number of O-acetyl group per polysaccharide repeating unit.
• the presence of glycerolphosphate side chains can be determined by measurement of glycerol using high performance anion exchange chromatography with pulsed amperometric detection (HPAEC-PAD) after its release by treatment of the polysaccharide with hydrofluoric acid (HF).
• glycerol in a purified, isolated or activated serotype 15B polysaccharide or in a serotype 15B polysaccharide-carrier protein conjugate is expressed as the number of mM of glycerol per mM of serotype 15B polysaccharide.
• the isolated serotype 15B capsular polysaccharide can also be produced synthetically using methods known to the man skilled in the art.
• the isolated serotype 15B capsular polysaccharide has a molecular weight between 5 and 500kDa, 50 and 500 kDa, 50 and 450kDa, 100 and 400kDa, 100 and 350 kDa. In a preferred embodiment, the isolated serotype 15B capsular polysaccharide has a molecular weight between 100 and 350kDa. In a preferred embodiment, the isolated serotype 15B capsular polysaccharide has a molecular weight between 100 and 300kDa. In a preferred embodiment, the isolated serotype 15B capsular polysaccharide has a molecular weight between 150 and 300kDa.
• the isolated serotype 15B capsular polysaccharide comprises at least 0.1 , 0.2, 0.3, 0.4, 0.5, 0.6, 0.7 or 0.8 mM acetate per mM of said serotype 15B capsular polysaccharide. In a preferred embodiment, the isolated serotype 15B capsular polysaccharide comprises at least 0.5, 0.6 or 0.7 mM acetate per mM of said serotype 15B capsular polysaccharide. In a preferred embodiment, the isolated serotype 15B capsular polysaccharide comprises at least 0.6 mM acetate per mM of said serotype 15B capsular polysaccharide.
• the isolated serotype 15B capsular polysaccharide comprises at least 0.7 mM acetate per mM of said serotype 15B capsular polysaccharide.
• the presence of O-acetyl groups is determined by ion-HPLC analysis.
• the isolated serotype 15B capsular polysaccharide comprises at least 0.1 , 0.2, 0.3, 0.4, 0.5, 0.6, 0.7 or 0.8 mM glycerol per mM of said serotype 15B capsular polysaccharide. In a preferred embodiment, the isolated serotype 15B capsular polysaccharide comprises at least 0.5, 0.6 or 0.7 mM glycerol per mM of said serotype 15B capsular polysaccharide. In a preferred embodiment, the isolated serotype 15B capsular polysaccharide comprises at least 0.6 mM glycerol per mM of said serotype 15B capsular polysaccharide.
• the isolated serotype 15B capsular polysaccharide comprises at least 0.7 mM glycerol per mM of said serotype 15B capsular polysaccharide. In a preferred embodiment, the isolated serotype 15B capsular polysaccharide has a molecular weight between 100 and 350 kDa, preferably 150 and 350kDa, and comprises at least 0.6 mM acetate per mM of said serotype 15B capsular polysaccharide.
• the isolated serotype 15B capsular polysaccharide has a molecular weight between 100 and 350 kDa, preferably 150 and 350kDa, and comprises at least 0.6 mM glycerol per mM of said serotype 15B capsular polysaccharide.
• the isolated serotype 15B capsular polysaccharide comprises at least 0.6 mM acetate per mM of said serotype 15B capsular polysaccharide and at least 0.6 mM glycerol per mM of said serotype 15B capsular polysaccharide.
• the isolated serotype 15B capsular polysaccharide has a molecular weight between 100 and 350 kDa, preferably 150 and 350kDa, and comprises at least 0.6 mM acetate per mM of said serotype 15B capsular polysaccharide and at least 0.6 mM glycerol per mM of said serotype 15B capsular polysaccharide.
• Serotype 15B capsular polysaccharide-carrier protein conjugate
• the isolated serotype 15B capsular polysaccharide may be conjugated to a carrier protein to obtain an immunogenic conjugate.
• the isolated polysaccharide can be conjugated to the carrier protein by methods known to the skilled person (See, for example, U.S. Patent App. Pub. Nos. 20060228380, 20070184071 , 20070184072, 20070231340 or WO2011/100151).
• the polysaccharide may be activated with 1-cyano-4-dimethylamino pyridinium tetrafluoroborate (CDAP) to form a cyanate ester.
• CDAP 1-cyano-4-dimethylamino pyridinium tetrafluoroborate
• the activated polysaccharide may be coupled directly or via a spacer (linker) group to an amino group on the carrier protein.
• the spacer could be cystamine or cysteamine to give a thiolated polysaccharide which could be coupled to the carrier via a thioether linkage obtained after reaction with a maleimide-activated carrier protein (for example using GMBS) or a haloacetylated carrier protein (for example using iodoacetimide or N-succinimidyl bromoacetate or SIAB, or SIA, or SBAP).
• a maleimide-activated carrier protein for example using GMBS
• a haloacetylated carrier protein for example using iodoacetimide or N-succinimidyl bromoacetate or SIAB, or SIA, or SBAP.
• the cyanate ester is coupled with hexane diamine or adipic acid dihydrazide (ADH) and the amino-derivatised saccharide is conjugated to the carrier protein using carbodiimide (e.g.
• EDAC or EDC chemistry via a carboxyl group on the protein carrier.
• Such conjugates are described for example in WO93/15760, WO 95/08348 and WO 96129094.
• Other suitable techniques use carbodiimides, hydrazides, active esters, norborane, p- nitrobenzoic acid, N-hydroxysuccinimide, S--NHS, EDC, TSTU.
• Conjugation may involve a carbonyl linker which may be formed by reaction of a free hydroxyl group of the saccharide with CDI (See Bethell et al., 1979, 1. Biol. Chern.
• the isolated serotype 15B capsular polysaccharide is conjugated to the carrier protein by reductive amination.
• Reductive amination involves activation of the polysaccharide by oxidation and conjugation of the activated polysaccharide to a protein carrier by reduction.
• An activated serotype 15B capsular polysaccharide is obtained by reacting an isolated serotype 15B capsular polysaccharide with an oxidizing agent.
• said activated serotype 15B capsular polysaccharide can be obtained by a process comprising the following steps:
• the concentration of isolated serotype 15B capsular polysaccharide which is reacted with an oxidizing agent is between 0.1 and 10 mg/mL, 0.5 and 5 mg/mL, 1 and 3 mg/mL, or about 2 mg/mL.
• the oxidizing agent is periodate. The periodate oxidises vicinal hydroxyl groups to form carbonyl or aldehyde groups and causes cleavage of a C-C bond.
• the term 'periodate' includes both periodate and periodic acid.
• This term also includes both metaperiodate (I0 4 " ) and orthoperiodate (I0 6 5" )-
• the term 'periodate' also includes the various salts of periodate including sodium periodate and potassium periodate.
• the oxidizing agent is sodium periodate.
• the periodate used for the oxidation of serotype 15B capsular polysaccharide is metaperiodate.
• the periodate used for the oxidation of serotype 15B capsular polysaccharide is sodium metaperiodate.
• the polysaccharide is reacted with 0.01 to 10, 0.05 to 5, 0.1 to 1 , 0.5 to 1 , 0.7 to 0.8, 0.05 to 0.5, 0.1 to 0.3 molar equivalent of oxidizing agent. In a preferred embodiment, the polysaccharide is reacted with about 0.1 , 0.15, 0.2, 0.25, 0.3, 0.35, 0.4, 0.45, 0.5, 0.55, 0.6, 0.65, 0.7, 0.75, 0.8, 0.85, 0.9, 0.95 molar equivalent of oxidizing agent. In a preferred embodiment, the polysaccharide is reacted with about 0.15 molar equivalent of oxidizing agent.
• the polysaccharide is reacted with about 0.25 molar equivalent of oxidizing agent. In a preferred embodiment, the polysaccharide is reacted with about 0.5 molar equivalent of oxidizing agent. In a preferred embodiment, the polysaccharide is reacted with about 0.6 molar equivalent of oxidizing agent. In a preferred embodiment, the polysaccharide is reacted with about 0.7 molar equivalent of oxidizing agent.
• the duration of the reaction is between 1 and 50, 10 and 30, 15 and 20, 15 and 17 hours or about 16 hours.
• the temperature of the reaction is maintained between 15 and 45°C, 15 and 30°C, 20 and 25°C. In a preferred embodiment, the temperature of the reaction is maintained at about 23°C.
• the oxidation reaction is carried out in a buffer selected from sodium phosphate, potassium phosphate, 2-(N-morpholino)ethanesulfonic acid (MES) or Bis- Tris. In a preferred embodiment, the buffer is potassium phosphate.
• the buffer has a concentration of between 1 and 500 mM, 1 and 300mM, 50 and 200mM. In a preferred embodiment the buffer has a concentration of about 100mM.
• the oxidation reaction is carried out at a pH between 4 and 8, 5 and 7, 5.5 and 6.5. In a preferred embodiment, the pH is about 6.
• the activated serotype 15B capsular polysaccharide is obtained by reacting 0.5 to 5 mg/mL of isolated serotype 15B capsular polysaccharide with 0.2 to 0.3 molar equivalent of periodate at a temperature between 20 and 25°C.
• the activated serotype 15B capsular polysaccharide is purified.
• the activated serotype 15B capsular polysaccharide is purified according to methods known to the man skilled in the art such as gel permeation chromatography (GPC), dialysis or ultrafiltration/diafiltration.
• GPC gel permeation chromatography
• dialysis dialysis
• ultrafiltration/diafiltration ultrafiltration/diafiltration.
• the activated capsular polysaccharide is purified by concentration and diafiltration using an ultrafiltration device.
• the invention relates to an activated serotype 15B capsular polysaccharide obtained or obtainable by the above disclosed process.
• the degree of oxidation of the activated serotype 15B capsular polysaccharide is between 2 and 20, 2 and 15, 2 and 10, 2 and 5, 5 and 20, 5 and 15, 5 and 10, 10 and 20, 10 and 15, 15 and 20. In a preferred embodiment the degree of oxidation of the activated serotype 15B capsular polysaccharide is between 2 and 10, 4 and 8, 4 and 6, 6 and 8, 6 and 12, 8 and 12, 9 and 11 , 10 and 16, 12 and 16, 14 and 18, 16 and 20, 16 and 18, or 18 and 20.
• the activated serotype 15B capsular polysaccharide has a molecular weight between 5 and 500kDa, 50 and 500 kDa, 50 and 450kDa, 100 and 400kDa, 100 and 350 kDa. In a preferred embodiment, the activated serotype 15B capsular polysaccharide has a molecular weight between 100 and 350kDa. In a preferred embodiment, the activated serotype 15B capsular polysaccharide has a molecular weight between 100 and 300kDa. In a preferred embodiment, the activated serotype 15B capsular polysaccharide has a molecular weight between 150 and 300kDa. In a preferred embodiment, the activated serotype 15B capsular polysaccharide has a molecular weight between 100 and 250kDa.
• the activated serotype 15B capsular polysaccharide comprises at least 0.1 , 0.2, 0.3, 0.4, 0.5, 0.6, 0.7 or 0.8 mM acetate per mM of said serotype 15B capsular polysaccharide. In a preferred embodiment, the activated serotype 15B capsular polysaccharide comprises at least 0.5, 0.6 or 0.7 mM acetate per mM of said serotype 15B capsular polysaccharide. In a preferred embodiment, the activated serotype 15B capsular polysaccharide comprises at least 0.6 mM acetate per mM of said serotype 15B capsular polysaccharide.
• the activated serotype 15B capsular polysaccharide comprises at least 0.7 mM acetate per mM of said serotype 15B capsular polysaccharide.
• the presence of O-acetyl groups is determined by ion-HPLC analysis.
• the activated serotype 15B capsular polysaccharide comprises at least 0.1 , 0.2, 0.3, 0.4, 0.5, 0.6, 0.7 or 0.8 mM glycerol per mM of said serotype 15B capsular polysaccharide. In a preferred embodiment, the activated serotype 15B capsular polysaccharide comprises at least 0.5, 0.6 or 0.7 mM glycerol per mM of said serotype 15B capsular polysaccharide. In a preferred embodiment, the activated serotype 15B capsular polysaccharide comprises at least 0.6 mM glycerol per mM of said serotype 15B capsular polysaccharide. In a preferred embodiment, the activated serotype 15B capsular polysaccharide comprises at least 0.7 mM glycerol per mM of said serotype 15B capsular polysaccharide.
• the activated serotype 15B capsular polysaccharide has a molecular weight between 100 and 250 kDa and comprises at least 0.6 mM acetate per mM of said serotype 15B capsular polysaccharide.
• the activated serotype 15B capsular polysaccharide has a molecular weight between 100 and 250 kDa and comprises at least 0.6 mM glycerol per mM of said serotype 15B capsular polysaccharide.
• the activated serotype 15B capsular polysaccharide comprises at least 0.6 mM acetate per mM of said serotype 15B capsular polysaccharide and at least 0.6 mM glycerol per mM of said serotype 15B capsular polysaccharide.
• the activated serotype 15B capsular polysaccharide has a molecular weight between 100 and 250 kDa and comprises at least 0.6 mM acetate per mM of said serotype 15B capsular polysaccharide and at least 0.6 mM glycerol per mM of said serotype 15B capsular polysaccharide.
• the activated serotype 15B capsular polysaccharide is lyophilized, optionally in the presence of cryoprotectant/lyoprotectant.
• said cryoprotectant/lyoprotectant is a saccharide.
• the saccharide is selected from sucrose, trehalose, raffinose, stachyose, melezitose, dextran, mannitol, lactitol and palatinit.
• the saccharide is sucrose.
• the lyophilized activated capsular polysaccharide can then be compounded with a solution comprising the carrier protein.
• the activated serotype 15B capsular polysaccharide is compounded with the carrier protein and lyophilized optionally in the presence of cryoprotectant/lyoprotectant.
• said cryoprotectant/lyoprotectant is a saccharide.
• the saccharide is selected from sucrose, trehalose, raffinose, stachyose, melezitose, dextran, mannitol, lactitol and palatinit.
• the saccharide is sucrose.
• the co-lyophilized polysaccharide and carrier protein can then be resuspended in solution and reacted with a reducing agent.
• the invention relates to a lyophilized activated serotype 15B capsular polysaccharide.
• the invention relates to the co-lyophilized activated serotype 15B capsular polysaccharide and protein carrier.
• the protein carrier is CRM 197 . Conjugation of activated serotype 15B capsular polysaccharide with a carrier protein
• the activated serotype 15B capsular polysaccharide can be conjugated to a carrier protein by a process comprising the step of:
• step (b) reacting the compounded activated serotype 15B capsular polysaccharide and carrier protein with a reducing agent to form a serotype 15B capsular polysaccharide-carrier protein conjugate.
• the conjugation of activated serotype 15B capsular polysaccharide with a protein carrier by reductive amination in dimethylsulfoxide (DMSO) is suitable to preserve the O-acetyl content of the polysaccharide as compared for example to reductive amination in aqueous solution where the level of O-acetylation of the polysaccharide is significantly reduced.
• step (a) and step (b) are carried out in DMSO.
• step (a) comprises dissolving lyophilized serotype 15B capsular polysaccharide in a solution comprising a carrier protein and DMSO. In a preferred embodiment, step (a) comprises dissolving co-lyophilized serotype 15B capsular polysaccharide and carrier protein in DMSO.
• steps (a) and (b) are carried out in aqueous solution
• steps (a) and (b) are carried out in a buffer, preferably selected from PBS, MES, HEPES, Bis-tris, ADA, PIPES.
• MOPSO, BES, MOPS, DIPSO, MOBS, HEPPSO, POPSO, TEA, EPPS, Bicine or HEPB at a pH between 6.0 and 8.5, 7 and 8 or 7 and 7.5.
• the buffer is PBS.
• the pH is about 7.3.
• the concentration of activated serotype 15B capsular polysaccharide in step (b) is between 0.1 and 10 mg/mL, 0.5 and 5 mg/mL, 0.5 and 2 mg/mL. In a preferred embodiment, the concentration of activated serotype 15B capsular polysaccharide in step (b) is about 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1, 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9, 2, 2.1,2.2, 2.3, 2.4, 2.5, 2.6, 2.7,2.8, 2.9 or 3 mg/mL.
• the initial input ratio (weight by weight) of activated serotype 15B capsular polysaccharide to carrier protein is between 5:1 and 0.1:1, 2:1 and 0.1:1, 2:1 and 1:1, 1.5:1 and 1:1, 0.1:1 and 1:1, 0.3:1 and 1:1, 0.6:1 and 1:1.
• the initial input ratio of activated serotype 15B capsular polysaccharide to carrier protein is about 0.6:1 to 1.5:1, preferably 0.6:1 to 1:1.
• Such initial input ratio is particularly suitable to obtain low levels of free polysaccharide in the immunogenic conjugate.
• the initial input ratio of activated serotype 15B capsular polysaccharide to carrier protein is about 0.4:1, 0.5:1, 0.6:1, 0.7:1, 0.8:1, 0.9:1, 1:1, 1.1:1, 1.2:1, 1.3:1, 1.4:1, 1.5:1, 1.6:1, 1.7:1, 1.8:1, 1.9:1 or2:1.
• the reducing agent is sodium cyanoborohydride, sodium triacetoxyborohydride, sodium or zinc borohydride in the presence of Bronsted or Lewis acids, amine boranes such as pyridine borane, 2-Picoline Borane, 2,6-diborane-methanol, dimethylamine-borane, t-BuMe'PrN-BH 3 , benzylamine-BH 3 or 5-ethyl-2-methylpyridine borane (PEMB).
• the reducing agent is sodium cyanoborohydride.
• the reducing agent is sodium 2-Picoline Borane.
• the quantity of reducing agent used in step (b) is between about 0.1 and 10 molar equivalents, 0.5 and 5 molar equivalents, 1 and 2 molar equivalents. In a preferred embodiment, the quantity of reducing agent used in step (b) is about 1 , 1.1 , 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, 1.9 or 2 molar equivalents.
• the duration of step (b) is between 1 and 60 hours, 10 and 50 hours, 40 and 50 hours; 42 and 46 hours. In a preferred embodiment, the duration of step (b) is about 44 hours.
• the temperature of the reaction in step (b) is maintained between 10 and 40°C, 15 and 30°C or 20 and 26°C. In a preferred embodiment, the temperature of the reaction in step (b) is maintained at about 23°C.
• the process for the preparation of an immunogenic conjugate comprising Streptococcus pneumoniae serotype 15B capsular polysaccharide covalently linked to a carrier protein further comprises a step (step (c)) of capping unreacted aldehyde (quenching) by addition of NaBH 4 .
• the quantity of NaBH 4 used in step (c) is between 0.1 and 10 molar equivalents, 0.5 and 5 molar equivalent 1 and 3 molar equivalents. In a preferred embodiment, the quantity of NaBH 4 used in step (c) is about 2 molar equivalents.
• the duration of step (c) is between 0.1 and 10 hours, 0.5 and 5 hours, 2 and 4 hours. In a preferred embodiment, the duration of step (c) is about 3 hours.
• the temperature of the reaction in step (c) is maintained between 15 and 45°C, 15 and 30°C or 20 and 26°C. In a preferred embodiment, the temperature of the reaction in step (c) is maintained at about 23°C.
• the yield of the conjugation step (step b) is greater than 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85% or 90%. In a preferred embodiment the yield of the conjugation step (step b) is greater than 60%. In a preferred embodiment the yield of the conjugation step (step b) is greater than 70%.
• the yield is the amount of serotype 15B polysaccharide in the conjugate x100 / amount of activated polysaccharide used in the conjugation step.
• the process for the preparation of an immunogenic conjugate comprising Streptococcus pneumoniae serotype 15B capsular polysaccharide covalently linked to a carrier protein comprises the steps of: (a) preparing a fermentation culture of serotype 15B Streptococcus pneumonia bacterial cells;
• the yield of the conjugation step (step g) of the above process is greater than 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85% or 90%. In a preferred embodiment the yield of the conjugation step (step g) is greater than 60%. In a preferred embodiment the yield of the conjugation step (step g) is greater than 70%. The yield is the amount of serotype 15B polysaccharide in the conjugate x100) / amount of activated polysaccharide used in the conjugation step.
• the polysaccharide-protein conjugate can be purified (enriched with respect to the amount of polysaccharide-protein conjugate) by a variety of techniques known to the skilled person. These techniques include dialysis, concentration/diafiltration operations, tangential flow filtration, precipitation/elution, column chromatography (DEAE or hydrophobic interaction chromatography), and depth filtration.
• the carrier protein is non-toxic and non-reactogenic and obtainable in sufficient amount and purity. Carrier proteins should be amenable to standard conjugation procedures.
• the activated serotype 15B capsular polysaccharide is conjugated to a carrier protein which is selected in the group consisiting of: DT (Diphtheria toxin), TT (tetanus toxid) or fragment C of TT, CRM 197 (a nontoxic but antigenically identical variant of diphtheria toxin) other DT point mutants, such as CRM 176, CRM228, CRM 45 (Uchida et al J. Biol. Chem.
• meningitidis serogroup B - EP0372501 PorB (from N. meningitidis), PorB (from N. meningitidis), PD (Haemophilus influenza protein D - see, e.g., EP 0 594 610 B), or immunologically functional equivalents thereof, synthetic peptides (EP0378881 , EP0427347), heat shock proteins (WO 93/17712, WO 94/03208), pertussis proteins (WO 98/58668, EP0471 177), cytokines, lymphokines, growth factors or hormones (WO10 91/01 146), artificial proteins comprising multiple human CD4+ T cell epitopes from various pathogen derived antigens (Falugi et al (2001 ) Eur J Immunol 31 ; 3816-3824) such as N19 protein (Baraldoi et al (2004) Infect Immun 72; 4884-7) pneumococcal surface protein PspA (WO 02/091998),
• the activated serotype 15B capsular polysaccharide is conjugated to DT (Diphtheria toxoid). In another embodiment, the activated serotype 15B capsular polysaccharide is conjugated to TT (tetanus toxid). In another embodiment, the activated serotype 15B capsular polysaccharide is conjugated to fragment C of TT. In another embodiment, the activated serotype 15B capsular polysaccharide is conjugated to PD (Haemophilus influenza protein D - see, e.g., EP 0 594 610 B).
• the activated serotype 15B capsular polysaccharide of the invention is conjugated to CRM 197 protein.
• the CRM 197 protein is a nontoxic form of diphtheria toxin but is immunologically indistinguishable from the diphtheria toxin.
• CRM 197 is produced by C. diphtheriae infected by the nontoxigenic phage ⁇ 197' ⁇ " created by nitrosoguanidine mutagenesis of the toxigenic corynephage beta (Uchida, T. et al. 1971 , Nature New Biology 233:8-11).
• CRM 197 is purified through ultrafiltration, ammonium sulfate precipitation, and ion-exchange chromatography.
• the CRM 197 protein has the same molecular weight as the diphtheria toxin but differs therefrom by a single base change (guanine to adenine) in the structural gene. This single base change causes an amino acid substitution glutamic acid for glycine) in the mature protein and eliminates the toxic properties of diphtheria toxin.
• the CRM 197 protein is a safe and effective T-cell dependent carrier for saccharides. Further details about CRM 197 and production thereof can be found e.g. in US 5,614,382.
• the invention relate to an immunogenic conjugate comprising Streptococcus pneumoniae serotype 15B capsular polysaccharide covalently linked to a carrier protein. In an embodiment, the invention relate to an immunogenic conjugate comprising Streptococcus pneumoniae serotype 15B capsular polysaccharide covalently linked to a carrier protein by reductive amination. In an embodiment, the invention relate to an immunogenic conjugate comprising Streptococcus pneumoniae serotype 15B capsular polysaccharide covalently linked to a carrier protein by reductive amination in DMSO. In a preferred embodiment, the carrier protein is CRM 197 .
• the polysaccharide is an isolated serotype 15B capsular polysaccharide as defined herein. In a preferred embodiment, the polysaccharide is an isolated serotype 15B capsular polysaccharide as defined herein which has been sized by high pressure homogenization.
• the immunogenic conjugate comprises less than about 50, 45, 40, 35, 30, 25, 20 or 15% of free serotype 15B capsular polysaccharide compared to the total amount of serotype 15B capsular polysaccharide. In a preferred embodiment the immunogenic conjugate comprises less than about 25% of free serotype 15B capsular polysaccharide compared to the total amount of serotype 15B capsular polysaccharide. In a preferred embodiment the immunogenic conjugate comprises less than about 20% of free serotype 15B capsular polysaccharide compared to the total amount of serotype 15B capsular polysaccharide. In a preferred embodiment the immunogenic conjugate comprises less than about 15% of free serotype 15B capsular polysaccharide compared to the total amount of serotype 15B capsular polysaccharide.
• the immunogenic conjugate has a molecular weight between 3000 and 20000kDa; 5000 and 10000kDa; 5000 and 20000kDa; 8000 and 20000kDa; 8000 and 16000 KDa; or 10000 and 16000 KDa.
• the molecular weight of the immunogenic conjugate is measured by SEC-MALLS.
• the ratio (weight by weight) of serotype 15B capsular polysaccharide to carrier protein in the conjugate is between 0.5 and 3. In a preferred embodiment, the ratio of serotype 15B capsular polysaccharide to carrier protein in the conjugate is between 0.4 and 2, 0.5 and 2, 0.5 and 1.5, 0.5 and 1 , 1 and 1.5, 1 and 2. In a preferred embodiment, the ratio of serotype 15B capsular polysaccharide to carrier protein in the conjugate is between 0.7 and 0.9.
• Size exclusion chromatography media (CL-4B) can be used to determine the relative molecular size distribution of the conjugate.
• Size Exclusion Chromatography SEC is used in gravity fed columns to profile the molecular size distribution of conjugates. Large molecules excluded from the pores in the media elute more quickly than small molecules.
• Fraction collectors are used to collect the column eluate. The fractions are tested colorimetrically by saccharide assay.
• At least 20% of the immunogenic conjugate has a Kd below or equal to 0.3 in a CL-4B column. In a preferred embodiment, at least 30% of the immunogenic conjugate has a Kd below or equal to 0.3 in a CL-4B column. In a preferred embodiment, at least 40% of the immunogenic conjugate has a Kd below or equal to 0.3 in a CL-4B column.
• the immunogenic conjugate has a Kd below or equal to 0.3 in a CL-4B column.
• at least 60% of the immunogenic conjugate has a Kd below or equal to 0.3 in a CL-4B column.
• at least 70% of the immunogenic conjugate has a Kd below or equal to 0.3 in a CL-4B column.
• between 40% and 90% of the serotype 15B immunogenic conjugate has a Kd below or equal to 0.3 in a CL-4B column. In a preferred embodiment, between 50% and 90% of the serotype 15B immunogenic conjugate has a Kd below or equal to 0.3 in a CL-4B column. In a preferred embodiment, between 65% and 80% of the serotype 15B immunogenic conjugate has a Kd below or equal to 0.3 in a CL-4B column.
• the immunogenic conjugate comprises at least 0.1 , 0.2, 0.3, 0.4, 0.5, 0.6, 0.7 or 0.8 mM acetate per mM serotype 15B capsular polysaccharide. In a preferred embodiment, the immunogenic conjugate comprises at least 0.5, 0.6 or 0.7 mM acetate per mM serotype 15B capsular polysaccharide. In a preferred embodiment, the immunogenic conjugate comprises at least 0.6 mM acetate per mM serotype 15B capsular polysaccharide. In a preferred embodiment, the immunogenic conjugate comprises at least 0.7 mM acetate per mM serotype 15B capsular polysaccharide.
• the presence of O-acetyl groups is determined by ion-HPLC analysis.
• the ratio of mM acetate per mM serotype 15B capsular polysaccharide in the immunogenic conjugate to mM acetate per mM serotype 15B capsular polysaccharide in the isolated polysaccharide is at least 0.6, 0.65, 0.7, 0.75, 0.8, 0.85, 0.9, or 0.95.
• the ratio of mM acetate per mM serotype 15B capsular polysaccharide in the immunogenic conjugate to mM acetate per mM serotype 15B capsular polysaccharide in the isolated polysaccharide is at least 0.7. In a preferred embodiment, the ratio of mM acetate per mM serotype 15B capsular polysaccharide in the immunogenic conjugate to mM acetate per mM serotype 15B capsular polysaccharide in the isolated polysaccharide is at least 0.9. In a preferred embodiment, the presence of O-acetyl groups is determined by ion-HPLC analysis.
• the ratio of mM acetate per mM serotype 15B capsular polysaccharide in the immunogenic conjugate to mM acetate per mM serotype 15B capsular polysaccharide in the activated polysaccharide is at least 0.6, 0.65, 0.7, 0.75, 0.8, 0.85, 0.9, or 0.95. In a preferred embodiment, the ratio of mM acetate per mM serotype 15B capsular polysaccharide in the immunogenic conjugate to mM acetate per mM serotype 15B capsular polysaccharide in the activated polysaccharide is at least 0.7.
• the ratio of mM acetate per mM serotype 15B capsular polysaccharide in the immunogenic conjugate to mM acetate per mM serotype 15B capsular polysaccharide in the activated polysaccharide is at least 0.9.
• the presence of O-acetyl groups is determined by ion-HPLC analysis.
• the immunogenic conjugate comprises at least 0.1 , 0.2, 0.3, 0.4, 0.5, 0.6, 0.7 or 0.8 mM glycerol per mM serotype 15B capsular polysaccharide. In a preferred embodiment, the immunogenic conjugate comprises at least 0.5, 0.6 or 0.7 mM glycerol per mM serotype 15B capsular polysaccharide. In a preferred embodiment, the immunogenic conjugate comprises at least 0.6 mM glycerol per mM serotype 15B capsular polysaccharide. In a preferred embodiment, the immunogenic conjugate comprises at least 0.7 mM glycerol per mM serotype 15B capsular polysaccharide.
• the degree of conjugation is the number of lysine residues in the carrier protein that are conjugated to serotype 15B capsular polysaccharide.
• the evidence for lysine modification of the carrier protein, due to covalent linkages to the polysaccharides, is obtained by amino acid analysis using routine methods known to those of skill in the art. Conjugation results in a reduction in the number of lysine residues recovered, compared to the CRM 197 protein starting material used to generate the conjugate materials.
• the degree of conjugation of the immunogenic conjugate is between 2 and 15, 2 and 13, 2 and 10, 2 and 8, 2 and 6, 2 and 5, 2 and 4, 3 and 15, 3 and 13, 3 and 10, 3 and 8, 3 and 6, 3 and 5, 3 and 4, 5 and 15, 5 an 10, 8 and 15, 8 and 12, 10 and 15 or 10 and 12. In a preferred embodiment, the degree of conjugation of the immunogenic conjugate is between 2 and 5.
• Immunogenic composition relates to any pharmaceutical composition containing an antigen, e.g., a microorganism or a component thereof, which composition can be used to elicit an immune response in a subject.
• immunogenic means an ability of an antigen (or an epitope of the antigen), such as a bacterial capsular polysaccharide, or an immunogenic conjugate or immunogenic composition comprising an antigen, to elicit an immune response in a host such as a mammal, either humorally or cellularly mediated, or both.
• the disclosure relate to an immunogenic composition
• an immunogenic composition comprising an immunogenic serotype 15B capsular polysaccharide-carrier protein conjugate disclosed herein.
• the immunogenic composition disclosed herein when administered to a subject, induces the formation of antibodies capable of binding to serotype 15B Streptococcus pneumonia. In an embodiment, the immunogenic composition disclosed herein, when administered to a subject, induces the formation of antibodies capable of binding to serotype 15B Streptococcus pneumonia as measured by a standard ELISA assay.
• the immunogenic composition disclosed herein when administered to a subject, induces the formation of antibodies capable of binding to serotype 15B and 15A and/or 15C Streptococcus pneumonia. In an embodiment, the immunogenic composition disclosed herein, when administered to a subject, induces the formation of antibodies capable of binding to serotype 15B and 15A and/or 15C Streptococcus pneumonia as measured by a standard ELISA assay. In an embodiment, the immunogenic composition disclosed herein, when administered to a subject, induces the formation of antibodies capable of binding to serotype 15B and 15C Streptococcus pneumonia.
• the immunogenic composition disclosed herein when administered to a subject, induces the formation of antibodies capable of binding to serotype 15B and 15C Streptococcus pneumonia as measured by a standard ELISA assay.
• ELISA Enzyme-linked Immunosorbent Assay
• said ELISA assay is the standardized (WHO) ELISA assay as defined by the WHO in the Training manual for Enzyme linked immunosorbent assay for the quantitation of Streptococcus pneumoniae serotype specific IgG (Pn PS ELISA).' (accessible at http://www. vaccine. uab.edu/ELiSA 20protocoj.pd ; accessed on March 31 st , 2014).
• the ELISA measures type specific IgG anti-S. pneumoniae capsular polysaccharide (PS) antibodies present in human serum.
• PS capsular polysaccharide
• the antibodies bound to the plates are detected using a goat anti-human IgG alkaline phosphatase-labeled antibody followed by a p-nitrophenyl phosphate substrate.
• the optical density of the colored end product is proportional to the amount of anticapsular PS antibody present in the serum.
• the immunogenic composition of the invention is able to elicit IgG antibodies in human which are capable of binding S. pneumoniae serotypes 15B polysaccharide at a concentration of at least 0.05, 0.1 , 0.2, 0.3, 0.35, 0.4 or 0.5 ⁇ g/ml as determined by ELISA assay.
• the immunogenic composition of the invention is able to elicit IgG antibodies in human which are capable of binding S. pneumoniae serotypes 15C polysaccharide at a concentration of at least 0.05, 0.1 , 0.2, 0.3, 0.35, 0.4 or 0.5 ⁇ g/ml as determined by ELISA assay.
• the immunogenic composition of the invention is able to elicit IgG antibodies in human which are capable of binding S. pneumoniae serotypes 15B and 15C polysaccharide at a concentration of at least 0.05, 0.1 , 0.2, 0.3, 0.35, 0.4 or 0.5 ⁇ g/ml as determined by ELISA assay.
• the immunogenic composition disclosed herein when administered to a subject, induces the formation of antibodies capable of killing serotype 15B Streptococcus pneumonia in an opsonophagocytosis assay (OPA) as disclosed herein.
• OPA opsonophagocytosis assay
• the immunogenic composition disclosed herein when tested in an OPA assay as disclosed herein, has an OPA titer greater than the OPA titer obtained with an unconjugated native Streptococcus pneumonia serotype 15B capsular polysaccharide.
• the immunogenic composition disclosed herein when administered to a subject, induces the formation of antibodies capable of killing serotype 15C Streptococcus pneumonia in an opsonophagocytosis as disclosed herein.
• the immunogenic composition disclosed herein when tested in an OPA assay as disclosed herein, has an OPA titer greater than the OPA titer obtained with an unconjugated native Streptococcus pneumonia serotype 15C capsular polysaccharide.
• the immunogenic composition disclosed herein when administered to a subject, induces the formation of antibodies capable of killing serotype 15B and 15C and/or 15A Streptococcus pneumonia in an opsonophagocytosis assay as disclosed herein.
• the immunogenic composition disclosed herein when administered to a subject, induces the formation of antibodies capable of killing serotype 15B and 15C.
• the pneumococcal opsonophagocytic assay (OPA), which measures killing of S. pneumoniae cells by phagocytic effector cells in the presence of functional antibody and complement, is considered to be an important surrogate for evaluating the effectiveness of pneumococcal vaccines.
• Opsonophagocytic assay can be conducted by incubating together a mixture of Streptococcus pneumoniae cells, a heat inactivated human serum to be tested, differentiated HL-60 cells (phagocytes) and an exogenous complement source (e.g. baby rabbit complement). Opsonophagocytosis proceeds during incubation and bacterial cells that are coated with antibody and complement are killed upon opsonophagocytosis. Colony forming units (cfu) of surviving bacteria that escape from opsonophagocytosis are determined by plating the assay mixture.
• the OPA titer is defined as the reciprocal dilution that results in a 50% reduction in bacterial count over control wells without test serum.
• the immunogenic composition of the invention is able to elicit a titer of at least 1 :8 against S. pneumoniae serotype 15B in at least 50% of the subjects as determined by opsonophagocytic killing assay (OPA).
• the immunogenic composition of the invention is able to elicit a titer of at least 1 :8 against S. pneumoniae serotype 15B in at least 60%; 70%, 80%, 90%, or at least 93% of the subjects as determined by opsonophagocytic killing assay (OPA).
• the immunogenic composition of the invention is able to elicit a titer of at least 1 :8 against S. pneumoniae serotype 15C in at least 50% of the subjects as determined by opsonophagocytic killing assay (OPA). In an embodiment, the immunogenic composition of the invention is able to elicit a titer of at least 1 :8 against S. pneumoniae serotype 15C in at least 60%; 70%, 80%, 90%, or at least 95% of the subjects as determined by opsonophagocytic killing assay (OPA).
• OPA opsonophagocytic killing assay
• the immunogenic conjugates of the invention can be formulated with a physiologically acceptable vehicle to prepare the composition.
• a physiologically acceptable vehicle examples include, but are not limited to, water, buffered saline, polyols (e.g., glycerol, propylene glycol, liquid polyethylene glycol) and dextrose solutions.
• the immunogenic composition may comprise at least one additional antigen. In a preferred embodiments, the immunogenic composition may comprises at least one additional Streptococcus pneumoniae capsular polysaccharide.
• the immunogenic composition may comprise at least one additional Streptococcus pneumoniae capsular polysaccharide conjugated to a carrier protein.
• said carrier protein is CRM 197 .
• the immunogenic composition comprises one or more adjuvants.
• an "adjuvant” is a substance that serves to enhance the immunogenicity of an immunogenic composition of this invention.
• adjuvants are often given to boost the immune response and are well known to the skilled artisan.
• Suitable adjuvants to enhance effectiveness of the composition include, but are not limited to:
• aluminum salts such as aluminum hydroxide, aluminum phosphate, aluminum sulfate, etc.
• oil-in-water emulsion formulations with or without other specific immunostimulating agents such as muramyl peptides (defined below) or bacterial cell wall components), such as, for example,
• RibiTM adjuvant system (RAS), (Corixa, Hamilton, MT) containing 2% Squalene, 0.2% Tween 80, and one or more bacterial cell wall components from the group consisting of 3-0- deaylated monophosphorylipid A (MPLTM) described in U.S. Patent No. 4,912,094 (Corixa), trehalose dimycolate (TDM), and cell wall skeleton (CWS), preferably MPL + CWS (DetoxTM); (3) saponin adjuvants, such as Quil A or STIMULONTM QS-21 (Antigenics, Framingham, MA) (U.S. Patent No. 5,057,540) may be used or particles generated therefrom such as ISCOMs (immunostimulating complexes);
• AGP aminoalkyl glucosamine phosphate compounds
• one such AGP is 2-[(R)-3- Tetradecanoyloxytetradecanoylaminojethyl 2-Deoxy-4-Ophosphono-3-0-[(R)-3- tetradecanoyloxytetradecanoyl]-2-[(R)-3tetradecanoyloxytetradecanoylamino]-b-D- glucopyranoside, which is also know as 529 (formerly known as RC529), which is formulated as an aqueous form or as a stable emulsion, synthetic polynucleotides such as oligonucleotides containing CpG motif(s) (U.S. Patent No. 6,207,646);
• cytokines such as interleukins (e.g., IL-1 , IL-2, IL-4, IL-5, IL-6, IL-7, IL-12, IL-15, IL-18, etc.), interferons (e.g., gamma interferon), granulocyte macrophage colony stimulating factor (GM-CSF), macrophage colony stimulating factor (M-CSF), tumor necrosis factor (TNF), costimulatory molecules 87-1 and 87-2, etc.;
• interleukins e.g., IL-1 , IL-2, IL-4, IL-5, IL-6, IL-7, IL-12, IL-15, IL-18, etc.
• interferons e.g., gamma interferon
• GM-CSF granulocyte macrophage colony stimulating factor
• M-CSF macrophage colony stimulating factor
• TNF tumor necrosis factor
• a bacterial ADP-ribosylating toxin such as a cholera toxin (CT) either in a wild-type or mutant form, for example, where the glutamic acid at amino acid position 29 is replaced by another amino acid, preferably a histidine, in accordance with published international patent application number WO 00/18434 (see also WO 02/098368 and WO 02/098369), a pertussis toxin (PT), or an E.
• CT cholera toxin
• PT pertussis toxin
• coli heat-labile toxin particularly LT-K63, LT-R72, CT-S109, PT-K9/G129 (see, e.g., WO 93/13302 and WO 92/19265); and (7) other substances that act as immunostimulating agents to enhance the effectiveness of the composition.
• Muramyl peptides include, but are not limited to, N-acetyl-muramyl-L-threonyl-D-isoglutamine (thr-MDP), N-acetyl-normuramyl-L-alanine-2-(T-2'-dipalmitoyl-sn-glycero-3- hydroxyphosphoryloxy)-ethylamine (MTP-PE), etc.
• thr-MDP N-acetyl-muramyl-L-threonyl-D-isoglutamine
• MTP-PE N-acetyl-normuramyl-L-alanine-2-(T-2'-dipalmitoyl-sn-glycero-3- hydroxyphosphoryloxy)-ethylamine
• the immunogenic compositions as disclosed herein comprise a CpG Oligonucleotide as adjuvant.
• a CpG oligonucleotide as used herein refers to an immunostimulatory CpG oligodeoxynucleotide (CpG ODN), and accordingly these terms are used interchangeably unless otherwise indicated.
• Immunostimulatory CpG oligodeoxynucleotides contain one or more immunostimulatory CpG motifs that are unmethylated cytosine-guanine dinucleotides, optionally within certain preferred base contexts. The methylation status of the CpG immunostimulatory motif generally refers to the cytosine residue in the dinucleotide.
• An immunostimulatory oligonucleotide containing at least one unmethylated CpG dinucleotide is an oligonucleotide which contains a 5' unmethylated cytosine linked by a phosphate bond to a 3' guanine, and which activates the immune system through binding to Toll-like receptor 9 (TLR-9).
• TLR-9 Toll-like receptor 9
• the immunostimulatory oligonucleotide may contain one or more methylated CpG dinucleotides, which will activate the immune system through TLR9 but not as strongly as if the CpG motif(s) was/were unmethylated.
• CpG immunostimulatory oligonucleotides may comprise one or more palindromes that in turn may encompass the CpG dinucleotide.
• CpG oligonucleotides have been described in a number of issued patents, published patent applications, and other publications, including U.S. Patent Nos. 6, 194,388; 6,207,646; 6,214,806; 6,218,371 ; 6,239, 1 16; and 6,339,068.
• the immunogenic compositions as disclosed herein comprise any of the CpG Oligonucleotide described at pages 3 lines 22 to page 12 line 36 of WO2010/125480.
• CpG immunostimulatory oligonucleotides Different classes of CpG immunostimulatory oligonucleotides have been identified. These are referred to as A, B, C and P class, and are described in greater detail at pages 3 lines 22 to page 12 line 36 of WO2010/125480. Methods of the invention embrace the use of these different classes of CpG immunostimulatory oligonucleotides.
• the immunogenic compositions as disclosed herein comprise an A class CpG Oligonucleotide.
• the "A class" CpG oligonucleotide of the invention has the following nucleic acid sequence: 5' GGGGACGACGTCGTGGGGGGG 3' (SEQ ID NO: 1).
• A- Class oligonucleotides include: 5' G*G*G_G_A_C_G_A_C_G_T_C_G_T_G_G*G*G*G*G 3' (SEQ ID NO: 2) ; wherein * refers to a phosphorothioate bond and _ refers to a phosphodiester bond.
• the immunogenic compositions as disclosed herein comprise a B class CpG Oligonucleotide.
• the CpG oligonucleotide for use in the present invention is a B class CpG oligonucleotide represented by at least the formula:
• X 1 X 2 CGX 3 X 4 3' wherein X1 , X2, X3, and X4 are nucleotides.
• X 2 is adenine, guanine, or thymine.
• X 3 is cytosine, adenine, or thymine.
• the B class CpG oligonucleotide sequences of the invention are those broadly described above in US patents Ps 6, 194,388, 6,207,646, 6,214,806, 6,218,371 , 6,239, 116 and 6,339,068. Exemplary sequences include but are not limited to those disclosed in these latter applications and patents.
• the "B class" CpG oligonucleotide of the invention has the following nucleic acid sequence:
• all of the linkages may be all phosphorothioate bonds.
• one or more of the linkages may be phosphodiester, preferably between the "C" and the "G" of the CpG motif making a semi-soft CpG oligonucleotide.
• an ethyl-uridine or a halogen may substitute for the 5' T; examples of halogen substitutions include but are not limited to bromo-uridine or iodo-uridine substitutions.
• B-Class oligonucleotides include:
• the immunogenic compositions as disclosed herein comprise a C class CpG Oligonucleotide.
• the "C class" CpG oligonucleotides of the invention has the following nucleic acid sequence:
• all of the linkages may be all phosphorothioate bonds.
• one or more of the linkages may be phosphodiester, preferably between the "C” and the "G” of the CpG motif making a semi-soft CpG oligonucleotide.
• C-Class oligonucleotides include:
• an ethyl-uridine or a halogen may substitute for the 5' T; examples of halogen substitutions include but are not limited to bromo-uridine or iodo-uridine substitutions.
• the immunogenic compositions as disclosed herein comprise a P class CpG Oligonucleotide.
• the CpG oligonucleotide for use in the present invention is a P class CpG oligonucleotide containing a 5' TLR activation domain and at least two palindromic regions, one palindromic region being a 5' palindromic region of at least 6 nucleotides in length and connected to a 3' palindromic region of at least 8 nucleotides in length either directly or through a spacer, wherein the oligonucleotide includes at least one YpR dinucleotide.
• said oligoonucleotide is not T*CJ3*T*CJ3 C_G*T*T*C_G*G*C*G*C_G*C*G*C*G (SEQ ID NO: 27).
• the a P class CpG oligonucleotide includes at least one unmethylated CpG dinucleotide.
• the TLR activation domain is TCG, TTCG, TTTCG, TYpR, TTYpR, TTTYpR, UCG, UUCG, UUUCG, TTT, or TTTT.
• the TLR activation domain is within the 5' palindromic region.
• the TLR activation domain is immediately 5' to the 5' palindromic region.
• the "P class" CpG oligonucleotides of the invention has the following nucleic acid sequence: 5' TCGTCGACGATCGGCGCGCGCCG 3' (SEQ ID NO: 39).
• all of the linkages may be all phosphorothioate bonds.
• one or more of the linkages may be phosphodiester, preferably between the "C" and the "G" of the CpG motif making a semi-soft CpG oligonucleotide.
• an ethyl-uridine or a halogen may substitute for the 5' T; examples of halogen substitutions include but are not limited to bromo-uridine or iodo-uridine substitutions.
• P-Class oligonucleotides include:
• the oligonucleotide includes at least one phosphorothioate linkage. In another embodiment all internucleotide linkages of the oligonucleotide are phosphorothioate linkages. In another embodiment the oligonucleotide includes at least one phosphodiester- like linkage. In another embodiment the phosphodiester-like linkage is a phosphodiester linkage. In another embodiment a lipophilic group is conjugated to the oligonucleotide. In one embodiment the lipophilic group is cholesterol.
• all the internucleotide linkage of the CpG oligonucleotides disclosed herein are phosphodiester bonds ("soft" oligonucleotides, as described in the PCT application WO2007/026190).
• CpG oligonucleotides of the invention are rendered resistant to degradation (e.g., are stabilized).
• a "stabilized oligonucleotide" refers to an oligonucleotide that is relatively resistant to in vivo degradation (e.g. via an exo- or endo-nuclease). Nucleic acid stabilization can be accomplished via backbone modifications.
• Oligonucleotides having phosphorothioate linkages provide maximal activity and protect the oligonucleotide from degradation by intracellular exo- and endo-nucleases.
• the immunostimulatory oligonucleotides may have a chimeric backbone, which have combinations of phosphodiester and phosphorothioate linkages.
• a chimeric backbone refers to a partially stabilized backbone, wherein at least one internucleotide linkage is phosphodiester or phosphodiester-like, and wherein at least one other internucleotide linkage is a stabilized internucleotide linkage, wherein the at least one phosphodiester or phosphodiester-like linkage and the at least one stabilized linkage are different.
• the phosphodiester linkage is preferentially located within the CpG motif such molecules are called "semi-soft" as described in the PCT application WO2007/026190.
• the size of the CpG oligonucleotide (i.e., the number of nucleotide residues along the length of the oligonucleotide) also may contribute to the stimulatory activity of the oligonucleotide.
• CpG oligonucleotide of the invention preferably have a minimum length of 6 nucleotide residues. Oligonucleotides of any size greater than 6 nucleotides (even many kb long) are capable of inducing an immune response if sufficient immunostimulatory motifs are present, because larger oligonucleotides are degraded inside cells.
• the CpG oligonucleotides are 6 to 100 nucleotides long, preferentially 8 to 30 nucleotides long.
• nucleic acids and oligonucleotides of the invention are not plasmids or expression vectors.
• the CpG oligonucleotides disclosed herein comprise substitutions or modifications, such as in the bases and/or sugars as described at paragraph 134 to 147 of WO2007/026190.
• the CpG oligonucleotide of the present invention is chemically modified.
• Examples of chemical modifications are known to the skilled person and are described, for example in Uhlmann E. et al. (1990), Chem. Rev. 90:543, S. Agrawal, Ed., Humana Press, Totowa, USA 1993; Crooke, S . et al. (1996) Annu. Rev. Pharmacol. Toxicol. 36: 107-129; and Hunziker J. et al., (1995), Mod. Synth. Methods 7:331-417.
• An oligonucleotide according to the invention may have one or more modifications, wherein each modification is located at a particular phosphodiester internucleoside bridge and/or at a particular ⁇ -D-ribose unit and/or at a particular natural nucleoside base position in comparison to an oligonucleotide of the same sequence which is composed of natural DNA or RNA.
• CpG-containing nucleic acids might be simply mixed with immunogenic carriers according to methods known to those skilled in the art (see, e.g. WO03/024480).
• any of the immunogenic composition disclosed herein comprises from 2 ⁇ g to 100mg of CpG oligonucleotide, preferably from 0.1 mg to 50 mg CpG oligonucleotide, preferably from 0.2mg to 10 mg CpG oligonucleotide, preferably from 0.3 mg to 5 mg CpG oligonucleotide, even preferably from 0.5 to 2 mg CpG oligonucleotide, even preferably from 0.75 to 1.5 mg CpG oligonucleotide.
• the immunogenic composition disclosed herein comprises approximately 1 mg CpG oligonucleotide.
• the adjuvant is an aluminum-based adjuvant selected from the group consisting of aluminum phosphate, aluminum sulfate and aluminum hydroxide.
• the immunogenic compositions described herein comprise the adjuvant aluminum phosphate.
• the immunogenic compositions of the invention further comprise at least one of a buffer, a cryoprotectant, a salt, a divalent cation, a non-ionic detergent, an inhibitor of free radical oxidation, a diluent or a carrier.
• the immunogenic composition optionally can comprise one or more physiologically acceptable buffers selected from, but not limited to Tris (trimethamine), phosphate, acetate, borate, citrate, glycine, histidine and succinate.
• the formulation is buffered to within a pH range of about 5.0 to about 7.0, preferably from about 5.5 to about 6.5.
• the immunogenic composition optionally can comprise one or more non-ionic surfactants, including but not limited to polyoxyethylene sorbitan fatty acid esters, Polysorbate-80 (Tween 80), Polysorbate-60 (Tween 60), Polysorbate-40 (Tween 40) and Polysorbate-20 (Tween 20), polyoxyethylene alkyl ethers, including but not limited to Brij 58, Brij 35, as well as others such as Triton X-100; Triton X- 114, NP40, Span 85 and the Pluronic series of non-ionic surfactants (e. g. , Pluronic 121).
• the immunogenic composition comprises Polysorbate-80 or Polysorbate-40, preferably Polysorbate-80.
• the immunogenic composition comprises Polysorbate-80 at a concentration from about 0.001 % to about 2% (with up to about 0.25% being preferred) or Polysorbate-40 at a concentration from about 0.001 % to 1 % (with up to about 0.5% being preferred).
• the invention further relates to vaccines comprising the immunogenic composition of the invention.
• Methods for inducing an immune response and protecting against infection also includes methods of use for immunogenic compositions described herein.
• one embodiment of the disclosure provides a method of inducing an immune response against Streptococcus pneumoniae, comprising administering to a subject an immunogenic amount of any of the immunogenic compositions described herein.
• One embodiment of the disclosure provides a method of protecting a subject against an infection with Streptococcus pneumoniae, or a method of preventing infection with Streptococcus pneumoniae, or a method of reducing the severity of or delaying the onset of at least one symptom associated with an infection caused by Streptococcus pneumoniae, the methods comprising administering to a subject an immunogenic amount of any of the immunogenic compositions described herein.
• One embodiment of the disclosure provides a method of protecting a subject against an infection with serotype 15B Streptococcus pneumoniae, or a method of preventing infection with serotype 15B Streptococcus pneumoniae, or a method of reducing the severity of or delaying the onset of at least one symptom associated with an infection caused by serotype 15B Streptococcus pneumoniae, the methods comprising administering to a subject an immunogenic amount of any of the immunogenic compositions described herein.
• One embodiment of the disclosure provides a method of protecting a subject against an infection with serotype 15C Streptococcus pneumoniae, or a method of preventing infection with serotype 15C Streptococcus pneumoniae, or a method of reducing the severity of or delaying the onset of at least one symptom associated with an infection caused by serotype 15C Streptococcus pneumoniae, the methods comprising administering to a subject an immunogenic amount of any of the immunogenic compositions described herein.
• One embodiment of the disclosure provides a method of protecting a subject against an infection with serotype 15A Streptococcus pneumoniae, or a method of preventing infection with serotype 15A Streptococcus pneumoniae, or a method of reducing the severity of or delaying the onset of at least one symptom associated with an infection caused by serotype 15A Streptococcus pneumoniae, the methods comprising administering to a subject an immunogenic amount of any of the immunogenic compositions described herein.
• One embodiment of the disclosure provides a method of treating or preventing a Streptococcus pneumoniae infection, disease or condition associated with serotype 15A, 15B and/or 15C (preferably 15B and/or 15C, more preferably 15B) Streptococcus pneumoniae in a subject, the method comprising the step of administering a therapeutically or prophylactically effective amount of an immunogenic composition described herein to the subject.
• Another embodiment provides a method of treating or preventing a Streptococcus pneumoniae infection, disease or condition associated with a serotype 15A, 15B and/or 15C (preferably 15B and/or 15C, more preferably 15B) Streptococcus pneumoniae in a subject, the method comprising generating a polyclonal or monoclonal antibody preparation from the immunogenic composition described herein, and using said antibody preparation to confer passive immunity to the subject.
• the disclosure relates to the use of the immunogenic conjugate or immunogenic composition disclosed herein for the manufacture of a medicament for protecting a subject against an infection with Streptococcus pneumoniae, and/or preventing infection with Streptococcus pneumoniae, and/or reducing the severity of or delaying the onset of at least one symptom associated with an infection caused by Streptococcus pneumoniae, and/or protecting a subject against an infection with serotype 15A, 15B and/or 15C (preferably 15B and/or 15C, more preferably 15B) Streptococcus pneumoniae and/or preventing infection with serotype 15A, 15B and/or 15C (preferably 15B and/or 15C, more preferably 15B) Streptococcus pneumoniae, and/or reducing the severity of or delaying the onset of at least one symptom associated with an infection caused by serotype 15A, 15B and/or 15C (preferably 15B and/or 15C, more preferably 15B) Streptococcus pneumoniae, and
• the disclosure relates to the use of the immunogenic conjugate or immunogenic composition disclosed herein for protecting a subject against an infection with Streptococcus pneumoniae, and/or preventing infection with Streptococcus pneumoniae, and/or reducing the severity of or delaying the onset of at least one symptom associated with an infection caused by Streptococcus pneumoniae, and/or protecting a subject against an infection with serotype 15A, 15B and/or 15C (preferably 15B and/or 15C, more preferably 15B) Streptococcus pneumoniae and/or preventing infection with serotype 15A, 15B and/or 15C (preferably 15B and/or 15C, more preferably 15B) Streptococcus pneumoniae, and/or reducing the severity of or delaying the onset of at least one symptom associated with an infection caused by serotype 15A, 15B and/or 15C (preferably 15B and/or 15C, more preferably 15B) Streptococcus pneumoniae.
• an “immune response" to an immunogenic composition is the development in a subject of a humoral and/or a cell-mediated immune response to molecules present in the immunogenic composition or vaccine composition of interest.
• a “humoral immune response” is an antibody-mediated immune response and involves the induction and generation of antibodies that recognize and bind with some affinity for the antigen in the immunogenic composition or vaccine of the disclosure, while a “cell-mediated immune response” is one mediated by T-cells and/or other white blood cells.
• a “cell-mediated immune response” is elicited by the presentation of antigenic epitopes in association with Class I or Class II molecules of the major histocompatibility complex (MHC), CD1 or other non-classical MHC-like molecules.
• MHC major histocompatibility complex
• CTLs cytotoxic T lymphocyte cells
• CTLs have specificity for peptide antigens that are presented in association with proteins encoded by classical or non-classical MHCs and expressed on the surfaces of cells. CTLs help induce and promote the intracellular destruction of intracellular microbes, or the lysis of cells infected with such microbes.
• helper T-cells act to help stimulate the function, and focus the activity of, nonspecific effector cells against cells displaying peptide or other antigens in association with classical or non-classical MHC molecules on their surface.
• a “cell-mediated immune response” also refers to the production of cytokines, chemokines and other such molecules produced by activated T-cells and/or other white blood cells, including those derived from CD4+ and CD8+ T-cells.
• the ability of a particular antigen or composition to stimulate a cell-mediated immunological response may be determined by a number of assays, such as by lymphoproliferation (lymphocyte activation) assays, CTL cytotoxic cell assays, by assaying for T-lymphocytes specific for the antigen in a sensitized subject, or by measurement of cytokine production by T cells in response to re-stimulation with antigen.
• assays are well known in the art. See, e.g., Erickson et al. (1993) J. Immunol. 151 :4189-4199; and Doe et al. (1994) Eur. J. Immunol. 24:2369-2376.
• treatment means any one or more of the following: (i) the prevention of infection or re-infection, as in a traditional vaccine, (ii) the reduction in the severity of, or, in the elimination of symptoms, and (iii) the substantial or complete elimination of the pathogen or disorder in question.
• treatment may be effected prophylactically (prior to infection) or therapeutically (following infection).
• prophylactic treatment is the preferred mode.
• compositions and methods that treat, including prophylactically and/or therapeutically immunize, a host animal against a serotype 15A, 15B and/or 15C (preferably 15B and/or 15C, more preferably 15B) Streptococcus pneumoniae infection.
• the methods of the present disclosure are useful for conferring prophylactic and/or therapeutic immunity to a subject.
• the methods of the present disclosure can also be practiced on subjects for biomedical research applications.
• an “immunogenic amount”, and “immunologically effective amount,” both of which are used interchangeably herein, refers to the amount of antigen or immunogenic composition sufficient to elicit an immune response, either a cellular (T-cell) or humoral (B-cell or antibody) response, or both, as measured by standard assays known to one skilled in the art.
• said subject is a human.
• said subject is a newborn (i.e. under three months of age), an infant (from 3 months to one year of age) or a toddler (i.e. from one year to four years of age).
• the immunogenic compositions disclosed herein are for use as a vaccine.
• the subject to be vaccinated may be less than 1 year of age.
• the subject to be vaccinated can be about 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 or 12 months of age.
• the subject to be vaccinated is about 2, 4 or 6 months of age.
• the subject to be vaccinated is less than 2 years of age.
• the subject to be vaccinated can be about 12-15 months of age.
• a second, third or fourth dose may be given (see regimen section).
• the subject to be vaccinated is a human adult 50 years of age or older, more preferably a human adult 55 years of age or older. In an embodiment, the subject to be vaccinated is a human adult 65 years of age or older, 70 years of age or older, 75 years of age or older or 80 years of age or older.
• the subject to be vaccinated is an immunocompromised individual, in particular a human.
• An immunocompromised individual is generally defined as a person who exhibits an attenuated or reduced ability to mount a normal humoral or cellular defense to challenge by infectious agents.
• the immunocompromised subject to be vaccinated suffers from a disease or condition that impairs the immune system and results in an antibody response that is insufficient to protect against or treat pneumococcal disease.
• said disease is a primary immunodeficiency disorder.
• said primary immunodeficiency disorder is selected from the group consisting of: combined T- and B-cell immunodeficiencies, antibody deficiencies, well-defined syndromes, immune dysregulation diseases, phagocyte disorders, innate immunity deficiencies, autoinflammatory disorders, and complement deficiencies.
• said primary immunodeficiency disorder is selected from the one disclosed on page 24 line 11 to page 25 line 19 of the PCT application WO2010/125480.
• the immunocompromised subject to be vaccinated suffers from a disease selected from the groups consisting of: HIV-infection, acquired immunodeficiency syndrome (AIDS), cancer, chronic heart or lung disorders, congestive heart failure, diabetes mellitus, chronic liver disease, alcoholism, cirrhosis, spinal fluid leaks, cardiomyopathy, chronic bronchitis, emphysema, Chronic obstructive pulmonary disease (COPD), spleen dysfunction (such as sickle cell disease), lack of spleen function (asplenia), blood malignancy, leukemia, multiple myeloma, Hodgkin's disease, lymphoma, kidney failure, nephrotic syndrome and asthma.
• AIDS acquired immunodeficiency syndrome
• the immunocompromised subject to be vaccinated suffers from malnutrition.
• the immunocompromised subject to be vaccinated is taking a drug or treatment that lowers the body's resistance to infection.
• said drug is selected from the one disclosed on page 26 line 33 to page 26 line 40 of the PCT application WO2010/125480.
• the immunocompromised subject to be vaccinated is a smoker.
• the immunocompromised subject to be vaccinated has a white blood cell count (leukocyte count) below 5 x 10 9 cells per liter, or below 4 x 10 9 cells per liter, or below 3 x 10 9 cells per liter, or below 2 x 10 9 cells per liter, or below 1 x 10 9 cells per liter, or below 0.5 x 10 9 cells per liter, or below 0.3 x 10 9 cells per liter, or below 0.1 x 10 9 cells per liter.
• a white blood cell count leukocyte count
• White blood cell count The number of white blood cells (WBCs) in the blood.
• the WBC is usually measured as part of the CBC (complete blood count).
• White blood cells are the infection-fighting cells in the blood and are distinct from the red (oxygen- carrying) blood cells known as erythrocytes.
• the normal range for the white blood cell count is usually between 4,300 and 10,800 cells per cubic millimeter of blood. This can also be referred to as the leukocyte count and can be expressed in international units as 4.3 - 10.8 x 10 9 cells per liter.
• the immunocompromised subject to be vaccinated suffers from neutropenia.
• the immunocompromised subject to be vaccinated has a neutrophil count below 2 x 10 9 cells per liter, or below 1 x 10 9 cells per liter, or below 0.5 x 10 9 cells per liter, or below 0.1 x 10 9 cells per liter, or below 0.05 x 10 9 cells per liter.
• a low white blood cell count or "neutropenia" is a condition characterized by abnormally low levels of neutrophils in the circulating blood. Neutrophils are a specific kind of white blood cell that help prevent and fight infections. The most common reason that cancer patients experience neutropenia is as a side effect of chemotherapy. Chemotherapy-induced neutropenia increases a patient's risk of infection and disrupts cancer treatment.
• the immunocompromised subject to be vaccinated has a CD4+ cell count below 500/mm 3 , or CD4+ cell count below 300/mm 3 , or CD4+ cell count below 200/mm 3 , CD4+ cell count below 100/mm 3 , CD4+ cell count below 75/mm 3 , or CD4+ cell count below 50/mm 3 .
• CD4 cell tests are normally reported as the number of cells in mm 3 . Normal CD4 counts are between 500 and 1600, and CD8 counts are between 375 and 1 100. CD4 counts drop dramatically in people with HIV.
• any of the immunocompromised subject disclosed herein is a human male or a human female.
• the amount of a conjugate in a composition is generally calculated based on total polysaccharide, conjugated and non-conjugated for that conjugate. For example, a conjugate with 20% free polysaccharide will have about 80 ⁇ g of conjugated polysaccharide and about 20 ⁇ g of non-conjugated polysaccharide in a 100 ⁇ g polysaccharide dose. The protein contribution to the conjugate is usually not considered when calculating the dose of a conjugate.
• each dose will comprise 0.1 to 100 ⁇ g of polysaccharide, particularly 0.1 to 10 ⁇ g, and more particularly 1 to 10 ⁇ g and more particularly 1 to 5 ⁇ g.
• each dose will comprise about 1.1 , 2, 2.2, 3, 3.3, 4, 4.4 ⁇ g of polysaccharide.
• Optimal amounts of components for a particular immunogenic composition or vaccine can be ascertained by standard studies involving observation of appropriate immune responses in subjects. Following an initial vaccination, subjects can receive one or several booster immunizations adequately spaced.
• an antigen as an immunogen can be measured either by proliferation assays, by cytolytic assays, such as chromium release assays to measure the ability of a T-cell to lyse its specific target cell, or by measuring the levels of B-cell activity by measuring the levels of circulating antibodies specific for the antigen in serum.
• An immune response may also be detected by measuring the serum levels of antigen specific antibody induced following administration of the antigen, and more specifically, by measuring the ability of the antibodies so induced to enhance the opsonophagocytic ability of particular white blood cells, as described herein.
• the level of protection of the immune response may be measured by challenging the immunized host with the antigen that has been administered.
• the level of protection induced by the immunogenic amount of the antigen is measured by detecting the percent survival or the percent mortality after challenge of the animals with the bacterial cells.
• the amount of protection may be measured by measuring at least one symptom associated with the bacterial infection, e.g., a fever associated with the infection.
• the amount of each of the antigens in the multi-antigen or multi-component vaccine or immunogenic compositions will vary with respect to each of the other components and can be determined by methods known to the skilled artisan. Such methods would include procedures for measuring immunogenicity and/ or in vivo efficacy.
• the disclosure further provides antibodies and antibody compositions which bind specifically and selectively to the capsular polysaccharides or immunogenic conjugates of the present disclosure.
• antibodies are generated upon administration to a subject of the capsular polysaccharides or immunogenic conjugates of the present disclosure.
• the disclosure provides purified or isolated antibodies directed against one or more of the capsular polysaccharides or immunogenic conjugates of the present disclosure.
• the antibodies of the present disclosure are functional as measured by killing bacteria in either an animal efficacy model or via an opsonophagocytic killing assay.
• the antibodies of the disclosure confer passive immunity to a subject.
• the present disclosure further provides polynucleotide molecules encoding an antibody or antibody fragment of the disclosure, and a cell, cell line (such as hybridoma cells or other engineered cell lines for recombinant production of antibodies) or a transgenic animal that produces an antibody or antibody composition of the disclosure, using techniques well-known to those of skill in the art.
• Example 1 Preparation of isolated Streptococcus pneumoniae serotype 15B capsular polysaccharide
• Serotype 15B capsular polysaccharides can be obtained directly from bacteria using isolation procedures known to one of ordinary skill in the art (see for example methods disclosed U.S. Patent App. Pub. Nos. 20060228380, 20060228381 , 20070184071 , 20070184072, 20070231340, and 20080102498 or WO2008118752).
• the serotype 15B Streptococcus pneumonia were grown in a seed bottle and then transferred to a seed fermentor. Once the targeted optical density was reached, the cells were transferred to a production fermentor. The fermentation was broth was inactivated by the addition of N-lauroyl sarcosine and purified by ultrafiltration and diafiltration.
• the purified Streptococcus pneumoniae serotype 15B polysaccharide was then sized by high pressure homogenization using a PANDA 2K homogenizer ® (GEA Niro Soavi) to produce the isolated Streptococcus pneumoniae serotype 15B polysaccharide.
• the isolated Streptococcus pneumoniae serotype 15B capsular polysaccharide obtained by the above process comprises at least 0.6 mM acetate per mM of serotype 15B capsular polysaccharide and has a molecular weight between 50kDa and 500kDa, preferably 150 to 350kDa.
• Polysaccharide oxidation was carried out in 100 mM potassium phosphate buffer (pH 6.0 ⁇ 0.2) by sequential addition of calculated amount of 500 mM potassium phosphate buffer (pH 6.0) and WFI to give final polysaccharide concentration of 2.0 g/L. If required, the reaction pH was adjusted to pH 6.0, approximately. After pH adjustment, the reaction temperature was adjusted to 23 ⁇ 2 °C. Oxidation was initiated by the addition of approximately 0.25 molar equivalents of sodium periodate. The oxidation reaction was performed at 23 ⁇ 2 °C during 16 hrs, approximately.
• the purified activated polysaccharide was then stored at 5 ⁇ 3°C.
• the purified activated saccharide was characterized inter alia by (i) saccharide concentration by colorimetric assay; (ii) aldehyde concentration by colorimetric assay; (iii) Degree of Oxidation (iv) Molecular Weight by SEC-MALLS and (v) presence of O-acetyl and glycerol.
• SEC-MALLS is used for the determination of the molecular weight of polysaccharides and polysaccharide-protein conjugates.
• SEC is used to separate the polysaccharides by hydrodynamic volume.
• Refractive index (Rl) and multi-angle laser light scattering (MALLS) detectors are used for the determination of the molecular weight. When light interacts with matter, it scatters and the amount of scattered light is related to the concentration, the square of the dn/dc (the specific refractive index increments), and the molar mass of the matter.
• the molecular weight measurement is calculated based on the readings from the scattered light signal from the MALLS detector and the concentration signal from the Rl detector.
• the degree of oxidation (DO moles of sugar repeat unit / moles of aldehyde) of the activated polysaccharide was determined as follows:
• the moles of sugar repeat unit is determined by various colorimetric methods, example by using Anthrone method.
• Anthrone mthod the polysaccharide is first broken down to monosaccharides by the action of sulfuric acid and heat.
• the Anthrone reagent reacts with the hexoses to form a yellow-green colored complex whose absorbance is read spectrophotometrically at 625nm. Within the range of the assay, the absorbance is directly proportional to the amount of hexose present.
• the moles of aldehyde also is determined simultaneously, using MBTH colorimetric method.
• the MBTH assay involves the formation of an azine compound by reacting aldehyde groups (from a given sample) with a 3-methyl-2-benzothiazolone hydrazone (MBTH assay reagent). The excess 3-methyl-2-benzothiazolone hydrazone oxidizes to form a reactive cation. The reactive cation and the azine react to form a blue chromophore. The formed chromophore is then read spectroscopically at 650 nm.
• the activated Streptococcus pneumoniae serotype 15B capsular polysaccharide obtained by the above process comprises at least 0.6 mM acetate per mM of serotype 15B capsular polysaccharide and has a molecular weight between 50kDa and 500kDa, preferably 100 to 250kDa.
• the conjugation process consists of the following steps:
• the activated polysaccharide was compounded with sucrose to a ratio of 25 grams of sucrose per gram of activated polysaccharide. The bottle of compounded mixture was then lyophilized. Following lyophilization, bottles containing lyophilized activated polysaccharide were stored at -20 ⁇ 5°C. Calculated amount of CRM 197 protein was shell-frozen and lyophilized separately. Lyophilized CRM 197 was stored at -20 ⁇ 5°C. b) Reconstitution of Lyophilized Activated Polysaccharide and CRM 197 Protein
• Lyophilized activated polysaccharide was reconstituted in anhydrous dimethyl sulfoxide (DMSO). Upon complete dissolution of polysaccharide, an equal amount of anhydrous DMSO was added to lyophilized CRM 197 for reconstitution. c) Conjugation and Capping
• Reconstituted activated polysaccharide was combined with reconstituted CRM 197 in the reaction vessel (input ratio: 0.8: 1), followed by mixing thoroughly to obtain a clear solution before initiating the conjugation with sodium cyanoborohydride.
• the final polysaccharide concentration in reaction solution is approximately 1 g/L.
• Conjugation was initiated by adding 1.0 - 1.5 MEq of sodium cyanoborohydride to the reaction mixture and was incubated at 23 ⁇ 2 °C for 40-48 hrs.
• Conjugation reaction was terminated by adding 2 MEq of sodium borohydride (NaBH 4 ) to cap unreacted aldehydes. This capping reaction continued at 23 ⁇ 2°C for 3 ⁇ 1 hrs.
• the conjugate solution was diluted 1 : 10 with chilled 5 mM succinate-0.9% saline (pH 6.0) in preparation for purification by tangential flow filtration using 100-300K MWCO membranes.
• the diluted conjugate solution was passed through a 5 ⁇ filter and diafiltration was performed using 5 mM succinate-0.9% saline (pH 6.0) as the medium. After the diafiltration was completed, the conjugate retentate was transferred through a 0.22 ⁇ filter.
• the conjugate was diluted further with 5 mM succinate / 0.9% saline (pH 6), to a target saccharide concentration of approximately 0.5 mg/mL.
• Final 0.22 ⁇ filtration step was completed to obtain the immunogenic conjugate.
• the conjugate obtained by the above process comprises at least 0.6 mM acetate per mM of serotype 15B capsular polysaccharide, has a molecular weight between 3000 and 20000kDa and has a degree of conjugation between 2 and 6.
• Example 2 Characterization of immunogenic conjugate comprising Streptococcus pneumoniae serotype 15B capsular polysaccharide covalently linked to a CRM 197
• Conjugate 1 was prepared by the process disclosed in example 1.
• Conjugates 2 and 3 were prepared by a similar process using different amount of oxidizing agent.
• Conjugate 4 was prepared by a similar process except that the purified serotype 15B capsular polysaccharide was not sized and was activated to a lower DO (higher oxidation level) and the conjugation was performed in aqueous medium.
• Conjugate 5 was prepared by a similar process except that the purified serotype 15B capsular polysaccharide was sized by chemical hydrolysis and the conjugation was performed in aqueous medium.
• Conjugates 6 and 7 were prepared by a similar process except that the purified serotype 15B capsular polysaccharide was not sized. The obtained conjugates were characterized and the results are summarized in Table 1.
• the percentage of free polysaccharide is measured by a procedure utilizing aluminium hydroxide gel to bind protein and covalently bound saccharide for removal by centrifugation. Samples are mixed with phosphate buffered aluminium hydroxide gel and centrifuged. Bound saccharide is pelleted with the gel and free saccharide remains in the supernatant. The resulting supernatant and controls samples are quantitated by appropriate colorimetric assays to determine the percentage of free saccharide and to confirm sufficient removal of protein and recovery of saccharide.
• the polysaccharide-protein sample is first hydrolyzed into its individual components as free amino acids, using 6N hydrochloric acid (HCI) hydrolysis under vacuum and heat (160° C for 15 minutes). After hydrolysis, the samples are analyzed using Amino Acid Analyzer. The individual amino acids are separated through ion exchange chromatography using a step gradient of sodium citrate buffer with temperature and flow rate changes. After separation, the amount of each amino acid residual is quantitatively determined using a postcolumn ninhydrin coupling detection system. In this system, the ninhydrin is mixed with the column eluate in the postcolumn reactor system and the mixture passed into the photometer.
• HCI hydrochloric acid
• the reaction of ninhydrin with eluated amino acids yields a purple compound that absorbs maximally at 570 nm. This absorbance is a linear response (function) of the amount of -amino groups present and this reaction provides quantitative colorimetric assay for all organic compounds with -amino groups.
• imino acids such as proline and hydroxylproline, which do not have free amino group
• a bright yellow compound is generated and monitored at 440 nm.
• the peak areas for each amino acid are calculated using both 570 and 440 nm wavelength outputs. The yield is calculated as follows: (amount of polysaccharide in the conjugate x100) / amount of activated polysaccharide.
• Conjugates (4 and 5) generated using in aqueous medium demonstrated significant loss in O-acetyl levels.
• Conjugates generated in DMSO solvent, using native polysaccharide without MW sizing (6 and 7) did not demonstrate loss in O-acetyl levels.
• the conjugate yields were very poor in addition to poor filterability characteristics.
• Conjugates generated in DMSO using polysaccharides that were sized by high pressure homogenization (1 , 2 and 3) had high yield and better filterability characteristics with significant preservation of O-acetyl levels. These conjugates also had very low levels of free polysaccharides.
• the immunogenicity of the conjugates of the invention can be assessed using the opsonophagocytic assay (OPA) described below.
• OPA opsonophagocytic assay
• OPAs are used to measure functional antibodies in murine sera specific for S. pneumoniae serotype 15B.
• Test serum is set up in assay reactions that measure the ability of capsular polysaccharide specific immunoglobulin to opsonize bacteria, trigger complement deposition, thereby facilitating phagocytosis and killing of bacteria by phagocytes.
• the OPA titer is defined as the reciprocal dilution that results in a 50% reduction in bacterial count over control wells without test serum. The OPA titer is interpolated from the two dilutions that encompass this 50% killing cut-off.
• Test serum was serially diluted 2.5-fold and added to microtiter assay plates. Live serotype 15B target bacteria were added to the wells and the plates were shaken at 37°C for 30 minutes. Differentiated HL-60 cells (phagocytes) and baby rabbit serum (3- to 4-week old, Pel-Freez®, 6.25% final concentration) were added to the wells, and the plates were shaken at 37°C for 45 minutes.
• conjugates 1 and 2 The immunogenicity of conjugates 1 and 2 has been tested according to the above mentioned assay.
• One additional conjugate and an unconjugated native S. pneumoniae serotype 15B capsular polysaccharide (unconjugated PS) were also tested in the same assay:
• Conjugate 9 was prepared by conjugation of native (i.e not sized) serotype 15B capsular polysaccharide to CRM 197 by reductive amination in aqueous solution.
• conjugates 1 and 2 when administered to mice, generate antibodies capable of opsonizing serotype 15B S. pneumoniae, triggering complement deposition, thereby facilitating phagocytosis and killing of bacteria by phagocytes.
• conjugates 1 and 2 when administered to mice, generate antibodies capable of opsonizing serotype 15B S. pneumoniae, triggering complement deposition, thereby facilitating phagocytosis and killing of bacteria by phagocytes.
• conjugates 1 and 2 when administered to mice, generate antibodies capable of opsonizing serotype 15B S. pneumoniae, triggering complement deposition, thereby facilitating phagocytosis and killing of bacteria by phagocytes.
• conjugate 9 which has not been sized.
• Pneumococcal serogroup 15 includes four structurally-related serotypes: 15A, 15B, 15C, and 15F.
• Serotypes 15B and 15C are undistinguishable by genetic typing techniques and have similar capsular polysaccharide (PS) composition, except that the 15B-PS is the O- acetylated variant of 15C-PS.
• PS capsular polysaccharide
• PCV16v is a 16-valent conjugates composition comprising glycoconjugates from S. pneumoniae serotypes 1 , 3, 4, 5, 6A, 6B, 7F, 9V, 14, 15B, 18C, 19A, 19F, 22F, 23F and 33F (16vPnC) all individualy conjugated to CRM 97 .
• PCV20v is a 20 valent conjugates composition comprising glycoconjugates from S. pneumoniae serotypes 1 , 3, 4, 5, 6A, 6B, 7F, 8, 9V, 10A, 1 1A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F and 33F (20vPnC) all individualy conjugated to CRM 97 .
• Table 1 OPA Titers against serotypes 15B and 15C strains in Rabbit Sera Pre and Post vaccination with PCV16v

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