WO2020210149A1 - Broad and long-lasting influenza vaccine - Google Patents
Broad and long-lasting influenza vaccine Download PDFInfo
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- WO2020210149A1 WO2020210149A1 PCT/US2020/026841 US2020026841W WO2020210149A1 WO 2020210149 A1 WO2020210149 A1 WO 2020210149A1 US 2020026841 W US2020026841 W US 2020026841W WO 2020210149 A1 WO2020210149 A1 WO 2020210149A1
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- C12N2710/10011—Adenoviridae
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- C12N2800/00—Nucleic acids vectors
- C12N2800/22—Vectors comprising a coding region that has been codon optimised for expression in a respective host
Definitions
- This application pertains generally to a monovalent influenza pharmaceutical formulation for intranasal administration that induces a combined mucosal, humoral and cell- mediated protective immune response in human subjects and provides seroprotection against Influenza A and Influenza B subtypes for an extended period of time.
- Influenza is one of the most common viral respiratory infections, leading to significant morbidity and mortality.
- the US Centers for Disease Control and Prevention recommends that everyone in the US over 6 months of age receives an annual influenza vaccination. Vaccine effectiveness can vary greatly from year to year, and in many years overall protection is poor.
- Influenza viruses are enveloped ribonucleic acid viruses belonging to the family of Orthomyxoviridae and are divided into three distinct types on the basis of antigenic differences of internal structural proteins (Lamb RA, Krug RM. Orthomyxoviridae : The Viruses and Their Replication. In: Fields Virology, Editors-in-Chief: Knipe DM and Howley PM. 4th Edition. Philadelphia, PA: Lippincott Williams and Wilkins, Publishers; 2001;1487-1531).
- Two influenza types, Type A and B are responsible for yearly epidemic outbreaks of respiratory illness in humans and are further classified based on the structure of two major external glycoproteins, hemagglutinin (HA) and neuraminidase (NA).
- HA hemagglutinin
- NA neuraminidase
- Type B viruses which are largely restricted to the human host, have a single HA and NA subtype. In contrast, numerous HA and NA Type A influenza subtypes have been identified to date. Type A strains infect a wide variety of avian and mammalian species.
- Type A and B influenza variant strains emerge as a result of frequent antigenic change, principally from mutations in the HA and NA glycoproteins. These variant strains may arise through one of two mechanisms: selective point mutations in the viral genome [Palese P, Garcia- Sastre A. Influenza vaccines: present and future. The Journal of Clinical Investigation. 2002; 110:9- 13; Nakajima S, Nobusawa E, Nakajima K. Variation in response among individuals to antigenic sites on the HA protein of human influenza virus may be responsible for the emergence of drift strains in the human population. Virology.
- influenza A vims subtypes H1N1 and H3N2, and influenza B viruses have been in global circulation in humans.
- the current U.S. licensed inactivated trivalent and quadrivalent (containing two strain lineages of influenza B virus) vaccines are formulated to prevent influenza illness caused by these influenza viruses.
- the antigenic composition of influenza vaccines need to be evaluated yearly, and the influenza vaccines are reformulated almost every year. The immune response elicited by previous vaccination may not be protective against new variants.
- Vaccines produced in eggs are not only more likely to be antigenically dissimilar the corresponding strains in circulation than vaccine produced in tissue culture [Seqirus presents favorable outcomes data for adjuvanted trivalent influenza vaccine (FLUAD®) at 6th annual IDWeek. Seqiris Web site] but are also associated with longer manufacturing timelines and supply chain risks and induce allergic response in many individuals. [0008] Most currently licensed vaccines are based on circulating influenza strains adapted to grow in chicken eggs. In general, these vaccines are well tolerated but provide limited protection to influenza viruses that are not well matched to the vaccine strains. An intranasal live attenuated influenza virus (LAIV) vaccine has been licensed since 2003, but its use is limited to older children and adults up to age 49 years.
- LAIV intranasal live attenuated influenza virus
- Intranasal vaccines may be preferred over parenteral vaccines due to the ease of administration and decreased discomfort associated with administration.
- a significant fraction of the US population manifests fear of needles (McLenon J. et al. The fear of needles: A systematic review and meta-analysis (2019; Jan) J. Adv. Nurs.; 75(l):30-42).
- Recent post-marketing studies have shown declining effectiveness, and it was not recommended for use in the 2016-2017 and 2017-2018 influenza seasons (CDC website).
- Cellular immunity to influenza may reduce disease severity and contagiousness in those infected, mucosal immune responses provide protection against influenza at the initial site of infection and both may be able to protect against infection in the absence of seroprotective levels of serum HAI antibody [Gould VMW, Francis JN, Anderson KJ, et al. Nasal IgA provides protection against human influenza challenge in volunteers with low serum influenza antibody titre. Front Microbiol. 2017;8:900; McMichael AJ, Gotch FM, Noble GR, et al. Cytotoxic T-cell immunity to influenza. N Engl J Med. 1983;309: 13-7; Seibert CW, Rahmat S, Krause JC, et al.
- Recombinant IgA is sufficient to prevent influenza virus transmission in guinea pigs. J Virol. 2013;87:7793-804; Wilkinson TM, Li CK, Chui CS, et al. Preexisting influenza specific CD4+ T cells correlate with disease protection against influenza challenge in humans. Nat Med. 2012;18:274-80].
- no single influenza vaccine induces those combined responses of the immune system arms to provide long term seroprotection against influenza A and influenza B subtypes. Therefore, a need remains for an influenza vaccine that induces long term seroprotection, along with a combined immune response of the mucosal, humoral and cell-mediate types.
- compositions and methods for inducing long term systemic immune protection against influenza A and influenza B virus subtypes in human subjects include compositions and methods for inducing long term systemic immune protection against influenza A and influenza B virus subtypes in human subjects.
- the formulation comprises an effective amount of at least 10 11 viral particle (vp) of replication deficient adenovirus vector that contains and expresses influenza virus hemagglutinin antigen codon optimized for the human subject, wherein the effective amount induces a combined mucosal, humoral (i.e., ex-mucosal antibodies, such as in blood or serum), and T cell immune response that is preferably protective from influenza infection; and, a pharmaceutically acceptable diluent or carrier.
- the formulation is configured to provide seroprotection to the human subject of an HAI antibody titer >40 for at least 12 months against the influenza virus.
- influenza pharmaceutical formulation suitable for a single dose intranasal administration to a human subject, wherein the formulation comprises an effective amount of at least 10 9 viral particles (vp) of replication deficient adenovirus vector that contains and expresses influenza virus hemagglutinin antigen codon optimized for the human subject, wherein the effective amount induces a combined mucosal and humoral immune response that is preferably protective, preferably being configured to provide seroprotection to the human subject of an HAI antibody titer >40 for at least 12 months against the influenza virus; and, a pharmaceutically acceptable diluent or carrier.
- the HAI antibody titer is at least 50.
- the influenza vims hemagglutinin antigen is from an Influenza A vims.
- the Influenza A vims is subtype H1N1.
- the methods comprise administering intranasally to a human subject a single dose of the present influenza pharmaceutical formulation, wherein the administration induces serum antibodies, mucosal antibodies and T cells against influenza vims whereby the human subject is seroprotected for at least 12 months.
- the seroprotection lasts at least 13 months, at least 14 months, or longer.
- administration induces an HAI antibody titer of at least 50 for at least 12 months post administration.
- the present disclosure provides methods that provide a combined mucosal, humoral and T cell immune response that is preferably protective against Influenza A vims.
- the Influenza vims A is subtype H1N1 and/or H3N2.
- the present methods provide a combined mucosal, humoral and T cell immune response that is preferably protective against Influenza B vims.
- the present methods provide a combined mucosal, humoral and T cell immune response that is preferably protective against Influenza A vims subtypes and Influenza B vims infection.
- Figure 1 shows the schematic diagram of the adenoviral vector containing the influenza vims HA gene, wherein the numbers refer to base pair number in wild-type Ad5 sequence, GenBank ID AY339865.1.
- Figure 2 shows the semm antibody (hemagglutination-inhibiting antibody, HAI) (humoral) response at day 29 post administration induced following single administration of the present monovalent influenza vaccine composition with 100% seroprotection at two dose levels, wherein the antibodies are sufficient to prevent an infection from influenza vims.
- Fluzone is an inactivated quadrivalent high dose seasonal influenza vaccine.
- FIG 3 shows in table format the serum antibodies (HAI, MN) measured at day 29 post administration of the present monovalent influenza vaccine composition, wherein serum neutralizing antibodies were measured in a microneutralization (“MN”) assay and the serum hemagglutination inhibiting antibodies measured in a HAI assay are presented as a geometric mean titer (“GMT”).
- MN microneutralization
- GTT geometric mean titer
- Figure 4 shows T cell immunity (cell mediated immune) response induced following single administration of the present monovalent influenza vaccine composition.
- Figure 5 shows mucosal IgA antibody (mucosal) response induced following single administration of the present monovalent influenza vaccine composition.
- Figure 6 shows extended seroprotection via measurement of serum antibody (HAI) at amounts sufficient to prevent an infection from influenza virus.
- HAI serum antibody
- the figure shows the geometric mean (95% Confidence Interval) hemagglutination inhibition titer against influenza A/Calif omia/07/2009(H INI) to end point day 181 by dose of the present monovalent influenza vaccine composition.
- Figure 7 shows geometric mean (GMR) (95% confidence interval) microneutralization titer against Influenza A/Calif omia/07/2009(H INI) to end point day 181 by dose of the present monovalent influenza vaccine composition.
- GMR geometric mean
- Figure 8 shows the cellular immune response to the present monovalent influenza vaccine composition by dose.
- Cl confidence interval
- GM geometric mean titer
- LS least squares
- SFU spot-forming units
- vp viral particles
- a The analysis of covariance uses log-transformed level as dependent variable, dose group as a factor, and baseline log-transformed analysis as a covariate. Differences of LS mean estimates and 95% CIs were back-transformed to the original scale, resulting in a ratio of the geometric means; b. Post-hoc analysis; c. The number and percentage of subjects with 3-fold rise since Baseline and 25 SFU/10 6 cells greater than Baseline; and, d. From Fisher’s exact test.
- FIG 9 shows humoral immune response induced by the present monovalent influenza vaccine composition (e.g., NasoVAX) at a dose of l lxlO 11 vp and Fluzone® Groups on days 29, 91 and 181 post administration, with the HAI presented as a geometric mean ratio (“GMR”) along with the seroconversion rate (“SCR”) and the percentage of subjects with a HAI titer > 1:40 (“a”), and the seroprotection rate (“SPR”), wherein the percentage of subjects with either a baseline HAI titer, 1: 10 and postvaccination titer > 1:40 (“b) (which is 4 times the assay lower limit of quantification) are included in the last row.
- the present monovalent influenza vaccine composition e.g., NasoVAX
- HAI presented as a geometric mean ratio (“GMR”) along with the seroconversion rate (“SCR”) and the percentage of subjects with a HAI titer > 1:40 (“a”), and the seroprotection
- FIG 10A shows the HAI titer (“GMT”) over 13 months induced by the present monovalent influenza vaccine composition (e.g., NasoVAX), wherein 8/15 subjects in the high dose group (1 lxlO 11 vp) returned at about 13 months for evaluation with an average of 13.5 months from administration to measurement of HAI titer.
- GTT HAI titer
- NasoVAX monovalent influenza vaccine composition
- Figure 10B shows seroprotection and seroconversion rates induced by the present monovalent influenza vaccine composition (e.g., NasoVAX), demonstrating the seroprotection and seroconversion rates are identical between study days 15 and 400 (days post administration of the present monovalent influenza vaccine composition). The immune response was intact at 13 months with the rate of seroprotection and the rate of seroconversion unchanged.
- present monovalent influenza vaccine composition e.g., NasoVAX
- Figure 11 shows a dose-dependent vector shedding that is absent at 2 weeks post administration (of the present monovalent influenza vaccine composition (e.g., NasoVAX)) with no replication competent vims found (as determined via polymerase chain reaction (“PCR”) assay) and anti- vector antibody presented as GMR at Day 29 vs baseline wherein only a 2.3-fold induction after 1 month at highest dose was demonstrated.
- the present monovalent influenza vaccine composition demonstrates a transient shedding (Advector) with limited anti-vector (Ad-vector) immune response.
- Figure 12 shows the effect on NasoVAX immunogenicity (high dose; l lxlO 11 vp) of pre existing anti-vector (Ad5) immunity as measured for humoral (“HAI” or microneutralization “MN” at day 29), mucosal (“IgA” at day 29) and cellular (“ELISpot” at day 8) wherein no difference in an immune response between Ad5 seronegative or Ad5 seropositive subjects was observed.
- Median titer of Ad5+ subjects (seropositive) was 22-fold above the lower limit of quantification (LLOQ), wherein seroconversion is typically about 4-fold over background or the LLOQ assay.
- the present invention provides compositions and methods for inducing long term systemic immune protection against influenza A virus subtypes and influenza B viruses in human subjects.
- a influenza pharmaceutical formulation (preferably monovalent) suitable for a single dose intranasal administration to a human subject.
- the formulation comprises an effective amount of at least 10 11 viral particle (vp) of replication deficient adenovirus vector that contains and expresses influenza vims hemagglutinin antigen codon optimized for the human subject, wherein the effective amount induces a combined mucosal, humoral and T cell immune response, which is preferably protective against influenza infection; and, a pharmaceutically acceptable diluent or carrier.
- an influenza pharmaceutical formulation suitable for a single dose intranasal administration to a human subject comprising an effective amount of at least 10 9 viral particles (vp) of replication deficient adenovirus vector that contains and expresses influenza vims hemagglutinin antigen codon optimized for the human subject, wherein the effective amount induces a combined mucosal and humoral immune response, which is preferably protective against influenza infection, and is some preferred embodiments configured to provide seroprotection to the human subject of an HAI antibody titer >40 for at least 12 months against the influenza vims; and, a pharmaceutically acceptable diluent or carrier
- a method for inducing a combined mucosal, humoral and T cell immune response, preferably protective, in a human subject against influenza vims comprise administering intranasally to a human subject a single dose of a present influenza pharmaceutical formulation, wherein the administration induces serum antibodies, mucosal antibodies and T cells against influenza vims whereby the human subject is seroprotected for at least 12 months.
- adenoviral vector e.g., Ad5-vectored
- Ad5-vectored intranasal influenza vaccine produced in tissue culture
- Ad-HA replication-deficient adenovirus
- Ad-HA Ad-HA
- NasoVAX is delivered intranasally, where we herein demonstrate the vaccine composition induced both local and long-lasting systemic immune responses. See Example 3. Subsequent production of the HA antigen in normal human epithelial cells allows for an immune response against the HA antigen as it occurs in natural circulating influenza virus. Moreover, Applicants have shown the use of the adenoviral vector, when administered intranasally, even in subjects seropositive for Ad5, bypasses the adenovirus immunity of the subjects and thereby its effects are not adversely affected by a pre-existing immune response against the vector. See Figure 13.
- the present intranasal influenza vaccine (comprising an adenoviral vector) can be administered repeatedly (e.g., as a seasonal influenza vaccine administered about once every 11-14 months) without inducing a significant immune response against the viral vector.
- HAI hemagglutination inhibition
- HAI titer equal to or greater than 40 is used as an immunological correlate of protection and is regarded as the best currently available parameter for predicting protection from natural infection, according to FDA guidelines for pandemic influenza vaccines (Noah et al. Qualification of the hemagglutination inhibition assay in support of pandemic influenza vaccine licensure. Clin. Vaccine Immunol. 2009;16:558-566).
- the present intranasal influenza vaccine (Naso VAX) is stable for about 3 months at an ambient temperature, such as room temperature (e.g.,15 to 30°C, preferably 20-25°C). See Example 7.
- the present intranasal influenza vaccine can be stored, or shipped, without the need for refrigeration or specific storage conditions.
- the present intranasal influenza vaccine comprises influenza antigens present in an Influenza A pandemic virus strain and may be shipped directly to the user i.e., vaccinee, for intranasal administration.
- the term "about” is used to refer to an amount that is approximately, nearly, almost, or in the vicinity of being equal to or is equal to a stated amount, e.g., the state amount plus/minus about 5%, about 4%, about 3%, about 2% or about 1%.
- compositions, formulations and methods of the present invention may comprise, consist essentially of, or consist of the components and ingredients of the present invention as well as other ingredients described herein.
- consisting essentially of means that the compositions, formulations and methods may include additional steps, components or ingredients, but only if the additional steps, components or ingredients do not materially alter the basic and novel characteristics of the claimed compositions, formulations and methods.
- the term “configured” describes a system, apparatus, or other structure that is constructed or configured to perform a particular task or adopt a particular configuration.
- the term “configured” can be used interchangeably with other similar phrases such as arranged and configured, constructed and arranged, adapted and configured, adapted, constructed, manufactured and arranged, and the like.
- an“adjuvant” refers to a substance that enhances the body’s immune response to an antigen.
- the present monovalent influenza pharmaceutical formulation is a non-adjuvanted vaccine composition.
- “administration” is meant introducing a vaccine composition of the present disclosure into a subject; it may also refer to the act of providing a composition of the present disclosure to a subject (e.g., by prescribing).
- the term“therapeutically effective amount” as used herein refers to that amount of the compound being administered which will induce a combined, mucosal, humoral and cell mediated immune response.
- the term also refers to an amount of the present compositions that will relieve or prevent to some extent one or more of the symptoms of the condition to be treated.
- a therapeutically effective amount refers to that amount which has the effect of preventing the condition/disease from occurring in a mammal that may be predisposed to the disease but does not yet experience or exhibit symptoms of the condition/disease (prophylactic treatment), alleviation of symptoms of the condition/disease, diminishment of extent of the condition/disease, stabilization (e.g., not worsening) of the condition/disease, preventing the spread of condition/disease, delaying or slowing of the condition/disease progression, amelioration or palliation of the condition/disease state, and combinations thereof.
- the term“effective amount” refers to that amount of the compound being administered which will produce a reaction that is distinct from a reaction that would occur in the absence of the compound.
- an effective amount of the present monovalent influenza pharmaceutical formulation comprises at least 10 9 infectious units (ifu) of a replication deficient adenoviral vector containing and expressing influenza virus hemagglutinin antigen codon optimized for the human subject.
- the term“ambient temperature” is the air temperature for storing the present monovalent influenza pharmaceutical formulation.
- the ambient temperature is a room temperature, such as selected from any temperature within the range from about 15 to 30°C, preferably from about 20 to 25 °C.
- the term“human adenovirus” is intended to encompass all human adenoviruses of the Adenoviridae family, which include members of the Mastadenovirus genera. To date, over fifty-one human serotypes of adenoviruses have been identified (see, e.g., Fields et ah, Virology 2, Ch.
- the adenovirus may be of serogroup A, B, C, D, E, or F.
- the human adenovirus may be a serotype 1 (Ad 1), serotype 2 (Ad2), serotype 3 (Ad3), serotype 4 (Ad4), serotype 5 (Ad5), serotype 6 (Ad6), serotype 7 (Ad7), serotype 8 (Ad8), serotype 9 (Ad9), serotype 10 (AdlO), serotype 11 (Adl l), serotype 12 (Adl2), serotype 13 (Adl3), serotype 14 (Adl4), serotype 15 (Adl5), serotype 16 (Adl6), serotype 17 (Adl7), serotype 18 (Adl8), serotype 19 (Adl9), serotype 19a (Adl9a), serotype 19p
- serotype 30 (Ad29), serotype 30 (Ad30), serotype 31 (Ad31), serotype 32 (Ad32), serotype 33 (Ad33), serotype 34 (Ad34), serotype 35 (Ad35), serotype 36 (Ad36), serotype 37 (Ad37), serotype 38 (Ad38), serotype 39 (Ad39), serotype 40 (Ad40), serotype 41 (Ad41), serotype 42 (Ad42), serotype 43 (Ad43), serotype 44 (Ad44), serotype 45 (Ad45), serotype 46 (Ad46), serotype 47
- the adenovirus is serotype 5 (Ad5).
- a“pharmaceutically acceptable carrier” refers to a carrier or diluent that does not cause significant irritation to the human subject and does not abrogate the biological activity and properties of the administered vaccine compositions.
- the term“seroconversion” is a rate defined as the percentage of individuals vaccinated (administered a present vaccine formulation) who have at least a 4-fold increase in serum haemagglutinin inhibition (HI) titers after vaccination.
- “conversion factor” is defined as the fold increase in serum HI geometric mean titers (GMTs) after vaccination.
- the term“seroprotection” refers to an HAI antibody titer of 40 or greater measured in serum from a human subject post-vaccination.
- the term“protection rate” as used herein is defined as the percentage of individuals vaccinated with a serum HAI titer equal to or greater than 1:40 after vaccination and is normally accepted as indicating protection.
- the term“seasonal influenza virus” refers to an influenza A and/or B virus that circulates and are responsible for seasonal flu epidemics each year. Influenza A viruses are divided into subtypes based on two proteins on the surface of the virus: hemagglutinin (HA) and neuraminidase (NA).
- influenza A viruses There are 18 different hemagglutinin subtypes and 11 different neuraminidase subtypes (HI through HI 8 and N1 through Ni l, respectively). While there are potentially 198 different influenza A subtype combinations, only 131 subtypes have been detected in nature. Current subtypes of influenza A viruses that routinely circulate in humans include A(H1N1) and A(H3N2). Influenza B viruses are further classified into two lineages: B/Yamagata and B/Victoria. Both influenza A and B viruses can be further classified into specific clades and sub-clades (which are sometimes called groups and sub-groups).
- beneficial or desired clinical results include, but are not limited to, alleviation of symptoms, diminishment of extent of disease, stabilization (e.g., not worsening) of disease, delaying or slowing of disease progression, substantially preventing spread of disease, amelioration or palliation of the disease state, and remission (partial or total) whether detectable or undetectable.
- stabilization e.g., not worsening
- substantially preventing spread of disease amelioration or palliation of the disease state
- remission partial or total
- “treat”, “treating”, and “treatment” can also mean prolonging survival as compared to expected survival if not receiving treatment and/or can be therapeutic in terms of a partial or complete cure for a disease and/or adverse effect attributable to the disease.
- the terms“prophylactically treat” or“prophylactically treating” refers completely, substantially, or partially preventing a disease/condition or one or more symptoms thereof in a host. Similarly, “delaying the onset of a condition” can also be included in “prophylactic ally treating” and refers to the act of increasing the time before the actual onset of a condition in a patient that is predisposed to the condition.
- a“vector” carries a genetic code, or a portion thereof, for an antigen, however it is not the antigen itself.
- a vector can include a viral vector or bacterial vector.
- an "antigen" means a substance that induces a specific immune response in a subject, including humans and/or animals.
- the antigen may comprise a whole organism, killed, attenuated or live; a subunit or portion of an organism; a recombinant vector containing an insert with immunogenic properties; a piece or fragment of DNA capable of inducing an immune response upon presentation to a host animal; a polypeptide, an epitope, a hapten, or any combination thereof.
- the antigen is a virus, bacterium, a subunit of an organism, an auto-antigen, or a cancer antigen.
- influenza pharmaceutical formulations also referred to herein as vaccine formulations, suitable and/or configured for a single dose intranasal administration to a human subject.
- the instant formulations comprise an effective amount of at least 10 9 viral particle (vp) of replication deficient adenovirus vector that contains and expresses influenza vims hemagglutinin antigen codon optimized for the human subject and a pharmaceutically acceptable diluent or carrier.
- the formulation is a monovalent influenza pharmaceutical formulation.
- the adenoviral vector is present in a formulation buffer comprising 10 mM TRIS, 75 mM NaCl, 0.2% Polysorbate 80, 5% sucrose, 1 mM MgCk, 0.1 mM EDTA, 0.5% ethanol, 10 mM L-Histidine.
- the non-replicating adenoviral viral vector is a human adenovirus.
- the adenovirus is a bovine adenovirus, a canine adenovirus, a non human primate adenovirus, a chicken adenovirus, or a porcine or swine adenovirus.
- the non-replicating viral vector is a human adenovirus.
- non-replicating adenoviral vectors are particularly useful for gene transfer into eukaryotic cells and vaccine development, and in animal models.
- any adenoviral vector known to one of skill in art, and prepared for administration to a mammal, which may comprise and express an influenza antigen may be used in the compositions and with the methods of this application.
- Ad-vectors include any of those in US Patent Nos. 6,706,693; 6,716,823; 6,348,450; or US Patent Publ. Nos. 2003/0045492; 2004/0009936; 2005/0271689; 2007/0178115; 2012/0276138 (herein incorporated by reference in entirety).
- the recombinant adenovirus vector may be non-replicating or replication-deficient requiring complementing El activity for replication.
- the recombinant adenovirus vector may include El-defective, E3-defective, and/or E4-defective adenovirus vectors, or the“gutless” adenovirus vector in which viral genes are deleted.
- the El mutation raises the safety margin of the vector because El -defective adenovirus mutants are replication incompetent in non-permissive cells.
- the E3 mutation enhances the immunogenicity of the antigen by disrupting the mechanism whereby adenovirus down-regulates MHC class I molecules.
- the E4 mutation reduces the immunogenicity of the adenovirus vector by suppressing the late gene expression, thus may allow repeated re-vaccination utilizing the same vector.
- the recombinant adenovirus vector is an El and E3 defective vector.
- The“gutless” adenovirus vector replication requires a helper virus and a special human 293 cell line expressing both Ela and Cre, a condition that does not exist in natural environment; the vector is deprived of viral genes, thus the vector as a vaccine carrier is non-immunogenic and may be inoculated for multiple times for re-vaccination.
- The“gutless” adenovirus vector also contains 36 kb space for accommodating transgenes, thus allowing co-delivery of a large number of antigen genes into cells.
- Specific sequence motifs such as the RGD motif may be inserted into the H-I loop of an adenovirus vector to enhance its infectivity.
- the formulations may be present in a liquid preparation for mucosal administration, e.g., oral, nasal, ocular, etc., formulations such as suspensions and, preparations for parenteral, subcutaneous, intradermal, intramuscular, intravenous (e.g., injectable administration) such as sterile suspensions or emulsions.
- the adenoviral vector may be in admixture with a suitable carrier, diluent, or excipient such as sterile water, physiological saline, or the like.
- the formulations can also be lyophilized or frozen.
- the present monovalent influenza formulation comprises an effective amount of about 10 9 viral particles (vp) of a replication deficient adenoviral vector. In exemplary embodiments, the present monovalent influenza formulation comprises an effective amount of about 10 10 viral particles (vp) of a replication deficient adenoviral vector. In certain other exemplary embodiments, the present monovalent influenza formulation comprises an effective amount of about 10 11 viral particles (vp) of a replication deficient adenoviral vector.
- the effective amount of adenoviral vector in the present vaccine formulation induces a combined influenza- specific mucosal (as demonstrated via IgA measurement), humoral (as demonstrated via sera HAI and microneutralization antibodies) and cell mediated (as demonstrated via influenza HA antigen specific T cell activation) immune response in a human subject against influenza virus.
- the serum antibodies are seroprotective for at least 6 months, at least 12 months, at least 13 month or at least 14 months.
- the present adenoviral vector comprises a genetic insert encoding the HA surface protein antigen from an A/Califomia/04/2009(H1N1) virus.
- the present adenoviral vector contains and expresses a hemagglutinin antigen from an H1N1 influenza A virus subtype.
- the present adenoviral vector contains and expresses a hemagglutinin antigen from an H3N2 influenza A virus subtype.
- the present adenoviral vector contains and expresses a hemagglutinin antigen from an influenza B virus.
- the present adenoviral vector contains and expresses a hemagglutinin antigen from a pandemic Influenza A virus. In certain other embodiments, the present adenoviral vector contains and expresses a hemagglutinin antigen (HA) from a seasonal influenza virus.
- HA hemagglutinin antigen
- the present monovalent influenza pharmaceutical formulation is used to provide protection against seasonal influenza virus. In certain other embodiments, the present monovalent influenza pharmaceutical formulation is used to provide protection against pandemic influenza virus.
- the present methods provide protection against infection by Influenza A virus subtypes. In certain embodiments, the present methods provide protection against infection by Influenza A virus subtypes H1N1 and/or H3N2. In other embodiments, the present methods provide protection against infection by Influenza B virus.
- the seroprotection lasts at least about 13 months. In certain embodiments, the seroprotection lasts at least about 14 months, or longer.
- the step of administering a single dose of a present (monovalent) influenza pharmaceutical formulation induces HAI antibodies at a titer of 50 or greater for at least 6 months, at least 12 months, at least 13 months, at least 14 months or longer.
- the titer of HAI antibodies in a human subject 12 months post vaccination is at least 50, at least 60, at least 70, at least 80, at least 90, or at least 100.
- NasoVAX has been surprisingly found to be seroprotective and to induce the production of neutralizing antibody response rates similar to commercial influenza vaccine (e.g. Fluzone ® ), an antibody response that is durable for at least one year, strong mucosal (IgA) and cellular (e.g., T cells as measured by ELISspot) responses, minimal induction of anti-vector (e.g., Ad5) antibodies, to have be little or unaffected by pre-existing vector (e.g., Ad5) antibody, to be well-tolerated at all dose levels tested, and to be stable (i.e., comprise an effective amount of viral particles) after about three months at ambient temperature (e.g., about 20-25°C).
- commercial influenza vaccine e.g. Fluzone ®
- IgA strong mucosal
- cellular e.g., T cells as measured by ELISspot
- minimal induction of anti-vector (e.g., Ad5) antibodies to have be little or unaffected by pre-existing vector (
- influenza pharmaceutical formulations suitable for a single dose intranasal administration to a human subject, the formulations comprising: an effective amount such as at least about any of 10 6 vp, 10 7 vp, 10 8 vp, 10 9 vp, 10 10 vp, or 10 11 vp, preferably at least 10 9 vp or 10 11 vp of replication deficient adenovirus vector that contains and expresses influenza virus hemagglutinin antigen (HA) codon optimized for the human subject, wherein the effective amount induces a combined mucosal, humoral and T cell immune response, which is preferably protective; and, a pharmaceutically acceptable diluent or carrier.
- an effective amount such as at least about any of 10 6 vp, 10 7 vp, 10 8 vp, 10 9 vp, 10 10 vp, or 10 11 vp, preferably at least 10 9 vp or 10 11 vp of replication deficient adenovirus vector that contains and expresses influenza virus
- the mucosal immune response which is preferably protective either alone or in combination with the other immune responses, is determined by anti-hemagglutinin (HA) IgA ELISA
- the humoral immune response which is preferably protective either alone or in combination with the other immune responses
- HAI hemagglutination inhibition assay
- the T cell immune response is determined by using g-interferon ELISpot.
- the formulation is configured to provide seroprotection to the human subject as determined by the subject having an HAI antibody titer >40 for at least 12 months against the influenza virus.
- this disclosure provides pharmaceutical formulations suitable for a single dose intranasal administration to a human subject, comprising: an effective amount of at least 10 9 viral particles (vp) of replication deficient adenovirus vector that contains and expresses influenza virus hemagglutinin antigen (HA) codon optimized for the human subject, wherein the effective amount induces a combined mucosal and humoral protective immune response configured to provide seroprotection to the human subject as determined by the subject having an HAI antibody titer >40 (or, in some embodiments, >50) for at least 12 months against the influenza vims; and, a pharmaceutically acceptable diluent or carrier.
- vp viral particles
- HA hemagglutinin antigen
- the effective amount is at least about 10 10 viral particles (vp) or at least about 10 11 viral particles (vp) and, in further embodiments, induces a T cell response.
- the formulation does not comprise an adjuvant.
- the formulation does not comprise an adjuvant.
- the HA antigen is from an Influenza A virus (in some preferred embodiments subtype H1N1 or H3N2) or an Influenza B vims.
- the formulation comprises Tris HC1 (pH 7.4), histidine, sucrose, sodium chloride, magnesium chloride, polysorbate 80, ethylenediaminetetraacetic acid, and ethanol.
- the formulation comprises a single dose, preferably an intranasal dose, of about lxlO 9 vp, about lxlO 10 vp, or about lxlO 11 vp.
- the formulation is frozen.
- the formulation is stable at ambient temperature for at least about three months.
- the ambient temperature is a room temperature from about 15 to 30°C, preferably from about 20 to 25°C.
- the formulation is stored at about -20°C or about 4-8°C until distribution, which could require storage at ambient temperature.
- the formulation is configured as a seasonal influenza vaccine comprising antigens from a seasonal influenza vims.
- the vial can be a multi-dose vial (i.e., a vial comprising multiple doses (e.g., each dose comprising an effective dose of viral particles) of the formulation) that could be used in, e.g., pandemic situations in combination with a pipette and/or eye dropper and administered to subjects dropwise).
- the container has contained the formulation for at least about three months at ambient temperature (e.g. room temperature).
- the formulation is configured to contain at least about 33% (i.e., allowing for about a 0.5 log decrease (about a three fold decrease)), preferably in some embodiments about 50%, infectious viral particles after about three months at ambient temperature (e.g. room temperature) within the container.
- this disclosure also provides methods of inducing a combined mucosal, humoral and T cell protective immune response in a human subject against influenza vims comprising: administering intranasally to a human subject at least a single dose of the influenza pharmaceutical formulation disclosed herein, wherein the administration induces a combined mucosal, humoral and T cell protective immune response against influenza vims and the human subject is seroprotected from infection by influenza vims for at least 12 months after said administration.
- the mucosal protective immune response is determined by anti-hemagluttinin (HA) IgA ELISA
- the humoral protective immune response is determined by hemagglutination inhibition assay (HAI) titer and/or presence of neutralizing antibody as determined using a microneutralization assay, optionally as measured using one or more of the geometric mean titer (GMT), geometric mean ratio (GMR), seroconversion rate (SCR), seropositivity rate (SPR); and/or
- the T cell protective immune response is determined by using g- interferon ELISpot.
- the method(s) can include administration of multiple doses of the formulation (e.g., during an epidemic or pandemic situation).
- the seroprotection lasts for at least about 13 months, or at least about 14 months.
- the influenza virus is Influenza A (in some preferred embodiments subtype H1N1 or H3N2) and/or Influenza B virus.
- the combined immune response provides protection against Influenza A virus subtypes and Influenza B virus.
- the influenza virus is a seasonal influenza virus.
- the administration induces an HAI antibody titer of at least 50 for at least 12 months post administration.
- the subject exhibits anti- adenovirus vector immunity (preferably wherein the replication deficient adenovirus vector is human adenovirus serotype 5 (Ad5)) prior to the administering intranasally, said immunity being determined by hemagglutinin inhibition assay, microneutralization assay, IgA ELISA, and/or ELIspot assay.
- the replication deficient adenovirus vector is human adenovirus serotype 5 (Ad5)
- Ad5 human adenovirus serotype 5
- administration of the formulation does not significantly enhance the anti-adenovirus vector immunity of the subject (e.g., not more than about three-fold, four-fold, five-fold or six fold above anti-adenovirus vector immunity of the subject present before administration of the formulation), said immunity in preferred embodiments being determined by hemagglutinin inhibition assay, microneutralization assay, IgA ELISA, and/or ELIspot assay.
- the subject is seropositive for human adenovirus prior to the administration.
- the method(s) can further comprise administering a single dose of a second influenza pharmaceutical formulation about one year after administration of at least one dose of the previously administered influenza pharmaceutical formulation.
- the second influenza pharmaceutical formulation comprises antigens of a seasonal influenza that are the same or different as that comprised by the previously administered influenza pharmaceutical formulation.
- the human subject is an adult.
- the present adenoviral vector is an El/E3-deleted, replication deficient (RD)-Ad5 vector that expresses the protein of interest (e.g., Influenza HA) within respiratory epithelial cells.
- the vector contains a genetic insert encoding the HA surface protein antigen from influenza type A or B.
- the recombinant Ad5 vector lacks the El region of the viral genome (nucleotides 343 to 3511), which renders the vims RD and incapable of producing infectious vims particles upon entry into a host cell.
- the vector contained a genetic insert encoding the HA surface protein antigen from an A/Califomia/04/2009(H1N1)-Iike strain of influenza (AdcoCA09.HA).
- Naso VAX was manufactured by propagation of the RD-Ad5 vector in replication- permissive PER.C6 cells, followed by purification of the virus from the infected cell harvest, and the final product included the following excipients: Tris HC1 (pH 7.4), histidine, sucrose, sodium chloride, magnesium chloride, polysorbate 80, ethylenediaminetetraacetic acid, and ethanol.
- Example 2 Study Protocol: Single-Ascending-Dose Study of Immunogenicity of NasoVAX
- the objectives of this study included: 1) To evaluate the humoral immune response to NasoVAX when administered by intranasal spray at a single dose of lxlO 9 , lxlO 10 , or lxlO 11 vp; 2) To evaluate the cellular immune response to NasoVAX when administered by intranasal spray at a single dose of lxlO 9 , lxlO 10 , or lxlO 11 vp; 3) To evaluate the mucosal immune response NasoVAX when administered by intranasal spray at a single dose of lxlO 9 , lxlO 10 , or lxlO 11 vp; and, 4) To evaluate the humoral immune response against non-represented influenza strains after NasoVAX administration.
- Immune measures included hemagglutination inhibition (HAI) and neutralizing antibody (MN) at days one (1), 15, 29, 90 and 180, and g-interferon ELISpot at day 1 and 8.
- HAI hemagglutination inhibition
- MN neutralizing antibody
- a parallel cohort of 20 similar subjects were dosed with Fluzone® injectable influenza vaccine containing an A/California 2009 component and had assessments at the same timepoints.
- a sentinel cohort of five (5) subjects from each cohort was dosed. Dosing of the remainder of each cohort proceeded after the last sentinel subject completed Day eight (8) if no events meeting stopping criteria had occurred.
- a serum sample was collected from each subject for HAI and microneutralization assays against influenza A/Calif omia/07/2009(H INI) [a strain homologous to the one used for NasoVAX (monovalent AdcoCA.09.HA)] pre-dose on Day 1 and on Days 4, 8, 15, 29, 91, and 181; Ad5 antibody and HAI and microneutralization assays against non-represented influenza strains were also performed on the Day 1 and Day 29 samples.
- a whole blood sample was collected from each subject and processed to isolate PBMCs for evaluation of T-cell responses by ELISpot pre-dose on Day 1 and on Day 8.
- ANCOVA Analysis of covariance
- Categorical data derived from the assay data (e.g., SPR, SCR, responder rate) were tabulated by counts and percentages per dose group, as well as the 95% Clopper- Pearson exact Cl of the percentage.
- Naso VAX monovalent AdcoCA09.HA
- lxlO 9 , lxlO 10 , or lxlO 11 vp elicited a combined humoral and mucosal immune responses and at a dose of lxlO 11 a combined immune response including a cellular response (e.g., T cells).
- a cellular response e.g., T cells
- a monovalent influenza pharmaceutical formulation suitable for a single dose intranasal administration to a human subject, comprising: an effective amount of at least 10 11 viral particle (vp) of replication deficient adenovirus vector that contains and expresses influenza vims hemagglutinin antigen codon optimized for the human subject, wherein the effective amount induces a combined mucosal, humoral and T cell protective immune response; and, a pharmaceutically acceptable diluent or carrier.
- vp viral particle
- an influenza pharmaceutical formulation suitable for a single dose intranasal administration to a human subject comprising: an effective amount of at least 10 9 viral particles (vp) of replication deficient adenovirus vector that contains and expresses influenza vims hemagglutinin antigen codon optimized for the human subject, wherein the effective amount induces a combined mucosal and humoral protective immune response configured to provide seroprotection to the human subject of an HAI antibody titer >40 for at least 12 months against the influenza vims; and, a pharmaceutically acceptable diluent or carrier.
- vp viral particles
- Also provided in certain embodiments is a method of inducing a combined mucosal, humoral and T cell protective immune response in a human subject against influenza vims whereby the human subject is seroprotected for at least 6 months.
- the method comprises administering intranasally to the human subject a single dose of any present influenza pharmaceutical formulation, wherein the administration induces serum antibodies, mucosal antibodies and T cells against influenza vims.
- Humoral immune response i.e., antibodies in the blood or serum
- HAI Humoral immune response to the influenza HA protein as measured by HAI is a recognized correlate of protection for influenza (Clinical Data Needed to Support the Ficensure of Seasonal Inactivated Influenza Vaccines, May 2007).
- HI hemagglutination inhibition
- HI antibody response to the new vaccine may demonstrate protection when a percentage of subjects achieve an HI antibody titer > 1:40.
- test plate 96-well V-bottom microtiter plate
- quality controls on each plate consisting of positive (reference antiserum), negative, vims, and cell quality controls.
- a single QC plate was included in each assay and contained quality controls and a viral back titer (VBT) to confirm vims concentration on a 96- well V-bottom microtiter plate.
- VBT viral back titer
- Samples were treated with receptor destroying enzyme in accordance with the laboratory Standard Operation Procedure. Both test plates and QC plates were covered and incubated for 120 to 140 minutes at room temperature (15°C to 30°C).
- Titers > 1280 were assigned a titer of 1280 for use in GMT calculation; and, 2) The VBT on the QC plate had to be 4 HA units/25 pL ⁇ 1 dilution for a valid assay. Samples were analyzed in triplicate for all assays.
- microneutralization assay up to nine (9) samples were analyzed on each 96-well flat-bottom microtiter plate (the test plate) along with QC on each plate consisting of a positive (reference antiserum), vims, and cell controls. At least three (3) QC plates were included in each assay and contained quality controls and a VBT to confirm vims concentration on a 96- well flat-bottom microtiter plate.
- Fifty microliters (50 pL) of diluted vims (diluted to target a VBT within the range of 1.17 to 9.38xTCIDso [the amount of vims required to kill 50% of infected hosts or to produce a cytopathic effect in 50% of inoculated tissue culture cells]/50 pL) was added to all wells in all columns containing serum and the wells designated as the vims control; no vims was added to cell control wells. Both test plates and QC plates were incubated at 37°C ⁇ 2°C with 0% to 5% CO2) for 2 to 2.5 hours.
- One hundred microliters (100 pL) of MDCK cells (1.5x10 s cells/mL in diluent, 50% to 99% confluent) were added to all wells on every plate. Plates were incubated for 19 to 21 hours at 37°C ⁇ 2°C with 5% ⁇ 1% CO2. Media was removed from all plates and each well washed with 100 pL Dulbecco's phosphate-buffered saline (DPBS,lx concentration). DPBS was removed, and 100 pL of fixative was added to each well. Plates were covered and incubated at room temperature (15°C to 30°C) for 10 to 15 minutes.
- DPBS Dulbecco's phosphate-buffered saline
- Fixative was removed, and plates were air-dried before washing 3 times with 200 pL/well of wash buffer. 100 mL of diluted primary antibody was added to each well, and plates were incubated for 1 to 1.25 hours at room temperature. Plates were washed four times with 200 mL/well of wash buffer, and 100 mL of diluted secondary antibody was added to each well. Plates were incubated for 1 to 1.25 hours at room temperature. Plates were washed four times with 200 mL/well of wash buffer, and 100 mL fresh substrate was added (in low light) to each well followed by incubation for 15 to 25 minutes in low light at room temperature. Stop solution (100 mL) was immediately added to each well, and absorbance was read at 490 to 495 nm.
- the resulting data were evaluated in accordance with the following criteria: 1) the plate cut-off value for each plate was calculated according to the following equation: (average of vims control wells - average of cell control wells)/2; and, 2) semm samples with an absorbance value below the plate cut-off were positive for neutralizing antibody, whereas those above the plate cut-off were negative for neutralizing antibody. VBT values with an absorbance value above the plate cut-off were positive for virus replication. VBT values with an absorbance value below the plate cut-off were negative for virus replication. The titer was calculated as the reciprocal of the highest dilution scored as a positive. A negative titer (all absorbance values above the plate cut-off) was assigned a value of 5.
- Dilutions were designated 1: 10 to 1: 1280. Titers > 1280 were assigned a titer of 1280 for use in GMT calculations but were reported as > 1280 in the data tables. Exceptions included: absorbance value that crossed over the plate cut-off value (value fell below the cut-off, rose above it (noted as‘flag’), then fell back below) had the titer assigned for the final absorbance value that fell below the plate cut-off value unless there was a > 2-fold difference between the initial fall in absorbance and when it rose again above it; samples with more than one flag were not accepted unless a mechanical issue was noted on data evaluation or the final absorbance value was more than two dilutions from the last flag; values that crossed over the plate cut-off in the VBT were reported as the titer prior to the cross; and, when evaluating absorbance values on all plates, data trending was evaluated down and across plates to look for indications of mechanical issues (e.g., partial or complete clogged tip that could result in absorbance values higher
- Test plates and the assay were acceptable if the following criteria were met: 1) Positive QC values on individual test plates were within ( ⁇ ) 1 dilution of the calculated median value for the assay, or the individual plate was rejected; 2) The VBT median value determined for all accepted QC plates for an assay was in the range of 1.17 to 9.38, or the assay was rejected; and, 3) At least 5 of the 9 serum samples on a test plate match at least 1 of their respective replicates, or all 9 test samples were reanalyzed. Samples were analyzed in triplicate for all assays.
- a blood sample was collected in a heparinized tube from each subject at day -28 to day -1, day 1, 2, 4, 8, 15, 29, 91 and 181 for evaluation of HA-specific T-cell response by ELISpot.
- PBMCs were isolated by standard Ficoll-Hypaque gradient density technique with centrifugation steps adjusted to obtain optimal yield and viability with site equipment. PBMCs were cryopreserved at a density of 10 7 cells/mL and stored at -80°C before shipment on dry ice to the testing laboratory. Samples were stored on liquid nitrogen before testing.
- PBMCs were added at a concentration of 0.2xl0 6 cells per well to a 96-well polyvinyl difluoride membrane ELISpot plate coated with the capture interferon gamma (IFN-g) antibody.
- IFN-g capture interferon gamma
- PBMCs were stimulated for 18 hours in the presence of 7 pooled HA-derived peptides, positive and negative controls.
- HA-derived peptide pools (19 to 20 peptides each) were prepared from 139 short peptides (14 or 15 amino-acid long, 11 amino-acid overlap) derived from the HA sequence of the A/California/04/2009(H1N1) strain.
- Positive controls used a CEF (cytomegalovirus, Epstein Barr vims and influenza virus) peptide pool and phytohemagglutinin.
- Negative controls were based on irrelevant human myelin oligodendrocyte glycoprotein peptide pool and media alone. All conditions were tested in triplicate except media alone, which was tested in sextuplicate. After revelation of the IFN-g ELISpot plate, the number of spots was counted with an automated ELISpot counter and expressed as SFU/10 6 PBMCs.
- FIGs 4 and 8 summarize the cellular immune response (SFUs from ELISpot) at Day 8.
- Baseline geometric mean SFU/10 6 cells varied widely among the dose groups and, therefore, a post-hoc analysis of change from Baseline was added.
- Post-vaccination results in the NasoVAX groups were higher than in the placebo group, and the difference was statistically significant in the lxlO 11 vp, overall NasoVAX groups for LS GM SFUs and responder rate, and in the lxlO 11 vp group for median change from Baseline.
- Nasal swab extract i.e., sample
- HA i.e., allowed to bind to HA
- a biotinylated detection antibody added to the wells to detect the captured IgA (i.e., mucosal IgA).
- the anti-HA IgA titer was determined using a cut-off absorbance-based method.
- the total IgA per sample was also quantitated using the Human IgA ELISA Quantitation Set, E80- 102 (Bethyl Laboratories; Montgomery, TX). The results were reported as a ratio of HA-specific IgA (U/mL) to total Ig A (pg/ml) to allow for direct comparison between different nasal swab samples. Results were transferred electronically into the study database.
- Table 2 and Figure 5 summarize mucosal immune response to vaccine strain HA protein (IgA by ELISA) at Day 29. Unlike for humoral antibodies (i.e., antibodies present in blood), mucosal IgA GMTs were similar across all groups at Baseline (range: 1.8 to 3.0). GMRs at Day 29 showed no mucosal response in the placebo group and mucosal response in all the NasoVAX groups; the difference to placebo was statistically significant for the lxlO 10 vp and the lxlO 11 vp groups dose groups.
- the mucosal immune response observed in these studies has the potential to provide an effect additive to the humoral and cellular response pathways by blocking influenza at the site of infection.
- the cellular response elicited by NasoVAX was superior to that from Fluzone ® , and mucosal immune response was elicited by NasoVAX but not by Fluzone.
- Example 4 Comparison of Induced Immune Response by Monovalent Influenza Pharmaceutical Formulation (NasoVAX) and Fluzone ®
- Fluzone ® is a high-dose quadrivalent influenza vaccine administered via injection for influenza A and influenza B subtypes present in the vaccine.
- HAI antibodies were measured at day 29, 91 and 181 and results reported for a HAI assay, seroconversion rate and seroprotection. See Figure 9.
- NasoVAX monovalent AdcoCA09.HA
- lxlO 9 , lxlO 10 , or lxlO 11 vp elicited a humoral immune response to influenza A/Calif omia/07/2009(HlNl). All postvaccination results in the NasoVAX groups were higher than in the placebo group from Day 15 through Day 181. A clear dose effect was seen in the NasoVAX groups for HAI assay GMT, GMR, SCR, and SPR and for microneutralization GMT, GMR, and responder rates (2-fold and 4-fold).
- NasoVAX elicited a strain- specific cellular immune response.
- Example 5 Durability: Seroprotection for 13 months Induced by Monovalent Influenza Pharmaceutical Formulation (NasoVAX)
- Example 2 and 3 The above study disclosed in Example 2 and 3 was extended an additional six (6) months wherein a blood sample was collected in a serum separation tube from each available subject between day 403 and day 433 for evaluation of humoral response. In total eight of the 15 subjects at the 1 x 10 11 vp dose group returned for evaluation after one year. HAI and microneutralization assays against A/California/07/2009(H1N1) were performed on all eight samples collected. All subjects that participated in the extension study demonstrated seroprotection at least 13 months post administration with the present monovalent influenza vaccine. See Table 3 and Figure 10.
- NasoVAX was administered to human subjects as a single intranasal dose of 10 9 vp, 10 10 vp, or 10 11 vp.
- nasopharyngeal swab samples were collected from each subject and the concentration of the Ad5 vector shed at each time point quantified by polymerase chain reaction (PCR) assay.
- PCR polymerase chain reaction
- An adenovirus microneutralization (MN) assay was carried out to determine anti adenovirus antibodies in subjects. Dilutions of human sera were mixed with a consistent quantity of a replication deficient Ad5 vector that expresses green fluorescent protein (GFP) from a human cytomegalovirus (CMV) promoter (termed Ad5.CMV-GFP) and incubated to allow potential neutralization to occur. These mixtures were then inoculated onto VERO E6 cells in a 96-well plate and incubated for approximately three days. During this incubation, Ad5.CMV-GFP that is not neutralized infects the cells and produce GFP, which was used as a readout for the assay.
- GFP green fluorescent protein
- CMV human cytomegalovirus
- Fig. 11 also illustrates the GMR of antibodies against the adenovims vector component of NasoVAX (Ad5) following administration of a single intranasal dose of 10 9 vp, 10 10 vp, or 10 11 vp of NasoVAX.
- Fig. 12 shows the effect of pre-existing anti-Ad5 immunity on Ad5 serostatus following administration of a single intranasal dose (10 11 vp) of NasoVAX to subjects.
- pre-existing anti-Ad5 immunity (“Ad5 Seropositive” (median titer being 22-fold above the lower limit of quantitation (LLOQ)) had little effect on humoral (HAI), microneutralization (MN), mucosal (IgA), or cellular (ELISpot) anti-Ad5 immunity following administration of the intranasal dose of NasoVAX. This is another important finding as it indicates that NasoVAX can be administered intranasally even to subject with pre-existing immunity to Ad5.
- This example describes the long-term stability of NasoVAX in a liquid formulation at room temperature.
- Long-term stability at room temperature is desire feature of vaccines that can be used in situations in which refrigeration or other means for stabilizing a formulation may not be available. This would be important in epidemic or pandemic situations during which vaccines need to be shipped to remote areas that may lack the equipment to maintain formulations at a cooler temperature.
- the FFU assay is carried out by infecting cell monolayers with the appropriate NasoVAX dilution and incubated for 24-48 hours. The cells were then washed, inspected, fixed (e.g., ice-cold 90% methanol for four minutes), and washed again. Anti-Ad5 antibody was then added at various dilutions (antibody omitted in control samples), followed by a detection agent (e.g., NCL-Adeno (Novocastra, Newcastle, UK)) under appropriate conditions (e.g., ten minutes at room temperature with shaking).
- a detection agent e.g., NCL-Adeno (Novocastra, Newcastle, UK
- the cells are then washed, and the total number of infectious particles determined (e.g., by digital light scattering (DLS)).
- the low-dose and high-dose NasoVAX formulations were stable for at least three months at room temperature.
Abstract
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US20090175897A1 (en) * | 2005-05-23 | 2009-07-09 | Tang De-Chu C | System for rapid production of high-titer and replication-competent adenovirus-free recombinant adenovirus vectors |
US20150071964A1 (en) * | 2013-09-06 | 2015-03-12 | Vaxin Inc. | Methods and compositions for viral vectored vaccines |
US9452209B2 (en) * | 2007-04-20 | 2016-09-27 | Glaxosmithkline Biologicals Sa | Influenza vaccine |
US10131695B2 (en) * | 2011-09-20 | 2018-11-20 | Icahn School Of Medicine At Mount Sinai | Influenza virus vaccines and uses thereof |
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WO2008048976A2 (en) * | 2006-10-18 | 2008-04-24 | The Government Of The United States Of America As Represented By The Secretary Of The Deparment Of Health And Human Services, Centers For Disease Control And Prevention | Enhancing disease resistance against rna viral infections with intracytoplasmic pathogen sensors |
WO2010044921A2 (en) * | 2008-06-03 | 2010-04-22 | Vaxin Inc. | Intranasal administration of receptor-binding ligands or genes encoding such ligands as a therapeutic regimen for mitigating infections caused by respiratory pathogens |
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US20090175897A1 (en) * | 2005-05-23 | 2009-07-09 | Tang De-Chu C | System for rapid production of high-titer and replication-competent adenovirus-free recombinant adenovirus vectors |
US9452209B2 (en) * | 2007-04-20 | 2016-09-27 | Glaxosmithkline Biologicals Sa | Influenza vaccine |
US10131695B2 (en) * | 2011-09-20 | 2018-11-20 | Icahn School Of Medicine At Mount Sinai | Influenza virus vaccines and uses thereof |
US20150071964A1 (en) * | 2013-09-06 | 2015-03-12 | Vaxin Inc. | Methods and compositions for viral vectored vaccines |
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