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Vaccines Leslie Lobel Department of Microbiology, Immunology & Genetics Faculty of Health Sciences Ben Gurion University E-mail: [email protected] Phone: 052-6488000 Vaccine Immunobiology Passive Immunization: Administration of preformed antibody (hepatitis A, hepatitis B, measles, rabies, chickenpox, tetanus, botulism, diptheria Active Immunization (Vaccination): prophylactic approach dependent on specificity and memory Effective Vaccine Design Which antigens are likely to induce a useful protective response? At what anatomical site is the immune response required? Which immunological mechanism(s) is (are) required for protection? What adjuvant and immunization schedule is safe and evokes a protective response? Practical Considerations Cost per dose Biological stability (esp. for live vaccines) Ease of administration Benefit versus risk Adjuvant A substance that enhances the immune response to an antigen with which it is mixed Depot effect Activation of APC’s and lymphoid cells Activation of complement Increased synthesis/activity of cytokines Carrier A foreign protein to which nonimmunogenic antigens (eg polysaccharides or haptens) can be coupled. This term is also now used to denote a living organism or vector bearing genes for expression of foreign antigens Toxoid Inactivated toxin which is no longer toxic, but retains its immunogenicity Live Vaccines Able to replicate in the host Attenuated in pathogencity Advantages over killed vaccines May elicit both humoral and cell-mediated immunity Generally require fewer doses Generally result in longer lasting protection Examples of live vaccines Viral Polio, Measles, Mumps, Rubella, Smallpox (varicella), Chickenpox, Adenovirus (military), Yellow fever (travelers, military) Bacterial Salmonella typhi, Vibrio cholera (travelers), Tuberculosis (bacille Calmette-Guerin), Francisella tularensis (tularemia, animal handlers) Viral Vectors considered for human vaccines Poxviruses (vaccinia) Adenovirus Adeno-associated virus Herpes simplex virus Retrovirus Alphavirus Virus-like particles Killed Vaccines (whole organisms and subunit). Unable to replicate in the host Advantages over live vaccines Cannot multiply or revert to pathogenicity Generally less reactogenic Non-transmissible Technically more feasible Examples of killed vaccines (inactivated whole organisms) Viral influenza, rabies, polio, hepatitis A, Japanese, Eastern and Western encephalitis Bacterial Bordetella pertusis (whooping cough), Vibrio cholera (travelers), Coxiella burnetii (Q fever, animal handlers), Bacillus anthracis (anthrax, military), Yersinia pestis (plague, animal handlers) Examples of subunit vaccines Viral Hepatitis B (recombinant surface protein) Bacterial Bordetella pertussis (acellular), tetanus (toxoid), diphtheria (toxoid), anthrax, Salmonella typhi (conjugate), Hemophilus influenza (conjugate), Streptococcus pneumonia (conjugate), Neisseria meningitidis (conjugate) Vaccine Approaches Under Development Synthetic peptides Delivery of T cell epitopes within heterologous recombinant polypeptides Immunomodulation (with cytokines, Mab) Targeted delivery Immunization with DNA Why Synthetic Peptide Vaccines? Chemically well defined, selective and safe. Stable at ambient temperature. Simple and standardized production facility. Epitopes … B-cell epitopes Th-cell epitopes What Are Epitopes? Antigenic determinants or Epitopes are the portions of the antigen molecules which are responsible for specificity of the antigens in antigen-antibody (Ag-Ab) reactions and that combine with the antigen binding site of Ab, to which they are complementary. Epitopes could be contiguous (when Ab binds to a contiguous sequence of amino acids) non-contiguous (when Ab binds to noncontiguous residues, brought together by folding). Sequential epitopes are contiguous epitopes. Conformational epitopes are noncontiguous antigenic determinants. Retro-Inverso peptides Potential Synthetic peptide Vaccines • A retro structure is obtained by synthesizing peptides in reverse order, in which the direction of peptide bond is reversed and side-chains are oriented in the manner similar to that in D-enantiomer, which explains why these two analogs cross-react immunochemically. • When both of these transformations are combined in the form of an all-D-retro or Retro-Inverso (RI) peptide, the side-chains are oriented as in original L-peptide. • As a result, antibodies raised against the L- or the all-Dretro form cross-react strongly with both structures. • Ex: RI peptide as vaccine candidate for FMDV (Muller, S., Brown, F, MHV Van Regenmortel) Mirror symmetry between L- and Dforms of peptides Note that the retro modification does not take the peptide through an axis of symmetry. Maternal immunization Mechanisms by which maternal antibodies influence infant vaccine responses: review of hypotheses and definition of main determinants Previous hypotheses and their basis Maternal antibodies inactivate live attenuated vaccines given to infants. Maternal antibodies bind vaccine antigen administered to infants, macrophages dispose of these antigenantibody complexes. Lower seroconversion rates in presence of higher compared to lower levels of maternal antibodies Observed inhibition of infant antibody responses to killed or subunit vaccines is B cell determinant specific (but quite variable). Influence of dose of vaccine on antibody responses to TT in 2week old BALB/c pups Solid lines: immune mothers Control mothers Does this rule out maternal immunization for infant protection against severe infection during the first few weeks of life? Not necessarily, but higher antigenic loads or more vaccine doses may be necessary for the infants. Technology Premise Identify, Capture and Produce large quantities of the most effective human antibodies. General Introduction - MAbs • Monoclonal antibody technology, a particular class of modern biotechnology, can be employed to combat and prevent viral infections. • Antibodies are a critical component of the body’s immune defense against viruses and other infectious agents. • Vaccines stimulate the body to produce antibodies that will recognize a particular virus. General Intro. – MAbs History • In the absence of an effective vaccine, monoclonal antibodies (i.e., fully human or genetically engineered antibodies) can potentially provide protection from infection. • Antibody based therapies have been employed since their first discovery over a hundred years ago by Kitasano and Behring. • The first such therapies used serum from immunized large animals such as horses and sheep. General Intro - MAbs Usage Today • Human and animal serum products are still used today; however, we now have new tools that allow for the development of totally human—monoclonal—antibody based therapeutic drugs. • There are now 12 monoclonal antibody based therapeutic products that are approved by the FDA. • The 12 monoclonal antibody based therapeutic products are used in a variety of indications, including cancer, heart disease, arthritis, and infectious diseases. Passive Vaccines: Emerging Class Prophylactic vaccines Passive vaccines • Stimulates immune system to prevent diseases Support/replace immune system in curing diseases • Administered either once or a limited number of times Are in many cases administered repeatedly • Highly developed regulatory standards due to significant liability, since administered to group of healthy people Regulatory guidelines not yet established, for most indications, due to significant fewer potential complications. • Low margins in many countries; no reimbursement by health insurances Attractive margins, normally covered by health insurances just as other therapeutic drugs Why Not Vaccines? • • • • • Side effects Compounding effect of multiple vaccinations Long development time for new indications Large population that cannot be vaccinated For biodefense, cannot mass vaccinate against unknown risk due to the resulting morbidity and mortality huMAbs Technologies Evolution – From Mouse to Human totally human fully human humanized chimeric mouse 1970s 1st generation 1980s 2nd generation 1990s 3rd generation 2000s 4th generation