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Combination nanovaccine provides protection against influenza in aged mice Ross Darling1, Kathleen Ross2, Sujata Senapati2, Jessica Alley3, Matthew Jefferson4, Michael J. Wannemuehler1, Surya Mallapragada2, Marian Kohut3, Balaji Narasimhan3 1 Veterinary Microbiology and Preventive Medicine; 2Chemical & Biological Engineering; 3Kinesiology; and 4Neuroscience. Iowa State University, Ames, IA Statement of Purpose: Influenza is responsible for a significant number of hospitalizations and mortalities in individuals of all age groups. However, the heaviest burden of influenza resides in the elderly, the fastest growing segment of the U.S. population. Despite increased vaccination programs, the effectiveness of influenza vaccines in the elderly is highly variable due to age-associated deficiencies of the immune response [1, 2]. Thus, next generation vaccines that may overcome age related immune deficiencies are needed urgently. Polyanhydride nanoparticles represent an adjuvant platform that provides sustained release of encapsulated antigen, leading to enhanced humoral and cell-mediated immune responses [3, 4]. In addition, novel pentablock copolymer-based micelles promote rapid antibody development, and in combination with polyanhydride nanoparticles and/or other adjuvants, may activate multiple immune activation pathways [5]. In this work, we demonstrate that a combination nanovaccine formulation can improve immune efficacy in aged mice subsequently infected with influenza A virus compared to existing inactivated virus vaccines. Methods: Dendritic cells (DCs) derived from bone marrow and spleens of young (6-7 weeks) and aged (18 months) mice were cultured and stimulated in vitro with polyanhydride nanoparticles, micelles, imiquimod (TLR7 agonist) and cyclic dinucleotides (STING pathway activator). The expression of cell surface markers was examined via flow cytometry. In addition, cytokine secretion was measured via a multiplex assay. To assess the protection provided by the nanovaccines against H1N1 virus challenge, aged and young mice were subcutaneously immunized with 20 µg H1 hemagglutinin and 20 µg nucleoprotein in a primeboost or single dose regimen. Total anti-HA and anti-NP IgG serum antibody titers were determined at 21 days and 32 days post-immunization via ELISA. Additionally, serum hemagglutination-inhibition titers were also examined. Finally, body weight and survival was monitored for two weeks post challenge with 1 LD50 IAV. Results: Following the stimulation with nanoadjuvants, the expression of cell surface markers such as CD40, CD80, and CD86 was enhanced in bone marrow dendritic cells (BMDCs) of both age groups (Figure 1). In particular, DCs stimulated with nanoparticles or micelles had the greatest upregulation of co-stimulatory markers. Upon immunization with the combination nanovaccine, robust anti-HA and anti-NP antibody titers were generated in young mice while aged mice administered the nanovaccine had lower titers in comparison. These titers were greater than mice administered an inactivated virus (IAV) control. Clinically, the nanovaccine protected the aged mice as evidenced by the mild weight loss in these IAV infected mice relative to control (i.e., saline treated) mice (Figure 2). Figure 1. Nanovaccine adjuvants enhance surface expression of BMDCs. Figure 2. Nanovaccines protected aged mice from weight loss postchallenge. Conclusions: In this work, multiple adjuvants were demonstrated to enhance expression of co-stimulatory molecules and cytokine secretion from both aged and young mice. While the antibody titers in aged mice were lower in comparison to young mice, these titers were greater than control animals immunized with an inactivated virus vaccine. Furthermore, mice immunized with the nanovaccines formulation demonstrated less weight loss post-challenge. Together, these data demonstrate the potential of nanovaccines to overcome age-related immune defects and enhance vaccine efficacy. References: [1] McElhaney JE. Ageing Res. Rev. 2011; 10: 379-88. [2] Haynes L, Swain SL. Immunity 2006; 24: 663-6. [3] Ross KA, et al. Int. J. Nanomedicine 2015; 10: 229-43. [4] Ross KA, et al. J. Biomed. Mater. Res. A. 2014; 102: 41618. [5] Ross KA, et al. ACS Biomater. Sci. Eng. 2016; 2: 368-374.