Safety and immunogenicity of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine in two formulations: two open, non-randomised phase 1/2 studies from Russia

被引：730

作者：

Logunov, Denis Y. ^{[1
]}

Dolzhikova, Inna V. ^{[1
]}

Zubkova, Olga V. ^{[1
]}

Tukhvatullin, Amir I. ^{[1
]}

Shcheblyakov, Dmitry V. ^{[1
]}

Dzharullaeva, Alina S. ^{[1
]}

Grousova, Daria M. ^{[1
]}

Erokhova, Alina S. ^{[1
]}

Kovyrshina, Anna V. ^{[1
]}

Botikov, Andrei G. ^{[1
]}

Izhaeva, Fatima M. ^{[1
]}

Popova, Olga ^{[1
]}

Ozharovskaya, Tatiana A. ^{[1
]}

Esmagambetov, Ilias B. ^{[1
]}

Favorskaya, Irina A. ^{[1
]}

Zrelkin, Denis I. ^{[1
]}

Voronina, Daria V. ^{[1
]}

Shcherbinin, Dmitry N. ^{[1
]}

Semikhin, Alexander S. ^{[1
]}

Simakova, Yana V. ^{[1
]}

Tokarskaya, Elizaveta A. ^{[1
]}

Lubenets, Nadezhda L. ^{[1
]}

Egorova, Daria A. ^{[1
]}

Shmarov, Maksim M. ^{[1
]}

Nikitenko, Natalia A. ^{[1
]}

Morozova, Lola F. ^{[2
]}

Smolyarchuk, Elena A. ^{[2
]}

Kryukov, Evgeny V. ^{[3
]}

Babira, Vladimir F. ^{[4
]}

Borisevich, Sergei V. ^{[5
]}

Naroditsky, Boris S. ^{[1
]}

Gintsburg, Alexander L. ^{[1
]}

机构：

[1] Minist Hlth Russian Federat, Fed State Budget Inst, Natl Res Ctr Epidemiol & Microbiol, Moscow, Russia

[2] Sechenov Univ, Fed State Autonomous Educ Inst Higher Educ, IM Sechenov First Moscow State Med Univ, Minist Hlth Russian Federat, Moscow, Russia

[3] Minist Def Russian Federat, Main Mil Clin Hosp, Fed State Budgetary Inst, Moscow, Russia

[4] Minist Def Russian Federat, Branch 7, Fed State Budgetary Inst, Main Mil Clin Hosp, Moscow, Russia

[5] Minist Def Russian Federat, Cent Res Inst 48, Moscow, Russia

来源：

LANCET | 2020年 / 396卷 / 10255期

关键词：

GENE-THERAPY; SPIKE PROTEIN; SARS-COV-2; STRATEGIES; INFECTION; RESPONSES; RECEPTOR;

D O I：

10.1016/S0140-6736(20)31866-3

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Background We developed a heterologous COVID-19 vaccine consisting of two components, a recombinant adenovirus type 26 (rAd26) vector and a recombinant adenovirus type 5 (rAd5) vector, both carrying the gene for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike glycoprotein (rAd26-S and rAd5-S). We aimed to assess the safety and immunogenicity of two formulations ( frozen and lyophilised) of this vaccine. Methods We did two open, non-randomised phase 1/2 studies at two hospitals in Russia. We enrolled healthy adult volunteers (men and women) aged 18-60 years to both studies. In phase 1 of each study, we administered intramuscularly on day 0 either one dose of rAd26-S or one dose of rAd5-S and assessed the safety of the two components for 28 days. In phase 2 of the study, which began no earlier than 5 days after phase 1 vaccination, we administered intramuscularly a prime-boost vaccination, with rAd26-S given on day 0 and rAd5-S on day 21. Primary outcome measures were antigen-specific humoral immunity (SARS-CoV-2-specific antibodies measured by ELISA on days 0, 14, 21, 28, and 42) and safety (number of participants with adverse events monitored throughout the study). Secondary outcome measures were antigen-specific cellular immunity (T-cell responses and interferon-gamma concentration) and change in neutralising antibodies (detected with a SARS-CoV-2 neutralisation assay). These trials are registered with ClinicalTrials.gov, NCT04436471 and NCT04437875. Findings Between June 18 and Aug 3, 2020, we enrolled 76 participants to the two studies (38 in each study). In each study, nine volunteers received rAd26-S in phase 1, nine received rAd5-S in phase 1, and 20 received rAd26-S and rAd5-S in phase 2. Both vaccine formulations were safe and well tolerated. The most common adverse events were pain at injection site (44 [58%]), hyperthermia (38 [50%]), headache (32 [42%]), asthenia (21 [28%]), and muscle and joint pain (18 [24%]). Most adverse events were mild and no serious adverse events were detected. All participants produced antibodies to SARS-CoV-2 glycoprotein. At day 42, receptor binding domain-specific IgG titres were 14 703 with the frozen formulation and 11 143 with the lyophilised formulation, and neutralising antibodies were 49.25 with the frozen formulation and 45.95 with the lyophilised formulation, with a seroconversion rate of 100%. Cell-mediated responses were detected in all participants at day 28, with median cell proliferation of 2.5% CD4(+) and 1.3% CD8(+) with the frozen formulation, and a median cell proliferation of 1.3% CD4(+) and 1.1% CD8(+) with the lyophilised formulation. Interpretation The heterologous rAd26 and rAd5 vector-based COVID-19 vaccine has a good safety profile and induced strong humoral and cellular immune responses in participants. Further investigation is needed of the effectiveness of this vaccine for prevention of COVID-19. Copyright (C) 2020 Elsevier Ltd. All rights reserved.

引用

页码：887 / 897

页数：11

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