Evaluation of two live attenuated cold-adapted H5N1 influenza virus vaccines in healthy adults

被引:100
作者
Karron, Ruth A. [1 ]
Talaat, Kawsar [1 ]
Luke, Catherine [2 ]
Callahan, Karen [1 ]
Thumar, Bhagvanji [1 ]
DiLorenzo, Susan [1 ]
McAuliffe, Josephine [2 ]
Schappell, Elizabeth [1 ]
Suguitan, Amorsolo [2 ]
Mills, Kimberly [2 ]
Chen, Grace [2 ]
Lamirande, Elaine [2 ]
Coelingh, Kathleen [3 ]
Jin, Hong [3 ]
Murphy, Brian R. [2 ]
Kemble, George [3 ]
Subbarao, Kanta [2 ]
机构
[1] Johns Hopkins Bloomberg Sch Publ Hlth, Ctr Immunizat Res, Baltimore, MD 21205 USA
[2] NIAID, Infect Dis Lab, NIH, Bethesda, MD 20892 USA
[3] Medimmune Inc, Gaithersburg, MD 20878 USA
基金
美国国家卫生研究院;
关键词
Influenza; Vaccine; Pandemic; H5N1; Clinical trial; RANDOMIZED CONTROLLED-TRIAL; MF59-ADJUVANTED INFLUENZA; PHASE-I; ANTIBODY-RESPONSES; YOUNG-CHILDREN; SAFETY; IMMUNOGENICITY; CANDIDATE; REASSORTANT; TRIVALENT;
D O I
10.1016/j.vaccine.2009.05.099
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Development of live attenuated influenza vaccines (LAIV) against avian viruses with pandemic potential is an important public health strategy. Methods and findings: We performed open-label trials to evaluate the safety, infectivity, and immunogenicity of H5N1 VN 2004 AA ca and H5N1 HK 2003 AA ca. Each of these vaccines contains a modified H5 hemagglutinin and unmodified N1 neuraminidase from the respective wild-type (wt) parent virus and the six internal protein gene segments of the A/Ann Arbor/6/60 cold-adapted (ca) master donor virus. The H5N1 VN 2004 AA ca vaccine virus was evaluated at dosages of 10(6.7) TCID50 and 10(7.5) TCID50, and the H5N1 HK 2003 AA ca vaccine was evaluated at a dosage of 10(7.5) TCID50. Two doses were administered intranasally to healthy adults in isolation at 4-8 week intervals. Vaccine safety was assessed through daily examinations and infectivity was assessed by viral culture and by realtime reverse transcription-polymerase chain reaction testing of nasal wash (NW) specimens. Immunogenicity was assessed by measuring hemagglutination-inhibition (HI) antibodies, neutralizing antibodies, and IgG or IgA antibodies to recombinant (r)H5 VN 2004 hemagglutinin (HA) in serum or NW. Fifty-nine participants were enrolled: 21 received 10(6.7) TCID50 and 21 received 10(6.7) TCID50 of H5N1 VN 2004 AA ca and 17 received H5N1 HK 2003 AA ca. Shedding of vaccine virus was minimal, as were HI and neutralizing antibody responses. Fifty-two percent of recipients of 10(7.5) TCID50 of H5N1 VN 2004 AA ca developed a serum IgA response to rH5 VN 2004 HA. Conclusions: The live attenuated H5N1 VN 2004 and HK 2003 AA ca vaccines bearing avian H5 HA antigens were very restricted in replication and were more attenuated than seasonal LAIV bearing human H1, H3 or B HA antigens. The H5N1 AA ca LAW elicited serum ELISA antibody but not HI or neutralizing antibody responses in healthy adults. (ClinicalTrials.gov Identifiers: NCT00347672 and NC700488046). (C) 2009 Published by Elsevier Ltd.
引用
收藏
页码:4953 / 4960
页数:8
相关论文
共 40 条
[1]  
Abdel-Ghafar AN, 2008, NEW ENGL J MED, V358, P261, DOI 10.1056/NEJMra0707279
[2]   Efficacy of vaccination with live attenuated, cold-adapted, trivalent, intranasal influenza virus vaccine against a variant (A/Sydney) not contained in the vaccine [J].
Belshe, RB ;
Gruber, WC ;
Mendelman, PM ;
Cho, I ;
Reisinger, K ;
Block, SL ;
Wittes, J ;
Iacuzio, D ;
Piedra, P ;
Treanor, J ;
King, J ;
Kotloff, K ;
Bernstein, DI ;
Hayden, FG ;
Zangwill, K ;
Yan, LH ;
Wolff, M .
JOURNAL OF PEDIATRICS, 2000, 136 (02) :168-175
[3]   Live attenuated versus inactivated influenza vaccine in infants and young children [J].
Belshe, Robert B. ;
Edwards, Kathryn M. ;
Vesikari, Timo ;
Black, Steven V. ;
Walker, Robert E. ;
Hultquist, Micki ;
Kemble, George ;
Connor, Edward M. .
NEW ENGLAND JOURNAL OF MEDICINE, 2007, 356 (07) :685-696
[4]   Effects of adjuvants on the safety and immunogenicity of an avian influenza H5N1 vaccine in adults [J].
Bernstein, David I. ;
Edwards, Kathryn M. ;
Dekker, Cornelia L. ;
Belshe, Robert ;
Talbot, Helen K. B. ;
Graham, Irene L. ;
Noah, Diana L. ;
He, Fenhua ;
Hill, Heather .
JOURNAL OF INFECTIOUS DISEASES, 2008, 197 (05) :667-675
[5]   Safety and immunogenicity of an inactivated split-virion influenza A/Vietnam/1194/2004 (H5N1) vaccine:: phase I randomised trial [J].
Bresson, Jean-Louis ;
Perronne, Christian ;
Launay, Odile ;
Gerdil, Catherine ;
Saville, Melanie ;
Wood, John ;
Hoeschler, Katja ;
Zambon, Maria C. .
LANCET, 2006, 367 (9523) :1657-1664
[6]   Generation and characterization of a cold-adapted influenza A H9N2 reassortant as a live pandemic influenza virus vaccine candidate [J].
Chen, H ;
Matsuoka, Y ;
Swayne, D ;
Chen, Q ;
Cox, NJ ;
Murphy, BR ;
Subbarao, K .
VACCINE, 2003, 21 (27-30) :4430-4436
[7]   DOSE-RESPONSE OF A/ALASKA/6/77 (H3N2) COLD-ADAPTED REASSORTANT VACCINE VIRUS IN ADULT VOLUNTEERS - ROLE OF LOCAL ANTIBODY IN RESISTANCE TO INFECTION WITH VACCINE VIRUS [J].
CLEMENTS, ML ;
ODONNELL, S ;
LEVINE, MM ;
CHANOCK, RM ;
MURPHY, BR .
INFECTION AND IMMUNITY, 1983, 40 (03) :1044-1051
[8]   A clinical trial of a whole-virus H5N1 vaccine derived from cell culture [J].
Ehrlich, Hartmut J. ;
Mueller, Markus ;
Oh, Helen M. L. ;
Tambyah, Paul A. ;
Joukhadar, Christian ;
Montomoli, Emanuele ;
Fisher, Dale ;
Berezuk, Greg ;
Fritsch, Sandor ;
Loew-Baselli, Alexandra ;
Vartian, Nina ;
Bobrovsky, Roman ;
Pavlova, Borislava G. ;
Poellabauer, Eva Maria ;
Kistner, Otfried ;
Barrett, P. Noel .
NEW ENGLAND JOURNAL OF MEDICINE, 2008, 358 (24) :2573-2584
[9]  
FAZEKAS G, 2008, CLIN VACCINE IMMUNOL, P19
[10]   Can immunity induced by the human influenza virus N1 neuraminidase provide some protection from avian influenza H5N1 viruses? [J].
Gillim-Ross, Laura ;
Subbarao, Kanta .
PLOS MEDICINE, 2007, 4 (02) :226-228