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Novel genetically-modified chimpanzee adenovirus and MVA-vectored respiratory syncytial virus vaccine safely boosts humoral and cellular immunity in healthy older adults - 19/04/19

Doi : 10.1016/j.jinf.2019.02.003 
Christopher A. Green a, 1, , Charles J. Sande a, 1, Elisa Scarselli b, Stefania Capone c, Alessandra Vitelli c, Alfredo Nicosia d, e, f, Laura Silva-Reyes a, Amber J. Thompson a, Catherine M. de Lara g, Kathryn S. Taylor h, Kathryn Haworth a, Claire L. Hutchings g, Tamsin Cargill g, Brian Angus a, Paul Klenerman g, Andrew J. Pollard a
a Oxford Vaccine Group, Department of Paediatrics and the NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom 
b Nouscom Srl, via di Castel Romano 100, 00128 Roma, Italy 
c ReiThera Srl, Via di Castel Romano 100, 00128 Roma, Italy 
d Keires AG, Baumleingasse 18, CH 4051 Basel, Switzerland 
e CEINGE, Via Gaetano Salvatore 486, 80145 Naples, Italy 
f Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy 
g Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, Peter Medawar building, Oxford OX1 3SY, United Kingdom 
h Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom 

Corresponding author.

Highlights

There is no licensed vaccine to prevent severe disease caused by respiratory syncytial virus (RSV) infection.
RSV is a major cause of hospitalisation and death in the elderly.
The novel viral-vectored vaccines PanAd3-RSV and MVA-RSV appeared safe and boosted both humoral and cellular RSV-specific immune responses in healthy older adults.
The magnitude of immune responses to vaccination appeared similar to what was observed in younger adults.

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Abstract

Objectives

Respiratory syncytial virus (RSV) causes respiratory infection across the world, with infants and the elderly at particular risk of developing severe disease and death. The replication-defective chimpanzee adenovirus (PanAd3-RSV) and modified vaccinia virus Ankara (MVA-RSV) vaccines were shown to be safe and immunogenic in young healthy adults. Here we report an extension to this first-in-man vaccine trial to include healthy older adults aged 60–75 years.

Methods

We evaluated the safety and immunogenicity of a single dose of MVA-RSV given by intra-muscular (IM) injection (n = 6), two doses of IM PanAd3-RSV given 4-weeks apart (n = 6), IM PanAd3-RSV prime and IM MVA-RSV boost 8-weeks later (n = 6), intra-nasal (IN) spray of PanAd3-RSV prime and IM MVA-RSV boost 8-weeks later (n = 6), or no vaccine (n = 6). Safety measures included all adverse events within one week of vaccination and blood monitoring. Immunogenicity measures included serum antibody responses (RSV- and PanAd3-neutralising antibody titres measured by plaque-reduction neutralisation and SEAP assays, respectively), peripheral B-cell immune responses (frequencies of F-specific IgG and IgA antibody secreting cells and memory B-cells by ex vivo and cultured dual-colour ELISpot assays respectively), and peripheral RSV-specific T-cell immune responses (frequencies of IFNγ-producing T-cells by ex vivo ELISpot and CD4+/CD8+/Tfh-like cell frequencies by ICS/FACS assay).

Results

The vaccines were safe and well tolerated. Compared with each individual baseline immunity the mean fold-changes in serum RSV-neutralising antibody, appearance and magnitude of F-specific IgG and IgA ASCs and expansion of CD4+/CD8+ IFNγ-producing T-cells in peripheral circulation were comparable to the results seen from younger healthy adults who received the same vaccine combination and dose. There were little/no IgA memory B-cell responses in younger and older adults. Expansion of IFNγ-producing T-cells was most marked in older adults following IM prime, with balanced CD4+ and CD8+ T cell responses. The RSV-specific immune responses to vaccination did not appear to be attenuated in the presence of PanAd3 (vector) neutralising antibody.

Conclusions

PanAd3-RSV and MVA-RSV was safe and immunogenic in older adults and the parallel induction of RSV-specific humoral and cellular immunity merits further assessment in providing protection from severe disease.

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Keywords : Respiratory syncytial virus, Vaccine, Elderly, Older adults, Viral vectors


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Vol 78 - N° 5

P. 382-392 - mai 2019 Retour au numéro
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