2区 · 医学
Article
作者: Karita, Etienne ; Dally, Len ; Lombardo, Angela ; Hironaka, Takashi ; Laufer, Dagna S ; Parks, Christopher L ; Bergin, Philip ; Jackson, Akil ; Gilmour, Jill ; Hayes, Peter ; Fast, Patricia ; Matano, Tetsuro ; Barin, Burc ; Sayeed, Eddy ; Inoue, Makoto ; Nyombayire, Julien ; Omosa-Manyonyi, Gloria ; Park, Harriet ; Bizimana, Jean ; Shu, Tsugumine ; Excler, Jean-Louis ; Kopycinski, Jakub ; Hara, Hiroto ; Cox, Josephine H ; Farah, Bashir ; Gazzard, Brian ; Anzala, Omu
BACKGROUND:We report the first-in-human safety and immunogenicity assessment of a prototype intranasally administered, replication-competent Sendai virus (SeV)-vectored, human immunodeficiency virus type 1 (HIV-1) vaccine.
METHODS:Sixty-five HIV-1-uninfected adults in Kenya, Rwanda, and the United Kingdom were assigned to receive 1 of 4 prime-boost regimens (administered at 0 and 4 months, respectively; ratio of vaccine to placebo recipients, 12:4): priming with a lower-dose SeV-Gag given intranasally, followed by boosting with an adenovirus 35-vectored vaccine encoding HIV-1 Gag, reverse transcriptase, integrase, and Nef (Ad35-GRIN) given intramuscularly (SLA); priming with a higher-dose SeV-Gag given intranasally, followed by boosting with Ad35-GRIN given intramuscularly (SHA); priming with Ad35-GRIN given intramuscularly, followed by boosting with a higher-dose SeV-Gag given intranasally (ASH); and priming and boosting with a higher-dose SeV-Gag given intranasally (SHSH).
RESULTS:All vaccine regimens were well tolerated. Gag-specific IFN-γ enzyme-linked immunospot-determined response rates and geometric mean responses were higher (96% and 248 spot-forming units, respectively) in groups primed with SeV-Gag and boosted with Ad35-GRIN (SLA and SHA) than those after a single dose of Ad35-GRIN (56% and 54 spot-forming units, respectively) or SeV-Gag (55% and 59 spot-forming units, respectively); responses persisted for ≥8 months after completion of the prime-boost regimen. Functional CD8+ T-cell responses with greater breadth, magnitude, and frequency in a viral inhibition assay were also seen in the SLA and SHA groups after Ad35-GRIN boost, compared with those who received either vaccine alone. SeV-Gag did not boost T-cell counts in the ASH group. In contrast, the highest Gag-specific antibody titers were seen in the ASH group. Mucosal antibody responses were sporadic.
CONCLUSIONS:SeV-Gag primed functional, durable HIV-specific T-cell responses and boosted antibody responses. The prime-boost sequence appears to determine which arm of the immune response is stimulated.
CLINICAL TRIALS REGISTRATION:NCT01705990.