3D visualisation of hepatitis B vaccine in the oral delivery vehicle SBA-15.

Developing a technology that enables oral vaccines to work efficiently remains a considerable effort since a number of difficulties must be addressed. The key objective being to ensure the safe passage through the harsh conditions within the gastrointestinal tract, promoting delivery that induces enhanced immune response. In the particular case of hepatitis B, the oral formulation in the nanostructured silica SBA-15 is a viable approach. As a result of its porous structure, low toxicity and structural stability, SBA-15 is capable to protect and release the hepatitis B surface antigen (HBsAg), used in the vaccination scheme, at the desired destination. Furthermore, when compared to the currently used injection based delivery method, better or similar antibody response has been observed. However, information about the organisation of the antigen protein remains unknown. For instance, HBsAg is too large to enter the 10 nm ordered mesopores of SBA-15 and has a tendency to agglomerate when protected by the delivery system. Here we report on the pH dependence of HBsAg aggregation in saline solution investigated using small angle X-rays scattering that resulted in an optimisation of the encapsulation conditions. Additionally, X-ray microscopy combined with neutron and X-ray tomography provided full 3D information of the HBsAg clustering (i.e. agglomeration) inside the SBA-15 macropores. This method enables the visualisation of the organisation of the antigen in the interior of the delivery system, where agglomerated HBsAg coexists with its immunological effective uniformly distributed counterpart. This new approach, to be taken into account while preparing the formulation, can greatly help in the understanding of clinical studies and advance new formulations.

Uptake and safety of Hepatitis B vaccination during pregnancy: A Vaccine Safety Datalink study.

INTRODUCTION: Hepatitis B virus (HBV) infection acquired during pregnancy can pose a risk to the infant at birth that can lead to significant and lifelong morbidity. Hepatitis B vaccine (HepB) is recommended for anyone at increased risk for contracting HBV infection, including pregnant women. Limited data are available on the safety of HepB administration during pregnancy. OBJECTIVES: To assess the frequency of maternal HepB receipt among pregnant women and evaluate the potential association between maternal vaccination and pre-specified maternal and infant safety outcomes. METHODS: We examined a retrospective cohort of pregnancies in the Vaccine Safety Datalink (VSD) resulting in live birth outcomes from 2004 through 2015. Eligible pregnancies in women aged 12-55 years who were continuously enrolled from 6 months pre-pregnancy to 6 weeks postpartum in VSD integrated health systems were included. We compared pregnancies with HepB exposure to those with other vaccine exposures, and to those with no vaccine exposures. High-risk conditions for contracting HBV infection were identified up to one-year prior to or during the pregnancy using ICD-9 codes. Maternal and fetal adverse events were also evaluated according to maternal HepB exposure status. RESULTS: Among over 650,000 pregnancies in the study period, HepB was administered at a rate of 2.1 per 1000 pregnancies (n = 1399), commonly within the first 5 weeks of pregnancy. Less than 3% of the HepB-exposed group had a high-risk ICD-9 code indicating need for HepB; this was similar to the rate among HepB unvaccinated groups. There were no significant associations between HepB exposure during pregnancy and gestational hypertension, gestational diabetes, pre-eclampsia/eclampsia, cesarean delivery, pre-term delivery, low birthweight or small for gestational age infants. CONCLUSIONS: Most women who received maternal HepB did not have high-risk indications for vaccination. No increased risk for the adverse events that were examined were observed among women who received maternal HepB or their offspring.

Development of Adjuvanted Solid Fat Nanoemulsions for Pulmonary Hepatitis B Vaccination.

Pulmonary vaccination is one of the most promising routes for immunization owing to its noninvasive nature and induction of strong mucosal immunity and systemic response. In the present study, recombinant hepatitis B surface antigen loaded solid fat nanoemulsions (SFNs) as carrier system and monophosphoryl lipid A as an adjuvant-carrier system was prepared and evaluated as multiadjuvanted vaccine system for deep pulmonary vaccination. Deposition and clearance from the deep lung of rats were determined by gamma scintigraphy. Biodistribution of SFNs was determined by the live animal imaging system. SFNs dispersion showed slower clearance as compared with sodium pertechnetate control solution (∗∗∗p <0.001) from the pulmonary region due to the virtue of particulate and hydrophobic nature of formulations. Humoral (sIgA and IgG) and cellular (IL-2 and IF-γ) immune responses were found to be significant (∗∗∗p <0.001) when compared with naïve antigen (recombinant surface antigen without any excipient) solution. Data indicate that deep pulmonary immunization offers a stronger immune response with balanced humoral, mucosal, and cellular immunization, which further needs to be tested in higher animals to support this hypothesis for clinical translation of this so far neglected yet potential target tissue for immunization.

Development and characterization of surface modified PLGA nanoparticles for nasal vaccine delivery: effect of mucoadhesive coating on antigen uptake and immune adjuvant activity.

In this study, the efficacy of mucoadhesive polymers, i.e., chitosan and glycol chitosan as a mucoadhesive coating material in nasal vaccine delivery was investigated. The Hepatitis B surface Antigen (HBsAg) encapsulated PLGA, chitosan coated PLGA (C-PLGA), and Glycol chitosan coated PLGA (GC-PLGA) nanoparticles (NPs) were prepared. The formulations were characterized for particle size, shape, surface charge, and entrapment efficiency. The mucoadhesive ability of coated and non-coated NPs was determined using in vitro mucoadhesion and nasal clearance test. In addition, the systemic uptake and bio-distribution were also evaluated to understand the fate of NPs following nasal delivery. The immuno-adjuvant ability of various formulations was compared by measuring specific antibody titer in serum and secretory. The results indicated that PLGA NPs exhibit negative surface charge, whereas C-PLGA and GC-PLGA NPs exhibited positive surface charge. The GC-PLGA NPs demonstrated lower clearance and better local and systemic uptake compared to chitosan coated and uncoated PLGA NPs. In vivo immunogenicity studies indicated that GC-PLGA NPs could induce significantly higher systemic and mucosal immune response compared to PLGA and C-PLGA NPs. In conclusion, GC-PLGA NPs could be a promising carrier adjuvant for the nasal vaccine delivery for inducing a potent immune response at mucosal surface(s) and systemic circulation.

Effect of adjuvant on pharmacokinetics, organ distribution and humoral immunity of hepatitis B surface antigen after intramuscular injection to rats.

Two types of radioiodinated plasma driven antigens, heat-inactivated (¹²5I-h-HBsAg) and formalin-inactivated HBsAg (¹²5I-f-HBsAg) were investigated for the effect of immunoadjuvant, aluminium phosphate (AP) on pharmacokinetics, organ distribution and humoral immunity of differently inactivated hepatitis B surface antigens (HBsAg) in rats. As a result, most of h-HBsAg (90%) was retained and slowly eliminated from the injection site. The h-HBsAg was highly localized in regional lymph node (RLN), but resulted in low humoral immune response. On the other hand, f-HBsAg was less localized in the injection site and RLN, but mainly distributed into serum and liver (62.9 and 22.4%, respectively). However, both h-HBsAg and f-HBsAg slowly disappeared from the injection site with AP, resulting in the increased area under the amount-time curve (AUQ) of h-HBsAg and f-HBsAg in the injection site. Exposures of h-HBsAg and f-HBsAg in serum were increased (1.4 and 2.8 times increase in AUC, respectively) with AP. The RLN uptake of both antigens were dramatically increased (25 and 3.1 times increase in AUC, respectively) with higher humoral immune response. The antibody titres were also increased with AP. In conclusion, pharmacokinetics, organ distribution and humoral immunity of h-HBsAg were highly dependent on the inactivation method of antigen and the presence of immunoadjuvant such as AP.

Amiloride enhances antigen specific CTL by faciliting HBV DNA vaccine entry into cells.

The induction of relatively weak immunity by DNA vaccines in humans can be largely attributed to the low efficiency of transduction of somatic cells. Although formulation with liposomes has been shown to enhance DNA transduction of cultured cells, little, if any, effect is observed on the transduction of somatic tissues and cells. To improve the rate of transduction, DNA vaccine delivery by gene gun and the recently developed electroporation techniques have been employed. We report here that to circumvent requirement for such equipment, amiloride, a drug that is prescribed for hypertension treatment, can accelerate plasmid entry into antigen presenting cells (APCs) both in vitro and in vivo. The combination induced APCs more dramatically in both maturation and cytokine secretion. Amiloride enhanced development of full CD8 cytolytic function including induction of high levels of antigen specific CTL and expression of IFN-γ+perforin+granzymeB+ in CD8+ T cells. Thus, amiloride is a facilitator for DNA transduction into host cells which in turn enhances the efficiency of the immune responses.

In vitro study of transdermal penetration and iontophoresis of hepatitis B vaccines through rat skin.

In vitro percutaneous delivery of hepatitis B vaccines was investigated in order to assess the penetration of vaccine under passive diffusion and iontophoresis conditions. The study was carried out using Franz vertical diffusion cell through the hairless abdominal skin of Sprague-Dawley (SD) rats. Enzyme-linked immunosorbent assay (ELISA) was used to determine the cumulative amount of permeation and the retention amount of drug in skin. Passive diffusion alone resulted in less skin permeation and retention of hepatitis B vaccines, only (2.1 +/- 0.1) ng x cm(-2) and (2.3 +/- 0.1) ng x cm(-2) after 24 h when the initial concentration of vaccine in the donor compartment was 23 microg x mL(-1) and 46 microg x mL(-1), respectively. After removing the stratum corneum, the permeation and retention amount of hepatitis B vaccines increased to (383.7 +/- 86.2) ng x cm(-2) and (16.8 +/- 4.6) ng x cm(-2), respectively, 171.6-folds and 2.1-folds more than that from its intact skin with the drug loaded at 46 microg x mL(-1). Iontophoresis induced a significant increase of cumulative and retention amount of hepatitis B vaccines through the skin (P < 0.05). Application of iontophoresis significantly enhanced the permeation of hepatitis B vaccines (P < 0.05) by 2.7-folds and 6.6-folds for the intact skin, and by 1.6-folds and 1.8-folds for the tape-stripped skin with initial drug loading of 23 microg x mL(-1) and 46 microg x mL(-1), respectively. Iontophoresis also significantly increased the amount of drug retained in the skin. After applying iontophoresis for 6 h, the amount of skin retention was nearly the same as passive diffusion for 24 h both from intact skin [(16.8 +/- 4.6) ng x cm(-2) vs (13.3 +/- 5.4) ng x cm(-2)] (P > 0.05) and tape-stripped skin [(36.7 +/- 14.1) ng x cm(-2) vs (26.8 +/- 11.2) ng x cm(-2)] (P > 0.05). Overall, these findings revealed that the transportation efficiency of bioactive substance like hepatitis B vaccines may be improved by iontophoresis, which can be potentially used in the field of transcutaneous immunization.

Immunopotentiation of hepatitis B vaccine using biodegradable polymers as an adjuvant.

BACKGROUND/PURPOSE: The purpose of this research was to develop an alternative adjuvant for hepatitis B vaccine (HBsAg) that elicits a long-lasting immune response after a single administration. In this study, the suitability of Poly (D, L)-lactide-co-glycolic acid (PLGA), Poly lactic acid (PLA) and Chitosan polymers as adjuvants for HBsAg were investigated. METHODS: We used solvent evaporation and emulsion cross-linking techniques to encapsulate HBsAg into the different polymeric systems. The newly developed microparticles were evaluated for vaccine content, particle size distribution, in vitro release and immunogenicity. RESULTS: HBsAg-encapsulated PLGA and PLA microparticles were smooth and spherical. However, Chitosan microparticles were homogeneous, and almost spherical, with rough surfaces. The vaccine loading and release patterns varied with the type of polymer used. In this study, Chitosan polymeric microparticles released antigen until day 63 post-injection; however, the release period of the PLGA and PLA systems was shorter. A significant increase in the level of antibodies to HBsAg was induced by all the polymeric microparticles. CONCLUSION: The results indicate that Chitosan microparticles are a more efficient adjuvant for HBsAg than PLGA and PLA polymeric microparticles.

[Efficacy and safety of the Brazilian vaccine against hepatitis B in newborns]. / Eficácia e segurança da vacina brasileira contra hepatite B em recém-nascidos.

OBJECTIVE: To analyze the efficacy and safety of a recombinant Hepatitis B vaccine in newborns. METHODS: The study was carried out in a general hospital in the city of Guarulhos, Southeastern Brazil, between 2002 and 2005. The recombinant Hepatitis B vaccine from Instituto Butantan (VrHB-IB) was tested in two clinical trials. In both trials, newborns were randomly allocated to the experimental or control (reference vaccine) groups. Newborns were given three doses of vaccine, one up to 24 hours after birth and the other two 30 and 180 days later. In the first trial, 538 newborns completed the immunization protocol, and 486 in the second. Vaccines were considered equivalent when seroprotection difference was below 5%. RESULTS: Seroprotection in the first trial (anti-HBs > or = 10mUI/ml) was 92.5% (247/267) in the experimental group, compared to 98.5% (267/271) in the control (p = 0.001). With this result, VrHB-IB did not fulfill the pre-established criterion for equivalence. After increasing the concentration of antigen in the vaccine to 25 microg, seroprotection reached 100% in the experimental group and 99.2% in the control. No severe adverse effects were recorded. CONCLUSIONS: The reformulated VrHB-IB is considered equivalent to the reference vaccine, and its use is recommended in newborns.

Eficácia e segurança da vacina brasileira contra hepatite B em recém-nascidos / Efficacy and safety of the Brazilian vaccine against Hepatitis B in newborns

OBJETIVO: Analisar a eficácia e segurança de vacina recombinante contra hepatite B em recém-nascidos. MÉTODOS: O estudo foi conduzido em hospital geral do município de Guarulhos, SP, entre 2002 e 2005. A vacina recombinante contra hepatite B do Instituto Butantan (VrHB-IB) foi analisada em dois ensaios clínicos. Em ambos os ensaios, os recém-nascidos foram alocados aleatoriamente ao grupo experimental ou controle (vacina de referência). Os recém-nascidos receberam três doses das vacinas, uma em até 24 h após o nascimento e as subseqüentes 30 e 180 dias após. No primeiro ensaio 538 recém-nascidos completaram o protocolo e no segundo ensaio, 486. Considerou-se critério de equivalência a diferença na soroproteção inferior a 5 por cento. RESULTADOS: A soroproteção no primeiro ensaio (anti HBs > 10mUI/ml) foi de 92,5 por cento (247/267) no grupo experimental, comparada a 98,5 por cento (267/271) no grupo controle (p = 0,001). Com este resultado, a VrHB-IB não atingiu o critério de equivalência estabelecido. Após o aumento da concentração de antígeno na vacina para 25»g, a soroproteção no segundo ensaio foi de 100 por cento no grupo experimental e 99,2 por cento no grupo controle. Nenhum evento adverso grave foi registrado. CONCLUSÕES: A vacina VrHB-IB modificada foi considerada equivalente à vacina de referência e seu uso recomendado à vacinação de recém-nascidos.

OBJECTIVE: To analyze the efficacy and safety of a recombinant Hepatitis B vaccine in newborns. METHODS: The study was carried out in a general hospital in the city of Guarulhos, Southeastern Brazil, between 2002 and 2005. The recombinant Hepatitis B vaccine from Instituto Butantan (VrHB-IB) was tested in two clinical trials. In both trials, newborns were randomly allocated to the experimental or control (reference vaccine) groups. Newborns were given three doses of vaccine, one up to 24 hours after birth and the other two 30 and 180 days later. In the first trial, 538 newborns completed the immunization protocol, and 486 in the second. Vaccines were considered equivalent when seroprotection difference was below 5 percent. RESULTS: Seroprotection in the first trial (anti-HBs > 10mUI/ml) was 92.5 percent (247/267) in the experimental group, compared to 98.5 percent (267/271) in the control (p = 0.001). With this result, VrHB-IB did not fulfill the pre-established criterion for equivalence. After increasing the concentration of antigen in the vaccine to 25»g, seroprotection reached 100 percent in the experimental group and 99.2 percent in the control. No severe adverse effects were recorded. CONCLUSIONS: The reformulated VrHB-IB is considered equivalent to the reference vaccine, and its use is recommended in newborns.

Novel nanoparticles for the delivery of recombinant hepatitis B vaccine.

We describe the use of methoxypolyethylene glycol-poly(lactide-co-glycolide) nanoparticles as a delivery system for recombinant hepatitis B surface antigen (HBsAg). Evaluation of the stability and release kinetics of nanoencapsulated HBsAg in vitro in serum revealed an initial burst effect and a subsequent slower release of the antigen. Importantly the antigenicity was not destroyed by the encapsulation process, because upon release it was able to react with an anti-HBs antibody. Bone marrow-derived dendritic cells showed efficient uptake of the nanoparticle vaccine as visualized by confocal imaging. To determine whether nano-encapsulated HBsAg was capable of eliciting an immune response in the absence of an adjuvant, mice were immunized with the nanoparticle vaccine or with nonencapsulated recombinant HBsAg. In mice immunized with the nanoparticle vaccine, anti-HBs antibodies were detected at significantly earlier time points than in mice immunized with the nonencapsulated recombinant HBsAg.

Systemic and mucosal immune response induced by transcutaneous immunization using Hepatitis B surface antigen-loaded modified liposomes.

We have evaluated the efficiency of novel modified liposomes (ethosomes) for transcutaneous immunization (TCI) against Hepatitis B. Antigen-loaded ethosomes were prepared and characterized for shape, lamellarity, fluidity, size distribution, and entrapment efficiency. Spectral bio-imaging and flow cytometric studies showed efficient uptake of Hepatitis B surface antigen (HBsAg)-loaded ethosomes by murine dendritic cells (DCs) in vitro, reaching a peak by 180 min. Transcutaneous delivery potential of the antigen-loaded system using human cadaver skin demonstrated a much higher skin permeation of the antigen in comparison to conventional liposomes and soluble antigen preparation. Topically applied HBsAg-loaded ethosomes in experimental mice showed a robust systemic and mucosal humoral immune response compared to intramuscularly administered alum-adsorbed HBsAg suspension, topically applied plain HBsAg solution and hydroethanolic (25%) HBsAg solution. The ability of the antigen-pulsed DCs to stimulate autologous peripheral blood lymphocytes was demonstrated by BrdU assay and a predominantly TH1 type of immune response was observed by multiplex cytometric bead array analysis. HBsAg-loaded ethosomes are able to generate a protective immune response and their ability to traverse and target the immunological milieu of the skin may find a potential application in the development of a transcutaneous vaccine against Hepatitis B virus (HBV).

Mercury levels in newborns and infants after receipt of thimerosal-containing vaccines.

OBJECTIVES: Thimerosal is a mercurial preservative that was widely used in multidose vaccine vials in the United States and Europe until 2001 and continues to be used in many countries throughout the world. We conducted a pharmacokinetic study to assess blood levels and elimination of ethyl mercury after vaccination of infants with thimerosal-containing vaccines. METHODS: Blood, stool, and urine samples were obtained before vaccination and 12 hours to 30 days after vaccination from 216 healthy children: 72 newborns (group 1), 72 infants aged 2 months (group 2), and 72 infants aged 6 months (group 3). Total mercury levels were measured by atomic absorption. Blood mercury pharmacokinetics were calculated by pooling the data on the group and were based on a 1-compartment first-order pharmacokinetics model. RESULTS: For groups 1, 2, and 3, respectively, (1) mean +/- SD weights were 3.4 +/- 0.4, 5.1 +/- 0.6, and 7.7 +/- 1.1 kg; (2) maximal mean +/- SD blood mercury levels were 5.0 +/- 1.3, 3.6 +/- 1.5, and 2.8 +/- 0.9 ng/mL occurring at 0.5 to 1 day after vaccination; (3) maximal mean +/- SD stool mercury levels were 19.1 +/- 11.8, 37.0 +/- 27.4, and 44.3 +/- 23.9 ng/g occurring on day 5 after vaccination for all groups; and (4) urine mercury levels were mostly nondetectable. The blood mercury half-life was calculated to be 3.7 days and returned to prevaccination levels by day 30. CONCLUSIONS: The blood half-life of intramuscular ethyl mercury from thimerosal in vaccines in infants is substantially shorter than that of oral methyl mercury in adults. Increased mercury levels were detected in stools after vaccination, suggesting that the gastrointestinal tract is involved in ethyl mercury elimination. Because of the differing pharmacokinetics of ethyl and methyl mercury, exposure guidelines based on oral methyl mercury in adults may not be accurate for risk assessments in children who receive thimerosal-containing vaccines.

Controlled release of PEI/DNA complexes from mannose-bearing chitosan microspheres as a potent delivery system to enhance immune response to HBV DNA vaccine.

A novel approach involving the preparation of mannose-bearing chitosan microspheres with entrapping complexes of HBV DNA and PEI was developed to improve the delivery of DNA into antigen-presenting cells (APCs) after intramuscular (i.m.) injection. Compared with the traditional chitosan microspheres, the microspheres could quickly release intact and penetrative PEI/DNA complexes. What's more, chitosan was modified with mannose to target the primary APCs such as dendritic cells (DCs) owing to the high density of mannose receptors expressing on the surface of immature DCs. After i.m. immunization, the microspheres induced significantly enhanced serum antibody and cytotoxic T lymphocyte (CTL) responses in comparison to naked DNA.

In vivo kinetics and biodistribution of HB-110, a novel HBV DNA vaccine, after administration in mice.

This study investigated the pharmacokinetic profile and biodistribution of HB-110, a novel HBV therapeutic vaccine candidate, in mice. HB-110 was rapidly degraded in the blood after i.v. injection with a half-life of 1.9+/-0.083 min, and was no longer detected at 60 min except in one individual near the detection limit. In the i.m. injection, plasmid DNA was detectable at the injection site until 11 days after administration, but the amounts were just above the detection limit. The blood concentration of HB-110 showed a maximum of 604 pg/mL at 15 min after i.m. injection, which was followed by degradation to undetectable levels at 90 min. The plasmid DNA in tissues peaked at 90 min after administration. The highest concentration of plasmid DNA was detected in the liver (24.172 pg/mg tissue), and considerable amounts were also observed in the lung (9.467 pg/mg tissue) and spleen (7.688 pg/mg tissue). The amount of plasmid DNA in tissues was 2 to 3 orders of magnitude lower than in the injection site at the same time points. The HB-110 concentration in tissues, including gonads, decreased rapidly and was undetectable 24 h after administration.

[Preparation, release and immunogenicity evaluation of HBsAg-PLGA microspheres].

OBJECTIVE: To investigate microencapsulation technique, release of HBsAg-PLGA microspheres and degradation of the polymer in vitro, and the level of immune response after the single-dose HBsAg-PLGA microspheres subcutaneously injected (sc) to BALB/c mice. METHODS: HBsAg-PLGA microspheres were prepared by double emulsion microencapsulation technique with orthogonal experiments. The pharmaceutical characteristics of size and surface morphology, antigen loading efficiency, release of HBsAg-PLGA microspheres and degradation of the polymer in vitro, and the level of immune response after single sc of PLGA microspheres in BALB/c mice were investigated. RESULTS: The concentration of PVA was the significant factor affecting the particle size (P<0.05). The release of protein from the microspheres was controlled mainly by the bulk erosion of polymer matrix. When single sc of HBsAg-PLGA microspheres mixed with different formulations, the immunogenicity effect was comparable to that of the aluminium adjuvant vaccine. CONCLUSION: The single-dose HBsAg-PLGA microspheres mixture with different release behavior is a promising candidate for controlled delivery vaccine.

Comparison of two recombinant hepatitis B vaccines and their interchangeability in Argentine infants.

OBJECTIVE: To compare two pediatric recombinant hepatitis B vaccines-the Engerix-B reference vaccine and the Euvax-B vaccine-in terms of immunogenicity and reactogenicity, and also to investigate their interchangeability, that is, whether a three-dose hepatitis B vaccination schedule begun with a first dose of Engerix-B could be completed with two doses of Euvax-B. METHODS: This study was conducted in the city of Córdoba, Argentina, from March 1999 through February 2000. Three groups of Argentine newborns (100 per group) were vaccinated at 0, 1, and 6 months of age with hepatitis B vaccine: group A, three doses of Euvax-B; group B, three doses of Engerix-B; and group C, one dose of Engerix-B followed by two doses of Euvax-B. Reactogenicity was evaluated based on parental reporting of any solicited local or systemic event occurring during the 7-day period following vaccination. Whether Euvax-B and Engerix-B were clinically identical was assessed in terms of the seroprotection rates (antibodies to hepatitis B surface antigen (anti-HBsAg) >/= 10 milli-international units per mL (mIU/mL) 2 months after the third vaccination). RESULTS: Reactogenicity was low in all three groups. Five months after the second dose (that is, immediately prior to the third vaccination), seroprotection rates were 95.9%, 94.7%, and 90.2% for groups A, B, and C, respectively. Two months after the third dose all subjects were seroprotected, with geometric mean concentrations of anti-HBsAg of 2 468.1, 1 714.8, and 2 075.3 mIU/mL for groups A, B, and C, respectively. CONCLUSIONS: Both of the recombinant hepatitis B vaccines that we studied were well tolerated and highly immunogenic. Euvax-B was clinically identical (not inferior) to the EngerixB reference vaccine, and either vaccine could be used to achieve the World Health Organization goal of immunizing all infants against hepatitis B. Further, Euvax-B can be safely used in infants given an initial dose of either Euvax-B or Engerix-B.

Comparison of two recombinant hepatitis B vaccines and their interchangeability in Argentine infants

OBJETIVO: Comparar dos vacunas pediátricas recombinantes contra la hepatitis B ùEuvax-B y la vacuna de referencia Engerix-Bù en cuanto a su inmunogenicidad y reactogenicidad, e investigar su intercambiabilidad, es decir, si el esquema de vacunación contra la hepatitis B de tres dosis comenzado con una primera dosis de Engerix-B puede completarse con dos dosis de Euvax-B. MÉTODOS: Este estudio se llevó a cabo en la ciudad de Córdoba, Argentina, entre marzo de 1999 y febrero de 2000. Se vacunó contra la hepatitis B a tres grupos de 100 lactantes argentinos a los 0, 1 y 6 meses de edad. El grupo A recibió tres dosis de Euvax-B; el grupo B, tres dosis de Engerix-B; y el grupo C, una dosis de Engerix-B seguida de dos dosis de Euvax-B. Para evaluar la reactogenicidad se utilizó la información brindada por los padres acerca de determinados fenómenos locales o sistémicos solicitados por los investigadores que hubieran ocurrido durante los siete días posteriores a la vacunación. Para establecer si eran idénticas clínicamente las vacunas Euvax-B y Engerix-B se utilizaron las tasas de seroprotección ùes decir, títulos de anticuerpos contra el antígeno de superficie de hepatitis B (anti-HBsAg) > 10 miliunidades internacionales por mililitro (mUI/mL)ù alcanzados dos meses después de la tercera dosis. RESULTADOS: La reactogenicidad fue baja en los tres grupos de estudio. A los 5 meses de la segunda dosis (es decir, inmediatamente antes de la tercera dosis), las tasas de seroprotección fueron 95,9%, 94,7% y 90,2% en los grupos A, B y C, respectivamente. Dos meses después de la tercera dosis, todos los lactantes se encontraban protegidos, con concentraciones medias geométricas de anti-HBsAg de 2 468,1 mUI/mL en el grupo A, de 1 714,8 mUI/mL en el grupo B y de 2 075,3 mUI/mL en el grupo C. CONCLUSIONES: Las dos vacunas recombinantes contra la hepatitis B estudiadas fueron bien toleradas y altamente inmunogénicas. La vacuna Euvax-B fue clínicamente idéntica (no inferior) a la vacuna de referencia Engerix-B y cualquiera de ellas puede utilizarse para alcanzar la meta propuesta por la Organización Mundial de la Salud de inmunizar a todos los recién nacidos contra la hepatitis B. Además, puede emplearse con seguridad la vacuna Euvax-B en lactantes que recibieron una primera dosis con Euvax-B o Engerix-B.

The assessment of local tolerance, acute toxicity, and DNA biodistribution following particle-mediated delivery of a DNA vaccine to minipigs.

Particle-mediated DNA delivery was used to administer a DNA vaccine against Hepatitis B to minipigs. The study represented one arm of the safety evaluation program for this product and was designed to assess local tolerance, acute toxicity, and biodistribution of the DNA plasmid. The vaccine was given to 4 groups of minipigs that were sacrificed at 2, 28, 56, or 141 days after treatment. The procedure was well tolerated with mild local skin reactions at 2 days postdosing and no evidence of systemic toxicity. By 28 days the skin lesions had regressed apart from a low grade perivascular mononuclear cell infiltrate in the upper dermis, together with a small number of phagocytosed gold particles. This infiltrate persisted up to 141 days. The expressed HBsAg was detected by immunohistochemistry in keratinocytes (usually in association with an intranuclear gold particle) at 2 days but not at later time points. Polymerase chain reaction (PCR) was used to assay treatment sites and selected internal organs to evaluate biodistribution and persistence of the DNA plasmid. At 2 days the plasmid was detected in the treatment sites and also in the inguinal lymph nodes. At day 57 it was present in the treatment sites only and by day 141 appeared to have cleared. The results from this study demonstrate that particle-mediated gene delivery was well tolerated in the minipig. The biodistribution and persistence of the plasmid was within acceptable limits for this type of vaccine. As the minipig is regarded as a good model for humans these data support the concept that particle-mediated DNA delivery will be safe in human clinical applications.

Pharmaceutical and immunological evaluation of a single-shot hepatitis B vaccine formulated with PLGA microspheres.

A single-shot Hepatitis B vaccine formulation using poly(d,l)-lactide-co-glycolide acid (PLGA) microspheres as a delivery system was examined using a variety of biophysical and biochemical techniques as well as immunological evaluation in C3H mice. PLGA microsphere encapsulation of the Hepatitis B surface antigen (HBsAg), a lipoprotein particle, resulted in good recoveries of protein mass, protein particle conformational integrity, and in vitro antigenicity. Some partial delipidation of the HBsAg, however, was observed. The loading and encapsulation efficiency of HBsAg into the PLGA microspheres were measured along with the morphology and size distribution of the vaccine-loaded PLGA microspheres. The in vitro release kinetics of HBsAg from the PLGA microspheres was evaluated and found to be affected by experimental conditions such as stirring rate. HBsAg showed enhanced storage stability at 37 degrees C in the slightly acidic pH range reported to be found inside PLGA microspheres; thus, the antigen is relatively stable under conditions of temperature and pH that may mimic in vivo conditions. The immunogenicity of the microsphere formulations of HBsAg was compared with conventional aluminum adjuvant formulated HBsAg vaccine in C3H mice. Comparisons were made between aluminum formulations (one and two injections), PLGA microsphere formulations (single injection), and a mixture of aluminum and PLGA microsphere formulations (single injection). The nine-month serum antibody titers indicate that a single injection of a mixture of aluminum and PLGA-formulated HBsAg results in equal or better immune responses than two injections of aluminum-formulated HBsAg vaccine. Based on these in vitro and in vivo studies, it is concluded that HBsAg can be successfully encapsulated and recovered from the PLGA microspheres and a mixture of aluminum-adjuvanted and PLGA-formulated HBsAg can auto-boost an immune response in manner comparable to multiple injections of an aluminum-formulated vaccine.