Enhancement by muramyl peptides of the protective response of interferon-alpha/beta against encephalomyocarditis virus infection.

The use of interferon-alpha (IFN-alpha) in the treatment of infectious diseases has shown limited efficacy and dose-limiting toxicity. We have selected safe immunomodulators of the muramyl peptide family with the potential of enhancing the efficacy of IFN-alpha without resulting in increased toxicity. One of these synthetic muramyl dipeptide (MDP) derivatives, namely murabutide which is in a clinical stage of development, has been recently found to synergize with IFN-alpha 2a in the selective induction of anti-inflammatory mediators and to enhance the biological activities of the therapeutic cytokine. The present study was performed to assess the antiviral activity of such muramyl peptides and a possible potentiation of the antiviral activity of IFN-alpha/beta by associated therapy using the classical assay of Encephalomyocarditis virus (EMCV) infection. In vitro, pretreatment of Moloney Sarcoma virus (MSV)-transformed cell line with MDP derivatives followed by treatment with IFN-alpha/beta showed a synergistic protection against the cytopathogenic effect of a subsequent EMCV infection. None of the MSV cultures could be protected by stimulation with muramyl peptides alone. In vivo, all of the muramyl peptide derivatives tested were found to be more potent than the parent molecule MDP in inducing protection against death or in the prolongation of the mean survival time of infected mice. Sequential administration of suboptimal doses of exogenous IFN-alpha/beta and muramyl peptides established a strong antiviral state and considerably improved the protective effect of the cytokine, frequently leading to an abortive infection. Our findings suggest that combination therapy with safe muramyl peptides and IFN-alpha/beta could constitute a highly effective and new regimen for the treatment of viral infections in humans.

Adjuvants: current status, clinical perspectives and future prospects.

Adjuvants represent a key issue for vaccines currently under development. Adjuvanticity is linked to the ability to stimulate the T-cell subsets that control the major features of specific immune responses: CD4+ TH1 and TH2 cells and CD8+ cells involved in cytotoxic T lymphocyte responses. Some well-defined immunomodulatory compounds can achieve this stimulation by inducing selective production of appropriate cytokines. Françoise Audibert and Luc Lise review the development of adjuvants and discuss how their combination with suitable vehicles should allow customization of adjuvant preparations capable of inducing protective immune responses better adapted to each type of pathogenicity.

Adjuvants: current status, clinical perspectives and future prospects.

Adjuvants represent a key issue for vaccines currently under development. Adjuvanticity is linked to the ability to stimulate the T-cell subsets that control the major features of specific immune responses: CD4+ TH1 and TH2 cells and CD8+ cells involved in cytotoxic T-lymphocyte responses. Some well-defined immunomodulatory compounds can achieve this stimulation by inducing selective production of appropriate cytokines. Françoise Audibert and Luc Lise review the development of adjuvants and discuss how their combination with suitable vehicles should allow customization of adjuvant preparations capable of inducing protective immune responses better adapted to each type of pathogenicity.

Influence of a muramyl dipeptide on human blood leukocyte functions and their membrane antigens.

Murabutide, which belongs to the immunomodulator family of muramyl peptides, was applied directly to fresh human blood to evaluate changes in leukocyte properties. After blood incubation with murabutide, lymphocytes presented a higher responsiveness to T-mitogens, and monocytes and polymorphonuclear cells exhibited an increase in their capacity to produce hydrogen peroxide. In addition, murabutide treatment enhanced phagocytic activity of neutrophils, whereas monocytes presented a decrease in this activity. Some surface markers were also investigated in the distinct leukocyte populations. After incubation with murabutide, a larger number of lymphocytes expressed Ta1 antigen (CD W26) and transferrin receptor (CD 71). In contrast, expression of interleukin-2 receptor (CD 25) was slightly decreased. Monocytes from treated blood displayed a larger number of receptors for C3bi (CD 11b), whereas the surface marker CD 14 and the class I receptor for the Fc portion of IgG were down-regulated. Activation of polymorphonuclear cells by murabutide was confirmed by the up-regulation of the C3bi receptor, Fc receptor, and CD 14 surface antigen. The effects of murabutide on leukocytes described in this paper may contribute to understanding mechanisms of the modulating activity of muramyl peptides on specific and nonspecific immunity.

Synthetic peptide vaccines against pathogens and biological mediators.

Recent advances in immunology and biotechnology have opened the way for new approaches to vaccine design. Gilles Riveau and Françoise Audibert discuss progress in the design of synthetic peptide antigens for vaccines against pathogens, and discuss the possibility that such vaccines could also be used to control the activity of endogenous mediators.

Induction of biologically active antibodies by a polyvalent synthetic vaccine constructed without carrier.

Four synthetic peptides that copy fragments of two bacterial antigens (Streptococcus pyogenes M protein and diphtheria toxin), one viral antigen (hepatitis B surface antigen), and one parasitic antigen (circumsporozoite protein of Plasmodium knowlesi) were covalently bound within the same construct. This totally synthetic polyvalent administered to mice with Freund complete adjuvant or in saline with murabutide (an adjuvant-active muramyl peptide) elicited high levels of antibodies which, in certain cases, were shown to be biologically active. The results indicated that these antibodies recognized specifically the four peptides. None of the epitopes were immunodominant. It was also demonstrated that the association of several peptides enhanced their respective immunogenicities as compared with those of their homopolymers. Finally, this study shows that a totally synthetic vaccine administered in saline with a synthetic adjuvant can be immunogenic in the absence of a protein carrier.

Influence of CONH2 or COOH as C-terminus groups on the antigenic characters of immunogenic peptides.

The influence of the presence of a terminal COOH or CONH2 on the antigenic characters of synthetic immunogenic peptides has been studied on a streptococcal synthetic vaccine model. The obtained results show that when a peptide amide is used, the antibodies raised specifically against the amide group recognize neither free COOH nor the parent protein. The carboxamide group is thus unsuitable as was postulated for raising antibodies which recognize the peptide bond.

Biologically active antibodies elicited by a synthetic circumsporozoite peptide of Plasmodium knowlesi administered in saline with a muramyl dipeptide derivative.

A synthetic peptide whose sequence was derived from the circumsporozoite protein of Plasmodium knowlesi coupled to bovine gamma globulin has been shown to be immunogenic when administered with Freund complete adjuvant. The present experiments were designed to test the immunogenicity of the peptide when attached to a tetanus toxoid carrier and administered with alum or murabutide, both acceptable clinical adjuvants. In both cases, the use of an adjuvant increased the levels of circulating anti-peptide antibodies over those observed when no adjuvant was used. However, when the antisera were tested for reactivity with the native protein, animals of the group receiving the conjugate associated with murabutide always had titers greatly exceeding those observed in animals that received the conjugate with alum. Moreover, the sera of the murabutide-treated group were shown to be more active in eliciting shedding of the circumsporozoite protein than were sera of animals of the Freund complete adjuvant-treated group. The use of tetanus toxoid in secondary immunizations could be eliminated when the mice primed with peptide-tetanus toxoid and murabutide were boosted with a polymer of the peptide. The results indicate that the synthetic malarial peptide-tetanus toxoid conjugate is capable of stimulating high levels of biologically active antibodies only when administered with murabutide.

Enhancement by murabutide of the immune response to natural and synthetic hepatitis B surface antigens.

Adjuvant-active murabutide (N-acetylmuramyl-L-alanyl-D-glutamine-alpha-n-butyl ester), devoid of the side effects of muramyl dipeptide (N-acetylmuramyl-L-alanyl-D-isoglutamine), was administered in saline with natural and synthetic hepatitis B surface antigens (HBsAgs). This derivative enhanced the antibody responses against natural HBsAg. The persistence of high antibody titers was the same in the murabutide-treated group as in the alum-treated group. A synergistic enhancement of the antibody was obtained when both adjuvants were administered together. Cell-mediated immunity to HBsAg, tested by the proliferative response of lymph node cells to the antigen, was also shown to be induced in mice treated with alum-associated murabutide. When administered with natural HBsAg, murabutide produced titers of total antibodies as high as did alum but lower titers of specific immunoglobulin E. High levels of antipeptide antibodies were obtained when a synthetic fragment [HBsAg(99-121)] conjugated to a toxoid carrier was administered with murabutide in saline.

Comparison of immunomodulatory activities in mice and guinea pigs of a synthetic desmuramyl peptidolipid triglymyc.

A nonpyrogenic desmuramyl peptidolipid, 1-O-(L-alanyl-D-isoglutaminyl-L-alanyl-glycerol-mycolate), had previously been shown to be inactive as adjuvant in guinea pigs, but to be very active in stimulating nonspecific resistance. We now show that 1-O-(L-alanyl-D-isoglutaminyl-L-alanyl-glycerol-mycolate) is capable of enhancing or suppressing the immune responses in mice when injected with or before an antigen. In vivo suppression of the immune response to sheep erythrocytes was also observed with high doses of murabutide, a nonpyrogenic adjuvant-active N-acetylmuramyl-L-alanyl-D-isoglutamine analog. Chemiluminescence measurements with mouse spleen cells show a very strong activity of 1-O-(L-alanyl-D-isoglutaminyl-L-alanyl-glycerol-mycolate) by far superior to the effect obtained with the corresponding muramyl peptide, N-acetylmuramyl-L-alanyl-D-isoglutaminyl-L-alanyl-glycerol-myco late.

Biological activity of a new synthetic muramyl peptide adjuvant devoid of pyrogenicity.

Immunostimulant activities of muramyl dipeptide (enhancement of specific immune responses and of nonspecific resistance to infection) were retained by its N-acetylmuramyl-L-alanyl-D-glutaminyl-n-butyl ester derivative, although very large amounts administered intravenously, or even by the very sensitive intracerebroventricular route, did not elicit fever in the rabbit. This analog also appeared to be devoid of other secondary effects which have been observed after administration of muramyl dipeptide.

Immunostimulant activities of a lipophilic muramyl dipeptide derivative and of desmuramyl peptidolipid analogs.

The immunostimulant properties of a new muramyl dipeptide (MDP) derivative bearing a lipophilic moiety on the C-terminal end of the peptide chain are described. It is shown, in particular, that 1,O-(acetylmuramyl-L-alanyl-D-isoglutamine-L-alanyl)-glycerol-3-mycolate had increased immunostimulant activity in comparison with MDP. It induced hypersensitivity even when administered with an antigen in saline, and it gave higher protection against bacterial infections than did MDP. A quite unexpected finding was obtained with the corresponding desmuramyl compound 1,O-(L-alanyl-D-isoglutamine-L-alanyl)-glycerol-3-mycolate, which had no activity in producing humoral antibodies but was just as active as the muramic acid-containing compound in stimulating nonspecific resistance to bacterial infections. It was not pyrogenic. Modifications of the peptide moiety or the lipid moiety of this peptidolipid led to decrease, or even loss, of activity. These results show the importance of the N-acetylmuramyl moiety in MDP for humoral antibody production. The peptidolipid 1,O-(L-alanyl-D-isoglutamine-L-alanyl)-glycerol-3-mycolate is the first member of a new category of nonspecific immunostimulants.