Integration of Preclinical and Clinical Vaccine Safety and Immunogenicity Testing for Development of a Pediatric HIV Vaccine to Achieve Protective HIV Immunity Prior to Adolescence.

IF 1 4区 医学 Q4 IMMUNOLOGY
Genevieve G Fouda, Anjali Singh, Ashley Nelson, Holly Janes, Troy Martin, Ofer Levy, Di Wu, Fei Zou, Patrick Jean-Philippe, Kristina De Paris, Koen K A Van Rompay, Sallie R Permar
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Abstract

An optimal HIV vaccine should provide protective immunity before sexual debut to prevent infection in adolescents and young adults, including acute infections in women of childbearing age. Such a vaccine will likely require multiple sequential immunization doses and would therefore be ideally initiated in childhood. Many of the world's most successful vaccines are initiated in childhood for the induction of lifelong immunity and/or immunity that can be boosted later in life as part of the WHO Expanded Program on Immunization (EPI). Thus, the EPI vaccine framework provides an infrastructure that could be leveraged for the implementation of a multidose HIV immunization regimen. Early childhood also provides a window of time in which there is minimal HIV exposure risk, and the plasticity of the early life immune landscape may present advantages for the elicitation of broadly neutralizing Antibodies (bnAbs), a primary target for HIV vaccination. Sequential vaccination with adjuvanted immunogens targeting spe-cific bnAb lineages is a promising HIV vaccine strategy, and several vaccine candidates are cur-rently being tested in adult clinical trials. It will be critical also to evaluate the most promising immunogens and adjuvants in pediatric settings. Preclinical studies, including in vitro and in sil-ico modelling as well as studies in animal models, will be essential to guide the design of future pediatric vaccine trials. This review summarizes current advances in bnAb germline targeting immunization. It provides the rationale for a better integration of preclinical and clinical vaccine studies to facilitate the development of a vaccine that achieves protective immunity in preadoles-cence.

整合临床前和临床疫苗安全性和免疫原性测试,开发儿童艾滋病毒疫苗,实现青春期前的保护性艾滋病毒免疫。
最佳的艾滋病毒疫苗应在初次性行为之前提供保护性免疫,以预防青少年和青壮年的感染,包括育龄妇女的急性感染。这种疫苗可能需要多次连续免疫剂量,因此最好在儿童时期开始接种。世界上许多最成功的疫苗都是在儿童时期接种的,目的是诱导终身免疫和/或在以后的生活中作为世卫组织扩大免疫规划的一部分得到加强。因此,扩大免疫方案疫苗框架提供了可用于实施多剂量艾滋病毒免疫方案的基础设施。幼儿期也提供了一个接触艾滋病毒风险最小的时间窗口期,并且生命早期免疫环境的可塑性可能对激发广泛中和抗体(bnAbs)(艾滋病毒疫苗接种的主要目标)具有优势。连续接种针对特异性bnAb谱系的佐剂免疫原是一种有希望的HIV疫苗策略,目前正在成人临床试验中测试几种候选疫苗。评估儿童环境中最有前途的免疫原和佐剂也将是至关重要的。临床前研究,包括体外和硅质ico模型以及动物模型研究,对于指导未来儿科疫苗试验的设计至关重要。本文综述了目前bnAb种系靶向免疫的研究进展。它为更好地整合临床前和临床疫苗研究提供了理论依据,以促进开发在青春期前实现保护性免疫的疫苗。
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来源期刊
Current HIV Research
Current HIV Research 医学-病毒学
CiteScore
1.90
自引率
10.00%
发文量
81
审稿时长
6-12 weeks
期刊介绍: Current HIV Research covers all the latest and outstanding developments of HIV research by publishing original research, review articles and guest edited thematic issues. The novel pioneering work in the basic and clinical fields on all areas of HIV research covers: virus replication and gene expression, HIV assembly, virus-cell interaction, viral pathogenesis, epidemiology and transmission, anti-retroviral therapy and adherence, drug discovery, the latest developments in HIV/AIDS vaccines and animal models, mechanisms and interactions with AIDS related diseases, social and public health issues related to HIV disease, and prevention of viral infection. Periodically, the journal invites guest editors to devote an issue on a particular area of HIV research of great interest that increases our understanding of the virus and its complex interaction with the host.
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