Phase 1 clinical trials of the safety and immunogenicity of adjuvanted plasmid DNA vaccines encoding influenza A virus H5 hemagglutinin

Vaccine. 2010 Mar 16;28(13):2565-72. doi: 10.1016/j.vaccine.2010.01.029. Epub 2010 Jan 29.

Abstract

Background: Development of vaccines against highly pathogenic avian influenza virus H5N1 subtypes posing a pandemic threat remains a priority. Limitations in manufacturing capacity and production time of conventional inactivated vaccines highlight the need for additional approaches.

Methods: We conducted two double-blind, placebo-controlled phase 1 studies involving a total of 103 healthy adults who received two intramuscular injections of Vaxfectin-adjuvanted plasmid DNA vaccine or placebo 21 days apart. Vaccine cohorts received either a monovalent vaccine containing an A/Vietnam/1203/04 H5 hemagglutinin-encoding plasmid or a trivalent vaccine with plasmids encoding H5, NP, and M2 proteins in doses from 0.1 to 1mg of DNA/injection.

Results: All doses were well tolerated without vaccine-related serious adverse events or discontinuations. In the monovalent cohorts, hemagglutination inhibition (HI) titers of > or =40 and 4-fold rises from baseline were achieved in 47-67% of subjects and H5-specific T-cell responses in 75-100%. Trivalent cohorts had lower HI response rates (< or = 20%), but 72% of subjects achieved T-cell and/or antibody responses to one or more antigens.

Conclusions: Vaxfectin-adjuvanted monovalent H5 DNA vaccines were well tolerated and induced HI response rates and titers in the reported range of inactivated protein-based H5 vaccines, suggesting that adjuvanted DNA vaccines with rapid vaccine production could be useful for pandemic control.

Publication types

  • Clinical Trial, Phase I
  • Randomized Controlled Trial

MeSH terms

  • Adjuvants, Immunologic / administration & dosage
  • Adjuvants, Immunologic / adverse effects
  • Adult
  • Antibodies, Viral / blood
  • Double-Blind Method
  • Female
  • Hemagglutination Inhibition Tests
  • Hemagglutinin Glycoproteins, Influenza Virus / administration & dosage
  • Hemagglutinin Glycoproteins, Influenza Virus / adverse effects*
  • Hemagglutinin Glycoproteins, Influenza Virus / genetics
  • Hemagglutinin Glycoproteins, Influenza Virus / immunology*
  • Humans
  • Immunization, Secondary / methods
  • Influenza A virus / genetics
  • Influenza A virus / immunology*
  • Influenza Vaccines / administration & dosage
  • Influenza Vaccines / adverse effects*
  • Influenza Vaccines / genetics
  • Influenza Vaccines / immunology*
  • Injections, Intramuscular
  • Male
  • Nucleocapsid Proteins
  • Phosphatidylethanolamines / administration & dosage
  • Phosphatidylethanolamines / adverse effects
  • Placebos / administration & dosage
  • Plasmids
  • RNA-Binding Proteins / genetics
  • RNA-Binding Proteins / immunology
  • T-Lymphocytes / immunology
  • Vaccines, DNA / administration & dosage
  • Vaccines, DNA / adverse effects*
  • Vaccines, DNA / genetics
  • Vaccines, DNA / immunology*
  • Viral Core Proteins / genetics
  • Viral Core Proteins / immunology
  • Viral Matrix Proteins / genetics
  • Viral Matrix Proteins / immunology

Substances

  • Adjuvants, Immunologic
  • Antibodies, Viral
  • Hemagglutinin Glycoproteins, Influenza Virus
  • Influenza Vaccines
  • M2 protein, Influenza A virus
  • NP protein, Influenza A virus
  • Nucleocapsid Proteins
  • Phosphatidylethanolamines
  • Placebos
  • RNA-Binding Proteins
  • Vaccines, DNA
  • Viral Core Proteins
  • Viral Matrix Proteins
  • hemagglutinin, avian influenza A virus
  • vaxfectin