Patent Application
20220118081
This invention relates to the fields of medical microbiology, immunology and vaccines. In particular the invention relates to methods and compositions for obtaining a broad T-cell immune response to an HIV antigen in a subject which can be used to provide a treatment against HIV infection.
Infectious diseases are the second leading cause of death worldwide after cardiovascular disease but are the leading cause of death in infants and children. Vaccination is the most efficient tool for preventing a variety of infectious diseases. The goal of vaccination is to generate a pathogen specific immune response providing preferably long-lasting protection against infection. Despite the significant success of vaccines, development of safe and strong vaccines is still required due to the emergence of new pathogens, re-emergence of old pathogens and suboptimal protection.
Human Immunodeficiency Virus (HIV) infection, particularly HIV-1 infection, continues to be a significant cause of mortality and morbidity worldwide despite the advances in anti-retroviral therapy (ART) and implementation of various prevention strategies, mainly due to poor adherence and heterogeneous access. In 2017, approximately two million new HIV infections occurred and roughly one million people died of AIDS-related illness. Effective HIV vaccines are needed to control and ultimately end the AIDS pandemic.
Recombinant adenovirus vectors (rAd) are powerful inducers of cellular immune responses and have therefore come to serve as useful vectors for gene-based vaccines for viral and non-viral pathogens alike. Adenovirus-based vaccines have several advantages as human vaccines since they can be produced to high titers under GMP conditions and have proven to be safe and immunogenic in humans.
Modified Vaccinia Ankara (MVA) virus is related to Vaccinia virus, a member of the genera Orthopoxvirus in the family of Poxviridae. Poxviruses are known to be good inducers of CD8 T cell responses because of their intracytoplasmic expression. MVA has been engineered for use as a viral vector for recombinant gene expression or as recombinant vaccine.
Cell-mediated immunity (CMI) breadth describes the number of epitopic regions in a vaccine antigen recognized by the cellular immune response. In preclinical therapeutic HIV vaccine studies in non-human primates (NHPs), CMI breadth has been identified as an important correlate of efficacy (Borducchi et al., Nature 540 (2016) 284-287). Published preclinical mouse data suggests that repeated homologous immunization modifies T cell hierarchy with a narrowing and focus on immunodominant epitopes (Rollier et al., Vaccine 34 (2016) 4470-4474). Clinical studies assessed the influence of various vaccine components, immunization regimens and intervals on immunogenicity and CMI breadth in naïve trial participants and HIV infected individuals (e.g. Borthwick et al Mol Ther. 2014 February; 22(2): 464-475; Mothe et al EClinicalMedicine. 2019 Jun. 5; 11:65-80; Viegas et al PLoS One. 2018 Nov. 29; 13(11):e0206838), showing that these factors can have a profound impact. Various combinations of vectors, components, and regimens are possible. One of the many possible combinations for vaccine components that can be useful in HIV vaccine regimens are combinations of adenoviral vectors and poxviral vectors. Clinical trials wherein human adenovirus vectors encoding HIV antigens are used for initial immunization, followed by immunization with MVA vectors encoding HIV antigens, with 12 weeks between administration of the adenovirus vectors and the MVA vectors have been described (e.g. WO 2018/045267; Colby et al, 2020, Nature Medicine 26: 498-501; WO 2019/055888). WO 2018/229711 discloses MVA vectors encoding HIV Env antigens and use thereof also in heterologous administration regimens with human adenovirus vectors. The examples therein describe initial administration with adenovirus vectors followed by administration of the MVA vectors. Roshorm et al in the group led by Hanke (European journal of immunology 42: 3243-3255 (2012)) describe a vaccination regimen that includes an initial administration of ChAdV68.GagB (recombinant chimpanzee adeno virus 68 comprising the HIV antigen GagB) followed by administration of MVA.GagB. These authors also describe the reverse vaccination scheme but neither study nor describe CMI breadth, they highlight the attractiveness of chimpanzee adenoviral vectors compared to human adenoviral vectors for which they indicate major disadvantages, and they refer to then ongoing clinical trials with regimens that include chimpanzee adenovirus vectors and poxvirus vectors. The state of such and following trials and studies aiming at protective T-cell responses against HIV is reviewed by Hanke (T Hanke. 2019. Expert Review of Vaccines, 18:10, 1029-1041). This review indicates that in the initial studies that included arms with chimpanzee adenovirus and poxvirus (MVA), the frequency of effector T-cells was substantially higher for regimens where MVA followed chimpanzee adenovirus administration as compared to reverse regimens where chimpanzee adenovirus administration followed MVA administration, and in addition this review does not appear to refer to any later studies wherein poxvirus administration is followed by adenovirus administration, whereas it describes several further studies that include arms wherein adenovirus administration is followed by poxvirus administration.
The art describing heterologous vaccine regimens using adenovirus and poxvirus vectors is thus heavily biased towards initial administration of the human adenovirus vector followed by administration of a poxvirus vector.
There is still a need in the art for HIV vaccination strategies that improve immunogenicity and particularly CMI breadth. It is an object of the instant invention to provide vaccine compositions and regimens for their administration that improve the breadth and/or the magnitude of the induced immune response against HIV.
In a first aspect, the invention provides for a vaccine combination for use in the treatment of HIV in a subject, comprising:
i) a first composition comprising a poxvirus vector comprising a polynucleotide that encodes an HIV antigen;
ii) a second composition comprising a human adenovirus vector comprising a polynucleotide that encodes an HIV antigen, wherein the first composition is for administration to the subject and the second composition is for administration to the subject less than six weeks after administration of the first composition.
In a second aspect the invention provides for a method for obtaining a broad T-cell immune response to an antigen in a subject, the method comprising:
i) the administration of a first composition comprising a poxvirus vector comprising a polynucleotide that encodes an HIV antigen;
ii) followed less than 6 weeks after administration of the first composition by the administration of a second composition comprising a human adenovirus vector comprising a polynucleotide that encodes an HIV antigen,
wherein the broad T-cell immune response is characterized by a significant increase of positive peptide pools from the HIV antigen in an interferon-gamma ELISpot assay as compared to the response obtained in the same assay when the first administration to the subject is with the second composition and the second administration to the subject is with the first composition with the same interval between the first and second administration.
In a third aspect, the invention provides for a kit comprising:
In another aspect, the invention provides:
a first composition comprising a poxvirus vector comprising a polynucleotide that encodes an HIV antigen, for use in combination with a second composition comprising a human adenovirus vector comprising a polynucleotide that encodes an HIV antigen; wherein the first composition is for administration to the subject and the second composition is for administration to the subject less than six weeks after administration of the first composition.
In another aspect, the invention provides:
a second composition comprising a human adenovirus vector comprising a polynucleotide that encodes an HIV antigen, for use in combination with a first composition comprising a poxvirus vector comprising a polynucleotide that encodes an HIV antigen; wherein the first composition is for administration to the subject and the second composition is for administration to the subject less than six weeks after administration of the first composition.
It was surprisingly found herein that when a composition comprising a poxviral vector expressing a HIV antigen is administered before administration of a composition comprising a human adenoviral vector expressing the HIV antigen, a significantly higher CMI breadth and magnitude were found as compared to another tested vaccine regimen herein with a different order or number of immunizations. Greater cellular breadth has been indicated as favorable in a therapeutic vaccination. Advantageously, this effect was already observed with short vaccine regimens. Short vaccine regimens, i.e. regimens wherein the time interval between the first and the second administration is relatively short (such as a few weeks) have several advantages over long vaccine regimens, as the short timespan between doses may simplify the vaccine dosing regimen in a clinical setting. Such broad T-cell responses may be especially beneficial for HIV, which is known to exist in many variants and prone to mutations, so that a broader T-cell immune response towards many different epitopes may lower the chance that escape variants will arise.
Furthermore, the vaccine regimen as described herein requires fewer rounds of immunization to achieve a significantly higher CMI breadth and magnitude as compared to any other tested vaccine regimen herein which is advantageous as it reduces cost and increases uptake of the vaccine by the eligible population.
Accordingly, in a first aspect, the invention provides for a vaccine combination for use in the treatment of HIV in a subject comprising:
i) a first composition comprising a poxvirus vector comprising a polynucleotide that encodes a HIV antigen; and
ii) a second composition comprising a human adenovirus vector comprising a polynucleotide that encodes a HIV antigen,
wherein the first composition is for administration to the subject and the second composition is for administration to the subject less than six weeks after administration of the first composition.
The term “antigen” refers to an antigenic or immunogenic protein, polypeptide or peptide comprising one or more epitopes (of a pathogen) against which the vaccine combination aims to induce an immune response. For vaccination purposes, it is often beneficial if the same antigen, or the nucleic acid encoding that antigen, is administered several times. In one embodiment, the antigen encoding polynucleotide comprised in the poxvirus vector of the first composition is substantially identical, preferably identical, to the antigen encoding polynucleotide comprised in the adenoviral vector of the second composition. “Substantially identical” as used herein refers to the idea that the antigen might be slightly different, but should still elicit an immune response that would fully (or at least sufficiently) protect the vaccinated individual from the pathogen. For example, the antigen encoding polynucleotide in the second composition may be slightly different, e.g. may have at least 95, 96, 97, 98 or 99% sequence identity with the antigen encoding polynucleotide of the first composition. Preferably the antigen that is encoded by the polynucleotide comprised in the poxvirus vector has at least one epitope in common with the antigen that is encoded by the polynucleotide comprised in the human adenovirus vector. More preferably, a contiguous stretch of at least 10, 20, 30, 40, 50, 60, 70, 80, 90 or 100 of the amino acids in the sequence of the antigen that is encoded by the polynucleotide comprised in the poxvirus vector is identical to the amino acid sequence of the antigen that is encoded by the polynucleotide comprised in the human adenovirus vector. Most preferably, the amino acid sequence of the antigen that is encoded by the polynucleotide comprised in the poxvirus vector is identical to the amino acid sequence of the antigen that is encoded by the polynucleotide comprised in the human adenovirus vector.
Preferably the pox viral vector according to the invention is an orthopox viral vector; preferably the pox viral vector used is the recombinant vaccinia virus Modified Vaccinia virus Ankara (MVA) vector; MVA is a highly attenuated pox viral vector. Preferably the pox viral vector is non-replicating or replication impaired. In additional preferred embodiments, the MVA virus vector is MVA-BN or derivatives thereof.
Chorioallantois vaccinia virus Ankara virus (CVA) was maintained in the Vaccination Institute, Ankara, Turkey for many years and used as the basis for vaccination of humans. The attenuated CVA-virus MVA (Modified Vaccinia Virus Ankara) was obtained by serial propagation (more than 570 passages) of the CVA on primary chicken embryo fibroblasts (CEF).
However, due to the often severe post-vaccination complications associated with vaccinia viruses, there were several attempts to generate a more attenuated, safer vaccine. As a result of the passaging used to attenuate MVA, there are a number of different strains or isolates, depending on the number of passages conducted in CEF cells. Strains of MVA having enhanced safety profiles for the development of safer products, such as vaccines or pharmaceuticals, have been developed, for example by Bavarian Nordic. MVA was further passaged by Bavarian Nordic and is designated MVA-BN. A representative sample of MVA-BN was deposited on Aug. 30, 2000 at the European Collection of Cell Cultures (ECACC) under Accession No. V00083008. MVA-BN is further described in WO 02/42480 (see also e.g., U.S. Pat. Nos. 6,761,893 and 6,913,752 and US 2003/0206926) and WO 03/048184 (US 2006/0159699. MVA as well as MVA-BN lacks approximately 15% (31 kb from six regions) of the genome compared with ancestral CVA virus. The deletions affect a number of virulence and host range genes, as well as the gene for Type A inclusion bodies.
In various embodiments, the MVA or MVA used for generating the recombinants suitable for the present invention are MVA-572, MVA-575, MVA-1721, MVA as deposited as ATCC® VR-1508™, MVA as deposited as ATCC® VR-1566™, ACAM3000 MVA, MVA-BN or any similarly attenuated MVA strain. In preferred embodiments, the MVA used for generating the recombinants are MVA-575, MVA as deposited as ATCC® VR-1508™, MVA as deposited as ATCC® VR-1566™, ACAM3000 MVA and MVA-BN. Preferably the MVA used for generating the recombinants is MVA-BN.
MVA-572 was deposited at the European Collection of Animal Cell Cultures (ECACC, Vaccine Research and Production Laboratory, Public Health Laboratory Service, Centre for Applied Microbiology and Research, Porton Down, Salisbury, Wiltshire SP4 0JG, United Kingdom) with the deposition number ECACC V94012707 on Jan. 27, 1994. MVA-575 was deposited under ECACC V00120707 on Dec. 7, 2000. Acam3000 MVA was deposited at the American Type Culture Collection (ATCC) under Accession No.: PTA-5095 on Mar. 27, 2003 (American Type Culture Collection, 10801 University Blvd., Manassas, Va. 20110-2209, USA). MVA-1721 was deposited as CNCM 1721 at the Collection Nationale de Cultures de Microorganisms, Institute Pasteur. MVA-BN was deposited on Aug. 30, 2000 at the ECACC under number V00083008. MVA-BN has been described in WO 02/042480.
Also encompassed by the invention are derivatives or variants of any of the MVA viruses or MVA-BN described herein. “Derivatives” or “variants” of MVA or MVA-BN refer to MVA or MVA-BN viruses exhibiting essentially the same replication characteristics as the MVA or MVA-BN to which it refers, but exhibiting differences in one or more parts of their genomes. Viruses having the same “replication characteristics” as the deposited virus are viruses that replicate with similar amplification ratios as the deposited strain in chicken embryo fibroblasts (CEF) cells and the cell lines HaCat (Boukamp et al. (1988), J Cell Biot 106: 761-771), the human bone osteosarcoma cell line 143B (ECACC No. 91112502), the human embryo kidney cell line 293 (ECACC No. 85120602), and the human cervix adenocarcinoma cell line HeLa (ATCC No. CCL-2). Tests and assay to determine these properties of MVA, its derivatives and variants are well known to the skilled person, such as the cell line permissivity assay as described in WO 02/42480. In an exemplary cell line permissivity assay, mammalian cell lines are infected with the parental and derivative or variant MVA virus at a low multiplicity of infection per cell, i.e., 0.05 infectious units per cell (5×104 TCID50). Following absorption of 1 hour the virus inoculum is removed and the cells washed three times to remove any remaining unabsorbed viruses. Fresh medium supplemented with 3% FCS is added and infections are left for a total of 4 days (at 37° C., 5% CO2) where viral extracts can be prepared. The infections are stopped by freezing the plates at −80° C. for three times. Virus multiplication and cytopathic effects (CPE) are subsequently determined on CEF cells using methods well known to the skilled person such as those described in Carroll and Moss (1997), Virology 238, 198-211.
More specifically, MVA-BN or a derivative or variant of MVA-BN preferably has the capability of reproductive replication in CEF cells, but no capability of reproductive replication in the human keratinocyte cell line HaCat (Boukamp et al (1988), J. Cell Biol. 106:761-771), the human bone osteosarcoma cell line 143B (ECACC Deposit No. 91112502), the human embryo kidney cell line 293 (ECACC Deposit No. 85120602), and the human cervix adenocarcinoma cell line HeLa (ATCC Deposit No. CCL-2). Additionally, a derivative or variant of MVA-BN has a virus amplification ratio at least two-fold less, preferably three-fold less than MVA-575 in Hela cells and HaCaT cell lines. Tests and assays for these properties of MVA variants are described in WO 02/42480 or in the exemplary cell line permissivity assay as described above.
The term “not capable of reproductive replication” or “no capability of reproductive replication” is, for example, described in WO 02/42480, which also teaches how to obtain MVA having the desired properties as mentioned above. The term applies to a virus that has a virus amplification ratio at 4 days after infection of less than 1 using the assays described in WO 02/42480 or in U.S. Pat. No. 6,761,893.
The term “fails to reproductively replicate” refers to a virus that has a virus amplification ratio at 4 days after infection of less than 1. Assays described in WO 02/42480 or in U.S. Pat. No. 6,761,893 are applicable for the determination of the virus amplification ratio.
Methods to obtain recombinant poxviruses or to insert exogenous coding sequences into a poxviral genome are well known to the person skilled in the art. For example, methods for standard molecular biology techniques such as cloning of DNA, DNA and RNA isolation. Western blot analysis, RT-PCR and PCR amplification techniques, techniques for the handling and manipulation of viruses, and techniques and know-how for the handling, manipulation and genetic engineering of MVA, are described in widely available textbooks and laboratory manuals.
For the generation of the various recombinant MVAs disclosed herein, different methods can be applicable. The DNA sequence to be inserted into the virus can be placed into an E. coli plasmid construct into which DNA homologous to a section of DNA of the MVA has been inserted. Separately, the DNA sequence to be inserted can be ligated to a promoter. The promoter-gene linkage can be positioned in the plasmid construct so that the promoter-gene linkage is flanked on both ends by DNA homologous to a DNA sequence flanking a region of MVA DNA containing a non-essential locus. The resulting plasmid construct can be amplified by propagation within E. coli bacteria and isolated. The isolated plasmid containing the DNA gene sequence to be inserted can be transfected into a cell culture, e.g., of chicken embryo fibroblasts (CEFs), at the same time the culture is infected with MVA. Recombination between homologous MVA DNA in the plasmid and the viral genome, respectively, can generate an MVA modified by the presence of foreign DNA sequences.
According to a preferred embodiment, a cell of a suitable cell culture as, e.g., CEF cells, can be infected with a poxvirus. The infected cell can be, subsequently, transfected with a first plasmid vector comprising a foreign or heterologous gene or genes, preferably under the transcriptional control of a poxvirus expression control element. As explained above, the plasmid vector also comprises sequences capable of directing the insertion of the exogenous sequence into a selected part of the poxviral genome. Optionally, the plasmid vector also contains a cassette comprising a marker and/or selection gene operably linked to a poxviral promoter.
Non-limiting examples of suitable promoters for the poxvirus vectors include the 30K promoter, the 13 promoter, the PrS promoter, the PrS5E promoter, the Pr7.5K, the Pr13.5 long promoter, the PrHyb promoter, the 40K promoter, the MVA-40K promoter, the FPV 40K promoter, 30 k promoter, the PrSynllm promoter, and the PrLE1 promoter. Additional promoters are further described in WO 2010/060632, WO 2010/102822, WO 2013/189611 and WO 2014/063832. In certain embodiments, the HIV antigen is Env and the promoter used to regulate the expression of the antigen in the poxvirus vector is PrHyb; in certain embodiments, the HIV antigen is GagPol and the promoter used to regulate the expression of the antigen in the poxvirus vector is Fri 3.5 long (see e.g. WO 2018/229711 for examples of such vectors).
Suitable marker or selection genes are, e.g., the genes encoding the green fluorescent protein, β-galactosidase, neomycin-phosphoribosyltransferase or other markers. The use of selection or marker cassettes simplifies the identification and isolation of the generated recombinant poxvirus. However, a recombinant poxvirus can also be identified by PCR technology. Subsequently, a further cell can be infected with the recombinant poxvirus obtained as described above and transfected with a second vector comprising a second foreign or heterologous gene or genes. In case, this gene shall be introduced into a different insertion site of the poxviral genome, the second vector also differs in the poxvirus-homologous sequences directing the integration of the second foreign gene or genes into the genome of the poxvirus. After homologous recombination has occurred, the recombinant virus comprising two or more foreign or heterologous genes can be isolated. For introducing additional foreign genes into the recombinant virus, the steps of infection and transfection can be repeated by using the recombinant virus isolated in previous steps for infection and by using a further vector comprising a further foreign gene or genes for transfection. Alternatively, the steps of infection and transfection as described above are interchangeable, i.e., a suitable cell can at first be transfected by the plasmid vector comprising the foreign gene and, then, infected with the poxvirus. As a further alternative, it is also possible to introduce each foreign gene into different viruses, co-infect a cell with all the obtained recombinant viruses and screen for a recombinant including all foreign genes. A third alternative is ligation of DNA genome and foreign sequences in vitro and reconstitution of the recombined vaccinia virus DNA genome using a helper virus. A fourth alternative is homologous recombination in E. coli or another bacterial species between a vaccinia virus genome, such as MVA, cloned as a bacterial artificial chromosome (BAC) and a linear foreign sequence flanked with DNA sequences homologous to sequences flanking the desired site of integration in the vaccinia virus genome.
One or more nucleic acid sequences encoding at least one antigen that can be used according to embodiments of the invention can be inserted into any suitable part of the poxvirus or poxviral vector. In a preferred aspect, the poxvirus used for the present invention includes an MVA virus or viral vector, preferably an MVA-BN virus or viral vector. Suitable parts of the MVA virus into which one or more nucleic acids of the present disclosure can be inserted include non-essential parts of the MVA virus.
An adenovirus that can be used according to the invention is a human adenovirus (HAdV, or AdHu). In the invention, a human adenovirus is meant if referred to as Ad without indication of species, e.g. the brief notation “Ad26” means the same as HAdV26, which is human adenovirus serotype 26. Also as used herein, the notation “rAd” means recombinant adenovirus, e.g., “rAd26” refers to recombinant human adenovirus 26.
Most advanced studies have been performed using human adenoviruses, and human adenoviruses are used according to the invention. A recombinant adenovirus according to the invention is thus based upon a human adenovirus. In preferred embodiments, the recombinant adenovirus is based upon a human adenovirus serotype 5, 11, 26, 34, 35, 48, 49, 50, 52, etc. According to a particularly preferred embodiment of the invention, an adenovirus is a human adenovirus of serotype 26. Advantages of these serotypes include a low seroprevalence and/or low pre-existing neutralizing antibody titers in the human population, and experience with use in human subjects in clinical trials.
Preferably, the adenovirus vector is a replication deficient recombinant viral vector, such as rAd26, rAd35, rAd48, rAd5HVR48, etc.
In a preferred embodiment of the invention, the adenoviral vectors comprise capsid proteins from rare serotypes, e.g. including Ad26. In the typical embodiment, the vector is an rAd26 virus. An “adenovirus capsid protein” refers to a protein on the capsid of an adenovirus (e.g., Ad26, Ad35, rAd48, rAd5HVR48 vectors) that is involved in determining the serotype and/or tropism of a particular adenovirus. Adenoviral capsid proteins typically include the fiber, penton and/or hexon proteins. As used herein a “capsid protein” for a particular adenovirus, such as an “Ad26 capsid protein” can be, for example, a chimeric capsid protein that includes at least a part of an Ad26 capsid protein. In certain embodiments, the capsid protein is an entire capsid protein of Ad26. In certain embodiments, the hexon, penton and fiber are of Ad26.
One of ordinary skill in the art will recognize that elements derived from multiple serotypes can be combined in a single recombinant adenovirus vector. Thus, a chimeric adenovirus that combines desirable properties from different serotypes can be produced. Thus, in some embodiments, a chimeric adenovirus of the invention could combine the absence of pre-existing immunity of a first serotype with characteristics such as temperature stability, assembly, anchoring, production yield, redirected or improved infection, stability of the DNA in the target cell, and the like. See for example WO 2006/040330 for chimeric adenovirus Ad5HVR48, that includes an Ad5 backbone having partial capsids from Ad48, and also e.g. WO 2019/086461 for chimeric adenoviruses Ad26HVRPtr1, Ad26HVRPtr12, and Ad26HVRPtr13, that include an Ad26 virus backbone having partial capsid proteins of Ptr1, Ptr12, and Ptr13, respectively).
In certain embodiments the recombinant adenovirus vector useful in the invention is derived mainly or entirely from Ad26 (La, the vector is rAd26). In some embodiments, the adenovirus is replication deficient, e.g., because it contains a deletion in the E1 region of the genome. For adenoviruses being derived from non-group C adenovirus, such as Ad26 or Ad35, it is typical to exchange the E4-orf6 coding sequence of the adenovirus with the E4-orf6 of an adenovirus of human subgroup C such as Ad5. This allows propagation of such adenoviruses in well-known complementing cell lines that express the E1 genes of Ad5, such as for example 293 cells, PER.C6 cells, and the like (see, e.g. Havenga, et al., 2006, J Gen Virol 87: 2135-43; WO 03/104467). However, such adenoviruses will not be capable of replicating in non-complementing cells that do not express the E1 genes of Ad5.
The preparation of recombinant adenoviral vectors is well known in the art. For example, preparation of rAd26 vectors is described, in WO 2007/104792 and in Abbink et al., 2007 Virology 81: 4654-63. Exemplary genome sequences of Ad26 are found in GenBank Accession EF 153474 and in SEQ ID NO:1 of WO 2007/104792.
Typically, an adenovirus vector useful in the invention is produced using a nucleic acid comprising the entire recombinant adenoviral genome (e.g., a plasmid, cosmid, or baculovirus vector).
The adenovirus vectors useful in the invention are typically replication deficient. In these embodiments, the virus is rendered replication deficient by deletion or inactivation of regions critical to replication of the virus, such as the E1 region. The regions can be substantially deleted or inactivated by, for example, inserting a gene of interest, such as a gene encoding an antigenic HIV protein, e.g. an HIV Env protein (usually linked to a promoter), within the region. In some embodiments, the vectors of the invention can contain deletions in other regions, such as the E2, E3 or E4 regions, or insertions of heterologous genes linked to a promoter within one or more of these regions. For E2- and/or E4-mutated adenoviruses, generally E2- and/or E4-complementing cell lines are used to generate recombinant adenoviruses. Mutations in the E3 region of the adenovirus need not be complemented by the cell line, since E3 is not required for replication.
Non-limiting examples of suitable promoters for the adenovirus vectors include the immediate early promoter of CMV (CMV promoter) and the Rous Sarcoma Virus Long Terminal Repeat promoter (RSV promoter). Preferably, the promoter is located upstream of the heterologous gene of interest within an expression cassette. A non-limiting example of a CMV promoter sequence that can be used in an adenovirus vector to drive expression of the HIV antigen is provided in SEQ ID NO: 24 of WO 2017/102929. Preferably, the promoter used in the human adenovirus vector of the invention is the CMV promoter.
A packaging cell line is typically used to produce sufficient amount of adenovirus vectors of the invention. A packaging cell is a cell that comprises those genes that have been deleted or inactivated in a replication-defective vector, thus allowing the virus to replicate in the cell. Suitable packaging cell lines include, for example, PER.C6, 911, 293, CAP, and E1 A549.
In certain embodiments, a recombinant adenovirus according to the invention is deficient in at least one essential gene function of the E1 region, e.g. the E1a region and/or the E1 b region, of the adenoviral genome that is required for viral replication. In certain embodiments, an adenoviral vector according to the invention is deficient in at least part of the non-essential E3 region. In certain embodiments, the vector is deficient in at least one essential gene function of the E1 region and at least part of the non-essential E3 region. The adenoviral vector can be “multiply deficient,” meaning that the adenoviral vector is deficient in one or more essential gene functions in each of two or more regions of the adenoviral genome. For example, the aforementioned E1-deficient or E1-, E3-deficient adenoviral vectors can be further deficient in at least one essential gene of the E4 region and/or at least one essential gene of the E2 region (e.g., the E2A region and/or E2B region).
In a preferred embodiment of the invention, the secondly administered vector is an adenovirus vector, and preferably a rAd26 vector, most preferably a rAd26 vector with at least a deletion in the E1 region of the adenoviral genome, e.g. such as that described in Abbink, J Virol, 2007. 81(9): p. 4654-63. Typically, the nucleic acid sequence encoding at least one antigen according to embodiments of the invention (e.g. an HIV envelope protein and/or other antigens) is cloned into the E1 and/or the E3 region of the adenoviral genome.
In certain embodiments, the HIV antigen is selected from HIV-1 Group Antigen (Gag), Polymerase (Pol), and/or Envelope (Env) proteins, or an antigenic part thereof. In preferred embodiments, the HIV antigen encoded in the poxvirus vector and in the adenovirus vector is an envelope (Env) protein or an immunogenic part thereof.
In one embodiment, the antigen is a “mosaic” antigen derived from HIV-1 Gag, Poi and/or Env antigens. Such mosaic antigens have been described before and developed in an attempt to provide maximal coverage of potential T-cell epitopes (e.g., Barouch et al, Nat Med 2010, 16: 319-323). The mosaic antigens are similar in length and domain structure to wild-type, naturally occurring HIV-1 antigens. For example, mosaic HIV antigens described and used in vaccines include those described in Barouch et al, supra, and for instance in WO 2010/059732, or in WO 2017/102929. Non-limiting examples of suitable mosaic HIV antigens (e.g. Table 1) that can be used in the instant invention include one or more of: (i) mosaic Gag antigen sequences as set forth in SEQ ID NO: 1 (“mos1.Gag”) or SEQ ID NO: 2 (“mos2.Gag”); (ii) mosaic Poi antigen sequences as set forth in SEQ ID NO: 3 (“mos1.Pol”) or SEQ ID NO: 4 (“mos2.Pol”); (iii) mosaic Env antigen as set forth in SEQ ID NO: 5 (“mos1.Env”) or SEQ ID NO: 6 (“mos2S.Env”); or fusions thereof, such as mos1.GagPol (SEQ ID NO: 11) or mos2.GagPol (SEQ ID NO: 12). Examples of suitable nucleic acid sequences encoding these antigens are set forth in SEQ ID NO: 7 (encoding mos1.GagPol), SEQ ID NO: 8 (encoding mos2.GagPol), SEQ ID NO: 9 (encoding mos1.Env), and SEQ ID NO: 10 (encoding mos2S.Env).
In a preferred embodiment of the invention, the polynucleotide encodes an Env polypeptide, e.g. in certain embodiments the polynucleotide may encode mos1.Env or mos2S.Env. In certain embodiments, a combination of Ad26 vectors is used, wherein each Ad26 vector comprises a polynucleotide encoding an antigen as indicated above, and the combination of Ad26 vectors together encodes a combination of the antigens as indicated above, for instance a combination of (i) mos1.GagPol, (ii) mos2.GagPol, (iii) mos1.Env, and (iv) mos2S.Env. Such combinations of vectors can be mixed in a single composition (see e.g. WO 2017/102929).
Other examples of HIV Gag, Pol, Env antigen sequences, or other HIV antigen sequences such as Nef, Tat, Rev, Vif, Vpr, or Vpu, are available to the skilled person from public databases, such as GenBank. Many different variants of HIV antigens have been described and could be used in the invention. Another non-limiting example would be the HIV T-cell immunogens described in WO 2013/110818.
In certain embodiments, further components can be administered to a subject to which the vectors are administered according to the invention, e.g. by additionally administering isolated HIV Env protein antigen, such as gp140 protein (see e.g. WO 2017/102929, for instance one or both proteins having amino acids 30-708 of SEQ ID NO: 7 of WO 2017/102929 and/or amino acids 30-724 of SEQ ID NO: 36 of WO 2017/102929).
As shown herein, a vaccine regimen comprising administration of a first composition comprising a poxviral vector followed by a second composition comprising an adenoviral vector significantly increases CMI breadth and magnitude in subjects receiving that vaccine regimen, as compared to the reverse regimen wherein adenoviral vector administration is followed by poxvirus vector administration. Such an immunization regimen inducing high CMI breadth and magnitude have been shown to be particularly efficacious as therapeutic HIV vaccine.
Accordingly, in an embodiment, the invention provides for a vaccine combination as described herein and a method as described herein for inducing a therapeutic immune response in an HIV infected subject.
In certain embodiments, the vaccine combination for use in the treatment of AIDS or an infection with HIV is given concurrently or in addition to treatment with anti-retroviral therapy (ART).
As used herein, “treatment of HIV in a subject” means administration of the vaccine to induce a therapeutic immune response against HIV or against cells that express (epitopes) of HIV in a subject which leads to at least reduction of the level of and preferably complete removal of HIV infection, which results in at least slowing and preferably stopping the progress of a disease caused by HIV such as AIDS and/or symptoms thereof. HIV/AIDS is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV). HIV is spread primarily by unprotected sex (including anal and oral sex), contaminated blood transfusions, hypodermic needles, and from mother to child during pregnancy, delivery or breastfeeding.
As used herein, the term “therapeutic immunity” or “therapeutic immune response” means that the HIV infected vaccinated subject is able to control an infection with the pathogenic agent, i.e., HIV, against which the vaccination was directed. Typically, the administration of the vaccine combination for use in the treatment of HIV in a subject as described herein will have a therapeutic aim to generate an immune response against HIV after HIV infection or development of symptoms characteristic of HIV infection. Preferably, the methods of the invention are for therapeutic purposes, such as for therapeutic vaccination, in which the compositions and vaccines described herein are administered to a subject already infected with HIV. Thus, the eligible population for treatment of HIV in a subject is preferably HIV-infected subjects, and preferably HIV-infected human subjects. The terms “HIV infection” and “HIV-infected” as used herein refer to invasion of a human host by HIV. As used herein, “an HIV-infected subject” refers to a subject in whom HIV has invaded and subsequently replicated and propagated within the host, thus causing the host to be infected with HIV or have an HIV infection or symptoms thereof.
In a preferred embodiment of the invention, the immune response is or comprises a cellular immune response, preferably a CD8+ T-cell response.
In one embodiment, the polynucleotide that encodes an HIV antigen comprised in the poxvirus vector of the first composition is substantially identical, preferably identical, to polynucleotide that encodes an HIV antigen comprised in the human adenoviral vector of the second composition as described herein.
In certain embodiments, the time interval between administration of the first and the second composition is less than 6 weeks such as for example 4 to 25 days, preferably 10 to 18 days. In certain the embodiments the time interval is about two weeks (14 days).
The first composition comprising the poxvirus vector of the invention and the second composition comprising the adenovirus vector of the invention are preferably pharmaceutical compositions that may comprise any pharmaceutically acceptable excipient including at least one of a carrier, filler, preservative, solubilizer and diluent. In the present context, the term “Pharmaceutically acceptable” means that the carrier or excipient, at the dosages and concentrations employed, will not cause any unwanted or harmful effects in the subjects to which they are administered. Such pharmaceutically acceptable excipients and carriers are well known in the art and for instance described in textbooks and manuals. Saline solutions and aqueous dextrose and glycerol solutions can also be employed as liquid carriers, particularly for injectable solutions. Suitable excipients include starch, glucose, lactose, sucrose, gelatin, malt, rice, flour, chalk, silica gel, sodium stearate, glycerol monostearate, talc, sodium chloride, dried skim milk, glycerol, propylene, glycol, water, ethanol and the like.
The precise nature of the carrier or other material can depend on the route of administration, e.g., intramuscular, subcutaneous, oral, intravenous, cutaneous, intramucosal (e.g., gut), intranasal or intraperitoneal routes. For liquid injectable preparations, for example, suspensions and solutions, suitable carriers and additives include water, glycols, oils, alcohols, preservatives, coloring agents and the like. For solid oral preparations, for example, powders, capsules, caplets, gelcaps and tablets, suitable carriers and additives include starches, sugars, diluents, granulating agents, lubricants, binders, disintegrating agents and the like. For nasal sprays/inhalant mixtures, the aqueous solution/suspension can comprise water, glycols, oils, emollients, stabilizers, wetting agents, preservatives, aromatics, flavors, and the like as suitable carriers and additives.
Compositions of the invention can be formulated in any matter suitable for administration to a subject to facilitate administration and improve efficacy, including, but not limited to, oral (enteral) administration and parenteral injections. The parenteral injections include intravenous injection or infusion, intra-arterial injection, subcutaneous injection, intramuscular injection, intradermal injection and intra-articular injection. Compositions of the invention can also be formulated for other routes of administration including mucosal (e.g. intravaginal, intranasal, oral, rectal), transmucosal, ocular, rectal, long acting implantation, sublingual administration, under the tongue, from oral mucosa bypassing the portal circulation, inhalation, or intranasal.
Said compositions can be formulated as a vaccine (also referred to as an “immunogenic composition”) according to methods well known in the art. The optimal ratios of each component in the formulation can be determined by techniques well known to those skilled in the art in view of the present disclosure.
In certain embodiments, the vaccine combination as described herein is used in a vaccine regimen that is sometimes referred to as a prime-boost vaccine regimen, in this case being a heterologous prime-boost regimen, which in this context indicates that the priming and boosting vectors are different. In certain embodiments, the priming is with a poxviral vector, such as MVA, and the boosting is with a human adenoviral vector, such as Ad26.
In some embodiments, at least one of the first and second compositions of the invention can further optionally comprise an adjuvant to enhance immune responses. The terms “adjuvant” and “immune stimulant” are used interchangeably herein, and are defined as one or more substances that cause stimulation of the immune system. In this context, an adjuvant is used to enhance an immune response to the human adenovirus and/or poxvirus vectors of the invention.
Adjuvants are defined as substances whose role is to boost or direct antigen specific immune responses when used in combination with specific antigens. Usually, adjuvants combined with antigens, do not induce immune responses against themselves. Due to the poor immunogenic properties of certain antigens, adjuvants are used to enhance, activate and direct the innate and adaptive immune responses to those antigens. The concept of adjuvants has occasionally been extended to carriers that interact with surface molecules on specific cells of the immune system that operate at the interface between the immune system of the host and the administered antigen. In doing so adjuvants help to stimulate the immune system and increase the response to the co-administered antigen. Therefore, adjuvants have been widely used for the development of vaccines.
Preferred adjuvants enhance the immune response against a given antigen by at least a factor of 1.5, 2, 2.5, 5, 10 or 20, as compared to the immune response generated against the antigen under the same conditions but in the absence of the adjuvant. Tests for determining the statistical average enhancement of the immune response against a given antigen as produced by an adjuvant in a group of animals or humans over a corresponding control group are available in the art.
Adjuvants suitable for use with the invention should be ones that are potentially safe, well tolerated and effective in people, such as for instance QS-21, Detox-PC, MPL-SE, MoGM-CSF, TiterMax-G, CRL-1005, GERBU, TERamide, PSC97B, Adjumer, PG-026, GSK-I, GcMAF, B-alethine, MPC-026, Adjuvax, CpG ODN, Betafectin, aluminum salts (e.g. AdjuPhos), Adjuplex, and MF59. The optimal ratios of each component in the formulation can be determined by techniques well known to those skilled in the art in view of the present disclosure.
In preferred embodiments, the first and second compositions of the invention do not comprise an adjuvant.
The preparation and use of immunogenic compositions are well known to those of ordinary skill in the art. Liquid pharmaceutical compositions generally include a liquid carrier such as water, petroleum, animal or vegetable oils, mineral oil or synthetic oil. Physiological saline solution, dextrose or other saccharide solution or glycols such as ethylene glycol, propylene glycol or polyethylene glycol can also be included.
For instance recombinant adenovirus vector may be stored in the buffer that is also used for the Adenovirus World Standard: 20 mM Tris pH 8, 25 mM NaCl, 2.5% glycerol. Another useful adenovirus formulation buffer suitable for administration to humans is 20 mM Tris, 2 mM MgCl2, 25 mM NaCl, sucrose 10% w/v, polysorbate-80 0.02% w/v. Another formulation buffer that is suitable for recombinant adenovirus comprises 10-25 mM citrate buffer pH 5.9-6.2, 4-6% (w/w) hydroxypropyl-beta-cyclodextrin (HBCD), 70-100 mM NaCl, 0.018-0.035% (w/w) polysorbate-80, and optionally 0.3-0.45% (w/w) ethanol. Obviously, many other buffers can be used, and several examples of suitable formulations for the storage and for pharmaceutical administration of purified vectors are known.
An exemplary preparation and storage of poxviral vectors, including MVA and MVA-BN can be based on the experience in the preparation of poxvirus vaccines used for vaccination against smallpox. Other examples of suitable formulations for poxviral vectors such as MVA are disclosed in WO 2018/211419. Such formulations comprise poxviral vectors such as MVA for instance include but are not limited to compositions comprising 10 mM Tris buffer at pH 8.0 and 100 mM sodium sulfate, or 10 mM phosphate buffer at pH 7.5 and 100 mM sodium sulfate, each of these optionally further comprising 5% (w/w) glycerol.
A subject as used herein preferably is a mammal, or a non-human-primate, or a human. Preferably, the subject is a human subject.
Administration of the first and second composition of the vaccine combination as described herein is typically intramuscular, intradermal or subcutaneous, preferably intramuscular. However, other modes of administration such as intravenous, rectal, vaginal, cutaneous, oral, nasal, etc. can be envisaged as well. Intramuscular administration of the immunogenic compositions can be achieved by using a needle to inject a suspension of the expression vectors, e.g. adenovirus vectors, poxvirus vectors, e.g. into the deltoid muscle of the arm, or vastus lateralis muscle of the thigh, or ventrogluteal muscle of the hip, or in the dorsogluteal muscle of the buttock. An alternative is the use of a needleless injection device to administer the composition (using, e.g., Biojector™) or a freeze-dried powder containing the vaccine.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning commonly understood to one of ordinary skill in the art to which this invention pertains. Otherwise, certain terms cited herein have the meanings as set in the specification. All patents, published patent applications and publications cited herein are incorporated by reference as if set forth fully herein. It must be noted that as used herein and in the appended claims, the singular forms “a,” “an,” and “the” include plural reference unless the context clearly dictates otherwise.
Throughout this description and the claims which follow, unless the context requires otherwise, the word “comprise”, and variations such as “comprises” and “comprising”, will be understood to imply the inclusion of a stated integer or step or group of integers or steps but not the exclusion of any other integer or step or group of integer or step. When used herein the term “comprising” can be substituted with the term “containing” or “including” or sometimes when used herein with the term “having”.
When used herein “consisting of” excludes any element, step, or ingredient not specified in the claim element. When used herein, “consisting essentially of” does not exclude materials or steps that do not materially affect the basic and novel characteristics of the claim. Any of the aforementioned terms of “comprising”, “containing”, “including”, and “having”, whenever used herein in the context of an aspect or embodiment of the invention can be replaced with the term “consisting of” or “consisting essentially of” to vary scopes of the disclosure.
As used herein, the conjunctive term “and/or” between multiple recited elements is understood as encompassing both individual and combined options. For instance, where two elements are conjoined by “and/or”, a first option refers to the applicability of the first element without the second. A second option refers to the applicability of the second element without the first. A third option refers to the applicability of the first and second elements together. Any one of these options is understood to fall within the meaning, and therefore satisfy the requirement of the term “and/or” as used herein. Concurrent applicability of more than one of the options is also understood to fall within the meaning, and therefore satisfy the requirement of the term “and/or.”
The term “protein” or “polypeptide” refers to a molecule consisting of a chain of amino acids, without reference to a specific mode of action, size, 3-dimensional structure or origin. A “fragment” or “portion” of a protein may thus still be referred to as a “protein.” The antigenic protein or immunogenic peptide can be any HIV protein or peptide comprising an epitope (or antigenic determinant). Such antigens can be obtained by sequencing the genomes of the wild-type strains of the different HIV viruses, subcloning the nucleic acids encoding the antigenic determinants from such genomes, and cloning them into the adenoviral genomic sequence and/or the poxviral genomic sequence. Upon administration to a subject, the polypeptide encoded by the nucleic acid molecule in the adenoviral and/or poxviral vectors according to the invention will be expressed in the subject, which will lead to an immune response towards the antigenic fragments that are present in the polypeptide.
“Amino acid sequence”: This refers to the order of amino acid residues of, or within a protein. In other words, any order of amino acids in a protein may be referred to as amino acid sequence.
“Nucleotide sequence”: This refers to the order of nucleotides of, or within a nucleic acid. In other words, any order of nucleotides in a nucleic acid may be referred to as nucleotide sequence.
Methods to insert heterologous coding sequences into a poxviral vector and/or an adenoviral genome are well known to the person skilled in the art. For example, methods for standard molecular biology techniques such as cloning of DNA, DNA and RNA isolation, Western blot analysis, RT-PCR and PCR amplification techniques are described in textbooks and manuals. In a preferred embodiment, the polypeptide encoding the HIV antigen is codon optimized for expression in mammalian cells, preferably human cells. Codon-optimization is a technology well known to the skilled person and widely applied in the art.
Sequence identity is herein defined as a relationship between two or more amino acid (polypeptide or protein) sequences or two or more nucleic acid (polynucleotide) sequences, as determined by comparing the sequences. In the art, “identity” also means the degree of sequence relatedness between amino acid or nucleic acid sequences, as the case may be, as determined by the match between strings of such sequences. “Similarity” between two amino acid sequences is determined by comparing the amino acid sequence and its conserved amino acid substitutes of one polypeptide to the sequence of a second polypeptide.
“Identity” and “similarity” can be readily calculated by known methods. “Sequence identity” and “sequence similarity” can be determined by alignment of two peptide or two nucleotide sequences using global or local alignment algorithms, depending on the length of the two sequences. Sequences of similar lengths are preferably aligned using a global alignment algorithm (e.g. Needleman Wunsch) which aligns the sequences optimally over the entire length, while sequences of substantially different lengths are preferably aligned using a local alignment algorithm (e.g. Smith Waterman). Sequences may then be referred to as “substantially identical” or “essentially similar” when they (when optimally aligned by for example the programs GAP or BESTFIT using default parameters) share at least a certain minimal percentage of sequence identity (as defined below). GAP uses the Needleman and Wunsch global alignment algorithm to align two sequences over their entire length (full length), maximizing the number of matches and minimizing the number of gaps. A global alignment is suitably used to determine sequence identity when the two sequences have similar lengths. Generally, the GAP default parameters are used, with a gap creation penalty=50 (nucleotides)/8 (proteins) and gap extension penalty=3 (nucleotides)/2 (proteins). For nucleotides the default scoring matrix used is nwsgapdna and for proteins the default scoring matrix is Blosum62 (Henikoff & Henikoff, 1992, PNAS 89, 915-919). Sequence alignments and scores for percentage sequence identity may be determined using computer programs, such as the GCG Wisconsin Package, Version 10.3, available from Accelrys Inc., 9685 Scranton Road, San Diego, Calif. 92121-3752 USA, or using open source software, such as the program “needle” (using the global Needleman Wunsch algorithm) or “water” (using the local Smith Waterman algorithm) in EmbossWIN version 2.10.0, using the same parameters as for GAP above, or using the default settings (both for ‘needle’ and for ‘water’ and both for protein and for DNA alignments, the default Gap opening penalty is 10.0 and the default gap extension penalty is 0.5; default scoring matrices are Blosum62 for proteins and DNAFull for DNA).
Alternatively, percentage similarity or identity may be determined by searching against public databases, using algorithms such as FASTA, BLAST, etc. Thus, the nucleic acid and protein sequences described herein can further be used as a “query sequence” to perform a search against public databases to, for example, identify other family members or related sequences. Such searches can be performed using the BLASTn and BLASTx programs (https://blast.ncbi.nlm.nih.gov/Blast.cgi). BLAST nucleotide searches can be performed with the NBLAST program, score=100, wordlength=12 to obtain nucleotide sequences homologous to nucleic acid molecules of the invention. BLAST protein searches can be performed with the BLASTx program, score=50, word length=3 to obtain amino acid sequences homologous to protein molecules of the invention. To obtain gapped alignments for comparison purposes, Gapped BLAST can also be utilized. When utilizing BLAST and Gapped BLAST programs, the default parameters of the respective programs (e.g., BLASTx and BLASTn) can be used. See the homepage of the National Center for Biotechnology Information at http://www.ncbi.nlm.nih.gov/.
As used herein, “an effective amount” or “immunologically effective amount” means an amount of a composition sufficient to induce a desired immune effect or immune response in a subject in need thereof. In one embodiment, an effective amount means an amount sufficient to induce an immune response in a subject in need thereof. In another embodiment, an effective amount means an amount sufficient to produce immunity in a subject in need thereof, e.g., provide a protective or therapeutic effect against a disease such as a viral infection. An effective amount can vary depending upon a variety of factors, such as the physical condition of the subject, age, weight, health, etc.; the particular application, whether inducing immune response or providing protective immunity; the specific recombinant vector administered; the immunogen or antigenic polypeptide encoded by the recombinant vector administered; the specific antigenic polypeptide administered; and the particular disease, e.g., viral infection, for which immunity is desired. An effective amount can readily be determined by one of ordinary skill in the art in view of the present disclosure.
As general guidance, an immunogenically effective amount when used with reference to a recombinant viral vector such as an adenoviral vector can be for instance about 108 viral particles to about 1012 viral particles, for example 108, 109, 1010, 1011, or 1012 viral particles. A single dose of adenoviral vectors for administration to humans in certain embodiments is between 109 and 1011 viral particles. An immunogenically effective amount when used with reference to a recombinant viral vector such as a poxviral vector can be for instance about 104 to 1011 TCID50, 105 to 1010 TCID50, 106 to 109 TCID50, or 107 to 108 TCID50, such as 104, 105, 106, 107, 108, 109, 1010, or 1011 TCID50. A preferred dose for the subjects (preferably a human) comprises 105 to 1010 TCID50, such as a dose of 105 TCID50, 106 TCID50, 107 TCID50, 108 TCID50, 109 TCID50, or 1010 TCID50. The immunogenically effective amount of a poxviral vector such as an MVA vector can alternatively and conveniently be expressed in plaque forming units (pfu), and can for instance be about 105 to about 1011 pfu, e.g. about 105, 106, 107, 108, 109, 1010 or 1011 pfu, preferably about 107 to 109 pfu, and preferably about 108 pfu, such as for instance about 0.5×108, 1×108, 2×108, 3×108, 4×108, or 5×108 pfu. In certain embodiments, the immunogenically effective amount of an MVA vector according to the invention administered to a human subject is about 1×107 to 1×109 pfu, preferably about 1×108 pfu, preferably in a volume of 0.1 mL to 1 mL, e.g. 0.5 mL.
An immunogenically effective amount of a vector, such as an MVA vector and/or adenovirus vector, can be administered in a single composition, or in multiple compositions, such as 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 compositions (e.g., tablets, capsules or injectables), wherein the administration of the multiple capsules or injections collectively provides a subject with the immunogenically effective amount. It is also possible to administer an immunogenically effective amount to a subject, and subsequently administer another dose of an immunogenically effective amount to the same subject, in a so-called prime-boost regimen. Further booster administrations can optionally be added to the regimen, as needed.
The medical use herein described is formulated as a composition as defined herein for use as a medicament for treatment of the stated disease(s), but could equally be formulated as a method of treatment of the stated disease(s) using a composition as defined herein, a composition as defined herein for use in the preparation of a medicament to treat the stated disease(s) and use of a composition as defined herein for the treatment of the stated disease(s) by administering an effective amount. Such medical uses are all envisaged by the present invention.
Discussion of documents, acts, materials, devices, articles or the like which has been included in the present specification is for the purpose of providing context for the invention. Such discussion is not an admission that any or all of these matters form part of the prior art with respect to any inventions disclosed or claimed.
The inventors of present application have surprisingly found that when the composition comprising the poxviral vector is administered before administration of the composition comprising the adenoviral vector, antigen-specific T-cell responses and the number of positive peptide pools (giving an indication of the breadth of the response) are significantly increased as compared to other vaccine regimens. Advantageously, these results were already obtained by using a short vaccine regimen (i.e. wherein the time interval between administration of the first vaccine/composition and the second vaccine/composition is less than 6 weeks, preferably even shorter e.g. such a time interval being about 4-25 days, e.g. 10-18 days, e.g. about two weeks).
Accordingly, in certain embodiments the vaccine combination as described herein is for use in inducing a broad T-cell immune response in the subject wherein the broad T-cell immune response is characterized by a significant increase of the number of positive peptide pools as compared to the response obtained in the same assay when the first administration to the subject is with the second composition and the second administration to the subject is with the first composition with the same interval between the first and second administration. Preferably, the vaccine combination as described herein is also for use in inducing a strong T-cell response, which is characterized by a significant increase of immune cells responding to the HIV antigen (i.e. the response magnitude induced against the HIV antigen) in an interferon-gamma ELISpot assay as compared to the response obtained in the same assay when the first administration to the subject is with the second composition and the second administration to the subject is with the first composition with the same interval between the first and second administration.
Additionally, in a second aspect, the invention provides for a method for obtaining a broad T-cell immune response to an HIV antigen in a subject. The method comprises:
i) the administration (‘first administration’) of a first composition comprising a poxvirus vector comprising a polynucleotide that encodes an HIV antigen;
ii) followed less than 6 weeks after the first administration by the administration (‘second administration’) of a second composition comprising a human adenovirus vector comprising a polynucleotide that encodes an HIV antigen,
wherein the broad T-cell immune response is characterized by a significant increase of the number of positive peptide pools as compared to the response obtained when the first administration to the subject is with the second composition and the second administration to the subject is with the first composition under the same conditions (e.g. same time interval between the administrations, same sampling and assay conditions, using the same peptide pools). Preferably, such T-cell response is also a strong T-cell response, which is characterized by a significant increase of immune cells responding to the HIV antigen (i.e. the response magnitude induced against the HIV antigen) in an interferon-gamma ELISpot assay as compared to the response obtained in the same assay when the first administration to the subject is with the second composition and the second administration to the subject is with the first composition with the same interval between the first and second administration. In a preferred embodiment, the second composition is administered less than 6, 5, 4, 3, 2, or 1 week(s) after the administration of the first composition. Preferably, the second composition is administered less than 6 weeks after administration of the first composition, preferably between about 4-25 days, preferably between about 10 to 18 days after administration of the first composition. Preferably, the second composition is administered about 2 weeks (14 days) after administration of the first composition.
As herein described a significant increase in the number of positive peptide pools is an increase of at least 20, 25, 30, 35, 40, 45, 50, 55, 60, or 65% of positive peptide pools as compared to the number of positive peptide pools that are obtained the first administration to the subject is with the second composition and the second administration to the subject is with the first composition.
The method according to the invention provides for a method for obtaining a broad a T-cell immune response to an HIV antigen in a subject. The broad T-cell immune response obtained by the method of the invention may encompass providing protective immunity and/or vaccinating a subject against an HIV antigen for prophylactic purposes, and/or causing a desired immune response or effect in a subject in need thereof against an HIV infection for therapeutic purposes, i.e., therapeutic vaccination. “Inducing an immune response” also encompasses providing a therapeutic immunity for treating against a pathogenic agent. Typically, for prophylactic vaccination, compositions and vaccines are administered to subjects who have not been previously infected with a target pathogen, whereas for therapeutic vaccination, compositions and vaccines are administered to a subject already infected with a target pathogen. CMI breadth (broad T-cell response) is particularly beneficial for therapeutic vaccination, and in certain preferred embodiments the compositions of the invention are used for therapeutic vaccination, e.g. to generate immune responses against HIV in a subject already having an HIV infection.
As described herein a “broad T-cell immune response” is characterized by a significant increase of cell-mediated immunity (CMI) breadth and magnitude. CMI breadth describes the number of epitopic regions in a vaccine antigen recognized by the cellular immune response. CMI magnitude refers to the number of immune cells responding to single peptide or peptide pool stimulation with cytokine secretion, for example measured by IFN-gamma ELISPOT, upon immunization.
CMI breadth can be determined by measuring the positive (response above background) peptide pools against the antigen in an interferon-gamma (IFN-γ) ELISpot assay. The IFN-γ ELISpot assay is well-known to the person skilled in the art; for example, protocols of IFN-γ ELISpot assays have been described in Barouch D H et al (Nature 482.7383 (2012): 89-93) and Barouch D H et al (The Lancet 392.10143 (2018): 232-243).
A non-limiting example of a method for an IFN-γ ELISpot assay and Env peptide pools that can be used to demonstrate a significant increase in the vaccine-induced number of HIV Env positive peptides or peptide pools and/or in the magnitude of the T-cell responses, is the ELISpot assay as described in Barouch et al, The Lancet 392.10143 (2018): 232-243, including the Env peptide pools used therein. In certain embodiments, the number of peptide pools used for one HIV antigen (sometimes also referred to as ‘sub pools’, when belonging to one antigen; herein, the terms ‘pool’ and ‘sub pool’ are used interchangeably) such as Env is at least 10, preferably at least 15, for instance 15, 16, 17, 18, 19, 20, or more. In one particular embodiment the number of Env peptide pools is 17. In certain preferred embodiments peptide pools are potential T-cell epitope (PTE) pools. The peptide pools can be prepared according to known methods, and peptides and/or peptide sequences can for instance be obtained from the NIH AIDS Reagent Program (see e.g. https://www.aidsreagent.org/reagentdetail.cfm?t=peptides&id=330). In one particular embodiment, the Env peptide sequences and allocation to different sub pools in the IFN-γ ELISpot assay described above is provided in Table 2. Thus in certain particular embodiments according to the invention, a T-cell immune response is measured in an interferon-gamma ELISpot assay using 17 Env peptide sub pools, wherein a first sub pool comprises Env peptides having SEQ ID NOs: 13-33, a second sub pool comprises Env peptides having SEQ ID NOs: 34-57, a third sub pool comprises Env peptides having SEQ ID NOs: 58-77, a fourth sub pool comprises Env peptides having SEQ ID NOs: 78-90, a fifth sub pool comprises Env peptides having SEQ ID NOs: 91-110, a sixth sub pool comprises Env peptides having SEQ ID NOs: 111-137, a seventh sub pool comprises Env peptides having SEQ ID NOs: 138-161, an eighth sub pool comprises Env peptides having SEQ ID NOs: 162-180, a ninth sub pool comprises Env peptides having SEQ ID NOs: 181-190, a tenth sub pool comprises Env peptides having SEQ ID NOs: 191-203, an eleventh sub pool comprises Env peptides having SEQ ID NOs: 204-233, a twelfth sub pool comprises Env peptides having SEQ ID NOs: 234-247, a thirteenth sub pool comprises Env peptides having SEQ ID NOs: 248-277, a fourteenth sub pool comprises Env peptides having SEQ ID NOs: 278-300, a fifteenth sub pool comprises Env peptides having SEQ ID NOs: 301-329, a sixteenth sub pool comprises Env peptides having SEQ ID NOs: 330-355, and a seventeenth sub pool comprises Env peptides having SEQ ID NOs: 356-375. Similar assays can be done for other HIV antigens using PTE pools or peptides for such antigens as known to the skilled person, such as Gag, Pol, etc.
CMI magnitude can be determined by counting the number of immune cells responding to single peptide or peptide pool stimulation with cytokine secretion, for example measured by IFN-gamma ELISPOT assay.
Accordingly, the T-cell immune response induced by the method of the invention is characterized by a significant increase of at least one and preferably both of (i) the number and (ii) the magnitude of responses enumerated by the number of responding cells, of positive peptide pools from the antigen in an interferon-gamma ELISpot assay as compared to the response obtained in the same assay when the first administration to the subject is with the second composition and the second administration to the subject is with the first composition under the same conditions (as indicated above).
The first composition according to the second aspect of the invention comprises a poxviral vector as described in the first aspect herein.
The second composition according to the second aspect of the invention comprises a human adenoviral vector as described in the first aspect herein.
The HIV antigen according to the second aspect is as described in the first aspect herein. Preferably, the HIV antigen is Env as described in the first aspect herein.
In a third aspect, the present invention provides for a kit of parts comprising i) a first composition comprising a poxvirus vector as described herein;
The kit of parts is preferably for a use in treating a HIV infection as described herein.
Optionally, the kit of parts further comprises a leaflet. The leaflet may comprise instructions for use. In addition or alternatively, the leaflet may be at least one of a patient information leaflet and a Summary of Product Characteristics (an SmPC).
In a fourth aspect, the invention provides a first composition comprising a poxvirus vector comprising a polynucleotide that encodes an HIV antigen, for use in combination with a second composition comprising a human adenovirus vector comprising a polynucleotide that encodes an HIV antigen, wherein the first composition is for administration to the subject and the second composition is for administration to the subject less than six weeks after administration of the first composition.
In a fifth aspect, the invention provides a second composition comprising a human adenovirus vector comprising a polynucleotide that encodes an HIV antigen, for use in combination with a first composition comprising a poxvirus vector comprising a polynucleotide that encodes an HIV antigen, wherein the first composition is for administration to the subject and the second composition is for administration to the subject less than six weeks after administration of the first composition.
The first and second composition, the vectors, timing of administration, and the HIV antigen, can all be varied and are preferred also for the fifth and sixth aspects of the invention according to embodiments of the invention as described in more detail above for the first and second aspects.
The following examples of the invention are to further illustrate the nature of the invention. It should be understood that the following examples do not limit the invention and that the scope of the invention is to be determined by the appended claims.
Cell-mediated immunity (CMI) breadth describes the number of epitopic regions in a vaccine antigen recognized by the cellular immune response. In non-human primate studies, CMI breadth has been identified as an important correlate of efficacy. To determine if CMI breadth could be optimized by modifying the immunization regimen, e.g. order of administration of vaccine components and timing of administration, vaccine regimens were compared as described below.
Female CB6/F1 mice, 6-8 weeks old, received intramuscular immunizations with MVA-BN-HIV (MVA vector encoding Mos1.GagPol, Mos2.GagPol, Mos1.Env, and Mos2S.Env, for instance described in WO 2018/229711, referred to therein as ‘MVA-mBN414’; dosed at a total of 2×107 TCID5O per complete regimen either split between 2 administrations or in a single administration, see Brief description of the drawings for
Briefly, IFN-γ ELISpot was performed on splenocytes of mice isolated after sacrifice using mouse IFN-γ ELISpot-plus kit (Mabtech). Splenocytes were obtained by disaggregation of spleens with the gentleMACS (Miltenyibiotech) dissociator. IFN-γ ELISpot assay was performed by stimulating splenocytes from individual mice for 18 h with 17 different HIV PTE Env peptide pools (see Table 2 for sequences of peptides and allocation to the sub pools) at a final concentration of 1 μg/peptide/mL. PMA/ionomycin stimulation was used as a positive control; the data were gathered for information purposes only. Medium was used as negative control (background) and used to calculate the lower limit of detection (less than 50 spots/106 cells expected). Stimulation was done overnight in duplicate wells containing 5×105 cells per well.
To analyze CMI breadth, splenocytes were stimulated overnight with 17 peptide pools (see Table 2) longitudinally covering the HIV Envelope protein and designed to cover potential human T cell epitopes (PTE) of circulating HIV-1 strains. Medium was used as a negative control and the lower limit of detection was set at 50 spots/106 cells. A positive response to a peptide pool was defined as a spot count above background.
As can be seen in
Higher breadth also correlated with higher magnitude (
The results described for the experiments above show that a regimen consisting of immunization with MVA-BN-HIV followed by Ad26.Mos4.HIV showed significantly higher CMI breadth and magnitude compared to other tested vaccine regimens with different order or number of immunizations. Furthermore, these effects were already observed in the regimen wherein MVA-BN-HIV is administered at week 0 and wherein Ad26.Mos4.HIV is administered two weeks after the first administration. The fact that only a short time span between doses is sufficient to boost this response is especially beneficial in a clinical setting where it may simplify vaccine dosing regimens, and for instance increase compliance to the complete multiple dosing regimens. These results seem to be specific for HIV antigens as such an increase in CMI breadth and magnitude was not observed with other viral antigens (data not shown).
| Number | Date | Country | Kind |
|---|---|---|---|
| 20202762.9 | Oct 2020 | EP | regional |
| 20207201.3 | Nov 2020 | EP | regional |
