Stressed stability and protective efficacy of lead lyophilized formulations of ID93+GLA-SE tuberculosis vaccine.

With the recent exception of coronavirus disease 2019 (COVID-19), tuberculosis (TB) causes more deaths globally than any other infectious disease, and approximately 1/3 of the world's population is infected with Mycobacterium tuberculosis (Mtb). However, encouraging progress in TB vaccine development has been reported, with approximately 50% efficacy achieved in Phase 2b clinical testing of an adjuvanted subunit TB vaccine candidate. Nevertheless, current lead vaccine candidates require cold-chain transportation and storage. In addition to temperature stress, vaccines may be subject to several other stresses during storage and transport, including mechanical, photochemical, and oxidative stresses. Optimal formulations should enable vaccine configurations with enhanced stability and decreased sensitivity to physical and chemical stresses, thus reducing reliance on the cold chain and facilitating easier worldwide distribution. In this report, we describe the physicochemical stability performance of three lead thermostable formulations of the ID93 + GLA-SE TB vaccine candidate under various stress conditions. Moreover, we evaluate the impact of thermal stress on the protective efficacy of the vaccine formulations. We find that formulation composition impacts stressed stability performance, and our comprehensive evaluation enables selection of a lead single-vial lyophilized candidate containing the excipient trehalose and Tris buffer for advanced development.

Lyophilization Process Engineering and Thermostability of ID93 + GLA-SE, a Single-Vial Adjuvanted Subunit Tuberculosis Vaccine Candidate for Use in Clinical Studies.

Promising clinical efficacy results have generated considerable enthusiasm for the potential impact of adjuvant-containing subunit tuberculosis vaccines. The development of a thermostable tuberculosis vaccine formulation could have significant benefits on both the cost and feasibility of global vaccine distribution. The tuberculosis vaccine candidate ID93 + GLA-SE has reached Phase 2 clinical testing, demonstrating safety and immunogenicity as a two-vial point-of-care mixture. Earlier publications have detailed efforts to develop a lead candidate single-vial lyophilized thermostable ID93 + GLA-SE vaccine formulation. The present report describes the lyophilization process development and scale-up of the lead candidate thermostable ID93 + GLA-SE composition. The manufacture of three full-scale engineering batches was followed by one batch made and released under current Good Manufacturing Practices (cGMP). Up to 4.5 years of stability data were collected. The cGMP lyophilized ID93 + GLA-SE passed all manufacturing release test criteria and maintained stability for at least 3 months when stored at 37°C and up to 24 months when stored at 5°C. This work represents the first advancement of a thermostable adjuvant-containing subunit tuberculosis vaccine to clinical testing readiness.

Effects of emulsifier concentration, composition, and order of addition in squalene-phosphatidylcholine oil-in-water emulsions.

Development and characterization of stable and biocompatible oil-in-water emulsions is important for improved drug and vaccine delivery. In this work, two-component emulsions consisting of squalene and phosphatidylcholine have been developed. The reproducibility of the manufacturing process is established and production efficiency is improved by altering the order of component addition. The effects of emulsifier concentration and composition on emulsion stability and biocompatibility are assessed through dynamic light scattering, zeta potential measurement, viscosity, and hemolytic activity. High concentrations of egg phosphatidylcholine emulsifier decreased initial particle size and increased initial size polydispersity. However, high emulsifier concentrations also appeared to decrease long-term emulsion stability as well as absolute zeta potential values. Substitution of naturally derived egg phosphatidylcholine with synthetic 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) produced an emulsion with similar physicochemical properties and stability.

Monitoring the effects of component structure and source on formulation stability and adjuvant activity of oil-in-water emulsions.

Oil-in-water emulsions have shown promise as safe and effective adjuvant formulations for vaccines. In particular, formulations consisting of metabolizable oils such as shark-derived squalene and detergents such as egg phosphatidylcholine have been used to produce stable vaccine emulsion formulations. However, there is an emphasis in pharmaceutical regulatory bodies on using synthetic or plant-derived components from sustainable sources instead of animal-derived components. This study compares the physicochemical properties and biological efficacy of emulsions consisting of oil and detergent components from animal, plant, and synthetic sources. In particular, effects of component structure and source on emulsion stability and biological activity are examined. It is shown that oil-in-water emulsions using animal-derived components can be substituted with synthetic or plant-derived materials while still exhibiting satisfactory physicochemical and biological properties.

Lyophilization of Adjuvanted Vaccines: Methods for Formulation of a Thermostable Freeze-Dried Product.

Lyophilization of vaccines is advantageous for the distribution and storage of thermally labile products, particularly in regions where cold chain management is difficult. To date, current lyophilized vaccines do not contain an adjuvant. Instead, adjuvanted vaccines may be presented as a two vial system, that require bedside-mixing prior to immunization. Here we present an example of a lyophilization cycle that we have used to successfully freeze-dry an adjuvanted protein formulation in a single vial.

Physicochemical characterization and biological activity of synthetic TLR4 agonist formulations.

Immunostimulatory molecules such as monophosphoryl lipid A (MPL), a Toll-like receptor 4 (TLR4) agonist, can be formulated to enhance vaccine adjuvant effects and to promote a Th1-type immune response. This study compares the in vitro and in vivo potency of aqueous and emulsion formulations containing a synthetic MPL analogue. In addition, formulation structure and association of the synthetic TLR-4 agonist and antigen with the formulation are characterized using dynamic light scattering, zeta potential measurement, HPLC, and SDS-PAGE. The biological and biophysical effects of formulating the agonist with different oil and surfactant components from animal, plant, and synthetic sources are examined. These findings have important implications for the formulation of TLR4 agonists as well as the influence of formulation component substitution on adjuvant activity. The results indicate that (1) the agonist is associated with the oil droplets in emulsion formulations, (2) the emulsion formulations containing synthetic TLR4 agonist induce higher IgG2a/IgG1 antibody ratios than aqueous formulations or an emulsion formulation without the agonist, and (3) appropriate plant-derived components can be substituted for animal-derived components in oil-in-water emulsions without loss of biological activity.