Adjuvants for HIV vaccines.

PURPOSE OF REVIEW: Advances in the understanding of the structural biology of HIV-1 proteins, and in the vulnerabilities of HIV-1 at various points in the infectious process have led to innovative approaches for vaccine constructs for clinical trials. Lessons from the successful Retrovirology study 144 (RV144) phase III Thai trial have revealed the need for novel and more potent adjuvant formulations. Fortunately, the vaccine adjuvant field is experiencing an emergence of innovative new adjuvants and strategies that may lead to improved formulations. RECENT FINDINGS: The review highlights the status of currently used and available new adjuvant formulations for HIV antigens. Adjuvants used in preclinical or in human clinical trials using HIV-1 protein antigens will be discussed along with adjuvant improvements for vectors and DNA immunization. SUMMARY: The HIV-1 immunogen and the design of the adjuvant formulations are both equally important for the development of an effective HIV vaccine. Adjuvants work by numerous different mechanisms, many of which are quite complex and often not well comprehended. Understanding the interplay of innate and adaptive immune responses that can be harnessed by adjuvant formulations would aid in the rational design of a well tolerated and effective vaccine formulation that can block HIV at the site of transmission.

Comparable Antigenicity and Immunogenicity of Oligomeric Forms of a Novel, Acute HIV-1 Subtype C gp145 Envelope for Use in Preclinical and Clinical Vaccine Research.

UNLABELLED: Eliciting broadly reactive functional antibodies remains a challenge in human immunodeficiency virus type 1 (HIV-1) vaccine development that is complicated by variations in envelope (Env) subtype and structure. The majority of new global HIV-1 infections are subtype C, and novel antigenic properties have been described for subtype C Env proteins. Thus, an HIV-1 subtype C Env protein (CO6980v0c22) from an infected person in the acute phase (Fiebig stage I/II) was developed as a research reagent and candidate immunogen. The gp145 envelope is a novel immunogen with a fully intact membrane-proximal external region (MPER), extended by a polylysine tail. Soluble gp145 was enriched for trimers that yielded the expected "fan blade" motifs when visualized by cryoelectron microscopy. CO6980v0c22 gp145 reacts with the 4E10, PG9, PG16, and VRC01 HIV-1 neutralizing monoclonal antibodies (MAbs), as well as the V1/V2-specific PGT121, 697, 2158, and 2297 MAbs. Different gp145 oligomers were tested for immunogenicity in rabbits, and purified dimers, trimers, and larger multimers elicited similar levels of cross-subtype binding and neutralizing antibodies to tier 1 and some tier 2 viruses. Immunized rabbit sera did not neutralize the highly resistant CO6980v0c22 pseudovirus but did inhibit the homologous infectious molecular clone in a peripheral blood mononuclear cell (PBMC) assay. This Env is currently in good manufacturing practice (GMP) production to be made available for use as a clinical research tool and further evaluation as a candidate vaccine. IMPORTANCE: At present, the product pipeline for HIV vaccines is insufficient and is limited by inadequate capacity to produce large quantities of vaccine to standards required for human clinical trials. Such products are required to evaluate critical questions of vaccine formulation, route, dosing, and schedule, as well as to establish vaccine efficacy. The gp145 Env protein presented in this study forms physical trimers, binds to many of the well-characterized broad neutralizing MAbs that target conserved Env epitopes, and induce cross-subtype neutralizing antibodies as measured in both cell line and primary cell assays. This subtype C Env gp145 protein is currently undergoing good manufacturing practice production for use as a reagent for preclinical studies and for human clinical research. This product will serve as a reagent for comparative studies and may represent a next-generation candidate HIV immunogen.

Detection of liposomal cholesterol and monophosphoryl lipid A by QS-21 saponin and Limulus polyphemus amebocyte lysate.

Liposomes containing cholesterol (Chol) have long been used as an important membrane system for modeling the complex interactions of Chol with adjacent phospholipids or other lipids in a membrane environment. In this study we utilize a probe composed of QS-21, a saponin molecule that recognizes liposomal Chol and causes hemolysis of erythrocytes. The interaction of QS-21 with liposomal Chol results in a stable formulation which, after injection into the tissues of an animal, lacks toxic effects of QS-21 on neighboring cells that contain Chol, such as erythrocytes. Here we have used liposomes containing different saturated phospholipid fatty acyl groups and Chol, with or without monophosphoryl lipid A (MPLA), as model membranes. QS-21 is then employed as a probe to study the interactions of liposomal lipids on the visibility of membrane Chol. We demonstrate that changes either in the mole fraction of Chol in liposomes, or with different chain lengths of phospholipid fatty acyl groups, can have a substantial impact on the detection of Chol by the QS-21. We further show that liposomal MPLA can partially inhibit detection of the liposomal Chol by QS-21. The Limulus amebocyte lysate assay is used for binding to and detection of MPLA. Previous work has demonstrated that sequestration of MPLA into the liposomal lipid bilayer can block detection by the Limulus assay, but the binding site on the MPLA to which the Limulus protein binds is unknown. Changes in liposomal Chol concentration and phospholipid fatty acyl chain length influenced the detection of the liposome-embedded MPLA.

Antigen-specific enhancement of natural human IgG antibodies to phosphatidylcholine, phosphatidylglycerol, phosphatidylinositol-4-phosphate, cholesterol, and lipid A by a liposomal vaccine containing lipid A.

Natural IgG antibodies (NA) to lipids are ubiquitously distributed in sera of healthy humans and are believed to serve beneficial functions. Although NA to lipids generally exhibit germ line or near germ line binding specificities, the antibodies commonly increase transiently in the acute phases of most, if not all, infectious diseases and may serve as a first line of defense. In order to determine whether similar anti-lipid antibodies can be induced by a vaccine in humans, we examined stored sera obtained from volunteers who had previously received a candidate vaccine to Plasmodium falciparum. The vaccine had consisted of liposomes that contained both the recombinant protein antigen and also contained monophosphoryl lipid A (MPLA) as an adjuvant. All of the pre-immune sera contained NA to one or more of the liposomal lipids in the vaccine: dimyristol phosphatidylcholine (DMPC), dimyristoyl phosphatidylglycerol (DMPG), cholesterol, and MPLA. After initial immunization, followed by a boost, increased levels of IgG antibodies to all of the liposomal lipids, especially DMPG and MPLA, were observed by ELISA. Antibodies to phosphatidylinositol-4-phosphate (PIP) above the normal pre-immune NA to PIP were also observed. Although PIP was not present in the immunizing liposomes, based on the adsorption of anti-PIP antibodies by DMPG the anti-PIP antibodies were thought to represent cross-reacting anti-DMPG antibodies. The immune response was apparently antigen-specific in that NA to unrelated lipids, other than PIP, that were not present in the liposomes, galactosyl ceramide and ganglioside GM1, were not increased by the immunization. We conclude that antibodies to DMPC, DMPG, PIP, cholesterol, and MPLA can be induced in humans by immunization with liposomes containing MPLA.

Neutralizing antibodies induced by liposomal HIV-1 glycoprotein 41 peptide simultaneously bind to both the 2F5 or 4E10 epitope and lipid epitopes.

OBJECTIVES: There is a need to develop HIV-1 vaccine formulations that incorporate inexpensive antigens and clinically acceptable potent adjuvants for inducing neutralizing antibodies. The purpose of this initial vaccine study was to produce peptide- and lipid-induced murine mAbs that replicate the characteristics of the 2F5 and/or 4E10 human antibodies in binding both to the membrane proximal external region (MPER) of glycoprotein 41 and the adjacent lipid bilayer for neutralizing HIV-1 infection of CD4 lymphocytes. RESEARCH DESIGNS AND METHODS: Liposomes containing a synthetic MPER peptide as a peptide antigen, phosphatidylinositol-4-phosphate (PIP) as a lipid antigen, and monophosphoryl lipid A as a potent adjuvant were used as a formulation to immunize mice. mAbs were then produced and tested for binding to MPER, glycoprotein 41, and PIP and for the ability to neutralize HIV-1 infection of CD4 cells in a human peripheral blood mononuclear cell assay. RESULTS: Polyclonal antisera contained antibodies that bound both to MPER and PIP. Immunoglobulin M mAbs were produced that bound both to the core MPER site of 2F5, or that overlapped with the 4E10 site, and that simultaneously bound PIP. High concentrations of these mAbs neutralized infection of peripheral blood lymphocytes by a primary infectious molecular clone of HIV-1. CONCLUSION: Liposomes containing MPER peptide as an antigen, PIP as a lipid antigen, and lipid A as an adjuvant induce anti-MPER-specific multispecific antibodies that simultaneously bind glycoprotein 41 MPER and adjacent lipid and neutralize HIV-1 infection in a human peripheral blood mononuclear cell assay.

Lipid A and liposomes containing lipid A as antigens and adjuvants.

Lipid A derived from Gram-negative bacterial lipopolysaccharide is a potent adjuvant and antigen. Incorporation of lipid A into liposomes renders the liposomes themselves immunogenic, resulting in generation of specific antibodies that recognize either the individual liposomal lipids, or the unique pattern presented by the combination of lipids. Using liposomes containing lipid A, numerous polyclonal antisera and monoclonal antibodies have been produced against phospholipids, cholesterol, glycosphingolipids, and lipid A. Many of these antibodies have binding characteristics that are apparently similar to natural antibodies that are normally present in all human sera, and also antibodies that arise in response to various infections. Such antibodies probably represent a bridge between innate and adaptive immunity. The possible utility of liposomes containing lipid A as a constituent of certain types of novel vaccines was suggested by the observation that murine monoclonal antibodies to liposomal phosphatidylinositol-4-phosphate neutralized primary isolates of two different clades of HIV-1 in a human peripheral blood mononuclear cell neutralization assay.

F(ab)'2-mediated neutralization of C3a and C5a anaphylatoxins: a novel effector function of immunoglobulins.

High-dose intravenous immunoglobulin (IVIG) prevents immune damage by scavenging complement fragments C3b and C4b. We tested the hypothesis that exogenous immunoglobulin molecules also bind anaphylatoxins C3a and C5a, thereby neutralizing their pro-inflammatory effects. Single-cell calcium measurements in HMC-1 human mast cells showed that a rise in intracellular calcium caused by C3a and C5a was inhibited in a concentration-dependent manner by IVIG, F(ab)2-IVIG and irrelevant human monoclonal antibody. C3a- and C5a-induced thromboxane (TXB2) generation and histamine release from HMC-1 cells and whole-blood basophils were also suppressed by exogenous immunoglobulins. In a mouse model of asthma, immunoglobulin treatment reduced cellular migration to the lung. Lethal C5a-mediated circulatory collapse in pigs was prevented by pretreatment with F(ab)2-IVIG. Molecular modeling, surface plasmon resonance (SPR) and western blot analyses suggested a physical association between anaphylatoxins and the constant region of F(ab)2. This binding could interfere with the role of C3a and C5a in inflammation.