Real-world effectiveness of the heterologous SOBERANA-02 and SOBERANA-Plus vaccine scheme in 2-11 years-old children during the SARS-CoV-2 Omicron wave in Cuba: a longitudinal case-population study.

Background: Increased pediatric COVID-19 occurrence due to the SARS-CoV-2 Omicron variant has raised concerns about the effectiveness of existing vaccines. The protection provided by the SOBERANA-02-Plus vaccination scheme against this variant has not yet been studied. We aimed to evaluate the scheme's effectiveness against symptomatic Omicron infection and severe disease in children. Methods: In September 2021, Cuba implemented a mass pediatric immunization with the heterologous SOBERANA-02-Plus scheme: 2 doses of conjugated SOBERANA-02 followed by a heterologous SOBERANA-Plus dose. By December, before the Omicron outbreak, 95.4% of 2-18 years-old had been fully immunized. During the entire Omicron wave, we conducted a nationwide longitudinal post-vaccination case-population study to evaluate the real-world effectiveness of the SOBERANA-02-Plus scheme against symptomatic infection and severe disease in children without previous SARS-CoV-2 infection. The identification of COVID-19 cases relied on surveillance through first line services, which refer clinical suspects to pediatric hospitals where they are diagnosed based on a positive RT-PCR test. We defined the Incidence Rate ratio (IRR) as IRvaccinated age group/IRunvaccinated 1-year-old and calculated vaccine effectiveness as VE = (1-IRR)∗100%. 24 months of age being the 'eligible for vaccination' cut-off, we used a regression discontinuity approach to estimate effectiveness by contrasting incidence in all unvaccinated 1-year-old versus vaccinated 2-years-old. Estimates in the vaccinated 3-11 years-old are reported from a descriptive perspective. Findings: We included 1,098,817 fully vaccinated 2-11 years-old and 98,342 not vaccinated 1-year-old children. During the 24-week Omicron wave, there were 7003/26,241,176 person-weeks symptomatic COVID-19 infections in the vaccinated group (38.2 per 105 person-weeks in 2-years-old and 25.5 per 105 person-weeks in 3-11 years-old) against 3577/2,312,273 (154.7 per 105 person-weeks) in the unvaccinated group. The observed overall vaccine effectiveness against symptomatic infection was 75.3% (95% CI, 73.5-77.0%) in 2-years-old children, and 83.5% (95% CI, 82.8-84.2%) in 3-11 years-old. It was somewhat lower during Omicron BA.1 then during Omicron BA.2 variant circulation, which took place 1-3 and 4-6 months after the end of the vaccination campaign. The effectiveness against severe symptomatic disease was 100.0% (95% CI not estimated) and 94.6% (95% CI, 82.0-98.6%) in the respective age groups. No child death from COVID-19 was observed. Interpretation: Immunization of 2-11 years-old with the SOBERANA-02-Plus scheme provided strong protection against symptomatic and severe disease caused by the Omicron variant, which was sustained during the six months post-vaccination follow-up. Our results contrast with the observations in previous real-world vaccine effectiveness studies in children, which might be explained by the type of immunity a conjugated protein-based vaccine induces and the vaccination strategy used. Funding: National Fund for Science and Technology (FONCI-CITMA-Cuba).

Safety and efficacy of the two doses conjugated protein-based SOBERANA-02 COVID-19 vaccine and of a heterologous three-dose combination with SOBERANA-Plus: a double-blind, randomised, placebo-controlled phase 3 clinical trial.

Background: SOBERANA-02 is a COVID-19 conjugate vaccine (recombinant RBD conjugated to tetanus toxoid). Phases 1/2 clinical trials demonstrated high immunogenicity, promoting neutralising IgG and specific T-cell response. A third heterologous dose of SOBERANA-Plus (RBD-dimer) further increased neutralising antibodies. The aim of this study is to evaluate the safety and efficacy of two immunisation regimes: two doses of SOBERANA-02 and a heterologous three-dose combination with SOBERANA-Plus added to it. Methods: From March 8th to June 24th, 2021 we conducted in Havana, Cuba a multicentre randomised, double-blind, placebo-controlled, phase-3 trial evaluating a two doses SOBERANA-02 scheme and a heterologous scheme with one dose SOBERANA-Plus added to it (RPCEC00000354). Participants 19-80 years were randomly assigned to receiving 28 days apart either the two or three dose scheme or placebo. The main endpoint was vaccine efficacy in preventing the occurrence of RT-PCR confirmed symptomatic COVID-19 at least 14 days after the second or third dose in the per-protocol population. We also assessed efficacy against severe disease and, in all participants receiving at least one vaccine/placebo dose, safety for 28 days after each dose. Findings: We included 44,031 participants (52.0% female, 48.0% male; median age 50 years, range 19-80 years; 7.0% black, 24.0% mixed-race, 59.0% white) in a context of initial Beta VOC predominance, with this variant being partially replaced by Delta near the trial's end. Vaccine efficacy in the heterologous combination was 92.0% (95%CI 80.4-96.7) against symptomatic disease. There were no severe COVID-19 cases in the vaccine group against 6 in the placebo group. Two doses of SOBERANA-02 was 69.7% (95%CI 56.5-78.9) and 74.9% (95%CI 33.7-90.5) efficacious against symptomatic and severe COVID-19, respectively. The occurrence of serious and severe adverse events (AE) was very rare and equally distributed between placebo and vaccine groups. Solicited AEs were slightly more frequent in the vaccine group but predominantly local and mostly mild and transient. Interpretation: Our results indicate that the straightforward to manufacture SOBERANA vaccines are efficacious in a context of Beta and Delta VOC circulation, have a favourable safety profile, and may represent an attractive option for use in COVID-19 vaccination programmes. Funding: This study received funds from the National Fund for Science and Technology (FONCI-CITMA-Cuba, contract 2020-20) of the Ministry of Science, Technology and Environment of Cuba.

Open-label phase I/II clinical trial of SARS-CoV-2 receptor binding domain-tetanus toxoid conjugate vaccine (FINLAY-FR-2) in combination with receptor binding domain-protein vaccine (FINLAY-FR-1A) in children.

OBJECTIVES: To evaluate a heterologous vaccination scheme in children 3-18 years old (y/o) combining two SARS-CoV-2r- receptor binding domain (RBD)protein vaccines. METHODS: A phase I/II open-label, adaptive, and multicenter trial evaluated the safety and immunogenicity of two doses of FINLAY-FR-2 (subsequently called SOBERANA 02) and the third heterologous dose of FINLAY-FR-1A (subsequently called SOBERANA Plus) in 350 children 3-18 y/o in Havana Cuba. Primary outcomes were safety (phase I) and safety/immunogenicity (phase II) measured by anti-RBD immunoglobulin (Ig)G enzyme-linked immunoassay (ELISA), molecular and live-virus neutralization titers, and specific T-cells response. A comparison with adult immunogenicity and predictions of efficacy were made based on immunological results. RESULTS: Local pain was the unique adverse event with frequency >10%, and none was serious neither severe. Two doses of FINLAY-FR-2 elicited a humoral immune response similar to natural infection; the third dose with FINLAY-FR-1A increased the response in all children, similar to that achieved in vaccinated young adults. The geometric mean (GMT) neutralizing titer was 173.8 (95% confidence interval [CI] 131.7; 229.5) vs Alpha, 142 (95% CI 101.3; 198.9) vs Delta, 24.8 (95% CI 16.8; 36.6) vs Beta and 99.2 (95% CI 67.8; 145.4) vs Omicron. CONCLUSION: The heterologous scheme was safe and immunogenic in children 3-18 y/o. TRIAL REGISTRY: https://rpcec.sld.cu/trials/RPCEC00000374.

Safety and immunogenicity of anti-SARS-CoV-2 heterologous scheme with SOBERANA 02 and SOBERANA Plus vaccines: Phase IIb clinical trial in adults.

BACKGROUND: SOBERANA 02 has been evaluated in phase I and IIa studies comparing homologous versus heterologous schedule (this one, including SOBERANA Plus). Here, we report results of immunogenicity, safety, and reactogenicity of SOBERANA 02 in a two- or three-dose heterologous scheme in adults. METHOD: Phase IIb was a parallel, multicenter, adaptive, double-blind, randomized, and placebo-controlled trial. Subjects (n = 810) aged 19-80 years were randomized to receive two doses of SARS-CoV-2 RBD conjugated to tetanus toxoid (SOBERANA 02) and a third dose of dimeric RBD (SOBERANA Plus) 28 days apart; two production batches of active ingredients of SOBERANA 02 were evaluated. Primary outcome was the percentage of seroconverted subjects with ≥4-fold the anti-RBD immunoglobulin G (IgG) concentration. Secondary outcomes were safety, reactogenicity, and neutralizing antibodies. FINDINGS: Seroconversion rate in vaccinees was 76.3% after two doses and 96.8% after the third dose of SOBERANA Plus (7.3% in the placebo group). Neutralizing IgG antibodies were detected against D614G and variants of concern (VOCs) Alpha, Beta, Delta, and Omicron. Specific, functional antibodies were detected 7-8 months after the third dose. The frequency of serious adverse events (AEs) associated with vaccination was very low (0.1%). Local pain was the most frequent AE. CONCLUSIONS: Two doses of SOBERANA 02 were safe and immunogenic in adults. The heterologous combination with SOBERANA Plus increased neutralizing antibodies, detectable 7-8 months after the third dose. TRIAL REGISTRY: https://rpcec.sld.cu/trials/RPCEC00000347 FUNDING: This work was supported by Finlay Vaccine Institute, BioCubaFarma, and the Fondo Nacional de Ciencia y Técnica (FONCI-CITMA-Cuba, contract 2020-20).

Safety and immunogenicity of anti-SARS CoV-2 vaccine SOBERANA 02 in homologous or heterologous scheme: Open label phase I and phase IIa clinical trials.

BACKGROUND: SOBERANA 02 is a COVID-19 vaccine based on SARS-CoV-2 recombinant RBD conjugated to tetanus toxoid (TT). SOBERANA Plus antigen is dimeric-RBD. Here we report safety and immunogenicity from phase I and IIa clinical trials using two-doses of SOBERANA 02 and three-doses (homologous) or heterologous (with SOBERANA Plus) protocols. METHOD: We performed an open-label, sequential and adaptive phase I to evaluate safety and explore the immunogenicity of SOBERANA 02 in two formulations (15 or 25 µg RBD-conjugated to 20 µg of TT) in 40 subjects, 19-59-years-old. Phase IIa was open-label including 100 volunteers 19-80-years, receiving two doses of SOBERANA 02-25 µg. In both trials, half of volunteers were selected to receive a third dose of the corresponding SOBERANA 02 and half received a heterologous dose of SOBERANA Plus. Primary outcome was safety. The secondary outcome was immunogenicity evaluated by anti-RBD IgG ELISA, molecular neutralization of RBD:hACE2 interaction, live-virus-neutralization and specific T-cells response. RESULTS: The most frequent adverse event (AE) was local pain, other AEs had frequencies ≤ 5%. No serious related-AEs were reported. Phase IIa confirmed the safety in 60 to 80-years-old subjects. In phase-I SOBERANA 02-25 µg elicited higher immune response than SOBERANA 02-15 µg and progressed to phase IIa. Phase IIa results confirmed the immunogenicity of SOBERANA 02-25 µg even in 60-80-years. Two doses of SOBERANA02-25 µg elicited an immune response similar to that of the Cuban Convalescent Serum Panel and it was higher after the homologous and heterologous third doses. The heterologous scheme showed a higher immunological response. Anti-RBD IgG neutralized the delta variant in molecular assay, with a 2.5-fold reduction compared to D614G neutralization. CONCLUSIONS: SOBERANA 02 was safe and immunogenic in persons aged 19-80 years, eliciting neutralizing antibodies and specific T-cell response. Highest immune responses were obtained in the heterologous three doses protocol. TRIAL REGISTRY: https://rpcec.sld.cu/trials/RPCEC00000340, https://rpcec.sld.cu/trials/RPCEC00000347.

Repeat-dose and local tolerance toxicity of SARS-CoV-2 FINLAY-FR-02 vaccine candidate in Sprague Dawley rats.

This study evaluates safety of FINLAY-FR-02, a vaccine candidate against SARS-CoV-2 based on the recombinant receptor binding domain conjugated to tetanus toxoid, in a preclinical, repeat-dose toxicity and local tolerance study. Sprague Dawley rats were randomly allocated to three experimental groups: control (receiving physiological saline solution); placebo (receiving all vaccine components except antigens) and vaccine group (receiving three doses of the vaccine candidate, 37.5 µg of RBD) administered intramuscularly in hind limbs at 24 h intervals during three days. We evaluated physiological condition, pain, food and water consumption, body temperature, dermal irritability, injection site temperature and inflammation, immunological response, blood chemistry, relative organ weight, histopathology and immunotoxicology. The product was well tolerated; no clinically relevant changes, pain, local effects or adverse systemic toxicological changes or deaths were observed. These preliminary results permitted the Cuban regulatory authorities to authorize clinical trials in humans.

Reactividad de sueros de ratones inmunizados con vesículas de membrana externa derivadas de Salmonella entérica / Reactivity of sera from mice immunized with outer membrane vesicles derived from Salmonella enterica

La fiebre tifoidea causada por Salmonella Paratyphi A (fiebre paratifoidea) es indistinguible de la producida por Salmonella Typhi y el grado de incidencia ha aumentado en los últimos años, especialmente en el sudeste asiático. Por otro lado, la diarrea y otras complicaciones entéricas causadas por Salmonella Enteritidis y Salmonella Typhimurium continúan siendo un problema de salud grave, especialmente en países subdesarrollados. Las vacunas continúan siendo la forma más efectiva de prevenir estas enfermedades. Existen vacunas basadas en el polisacárido capsular de Salmonella Typhi que protegen contra la fiebre tifoidea; sin embargo, no hay vacunas efectivas licenciadas para uso en humanos que prevengan las enfermedades producidas por los serotipos de Salmonella no tifoideas. El desarrollo de una formulación con capacidad para proteger contra estas enfermedades sigue siendo un desafío para la comunidad científica. En este trabajo se evaluó, mediante Western blot, la reactividad de los sueros de ratones inmunizados por vía subcutánea con formulaciones basadas en vesículas de membrana externa derivadas de Salmonella Paratyphi A, Salmonella Enteritidis y Salmonella Typhimurium, contra los respectivos lisados celulares, para identificar la formulación que induce la mejor respuesta inmunológica cruzada. Los resultados obtenidos indicaron una alta reactividad de todos los sueros a los lisados, sin una diferencia aparente entre ellos. Sin lugar a dudas, se deberán realizar pruebas de inmunogenicidad seguidas de pruebas de retos cruzados para identificar un candidato vacunal. Estos resultados sugieren que las vesículas de membrana externa empleadas en este estudio están compuestas por antígenos posiblemente conservados en los tres serotipos de Salmonella y que pueden inducir una respuesta inmune de amplio espectro y protección cruzada(AU)

Typhoid fever caused by Salmonella Paratyphi A (paratyphoid fever) is indistinguishable from that caused by Salmonella Typhi and the degree of incidence has increased in recent years, especially in Southeast Asia. On the other hand, diarrhea and other enteric complications caused by Salmonella Enteritidis and Salmonella Typhimurium continue to be a serious health problem, especially in underdeveloped countries. Vaccines continue to be the most effective way to prevent these diseases. There are vaccines based on Salmonella Typhi capsular polysaccharide, which protects against typhoid fever; however, there are no effective vaccines licensed for use in humans to prevent disease caused by nontyphoidal Salmonella serotypes. Developing a formulation capable of protecting against these diseases remains a challenge for the scientific community. In this work, the reactivity of the sera of mice immunized subcutaneously with formulations based on Outer Membrane Vesicles (OMV) derived from Salmonella Paratyphi A, Salmonella Enteritidis and Salmonella Typhimurium, was evaluated by Western blot, against the respective cell lysates to identify the formulation that induces the best cross immune response. The results obtained indicated a high reactivity of all the sera to the lysates; without an apparent difference between them. Undoubtedly, immunogenicity tests followed by cross-challenge tests should be performed to identify a vaccine candidate. These results suggest that the OMV used in this study are composed of possibly conserved antigens in the three Salmonella serotypes and that they can induce a broad-spectrum immune response and cross protection(AU)

Condiciones de adsorción de un candidato vacunal basado en vesículas de membrana externa derivada de Salmonella Paratyphi A en adyuvantes de aluminio / Adsorption conditions of a vacunal candidate based on outer membrane vesicles of Salmonella Paratyphi A in aluminum adjuvants

La capacidad inmunoestimuladora de la mayoría de las vacunas es potenciada mediante la adsorción en adyuvantes que contienen aluminio. Variando las condiciones de adsorción (pH, tiempo de adsorción) cambia la cantidad de antígeno adsorbida y por lo tanto la capacidad de estimulación del sistema inmune. El Instituto Finlay de Vacunas investiga un nuevo candidato vacunal basado en vesículas de membrana externa de Salmonella Paratyphi A (VME-SPA). El objetivo de este trabajo fue determinar las condiciones de adsorción de las VME-SPA en dos adyuvantes de sales de aluminio (Al(OH)3 y AlPO4). Para ello, las VME-SPA fueron adsorbidas en ambos adyuvantes bajo diferentes condiciones de pH y tiempo. Mediante la construcción de una Isoterma de Langmuir se determinaron parámetros como la capacidad adsortiva (qm) y el coeficiente de adsorción (Kd). El lote de VME-SPA empleado estaba formado por poblaciones de nanoestructuras con un tamaño de partículas entre 60 y 100 nm. La adsorción de las VME-SPA en ambos adyuvantes, mostró valores ≥95 por ciento a pH neutro (6,5-7,0). Las VME-SPA en presencia de AlPO4 alcanzaron el estado de equilibrio en menor tiempo (99 por ciento a partir de 30 min) en comparación con Al(OH)3 (95 por ciento a partir de 3 h). Las isotermas evaluadas para ambos adyuvantes cumplieron con el modelo de Langmuir (R2≥0,99), con valores de qm y Kd diferentes entre los sistemas de adsorción. El estudio demostró que las VME-SPA se adsorbieron satisfactoriamente en ambos geles, proceso en el que están involucrados diferentes mecanismos de adsorción(AU)

The immunostimulation capacity of most vaccines is enhanced through antigen adsorption on aluminum adjuvants. The changes in adsorption conditions (pH, adsorption time), could change the amount of antigen adsorbed and therefore the ability to stimulate the immune system. The Finlay Institute of Vaccine researches a new vaccine candidate based on outer membrane vesicle from Salmonella Paratyphi A (OMV-SPA). The study aim was to determine adsorption condition of OMV-SPA with two aluminium adjuvants (Al(OH)3 and AlPO4). OMV-SPA was adsorbed in both adjuvants under differences conditions of pH and time. Parameters as adsorptive capacity (qm) and adsorption coefficient (Kd) were determined by construction of Langmuir Isotherm. The lot of OMV-SPA used is composed by population of nanostructure with a particle size between 60 and 100 nm. Adsorption of OMV-SPA in both adjuvants showed values ≥95 percent in neutral pH (6.5-7.0). OMV-SPA with AlPO4 got equilibrium state in less time (99 percent from 30 min) compared with Al(OH)3 (95 percent from 3 h). Isotherms from both adjuvants described Langmuir model (R2≥0.99), with qm and Kd values very different between adsorption systems. As conclusion, the study showed that OMV-SPA was adsorbed satisfactorily in both aluminium adjuvants, process in which are involved different adsorption mechanism(AU)

Estandarización de un ELISA para la cuantificación de anticuerpos IgG contra vesículas de membrana externa de Salmonella Paratyphi A / Standardization of an ELISA for the quantification of IgG antibodies against outer membrane vesicle of Salmonella Paratyphi A

Salmonella Paratyphi A es un patógeno exclusivo de humanos, siendo la segunda causa más común de fiebre entérica en el sudeste asiático. Recientemente la incidencia en este continente ha aumentado, desplazando a Salmonella entérica serotipo Typhi como la primera causa de fiebre entérica. En la actualidad no existen vacunas licenciadas contra S. Paratyphi A. El Instituto Finlay de Vacunas se encuentra trabajando en la obtención de un candidato vacunal basado en vesículas de membrana externa (VME) contra S. Paratyphi A, por lo que se hizo necesario contar con una técnica para la evaluación de su inmunogenicidad. El objetivo de este trabajo fue la estandarización de un ELISA para la cuantificación de anticuerpos IgG contra VME de S. Paratyphi A. Para ello, se determinaron las mejores condiciones de este ensayo en cuanto a concentración óptima de recubrimiento y dilución de trabajo del conjugado. Además, se definió el intervalo y linealidad de la curva, la precisión intra e interensayo, la especificidad y el límite de detección. La curva de calibración se generó con un suero estándar interno y presentó un buen ajuste lineal con un R² =0.98. Los coeficientes de variación en los ensayos de precisión intra e interensayo estuvieron en los intervalos establecidos para cada uno (=10 por ciento, =20 por ciento respectivamente). Los resultados obtenidos avalan el empleo de este ELISA cuantitativo para la evaluación de la inmunogenicidad de formulaciones de VME de S. Paratyphi A en fases de investigación y desarrollo(AU)

Salmonella Paratyphi A, is an exclusive pathogen of humans, being the second most common cause of enteric fever in Southeast Asia. Recently the incidence of this disease in this continent has increased, displacing Salmonella enterica serotype Typhi as the first cause of enteric fever. Currently there are no vaccines licensed against S. Paratyphi A. The Finlay Institute of Vaccines is working on obtaining a vaccine candidate based on outer membrane vesicles (VME) against S. Paratyphi A, so it became necessary to develop a technique for the evaluation of its immunogenicity. The objective of this work was the standardization of an ELISA for the quantification of IgG antibodies against VME of S. Paratyphi A. The best conditions of this assay were determined in terms of optimum concentration of coating and working dilution of the conjugate. In addition, the interval and linearity of the curve, the intra- and inter-assay precision, the specificity and the limit of detection were defined. The calibration curve was generated with an internal standard serum and presented a good linear fit with an R² =0.98. The coefficients of variation in the intra- and interassay precision tests were in the intervals established for each one (=10 percent, =20 percent respectively). The results obtained support the use of this quantitative ELISA for the evaluation of the immunogenicity of VME formulations of S. Paratyphi A in research and development phases(AU)

OMV-based vaccine formulations against Shiga toxin producing Escherichia coli strains are both protective in mice and immunogenic in calves.

Strains of Shiga toxin-producing Escherichia coli (STEC) can cause the severe Hemolytic Uremic Syndrome (HUS). Shiga toxins are protein toxins that bind and kill microvascular cells, damaging vital organs. No specific therapeutics or vaccines have been licensed for use in humans yet. The most common route of infection is by consumption of dairy or farm products contaminated with STEC. Domestic cattle colonized by STEC strains represent the main reservoir, and thus a source of contamination. Outer Membrane Vesicles (OMV) obtained after detergent treatment of gram-negative bacteria have been used over the past decades for producing many licensed vaccines. These nanoparticles are not only multi-antigenic in nature but also potent immunopotentiators and immunomodulators. Formulations based on chemical-inactivated OMV (OMVi) obtained from a virulent STEC strain (O157:H7 serotype) were found to protect against pathogenicity in a murine model and to be immunogenic in calves. These initial studies suggest that STEC-derived OMV has a potential for the formulation of both human and veterinary vaccines.

Estandarización de un ELISA para la cuantificación de anticuerpos IgG contra vesículas de membrana externa de Salmonella Paratyphi A / Standardization of an ELISA for the quantification of IgG antibodies against outer membrane vesicle of Salmonella Paratyphi A

Salmonella Paratyphi A es un patógeno exclusivo de humanos, siendo la segunda causa más común de fiebre entérica en el sudeste asiático. Recientemente la incidencia en este continente ha aumentado, desplazando a Salmonella entérica serotipo Typhi como la primera causa de fiebre entérica. En la actualidad no existen vacunas licenciadas contra S. Paratyphi A. El Instituto Finlay de Vacunas se encuentra trabajando en la obtención de un candidato vacunal basado en vesículas de membrana externa (VME) contra S. Paratyphi A, por lo que se hizo necesario contar con una técnica para la evaluación de su inmunogenicidad. El objetivo de este trabajo fue la estandarización de un ELISA para la cuantificación de anticuerpos IgG contra VME de S. Paratyphi A. Para ello, se determinaron las mejores condiciones de este ensayo en cuanto a concentración óptima de recubrimiento y dilución de trabajo del conjugado. Además, se definió el intervalo y linealidad de la curva, la precisión intra e interensayo, la especificidad y el límite de detección. La curva de calibración se generó con un suero estándar interno y presentó un buen ajuste lineal con un R2 =0.98. Los coeficientes de variación en los ensayos de precisión intra e interensayo estuvieron en los intervalos establecidos para cada uno (=10 por ciento, =20 por ciento respectivamente). Los resultados obtenidos avalan el empleo de este ELISA cuantitativo para la evaluación de la inmunogenicidad de formulaciones de VME de S. Paratyphi A en fases de investigación y desarrollo(AU)

Salmonella Paratyphi A, is an exclusive pathogen of humans, being the second most common cause of enteric fever in Southeast Asia. Recently the incidence of this disease in this continent has increased, displacing Salmonella enterica serotype Typhi as the first cause of enteric fever. Currently there are no vaccines licensed against S. Paratyphi A. The Finlay Institute of Vaccines is working on obtaining a vaccine candidate based on outer membrane vesicles (VME) against S. Paratyphi A, so it became necessary to develop a technique for the evaluation of its immunogenicity. The objective of this work was the standardization of an ELISA for the quantification of IgG antibodies against VME of S. Paratyphi A. The best conditions of this assay were determined in terms of optimum concentration of coating and working dilution of the conjugate. In addition, the interval and linearity of the curve, the intra- and inter-assay precision, the specificity and the limit of detection were defined. The calibration curve was generated with an internal standard serum and presented a good linear fit with an R2 =0.98. The coefficients of variation in the intra- and interassay precision tests were in the intervals established for each one (=10 percent, =20 percent respectively). The results obtained support the use of this quantitative ELISA for the evaluation of the immunogenicity of VME formulations of S. Paratyphi A in research and development phases(AU)

Vacunas contra rotavirus: estado actual y tendencias futuras / Rotavirus vaccines: current status and future trends

Antes de la introducción de las vacunas contra el rotavirus en 2006, este patógeno era considerado la principal causa de gastroenteritis entre los niños menores de cinco años de edad, de todo el mundo. Las vacunas son una estrategia fundamental para proteger a los niños de la gastroenteritis severa por rotavirus. Actualmente existen dos vacunas comerciales disponibles Rotarix® y RotaTeq® y su aplicación está teniendo un impacto en la reducción en las hospitalizaciones y consultas, sin embargo, para los países pobres los costos para sostener un programa de inmunización son relativamente elevados. Existe además la preocupación de que la vacuna conlleve a la selección y difusión de cepas nuevas y antigénicamente diferentes que traigan consigo la disminución de eficacia de la vacuna. Para solventar estos aspectos los productores trabajan en la búsqueda de nuevas vacunas como es la vacuna de origen indio ROTAVAC®. Las autoridades sanitarias de varios países han implementado programas de vigilancia en hospitales centinelas para seguir la hospitalización debido a la gastroenteritis por rotavirus y conducir estudios para evaluar la efectividad e impacto de la vacuna(AU)

Prior to the introduction of rotavirus vaccines in 2006, this pathogen was the leading cause of gastroenteritis among children under five years old of the entire world. Vaccines are a principal strategy to protect children against severe rotavirus gastroenteritis. There are currently two vaccines commercially available Rotarix® and RotaTeq® and their administration is having a significant impact on the reduction in rotavirus hospitalizations and ambulatory consultations. However, the cost of supporting a national immunization program for poor countries is relatively high. There is also the concern that the vaccine may lead to the selection and spread of new strains antigenically different, decreasing the vaccine efficacy. In order to solve these issues some vaccine manufacturers are developing new vaccines such as ROTAVAC® licensed for use in India. Health authorities in several countries have implemented monitoring programs in sentinel hospitals to follow hospitalization due to rotavirus gastroenteritis and to conduct studies to evaluate the effectiveness and impact of the vaccine(AU)

Obtención de un diagnosticador rápido de cólera, basado en partículas de látex acopladas a un anticuerpo monoclonal contra lipopolisacárido de Vibrio cholerae O1 / Obtaining of a rapid diagnostic test for Cholera, based on latex particles coupled with a monoclonal antibody against Vibrio cholerae O1 lipopolysaccharide

El cólera es una enfermedad infecto-contagiosa intestinal aguda, causada por la ingestión de alimentos o agua contaminada con los serotipos O1 y O139 de la bacteria Vibrio cholerae. Se caracteriza por diarrea secretora abundante que llevan rápidamente a la deshidratación. Sin tratamiento adecuado produce la muerte en horas, por lo que el diagnostico precoz es muy importante sobre todo porque al inicio es difícil diferenciarla de otras enfermedades diarreicas agudas. La prueba diagnóstico de oro es el coprocultivo; sin embargo, no garantiza una detección rápida de la enfermedad. Recientemente se desarrollaron ensayos rápidos, se basan en tiras reactivas y aglutinación con partículas de látex, muy efectivos, pero difíciles de adquirir por sus altos precios. El objetivo de este trabajo fue obtener un diagnosticador rápido basado en partículas de látex acopladas a un anticuerpo monoclonal (AcM) contra el lipopolisacárido de V. cholerae O1, el cual se obtuvo en el Instituto Finlay. Se usaron partículas de látex de 0,8 µm en una suspensión al 10 por ciento a las que se acopló durante 2 h a 37°C el AcM a 0,25 mg/mL. Se evaluó la sensibilidad, especificidad y el desempeño en 84 muestras de heces de pacientes con diagnóstico presuntivo de cólera. El diagnosticador que se obtuvo no evidenció reactividad cruzada frente a cepas no-O1, ni contra otros enteropatógenos. El diagnosticador látex presentó valores de sensibilidad, especificidad y eficacia de 97,87; 97,29 y 97,6 por ciento respectivamente, muy similares al diagnosticador comercial CTK-Biotech. El diagnosticador látex que se obtuvo se puede utilizar en el diagnóstico rápido de la enfermedad(AU)

Cholera is an acute contagious intestinal disease caused by ingestion of food or water contaminated with O1 and O139 serotypes of the bacterium Vibrio cholerae . Cholera is characterized by abundant secretory diarrhea leading to dehydration. Death occurs within hours without treatment, so early diagnosis is very important, especially at the beginning of the disease, because it is difficult to differentiate from other acute diarrheal diseases. The diagnostic golden test is the stool culture; however, it does not guarantee a rapid detection of the disease. Rapid tests have been recently developed; they are based on test strips and agglutination with latex particles, which are very effective, but difficult to acquire for their high prices. The objective of this research was to obtain a quick assay based on latex particles coupled with a monoclonal antibody (mAb) against V. cholerae O1 lipopolysaccharide obtained in Finlay Institute. Latex particles of 0.8 µm were used in a 10 percent suspension, and they were coupled to the mAb (0.25 mg/ml) for 2 hours at 37°C. The sensitivity, specificity and performance were evaluated in 84 stool samples from patients with presumptive diagnosis of cholera. The diagnostic test obtained showed no cross-reactivity against no-O1 strains and other enteropathogens. Latex diagnostic test showed values of sensitivity, specificity and efficacy of 97.87; 97.29 and 97.6 percent respectively, very similar to the commercial diagnostic test CTK-Biotech. The latex reagent obtained can be used in the rapid diagnosis of the disease(AU)

Antigenicidad e inmunogenicidad de una cepa inactivada de Vibrio cholerae O1 El Tor Inaba / Antigenicity and immunogenicity of inactivated Vibrio cholerae 01 El Tor Inaba

INTRODUCCIÓN: el cólera continúa siendo problema de salud, principalmente en las zonas más pobres. La mayoría de los aislamientos que se realizan al nivel mundial pertenecen a Vibrio cholerae O1 biotipo El Tor serotipo Ogawa, aunque se han reportado brotes causados por el serotipo Inaba, por lo que se aconseja que una vacuna efectiva contra la enfermedad deberá contener células o antígenos de ambos serotipos. OBJETIVO: describir las características de la cepa de V. cholerae O1 El Tor Inaba C6706 como posible cepa para la obtención de vacunas inactivadas contra el cólera. MÉTODOS: se elaboró un lote de siembra de trabajo crioconservado a - 70 ºC, se evaluó su identidad, pureza y viabilidad. La cepa fue cultivada en caldo triptona soya y su inactivación se realizó a 56 ºC durante 20 min. Se evaluó la capacidad antigénica del producto obtenido mediante western blot y ELISA de inhibición de lipopolisacárido. La inmunogenicidad en conejos, inoculados por vía intraduodenal, se determinó mediante la cinética de anticuerpos vibriocidas. RESULTADOS: el lote de siembra de trabajo mantuvo su identidad, pureza y viabilidad durante 18 meses de estudio. Se observó la presencia de los antígenos lipopolisacárido, hemaglutinina sensible a manosa y proteína de membrana externa U, en las suspensiones de células inactivadas de V. cholerae O1, no así de las subunidades A y B de la toxina colérica (CTA y CTB, respectivamente) o pilli corregulado con la toxina (TCP). Por otra parte, se obtuvieron títulos vibriocidas en los sueros de conejos, similares a la respuesta inducida por la cepa viva atenuada 638 de V. cholerae O1, candidata a vacuna oral. CONCLUSIONES: la cepa de V. cholerae O1 El Tor Inaba C6706 mostró características culturales, antigénicas e inmunogénicas que permiten considerarla como posible cepa para la obtención de vacunas inactivadas contra el cólera.

INTRODUCTION: cholera continues being a serius health problem, mainly in the poorest areas. Most of the isolations worldwide belong to Vibrio cholerae O1 biotype El Tor serotype Ogawa, although there have been reported outbreaks caused by serotype Inaba, that is why it is recommended that an effective vaccine against the illness should contain cells or antigens of both serotypes. OBJECTIVE: to describe the characteristics of the strain C6706 of V. cholerae O1 El Tor Inaba as a likely strain for the obtaining of inactivated vaccines for cholera. METHODS: a criopreserved working culture batch was made up at - 70 ºC to evaluate identity, purity and viability. The strain was cultured in tryptone soy broth and was inactivated at 56º C for 20 minutes. Antigenicity of this preparation was tested by Western Blot and ELISA inhibition test. Immunogenicity in adult rabbits, inoculated intraduodenally, was determined by means of kinetics of vibriocidal antibodies. RESULTS: the working culture batch kept their identity, purity and viability during 18 months of study. The results confirmed the presence of relevant antigens as lipopolysaccharide (LPS), mannose-sensitive hemagglutinin (MSHA) and outer membrane protein U (OmpU) in the suspension of inactivated V. cholerae O1 cells, but not cholera toxin subunits (CTA, CTB) or toxin-coregulated pili (TCP).On the other hand, vibriocidal titers were found in rabbit sera, which were similar to those previously reported for the live V. cholerae O1 strain 638, an attenuated oral vaccinal candidate CONCLUSIONS: the V. cholerae O1 El Tor Inaba C6706 strain showed cultural, antigenic and immunogenic characteristics that allow us to consider it as a possible strain for the obtaining of inactivated vaccines for cholera.

Antigenicidad e inmunogenicidad de una cepa inactivada de Vibrio cholerae O1 El Tor Inaba / Antigenicity and immunogenicity of inactivated Vibrio cholerae 01 El Tor Inaba

INTRODUCCIÓN: el cólera continúa siendo problema de salud, principalmente en las zonas más pobres. La mayoría de los aislamientos que se realizan al nivel mundial pertenecen a Vibrio cholerae O1 biotipo El Tor serotipo Ogawa, aunque se han reportado brotes causados por el serotipo Inaba, por lo que se aconseja que una vacuna efectiva contra la enfermedad deberá contener células o antígenos de ambos serotipos. OBJETIVO: describir las características de la cepa de V. cholerae O1 El Tor Inaba C6706 como posible cepa para la obtención de vacunas inactivadas contra el cólera. MÉTODOS: se elaboró un lote de siembra de trabajo crioconservado a - 70 ºC, se evaluó su identidad, pureza y viabilidad. La cepa fue cultivada en caldo triptona soya y su inactivación se realizó a 56 ºC durante 20 min. Se evaluó la capacidad antigénica del producto obtenido mediante western blot y ELISA de inhibición de lipopolisacárido. La inmunogenicidad en conejos, inoculados por vía intraduodenal, se determinó mediante la cinética de anticuerpos vibriocidas. RESULTADOS: el lote de siembra de trabajo mantuvo su identidad, pureza y viabilidad durante 18 meses de estudio. Se observó la presencia de los antígenos lipopolisacárido, hemaglutinina sensible a manosa y proteína de membrana externa U, en las suspensiones de células inactivadas de V. cholerae O1, no así de las subunidades A y B de la toxina colérica (CTA y CTB, respectivamente) o pilli corregulado con la toxina (TCP). Por otra parte, se obtuvieron títulos vibriocidas en los sueros de conejos, similares a la respuesta inducida por la cepa viva atenuada 638 de V. cholerae O1, candidata a vacuna oral. CONCLUSIONES: la cepa de V. cholerae O1 El Tor Inaba C6706 mostró características culturales, antigénicas e inmunogénicas que permiten considerarla como posible cepa para la obtención de vacunas inactivadas contra el cólera(AU)

INTRODUCTION: cholera continues being a serius health problem, mainly in the poorest areas. Most of the isolations worldwide belong to Vibrio cholerae O1 biotype El Tor serotype Ogawa, although there have been reported outbreaks caused by serotype Inaba, that is why it is recommended that an effective vaccine against the illness should contain cells or antigens of both serotypes. OBJECTIVE: to describe the characteristics of the strain C6706 of V. cholerae O1 El Tor Inaba as a likely strain for the obtaining of inactivated vaccines for cholera. METHODS: a criopreserved working culture batch was made up at - 70 ºC to evaluate identity, purity and viability. The strain was cultured in tryptone soy broth and was inactivated at 56º C for 20 minutes. Antigenicity of this preparation was tested by Western Blot and ELISA inhibition test. Immunogenicity in adult rabbits, inoculated intraduodenally, was determined by means of kinetics of vibriocidal antibodies. RESULTS: the working culture batch kept their identity, purity and viability during 18 months of study. The results confirmed the presence of relevant antigens as lipopolysaccharide (LPS), mannose-sensitive hemagglutinin (MSHA) and outer membrane protein U (OmpU) in the suspension of inactivated V. cholerae O1 cells, but not cholera toxin subunits (CTA, CTB) or toxin-coregulated pili (TCP).On the other hand, vibriocidal titers were found in rabbit sera, which were similar to those previously reported for the live V. cholerae O1 strain 638, an attenuated oral vaccinal candidate CONCLUSIONS: the V. cholerae O1 El Tor Inaba C6706 strain showed cultural, antigenic and immunogenic characteristics that allow us to consider it as a possible strain for the obtaining of inactivated vaccines for cholera(AU)