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onsdag 15 oktober 2014

ZMABb, EBOV specific monoclonal antibodies to NHP : Sustained protection against EBOV . VSVΔG/ZEBOVGP vaccine




Sustained protection against Ebola virus infection following treatment of infected nonhuman primates (NHP)  with ZMAb

Xiangguo Qiu,et al.

Scientific Reports3, Article number:3365
doi:10.1038/srep03365 Received Accepted
Published

Ebola virus (EBOV) is one of the most lethal filoviruses, with mortality rates of up to 90% in humans. Previously, we demonstrated 100% and 50% survival of EBOV-infected cynomologus macaques with a combination of 3 EBOV-GP-specific monoclonal antibodies (ZMAb) administered at 24 or 48 hours post-exposure, respectively.
The survivors demonstrated EBOV-GP–specific humoral and cell-mediated immune responses. In order to evaluate whether the immune response induced in NHPs during the ZMAb treatment and EBOV challenge is sufficient to protect survivors against a subsequent exposure, animals that survived the initial challenge were rechallenged at 10 or 13 weeks after the initial challenge.
 The animals rechallenged at 10 weeks all survived whereas 4 of 6 animals survived a rechallenge at 13 weeks. The data indicate that a robust immune response was generated during the successful treatment of EBOV-infected NHPs with EBOV, which resulted in sustained protection against a second lethal exposure.

Introduction

(Oma kommentti 26.10.2014  Käyttääkö EBV myös kuten influenssavirus  samanlaista antigeenivispilää, jossa sikakarja toimii yhtenä  väli-isäntä ennen ihmiskuntaan paremmin sopeutumista? Siinä tapauksessa EBOV omaa  kuuman pandemisen potentiaalin koska on nyt Kauko-Aasiassa tavattu sikakarjasta RESTON virus muotoisena.   Periaatteessa siis olisi odotettavissa hieman  uusimuotoinen ebolaviruspandemia  joidenkin vuosien, tai  vuosikymmenien päästä, joten rokotekehittelyllä on todellinen kiire).


Ebola virus is a member of the family Filoviridae1. It causes severe hemorrhagic fevers in primates and respiratory disease in pigs2. 
 Of the five Ebolavirus species, Zaire ebolavirus (EBOV) is the most lethal in humans, with a mortality rate approaching 90%. While EBOV is not currently a major burden on public health, the lack of an approved vaccine and post-exposure treatment raises concerns in the event of a possible outbreak. Several vaccines (reviewed in Falzarano et al.3), and post-exposure therapeutics have been developed with mixed success4. Many promising vaccines are moving through pre-clinical or clinical trials, but mass immunization is unlikely due to the localized and sporadic nature of EBOV infections.
 Post-exposure interventions are therefore necessary for the treatment of cases as they occur, but have been harder to develop as death from an EBOV infection typically occurs within 6–9 days in non-human primates (NHPs)5, 6.
 This leaves a very short window for the treatment to reduce virus replication until the immune response expands sufficiently to control the infection.

Currently, the majority of proposed post-exposure therapeutics needs to be administered within one hour in order to fully protect experimentally infected animals6, 7, 8.

The initial treatments evaluated against EBOV were more supportive in nature with a focus on remediating the coagulation abnormalities induced by the virus9, 10, 11, 12, 13.

(Kommentti: Viruksen suhteellisen pieni genomi ei sisällä mitään tekijää, joka ei olisi vitaalin tärkeä, vaikka primääri virionin kehittely toimisi  harvemmilla geeneillä kuin  systeemiset vaikutukset, mutta sekundäärinen koagulatiohäiriö  edistää taas viruksen hyvää laiduntamista ja invasoitumista  ja todennäköisesti  aiheutuu  VLP lehteilystä-. Jotkut virukset kuten influenssavirus hyötyvät isäntäkehon pysymisestä hengissä, mutta  ebolalavirukselle  on hyötyä isäntäkehon  solutuotyeiden kuten kalvolipidien kehityymisestä vain hyvin retriktiivisesti,   joten  virionien  valmistuttua  kehon kuolema on eduksi virionin  invasoitumiselle ja leviämiselle . kasvumiljööaineena.  Tämän takia  antivirusvaste ja virionin  esiinsilmukoitumisen  häiritseminen  pitäisi saada vireille ennen päivää 21. Tässä voisi käyttää jotain epäsuoraa keinoa. T- solujen  aktivoimiseksi.  Ehkä yleinen rokotusohelma olisi hyväksi, en tiedä.  Ebolan tyrmäävän evaasiostrategian heikkojen kohtien tarkka tunteminen on hyväksi.).

A study using the VSVΔG/ZEBOVGP vaccine as a post-exposure intervention showed that this strategy was more efficacious than previous interventions, protecting 50% of the infected animals if administered within 30 minutes after exposure6.

More recently, antisense therapy has been applied to EBOV infection with success.
 Modified phosphorodiamidate morpholino oligomers (PMOplus) were found to protect 62.5% of the infected animals when administered daily for 10–14 days8.

 Small interfering RNAs (siRNAs)   were shown to be fully protective in NHPs when administered daily for seven days7. In both cases, treatment began within 30–60 minutes of exposure.

Passive immunization constitutes another strategy to treat EBOV infections and was first attempted during the initial outbreak in 1976, where an infected laboratory employee was successfully treated with interferon and convalescent serum14.

 During the 1995 outbreak, convalescent serum was administered to eight infected individuals, seven of which survived15. However, evaluations of passive therapies in animal models have had mixed success.

The administration of immunoglobulin G (IgG) purified from EBOV-hypervaccinated horses failed to protect macaques against an EBOV challenge16, 17 and the neutralizing human monoclonal antibody KZ52, isolated from a survivor of EBOV infection, also failed to protect macaques18.

 However, polyclonal IgG from rhesus macaques which survived an EBOV challenge was shown to protect naïve rhesus macaques when administered up to 48 hours after infection19.

In 2012, two groups demonstrated partial protection in rhesus macaques following treatment with monoclonal antibodies at 24 hours after infection20, 21 and one group reported complete protection in cynomolgus macaques with another monoclonal antibody treatment (ZMAb) also initiated 24 hours after infection22. In addition, the ZMAb treatment protected two of four macaques when initiated 48 hours after exposure.

 In 2013, the treatment window was extended by using an adenovirus-vectored consensus human IFNα (Ad-IFN)23 administered with or before ZMAb24. While the precise mechanism of protection remains unclear, it was shown that the monoclonal antibody-based treatment did not completely inhibit EBOV replication, leading to the development of a host immune response against EBOV22, 24.

In order to evaluate whether the immune response induced in NHPs during the ZMAb treatment and EBOV challenge is of sufficient quality to protect survivors against a subsequent exposure, ZMAb-treated animals that survived an initial challenge22, 24 were rechallenged with EBOV either 10 or 13 weeks after the initial challenge and the memory immune responses were evaluated before and during the rechallenge.

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