A simian-adenovirus-vectored rabies vaccine suitable for thermostabilisation and clinical development for low-cost single-dose pre-exposure prophylaxis

<strong>Background</strong> Estimates of current global rabies mortality range from 26,000 to 59,000 deaths per annum. Although pre-exposure prophylaxis using inactivated rabies virus vaccines (IRVs) is effective, it requires two to three doses and is regarded as being too expensive and...

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Main Authors: Wang, C, Dulal, P, Zhou, X, Xiang, Z, Goharriz, H, Banyard, A, Green, N, Brunner, L, Ventura, R, Collin, N, Draper, S, Hill, A, Ashfield, R, Fooks, A, Ertl, H, Douglas, A
Format: Journal article
Language:English
Published: Public Library of Science 2018
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author Wang, C
Dulal, P
Zhou, X
Xiang, Z
Goharriz, H
Banyard, A
Green, N
Brunner, L
Ventura, R
Collin, N
Draper, S
Hill, A
Ashfield, R
Fooks, A
Ertl, H
Douglas, A
author_facet Wang, C
Dulal, P
Zhou, X
Xiang, Z
Goharriz, H
Banyard, A
Green, N
Brunner, L
Ventura, R
Collin, N
Draper, S
Hill, A
Ashfield, R
Fooks, A
Ertl, H
Douglas, A
author_sort Wang, C
collection OXFORD
description <strong>Background</strong> Estimates of current global rabies mortality range from 26,000 to 59,000 deaths per annum. Although pre-exposure prophylaxis using inactivated rabies virus vaccines (IRVs) is effective, it requires two to three doses and is regarded as being too expensive and impractical for inclusion in routine childhood immunization programmes. <strong>Methodology/ Principal findings</strong> Here we report the development of a simian-adenovirus-vectored rabies vaccine intended to enable cost-effective population-wide pre-exposure prophylaxis against rabies. ChAdOx2 RabG uses the chimpanzee adenovirus serotype 68 (AdC68) backbone previously shown to achieve pre-exposure protection against rabies in non-human primates. ChAdOx2 differs from AdC68 in that it contains the human adenovirus serotype 5 (AdHu5) E4 orf6/7 region in place of the AdC68 equivalents, enhancing ease of manufacturing in cell lines which provide AdHu5 E1 proteins in trans. We show that immunogenicity of ChAdOx2 RabG in mice is comparable to that of AdC68 RabG and other adenovirus serotypes expressing rabies virus glycoprotein. High titers of rabies virus neutralizing antibody (VNA) are elicited after a single dose. The relationship between levels of VNA activity and rabies virus glycoprotein monomer-binding antibody differs after immunization with adenovirus-vectored vaccines and IRV vaccines, suggesting routes to further enhancement of the efficacy of the adenovirus-vectored candidates. We also demonstrate that ChAdOx2 RabG can be thermostabilised using a low-cost method suitable for clinical bio-manufacture and ambient-temperature distribution in tropical climates. Finally, we show that a dose-sparing effect can be achieved by formulating ChAdOx2 RabG with a simple chemical adjuvant. This approach could lower the cost of ChAdOx2 RabG and other adenovirus-vectored vaccines. <strong>Conclusions/ Significance</strong> ChAdOx2 RabG may prove to be a useful tool to reduce the human rabies death toll. We have secured funding for Good Manufacturing Practice- compliant bio-manufacture and Phase I clinical trial of this candidate.
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spelling oxford-uuid:aa41fd37-35d8-4b55-91ed-6882c95aeeee2022-03-27T03:14:00ZA simian-adenovirus-vectored rabies vaccine suitable for thermostabilisation and clinical development for low-cost single-dose pre-exposure prophylaxisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:aa41fd37-35d8-4b55-91ed-6882c95aeeeeEnglishSymplectic Elements at OxfordPublic Library of Science2018Wang, CDulal, PZhou, XXiang, ZGoharriz, HBanyard, AGreen, NBrunner, LVentura, RCollin, NDraper, SHill, AAshfield, RFooks, AErtl, HDouglas, A<strong>Background</strong> Estimates of current global rabies mortality range from 26,000 to 59,000 deaths per annum. Although pre-exposure prophylaxis using inactivated rabies virus vaccines (IRVs) is effective, it requires two to three doses and is regarded as being too expensive and impractical for inclusion in routine childhood immunization programmes. <strong>Methodology/ Principal findings</strong> Here we report the development of a simian-adenovirus-vectored rabies vaccine intended to enable cost-effective population-wide pre-exposure prophylaxis against rabies. ChAdOx2 RabG uses the chimpanzee adenovirus serotype 68 (AdC68) backbone previously shown to achieve pre-exposure protection against rabies in non-human primates. ChAdOx2 differs from AdC68 in that it contains the human adenovirus serotype 5 (AdHu5) E4 orf6/7 region in place of the AdC68 equivalents, enhancing ease of manufacturing in cell lines which provide AdHu5 E1 proteins in trans. We show that immunogenicity of ChAdOx2 RabG in mice is comparable to that of AdC68 RabG and other adenovirus serotypes expressing rabies virus glycoprotein. High titers of rabies virus neutralizing antibody (VNA) are elicited after a single dose. The relationship between levels of VNA activity and rabies virus glycoprotein monomer-binding antibody differs after immunization with adenovirus-vectored vaccines and IRV vaccines, suggesting routes to further enhancement of the efficacy of the adenovirus-vectored candidates. We also demonstrate that ChAdOx2 RabG can be thermostabilised using a low-cost method suitable for clinical bio-manufacture and ambient-temperature distribution in tropical climates. Finally, we show that a dose-sparing effect can be achieved by formulating ChAdOx2 RabG with a simple chemical adjuvant. This approach could lower the cost of ChAdOx2 RabG and other adenovirus-vectored vaccines. <strong>Conclusions/ Significance</strong> ChAdOx2 RabG may prove to be a useful tool to reduce the human rabies death toll. We have secured funding for Good Manufacturing Practice- compliant bio-manufacture and Phase I clinical trial of this candidate.
spellingShingle Wang, C
Dulal, P
Zhou, X
Xiang, Z
Goharriz, H
Banyard, A
Green, N
Brunner, L
Ventura, R
Collin, N
Draper, S
Hill, A
Ashfield, R
Fooks, A
Ertl, H
Douglas, A
A simian-adenovirus-vectored rabies vaccine suitable for thermostabilisation and clinical development for low-cost single-dose pre-exposure prophylaxis
title A simian-adenovirus-vectored rabies vaccine suitable for thermostabilisation and clinical development for low-cost single-dose pre-exposure prophylaxis
title_full A simian-adenovirus-vectored rabies vaccine suitable for thermostabilisation and clinical development for low-cost single-dose pre-exposure prophylaxis
title_fullStr A simian-adenovirus-vectored rabies vaccine suitable for thermostabilisation and clinical development for low-cost single-dose pre-exposure prophylaxis
title_full_unstemmed A simian-adenovirus-vectored rabies vaccine suitable for thermostabilisation and clinical development for low-cost single-dose pre-exposure prophylaxis
title_short A simian-adenovirus-vectored rabies vaccine suitable for thermostabilisation and clinical development for low-cost single-dose pre-exposure prophylaxis
title_sort simian adenovirus vectored rabies vaccine suitable for thermostabilisation and clinical development for low cost single dose pre exposure prophylaxis
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