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Safety, tolerability, and immunogenicity of PIKA-adjuvanted recombinant SARS-CoV-2 spike protein subunit vaccine in healthy adults: an open-label randomized phase I clinical trial

  • 투고 : 2024.05.23
  • 심사 : 2024.09.25
  • 발행 : 2024.10.31

초록

Purpose: This phase I study aimed to assess the safety, tolerability, and immunogenicity of the PIKA-adjuvanted recombinant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) protein subunit vaccine in healthy adults aged 18 years and older. Materials and Methods: This is a phase I, open-label, dose-escalation study at three dose levels (5 ㎍, 10 ㎍, and 20 ㎍) of the PIKA coronavirus disease 2019 (COVID-19) vaccine administered intramuscularly. The three vaccine arms are (A) subjects who have never received any COVID-19 vaccination or have had COVID-19 infection for >6 months prior to enrolment; (B1) subjects whose COVID-19 primary vaccination series was completed with an inactivated COVID-19 vaccine; and (B2) subjects whose primary series was completed with messenger RNA COVID-19 vaccine. Results: Subjects who reported solicited adverse events (AEs) within seven days post-vaccination ranged from 35% to 60% within each vaccine arm. Most solicited AEs were mild local pain and tenderness. Systemic solicited AEs were only reported in Arm A. In all three vaccine arms, neutralizing antibody geometric mean titers were highest at day 28 (Arms B1 and B2) or day 35 (Arm A) than at baseline for all dose levels against the Wuhan (wild original SARS-CoV-2 virus, Wuhan-Hu-1), Delta (B.1.617.2), and Omicron (B.1.1.529) variants. These were sustained at day 183. Seroconversion rates at day 35 (Arm A, 85.7%-92.9%) or day 183 (Arms B1, 90.9%-100.0%, and B2, 18.2%-36.4%) and geometric mean fold rises were highest in the 5-㎍ dose level against all three variants. Conclusion: The PIKA-adjuvanted recombinant SARS-CoV-2 S protein subunit vaccine showed promising immunogenicity profile with no safety concerns. A dose-dependent immune response was observed, with slight advantages seen in low-dose (5 ㎍ and 10 ㎍) groups (ClinicalTrials.gov registration number: NCT05305300).

키워드

과제정보

We thank all the subjects who participated in this study. This work was funded and supported by YS Biopharma Co. Ltd.

참고문헌

  1. Ganesh B, Rajakumar T, Malathi M, et al. Epidemiology and pathobiology of SARS-CoV-2 (COVID-19) in comparison with SARS, MERS: an updated overview of current knowledge and future perspectives. Clin Epidemiol Glob Health 2021;10:100694.
  2. World Health Organization. WHO COVID-19 Dashboard [Internet]. Geneva: World Health Organization; 2020 [cited 2023 Sep 18]. Available from: https://data.who.int/dashboards/covid19/data
  3. Huang Y, Yang C, Xu XF, Xu W, Liu SW. Structural and functional properties of SARS-CoV-2 spike protein: potential antivirus drug development for COVID-19. Acta Pharmacol Sin 2020;41:1141-9.
  4. Walls AC, Park YJ, Tortorici MA, Wall A, McGuire AT, Veesler D. Structure, function, and antigenicity of the SARS-CoV-2 spike glycoprotein. Cell 2020;181:281-92.
  5. Bezbaruah R, Borah P, Kakoti BB, et al. Developmental landscape of potential vaccine candidates based on viral vector for prophylaxis of COVID-19. Front Mol Biosci 2021;8:635337.
  6. Nagy A, Alhatlani B. An overview of current COVID-19 vaccine platforms. Comput Struct Biotechnol J 2021;19:2508-17.
  7. Baden LR, El Sahly HM, Essink B, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med 2021;384:403-16.
  8. Polack FP, Thomas SJ, Kitchin N, et al. Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine. N Engl J Med 2020;383:2603-15.
  9. Voysey M, Clemens SAC, Madhi SA, et al. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet 2021;397:99-111.
  10. Shinde V, Bhikha S, Hoosain Z, et al. Efficacy of NVX-CoV2373 COVID-19 vaccine against the B.1.351 variant. N Engl J Med 2021;384:1899-909.
  11. Chi WY, Li YD, Huang HC, et al. COVID-19 vaccine update: vaccine effectiveness, SARS-CoV-2 variants, boosters, adverse effects, and immune correlates of protection. J Biomed Sci 2022;29:82.
  12. Logunov DY, Dolzhikova IV, Zubkova OV, et al. Safety and immunogenicity of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine in two formulations: two open, non-randomised phase 1/2 studies from Russia. Lancet 2020;396:887-97.
  13. Poland GA, Ovsyannikova IG, Kennedy RB. SARS-CoV-2 immunity: review and applications to phase 3 vaccine candidates. Lancet 2020;396:1595-606.
  14. Yang ZR, Jiang YW, Li FX, et al. Efficacy of SARS-CoV-2 vaccines and the dose-response relationship with three major antibodies: a systematic review and meta-analysis of randomised controlled trials. Lancet Microbe 2023;4:e236-46.
  15. Zhu FC, Li YH, Guan XH, et al. Safety, tolerability, and immunogenicity of a recombinant adenovirus type-5 vectored COVID-19 vaccine: a dose-escalation, open-label, non-randomised, first-in-human trial. Lancet 2020;395:1845-54.
  16. Zhang Y, Zeng G, Pan H, et al. Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine in healthy adults aged 18-59 years: a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial. Lancet Infect Dis 2021;21:181-92.
  17. Shen E, Li L, Li L, et al. PIKA as an adjuvant enhances specific humoral and cellular immune responses following the vaccination of mice with HBsAg plus PIKA. Cell Mol Immunol 2007;4:113-20.
  18. Zhang Y, Zhang S, Li W, et al. A novel rabies vaccine based-on toll-like receptor 3 (TLR3) agonist PIKA adjuvant exhibiting excellent safety and efficacy in animal studies. Virology 2016;489:165-72.
  19. Gai WW, Zhang Y, Zhou DH, Chen YQ, Yang JY, Yan HM. PIKA provides an adjuvant effect to induce strong mucosal and systemic humoral immunity against SARS-CoV. Virol Sin 2011;26:81-94.
  20. Lau YF, Tang LH, McCall AW, Ooi EE, Subbarao K. An adjuvant for the induction of potent, protective humoral responses to an H5N1 influenza virus vaccine with antigen-sparing effect in mice. J Virol 2010;84:8639-49.
  21. Lau YF, Tang LH, Ooi EE, Subbarao K. Activation of the innate immune system provides broad-spectrum protection against influenza A viruses with pandemic potential in mice. Virology 2010;406:80-7.
  22. Kalimuddin S, Wijaya L, Chan YF, et al. A phase II randomized study to determine the safety and immunogenicity of the novel PIKA rabies vaccine containing the PIKA adjuvant using an accelerated regimen. Vaccine 2017;35:7127-32.
  23. Asyura MM, Chandra AP, Agussalim A, Soloan G. Immunogenicity and safety analysis of inactivated virus vaccine against SARS-CoV-2: a systematic review of phase 1/2 clinical trials. J Asian Med Stud Assoc 2021;9:169-84.
  24. Ella R, Vadrevu KM, Jogdand H, et al. Safety and immunogenicity of an inactivated SARS-CoV-2 vaccine, BBV152: a double-blind, randomised, phase 1 trial. Lancet Infect Dis 2021;21:637-46.
  25. Wu Z, Hu Y, Xu M, et al. Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine (CoronaVac) in healthy adults aged 60 years and older: a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial. Lancet Infect Dis 2021;21:803-12.
  26. Xia S, Zhang Y, Wang Y, et al. Safety and immunogenicity of an inactivated SARS-CoV-2 vaccine, BBIBP-CorV: a randomised, double-blind, placebo-controlled, phase 1/2 trial. Lancet Infect Dis 2021;21:39-51.
  27. Huang Z, Xu S, Liu J, et al. Effectiveness of inactivated COVID-19 vaccines among older adults in Shanghai: retrospective cohort study. Nat Commun 2023;14:2009.
  28. Khoshnood S, Arshadi M, Akrami S, et al. An overview on inactivated and live-attenuated SARS-CoV-2 vaccines. J Clin Lab Anal 2022;36:e24418.
  29. Pu J, Yu Q, Yin Z, et al. The safety and immunogenicity of an inactivated SARS-CoV-2 vaccine in Chinese adults aged 18-59 years: a phase I randomized, double-blinded, controlled trial. Vaccine 2021;39:2746-54.
  30. Khairullin B, Zakarya K, Orynbayev M, et al. Efficacy and safety of an inactivated whole-virion vaccine against COVID-19, QazCovid-in(R), in healthy adults: a multicentre, randomised, single-blind, placebo-controlled phase 3 clinical trial with a 6-month follow-up. EClinicalMedicine 2022;50:101526.
  31. Zhugunissov K, Zakarya K, Khairullin B, et al. Development of the inactivated QazCovid-in vaccine: protective efficacy of the vaccine in Syrian hamsters. Front Microbiol 2021;12:720437.
  32. World Health Organization. COVID-19 advice for the public: getting vaccinated [Internet]. Geneva: World Health Organization; 2023 [cited 2024 Apr 27]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines/advice
  33. FE Online. Singapore braces for COVID-19 surge with over 25,900 cases recorded in a week; govt urges citizens to wear masks. Financial Express [Internet]. 2024 May 18 [cited 2024 May 22]. Available from: https://www.financialexpress.com/world-news/singapore-braces-for-covid-19-surge-with-over-25900-cases-recorded-in-a-week-govt-urges-citizens-to-wear-masks/3492837/
  34. Dou Y, Jansen DT, van den Bosch A, et al. Design of TLR2-ligand-synthetic long peptide conjugates for therapeutic vaccination of chronic HBV patients. Antiviral Res 2020;178:104746.
  35. Zom GG, Khan S, Filippov DV, Ossendorp F. TLR ligand-peptide conjugate vaccines: toward clinical application. Adv Immunol 2012;114:177-201.
  36. Jansen DT, Dou Y, de Wilde JW, Woltman AM, Buschow SI. Designing the next-generation therapeutic vaccines to cure chronic hepatitis B: focus on antigen presentation, vaccine properties and effect measures. Clin Transl Immunology 2021;10:e1232.
  37. Mohanan D, Slutter B, Henriksen-Lacey M, et al. Administration routes affect the quality of immune responses: a cross-sectional evaluation of particulate antigen-delivery systems. J Control Release 2010;147:342-9.