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Title:
Allergy vaccine composition, production method thereof and use of same in
allergy treatment
United States Patent: 7,648,709
Issued: January 19, 2010
Inventors: Lastre Gonzalez;
Miriam de San Juan Bosco (Playa, Ciudad de la Habana 11300, CU), Perez
Martin; Oliver German (Playa, Ciudad de la Habana 11300, CU), Labrada
Rosado; Alexis (Bejucal, La Habana 6048, CU), Bidot Martinez; Igor (Guantanamo,
CU), Bracho Granado; Gustavo Rafael (Marianao, Ciudad de la Habana, CU),
Del Campo Alonso; Judith Monica (Plaza de la Revolucion, Ciudad de la
Habana 10400, CU), Perez Lastre; Dainerys Aleida (Playa, Ciudad de la
Habana 11300, CU), Facenda Ramos; Elisa (Vegas, Boyeros, Ciudad de la
Habana, CU), Zayas Vignier; Caridad (Marianao, Ciudad de la Habana, CU),
Rodriguez Martinez; Claudio (Bejucal, La Habana 6048, CU), Sierra
Gonzalez; Victoriano Gustavo (Playa, Ciudad de la Habana 16017, CU), Perez
Lastre; Jorge Ernesto (Playa, Ciudad de la Habana 11300, CU)
Appl. No.: 10/513,493
Filed: May 8, 2003
PCT Filed: May 08, 2003
PCT No.: PCT/CU03/00007
371(c)(1),(2),(4) Date: January
19, 2006
PCT Pub. No.: WO03/094964
PCT Pub. Date: November 20,
2003
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Outsourcing Guide
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Abstract
The present invention relates to the
field of Immunology, specifically with the branch of Immuno-Allergy and in
particular with the use of adjuvant or carrier compounds, capable of
modulating the immune response to allergens. The technical objective that
is pursued is to obtain a pharmaceutical preparation of therapeutic or
prophylactic use using bacterial proteoliposomes, which transform the
allergic response Th2 and IgE when being applied in allergic individuals,
toward a protector response Th1; as well as it is able to prevent the
appearance and the development of allergies in individuals non-allergic
yet. The vaccine composition consists of proteoliposomes derived from
Gram-negative bacteria coupled to allergens and optionally contains other
adjuvants or antigens. The method for its preparation and an immunization
scheme of two doses are provided.
Description of the
Invention
PRIOR RELATED APPLICATIONS
This application claims priority to Cuban Patent Application 91/2002,
filed May 8, 2002 and Patent Cooperation Treaty Application
PCT/CU2003/00007, filed May 8, 2003, and incorporates the priority
applications herein in their entireties by reference thereto.
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates to the field of Immunology, specifically
with the branch of Immuno-Allergy and in particular with the use of
adjuvant or carrier compounds, capable of modulating the immune response
to allergens. The aim is to induce changes in this specific response that
can reduce or prevent its pathogenic effect.
Allergy is a very frequent pathology, mainly in the industrialized
countries. In allergy intervenes several immunopathological mechanisms and
particularly the so-called type I anaphylactic hypersensitivity.
Physiopathogeny of type I hypersensitivity is based on the increased
production of IgE, a cytotropic antibody. The IgE antibodies are raised
against foreign substances, denominated allergens, after a first exposure,
denominated sensitization.
IgE antibodies can bind to the IgE receptors on the surface of blood
basophiles and tissue mast cells, prolonging their mean life from a few
hours in blood to several months in tissues. Later contacts of the
allergens with the cell-bound IgE antibodies can provoke the cross-linking
of neighbor antibodies, which trigger a signal cascade to the cell
cytoplasm, leading to cell degranulation and release of inflammatory
mediators such as histamine, serotonine and kinines
The most common allergic diseases are rhinitis, asthma, and atopic
dermatitis. Allergic asthma is a chronic inflammatory disorder. In the
immunopathogenesis of asthma are involved not only IgE dependent
mechanisms (responsible for the Type 1 anaphylactic response), but also
T-cells, and particularly the so-called Th2 cell subset. Th2 lymphocytes
induce and maintain the inflammatory response by means of the recruitment
and activation of other cells and particularly through IL-5 production,
which is responsible for the recruitment and activation of Eosinophiles.
Eosinophilia plays an important role in the development of bronchial
hyperreactivity, which is an essential feature of asthma.
Common allergens are pollen, house dust mites, moulds, drugs, foods and
animal hair and dander. Indoor allergens and specially, house dust mites,
are a very relevant cause of respiratory allergy and asthma.
Clinical manifestations of allergic disorders are usually treated with
anti-histaminics, .beta.-agonists, sodium chromoglicate and
corticosteroids. These treatments are generally inadequate, because they
are purely symptomatic and do not influence the ethiopathogeny of the
disease. Nowadays, it is widely recognized the need of more effective
treatment approaches, among them, specific immunotherapy or therapeutic
vaccines.
2. Background of the Prior Art
Traditionally, the hyposensitization therapy with allergen extracts (also
called specific immunotherapy) has been widely used in the treatment of
allergic diseases. In this type of treatment, the patients are
administered with periodical subcutaneous injections of the specific
offending allergens. It is started injecting small allergen doses and if
allergic reactions do not appear, the dose is increased. The injections
are administered with a weekly frequency at the beginning; then, doses are
gradually increased until reaching a maintenance dose at monthly or
semimonthly frequency. This treatment should be maintained for several
years (WHO Position Paper. Allergen Immunotherapy: Therapeutic Vaccines
against Allergic Diseases. Geneva, January 1998).
In spite of the method is regarded as relatively effective for some
allergic diseases, the immunotherapy has been questioned due to safety
reasons. During this treatment, the patient can suffer from severe
anaphylactic reactions, which eventually can be even fatal. In addition,
the high number of injections to administer, that can be about 100-200 in
3 years, constitutes a serious drawback for its practical application.
Poor patient compliance and premature abandonment of the treatment are
frequent causes of lack of expected effectiveness.
In recent years, it has been a great progress in the understanding of the
mechanisms of the induction of IgE immune response in allergic subjects.
IgE production by B-cells is driven by specific mechanisms of the Th2
immune cell response, and particularly, it is induced by an overproduction
of IL-4 by Th2 cells. The Th2 cells are involved pathologically not only
through their regulatory role (IL-4 induces the class switch to IgE in
B-lymphocytes, mediated by a contact signal provided by T-cells), but also
participate directly in the effector phase of the delayed type allergic
inflammatory response and in the asthmatic chronic inflammation.
The exposure to environmental allergens, in addition to the own genetic
predisposition, constitutes the leading phenomenon of the allergic
sensitization process and causes the triggering of allergic reactions.
The immunological mechanism responsible for clinical improvement of the
patients during allergen immunotherapy is not totally explained yet.
Nevertheless, it is known that several immunological changes take place,
linked to a long-term decrease of allergen specific IgE: there is a
decrease of IL-4 and IL-5 secretion and increase of IFN-.gamma. and IgG
levels. These changes indicate a decrease of the Th2 response pattern,
like a possible consequence of the induction of a non-pathogenic
concurrent Th1 pattern (WHO Position Paper. Allergen Immunotherapy:
Therapeutic Vaccines against Allergic Diseases. Geneva, January 1998).
The Th1/Th2 response patterns distinguish themselves firstly by the
typical pattern of cytokines, secreted by Th-cells: namely IFN-.gamma. and
IL-2 by Th1 and IL-4 and IL-5 by Th2 (Mossman, T. R., Cherwinski, H.,
Bond, M. W., Giedlin, M. To, and R. L. Coffman. 1986. Two types of murine
T helper cell clones. I. Definition according to profiles of lymphokine
activities and secreted proteins. J. Immunol. 136:2348-2357). On the other
hand, it is also possible to determine the type of induced response
determining serum Ig class/subclass profiles. Thus, murine Th1 pattern
induces antibodies preferably of the IgG2 subclass (IFN-.gamma.
dependent), whereas Th2 induces IgE and IgG1 subclass (IL-4 dependent). In
humans, Th1 is linked to IgG1/IgG3 antibodies and Th2 to IgE.
Although the onset and development of Allergy are caused by environmental
factors, the fundamental role in the propensity of an individual to
develop a Th2/IgE response is of genetic order (Holgate ST. Environmental
Genetic and interaction in allergy and Asthma. J Allergy Clin Immunol
1999; 104:1139-1146). Therefore, the descendants of allergic parents will
develop an allergic disease with a greater frequency than the children of
non-allergic parents. This frequency has been estimated as 75, 50 and 25%
if both parents, the mother or the father are allergic, respectively).
That means that applying a diagnostic system to the parents, the behavior
of an individual within the population, can be predicted with a high
likelihood. Additionally, it is well known that the establishment of a
pathological Th2 pattern occurs in the first 6-24 months of life.
Environmental factors like exposition to bacterial infections can
influence positively on the disease onset, inducing a Th1 pattern, which
down-regulates the allergic Th2 pattern (Holt PG, Programming of Allergen
Specific Th-memory during Childhood. Proceedings XVII International
Congress of Allergology and Clinical Immunology. Sydney 2000. Allergy Clin
Immunol International Suppl. 1, 2000 pp 83-85). These findings suggest the
possibility of designing prophylactic anti-allergic vaccines, which could
prevent the establishment of a Th2 response to allergens, in the early
childhood. These vaccines could be based on Th1 adjuvants, which ideally
should be effective during the breast-feeding period.
Several approaches have been attempted to improve allergen immunotherapy,
aiming to reduce their negative aspects, preserving or extending their
benefits. Particularly, it is known that several methods have been used in
order to modify the allergens so that its allergenicity (i.e., its ability
to be recognized by IgE antibodies) and ability to induce IgE antibodies
following immunization could be reduced, as well as, to increase their
immunogenicity (i.e. its capacity to induce a therapeutic or possibly
protective response). Among them, there are physical methods by adsorption
of allergens, creating a depot effect (adjuvants), or chemical methods
aiming at modifying allergen molecules by means of covalent links with
other compounds or between themselves.
Several physical agents have been used, among them: Tyrosine (Patent No.
GB 1,377,074), Tyrosine Ester (U.S. Pat. No. 4,428,932); Liposomes (Patent
Application WO 89/10753); Monophosforil Lipid A (MLA) (U.S. Pat. No.
5,762,943); Saponine (U.S. Pat. No. 4,432,969) and the traditional ones:
Aluminum Hydroxide and Calcium Phosphate.
Among the chemical agents that have been used for allergen polymerization,
are Formaldehyde (Marsch DG et al. Studies on allergoids from naturally
occurring allergens. III Preparation of Ragweed pollen allergoids by
aldehyde modification. J. Allergy Clin. Immunol. 1981; 68:449-59);
Alginate (Corrado O J et al. Allergy 1989; 44:108-5) and Glutaraldehyde
(Patent No. GB 1,282,163). Also, there have been used: MPEG (Dreborg et
al. Crit Rev Ther Drug Carrier Syst. 1990; 6:315-65) and polysaccharide
conjugates (European Patent Application No. EP 3497 008 A2).
These solutions could, in some cases (Eg. Glutaraldehyde polymerized
allergens, Alum adjuvanted, Grammer et al., Modified forms of allergen
immunotherapy, J Allergy Clin Immunol 1985; 44:108-15) increase the
allergen-specific IgG titters in animal models. Nevertheless, the increase
of this antibody class does not necessarily imply a clinical improvement
of the patient, mainly if a parallel increase of IgE antibodies occurs. In
fact, some IgG subclasses (IgG1 in mice and IgG4 in humans) are involved,
also, in different allergic reactions, due to its ability to bind
themselves, transitorily, to mast cell surface. On the other hand,
clinical evidences in humans indicate that the increase of IgG antibodies
is not correlated directly with clinical improvement, suggesting that
these antibodies play only a secondary role in the regulatory mechanism,
induced by the treatment (Rak S. Lowhagen O., Venge P. Bronchial The
effect of immunotherapy on hyperresponsiveness and eosinophil cationic
protein in pollen-allergic patients. J Allergy Clin Immunol 1988;
82:470-80 and Jutel M, Muller Or, Fricker M, Rihs S, Pichler W, Dahinden
C. Influence of bee venom immunotherapy on degranulation and leukotriene
generation in human blood basophiles. Clin Exp Immunol 1996; 12:1112-18)
Although, chemically modified allergens (so-called allergoids), has some
advantages concerning the decrease of secondary adverse reactions during
the treatment as compared to traditional allergen extracts, they do not
produce a significant clinical improvement (Bousquet et al. J. Allergy
Clin. Immunol. 1989; 84:546-56 and Grammer et al. J Allergy Clin
Immunology 1985; 76:397-401). Another drawback of allergoids, used so far
in clinical trials (modified by Glutaraldehyde or Formaldehyde), is the
practical impossibility to obtain a standardized composition, since the
final products are obtained by means of chemical reactions starting from
allergen extracts, which are heterogeneous mixtures of polypeptides and
other biomolecules. In these reactions, it cannot be avoided that
molecular species with different degrees of polymerization or chemical
modifications are formed, which can constitute unwanted, difficult to
eliminate by-products.
The use of Aluminum Hydroxide has only managed to reduce the number of
injections necessary to obtain the same effect that with the non-adjuvanted
allergens, which is attributed to its depot and slow release effects.
Nevertheless, it is known that this adjuvant stimulates IgE production, as
much in animals as in humans, inducing a typical Th2 pattern, which could
possibly reinforce the pathogenic allergic response, during its
administration.
Calcium Phosphate and Tyrosine have also been used as adsorbents for
creating a depot effect and slow release of the allergens. Nevertheless,
these formulations have shown no significant advantages as compared to
aqueous or Alum-adjuvanted extracts, regarding the effectiveness or safety
of the treatment (Altintas D U et al. Comparison between the use of
adsorbed and aqueous immunotherapy material in Dermatophagoides
pteronyssinus sensitive asthmatic patients. Allergologie et
Immunopathologie 1999; 27(6):309-317).
None of the existing at the present time, previously mentioned solutions
could achieve completely effective immune modulation (expressed in
inhibition or reduction of Th2 pattern or induction of Th1) neither in
animals nor in humans, and no clinical effectiveness has been shown in
patients, using a reduced number of injections.
The use of liposomes containing allergens has been described in the Patent
Application WO 89/10753. It is regarded that liposomes, besides creating a
depot and reducing allergenicity of the product, can influence the
mechanisms of antigen presentation to the immune system, due to their
lipidic and particulate nature (WHO Position Paper. Allergen Immunotherapy:
Therapeutic Vaccines against Allergic Diseases. Geneva, January 1998).
Nevertheless, this approach has several drawbacks that have hampered a
wide introduction into the clinical practice. Among them: the lack of
stability of these formulations and availability of a technology for
inclusion of allergens into liposomes in a consistent way. The lack of
stability of the liposome formulation during storage or administration to
the patient has serious implications in the safety of the treatment, since
the possible uncontrolled release of allergens from liposomes can cause
severe anaphylactic reactions, similarly to allergens in aqueous form.
Moreover, definitive evidences of the induction of an effective immune
response, either that affects Th1/Th2 balance or that induces a
non-pathological or protectogenic pattern, have not been obtained.
More recent approaches have tried to use allergen formulations with
adjuvant inducers of Th1 response, such as Monophosforil Lipid A (MLA)
(U.S. Pat. No. 5,762,943) and Heat Shock Proteins (HSP) also known as
Mycobacterium Stress Proteins, which are described in the patent
WO9823735. MLA, a detoxified variant of LPS, has been shown that reduces
specific IgE and increases IgG levels, in experimental mice models.
Nevertheless, it has not been demonstrated that it can effectively reduce
the Th2 cellular component of the allergic response. Therefore, its use
would be limited strictly to the allergic diseases for which the type 1
hypersensitivity mechanism is the main one, which would exclude asthma.
Another major drawback is that, in spite of the fact that the toxicity of
LPS has been attenuated, it has not been completely removed (Baldrick P et
al. Vaccine 20, 2002 737-743), which could limit its use in small
children. In the case of HSP, experimental evidences have not been
provided, supporting that clinically relevant allergens mixed or
conjugated to these proteins could produce a deviation of
allergen-specific Th2 response, neither in animal models nor in humans.
The use of proteoliposomes derived from the outer membrane of
Gram-negative bacteria has described for prophylactic vaccine formulations
against infectious diseases, by Ruegg C L and cols. (Preparation of
proteosome-based vaccines. J Immunological Methods 1990; 135:101-9);
Lowell and cols. (Proteosome-Lipopeptide Vaccines Enhancement of Immunity
for Malaria CS Peptides. Science 1988; 240:800-2); also in the U.S. Pat.
No. 5,597,572. In this last case, the main core is an outer membrane
proteoliposome or vesicle (OMV) derived from Neisseria meningitidis
serogroup B. It is regarded that its particulate structure,
lipo-oligosaccharide traces (LPS) incorporated into the OMV;
polysaccharide C; lipid composition and adsorption into Alum, are relevant
for its proven immunogenicity and protectogenicity in humans.
In spite of containing LPS, this vaccine formulation does not cause toxic
effects neither in humans nor in animals, which is attributed to the OMV
peculiar structure and composition. On the other hand, the immunomodulator
and adjuvant effect of LPS could be retained.
The anti-meningococcal vaccine, based on this proteoliposome, has been
successfully applied in more than 50 million doses, demonstrating to be
safe, non-reactogenic and effective to protect against N. meningitidis
serogroups B and C. Moreover, it can be applied safely during the
breast-feeding period. It has been shown that it is able to turn the
T-independent Polysaccharide C antigen into a T-dependent one. This
vaccine induces a preferential Th1 pattern in humans and animals,
characterized by the induction of lymphoproliferation; anti-OMV IgG
antibodies (subclass IgG1 in humans and IgG2a in mice); IFN-.gamma., IL-2
and IL-12, both at protein and mRNA level. It does not induce anti-OMV IgE,
neither increases total IgE levels, nor IL-4, IL-5; both, at protein or
mRNA level (Infect Immun. 2001, 69(72001):4502-4508). The response induced
by the vaccine, as it is usual for the adaptive immunity, is specific to
the bacterial antigens contained in the product, and therefore, there are
no evidences of induction of an immune response towards well-known common
allergens.
SUMMARY OF THE INVENTION
The object of the present invention is to obtain a pharmaceutical
composition for therapeutic or prophylactic purposes, based on the use of
bacterial proteoliposomes. This composition, once applied into allergic
patients, is able to transform the allergic Th2 response, induced by the
allergen, towards a cellular Th1 response. The invention also relates to
the immunization scheme using this vaccine composition. It is also an
object of the present invention, to provide a pharmaceutical composition
able to prevent the onset and development of the allergic disease in
children with atopic familial history.
This composition can contain one or several allergens, which can be
coupled to the proteoliposomes or be administered simultaneously with it,
inducing a therapeutic or protective immune response, specific to the
allergen. This response is characterized by a decreased production of IgE
antibodies as compared to the traditional immunotherapy, the non-induction
of IL-5, as well as the induction of IgG1 antibody subclass (in humans)
and IgG2a (in mice), and IFN-.gamma. (in both). These features evidence
the induction of a Th1 type immune response and the transformation of the
allergenic Th2 response in to a cellular Th1.
It is still another object of this invention to provide the method for
coupling allergen(s) to proteoliposomes and to other adjuvants, as well as
to provide an appropriate pharmaceutical composition for its
administration by parenteral route.
The novelty of the invention is firstly in the use of proteoliposomes
derived from outer membrane proteins of Gram-negative bacteria and more
specifically from Neisseria meningitidis B in conjunction with Aluminum
Hydroxide. Thus, these proteoliposomes (alone or together with a
polysaccharide) are coupled in a non-covalent or covalent way to one or
several allergen proteins, adsorbed into the Aluminum Hydroxide gel, and,
then, administered to allergic subjects.
It has a particular novelty, that this pharmaceutical composition induces
a modulation of the specific immune response to the allergens included in
it, towards a non-pathogenic and protective Th1 pattern, by using only two
injections.
Another novel aspect is the prophylactic application of the pharmaceutical
composition in the offspring of allergic parents or in early-diagnosed
atopic individuals.
It is still novel, the procedure used in order to couple non-covalently
the main components of the formulation and particularly: proteoliposomes
to allergens, as well as the use of purified allergens for that purpose.
In the present invention, proteoliposomes or OMV, purified from
Gram-negative bacteria culture, and particularly from N. meningitidis B,
are used, as was described in the U.S. Pat. No. 5,597,572.
In the present invention, allergens of protein or glycoprotein nature are
used preferably, although, it is possible also to use polysaccharide
allergens. The allergens can be obtained from natural allergenic source
materials, using well-known extraction and purification methods or can be
obtained in recombinant form, by cloning and expression in microorganisms
or higher organism cells. Alternatively, chemically synthesized
polypeptides, according to the aminoacid sequence of the native allergens,
can be used. Particularly, respiratory allergens are preferred: in the
first place, from house dust mites belonging to Pyroglyphidae or
Glyciphagidae families, especially belonging to Dermatophagoides or Blomia
genus and specifically to Dermatophagoides siboney, Dermatophagoides
pteronyssinus or Dermatophagoides farinae species. Purified allergens of
these mite species are obtained preferably from any available commercial
allergenic extract, which is subjected first to freeze-drying or
concentration by ultrafiltration up to 10-100 mg/mL protein content, and
next to saline precipitation in 50-100% ammonium sulfate solution. The
pellet is reconstituted in aqueous solution and fractionated by means of
gel-filtration chromatography, using matrixes of composite cross-linked
dextran/agarose, such as SUPERDEX.TM. 75, or matrixes of cross-linked
copolymer of allyl dextran and N,N-methylenebisacrylamide, such as:
SEPHACRYL.TM. S-100, SEPHACRYL.TM. S-200 or SEPHACRYL.TM. S-300. The peak
corresponding to 10-60 kDa Molecular Weight, is collected. This fraction
contains mainly Group 1 (25 kDa glycoprotein: Der s 1, Der p 1, Der f 1)
and Group 2 (15 kDa protein: Der s 2, Der p 2, Der f 2) major allergens.
Alternatively, a separate purification procedure can be followed for each
major allergen, preferably using anti Group 1 and anti Group 2 Mab-affinity
chromatography; then, both components can be added to the formulation to
be coupled to the proteoliposomes, or alternatively, be coupled separately
to it.
The coupling of both basic components (allergen and proteoliposome) is
performed by covalent or non-covalent links. The choice can be made taking
into account the features of each particular allergen. For non-covalent
coupling, the mite allergens are embedded into proteoliposomes at a ratio
of 0.1-1 .mu.g by 10 .mu.g of proteoliposome. This coupling method takes
advantage of the hydrophobic and lipophylic interactions between both
components; the process is performed by means of mechanical agitation at
60 to 600 rpm rotation speed, during 30-60 minutes. The obtained mix can
be administered directly in aqueous solution or adsorbed into Alum
Hydroxide gel. In the last case, the allergen can also be adsorbed into
the gel prior to be coupled to proteoliposomes or preferably, be added
after adsorbing proteoliposomes into the gel. The amount of Alum Hydroxide
should be 10 to 25 times the amount of proteoliposome, keeping the
afore-mentioned proportion between allergen and proteoliposome content.
The adsorption process into the Alum gel is performed by means of
agitation at 60-600 rpm and pH values ranging from 6 to 8.
The efficacy of allergen adsorption in to Alum gel can be monitored using
Mab-ELISA, specific to major allergens, E.g. anti-Der s 1 ELISA (Sewer et
al. Int Arch Allergy Immunol 2000; 123:242-248) and anti-Group 2 ELISA (Heymann
P W, Chapman M D et al J Allergy Clin Immunol 1989; 83:1055-1067)
The coupling of allergen to proteoliposome can be performed also by a
covalent link, using a cross-linker or spacer, which can be coupled to the
available amino groups on the proteoliposome, followed by the coupling of
the spacer Maleimide group to the free Sulfhydryl (SH) groups on to the
allergen molecule. Such free SH groups are present in the mite major
allergen proteins (Group 1 and 2), nevertheless, they can also be induced
in other allergens by reducing the disulphide bridges or by derivatization
of proteins by well-known chemical methods. The obtained conjugates are
later purified by dialysis or ultrafiltration and finally by
gel-filtration chromatography (Sephacryl S-300 or Superdex 200) in order
to remove the conjugation reagents, as well as the non-bound allergens.
Allergen molecules must constitute between 1 and 10% of the total mass of
the conjugate, in order to induce a suitable immune response. Conjugates
are administered by injectable route in an appropriate aqueous excipient
or adsorbed into Alum Hydroxide gel or another suitable depot adjuvant.
The present invention also includes the conjugation, by the method
described before, of lipofilic residues, such as bipolar fatty acids of 16
to 20 carbons, to the allergens, aiming to facilitate its non-covalent
incorporation into the proteoliposome.
Alternatively, the vaccine composition may include other antigens, which
do not affect the induced cellular pattern and strengthen the expected
response to the allergen. Polysaccharides, and particularly polysaccharide
C from N. meningitidis, can be used for this purpose. They are added in a
non-covalent form to the formulation in a proportion of 0.5 to 4 times the
amount of proteoliposome.
The present invention also comprises the use of allergens of
polysaccharide nature. In that case, the allergens are added to the
formulation in the same way as described for N. meningitidis
polysaccharide C.
Unexpectedly, the administration of this vaccine composition by
parentheral route in only two doses, induced, not only a specific Th1
response to the proteoliposome antigens, as was previously known, but also
a similar Th1 response directed against the allergens included in the
formulation. Surprisingly, this Th1 response prevails, in spite of using
Alum Hydroxide in the formulation, preserving the depot effect. This
response is characterized by a cytokine pattern with high levels of IFN-.gamma.,
and no induction of IL-5, also, by induction of allergen-specific IgG2a
antibodies and reduction of IgE and IgG1 antibodies in mice. The
administration of this composition does not affect a preexisting response
against the bacterial antigens, induced by prior immunizations.
The Proposed Solution has the Following Advantages:
The immunological effect induced by this vaccine composition counteract
both: the anaphylactic type I hypersensitivity response (reduction of IgE
and IgG1), and the delayed type inflammatory and chronic allergic
reactions (IL-5 reduction), which makes it effective in the treatment of
asthma. The therapeutic effect is attributed to the presentation of
allergens to the immune system in a non-allergenic context, and it is
achieved in a reduced number of injections and in a shorter time as
compared to traditional immunotherapy with allergen extracts. Such effect
is used advantageously not only in the treatment of allergic patients, but
also it allows to prevent the disease development in individuals with an
early allergic state or to prevent the onset of new allergic
sensitizations to other allergens.
The immunological effect of proteoliposomes as an immune-modifier adjuvant
is effective and safe in the first months of life, during the
breast-feeding period. It makes possible the administration of the vaccine
in children at this age with a prophylactic purpose, before that the
disease has appeared and developed. It is particularly useful for children
with allergic familial history and therefore with a high probability of
being so.
The adsorption of the active components into a depot adjuvant,
specifically into Aluminum Hydroxide, reduces the allergenicity of the
formulation (i.e. the capacity of IgE binding), in more than 10 times in
relation to a similar dose of aqueous allergen. This implies a
considerable reduction of risk of severe anaphylactic reactions during its
administration. In addition, the adsorption into the gel contributes to
extend the shelf-life stability of the formulation by decreasing the
kinetics of the chemical reactions that can possibly cause degradation of
the active components.
The use of purified allergens and particularly of purified mite allergen
of the Dermatophagoides genus, including Group 1 and 2 allergens,
facilitate the standardization of the product composition. Then, it is
possible to determine and fit accurately the allergen content in the
formulation and to assess the efficacy of its coupling to the
proteoliposome and adsorption into Aluminum Hydroxide gel. In addition, in
the case of covalent coupling, it is possible to easily separate unwanted
by-products (such as the allergen-allergen polymers) from the active
compound (proteoliposome-allergen conjugate) thanks to the big difference
in Molecular Weight between both components. This separation can be
performed using commercially available size-exclusion chromatography. The
technology can be applied to allergens of different nature, being possible
to use several allergens in a same formulation.
Another advantage is the lack of toxicity of the product, in spite of
containing small amounts of LPS, which, on the other hand, retains their
immunogenic effect. That makes it appropriate for a safe administration to
humans and particularly to small children.
Proteoliposomes also turn T-independent antigens, such as carbohydrates,
into T-dependent antigens. This feature can also be advantageously applied
to allergens of polysaccharide nature, such as CCD.
Claim 1 of 17 Claims
1. A vaccine composition for diminishing
type I anaphylactic hypersensitivity to domestic mites and inducing a Th-1
type immune response to said mites comprising: a) a proteoliposome from
the outer membrane of Neisseria mentingitidis; b. at least one allergen
from domestic mites; and c) aluminum hydroxide as a depot adjuvant. ____________________________________________
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