Immunogenicity and safety of an investigational tetravalent recombinant subunit vaccine for dengue: results of a Phase I randomized clinical trial in flavivirus-naïve adults
Susan B Manoff, Michele Sausser, Amy Falk Russell, Jason Martin, David Radley, Donna Hyatt, Christine C Roberts, Jason Lickliter, Janakan Krishnarajah, Andrew Bett, Sheri Dubey, Tyler Finn, Beth-Ann Coller, Susan B Manoff, Michele Sausser, Amy Falk Russell, Jason Martin, David Radley, Donna Hyatt, Christine C Roberts, Jason Lickliter, Janakan Krishnarajah, Andrew Bett, Sheri Dubey, Tyler Finn, Beth-Ann Coller
Abstract
There is an unmet medical need for vaccines to prevent dengue. V180 is an investigational recombinant subunit vaccine that consists of truncated dengue envelope proteins (DEN-80E) for all 4 serotypes. Three dosage levels of the tetravalent DEN-80E antigens were assessed in a randomized, placebo-controlled, Phase I dose-escalation, first-in-human proof-of-principle trial in healthy, flavivirus-naïve adults in Australia (NCT01477580). The 9 V180 formulations that were assessed included either ISCOMATRIX™ adjuvant (2 dosage levels), aluminum-hydroxide adjuvant, or were unadjuvanted, and were compared to phosphate-buffered saline placebo. Volunteers received 3 injections of assigned product on a 0, 1, 2 month schedule, and were followed for safety through 1 year after the last injection. Antibody levels were assessed at 6 time-points: enrollment, 28 days after each injection, and 6 and 12 months Postdose 3 (PD3). Of the 98 randomized participants, 90 (92%) received all 3 injections; 83 (85%) completed 1-year follow-up. Immunogenicity was measured by a qualified Focus Reduction Neutralization Test with a 50% neutralization cutoff (FRNT50). All 6 V180 formulations with ISCOMATRIX™ adjuvant showed robust immunogenicity, while the 1 aluminum-adjuvanted and 2 unadjuvanted formulations were poorly immunogenic. Geometric mean antibody titers generally declined at 6 months and 1 year PD3. All 9 V180 formulations were generally well tolerated. Formulations with ISCOMATRIX™ adjuvant were associated with more adverse events than aluminum-adjuvanted or unadjuvanted formulations.
Keywords: dengue vaccine; immunogenicity; recombinant; safety; subunit.
Figures
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Figure 3A.
Proportions of participants with a…
Figure 3A.
Proportions of participants with a tetravalent response, by study month (per-protocol population). Note:…
Figure 3B.
Proportions of participants with a…
Figure 3B.
Proportions of participants with a tetravalent response, by study month (per-protocol population). Note:…
Figure 4.
Induction of B-cell memory to…
Figure 4.
Induction of B-cell memory to each of the four DENV serotypes in a…
![Figure 3A.](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/6773383/bin/khvi-15-09-1546523-g003.jpg)
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![Figure 4.](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/6773383/bin/khvi-15-09-1546523-g005.jpg)
Source: PubMed