Development of a PIV-vectored RSV vaccine: preclinical evaluation of safety, toxicity, and enhanced disease and initial clinical testing in healthy adults.

MEDI-534 is a bivalent live attenuated vaccine candidate against human respiratory syncytial virus (hRSV) and human parainfluenza virus type 3 (hPIV3) that was previously shown to be immunogenic and to protect rodents and African green monkeys from wild-type (wt) hRSV challenge. We performed further preclinical evaluations to address the safety of MEDI-534 prior to human testing. MEDI-534 did not predispose rodents to enhanced RSV disease following wt-RSV challenge, and the tissue tropism of the chimeric virus was confined to the respiratory tract. Representative clinical trial material did not produce toxicity in rats. In adults, MEDI-534 was highly restricted in replication, did not boost RSV and PIV3 antibody titers, and produced no medically significant vaccine-related adverse events thereby warranting further evaluation in pediatric populations.

[1]  Q. Sattentau,et al.  A potential molecular mechanism for hypersensitivity caused by formalin-inactivated vaccines , 2006, Nature Medicine.

[2]  W. P. Glezen,et al.  Parainfluenza virus type 3: seasonality and risk of infection and reinfection in young children. , 1984, The Journal of infectious diseases.

[3]  R. Chanock,et al.  Respiratory syncytial virus disease in infants despite prior administration of antigenic inactivated vaccine. , 1969, American journal of epidemiology.

[4]  B. Murphy,et al.  Live-attenuated virus vaccines for respiratory syncytial and parainfluenza viruses: applications of reverse genetics. , 2002, The Journal of clinical investigation.

[5]  R. Spaete,et al.  Parainfluenza Virus Type 3 Expressing the Native or Soluble Fusion (F) Protein of Respiratory Syncytial Virus (RSV) Confers Protection from RSV Infection in African Green Monkeys , 2004, Journal of Virology.

[6]  R. Karron,et al.  A live human parainfluenza type 3 virus vaccine is attenuated and immunogenic in young infants , 2003, The Pediatric infectious disease journal.

[7]  R. Belshe,et al.  Parenteral administration of live respiratory syncytial virus vaccine: results of a field trial. , 1982, The Journal of infectious diseases.

[8]  G. Meiklejohn,et al.  Respiratory virus immunization. I. A field trial of two inactivated respiratory virus vaccines; an aqueous trivalent parainfluenza virus vaccine and an alum-precipitated respiratory syncytial virus vaccine. , 1969, American journal of epidemiology.

[9]  M. Lebowitz,et al.  Risk factors for respiratory syncytial virus-associated lower respiratory illnesses in the first year of life. , 1991, American journal of epidemiology.

[10]  R. Karron,et al.  The absence of enhanced disease with wild type respiratory syncytial virus infection occurring after receipt of live, attenuated, respiratory syncytial virus vaccines. , 2007, Vaccine.

[11]  B. Murphy,et al.  Evaluation of bovine, cold-adapted human, and wild-type human parainfluenza type 3 viruses in adult volunteers and in chimpanzees , 1991, Journal of clinical microbiology.

[12]  Min-Shi Lee,et al.  Medical Burden of Respiratory Syncytial Virus and Parainfluenza Virus Type 3 Infection Among US Children: Implications for Design of Vaccine Trials , 2005, Human vaccines.

[13]  R. Holman,et al.  Bronchiolitis-associated mortality and estimates of respiratory syncytial virus-associated deaths among US children, 1979-1997. , 2001, The Journal of infectious diseases.

[14]  G. Prince,et al.  Pulmonary lesions in primary respiratory syncytial virus infection, reinfection, and vaccine-enhanced disease in the cotton rat (Sigmodon hispidus). , 1999, Laboratory investigation; a journal of technical methods and pathology.

[15]  E. Walsh,et al.  Enhancement of respiratory syncytial virus pulmonary pathology in cotton rats by prior intramuscular inoculation of formalin-inactiva ted virus , 1986 .

[16]  L. Anderson,et al.  Respiratory synctial virus infection in BALB/c mice previously immunized with formalin-inactivated virus induces enhanced pulmonary inflammatory response with a predominant Th2-like cytokine pattern , 1996, Journal of virology.

[17]  R. Karron,et al.  Evaluation of a live, cold-passaged, temperature-sensitive, respiratory syncytial virus vaccine candidate in infancy. , 2000, The Journal of infectious diseases.

[18]  R. Karron,et al.  Evaluation of two live, cold-passaged, temperature-sensitive respiratory syncytial virus vaccines in chimpanzees and in human adults, infants, and children. , 1997, The Journal of infectious diseases.

[19]  B. Murphy,et al.  Mutations in the C, D, and V open reading frames of human parainfluenza virus type 3 attenuate replication in rodents and primates. , 1999, Virology.

[20]  G. Prince,et al.  Vaccine-enhanced respiratory syncytial virus disease in cotton rats following immunization with Lot 100 or a newly prepared reference vaccine. , 2001, The Journal of general virology.

[21]  B. Graham,et al.  Priming immunization determines T helper cytokine mRNA expression patterns in lungs of mice challenged with respiratory syncytial virus. , 1993, Journal of immunology.

[22]  A. Osterhaus,et al.  Effects of Human Metapneumovirus and Respiratory Syncytial Virus Antigen Insertion in Two 3′ Proximal Genome Positions of Bovine/Human Parainfluenza Virus Type 3 on Virus Replication and Immunogenicity , 2003, Journal of Virology.

[23]  E. H. Lennette,et al.  Field evaluation of a respiratory syncytial virus vaccine and a trivalent parainfluenza virus vaccine in a pediatric population. , 1969, American journal of epidemiology.

[24]  A. A. Haller,et al.  Expression of the Surface Glycoproteins of Human Parainfluenza Virus Type 3 by Bovine Parainfluenza Virus Type 3, a Novel Attenuated Virus Vaccine Vector , 2000, Journal of Virology.

[25]  E. Walsh,et al.  Enhancement of respiratory syncytial virus pulmonary pathology in cotton rats by prior intramuscular inoculation of formalin-inactiva ted virus. , 1986, Journal of virology.

[26]  R. Karron,et al.  A live attenuated bovine parainfluenza virus type 3 vaccine is safe, infectious, immunogenic, and phenotypically stable in infants and children. , 1995, The Journal of infectious diseases.

[27]  R. Karron,et al.  A bovine parainfluenza virus type 3 vaccine is safe and immunogenic in early infancy. , 2005, The Journal of infectious diseases.

[28]  R. Karron,et al.  Progress in the development of respiratory syncytial virus and parainfluenza virus vaccines. , 2003, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[29]  R. Karron,et al.  Identification of a recombinant live attenuated respiratory syncytial virus vaccine candidate that is highly attenuated in infants. , 2005, The Journal of infectious diseases.

[30]  R. Chanock,et al.  An epidemiologic study of altered clinical reactivity to respiratory syncytial (RS) virus infection in children previously vaccinated with an inactivated RS virus vaccine. , 1969, American journal of epidemiology.

[31]  R. Karron,et al.  Evaluation of a live attenuated bovine parainfluenza type 3 vaccine in two- to six-month-old infants. , 1996, The Pediatric infectious disease journal.