AS04

Last updated

Adjuvant System 04 or AS04 is a trade name for a combination of adjuvants used in various vaccine products by GlaxoSmithKline, [1] in particular the Fendrix [2] hepatitis B vaccine and Cervarix [3] human papillomavirus (HPV) vaccine. It consists of aluminium hydroxide and monophosphoryl lipid A (MPL). It is the successor of AS03, a squalene based adjuvant used in H1N1/09 and H5N1 influenza vaccines. [4] [5] [6] [7]

Contents

Efficacy and safety

HPV vaccines

Studies on an AS04-adjuvanted HPV-16/18 vaccine showed a high and sustained immune response to HPV antigens after injection, including in patients receiving subsequent doses. [8] [9] [10] Immune response was enhanced by the MPL component which triggered local NF-kB and cytokine production, leading to increased activation of antigen-presenting cells. [11] Immune response duration was extended by the aluminium hydroxide component. The HPV-16/18 AS04-adjuvanted vaccine showed enhanced efficacy compared to an aluminium salt-adjuvanted formulation, with a higher level of antibodies subsequently detected in the body. [12] Long-term studies appear to show an adequate efficacy and safety profile. [13] [14]

Hepatitis B vaccines

AS04-adjuvanted HBV vaccines may be relevant for patients that are non-responsive to other HBV vaccines, [15] including those with immunodeficiency. [16] [17] [18] [19] [20] [21]

See also

Related Research Articles

A cancer vaccine is a vaccine that either treats existing cancer or prevents development of cancer. Vaccines that treat existing cancer are known as therapeutic cancer vaccines or tumor antigen vaccines. Some of the vaccines are "autologous", being prepared from samples taken from the patient, and are specific to that patient.

Virus-like particles (VLPs) are molecules that closely resemble viruses, but are non-infectious because they contain no viral genetic material. They can be naturally occurring or synthesized through the individual expression of viral structural proteins, which can then self assemble into the virus-like structure. Combinations of structural capsid proteins from different viruses can be used to create recombinant VLPs. Both in-vivo assembly and in-vitro assembly have been successfully shown to form virus-like particles. VLPs derived from the Hepatitis B virus (HBV) and composed of the small HBV derived surface antigen (HBsAg) were described in 1968 from patient sera. VLPs have been produced from components of a wide variety of virus families including Parvoviridae, Retroviridae, Flaviviridae, Paramyxoviridae and bacteriophages. VLPs can be produced in multiple cell culture systems including bacteria, mammalian cell lines, insect cell lines, yeast and plant cells.

<span class="mw-page-title-main">HPV vaccine</span> Class of vaccines against human papillomavirus

Human papillomavirus (HPV) vaccines are vaccines that prevent infection by certain types of human papillomavirus (HPV). Available HPV vaccines protect against either two, four, or nine types of HPV. All HPV vaccines protect against at least HPV types 16 and 18, which cause the greatest risk of cervical cancer. It is estimated that HPV vaccines may prevent 70% of cervical cancer, 80% of anal cancer, 60% of vaginal cancer, 40% of vulvar cancer, and show more than 90% efficacy in preventing HPV-positive oropharyngeal cancers. They additionally prevent some genital warts, with the quadrivalent and nonavalent vaccines that protect against HPV types HPV-6 and HPV-11 providing greater protection.

Neal A. Halsey is an American pediatrician, with sub-specialty training in infectious diseases, international health and epidemiology. Halsey is a professor emeritus of international health and director emeritus of the Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland. He had a joint appointment in the Department of Pediatrics at the Johns Hopkins School of Medicine and serves as co-director of the Center for Disease Studies and Control in Guatemala.

Cervarix is a vaccine against certain types of cancer-causing human papillomavirus (HPV).

In immunology, an adjuvant is a substance that increases or modulates the immune response to a vaccine. The word "adjuvant" comes from the Latin word adiuvare, meaning to help or aid. "An immunologic adjuvant is defined as any substance that acts to accelerate, prolong, or enhance antigen-specific immune responses when used in combination with specific vaccine antigens."

<span class="mw-page-title-main">Hepatitis B vaccine</span> Vaccine against hepatitis B

Hepatitis B vaccine is a vaccine that prevents hepatitis B. The first dose is recommended within 24 hours of birth with either two or three more doses given after that. This includes those with poor immune function such as from HIV/AIDS and those born premature. It is also recommended that health-care workers be vaccinated. In healthy people, routine immunization results in more than 95% of people being protected.

<span class="mw-page-title-main">Nventa Biopharmaceuticals Corporation</span> Canadian healthcare company

Nventa Biopharmaceuticals Corporation was a Canadian-incorporated biopharmaceutical company headquartered in San Diego, California developing therapeutics for the treatment of viral infections and cancer, focusing on diseases caused by human papillomavirus (HPV). Nventa is currently the only company applying heat shock protein (Hsp) technology to target the over 20 million Americans already infected with HPV. Previously headquartered in Victoria, British Columbia, Canada, the company’s common stock traded on the Toronto Stock Exchange under the symbol: NVN.

HspE7 is an investigational therapeutic vaccine candidate being developed by Nventa Biopharmaceuticals for the treatment of precancerous and cancerous lesions caused by the human papillomavirus (HPV). HspE7 uses recombinant DNA technology to covalently fuse a heat shock protein (Hsp) to a target antigen, thereby stimulating cellular immune system responses to specific diseases. HspE7 is a patented construct consisting of the HPV Type 16 E7 protein and heat shock protein 65 (Hsp65) and is currently the only candidate using Hsp technology to target the over 20 million Americans already infected with HPV.

Immune stimulating complexes (ISCOMs) are spherical open cage-like structures (typically 40 nm in diameter) that are spontaneously formed when mixing together cholesterol, phospholipids and Quillaja saponins under a specific stoichiometry. The complex displays immune stimulating properties and is thus mainly used as a vaccine adjuvant in order to induce a stronger immune response and longer protection. A specific adjuvant based on ISCOM technology is Matrix-M.

A hepatitis C vaccine, a vaccine capable of protecting against the hepatitis C virus (HCV), is not yet available. Although vaccines exist for hepatitis A and hepatitis B, development of an HCV vaccine has presented challenges. No vaccine is currently available, but several vaccines are currently under development.

A subunit vaccine is a vaccine that contains purified parts of the pathogen that are antigenic, or necessary to elicit a protective immune response. Subunit vaccine can be made from dissembled viral particles in cell culture or recombinant DNA expression, in which case it is a recombinant subunit vaccine.

<i>Hepatitis B virus</i> Species of the genus Orthohepadnavirus

Hepatitis B virus (HBV) is a partially double-stranded DNA virus, a species of the genus Orthohepadnavirus and a member of the Hepadnaviridae family of viruses. This virus causes the disease hepatitis B.

<span class="mw-page-title-main">HPV-positive oropharyngeal cancer</span> Cancer of the throat

Human papillomavirus-positive oropharyngeal cancer, is a cancer of the throat caused by the human papillomavirus type 16 virus (HPV16). In the past, cancer of the oropharynx (throat) was associated with the use of alcohol or tobacco or both, but the majority of cases are now associated with the HPV virus, acquired by having oral contact with the genitals of a person who has a genital HPV infection. Risk factors include having a large number of sexual partners, a history of oral-genital sex or anal–oral sex, having a female partner with a history of either an abnormal Pap smear or cervical dysplasia, having chronic periodontitis, and, among men, younger age at first intercourse and a history of genital warts. HPV-positive OPC is considered a separate disease from HPV-negative oropharyngeal cancer.

Peptide-based synthetic vaccines are subunit vaccines made from peptides. The peptides mimic the epitopes of the antigen that triggers direct or potent immune responses. Peptide vaccines can not only induce protection against infectious pathogens and non-infectious diseases but also be utilized as therapeutic cancer vaccines, where peptides from tumor-associated antigens are used to induce an effective anti-tumor T-cell response.

Christopher Ariel Shaw is a Canadian neuroscientist and professor of ophthalmology at the University of British Columbia.

<span class="mw-page-title-main">Vaccine ingredients</span> Ingredients used in a vaccine dose

A vaccine dose contains many ingredients very little of which is the active ingredient, the immunogen. A single dose may have merely nanograms of virus particles, or micrograms of bacterial polysaccharides. A vaccine injection, oral drops or nasal spray is mostly water. Other ingredients are added to boost the immune response, to ensure safety or help with storage, and a tiny amount of material is left-over from the manufacturing process. Very rarely, these materials can cause an allergic reaction in people who are very sensitive to them.

<span class="mw-page-title-main">CoVLP</span> COVID-19 vaccine candidate produced in a plant

CoVLP was a COVID-19 vaccine developed by Medicago in Canada and GlaxoSmithKline (GSK). The product and Medicago, Inc. were owned by Mitsubishi who terminated the company and program in February 2023 due to high international market competition for COVID-19 vaccines.

<span class="mw-page-title-main">SCB-2019</span> Vaccine candidate against COVID-19

SCB-2019 is a protein subunit COVID-19 vaccine developed by Clover Biopharmaceuticals using an adjuvant from Dynavax technologies. Positive results of Phase I trials for the vaccine were published in The Lancet and the vaccine completed enrollment of 29,000 participants in Phase II/III trials in July 2021. In September 2021, SCB-2019 announced Phase III results showing 67% efficacy against all cases of COVID-19 and 79% efficacy against all cases of the Delta variant. Additionally, the vaccine was 84% effective against moderate cases and 100% effective against hospitalization.

<span class="mw-page-title-main">MVC COVID-19 vaccine</span> Vaccine against COVID-19

The MVC COVID-19 vaccine, designated MVC-COV1901 and also known as the Medigen COVID-19 vaccine, is a protein subunit COVID-19 vaccine developed by Medigen Vaccine Biologics Corporation in Taiwan, American company Dynavax Technologies, and the U.S. National Institutes of Health.

References

  1. "Vaccine Adjuvant System Technology Background Information" (PDF). Archived from the original (PDF) on 2009-01-05.
  2. "Products | GSKpro". Archived from the original on 2013-03-04.
  3. "Products | GSKpro". Archived from the original on 2009-05-29.
  4. Ellis, Ronald W.; Rappuoli, Rino; Ahmed, Sohail (2013). "Technologies for making new vaccines". In Plotkin, Stanley A.; Orenstein, Walter A.; Offit, Paul A. (eds.). Vaccines (Sixth ed.). W.B. Saunders. pp. 1182–1199. doi:10.1016/B978-1-4557-0090-5.00013-6. ISBN   9781455700905.
  5. Garçon, Nathalie; Van Mechelen, Marcelle; Wettendorff, Martine (2006). "Development and evaluation of AS04, a novel and improved adjuvant system containing MPL and aluminum salt". Immunopotentiators in Modern Vaccines. pp. 161–177. doi:10.1016/B978-012088403-2/50011-3. ISBN   9780120884032.
  6. Laupèze, Béatrice; Hervé, Caroline; Di Pasquale, Alberta; Tavares Da Silva, Fernanda (2019). "Adjuvant Systems for vaccines: 13 years of post-licensure experience in diverse populations have progressed the way adjuvanted vaccine safety is investigated and understood". Vaccine. 37 (38): 5670–5680. doi: 10.1016/j.vaccine.2019.07.098 . PMID   31420171. S2CID   201042219.
  7. Garçon, N.; Di Pasquale, A. (2016). "From discovery to licensure, the Adjuvant System story". Human Vaccines & Immunotherapeutics. 13 (1): 19–33. doi:10.1080/21645515.2016.1225635. PMC   5287309 . PMID   27636098.
  8. Garçon, N.; Morel, S.; Didierlaurent, A.; Descamps, D.; Wettendorff, M.; Van Mechelen, M. (2011). "Development of an AS04-adjuvanted HPV vaccine with the adjuvant system approach". BioDrugs. 25 (4): 217–226. doi: 10.2165/11591760-000000000-00000 . PMID   21815697. S2CID   25608550.
  9. Keam, Susan J.; Harper, Diane M. (2008). "Human Papillomavirus Types 16 and 18 Vaccine (Recombinant, AS04 Adjuvanted, Adsorbed (Cervarix))". Drugs. 68 (3): 359–372. doi:10.2165/00003495-200868030-00007. PMID   18257611. S2CID   39629514.
  10. Schwarz, Tino F.; Spaczynski, Marek; Schneider, Achim; Wysocki, Jacek; Galaj, Andrzej; Perona, Pamela; Poncelet, Sylviane; Zahaf, Toufik; Hardt, Karin; Descamps, Dominique; Dubin, Gary; HPV Study Group for Adult Women (2009). "Immunogenicity and tolerability of an HPV-16/18 AS04-adjuvanted prophylactic cervical cancer vaccine in women aged 15–55 years". Vaccine. 27 (4): 581–587. doi:10.1016/j.vaccine.2008.10.088. PMID   19022320.
  11. Didierlaurent, Arnaud M.; Morel, Sandra; Lockman, Laurence; Giannini, Sandra L.; Bisteau, Michel; Carlsen, Harald; Kielland, Anders; Vosters, Olivier; Vanderheyde, Nathalie; Schiavetti, Francesca; Larocque, Daniel (2009-11-15). "AS04, an Aluminum Salt- and TLR4 Agonist-Based Adjuvant System, Induces a Transient Localized Innate Immune Response Leading to Enhanced Adaptive Immunity". The Journal of Immunology. 183 (10): 6186–6197. doi: 10.4049/jimmunol.0901474 . ISSN   0022-1767. PMID   19864596.
  12. Giannini, S.; Hanon, E.; Moris, P.; Vanmechelen, M.; Morel, S.; Dessy, F.; Fourneau, M.; Colau, B.; Suzich, J.; Losonksy, G.; Martin, M. T.; Dubin, G.; Wettendorff, M. A. (2006). "Enhanced humoral and memory B cellular immunity using HPV16/18 L1 VLP vaccine formulated with the MPL/Aluminium salt combination (AS04) compared to aluminium salt only". Vaccine. 24 (33–34): 5937–5949. doi: 10.1016/j.vaccine.2006.06.005 . PMID   16828940.
  13. Bi, Dan; Apter, Dan; Eriksson, Tiina; Hokkanen, Mari; Zima, Julia; Damaso, Silvia; Soila, Maaria; Dubin, Gary; Lehtinen, Matti; Struyf, Frank (2020). "Safety of the AS04-adjuvanted human papillomavirus (HPV)-16/18 vaccine in adolescents aged 12–15 years: End-of-study results from a community-randomized study up to 6.5 years". Human Vaccines & Immunotherapeutics. 16 (6): 1392–1403. doi:10.1080/21645515.2019.1692557. PMC   7482795 . PMID   31829767. S2CID   209341449.
  14. GlaxoSmithKline Vaccine HPV-007 Study Group; et al. (2009). "Sustained efficacy and immunogenicity of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine: Analysis of a randomised placebo-controlled trial up to 6·4 years". The Lancet. 374 (9706): 1975–1985. doi:10.1016/S0140-6736(09)61567-1. PMID   19962185. S2CID   30776042.{{cite journal}}: CS1 maint: numeric names: authors list (link)
  15. Tejada-Pérez, Juan José; Vázquez-Vicente, Juan José; Herrera-Burgos, María Renée; Martín-Martín, Francisco Gabriel; Parrón-Carreño, Tesifón; Alarcón-Rodríguez, Raquel (2021). "Fendrix® Vaccine Effectiveness in Healthcare Workers Who Are Non-Responsive to Engerix B® Vaccination". Vaccines. 9 (3): 279. doi: 10.3390/vaccines9030279 . PMC   8003400 . PMID   33808589.
  16. Machiels, Julian D.; Braam, Esmée E.; Van Bentum, Petra; Van Vugt, Michèle; De Vries-Sluijs, Theodora E.M.S.; Schouten, Ineke W.E.M.; Bierman, Wouter F.W.; Gisolf, Elisabeth H. (2019). "Vaccination with Fendrix of prior nonresponding patients with HIV has a high success rate". AIDS. 33 (3): 503–507. doi: 10.1097/QAD.0000000000002085 . PMID   30702518. S2CID   73414009.
  17. Horta, D.; Forné, M.; Agustí, A.; Raga, A.; Martín-Cardona, A.; Hernández-Soto, J. M.; Ruiz-Ramírez, P.; Esteve-Comas, M. (2022). "Efficacy of Hepatitis B Virus Vaccines HBVaxpro40© and Fendrix© in Patients with Chronic Liver Disease in Clinical Practice". Vaccines. 10 (8): 1323. doi: 10.3390/vaccines10081323 . PMC   9416157 . PMID   36016211.
  18. Chiew Tong, Norella Kong; Beran, Jiri; Kee, Swee Ann; Miguel, Jose Luisa; Sannchez, Carmen; Bayas, Jose Maria; Vilella, A.; De Juanes, J.R.; Arrazola, P.; Calbo-Torrecillas, Francisco; De Novales, Eduardo Lapez; Hamtiaux, Virginie; Lievens, Marc; Stoffel, Michel (2005). "Immunogenicity and safety of an adjuvanted hepatitis B vaccine in pre-hemodialysis and hemodialysis patients". Kidney International. 68 (5): 2298–2303. doi: 10.1111/j.1523-1755.2005.00689.x . PMID   16221232. S2CID   25535605.
  19. Fabrizi, Fabrizio; Cerutti, Roberta; Nardelli, Luca; Tripodi, Federica; Messa, Piergiorgio (2020). "HBV vaccination with Fendrix is effective and safe in pre-dialysis CKD population". Clinics and Research in Hepatology and Gastroenterology. 44 (1): 49–56. doi:10.1016/j.clinre.2019.06.010. hdl: 2434/672871 . PMID   31327620. S2CID   198135022.
  20. Fabrizi, Fabrizio; Cerutti, Roberta; Garcia-Agudo, Rebeca; Bellincioni, Cecilia; Porata, Giulia; Frontini, Giulia; Aoufi-Rabih, Sami; Messa, Piergiorgio (2020). "Adjuvanted recombinant HBV vaccine (HBV-AS04) is effective over extended follow-up in dialysis population. An open-label non randomized trial". Clinics and Research in Hepatology and Gastroenterology. 44 (6): 905–912. doi:10.1016/j.clinre.2020.01.010. PMID   32144074. S2CID   212622741.
  21. Fabrizi, Fabrizio; Tarantino, Antonio; Castelnovo, Claudia; Martin, Paul; Messa, Piergiorgio (2015). "Recombinant Hepatitis B Vaccine Adjuvanted with AS04 in Dialysis Patients: A Prospective Cohort Study". Kidney and Blood Pressure Research. 40 (6): 584–592. doi:10.1159/000368534. hdl: 2434/588627 . PMID   26566033. S2CID   207555753.