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Regulatory considerations for Campylobacter vaccine development.

The high, worldwide incidence of Campylobacter jejuni-associated diarrheal disease has recently prompted the development of anti-Campylobacter vaccines. However, the association of C. jejuni infections with subsequent development of Guillain-Barré syndrome has increased concerns from a pathogenesis standpoint and from a vaccine development and regulation standpoint. This brief overview describes the purpose and process of Food and Drug Administration review of vaccine products and highlights some important considerations pertinent to Campylobacter vaccine development.

Bacterial Vaccines↗

New approaches in vaccine development for parasitic infections.

Vaccines have had a tremendous impact on the control of infectious diseases. Not only are vaccines potentially the least expensive mechanism to combat infectious diseases, under optimal conditions, widespread vaccination can result in disease eradication - as in the case of smallpox. Despite this great potential, vaccines have had little impact on human parasitic infections. The reasons for this are many - these eukaryotic pathogens are genetically and biologically complex organisms, some with elaborate life cycles and well-honed immune evasion mechanisms. Additionally, our understanding of the mechanisms of immune control of many parasitic infections -- of what constitutes an effective immune response and of how to induce high-quality immunological memory -- is not fully developed. This review attempts to highlight recent advances that could impact vaccine discovery and development in parasitic infections and proposes areas where future studies may lead to breakthroughs in vaccines for the agents of parasitic diseases. There are several other recent reviews highlighting the results of vaccine trials, specifically in the malaria field.

Animals↗

Molecular analysis of the virulence determinants of enterotoxigenic Escherichia coli isolated from domestic animals: applications for vaccine development.

Enterotoxigenic strains of Escherichia coli are an important cause of diarrhoeal disease in young farm animals. Several virulence determinants have been shown to play a major role in the pathogenicity of these strains. The molecular structure of some of these determinants including adhesion fimbriae, heat-labile toxins and heat-stable toxins have been elucidated. This knowledge has made possible the development of novel vaccines effective against enterotoxigenic strains. In this short review, the structure of these virulence factors will be described and the implications for the development of future vaccines will be discussed.

Adhesiveness↗

Tuberculosis vaccine development.

If the end of the 20th century saw the flowering of genomics, the beginning of the 21st century is witnessing an equally rapid blossoming of proteomics. These twin technologies have had a dramatic influence on the study of tuberculosis (TB), and nowhere more so than in the development of new TB vaccines. Only a few years ago, it was generally accepted that clinical trials of new TB vaccines would not take place for at least a decade. However, the first trials are now scheduled to start within months. Much TB vaccine research has thus shifted from developing new vaccines, to selecting the best vaccines for human use from the increasing number of effective new candidates becoming available. This selection is being eased by the improved animal models that have been developed over the past few years and by our increasing understanding of immunity to TB.

Animals↗

A short review of biotechnological methods of relevance to modern vaccine development.

The development of new methods and techniques in biotechnology over the last two decades has opened the way for fresh strategies to develop new and better vaccines. The relevant techniques have been developed through important discoveries in immunology, gene technology and polymer chemistry. The purpose of this short review is to discuss these techniques in the light of vaccine development, without going into details regarding each specific disease and vaccine.

Biotechnology↗

Schistosomiasis vaccine development--the current picture.

Development of a vaccine for schistosomiasis, a parasitic disease currently affecting over 200 million people worldwide, has been targeted as a priority by the World Health Organisation. Research demonstrating the ability of humans to acquire natural immunity to schistosome infection, together with the successful use of attenuated vaccines in animals both under laboratory and field conditions, suggest that development of a human vaccine is feasible. Attenuated vaccines for schistosomiasis are considered neither safe nor practicable for human use, however, and therefore other approaches must be considered. This review examines progress currently being undertaken in a number of different areas towards achieving the goal of a safe and effective human vaccine for schistosomiasis.

Animals↗

PEPVAC: a web server for multi-epitope vaccine development based on the prediction of supertypic MHC ligands.

Prediction of peptide binding to major histocompatibility complex (MHC) molecules is a basis for anticipating T-cell epitopes, as well as epitope discovery-driven vaccine development. In the human, MHC molecules are known as human leukocyte antigens (HLAs) and are extremely polymorphic. HLA polymorphism is the basis of differential peptide binding, until now limiting the practical use of current epitope-prediction tools for vaccine development. Here, we describe a web server, PEPVAC (Promiscuous EPitope-based VACcine), optimized for the formulation of multi-epitope vaccines with broad population coverage. This optimization is accomplished through the prediction of peptides that bind to several HLA molecules with similar peptide-binding specificity (supertypes). Specifically, we offer the possibility of identifying promiscuous peptide binders to five distinct HLA class I supertypes (A2, A3, B7, A24 and B15). We estimated the phenotypic population frequency of these supertypes to be 95%, regardless of ethnicity. Targeting these supertypes for promiscuous peptide-binding predictions results in a limited number of potential epitopes without compromising the population coverage required for practical vaccine design considerations. PEPVAC can also identify conserved MHC ligands, as well as those with a C-terminus resulting from proteasomal cleavage. The combination of these features with the prediction of promiscuous HLA class I ligands further limits the number of potential epitopes. The PEPVAC server is hosted by the Dana-Farber Cancer Institute at the site http://immunax.dfci.harvard.edu/PEPVAC/.

Epitopes, T-Lymphocyte↗

The current status of typhoid vaccine development and clinical trials with typhoid vaccines.

The killed whole cell typhoid vaccines, although protective, have limited usefulness because of the adverse reactions they evoke. In contrast, new typhoid vaccines protect without reactogenicity. Attenuated oral vaccine Ty2la has been evaluated in field trials of efficacy in Santiago, Chile. Three doses of Ty2la in an enteric-coated formulation given within one week provided 69% efficacy for at least four years. Ty2la has reached the stage of being a practical public health tool. Two double auxotrophic (Aro-, Pur-) mutant strains of S. typhi (541Ty and 543Ty) were well-tolerated and stimulated cell-mediated immune responses but evoked little serological response. Parenteral purified Vi polysaccharide of S. typhi (single 25 mcg dose) was safe and immunogenic and provided 64-72% protection (for at least 17-21 months) in controlled field trials in Nepal and South Africa.

Adult↗

Toward a vaccine for AIDS: the emergence of immunobiology-based vaccine development.

Over a decade has passed since the identification of the human immunodeficiency virus (HIV) as the causative agent of AIDS. During this time, HIV has been extensively characterized, and a variety of vaccine constructs and strategies have been explored. For the most part, these have been driven by successes of the past with other pathogens, or by novel approaches enabled by technologies of the present. With the maturing of our insights into the immunopathology of HIV and basic immunological mechanisms, we are presented with unprecedented opportunities to rationally develop vaccine approaches strategically designed to counter the immunopathology of HIV. As opposed to absolute prevention of infection, the primary goal of these strategies may be to limit infection and to assure a response to infection that prevents disease and transmission. Thus, such vaccines may find utility in both preventive and therapeutic roles. In this paper, we present the background and current state of immunobiology-driven vaccine development for AIDS.

AIDS Vaccines↗

Drug and vaccine development.

Some of the activities in chemotherapeutic research and vaccine development which WHO has initiated, participated, coordinated or funded are reviewed. WHO has interests in research, particularly, although by means exclusively, in all the communicable diseases and in applied vaccinology. Examples are given from various fields including progress in human trials of anti-sporozoite vaccines in malaria due to Plasmodium falciparum, chemotherapeutic studies on artemisine and halofantrine, pragmatic and systemic approaches to vaccination in leishmaniasis, recent work on the chemotherapy of leishmanial infections, African leishmaniasis and Chagas' disease, the anticipated impact of ivermectin in onchocerciasis control, studies on new macro- and microfilaricides, progress in the diarrhoeal diseases control programme, and the control of taeniasis/cysticercosis, ascariasis and hookworm through different delivery systems using population-based chemotherapy.

Animals↗