Mucosal Immunity induced by VLPs

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Virus-like paticles (VLPs) as vaccines, vectors and adjuvants, Fondation Mérieux, Annecy, 04 Mucosal Immunity induced by VLPs Denise Nardelli-Haefliger Lausanne University Hospital, Switzerland

Purified Human Papillomavirus Virus-like particles = VLPs as SUBUNIT Vaccines HPV6 VLPs purified from insect cells infected with a HPV6 L recombinant baculovirus Antibody responses Mice:- mucosal immunization routes - adjuvant - recombinant bacteria Women: - antibody in genital secretions - mucosal routes

Induction of mucosal immune responses upon mucosal immunization B cell

Induction of mucosal immune responses upon mucosal immunization Compartimentalization pending the route of immunization Oral Nasal Rectal Vaginal

Antobody isotypes in different mucosal secretions

Immunization routes - Subcutaneous - Rectal - Vaginal - Nasal - Aerosol-like (inhaled) - Oral -Serum -Genital secretions -Saliva -Feces

Normalized IgG titers (log 0 ) Normalized IgA titers (log 0 ) IgG Titer (log 0 ) Serum anti-hpv6vlp IgG week 8 5 Mucosal immunization of mice and Anti-VLP antibodies 4 Rectal Vaginal Oral Aerosol Nasal s.c. Genital anti HPV6 VLP IgG 4 week 8 4 Genital anti HPV6 VLP IgA week 8 0 0 Rectal Vaginal Oral Aerosol Nasal s.c. Rectal Vaginal Oral Aerosol Nasal s.c. x 5ug VLP weeks 0,,

- Nasal - Aerosol-like NALT.. and swallowed (oral) NALT + inhaled and swallowed (oral Efficient VLP presentation in Tracheobronchial Lymph nodes Balmelli et al. J. Virol. 00

log 0 titers in U/mg of total IgG log 0 titers in U/mg of total IgA log 0 titers log 0 titers Aerosol and nasal vaccination of mice with HPV6 VLPs and mucosal adjuvants Serum anti-hpv6 VLP IgG titers *** 6 5 4 ** 5 4 + CT + HLT + HLT + CpG + CpG Aerosol-like Nasal Aerosol-like Nasal Vaginal anti-hpv6 VLP IgG titers Vaginal anti-hpv6 VLP IgA titers CT : cholera toxin an efficient but toxic mucosal adjuvant 4 *** 4 ** *** HLT : a natural non-toxic E. coli heat labile enterotoxin CpG: a TLR-9 agonist can act as + CT + HLT + HLT + CT + HLT Aerosol-like Nasal Aerosol-like Nasal + HLT systemic and mucosal adjuvant

IgG Titer (Log 0 ) Mucosal vaccination of mice with HPV6 VLPs and CT Serum anti-hpv6 VLP IgG titers week 8 6 5 4 CT : cholera toxin an efficient but toxic mucosal adjuvant Rectal Vaginal Oral Aerosol Rectal Vaginal Oral Aerosol

Normalized IgG titers (log 0 ) IgG Titer (log 0 ) IgG Titer (log 0 ) Rectal and vaginal vaccination of mice with adjuvanted HPV6 VLPs Rectal immunization Serum anti-hpv6 VLP IgG Vaginal immunization Serum anti-hpv6 VLP IgG 5 CT : cholera toxin an efficient but toxic mucosal 4 4 adjuvant (5mg) IM: Immiquimod a TLR 7 agonist (5%, 500mg) CT IM RS MPL Genital anti-hpv6 VLP 4 IgG IgA CT IM RS MPL N9 4 Genital anti-hpv6 VLP IgG IgA RS: Resiquimod a TLR 7/8 agonist (75mg) MPL: monophosphoryl lipid A (Salmonella) a TLR4 agonist (from GSK, 0mg) N9: nonoxynol-9, a known 0 CT IM RS MPL CT IM RS MPL 0 disrupter of vaginal epithelium (4%)

Normalized IgG + IgA titers (log 0 ) Normalized IgG + IgA titers (log 0 ) Induction of anti-hpv6 VLPs in Feces and Saliva FECES anti-hpv6 VLP IgA + IgG SALIVA anti-hpv6 VLP IgG + IgA 4 4 0 0 CT RS CT CT rectal aerosol oral CT RS CT aerosol rectal oral

Secreted Alkaline Phosphatase (SEAP) HPV Pseudovirus In Vitro Neutralization Assay Gold Standard for Quantitating Potentially Protective VLP Abs SEAP SV40 Ori Y Neutralizing Antibodies Y SEAP SV40 Ori Infection Genome Amplifies & Transcribes T Ag 9TT Cells in 96-well plate X T Ag No Infection SEAP SEAP SEAP SEAP SEAP Days No SEAP Collect Sups and Assay Alkaline Phosphatase D. Pastrana et al Virol 004; :05-6

Neutralizing Titer (log 0 ) HPV6 neutralizing titers in genital secretions Aer+CT R+CT Aer R+RS Vag+N9 x SC

Antobody in genital secretions vary along the estrus cycle s.c. immunization on MICE Aerosol like immunization in MICE anti-hpv6 IgG titers genital secretions anti-hpv6 IgG + IgA titers ovulation ovulation

Purified Human papillomavirus Virus-like particles = VLPs as SUBUNIT Vaccines HPV6 VLPs purified from insect cells infected with a HPV6 L recombinant baculovirus GMP preparations available for clinical trial through the National Cancer Institute of the NIH, USA Drs. John Schiller and Douglas Lowy

Anti-HPV6 VLPs IgG in cervical secretion of women i.m. vaccinated with purified HPV6 VLPs (from NCI/NIH-Novavax) IgG titer IgG titer wo w4 w8 w9 w9.5 w0 w0.5 w w.5 w w.5 w w.5 : sampling of serum and cervical secretions group I : women under oral contraception : 50mg HPV6 VLP group II: ovulating women anti-hpv6 VLPs IgG titers in cervical secretion 0000 0000 000 000 All women had detectable specific IgG in their cervical secretions 00 0 0 5 0 5 0 5 Days of contraceptive cycle 00 0-0 -0 0 0 0 Days before and after ovulation High variations throughout ovulating cycles (9-fold decrease during ovulation) Nardelli Haefliger et al. J.Natl. Cancer Inst. 00

Anti-HPV6 VLPs IgG in cervical secretion of women i.m. vaccinated with purified HPV6 VLPs (NCI/NIH-Novavax) Women under oral contraception Women during ovulation 0. 0. 0. 0.0 p=0.0008 Specific IgG titers in cervical secretions represent - 0 % of the serum titers (women under contraception). During ovulation, specific IgG are lower than those in women under oral contraception However very low Antibody levels are sufficient to afford protection i.e. full protection since 8.5 years.

In a PsV Vaginal Challenge Assay: sera with undetectable neutralizing antibodies provided protection Gardasil Intramuscular Sera: 4hours 0, 4, 8 wks Luciferase Intravaginal HPV6PsV luc 48 hours Ivag Luciferin Control Protected mice Longet et al, 0

Needle free administration in female volunteers? - Nasal - Aerosol-like NALT.. and swallowed (oral) NALT + inhaled and swallowed (oral Efficient VLP presentation in Tracheobronchial Lymph nodes Balmelli et al. J. Virol. 00

Nasal and aerosol immunization in female volunteers wo w w.5 w6 w8 Safety and immunogenicity of nasal spray or aerosol vaccination with purified HPV6 VLP (NCI/NIH-Novavax) was examined : group I= mg HPV6 VLP group II = 50mg HPV6 VLP group III = 50mg HPV6 VLP nasal spray (De Vilbis) aerosol (Nebulizer) Nardelli -Haefliger et al. Vaccine 005

Anti-HPV6 VLPIgs in U/mg of total Igs Anti-HPV6 VLP IgG and IgA in cervical secretions 000 IgG 000 IgA 00 00 0 0 0. Nasal Aerosol Nasal Aerosol Nardelli -Haefliger et al. Vaccine 005 aerosol vaccination may represent an alternative to i.m. injections. Need further optimalization Raise security concerns (inflammation, allergies..?)

SALMONELLA/HPV6 VLP prophylactic vaccine Vaccination HPV DNA L gene Salmonella Plasmid

VLP assembly in the bacteria? HPV6 VLP in attenuated Salmonella PhoPc HPV6 VLP subunits/capsomeres) in vaccine strain Tya Nardelli-Haefliger et al. 997 00 nm Fraillery et al. 007

Combined Vaccines HPV6/8/typhoïde Pre-clinical results in a murine model: HPV6 neutralizing Ab in genital secretions HPV8 neutralizing Ab in genital secretions.5 0.5 0 Tya/ HPV6 Vaccin VLP 6 x injections i.m..5 0.5 0 Tya/ HPV8 Phase I trial with oral doses (d0, d, d4 with TyHPV6 + Ty HPV8) under preparation in India (Indian immunological ltd)

Conclusion In MICE: - HPV VLPs alone are highly immunogenic by aerosol immunization - efficient antibody responses in genital and oral secretions - CT/HLT but not CpG are efficient adjuvant for nasal/aerosol immunization - Rectal immunization can be adjuvanted by TLR7/8 agonist - Vaginal immunization used with 4% N9 lead to efficient antibody responses - HPV VLP can assemble/expose neutralizing immunogenic epitopes in Salmonella for oral vaccine - In HUMAN - Aerosol immunization is effective - Systemic immunization lead to transudating IgG in genital secretions that vary along the estrus cycle

Dr. Schiller J. Dr. Lowy D. National Cancer Inst.-NIH Washington USA Dr. J. Benyacoub Dr. C. Balmelli Dr. D. Baud Dr. D. Fraillery Dr. V. Revaz Dr. D. Wirthner Dr. F. Lurati Dr. F. Spertini Dr. P. DeGrandi ONCOSUISSE