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INTRODUCTION. Vaccination is recognised as the only effective method for preventing rotavirus disease. Rotavirus remains a leading cause of death in young children, mainly, in developing countries. Currently, oral rotavirus vaccines for infant immunisation are available worldwide, and novel types of rotavirus vaccines are also under development, in particular, in the Russian Federation. However, there are no regulations or guidelines helping developers to design an optimal preclinical and clinical programme for rotavirus vaccines.AIM. This study aimed to analyse and summarise global experience in planning and conducting preclinical and clinical studies of rotavirus vaccines in order to provide recommendations for national vaccine developers.DISCUSSION. This study presents an analysis of the available data (and, specifically, the data obtained for the past five years) on all rotavirus vaccines used in the world that have been clinically proven to be effective in preventing severe rotavirus gastroenteritis and reducing the number of hospital admissions due to acute intestinal infections. The effectiveness of rotavirus vaccines varies in different regions of the world and may be lower in developing countries for various reasons. The safety profile of oral rotavirus vaccines is generally considered favourable. Nevertheless, there are still some concerns regarding intestinal intussusception in infants following vaccination. To address the abovementioned problems, researchers, including those in Russia, are developing novel types of rotavirus vaccines, predominantly focusing on inactivated (subunit or recombinant) preparations. For planning and conducting preclinical studies of a rotavirus vaccine, it is advisable to adopt general approaches that involve assessing the acute and chronic toxicity, immunogenicity, and safety pharmacology of the rotavirus vaccine and the virus-neutralising activity of vaccination-induced antibodies. Clinical trials of a rotavirus vaccine should assess its effectiveness in preventing rotavirus gastroenteritis of any severity, hospitalisation, and acute viral intestinal infections of any aetiology in the target age group of young children. Furthermore, it is important to confirm the safety of the rotavirus vaccine and demonstrate the absence of mutual interference with the immunogenicity of the rotavirus vaccine and other vaccines co-administered in the vaccination schedule.CONCLUSIONS. Preclinical studies of rotavirus vaccines may use standard and generally accepted approaches. However, planning and conducting clinical trials requires specific considerations associated with both the nature of rotavirus infection and the national infant vaccination schedule.
INTRODUCTION. Vaccination is recognised as the only effective method for preventing rotavirus disease. Rotavirus remains a leading cause of death in young children, mainly, in developing countries. Currently, oral rotavirus vaccines for infant immunisation are available worldwide, and novel types of rotavirus vaccines are also under development, in particular, in the Russian Federation. However, there are no regulations or guidelines helping developers to design an optimal preclinical and clinical programme for rotavirus vaccines.AIM. This study aimed to analyse and summarise global experience in planning and conducting preclinical and clinical studies of rotavirus vaccines in order to provide recommendations for national vaccine developers.DISCUSSION. This study presents an analysis of the available data (and, specifically, the data obtained for the past five years) on all rotavirus vaccines used in the world that have been clinically proven to be effective in preventing severe rotavirus gastroenteritis and reducing the number of hospital admissions due to acute intestinal infections. The effectiveness of rotavirus vaccines varies in different regions of the world and may be lower in developing countries for various reasons. The safety profile of oral rotavirus vaccines is generally considered favourable. Nevertheless, there are still some concerns regarding intestinal intussusception in infants following vaccination. To address the abovementioned problems, researchers, including those in Russia, are developing novel types of rotavirus vaccines, predominantly focusing on inactivated (subunit or recombinant) preparations. For planning and conducting preclinical studies of a rotavirus vaccine, it is advisable to adopt general approaches that involve assessing the acute and chronic toxicity, immunogenicity, and safety pharmacology of the rotavirus vaccine and the virus-neutralising activity of vaccination-induced antibodies. Clinical trials of a rotavirus vaccine should assess its effectiveness in preventing rotavirus gastroenteritis of any severity, hospitalisation, and acute viral intestinal infections of any aetiology in the target age group of young children. Furthermore, it is important to confirm the safety of the rotavirus vaccine and demonstrate the absence of mutual interference with the immunogenicity of the rotavirus vaccine and other vaccines co-administered in the vaccination schedule.CONCLUSIONS. Preclinical studies of rotavirus vaccines may use standard and generally accepted approaches. However, planning and conducting clinical trials requires specific considerations associated with both the nature of rotavirus infection and the national infant vaccination schedule.
Rotavirus group A (RVA) is a major cause of pediatric acute gastroenteritis (AGE). Vaccination is an effective public health strategy and Angola implemented it in 2014. This hospital-based study aimed to estimate the prevalence of RVA infection and the severity of AGE in children under five years of age treated at six hospitals in Luanda Province. Between April 2021 and May 2022, 1251 fecal samples were screened by an immunochromatographic rapid test (SD Bioline). Data on socio-demographic profile, nutritional status, and clinical assessment were obtained. The association of RVA infection and AGE severity with possible risk factors was evaluated with a binary logistic regression model. Overall, the detection rate was 57.8% and girls tend to be more often infected than boys (55.2%). Infection was more common in the youngest group (1 to 6 months, 60.3%). Important sources of RVA infection were drinking water kept in tanks (57.9%) and private sanitary facilities with piped water (61%). Surprisingly, according to the Vesikari Scale score, the most severe symptoms were observed in children vaccinated with two doses (80.7%). RVA prevalence remains high despite vaccination, and further studies should address the association between infection sources and disease severity, as well as the causes underlying vaccine (un)effectiveness.
Inducing T lymphocyte (T-cell) activation and proliferation with specificity against a pathogen is crucial in vaccine formulation. Assessing vaccine candidates’ ability to induce T-cell proliferation helps optimize formulation for its safety, immunogenicity, and efficacy. Our in-house vaccine candidates use microparticles (MPs) and nanoparticles (NPs) to enhance antigen stability and target delivery to antigen-presenting cells (APCs), providing improved immunogenicity. Typically, vaccine formulations are screened for safety and immunostimulatory effects using in vitro methods, but extensive animal testing is often required to assess immunogenic responses. We identified the need for a rapid, intermediate screening process to select promising candidates before advancing to expensive and time-consuming in vivo evaluations. In this study, an in vitro overlay assay system was demonstrated as an effective high-throughput preclinical testing method to evaluate the immunogenic properties of early-stage vaccine formulations. The overlay assay’s effectiveness in testing particulate vaccine candidates for immunogenic responses has been evaluated by optimizing the carboxyfluorescein succinimidyl ester (CFSE) T-cell proliferation assay. DCs were overlaid with T-cells, allowing vaccine-stimulated DCs to present antigens to CFSE-stained T-cells. T-cell proliferation was quantified using flow cytometry on days 0, 1, 2, 4, and 6 upon successful antigen presentation. The assay was tested with nanoparticulate vaccine formulations targeting Neisseria gonorrhoeae (CDC F62, FA19, FA1090), measles, H1N1 flu prototype, canine coronavirus, and Zika, with adjuvants including Alhydrogel® (Alum) and AddaVax™. The assay revealed robust T-cell proliferation in the vaccine treatment groups, with variations between bacterial and viral vaccine candidates. A dose-dependent study indicated immune stimulation varied with antigen dose. These findings highlight the assay’s potential to differentiate and quantify effective antigen presentation, providing valuable insights for developing and optimizing vaccine formulations.
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