Ling Zhao Huazhong Agricultural University Sep. 21, 2015

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Rabies vaccine development Ling Zhao Huazhong Agricultural University Sep. 21, 2015

Outlines 1. Rabies 2. Rabies virus 3. Rabies epidemiology 4. Rabies vaccine development 5. Perspective

Rabies-one of the oldest infectious diseases Rabies is a dangerous disease known for more than 5000 years and is still prevalent in our world today. It is present in the animal populations of almost every country in the world; about 69, 000 human deaths from rabies occur each year. More than 7 million people worldwide received post-exposure treatment each year. 3

Old disease Ancient Babylon(1930 BC) Baghdad school(1224 年 )

The human cost of rabies Having not received post-exposure prophylaxis after a dog bite, a 16-year-old boy suffers the terrifying symptoms of rabies. Lankester et al. Science 345(6204):1562-1564.

Outlines 1. Rabies 2. Rabies virus 3. Rabies epidemiology 4. Rabies vaccine development 5. Perspective

Rabies virus VNA Ab Adapted from CDC web site

Outlines 1. Rabies 2. Rabies virus 3. Rabies epidemiology 4. Rabies vaccine development 5. Perspective

North America/Europe <50 Cases < 100 000 PET Latin America <60 Cases < 500 000 PET Africa 5000 15000 Cases < 500 000 PET Asia 35-55 000 >8 000 000 PET Rabies Incidence

No of human rabies cases The human rabies cases in China from 1950-2007 7000 7037 in 1981 6000 5000 4000 3303 in 2007 3000 2000 1000 158 in 1996 0 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010

Geographical distribution of RABV in China Jiangsu Hunan Guangxi Guangdong Jiangxi

Outlines 1. Rabies 2. Rabies virus 3. Rabies epidemiology 4. Rabies control in China 5. Rabies vaccine development 6. Perspective

Rabies control in China 1. Epidemiological surveillance Surveillance system 2. Mass vaccination vaccines used in human and animals 3. Dog population control vaccinated, licensed

Mass vaccination Lankester et al. Science. 2014. 345(6204):1562-1564.

Vaccination of dogs in China Low vaccination coverage: in city areas, dog rabies vaccination coverage is less than 70%; in rural areas, this coverage is even less than 3%.

Outlines 1. Rabies 2. Rabies virus 3. Rabies epidemiology 4. Rabies control in China 5. Rabies vaccine development 6. Perspective

First vaccine Louis Pasteur (1885)

Timeline of human rabies vaccine development McGettigan et al. Expert Rev. Vaccines. 2010

Rabies vaccine in China Human Inactivated vaccines: ag, CTN-1, PM, PV strain primary hamster kidney cell culture vaccine (PHKCV), 1980; CTN-1 in Vero cells, 2000; purified Vero cell rabies vaccine (PVRV), 2006; the human diploid cell culture vaccine (HDCV) Domestic animals Inactivated vaccines: LEP-Flury CVS-11 SAD Wildlife animals Recombinant vaccines: under development

Pros and Cons Inactivated vaccine Attenuated live vaccines Recombinant vaccines Advantages High safety High efficiency Disadvantages Expensive And Multiple doses ( 4) And Low cost Cause diseases for young or immunocompr omised individuals High efficiency And Oral immunization Induce local reactions

Subunit rabies vaccine 1. Newcastle disease virus expressing RABV G protein (Journal of virology, 2011) 2. Parapoxvirus expressing RABV G protein (Journal of virology, 2012) 3. Canine parainfluenza virus expressing RABV G protein (Journal of virology, 2012)

Recombinant RABV with reverse genetics

The construction of the recombinant vaccines enhancing glycoprotein expression More glycoprotein, higher VNA titers!

Overexpression of the rabies virus glycoprotein results in antiviral immune response Faber et al. Journal of Virology. 2002

The construction of the recombinant vaccines stimulating innate immunity

Stray dogs and wild animals 26

Oral rabies vaccine 1. SAD or SAD modified live-attenuated rabies vaccine-sag2 (Europe) 2. Vaccinia virus expressing rabies virus glycoprotein (US)

Obstacles for oral vaccination Short windows Hard to induce mucosal immunity Low VNA titers

The construction of the recombinant oral vaccines GM-CSF: granulocyte-macrophage colony stimulating factor

Oral vaccine 控制发展中国家狂犬病的关键是众多流浪犬的免疫, 而流浪犬的有效免疫方式是口服免疫, 而犬的口服免疫效果通常比较差 表达沙门氏菌鞭毛蛋白 (Flagellin) 的重组疫苗能够有效刺激 TLR5 信号通路, 激活树突状细胞和 B 细胞, 促进体液免疫的发生, 最终提高口服性疫苗免疫效果 激活树突状细胞 提高小鼠保护率

Therapeutic vaccine 在小鼠感染狂犬病野毒 5 天后, 大脑直接注射表达粒细胞 集落因子 (GM-CSF) 的重组病毒仍然能够清除野毒而保 护动物不发病, 可作为治疗性疫苗 促进血脑屏障打开 小鼠存活率增加

Outlines 1. Rabies 2. Rabies virus 3. Rabies epidemiology 4. Rabies control in China 5. Rabies vaccine development 6. Perspective

Perspective for future RABV vaccines 1. Live attenuated vaccine for animals high safety, low cost, high efficiency replication-defective vaccines reduce to one shot

Perspective for future RABV vaccines 2. Oral vaccine for animals Used for stray dogs and wild animals Live-attenuated rabies vaccine expressing GM-CSF Themo-stability Bait design?

Perspective for future RABV vaccines 3. Therapeutic vaccines for human Induce production antibody and enhance the permeability of BBB Live-attenuated rabies vaccines SAD-TriG and SAD-GM/CSF were tested in a mouse model

谢谢! 36