Oncophage® (vitespen®) - Heat shock protein peptide complex 96-based vaccines in melanoma: How far we are, how far we can get?
Heat shock proteins (HSPs) are highly conserved, stress-induced proteins that function as chaperones stabilizing and delivering peptides. In several preclinical studies, tumor derived HSP-peptide complexes (HSPPCs) have been shown to induce immunity against several malignancies. HSP-based vaccines, indeed, work across tumor types, bypassing the need for the identification of the single immunogenic peptide and thus emerging as a class of tumor- and patient-specific vaccines. HSPPC-96-based vaccine vitespen® (formerly Oncophage®) is the first autologous cancer vaccine made from individual patients’ tumors which not only confirmed its activity in different malignancies (e.g., gastric cancer, colorectal cancer, pancreatic cancer, non-Hodgkin’s lymphoma and chronic myelogenous leukemia), but was also successfully tested in phase III clinical trials in melanoma and kidney cancer. HSPPC-96-based vaccine also demonstrated an excellent safety profile with almost no toxicity. HSP-based vaccines are emerging as a novel therapeutic approach with a suggestive role in cancer therapy.
Plant-based vaccines for potential human application
The worldwide need to produce safe and affordable vaccines with a minimum requirement of manufacture and processing, together with the advancements achieved in biotechnology, have promoted the development of efficient alternatives to traditional ones. One of the available options is the use of transgenic plants, not only as a protein production system but as an antigen transportation system as well, being capable of delivering antigens to the mucosal immune targets, becoming what is known as edible vaccines. The versatility of the plant production system allows for instance, to express and to accumulate foreign antigens in edible plant tissues. Thus, the hypothesis for the choice of plant-based vaccines is that once a plant-based vaccine is eaten, the susceptible host mounts a mucosal immune response against the antigen that is expressed in the plant, becoming protected against the pathogen from which the antigen was selected. This idea is still under study. Here, we described the basis of the system, the promising future and the possible drawbacks.
Simultaneous administration of vaccines in immunization protocols: an audit in healthcare workers in the Puglia Region of Italy
Through a standardized questionnaire, this study investigated the opinions and attitudes of Vaccine Service staff in the Puglia Region of Italy regarding simultaneous administration of vaccines. Coadministration was practiced by 89.4%, and the staff’s positive opinions were that it is important for work organization (80.8%) and as an opportunity to increase vaccine take-up (59.9%). Negative opinions were that it increases the risk of adverse reactions or undesired effects (11.3%) and can engender fear of such reactions in parents (31.1%).
Hospital-acquired rotavirus infections in Spain over a ten-year period (1998-2007)
Background and objectives: To analyze the epidemiology and burden of rotavirus infections amongst hospitalized children up to 5 years of age in Spain over a 10-year period (1998-2007). Patients and methods: Data provided by the National Epidemiology Surveillance System for Hospital Data (Conjunto Mínimo Básico de Datos; CMBD) were analyzed. This database includes clinical information on hospitalizations and associated costs. For the purpose of this study, hospital discharges that mentioned rotavirus disease as a secondary diagnosis (ICD-9CM 008.61) were considered rotavirus hospital-acquired infections. All such cases reported from January 1, 1998 to December 31, 2007 were selected. Results: During the study period (1998-2007), a total of 10,990 cases of rotavirus disease mentioned as a secondary diagnosis were recorded (annual incidence of 59.02 cases per 100,000 people and 0.45 cases per 100 admissions). The average patient age was 9.8 months (SD 9.3), with 71% of the patients younger than 12 months of age. The mortality rate for children hospitalized for other primary causes, with rotavirus gastroenteritis as a secondary diagnosis was 0.16 per 100,000, and the case-fatality rate was 0.27%. The hospitalization rate decreased significantly with age, from 226 cases per 100,000 children 12 months of age or younger to 1.78 cases per 100,000 in children at the age of four. The infection rate amongst hospitalized children also decreased significantly with age, from 0.55% and 0.66% in children under one and two years, respectively, to 0.04% in children at the age of four. Conclusion: Hospital-acquired rotavirus infection morbidity and the associated consumption of health care resources are still important in Spain, especially in the younger groups (24 months of age and younger).
Basis for immunization recommendations among countries of the World Health Organization European region
Despite World Health Organization (WHO) goals to reduce the incidence of several vaccine preventable diseases across the European region, the adoption of new vaccines has been slower than expected. To identify factors that influence the decision to recommend new vaccines, especially hepatitis B and Haemophilus influenzae, type b (Hib) vaccines, we studied the factors used in immunization decisionmaking across this region. A structured questionnaire was sent to the Immunization Program Manager of each country with the option to return the completed survey by e-mail, fax, or complete a web-based survey. Frequency distributions were explored for all survey items. Bivariate analysis was conducted to assess differences between countries by economic status. Of the 47 (89%) countries responding, the majority reported vaccine safety (91%), epidemiology of disease (85%), and the severity of disease prevented (74%) as very important factors when making immunization recommendations. Half of the countries reported the cost of disease burden and cost-effectiveness data were very important financial information when implementing vaccine recommendations. While no significant difference was seen by economic status in countries recommending hepatitis B vaccine (p=0.1129), high economic status countries were significantly more likely to report Hib vaccine is part of the country’s recommended schedule (p=0.0011). Understanding the importance of the factors considered by countries when making national immunization recommendation decisions can aid public health experts in providing countries with information needed to support these decisions.
Differences in the attitude and knowledge of hospital health care workers regarding older patient vaccinations
Streptococcus pneumoniae infections are lethal for certain high-risk groups including adults aged 65 years and over. Despite long-standing recommendations for their routine use among elderly persons and other high-risk groups, these vaccines continue to be underused, especially in the very frail elderly. The implementation of organized vaccination programs are important facilitators of vaccine delivery. However, pneumococcal vaccination has not been well embraced by hospital health care workers. For a vaccination program to be able to succeed multiple components should be incorporated such as standing orders, special clinics, and provider feedback. This survey aims to compare attitudes and knowledge of hospital-based doctors and nurses Results: The nurses are less enthusiastic about vaccination and consider the diseases less serious. This has implications particularly for hospital-based strategies for improving vaccination uptake, where gaining the support of nursing staff will be crucial. Discussion: Vaccine delivery efforts must make dramatic improvements if the pneumococcal vaccination goals for elderly persons and other high-risk adults are to be met. Material and Methods: Self administered survey of hospital nurses and doctors utilizing all wards in a large, tertiary referral adult hospital in Sydney, Australia.
Tuberculosis will not be brought under control without a more effective TB vaccine being made available. The only currently licensed TB vaccine, BCG, was discovered nearly 100 years ago, confers only variable and incomplete protection again pulmonary TB and is contraindicated in infants infected with HIV. New priming and boosting vaccines have been developed, have shown promise in preclinical and early clinical studies and are now approaching Phase IIB proof of concept and Phase III efficacy trials. Likely target populations include infants, adolescents and HIV infected adults. Phase III trials will need to be multi centre, enrol very large cohorts of subjects and follow them up for at least two years for clinical endpoints. There are insufficient efficacy trial sites globally. Such sites require a combination of high TB rates in target populations, clinical and laboratory support and infrastructure, and surveillance systems capable of detecting all important and relevant events in trial participants. Over the last decade significant progress has been made in assessing potential sites and assisting them to develop the necessary capacity to participate in future efficacy trials of new TB vaccines.
In early 2009, a new emerging infectious disease, "swine flu" emerged in Mexico and further spread around the world. It is presently accepted as the most problematic infection at present. To control this new infection, the swine flu vaccine is the hope. The reasons that we need the swine flu vaccine will be discussed. Also, the present status, current attempts and problems of swine flu vaccine development will be presented in this commentary