Reverse genetics has enabled US researchers to
construct an experimental vaccine against a potential pandemic influenza strain,
H5N1, in less than a month. A similar approach could be used to develop vaccines
for severe acute respiratory syndrome (SARS).
Vaccines against new strains of well-known viruses or emerging infectious
diseases used to take many months to develop. However, the increasing
availability of genome sequences for pathogens is now expediting the development
of safer, more effective vaccines.
Reverse genetics of flu
"To virologists," said Richard Webby, a postdoctoral fellow in the Department
of Infectious Diseases at St Jude Children's Research Hospital where the
research took place, "reverse genetics means the production of a virus from
cloned DNA."
A team led by Yoshihiro Kawaoka, Professor of Virology at the University of
Wisconsin-Madison was the first to achieve this feat for influenza, a segmented
negative-sense RNA virus, in 1999.
The classic method of making a vaccine to a new flu variant, explains Webby,
is to co-infect hens eggs with the field isolate and a vaccine strain and then
to genetically select for reassorted viruses containing the desired mix of
genome fragments, a process that can take many weeks.
"Because of its pathogenicity, traditional reassortment was never an option
for H5N1," said Webby. Instead, to develop a vaccine against H5N1, the St Jude
team isolated the H5N1 genome segments encoding haemagglutinin and neuraminidase
- the surface glycoproteins against which neutralizing antibodies are raised.
They then engineered haemagglutinin so that it was less pathogenic, and mixed
plasmids carrying these two fragments with six plasmids carrying the remaining
flu genome fragments from H1N1, a standard vaccine strain.
"In four weeks, we went from a newly isolated, potentially pandemic flu
strain to an experimental vaccine," said Webby. This flu vaccine will be the
first produced by reverse genetics to go into clinical trial, and the speed with
which it was produced, comments Rino Rappuoli, Vice President of Vaccine
Research at Chiron Corporation "could be critical if H5N1 turns out to be the
next, long-overdue pandemic strain to emerge from the Far East."
A powerful tool for vaccine development
Reverse genetics is being used to develop vaccines for many other viruses,
including respiratory syncytial viruses and parainfluenza viruses. And if the
definition of the technology is broadened to include expression of proteins from
engineered genes, then its future applications are virtually boundless. "Even
ten years ago, genetics was used minimally in vaccine development," said
Rappuoli. "Nowadays, we would not even try to develop a vaccine without using
all the genetics tools available."
Speed is only one aspect of this revolution. Even more important is the
flexibility that is now available for vaccine design. For example, says Kawaoka,
"many companies are planning to use reverse genetics to produce attenuated flu
strains to be used as live vaccines that should give more protection than
current inactivated vaccines." In other cases, says Rappuoli, "this technology
has facilitated the development of previously elusive vaccines," he said. "For
example, for 50 years we failed to develop an effective vaccine for
meningococcus B; With reverse genetics we went from getting its genome sequence
through identifying new antigens to starting clinical vaccine trials in less
than four years."
A speedy vaccine against SARS?
The earliest known cases of SARS were reported in mid November 2002. By 10
May 2003, 7296 probable cases and 526 deaths had occurred in more than 30
countries. In response to this threat to global health, researchers have moved
fast. "In early March, no-one knew what this disease was caused by," said
Rappuoli. "In late March somebody suggested it could be a coronavirus. By mid
April we knew its genetic code. At Chiron, we are already expressing SARS
envelope proteins to try to develop a vaccine," he added. "We will also be using
the information available on animal coronavirus to introduce attenuating
mutations into the SARS virus to make a live vaccine."
For the latter approach, recombinant virus will have to be generated, not an
easy task given the size of the coronavirus RNA genome. But, says Luis Enjuanes,
Research Professor at the Centro Nacional de Biotecnologia (CNB) in Spain, systems have been available to
do this since 2000. Several laboratories are engineering coronavirus genomes as
vectors for vaccine development and gene therapy, says Enjuanes, so it should be
possible to make vaccines for SARS by adapting the available infectious cDNA
clones.
However, Enjuanes warns that these will be the vaccines of the future. For
now, other types of vaccine - based on single viral components, for example -
can be made more quickly, he says. Other experts agree - the use of reverse
genetics to make a recombinant SARS vaccine could ultimately be the most
effective and adaptable system for vaccine development, but will require
considerable research set-up time.
For now, most emphasis is on using inactivated SARS virus as a vaccine. This
is the approach that the US National Institute for Allergy and Infectious
Diseases will initially focus on although NIAID Director Anthony Fauci says that
"other approaches will soon follow, as more knowledge about the cause of SARS
and its etiology becomes available." This classic approach will not be fast -
Fauci estimates that it will be least a year before a vaccine is ready for human
testing - but "it is probably the fastest way to go," concludes Kawaoka.
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