Herpes zoster vaccine composition
10940198 ยท 2021-03-09
Assignee
- MOGAM INSTITUTE FOR BIOMEDICAL RESEARCH (Yongin-si, KR)
- Infectious Disease Research Institute (Seattle, WA)
Inventors
- Hyo Jung Nam (Yongin-si, KR)
- Eun Mi KIM (Yongin-si, KR)
- Duck Hyang Shin (Yongin-si, KR)
- Steven G. Reed (Bellevue, WA)
- Kang Il Yoo (Yongin-si, KR)
- Sung Jun Hong (Seoul, KR)
Cpc classification
C12N2710/16734
CHEMISTRY; METALLURGY
A61K39/39
HUMAN NECESSITIES
International classification
A61K39/39
HUMAN NECESSITIES
Abstract
The present invention relates to a herpes zoster vaccine composition, which comprises glycoprotein E of Varicella zoster virus, a glucopyranosyl lipid adjuvant, and a metabolic oil, and selectively increases a cell-mediated immune reaction without having disadvantages of attenuated live vaccines, thereby exhibit high safety and a high preventive effect against herpes zoster.
Claims
1. A vaccine composition against chickenpox or herpes zoster comprising: glycoprotein E of varicella-zoster virus; a glucopyranosyl lipid adjuvant of the following Formula 1; and a squalene: ##STR00004## wherein, R.sup.1, R.sup.3, R.sup.5 and R.sup.6 are each independently C.sub.10 -C.sub.12 alkyl; and R.sup.2 and R.sup.4 are each independently C.sub.8-C.sub.10 alkyl.
2. The vaccine composition of claim 1, wherein the glucopyranosyl lipid adjuvant is the one of Formula 1 wherein R.sup.1, R.sup.3, R.sup.5 and R.sup.6 are C.sub.11 alkyl.
3. The vaccine composition of claim 1, wherein the glucopyranosyl lipid adjuvant is the one of Formula 1 wherein R.sup.2 and R.sup.4 are C.sub.9.
4. The vaccine composition of claim 1, wherein the glucopyranosyl lipid adjuvant is contained in an amount of 7.5 g to 20 g in a single dose of the vaccine composition.
5. The vaccine composition of claim 4, wherein the glucopyranosyl lipid adjuvant is contained in an amount of 9 g to 18 g in a single dose of the vaccine composition.
6. The vaccine composition of claim 1, wherein the squalene is contained in an amount of 1% (v/v) to 7% (v/v) of the total vaccine composition.
7. The vaccine composition of claim 6, wherein the squalene is contained in an amount of 1% (v/v) to 4% (v/v) of the total vaccine composition.
8. The vaccine composition of claim 1, wherein the glycoprotein E is contained in an amount of 5g to 100 g in a single dose of the vaccine composition.
Description
BRIEF DESCRIPTION OF DRAWINGS
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BEST MODE FOR CARRYING OUT THE INVENTION
(22) The present invention relates to a herpes zoster vaccine composition, which comprises glycoprotein E of varicella-zoster virus, a glucopyranosyl lipid adjuvant, and a metabolisable oil, and has a high safety and an excellent effect of preventing herpes zoster by selectively increasing the cell mediated immune response without having the disadvantages of live attenuated vaccines.
(23) Hereinafter, the present invention will be described in detail.
(24) The vaccine composition of the present invention comprises glycoprotein E of varicella-zoster virus (VZV), a glucopyranosyl lipid adjuvant of the following Formula 1, and a metabolisable oil:
(25) ##STR00002##
wherein, R.sup.1, R.sup.3, R.sup.5 and R.sup.6 are each independently C.sub.10-C.sub.12 alkyl; and R.sup.2 and R.sup.4 are each independently C.sub.8-C.sub.10 alkyl.
(26) The vaccine composition of the present invention comprises glycoprotein E (gE) of VZV. Glycoprotein E (gE) in the present invention means glycoprotein E of VZV or an immunogenic derivative thereof. The immunogenic derivative in the present invention may be the one wherein a part of glycoprotein E is modified. For example, it may be the one wherein a part of glycoprotein E is cut, one or more amino acids of glycoprotein E are replaced by another amino acids, one or more amino acids of glycoprotein E are removed, one or more amino acids are added to glycoprotein E, or one or more amino acids of glycoprotein E are chemically modified. For example, glycoprotein E of the present invention may be represented by the sequence of SEQ ID NO: 1.
(27) The vaccine composition of the present invention comprises a glucopyranosyl lipid adjuvant of the following Formula 1 and a metabolisable oil:
(28) ##STR00003##
wherein, R.sup.1, R.sup.3, R.sup.5 and R.sup.6 are each independently C.sub.10-C.sub.12 alkyl; and R.sup.2 and R.sup.4 are each independently C.sub.8-C.sub.10 alkyl. For example, R.sup.2 and R.sup.4 may be C.sub.8 alkyl, C.sub.9 alkyl, or C.sub.10 alkyl. According to a more specific example, R.sup.2 and R.sup.4 may be C.sub.9 alkyl or C.sub.10 alkyl. For example, R.sup.2 and R.sup.4 may be C.sub.9 alkyl.
(29) The term metabolisable oil as used herein means an oil whose structure is modified by metabolism, and includes vegetable oils, fish oils, animal oils, and synthetic oils, which have no biotoxicity and may undergo structural changes upon metabolic progression.
(30) According to a specific embodiment of the present invention, the metabolisable oil of the present invention is squalene. Squalene is a hydrocarbon of triterpene backbone having 30 carbons. A variety of squalenes commonly known in the art to be used as metabolisable oils or emulsions may be used, for example, squalene from shark liver oil. An exemplary composition of squalene is described in Fox C B et al. (2013) Vaccine 31 (49): 5848-55.
(31) In order to increase the effect of preventing herpes zoster, it is important to significantly enhance the activation of cell mediated immunity (CMI) to VZV antigens while minimizing the activation of humoral immunity thereto.
(32) High levels of Th2-specific cytokines favor induction of a humoral immune response to the provided antigen, while high levels of Th1-specific cytokines tend to prefer induction of cell mediated immune response (CMI) to the provided antigen. Thus, the more Th1-specific cytokines are generated than the Th2-specific cytokine, the higher the degree of activation of the cell mediated immune response becomes than that of the humoral immune response.
(33) Also, the greater the number of cells simultaneously producing two or more cytokines out of IFN-, TNF-, and IL-2, the higher the degree of activation of the cell mediated immune response.
(34) In addition, as the degree of activation of the cell mediated immune response becomes higher than that of the humoral immune response, the production of IgG2c antibody is greatly increased as compared to that of IgG1 antibody.
(35) The vaccine composition of the present invention can greatly increase the degree of activation of the cell mediated immune response rather than that of the humoral immune response in the body of a subject.
(36) For example, the vaccine composition of the present invention can significantly increase the production of Th1-specific cytokines (e.g., interferon-gamma (IFN-), tumor necrosis factor-alpha (TNF-), and interleukin-2 (IL-2)) as compared to the production of Th2-specific cytokines (e.g., interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10), and the like), in the body of a subject.
(37) Also, for example, the vaccine composition of the present invention is capable of greatly increasing the number of cells simultaneously producing two or more cytokines out of IFN-, TNF-, and IL-2 than the number of cells producing only one cytokine out of the above cytokines, among activated Th1 cells.
(38) In addition, for example, the vaccine composition of the present invention can greatly increase the production of gE-specific IgG antibodies in the body of a subject and, especially, can greatly increase the production of gE-specific IgG2c antibodies as compared to that of gE-specific IgG1 antibodies.
(39) The vaccine composition of the present invention may contain 5 g to 100 g of glycoprotein E in a single dose. For example, it may contain 5 g to 80 g, specifically 5 g to 70 g, more specifically 5 g to 60 g, and most specifically 5 g to 50 g of glycoprotein E in a single dose.
(40) The vaccine composition of the present invention may contain 7.5 g to 20 g, specifically 9 g to 18 g, more specifically, 9 g to 16 g, and most specifically 10 g to 15 g of the glucopyranosyl lipid adjuvant in a single dose. According to another embodiment of the present invention, the vaccine composition of the present invention may contain 13 g to 17 g of the glucopyranosyl lipid adjuvant in a single dose. When the glucopyranosyl lipid adjuvant is included in the above range, the cell mediated immune response can be selectively maximized.
(41) The vaccine composition of the present invention may contain 1 to 7% (v/v), more specifically 1 to 5% (v v), and most specifically 1 to 4% (v/v) of the metabolisable oil in a single dose.
(42) In addition to glycoprotein E, the glucopyranosyl lipid adjuvant, and the metabolisable oil, the vaccine composition of the present invention may include pharmaceutically acceptable excipients, carriers, and the like. For example, the vaccine composition of the present invention may contain physiological saline or PBS (phosphate buffered saline).
(43) The vaccine composition of the present invention can be formulated and packaged in various forms. According to one embodiment, the first vial containing glycoprotein E but not comprising the glucopyranosyl lipid adjuvant and the metabolisable oil, and the second vial containing the glucopyranosyl lipid adjuvant and the metabolisable oil but not comprising glycoprotein E may be separately packaged, and mixed prior to use (bedside mixing). According to another embodiment, a vaccine composition comprising all of glycoprotein E, the glucopyranosyl lipid adjuvant and the metabolic oil may be packaged in a vial, a syringe (prefilled syringe), or the like.
MODE FOR THE INVENTION
(44) Hereinafter, the present invention will be described in more detail with reference to experimental examples. These experimental examples are only intended to illustrate the present invention, and the scope of the present invention is not limited to those exemplified in these experimental examples.
Experimental Example 1: Immunization
(45) Since humans have a history of chickenpox infection, in order to mimic chickenpox infection in mice, live attenuated vaccine (LAV, 3000 pfu) was subcutaneously injected once to female C57BL/6 mice to perform primary immunization (LAV priming). After 28 days from the LAV priming (Day 0), various VZV vaccine compositions with or without VZV protein immunogen or adjuvant were administered by intramuscular injection to perform secondary immunization.
(46) In order to measure the humoral immune response to VZV, blood samples were taken once at the LAV priming point, and 28 days and 42 days thereafter (Day 0, Day 28 and Day 42), respectively, and leukocytes were collected from spleen samples 42 days after the LAV priming (Day 42) to measure CMI (cell-mediated immune response) against VZV.
(47) The experimental design for primary immunization (LAV priming), secondary immunization (Immunization), and immune response measurement is summarized as shown in Table 1 below. In Table 1 below, gE refers to VZV glycoprotein E of SEQ ID NO: 1, LAV refers to live attenuated virus, SLA refers to the glucopyranosyl lipid adjuvant of Formula 1 wherein R.sup.2 and R.sup.4 are C.sub.9 alkyl, and SE refers to squalene. SLA and squalene were obtained from the Infectious Disease Research Institute (Seattle, US) and Sigma-Aldrich (St. Louis, Mo.), respectively.
(48) Alum hydroxide is aluminum hydroxide; Addavax is a squalene-based oil-in-water nano-emulsion; Pam3CSK4 is a TLR 1/2 agonist, a synthetic triacylated lipoprotein of CAS number 112208-00-1; polyIC is polyinosinic-polycytidylic acid; MPL is Monophosphoryl Lipid A; and ODN1826 is a Class B CpG oligonucleotide-Murine TLR9 ligand. In addition, the days of immunization, blood sample collection, and spleen sample collection were calculated from Day 0 as the day of LAV priming.
(49) TABLE-US-00001 TABLE 1 Primary Day of Day of immunization Secondary immunization Day of blood spleen (LAV (Immunization) secondary sample sample Group priming*) Antigen Adjuvant immunization collection collection PBS PBS-only X X Day 28 Day 0, Day 42 LAV(1 shot) LAV PBS-only X Day 28, LAV(2 shot) LAV LAV X Day 42 (15,000 pfu) gE LAV gE (5 g) X gE + SLA-AF LAV gE (5 g) SLA (5 g) in aqueous formulation gE + SLA-SE LAV gE (5 g) SLA (5 g) + SE (2%) gE + SE LAV gE (5 g) SE (2%) gE + liposome LAV gE (5 g) liposome-only gE + Addavax LAV gE (5 g) Addavax (50%) gE + MPL + QuilA LAV gE (5 g) MPL (5 g) + QuilA (5 g) gI + SLA-SE LAV gI (5 g) SLA (5 g) + SE (2%) IE63 + SLA-SE LAV IE63 (5 g) SLA (5 g) + SE (2%) gB + SLA-SE LAV gB (5 g) SLA (5 g) + SE (2%) gC + SLA-SE LAV gC (5 g) SLA (5 g) + SE (2%) gL + SLA-SE LAV gL (5 g) SLA (5 g) + SE (2%) gE + Alum LAV gE (5 g) Alum hydroxide (0.5 mg) hydroxide gE + Addavax LAV gE (5 g) Addavax (50 L) gE + Pam3CSK4 LAV gE (5 g) Pam3CSK4 (11 g) gE + polyIC LAV gE (5 g) polyIC (55 g) gE + MPL LAV gE (5 g) MPL (11 g) gE + flagellin LAV gE (5 g) Flagellin (5.5 g) gE + imiquimod LAV gE (5 g) Imiquimod (55 g) gE + ODN1826 LAV gE (5 g) ODN1826 (35 g) *Primary immunization (LAV priming): Dose 100 L/head. 3,000 pfu *Secondary immunization (Immunization): Dose 100 L/head
Experimental Example 2: Experimental Methods
Experimental Example 2-1: Method for Measuring VZV Antigen-Specific IgG Titer (VZV Specific IgG Titer)
(50) After performing the primary immunization and the secondary immunization, ELISA (enzyme-linked immunosorbant assay) was carried out for measuring VZV antigen-specific IgG titer. A recombinant gE protein or VZV antigen (1 g/mL) was coated onto an ELISA plate and incubated overnight at 4 C. The ELISA plate was washed three times and blocking was carried out with PBS (Phosphate-buffered saline) solution containing 2% BSA (Bovine serum albumin) for 1 hour. After washing the ELISA plate, diluted serum samples were added thereto and incubated for 2 hours. HRP (Horseradish peroxidase)-conjugated goat anti-mouse IgG, IgG1, or IgG2c antibodies were added thereto and incubated for 1 hour. After the final incubation, the ELISA plate was washed and the HRP reaction was induced by the addition of TMB (3, 3, 5, 5-tetramethylbenzidine) substrate. The HRP reaction was stopped by adding ELISA stop solution and optical density (OD) was measured using a spectrometer at a wavelength of 450 nm.
Experimental Example 2-2: Method for Measuring VZV Antigen-Specific Cell-Mediated Immune Response Using the Enzyme-Linked Immunospot Assay (ELISPOT Assay)
(51) After performing the primary immunization and the secondary immunization, mouse IFN- ELISPOT (enzyme-linked immunospot) assay was carried out to confirm VZV antigen-specific cell-mediated immune response (CMI). IFN- capture antibody (5 g/mL) was coated onto an ELISPOT plate and incubated overnight at 4 C. The ELISPOT plate was washed 3 times and blocking was carried out with a medium containing 10% FBS (fetal bovine serum) for 1 hour. After washing the ELISPOT plate, leukocytes collected from the immunized mice and gE protein, gE OLP (overlapping peptide), or a VZV lysate were added thereto and incubated for 24 hours for leukocyte stimulation. Upon completion of the leukocyte stimulation, the ELISPOT plate was washed, and biotinylated mouse IFN- detection antibody (2 g/mL) was added thereto and incubated. After washing the plate, streptavidin-HRP was added thereto and incubated again. Then, after washing the ELISPOT plate, AEC substrate mixture was added thereto to induce a reaction at room temperature. The reaction was stopped by washing the ELISPOT plate with water and the plate was dried. The number of the resulting spots were counted with a device.
Experimental Example 2-3: Method for Identifying Cytokines Secreted by Antigen Stimulation (CBA Assay)
(52) After performing the primary immunization and the secondary immunization, CBA (cytometric bead array) assay was carried out to identify the types of cytokines secreted by T cells due to antigen stimulation. Leukocytes collected from mice were stimulated with gE protein or a VZV lysate for 3 days and centrifuged to obtain the supernatant, which was then assayed for cytokines with mouse Th1/Th2/Th17 CBA kit. Seven (7) kinds of cytokine capture beads (IL-2, IL-4, IL-6, IL-10, IFN-, TNF, and IL-17A), the supernatant sample, and cytokine detection beads were reacted together for 2 hours, the beads were washed, and the amounts of cytokines in the supernatant were determined.
Experimental Example 2-4: Method for Determining the Distribution of Cytokine-Secreting Cells (ICS Assay)
(53) After performing the primary immunization and the secondary immunization, the secretion of Th1-specific cytokines was measured by ICS (intracellular cytokine staining) assay to confirm the antigen-specific cell-mediated immune response. Leukocytes collected from mice were stimulated overnight with gE protein and, at this time, GolgiStop (BFA)/GolgiPlug (monensin) was also added to prevent cytokines in the cells from being secreted to the outside. After washing the stimulated leukocytes, the cell surface of leukocytes was labeled with antibodies (7-AAD, CD3-FITC, CD4-V500) to identify T cells. After the completion of the reaction, the leukocytes were washed, permeabilized, and subjected to a reaction with antibodies (TNF--PE, IFN--APC, IL-2-V450) which can be bound to cytokines to confirm the presence of cytokines in the cells. After the reaction, the leukocytes were washed and fixed, and the distribution of the cells secreting cytokines by the antigen stimulation was analyzed.
Experimental Example 2-5: Method for Determining IFN- Cytokine Secreted by gE Antigen Stimulation (IFN- ELISA)
(54) After performing the primary immunization and the secondary immunization, IFN- ELISA assay was carried out to determine the secretion amount of IFN-, a typical effector cytokine secreted by T cells by antigen stimulation. Leukocytes collected from mice were stimulated with gE protein or gE overlapping peptide for 3 days and centrifuged to obtain the supernatant, which was then analyzed with a mouse IFN- ELISA kit. IFN- capture antibody (4 g/mL) was coated onto an ELISA plate and incubated overnight at room temperature. The ELISA plate was washed three times and blocking was carried out with PBS containing 1% bovine serum albumin (BSA) for 1 hour. After washing the ELISA plate, the supernatant obtained by stimulating leukocytes was added thereto and incubated at room temperature for 2 hours. After washing the ELISA plate, biotinylated mouse IFN- detection antibody (400 ng/mL) was added thereto and incubated at room temperature for 2 hours. After washing, streptavidin-HRP was added thereto and incubated again for 20 minutes. After the incubation, the ELISA plate was washed and reacted with a substrate solution at room temperature for 20 minutes. After stopping the reaction with a stop solution, the optical density was measured using an instrument at 450 nm.
Experimental Example 3: Measurement of gE Antigen-Specific IgG Titer (gE Specific IgG Titer)
(55) The gE antigen-specific IgG titer was measured according to the method of Experimental Example 2-1, and the results of the experiment are summarized in FIGS. 1 and 2.
(56) As shown in
(57) As shown in
(58) Taking the results of
Experimental Example 4: Measurement of gE or VZV Antigen-Specific Cell Mediated Immune Responses (ELISPOT Assay)
(59) The gE protein, gE OLP, or VZV lysate-specific cell-mediated immune responses were measured according to the method of Experimental Example 2-2 (IFN- ELISPOT assay), and the experimental results are summarized in
(60) As shown in
(61) As shown in
(62) As shown in
(63) Taking the results of
Experimental Example 5: Confirmation of the Amount of Cytokines Secreted by Antigen Stimulation (CBA Assay)
(64) The confirmation of the cytokines secreted by the antigen stimulation (CBA assay) was performed according to the method of Experimental Example 2-3, and the experimental results are summarized in
(65) As shown in
Experimental Example 6: Confirmation of the Distribution of Cytokine-Secreting Cells
(66) The assay for confirming the distribution of the cells secreting cytokines by antigen stimulation (ICS assay) was performed according to the method of Experimental Example 2-4, and the results of the experiment are summarized in
(67) As shown in
Experimental Example 7: Measurement of VZV Antigen-Specific IgG Titers (Anti-VZV Glycoprotein Specific IgG Titer)
(68) Various VZV antigen-specific IgG titers depending on the use of SLA-SE were determined in the same manner as in Experimental Example 2-1 except that any one of gE, gI, IE63, gB, gC, and gL was used as an antigen in the secondary immunization and SLA-SE was used as an adjuvant, and the results are summarized in
(69) As shown in
(70) As shown in
(71) Taking the results of
Experimental Example 8: Confirmation of the Amount of Cytokines Secreted by VZV Antigen Stimulation
(72) An experiment (CBA assay) for confirming the cytokines secreted by antigen stimulation, following the immunization, was performed in the same manner as in Experimental Example 2-3 except that any one of gE, gI, IE63, gB, gC, and gL was used as an antigen in the secondary immunization and SLA-SE was used as an adjuvant, and the results are summarized in
(73) As shown in
Experimental Example 9: Confirmation of the Distribution of Cells Secreting VZV Antigen-Specific Cytokines
(74) An experiment (ICS assay) for confirming the distribution of T cells that secrete effector cytokines by antigen stimulation, following the immunization, was performed in the same manner as in Experimental Example 2-4 except that any one of gE, gI, IE63, gB, gC, and gL was used as an antigen in the secondary immunization and SLA-SE was used as an adjuvant, and the results are summarized in
(75) As shown in
Experimental Example 10: Identification of VZV-Specific Immunogenicity Depending on the Combination of Antigens
(76) In order to identify the VZV-specific immunogenicities induced when using the gE antigen alone and when using gE antigen in combination with another VZV antigen at the time of the secondary immunization, VZV antigen-specific IgG titers and VZV antigen-specific T cell immune responses were confirmed according to the methods of Experimental Examples 2-1 and 2-2, and the experimental results are summarized in
(77) As shown in
Experimental Example 11: Measurement of gE Antigen-Specific IgG Titers (gE Specific IgG Titer)
(78) The gE antigen-specific IgG titers depending on the use of various adjuvant were measured in the same manner as in Experimental Example 2-1 except that gE was used as an antigen and any one of SLA-SE, alum hydroxide, Addavax, Pam3CSK4, polyIC, MPL, flagellin, Imiquimod, and ODN1826 was used as an adjuvant in the secondary immunization, and the results are summarized in
(79) As shown in
(80) As shown in
(81) Taking the results of
Experimental Example 12: Measurement of gE or VZV Antigen-Specific Cell Mediated Immune Responses (ELISPOT Assay)
(82) The gE protein, gE OLP, or VZV lysate-specific cell-mediated immune responses were measured according to the method of Experimental Example 2-2 (IFN- ELISPOT assay), and the experimental results are summarized in
(83) As shown in
(84) As shown in
(85) As shown in
(86) Taking the results of
Experimental Example 13: Confirmation of IFN- Cytokine Secreted by gE Antigen or VZV Antigen Stimulation (IFN- ELISA Assay)
(87) An experiment (IFN- ELISA assay) for confirming IFN- cytokine secreted by gE antigen or gE OLP antigen stimulation was performed according to the method of Experimental Example 2-5, and the results are summarized in
(88) As shown in
(89) As shown in
(90) Taking the results of
Experimental Example 14: Determination of the Optimum Amount of SLA-SE Inducing VZV-Specific Immunogenicity
(91) Table 2 summarizes the experimental design for confirming the optimum amount of SLA-SE that can most effectively induce VZV antigen-specific cell-mediated immune response (CMI). Live attenuated vaccine (LAV, 3,000 pfu) was subcutaneously injected once to female C57BL/6 mice and, on day 28 thereafter, the secondary immunization (immunization) was performed. On day 56 after the LAV priming, leukocytes were collected from spleen samples to confirm cell-mediated immune response (CMI) specific for VZV.
(92) TABLE-US-00002 TABLE 2 Primary Day of immunization Secondary immunization Day of spleen (LAV (Immunization) secondary sample Group priming*) Antigen Adjuvant immunization collection PBS PBS-only X X Day 28 Day 56 gE LAV gE (5 g) X gE + SLA 0.2 g LAV gE (5 g) SLA (0.2 g) + SE (2%) gE + SLA 1 g LAV gE (5 g) SLA (1 g) + SE (2%) gE + SLA 2.5 g LAV gE (5 g) SLA (2.5 g) + SE (2%) gE + SLA 5 g LAV gE (5 g) SLA (5 g) + SE (2%) gE + SLA 7.5 g LAV gE (5 g) SLA (7.5 g) + SE (2%) gE + SLA 10 g LAV gE (5 g) SLA (10 g) + SE (2%) gE + SLA 15 g LAV gE (5 g) SLA (15 g) + SE (2%) gE + SLA 20 g LAV gE (5 g) SLA (20 g) + SE (2%) gE + SLA 22.5 g LAV gE (5 g) SLA (22.5 g) + SE (2%) *Primary immunization (LAV priming): Dose 100 L/head. 3,000 pfu *Secondary immunization (Immunization): Dose 100 L/head
(93) The gE antigen-specific cell-mediated immune response (IFN- ELISPOT assay) was measured according to the method of Experimental Example 2-2, and the results of the experiment are summarized in
(94) The VZV antigen-specific cell-mediated immune response (IFN- ELISPOT assay) was measured according to the method of Experimental Example 2-2, and the results of the experiment are summarized in
(95) Taking the results of