mRNA药物新时代

<正>2023年诺贝尔生理学或医学奖授予了卡塔琳·考里科(Katalin Karikó)和德鲁·韦斯曼(Drew Weissman),以表彰其“在核苷碱基修饰方面的发现,使得开发有效的针对COVID-19的m RNA疫苗成为可能”.他们的研究工作,从根本上改变了人们对m RNA如何与免疫系统相互作用的理解,使疫苗研发达到前所未有的速度.这两位科学家的突破性发现对迎接未来的健康挑战产生了深远的影响.     

mRNA疫苗及其基于聚合物的递送系统研究进展

2019年,全球暴发了严重急性呼吸综合征冠状病毒2型(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)疫情。由SARS-CoV-2引起的传染病(Corona Virus Disease 2019,COVID-19)具有极强的传染性及较高的病死率,对人类健康及经济发展造成了极大伤害。疫苗接种是预防和控制SARS-CoV-2传播的主要途径。信使RNA(mRNA)疫苗因具有制备简单、生产周期短、细胞毒性较小等优点而备受关注;最重要的是,mRNA容易实现量产,是应对突发疫情的重要手段之一。在此将对mRNA疫苗及其作用机制、递送载体以及给药方式等进行综述,旨在为mRNA疫苗研发工作提供参考。     

严重急性呼吸综合征冠状病毒2的突变株及其疫苗

伴随着严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome-coronavirus 2,SARS-CoV-2)疫苗(也称COVID-19疫苗)在世界各地预防接种的展开,SARS-CoV-2突变株也在世界多地相继出现,其中有的突变株可能对现行SARS-CoV-2疫苗诱导的抗体产...     

假尿苷修饰体外转录mRNA在翻译过程中发生的+1核糖体框架移码

为应对世界范围内的COVID-19疫情,假尿苷(Ψ)修饰的体外转录mRNA(Ψ-IVT-mRNA)被授权应用于SARS-Cov-2 mRNA疫苗。最近,Ψ-IVT-mRNA被发现在翻译蛋白质时发生核糖体“滞顿”,导致+1核糖体移码,在体外和体内翻译出异常的蛋白质。在接种SARS-Cov-2 mRNA疫苗的人群,这种异常蛋白可能激发脱靶T细胞反应或抗体反应或产生其它意想不到的副作用。这一发现对研制有效“安全”的mRNA疫苗/药物有“警示”和指导意义。     

新型冠状病毒疫苗研究策略分析

新型冠状病毒(SARS-CoV-2)是一种可引起人新型冠状病毒肺炎(COVID-19)的新发呼吸道病原体,与重症急性呼吸道综合症冠状病毒(SARS-CoV)和中东呼吸综合征冠状病毒(MERS-CoV)同属于β-冠状病毒,具有较高的传染性和一定的致死率。2019年12月在我国武汉被发现,随后蔓延到我国大部分省份,给我国人民健康和经济发展造成巨大损失。疫苗接种是预防和控制传染病的常规和有效手段,国内外多个机构已启动COVID-19疫苗研究工作。文中基于SARS和MERS疫苗研究的经验和教训,对COVID-19疫苗的研究策略和需要注意的关键问题进行了阐述,为相关研究人员提供参考。     

新型冠状病毒SARS-CoV-2研究进展

在武汉发生的由新型冠状病毒SARS-CoV-2引发的人类冠状病毒病COVID-19,仅仅2个多月时间在我国及国际上70多个国家出现迅速传播,致病和死亡率高,人类生命受到了极大威胁。一些科学家火速投入研究,对SARS-CoV-2的来源和进化、形态特征和基因结构、感染和致病分子机制开展深入研究,取得了重大进展,为科学防控COVID-19提供了重要依据。根据上述研究的基础,文中对COVID-19病毒疫苗、抗体和抑制剂研发提出了设想,在研究防控COVID-19核心技术上具有一定的参考价值。     

基于蛋白质组学技术的新型冠状病毒肺炎研究进展

新型冠状病毒肺炎（coronavirus disease 2019,COVID-19）是一种由严重急性呼吸综合征冠状病毒2 (severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)引发的传染病。此种病毒传染性强、传播速度快,对全球人民的身体健康和生命安全造成严重威胁。蛋白质组学技术以其高通量、高灵敏度的特点,在疾病生物标志物的发现、分子机制研究及治疗靶点研究中扮演着重要角色,并被广泛应用于COVID-19的研究中。本文介绍了SARS-CoV-2的基因组结构及病毒感染过程,总结了目前常用的基于质谱的蛋白质组学研究技术,重点综述了蛋白质组学技术在COVID-19生物标志物的发现、分子机制研究和药物治疗靶标研究中的应用进展,最后展望了蛋白质组学的未来发展方向,以期能够有助于推动蛋白质组学技术在COVID-19精准诊断和治疗中的发展。     

第二代新型冠状病毒疫苗研究进展

自2019年12月以来,新型冠状病毒（SARS-CoV-2）在全球范围内迅速传播,逐步发展成全球大流行疾病（COVID-19）,为全球社会带来了重大损失。疫苗接种是预防传染性疾病的重要措施之一,自COVID-19流行以来,研制安全、有效的疫苗成为了当下最紧急的任务。据报道,目前全球范围内多条技术路线研究的疫苗多达172种处于临床阶段。世界卫生组织紧急批准了超过10种新冠疫苗用于紧急预防。然而,目前已获批的疫苗几乎都是针对原始毒株进行研发的。面对目前不断突变的病毒,开发更加广谱、高效的第二代新冠疫苗就显得尤为重要了。本文汇总了目前研究进展较快的第二代新冠疫苗,同时对第二代新冠疫苗的临床研究所应关注的问题及所面临的挑战进行了论述。     

本期导读

自2019年12月以来,新型冠状病毒肺炎在全球蔓延,2020年1月30日,世界卫生组织(World Health Organization,WHO)将新型冠状病毒肺炎疫情列为"国际关注的突发公共卫生事件",我国也将该病作为急性呼吸道传染病纳入《中华人民共和国传染病防治法》规定的乙类传染病,并按照甲类传染病管理。2020年2月11日,WHO正式将新型冠状病毒肺炎命名为COVID-19(Corona Virus Disease 2019)。国际病毒分类委员会将该病毒命名为严重急性呼吸系统综合征冠状病毒(severe acute respiratory syndrome coromavirus 2,SARS-CoV-2)。截止2020年8月28日全球已累计确诊24356983人,累计死亡826791人。严重危害着人类的健康和生命安全。虽然中国政府采取了最强有力的措施,社会各界一起抗击疫情,取得了显著成效。但是由于目前COVID-19疫苗尚未上市,也无特效药物,COVID-19的全球快速蔓延势头仍没有得到有效遏制。世界各国的科学家、医学家们正在努力开发针对SARS-CoV-2和COVID-19的安全有效的预防疫苗和治疗方法。     

mRNA vaccines for COVID-19: what,why and how

The Coronavirus disease-19 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus -2 (SARS-CoV-2), has impacted human lives in the most profound ways with millions of infections and deaths. Scientists and pharmaceutical companies have been in race to produce vaccines against SARS-CoV-2. Vaccine generation usually demands years of developing and testing for efficacy and safety. However, it only took less than one year to generate two mRNA vaccines from their development to deployment. The rapid production time, cost-effectiveness, versatility in vaccine design, and clinically proven ability to induce cellular and humoral immune response have crowned mRNA vaccines with spotlights as most promising vaccine candidates in the fight against the pandemic. In this review, we discuss the general principles of mRNA vaccine design and working mechanisms of the vaccines, and provide an up-to-date summary of pre-clinical and clinical trials on seven anti-COVID-19 mRNA candidate vaccines, with the focus on the two mRNA vaccines already licensed for vaccination. In addition, we highlight the key strategies in designing mRNA vaccines to maximize the expression of immunogens and avoid intrinsic innate immune response. We also provide some perspective for future vaccine development against COVID-19 and other pathogens.     

Recipients of COVID-19 vaccines face challenges of SARS-CoV-2 variants

The coronavirus disease 19 (COVID-19) has been rampant since 2019, severely affecting global public health, and causing 5.75 million deaths worldwide. So far, many vaccines have been developed to prevent the infection of SARS-CoV-2 virus. However, the emergence of new variants may threat vaccine recipients as they might evade immunological surveillance that depends on the using of anti-SARS-CoV-2 antibody to neutralize the viral particles. Recent studies have found that recipients who received two doses of vaccination plus an additional booster shoot were able to quickly elevate neutralization response and immune response against wild-type SARS-CoV-2 virus and some initially appeared viral variants. In this review, we assessed the real-world effectiveness of different COVID-19 vaccines by population studies and neutralization assays and compared neutralization responses of booster vaccines in vitro. Finally, as the efficacy of COVID-19 vaccine is expected to decline over time, continued vaccination should be considered to achieve a long-term immune protection against coronavirus.     

DNA vaccination induced protective immunity against SARS CoV-2 infection in hamsterss

The development of efficient vaccines against COVID-19 is an emergent need for global public health. The spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major target for the COVID-19 vaccine. To quickly respond to the outbreak of the SARS-CoV-2 pandemic, a nucleic acid-based vaccine is a novel option, beyond the traditional inactivated virus vaccine or recombinant protein vaccine. Here, we report a DNA vaccine containing the spike gene for delivery via electroporation. The spike genes of SARS-CoV and SARS-CoV-2 were codon optimized for mammalian cell expression and then cloned into mammalian cell expression vectors, called pSARS-S and pSARS2-S, respectively. Spike protein expression was confirmed by immunoblotting after transient expression in HEK293T cells. After immunization, sera were collected for antigen-specific antibody and neutralizing antibody titer analyses. We found that both pSARS-S and pSARS2-S immunization induced similar levels of antibodies against S2 of SARS-CoV-2. In contrast, only pSARS2-S immunization induced antibodies against the receptor-binding domain of SARS-CoV-2. We further found that pSARS2-S immunization, but not pSARS-S immunization, could induce very high titers of neutralizing antibodies against SARS-CoV-2. We further analyzed SARS-CoV-2 S protein-specific T cell responses and found that the immune responses were biased toward Th1. Importantly, pSARS2-S immunization in hamsters could induce protective immunity against SARS-CoV-2 challenge in vivo. These data suggest that DNA vaccination could be a promising approach for protecting against COVID-19.     

In vitro selection of Remdesivir resistance suggests evolutionary predictability of SARS-CoV-2

Remdesivir (RDV), a broadly acting nucleoside analogue, is the only FDA approved small molecule antiviral for the treatment of COVID-19 patients. To date, there are no reports identifying SARS-CoV-2 RDV resistance in patients, animal models or in vitro. Here, we selected drug-resistant viral populations by serially passaging SARS-CoV-2 in vitro in the presence of RDV. Using high throughput sequencing, we identified a single mutation in RNA-dependent RNA polymerase (NSP12) at a residue conserved among all coronaviruses in two independently evolved populations displaying decreased RDV sensitivity. Introduction of the NSP12 E802D mutation into our SARS-CoV-2 reverse genetics backbone confirmed its role in decreasing RDV sensitivity in vitro. Substitution of E802 did not affect viral replication or activity of an alternate nucleoside analogue (EIDD2801) but did affect virus fitness in a competition assay. Analysis of the globally circulating SARS-CoV-2 variants (>800,000 sequences) showed no evidence of widespread transmission of RDV-resistant mutants. Surprisingly, we observed an excess of substitutions in spike at corresponding sites identified in the emerging SARS-CoV-2 variants of concern (i.e., H69, E484, N501, H655) indicating that they can arise in vitro in the absence of immune selection. The identification and characterisation of a drug resistant signature within the SARS-CoV-2 genome has implications for clinical management and virus surveillance.     

Induced pluripotent stem cell-based disease modeling and prospective immune therapy for coronavirus disease 2019

The emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic poses a never before seen challenge to human health and the economy. Considering its clinical impact, with no streamlined therapeutic strategies in sight, it is crucial to understand the infection process of SARS-CoV-2. Our limited knowledge of the mechanisms underlying SARS-CoV-2 infection impedes the development of alternative therapeutics to address the pandemic. This aspect can be addressed by modeling SARS-CoV-2 infection in the human context to facilitate drug screening and discovery. Human induced pluripotent stem cell (iPSC)-derived lung epithelial cells and organoids recapitulating the features and functionality of the alveolar cell types can serve as an in vitro human model and screening platform for SARS-CoV-2. Recent studies suggest an immune system asynchrony leading to compromised function and a decreased proportion of specific immune cell types in coronavirus disease 2019 (COVID-19) patients. Replenishing these specific immune cells may serve as useful treatment modality against SARS-CoV-2 infection. Here the authors review protocols for deriving lung epithelial cells, alveolar organoids and specific immune cell types, such as T lymphocytes and natural killer cells, from iPSCs with the aim to aid investigators in making relevant in vitro models of SARS-CoV-2 along with the possibility derive immune cell types to treat COVID-19.     

Phenotypes and Functions of SARS-CoV-2-Reactive T Cells

Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), which is an ongoing pandemic disease. SARS-CoV-2-specific CD4⁺ and CD8⁺ T-cell responses have been detected and characterized not only in COVID-19 patients and convalescents, but also unexposed individuals. Here, we review the phenotypes and functions of SARS-CoV-2-specific T cells in COVID-19 patients and the relationships between SARS-CoV-2-specific T-cell responses and COVID-19 severity. In addition, we describe the phenotypes and functions of SARS-CoV-2-specific memory T cells after recovery from COVID-19 and discuss the presence of SARS-CoV-2-reactive T cells in unexposed individuals and SARS-CoV-2-specific T-cell responses elicited by COVID-19 vaccines. A better understanding of T-cell responses is important for effective control of the current COVID-19 pandemic.     

表达新冠病毒S基因重组狂犬病病毒的构建及其免疫原性

【背景】新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)在全球流行已近3年,除对人类造成了巨大伤害,也影响了人类的伴侣动物。人的COVID-19疫苗已在全球应用,但动物用的新冠病毒疫苗却鲜有报道。【目的】研制兽用新冠病毒(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)和狂犬病病毒(rabies virus,RABV)的二联苗。【方法】将合成的SARS-CoV-2 S基因和S1基因分别克隆至RABV弱毒疫苗株rHEP-Flury基因组G与L基因间,并将2个重组质粒分别与辅助质粒共转染至BHK-21细胞中,拯救重组病毒rHEP-nCOV-S和rHEP-nCOV-S1。通过RT-PCR、Western blotting和荧光抗体染色,验证重组病毒、确证S和S1蛋白在RABV中成功表达。再将重组病毒接种NA细胞及成年小白鼠,测定病毒的体外生长特性、重组病毒的致病性及免疫原性。【结果】免疫荧光结果显示,转染7d后细胞上清均出现了绿色免疫荧光,表明已成功拯救嵌合SARS-CoV-2S和S1基因的重组病毒RABV rHEP-nCOV-S和rHEP-nCOV-S1,并且rHEP-nCOV-S1的增殖和扩散能力强于亲本株rHEP-Flury,但rHEP-nCOV-S与亲本株无显著差异。Western blotting结果显示,在目的位置处均出现72kDa和144kDa特异性条带,表明S和S1蛋白在重组RABV中高效表达。重组病毒免疫6周KM小鼠后,小鼠的体重变化与亲本RABV基本一致,重组病毒诱导小鼠产生狂犬中和抗体。【结论】本研究拯救出了嵌合SARS-CoV-2 S/S1基因的重组RABV,为动物COVID-19载体疫苗的研发奠定了基础。     

Immunogenicity,effectiveness and safety of COVID-19 vaccine in older adults living in nursing homes: A real-life study

IntroductionBNT162b2 (BioNTech and Pfizer) is a nucleoside-modified mRNA vaccine that provides protection against SARS-CoV-2 infection and is generally well tolerated. However, data about its efficacy, immunogenicity and safety in people of old age or with underlying chronic conditions are scarce.PurposeTo describe BNT162b2 (BioNTech and Pfizer) COVID-19 vaccine immunogenicity, effectiveness and reactogenicity after complete vaccination (two doses), and immunogenicity and reactogenicity after one booster, in elders residing in nursing homes (NH) and healthy NH workers in real-life conditions.MethodsObservational, ambispective, multicenter study. Older adults and health workers were recruited from three nursing homes of a private hospital corporation located in three Spanish cities. The primary vaccination was carried out between January and March 2021. The follow-up was 13 months. Humoral immunity, adverse events, SARS-CoV-2 infections, hospitalizations and deaths were evaluated. Cellular immunity was assessed in a participant subset.ResultsA total of 181 residents (mean age 84.1 years; 89.9% females, Charlson index ≥2: 45%) and 148 members of staff (mean age 45.2 years; 70.2% females) were surveyed (n:329). After primary vaccination of 327 participants, vaccine response in both groups was similar; ≈70% of participants, regardless of the group, had an antibody titer above the cut-off considered currently protective (260 BAU/ml). This proportion increased significantly to ≈ 98% after the booster (p < 0.0001 in both groups). Immunogenicity was largely determined by a prior history of COVID-19 infection. Twenty residents and 3 workers were tested for cellular immunity. There was evidence of cellular immunity after primary vaccination and after booster. During the study, one resident was hospitalized for SARS-CoV-2. No SARS-CoV-2-related deaths were reported and most adverse events were mild.ConclusionsOur results suggest that the BNT162b2 mRNA COVID-19 vaccine is immunogenic, effective and safe in elderly NH residents with underlying chronic conditions.