Система продуцирования: Hansenula polymorpha (Pichia angusta) Адекватность - свойства продукта экспрессии Эффективность

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Система продуцированияHansenula polymorpha(Pichia angusta)

Адекватность - свойства продукта экспрессииЭффективность ndash простая воспроизводимая технологияЭкономичность ndash низкая себестоимость продуктаProved - отработанное масштабное производство без рекламаций

(технологических или реализуемого продукта)

Дизайн Клонирование и Экспрессия структурных антигеновHBV и HCV = VLP

Технология- lab-scale - pilot scaleQCPre-clinical trials

Внедрение технологии и регистрация продуктов

Разработка противо-вирусных вакцин гепатитов В и С

Model of E2 glycoprotein The linear sequence of E2 ectodomain of the JFH-1 strain (GenBank access number AB237837) is represented as a chain of beads (coloured circles) labelled with the corresponding amino acids and threaded onto a class II fold which is an adapted version of the model published by Krey et al [7] (doi101371journalppat1000762g006) Amino acids are numbered with respect to the polyprotein of HCV strain H77 consensus sequence (GenBank accession number AF009606) used as a general reference The three putative domains are presented in red (DI) yellow (DII) and blue (DIII) the variable regions (HVR1 HVR2 and IgVR) are indicated in brown and the stem region is in grey Circles in pale and bright colours represent residues in the background and foreground of the domains respectively Disulphide bonds are indicated by black bars and glycosylation sites are shown by green circles numbered sequentially Amino acids of the putative fusion peptide are contoured in red and residues that participate in CD81 binding are contoured in blue

Ever closer to a prophylactic vaccine for HCVExpert Opin Biol Ther 2013 August13(8)1109-1124FreyChoo (Novartis)

CHO-derived E1-T2 with MP59Elmowalid Insect cells derived HCV-LP

() очевидно применение вакцин 3-го и 4-го поколений для иммунизации подростков ранее привитых по стандартной схеме для новорожденных по причинам - снижения уровня anti-HBs часто до недетектируемого уровня через 10-12 лет - особой важности достоточности иммунитета в критическом для заражения возрасте 13-16 лет

Поколе

ния

Состав

антигенов

Особенности Назначение

I HBsAg

(S preS2)

Была разработана в конце 70-х годов XX века на основе HBsAg выделяемого и очищенного из плазмы крови пациентов хронических носителей вируса гепатита В

Более не применяется в качестве профилактической вакцины

II HBsAg

(S)

Рекомбинантная на основе экспрессии S- области в клетках дрожжей

В настоящее время применяется для массовой иммунизации населения

III HBsAg

(S preS1 preS2)

Рекомбинантная на основе экспрессии preS-S области в дрожжах или перевиваемых клетках млекопитающих

Разработана для массовой иммунизации не иммунизированных II поколением как более эффективная

IVa HBsAg (S)

HBcAg (core)

Рекомбинантная на основе экспрессии в дрожжах Hansenula HBsAg и HBcAg вируса геапатита В

Предлагается для лечения хронических вирусоносителей

IVb HBsAg

(S preS1 preS2)

HBcAg (core)

Рекомбинантная на основе экспрессии в дрожжах Hansenula всех структурных белков вируса геапатита В

Предлагается как наиболее эффективная для массовой иммунизации не вакцинированных II поколением и лечения вирусоносителей

NLB

Классификация вакцин на основе вирусспецифического антигенного состава

HBV-дикий вирус

Anti-HBs пресс в результате массовой вакцинации Исходно5-7 мутантовЧерез 20 лет22 мутантов

Мутантные формы прогрессивно накапливаются у привитыхУ невакцинированных это случайные мутации а у привитых ndash MHR HBsAg

Анти-вирусная терапияс помощью нуклеозидных аналоговМутации происходят направленно в Pol-последовательности но фактически меняют аа последовательность в MHR HBsAg что приводит к неузнаванию anti-HBs

Мутанты иммунно-происхождения

Мутанты Pol-происхождения

Не узнают anti-HBs

Узнают anti-preS1 anti-preS2 anti-HBc

Вакцина 3-го пок

Вакцина 4в - пок

Drug-resistant mutations rtM204I (sI195M) and rtM204V (sW196S) caused significant reduction in antigenicity for the immune-escaped HBsAg mutants sG145K and sG145R which may hamper HBV diagnosis and disease controlVirology Journal 2013 10292

Due to the overlap between the polymerase and envelope genes drug-resistant mutants are accompanied by amino acid changes in the envelope proteins as well

Ito K et al J Virol 20108412850-12861

The HBV polymerase gene overlaps completely with the genes of the 3 surface (S) antigen proteins The area boxed by dashed lines indicates the area of the HBsAg immunodominant area and the HBV reverse transcription area indicates the genome area most likely to produce mutants in both genesHBsAg mutations selected during antiviral therapy can lead to a virus escaping HBV vaccination

Horvat RT Lab Med 201142(8)488-496

Several conditions have been recognized in which HBV escape mutants arise in clinical practice bulltreatment with anti-HBs immunoglobulin eg after liver transplantation to avoid reinfection of the graft (2332) bullantiviral therapy by itself as the reading frames of the envelope and polymerase genes overlap

and several resistance mutations in the polymerase selected during antiviral therapy simultaneously alter the antigenicity of HBsAg (2021 31) bullde novo infection of vaccinated individuals with escape mutants (19)

Moreover Datta et al recently reported that HBV variants with the sG145R immune escape mutation are frequently ldquohiderdquo in the peripheral blood leukocyte compartment of infected individuals and may then serve as a source of reactivation or transmission (7)

J Virol 2010 vol 84 no 2 1026-1033

По современным оценкам частота мутаций HBsAg среди вакцинированных колеблется от 2 до 28

Из-за повсеместной вакцинации частота мутаций будет возрастать

Математическая модель предсказывает исчезновение ВГВ дикого типа в областях с HBsAg-эндемичностью и появление S генных мутаций в течение 100 лет как следствия универсальной ВГВ-вакцинации

Гилязова ДГ руководитель отдела Иммунохимия ООО Текан

httpwwwlabmedicinarufilesPREZENTACII20-2020122320Gilyazovapdf

HBV-дикий вирус

Anti-HBs пресс в результате массовой вакцинации Исходно5-7 мутантовЧерез 20 лет22 мутантов

Мутантные формы прогрессивно накапливаются у привитыхУ невакцинированных это случайные мутации а у привитых ndash MHR HBsAg

Анти-вирусная терапияс помощью нуклеозидных аналоговМутации происходят направленно в Pol-последовательности но фактически меняют аа последовательность в MHR HBsAg что приводит к неузнаванию anti-HBs

Мутанты иммунно-происхождения

Мутанты Pol-происхождения

Не узнают anti-HBs

Узнают anti-preS1 anti-preS2 anti-HBc

Вакцина 3-го пок

Вакцина 4в - пок

Drug-resistant mutations rtM204I (sI195M) and rtM204V (sW196S) caused significant reduction in antigenicity for the immune-escaped HBsAg mutants sG145K and sG145R which may hamper HBV diagnosis and disease controlVirology Journal 2013 10292

Type of Vaccine Vaccine Antigen Adjuvant Host Cell Target Current Status References

Peptide

(a) Palmitolylated TT830-843 HTL

epitope covalently linked to the HBcAg 18 ndash27 CTL epitope

NACytotoxic T Lymphocyt

e

Phase II clinical trial

Livingston et al 1999 [22]

(b) HBV core antigen 18-27

peptide + tetanus taxoid peptide 830

843+palmic acid molecules

NACytotoxic T Lymphocyt

e

Pre-clinical amp clinical

Vitiello et al 1995 [23]

ProteinHBsAganti-

HBsIgAlum

Cytotoxic T Lymphocyt

e

Phase II clinical trial

Wen et al 2003

Xu et al 2008 [28]

DNA

Small(S) and middle (preS2S) proteins of the HBV envelope

(HBsAg)

NACD8+ T

Lymphocyte

Phase I clinical trial

Mancini et al 2004

Vector-basedModified

prHBV13HBVcore protein

NA

CD4+ and CD8+ T

Lymphocyte

Pre-clinicalDeng et al

2009 [8]

Cell-based

DCs pulsed with HBs28-39 peptide or

recombinant preS2S particles

NACytotoxic T Lymphocyt

ePre-clinical

Akbar et al 2004 [36]

Therapeutic Vaccine for Hepatitis B virusJ Infect Dis Immunol Tech 2012 11

Release Summary February 12 2014httpwwwbusinesswirecomnewshome20140212005051enCreation-ABIVAX---Leader-Therapeutic-Vaccines-FrenchU3PoW_ldW8AAbivax creation of ABIVAX - a leader in therapeutic vaccines and the first French company to sign an exclusive partnering agreement with Cuba in healthcareABIVAX specializes in therapeutic vaccines and antivirals combining the technologies and the product portfolios of three French biotech companies financed by Truffle CapitaABIVAX already has two therapeutic vaccines in development one in a Phase IIb clinical trial in patients with chronic hepatitis B

The HBsAgndashHBcAg vaccine candidate was safe well tolerated and immunogenic in this phase I study in healthy adults To our knowledge this is the first demonstration of safety and immunogenicity for a nasal vaccine candidate comprising HBV antigensThe vaccine elicited anti-HBc seroconversion in 100 of subjects as early as day 30 of the immunization schedule while a seroprotective anti-HBs titer (ge10 IUl) was at a maximum at day 90 (75) International Journal of Infectious DiseasesVolume 11 Issue 5 September 2007

A novel therapeutic hepatitis B vaccine induces cellular and humoral immune responses and breaks tolerance in hepatitis B virus (HBV) transgenic miceBuchmann P1 Dembek C Kuklick L Jaumlger C Tedjokusumo R von Freyend MJ Drebber U Janowicz Z Melber K Protzer U

1Rhein Biotech GmbH Duesseldorf Germany pbuchmanneudynavaxcomVaccine 2013 631(8)A paradigm of therapeutic vaccination is the potent induction of T-cell responses against key viral antigens ndash besides activation of a humoral immune response We have evaluated the potential of a novel vaccine formulation comprising particulate hepatitis B surface (HBsAg) and core antigen (HBcAg) and the saponin-based ISCOMATRIXtrade adjuvant for its ability to stimulate T and B cell responses in C57BL6 mice and its ability to break tolerance in HBV transgenic (HBVtg) mice The vaccine induced multifunctional HBsAg- and HBcAg-specific CD8+ T cells detected by staining for IFNγ TNFα and IL-2 as well as high antibody titers against both antigens Vaccination of HBVtg animals induced potent HBsAg- and HBcAg-specific CD8+ T-cell responses in spleens and HBcAg-specific CD8+ T-cell responses in livers as well as anti-HBs seroconversion two weeks post injection Vaccination further reduced HBcAg expression in livers of HBVtg mice without causing liver damage In summary this study demonstrates therapeutic efficacy of a novel vaccine formulation in a mouse model of immunotolerant chronic HBV infection

HBsAg-HBcAg vaccine version - IV generation

PreS1 is the priority target antigen for the new HBV vaccines because PreS1 has a greater number of immunogenic T cell and B cell epitopes than the S protein (9 12 15) including a strong T cell epitope (aa 21 to 28) and an effective B cell epitope (aa 12 to 32 and 32 to 53) The PreS1 protein has binding sites for liver cells (aa 21 to 47) that play an important role in viral attachment and entry (13 15) Neurath et al have shown that direct immunization with a PreS1 polypeptide (aa 21 to 47) can protect against HBV infection in chimpanzees (21) Additionally the PreS1 antibody is produced earlier than the S antibody and the PreS1-specific cell-mediated immunity may help overcome immune unresponsiveness to the S protein in certain individuals (19 24) Therefore the PreS1 antigen may play an important role in the neutralization blockade and clearance of HBV infections

Clin Vaccine Immun 2011 18(11) 1789-1795

Inclusion of PreS2S antigen in vaccine formulation could also mitigate the chances of non-responsiveness of vaccines against escape variants (Yamada et al 2001) The PreS2S gene is comprises of S gene with an extra 165 nucleotides at 5rsquo end (Tai et al 1997) and antigen is involved in nucleocapsid interaction (Poisson et al 1997) and extra cellular secretion of HBV particles (Le Seyec et al 1998) playing an important role in full stimulation of humoral and cellular immune responses In addition the PreS2S protein is also important for immunological responses at T-cell level and has T-cell and B-cell recognition sites spanning amino acids 1-25 of the protein (Neurath et al 1986) making it most suitable candidate antigen for HBV vaccine development This study describes the heterologous expression of a characterized PreS2S gene from genotype D of HBV in P pastoris The antigen will help to increase the efficacy of HBV recombinant vaccines

Pak J Bot 2012 44 355-359

Use of Pre-S Protein-Containing Hepatitis B Virus Surface Antigens and a Powerful Adjuvant To Develop an Immune Therapy for Chronic Hepatitis B Virus InfectionJung Sun Yum Byung Cheol Ahn [] and Hong Mo Moon

Clin Vaccine Immun 19(2) 2012

Роль preS-областей

J Hep 2011 54 1286-1296

НИИ вакцин и сывороток им И И Мечникова РАМН Москва

Сочетанная терапия laquoвакцина + альфа-2 бета-интерферонraquo позволила получить подавление вирусной репликации в первые 1ndash2 месяца от начала лечения у 786 больных сероконверсию HВsAg на анти-HВs mdash у 964 Исчезновение HВеAg наблюдалось через 6 месяца у всех больных а анти-HВе через 2ndash3 месяца от начала лечения появились у всех больных Наблюдение за пациентами в течение трех лет и более показало что стойкий ответ на лечение отмечался у 24 (857) К концу лечения нормализовались все популяции лимфоцитов высоким оставался только уровень лимфоцитов экспрессирующих рецептор к ИЛ-2 (CD25+) оставались сниженными резервы фагоцитоза и кислородзависимого киллинга [5]Таким образом вакцинация против ГВ является актуальной и необходимой больным с ХЗП пациентам с ХГВ иили ХГС носителям ВГВ иили ВГС поскольку способствует подавлению вирусной репликации у хронических вирусоносителей может играть существенную роль в контроле над виремией значительно повышает эффективность лечения ХВГ

Афигенова ВП Костинов МП 2011

Study Calls Into Question Effectiveness of Hepatitis B Vaccine for NewbornsDecember 17 2013httparticlesmercolacomsitesarticlesarchive20131217newborn-hepatitis-b-vaccineaspxBy Dr JM Mercola

New Study Hepatitis B Vaccination at Birth May Not Prevent Hidden InfectionsA new study is raising another red flag that the practice of universally vaccinating all newborn babies for hepatitis B is seriously flawed The researchers followed 259 babies born to hepatitis-B-positive mothers for two years in order to determine whether vaccinating such babies prevents asymptomatic occult HBV (hepatitis B virus) infectionThe researchers found that while the vaccine may help prevent overt HBV transmission it was not effective in preventing occult HBV infection in babies which may occur in up to 40 percent of babies born to hepatitis B-positive mothersHepatitis B Shot May Be Ineffective by the Time Your Child Is a TeenagerAnother issue to consider if you are weighing the benefits and risks of giving your newborn infant or young child hepatitis B vaccine is that vaccine acquired immunity often does not persist until a child reaches his or her teenage years ndash the time when acquiring a hepatitis B infection may be more likely Research shows that by that time the protection from the childhood vaccine may have long since wanedOne study found that about 15 percent of teens who received the full series of hepatitis B shots as infants tested positive for hepatitis B surface antigen (HBsAg) which is an early indicator of infection or a sign that the person is a chronic carrier of the virus3This percentage was even higher among teens who had received the hepatitis B vaccine off schedule or whose mothers were high risk meaning they tested positive for hepatitis B e antigen (HBeAg) In other words it appears that in many children hepatitis B vaccine acquired immunity does NOT provide lasting protection A Healthy Immune System Can Resolve Hepatitis B InfectionEven if you have been vaccinated as a child itrsquos important to remember that you may not be protected from these risks and could still be infected via IV drug abuse sexual activity with an infected partner a blood transfusion with contaminated blood or even getting a manicure or pedicurehellipFortunately in most cases the hepatitis B infection will resolve on its own provided you have a well-functioning immune system Symptoms can be relieved bybullRestingbullAvoiding foods that weaken your immune function such as sugarsfructose grains and processed foods Healthful foods that help boost your immune system include fermented foods and organic vegetablesbullOptimizing your vitamin D levelsbullDrinking plenty of pure waterbullAvoiding alcohol and drugs

Причинно-следственныеbull Перееданиеbull Неадекватное питаниеbull Вредные привычкиbull Гиподинамия либо перегрузкиbull Неадекватное дыханиеbull Неадекватность мироощущения (стресс дефицит мотивации подавленность- депрессия)bull ИНТОКСИКАЦИЯbull ПОДАВЛЕННОСТЬ ИММУНИТЕТА

Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

Курс оздоровления направленный на восстановление иммунной системы

Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

() Курс относится к категории SPA

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    Model of E2 glycoprotein The linear sequence of E2 ectodomain of the JFH-1 strain (GenBank access number AB237837) is represented as a chain of beads (coloured circles) labelled with the corresponding amino acids and threaded onto a class II fold which is an adapted version of the model published by Krey et al [7] (doi101371journalppat1000762g006) Amino acids are numbered with respect to the polyprotein of HCV strain H77 consensus sequence (GenBank accession number AF009606) used as a general reference The three putative domains are presented in red (DI) yellow (DII) and blue (DIII) the variable regions (HVR1 HVR2 and IgVR) are indicated in brown and the stem region is in grey Circles in pale and bright colours represent residues in the background and foreground of the domains respectively Disulphide bonds are indicated by black bars and glycosylation sites are shown by green circles numbered sequentially Amino acids of the putative fusion peptide are contoured in red and residues that participate in CD81 binding are contoured in blue

    Ever closer to a prophylactic vaccine for HCVExpert Opin Biol Ther 2013 August13(8)1109-1124FreyChoo (Novartis)

    CHO-derived E1-T2 with MP59Elmowalid Insect cells derived HCV-LP

    () очевидно применение вакцин 3-го и 4-го поколений для иммунизации подростков ранее привитых по стандартной схеме для новорожденных по причинам - снижения уровня anti-HBs часто до недетектируемого уровня через 10-12 лет - особой важности достоточности иммунитета в критическом для заражения возрасте 13-16 лет

    Поколе

    ния

    Состав

    антигенов

    Особенности Назначение

    I HBsAg

    (S preS2)

    Была разработана в конце 70-х годов XX века на основе HBsAg выделяемого и очищенного из плазмы крови пациентов хронических носителей вируса гепатита В

    Более не применяется в качестве профилактической вакцины

    II HBsAg

    (S)

    Рекомбинантная на основе экспрессии S- области в клетках дрожжей

    В настоящее время применяется для массовой иммунизации населения

    III HBsAg

    (S preS1 preS2)

    Рекомбинантная на основе экспрессии preS-S области в дрожжах или перевиваемых клетках млекопитающих

    Разработана для массовой иммунизации не иммунизированных II поколением как более эффективная

    IVa HBsAg (S)

    HBcAg (core)

    Рекомбинантная на основе экспрессии в дрожжах Hansenula HBsAg и HBcAg вируса геапатита В

    Предлагается для лечения хронических вирусоносителей

    IVb HBsAg

    (S preS1 preS2)

    HBcAg (core)

    Рекомбинантная на основе экспрессии в дрожжах Hansenula всех структурных белков вируса геапатита В

    Предлагается как наиболее эффективная для массовой иммунизации не вакцинированных II поколением и лечения вирусоносителей

    NLB

    Классификация вакцин на основе вирусспецифического антигенного состава

    HBV-дикий вирус

    Anti-HBs пресс в результате массовой вакцинации Исходно5-7 мутантовЧерез 20 лет22 мутантов

    Мутантные формы прогрессивно накапливаются у привитыхУ невакцинированных это случайные мутации а у привитых ndash MHR HBsAg

    Анти-вирусная терапияс помощью нуклеозидных аналоговМутации происходят направленно в Pol-последовательности но фактически меняют аа последовательность в MHR HBsAg что приводит к неузнаванию anti-HBs

    Мутанты иммунно-происхождения

    Мутанты Pol-происхождения

    Не узнают anti-HBs

    Узнают anti-preS1 anti-preS2 anti-HBc

    Вакцина 3-го пок

    Вакцина 4в - пок

    Drug-resistant mutations rtM204I (sI195M) and rtM204V (sW196S) caused significant reduction in antigenicity for the immune-escaped HBsAg mutants sG145K and sG145R which may hamper HBV diagnosis and disease controlVirology Journal 2013 10292

    Due to the overlap between the polymerase and envelope genes drug-resistant mutants are accompanied by amino acid changes in the envelope proteins as well

    Ito K et al J Virol 20108412850-12861

    The HBV polymerase gene overlaps completely with the genes of the 3 surface (S) antigen proteins The area boxed by dashed lines indicates the area of the HBsAg immunodominant area and the HBV reverse transcription area indicates the genome area most likely to produce mutants in both genesHBsAg mutations selected during antiviral therapy can lead to a virus escaping HBV vaccination

    Horvat RT Lab Med 201142(8)488-496

    Several conditions have been recognized in which HBV escape mutants arise in clinical practice bulltreatment with anti-HBs immunoglobulin eg after liver transplantation to avoid reinfection of the graft (2332) bullantiviral therapy by itself as the reading frames of the envelope and polymerase genes overlap

    and several resistance mutations in the polymerase selected during antiviral therapy simultaneously alter the antigenicity of HBsAg (2021 31) bullde novo infection of vaccinated individuals with escape mutants (19)

    Moreover Datta et al recently reported that HBV variants with the sG145R immune escape mutation are frequently ldquohiderdquo in the peripheral blood leukocyte compartment of infected individuals and may then serve as a source of reactivation or transmission (7)

    J Virol 2010 vol 84 no 2 1026-1033

    По современным оценкам частота мутаций HBsAg среди вакцинированных колеблется от 2 до 28

    Из-за повсеместной вакцинации частота мутаций будет возрастать

    Математическая модель предсказывает исчезновение ВГВ дикого типа в областях с HBsAg-эндемичностью и появление S генных мутаций в течение 100 лет как следствия универсальной ВГВ-вакцинации

    Гилязова ДГ руководитель отдела Иммунохимия ООО Текан

    httpwwwlabmedicinarufilesPREZENTACII20-2020122320Gilyazovapdf

    HBV-дикий вирус

    Anti-HBs пресс в результате массовой вакцинации Исходно5-7 мутантовЧерез 20 лет22 мутантов

    Мутантные формы прогрессивно накапливаются у привитыхУ невакцинированных это случайные мутации а у привитых ndash MHR HBsAg

    Анти-вирусная терапияс помощью нуклеозидных аналоговМутации происходят направленно в Pol-последовательности но фактически меняют аа последовательность в MHR HBsAg что приводит к неузнаванию anti-HBs

    Мутанты иммунно-происхождения

    Мутанты Pol-происхождения

    Не узнают anti-HBs

    Узнают anti-preS1 anti-preS2 anti-HBc

    Вакцина 3-го пок

    Вакцина 4в - пок

    Drug-resistant mutations rtM204I (sI195M) and rtM204V (sW196S) caused significant reduction in antigenicity for the immune-escaped HBsAg mutants sG145K and sG145R which may hamper HBV diagnosis and disease controlVirology Journal 2013 10292

    Type of Vaccine Vaccine Antigen Adjuvant Host Cell Target Current Status References

    Peptide

    (a) Palmitolylated TT830-843 HTL

    epitope covalently linked to the HBcAg 18 ndash27 CTL epitope

    NACytotoxic T Lymphocyt

    e

    Phase II clinical trial

    Livingston et al 1999 [22]

    (b) HBV core antigen 18-27

    peptide + tetanus taxoid peptide 830

    843+palmic acid molecules

    NACytotoxic T Lymphocyt

    e

    Pre-clinical amp clinical

    Vitiello et al 1995 [23]

    ProteinHBsAganti-

    HBsIgAlum

    Cytotoxic T Lymphocyt

    e

    Phase II clinical trial

    Wen et al 2003

    Xu et al 2008 [28]

    DNA

    Small(S) and middle (preS2S) proteins of the HBV envelope

    (HBsAg)

    NACD8+ T

    Lymphocyte

    Phase I clinical trial

    Mancini et al 2004

    Vector-basedModified

    prHBV13HBVcore protein

    NA

    CD4+ and CD8+ T

    Lymphocyte

    Pre-clinicalDeng et al

    2009 [8]

    Cell-based

    DCs pulsed with HBs28-39 peptide or

    recombinant preS2S particles

    NACytotoxic T Lymphocyt

    ePre-clinical

    Akbar et al 2004 [36]

    Therapeutic Vaccine for Hepatitis B virusJ Infect Dis Immunol Tech 2012 11

    Release Summary February 12 2014httpwwwbusinesswirecomnewshome20140212005051enCreation-ABIVAX---Leader-Therapeutic-Vaccines-FrenchU3PoW_ldW8AAbivax creation of ABIVAX - a leader in therapeutic vaccines and the first French company to sign an exclusive partnering agreement with Cuba in healthcareABIVAX specializes in therapeutic vaccines and antivirals combining the technologies and the product portfolios of three French biotech companies financed by Truffle CapitaABIVAX already has two therapeutic vaccines in development one in a Phase IIb clinical trial in patients with chronic hepatitis B

    The HBsAgndashHBcAg vaccine candidate was safe well tolerated and immunogenic in this phase I study in healthy adults To our knowledge this is the first demonstration of safety and immunogenicity for a nasal vaccine candidate comprising HBV antigensThe vaccine elicited anti-HBc seroconversion in 100 of subjects as early as day 30 of the immunization schedule while a seroprotective anti-HBs titer (ge10 IUl) was at a maximum at day 90 (75) International Journal of Infectious DiseasesVolume 11 Issue 5 September 2007

    A novel therapeutic hepatitis B vaccine induces cellular and humoral immune responses and breaks tolerance in hepatitis B virus (HBV) transgenic miceBuchmann P1 Dembek C Kuklick L Jaumlger C Tedjokusumo R von Freyend MJ Drebber U Janowicz Z Melber K Protzer U

    1Rhein Biotech GmbH Duesseldorf Germany pbuchmanneudynavaxcomVaccine 2013 631(8)A paradigm of therapeutic vaccination is the potent induction of T-cell responses against key viral antigens ndash besides activation of a humoral immune response We have evaluated the potential of a novel vaccine formulation comprising particulate hepatitis B surface (HBsAg) and core antigen (HBcAg) and the saponin-based ISCOMATRIXtrade adjuvant for its ability to stimulate T and B cell responses in C57BL6 mice and its ability to break tolerance in HBV transgenic (HBVtg) mice The vaccine induced multifunctional HBsAg- and HBcAg-specific CD8+ T cells detected by staining for IFNγ TNFα and IL-2 as well as high antibody titers against both antigens Vaccination of HBVtg animals induced potent HBsAg- and HBcAg-specific CD8+ T-cell responses in spleens and HBcAg-specific CD8+ T-cell responses in livers as well as anti-HBs seroconversion two weeks post injection Vaccination further reduced HBcAg expression in livers of HBVtg mice without causing liver damage In summary this study demonstrates therapeutic efficacy of a novel vaccine formulation in a mouse model of immunotolerant chronic HBV infection

    HBsAg-HBcAg vaccine version - IV generation

    PreS1 is the priority target antigen for the new HBV vaccines because PreS1 has a greater number of immunogenic T cell and B cell epitopes than the S protein (9 12 15) including a strong T cell epitope (aa 21 to 28) and an effective B cell epitope (aa 12 to 32 and 32 to 53) The PreS1 protein has binding sites for liver cells (aa 21 to 47) that play an important role in viral attachment and entry (13 15) Neurath et al have shown that direct immunization with a PreS1 polypeptide (aa 21 to 47) can protect against HBV infection in chimpanzees (21) Additionally the PreS1 antibody is produced earlier than the S antibody and the PreS1-specific cell-mediated immunity may help overcome immune unresponsiveness to the S protein in certain individuals (19 24) Therefore the PreS1 antigen may play an important role in the neutralization blockade and clearance of HBV infections

    Clin Vaccine Immun 2011 18(11) 1789-1795

    Inclusion of PreS2S antigen in vaccine formulation could also mitigate the chances of non-responsiveness of vaccines against escape variants (Yamada et al 2001) The PreS2S gene is comprises of S gene with an extra 165 nucleotides at 5rsquo end (Tai et al 1997) and antigen is involved in nucleocapsid interaction (Poisson et al 1997) and extra cellular secretion of HBV particles (Le Seyec et al 1998) playing an important role in full stimulation of humoral and cellular immune responses In addition the PreS2S protein is also important for immunological responses at T-cell level and has T-cell and B-cell recognition sites spanning amino acids 1-25 of the protein (Neurath et al 1986) making it most suitable candidate antigen for HBV vaccine development This study describes the heterologous expression of a characterized PreS2S gene from genotype D of HBV in P pastoris The antigen will help to increase the efficacy of HBV recombinant vaccines

    Pak J Bot 2012 44 355-359

    Use of Pre-S Protein-Containing Hepatitis B Virus Surface Antigens and a Powerful Adjuvant To Develop an Immune Therapy for Chronic Hepatitis B Virus InfectionJung Sun Yum Byung Cheol Ahn [] and Hong Mo Moon

    Clin Vaccine Immun 19(2) 2012

    Роль preS-областей

    J Hep 2011 54 1286-1296

    НИИ вакцин и сывороток им И И Мечникова РАМН Москва

    Сочетанная терапия laquoвакцина + альфа-2 бета-интерферонraquo позволила получить подавление вирусной репликации в первые 1ndash2 месяца от начала лечения у 786 больных сероконверсию HВsAg на анти-HВs mdash у 964 Исчезновение HВеAg наблюдалось через 6 месяца у всех больных а анти-HВе через 2ndash3 месяца от начала лечения появились у всех больных Наблюдение за пациентами в течение трех лет и более показало что стойкий ответ на лечение отмечался у 24 (857) К концу лечения нормализовались все популяции лимфоцитов высоким оставался только уровень лимфоцитов экспрессирующих рецептор к ИЛ-2 (CD25+) оставались сниженными резервы фагоцитоза и кислородзависимого киллинга [5]Таким образом вакцинация против ГВ является актуальной и необходимой больным с ХЗП пациентам с ХГВ иили ХГС носителям ВГВ иили ВГС поскольку способствует подавлению вирусной репликации у хронических вирусоносителей может играть существенную роль в контроле над виремией значительно повышает эффективность лечения ХВГ

    Афигенова ВП Костинов МП 2011

    Study Calls Into Question Effectiveness of Hepatitis B Vaccine for NewbornsDecember 17 2013httparticlesmercolacomsitesarticlesarchive20131217newborn-hepatitis-b-vaccineaspxBy Dr JM Mercola

    New Study Hepatitis B Vaccination at Birth May Not Prevent Hidden InfectionsA new study is raising another red flag that the practice of universally vaccinating all newborn babies for hepatitis B is seriously flawed The researchers followed 259 babies born to hepatitis-B-positive mothers for two years in order to determine whether vaccinating such babies prevents asymptomatic occult HBV (hepatitis B virus) infectionThe researchers found that while the vaccine may help prevent overt HBV transmission it was not effective in preventing occult HBV infection in babies which may occur in up to 40 percent of babies born to hepatitis B-positive mothersHepatitis B Shot May Be Ineffective by the Time Your Child Is a TeenagerAnother issue to consider if you are weighing the benefits and risks of giving your newborn infant or young child hepatitis B vaccine is that vaccine acquired immunity often does not persist until a child reaches his or her teenage years ndash the time when acquiring a hepatitis B infection may be more likely Research shows that by that time the protection from the childhood vaccine may have long since wanedOne study found that about 15 percent of teens who received the full series of hepatitis B shots as infants tested positive for hepatitis B surface antigen (HBsAg) which is an early indicator of infection or a sign that the person is a chronic carrier of the virus3This percentage was even higher among teens who had received the hepatitis B vaccine off schedule or whose mothers were high risk meaning they tested positive for hepatitis B e antigen (HBeAg) In other words it appears that in many children hepatitis B vaccine acquired immunity does NOT provide lasting protection A Healthy Immune System Can Resolve Hepatitis B InfectionEven if you have been vaccinated as a child itrsquos important to remember that you may not be protected from these risks and could still be infected via IV drug abuse sexual activity with an infected partner a blood transfusion with contaminated blood or even getting a manicure or pedicurehellipFortunately in most cases the hepatitis B infection will resolve on its own provided you have a well-functioning immune system Symptoms can be relieved bybullRestingbullAvoiding foods that weaken your immune function such as sugarsfructose grains and processed foods Healthful foods that help boost your immune system include fermented foods and organic vegetablesbullOptimizing your vitamin D levelsbullDrinking plenty of pure waterbullAvoiding alcohol and drugs

    Причинно-следственныеbull Перееданиеbull Неадекватное питаниеbull Вредные привычкиbull Гиподинамия либо перегрузкиbull Неадекватное дыханиеbull Неадекватность мироощущения (стресс дефицит мотивации подавленность- депрессия)bull ИНТОКСИКАЦИЯbull ПОДАВЛЕННОСТЬ ИММУНИТЕТА

    Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

    Курс оздоровления направленный на восстановление иммунной системы

    Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

    М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

    Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

    () Курс относится к категории SPA

    • Slide 1
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      Ever closer to a prophylactic vaccine for HCVExpert Opin Biol Ther 2013 August13(8)1109-1124FreyChoo (Novartis)

      CHO-derived E1-T2 with MP59Elmowalid Insect cells derived HCV-LP

      () очевидно применение вакцин 3-го и 4-го поколений для иммунизации подростков ранее привитых по стандартной схеме для новорожденных по причинам - снижения уровня anti-HBs часто до недетектируемого уровня через 10-12 лет - особой важности достоточности иммунитета в критическом для заражения возрасте 13-16 лет

      Поколе

      ния

      Состав

      антигенов

      Особенности Назначение

      I HBsAg

      (S preS2)

      Была разработана в конце 70-х годов XX века на основе HBsAg выделяемого и очищенного из плазмы крови пациентов хронических носителей вируса гепатита В

      Более не применяется в качестве профилактической вакцины

      II HBsAg

      (S)

      Рекомбинантная на основе экспрессии S- области в клетках дрожжей

      В настоящее время применяется для массовой иммунизации населения

      III HBsAg

      (S preS1 preS2)

      Рекомбинантная на основе экспрессии preS-S области в дрожжах или перевиваемых клетках млекопитающих

      Разработана для массовой иммунизации не иммунизированных II поколением как более эффективная

      IVa HBsAg (S)

      HBcAg (core)

      Рекомбинантная на основе экспрессии в дрожжах Hansenula HBsAg и HBcAg вируса геапатита В

      Предлагается для лечения хронических вирусоносителей

      IVb HBsAg

      (S preS1 preS2)

      HBcAg (core)

      Рекомбинантная на основе экспрессии в дрожжах Hansenula всех структурных белков вируса геапатита В

      Предлагается как наиболее эффективная для массовой иммунизации не вакцинированных II поколением и лечения вирусоносителей

      NLB

      Классификация вакцин на основе вирусспецифического антигенного состава

      HBV-дикий вирус

      Anti-HBs пресс в результате массовой вакцинации Исходно5-7 мутантовЧерез 20 лет22 мутантов

      Мутантные формы прогрессивно накапливаются у привитыхУ невакцинированных это случайные мутации а у привитых ndash MHR HBsAg

      Анти-вирусная терапияс помощью нуклеозидных аналоговМутации происходят направленно в Pol-последовательности но фактически меняют аа последовательность в MHR HBsAg что приводит к неузнаванию anti-HBs

      Мутанты иммунно-происхождения

      Мутанты Pol-происхождения

      Не узнают anti-HBs

      Узнают anti-preS1 anti-preS2 anti-HBc

      Вакцина 3-го пок

      Вакцина 4в - пок

      Drug-resistant mutations rtM204I (sI195M) and rtM204V (sW196S) caused significant reduction in antigenicity for the immune-escaped HBsAg mutants sG145K and sG145R which may hamper HBV diagnosis and disease controlVirology Journal 2013 10292

      Due to the overlap between the polymerase and envelope genes drug-resistant mutants are accompanied by amino acid changes in the envelope proteins as well

      Ito K et al J Virol 20108412850-12861

      The HBV polymerase gene overlaps completely with the genes of the 3 surface (S) antigen proteins The area boxed by dashed lines indicates the area of the HBsAg immunodominant area and the HBV reverse transcription area indicates the genome area most likely to produce mutants in both genesHBsAg mutations selected during antiviral therapy can lead to a virus escaping HBV vaccination

      Horvat RT Lab Med 201142(8)488-496

      Several conditions have been recognized in which HBV escape mutants arise in clinical practice bulltreatment with anti-HBs immunoglobulin eg after liver transplantation to avoid reinfection of the graft (2332) bullantiviral therapy by itself as the reading frames of the envelope and polymerase genes overlap

      and several resistance mutations in the polymerase selected during antiviral therapy simultaneously alter the antigenicity of HBsAg (2021 31) bullde novo infection of vaccinated individuals with escape mutants (19)

      Moreover Datta et al recently reported that HBV variants with the sG145R immune escape mutation are frequently ldquohiderdquo in the peripheral blood leukocyte compartment of infected individuals and may then serve as a source of reactivation or transmission (7)

      J Virol 2010 vol 84 no 2 1026-1033

      По современным оценкам частота мутаций HBsAg среди вакцинированных колеблется от 2 до 28

      Из-за повсеместной вакцинации частота мутаций будет возрастать

      Математическая модель предсказывает исчезновение ВГВ дикого типа в областях с HBsAg-эндемичностью и появление S генных мутаций в течение 100 лет как следствия универсальной ВГВ-вакцинации

      Гилязова ДГ руководитель отдела Иммунохимия ООО Текан

      httpwwwlabmedicinarufilesPREZENTACII20-2020122320Gilyazovapdf

      HBV-дикий вирус

      Anti-HBs пресс в результате массовой вакцинации Исходно5-7 мутантовЧерез 20 лет22 мутантов

      Мутантные формы прогрессивно накапливаются у привитыхУ невакцинированных это случайные мутации а у привитых ndash MHR HBsAg

      Анти-вирусная терапияс помощью нуклеозидных аналоговМутации происходят направленно в Pol-последовательности но фактически меняют аа последовательность в MHR HBsAg что приводит к неузнаванию anti-HBs

      Мутанты иммунно-происхождения

      Мутанты Pol-происхождения

      Не узнают anti-HBs

      Узнают anti-preS1 anti-preS2 anti-HBc

      Вакцина 3-го пок

      Вакцина 4в - пок

      Drug-resistant mutations rtM204I (sI195M) and rtM204V (sW196S) caused significant reduction in antigenicity for the immune-escaped HBsAg mutants sG145K and sG145R which may hamper HBV diagnosis and disease controlVirology Journal 2013 10292

      Type of Vaccine Vaccine Antigen Adjuvant Host Cell Target Current Status References

      Peptide

      (a) Palmitolylated TT830-843 HTL

      epitope covalently linked to the HBcAg 18 ndash27 CTL epitope

      NACytotoxic T Lymphocyt

      e

      Phase II clinical trial

      Livingston et al 1999 [22]

      (b) HBV core antigen 18-27

      peptide + tetanus taxoid peptide 830

      843+palmic acid molecules

      NACytotoxic T Lymphocyt

      e

      Pre-clinical amp clinical

      Vitiello et al 1995 [23]

      ProteinHBsAganti-

      HBsIgAlum

      Cytotoxic T Lymphocyt

      e

      Phase II clinical trial

      Wen et al 2003

      Xu et al 2008 [28]

      DNA

      Small(S) and middle (preS2S) proteins of the HBV envelope

      (HBsAg)

      NACD8+ T

      Lymphocyte

      Phase I clinical trial

      Mancini et al 2004

      Vector-basedModified

      prHBV13HBVcore protein

      NA

      CD4+ and CD8+ T

      Lymphocyte

      Pre-clinicalDeng et al

      2009 [8]

      Cell-based

      DCs pulsed with HBs28-39 peptide or

      recombinant preS2S particles

      NACytotoxic T Lymphocyt

      ePre-clinical

      Akbar et al 2004 [36]

      Therapeutic Vaccine for Hepatitis B virusJ Infect Dis Immunol Tech 2012 11

      Release Summary February 12 2014httpwwwbusinesswirecomnewshome20140212005051enCreation-ABIVAX---Leader-Therapeutic-Vaccines-FrenchU3PoW_ldW8AAbivax creation of ABIVAX - a leader in therapeutic vaccines and the first French company to sign an exclusive partnering agreement with Cuba in healthcareABIVAX specializes in therapeutic vaccines and antivirals combining the technologies and the product portfolios of three French biotech companies financed by Truffle CapitaABIVAX already has two therapeutic vaccines in development one in a Phase IIb clinical trial in patients with chronic hepatitis B

      The HBsAgndashHBcAg vaccine candidate was safe well tolerated and immunogenic in this phase I study in healthy adults To our knowledge this is the first demonstration of safety and immunogenicity for a nasal vaccine candidate comprising HBV antigensThe vaccine elicited anti-HBc seroconversion in 100 of subjects as early as day 30 of the immunization schedule while a seroprotective anti-HBs titer (ge10 IUl) was at a maximum at day 90 (75) International Journal of Infectious DiseasesVolume 11 Issue 5 September 2007

      A novel therapeutic hepatitis B vaccine induces cellular and humoral immune responses and breaks tolerance in hepatitis B virus (HBV) transgenic miceBuchmann P1 Dembek C Kuklick L Jaumlger C Tedjokusumo R von Freyend MJ Drebber U Janowicz Z Melber K Protzer U

      1Rhein Biotech GmbH Duesseldorf Germany pbuchmanneudynavaxcomVaccine 2013 631(8)A paradigm of therapeutic vaccination is the potent induction of T-cell responses against key viral antigens ndash besides activation of a humoral immune response We have evaluated the potential of a novel vaccine formulation comprising particulate hepatitis B surface (HBsAg) and core antigen (HBcAg) and the saponin-based ISCOMATRIXtrade adjuvant for its ability to stimulate T and B cell responses in C57BL6 mice and its ability to break tolerance in HBV transgenic (HBVtg) mice The vaccine induced multifunctional HBsAg- and HBcAg-specific CD8+ T cells detected by staining for IFNγ TNFα and IL-2 as well as high antibody titers against both antigens Vaccination of HBVtg animals induced potent HBsAg- and HBcAg-specific CD8+ T-cell responses in spleens and HBcAg-specific CD8+ T-cell responses in livers as well as anti-HBs seroconversion two weeks post injection Vaccination further reduced HBcAg expression in livers of HBVtg mice without causing liver damage In summary this study demonstrates therapeutic efficacy of a novel vaccine formulation in a mouse model of immunotolerant chronic HBV infection

      HBsAg-HBcAg vaccine version - IV generation

      PreS1 is the priority target antigen for the new HBV vaccines because PreS1 has a greater number of immunogenic T cell and B cell epitopes than the S protein (9 12 15) including a strong T cell epitope (aa 21 to 28) and an effective B cell epitope (aa 12 to 32 and 32 to 53) The PreS1 protein has binding sites for liver cells (aa 21 to 47) that play an important role in viral attachment and entry (13 15) Neurath et al have shown that direct immunization with a PreS1 polypeptide (aa 21 to 47) can protect against HBV infection in chimpanzees (21) Additionally the PreS1 antibody is produced earlier than the S antibody and the PreS1-specific cell-mediated immunity may help overcome immune unresponsiveness to the S protein in certain individuals (19 24) Therefore the PreS1 antigen may play an important role in the neutralization blockade and clearance of HBV infections

      Clin Vaccine Immun 2011 18(11) 1789-1795

      Inclusion of PreS2S antigen in vaccine formulation could also mitigate the chances of non-responsiveness of vaccines against escape variants (Yamada et al 2001) The PreS2S gene is comprises of S gene with an extra 165 nucleotides at 5rsquo end (Tai et al 1997) and antigen is involved in nucleocapsid interaction (Poisson et al 1997) and extra cellular secretion of HBV particles (Le Seyec et al 1998) playing an important role in full stimulation of humoral and cellular immune responses In addition the PreS2S protein is also important for immunological responses at T-cell level and has T-cell and B-cell recognition sites spanning amino acids 1-25 of the protein (Neurath et al 1986) making it most suitable candidate antigen for HBV vaccine development This study describes the heterologous expression of a characterized PreS2S gene from genotype D of HBV in P pastoris The antigen will help to increase the efficacy of HBV recombinant vaccines

      Pak J Bot 2012 44 355-359

      Use of Pre-S Protein-Containing Hepatitis B Virus Surface Antigens and a Powerful Adjuvant To Develop an Immune Therapy for Chronic Hepatitis B Virus InfectionJung Sun Yum Byung Cheol Ahn [] and Hong Mo Moon

      Clin Vaccine Immun 19(2) 2012

      Роль preS-областей

      J Hep 2011 54 1286-1296

      НИИ вакцин и сывороток им И И Мечникова РАМН Москва

      Сочетанная терапия laquoвакцина + альфа-2 бета-интерферонraquo позволила получить подавление вирусной репликации в первые 1ndash2 месяца от начала лечения у 786 больных сероконверсию HВsAg на анти-HВs mdash у 964 Исчезновение HВеAg наблюдалось через 6 месяца у всех больных а анти-HВе через 2ndash3 месяца от начала лечения появились у всех больных Наблюдение за пациентами в течение трех лет и более показало что стойкий ответ на лечение отмечался у 24 (857) К концу лечения нормализовались все популяции лимфоцитов высоким оставался только уровень лимфоцитов экспрессирующих рецептор к ИЛ-2 (CD25+) оставались сниженными резервы фагоцитоза и кислородзависимого киллинга [5]Таким образом вакцинация против ГВ является актуальной и необходимой больным с ХЗП пациентам с ХГВ иили ХГС носителям ВГВ иили ВГС поскольку способствует подавлению вирусной репликации у хронических вирусоносителей может играть существенную роль в контроле над виремией значительно повышает эффективность лечения ХВГ

      Афигенова ВП Костинов МП 2011

      Study Calls Into Question Effectiveness of Hepatitis B Vaccine for NewbornsDecember 17 2013httparticlesmercolacomsitesarticlesarchive20131217newborn-hepatitis-b-vaccineaspxBy Dr JM Mercola

      New Study Hepatitis B Vaccination at Birth May Not Prevent Hidden InfectionsA new study is raising another red flag that the practice of universally vaccinating all newborn babies for hepatitis B is seriously flawed The researchers followed 259 babies born to hepatitis-B-positive mothers for two years in order to determine whether vaccinating such babies prevents asymptomatic occult HBV (hepatitis B virus) infectionThe researchers found that while the vaccine may help prevent overt HBV transmission it was not effective in preventing occult HBV infection in babies which may occur in up to 40 percent of babies born to hepatitis B-positive mothersHepatitis B Shot May Be Ineffective by the Time Your Child Is a TeenagerAnother issue to consider if you are weighing the benefits and risks of giving your newborn infant or young child hepatitis B vaccine is that vaccine acquired immunity often does not persist until a child reaches his or her teenage years ndash the time when acquiring a hepatitis B infection may be more likely Research shows that by that time the protection from the childhood vaccine may have long since wanedOne study found that about 15 percent of teens who received the full series of hepatitis B shots as infants tested positive for hepatitis B surface antigen (HBsAg) which is an early indicator of infection or a sign that the person is a chronic carrier of the virus3This percentage was even higher among teens who had received the hepatitis B vaccine off schedule or whose mothers were high risk meaning they tested positive for hepatitis B e antigen (HBeAg) In other words it appears that in many children hepatitis B vaccine acquired immunity does NOT provide lasting protection A Healthy Immune System Can Resolve Hepatitis B InfectionEven if you have been vaccinated as a child itrsquos important to remember that you may not be protected from these risks and could still be infected via IV drug abuse sexual activity with an infected partner a blood transfusion with contaminated blood or even getting a manicure or pedicurehellipFortunately in most cases the hepatitis B infection will resolve on its own provided you have a well-functioning immune system Symptoms can be relieved bybullRestingbullAvoiding foods that weaken your immune function such as sugarsfructose grains and processed foods Healthful foods that help boost your immune system include fermented foods and organic vegetablesbullOptimizing your vitamin D levelsbullDrinking plenty of pure waterbullAvoiding alcohol and drugs

      Причинно-следственныеbull Перееданиеbull Неадекватное питаниеbull Вредные привычкиbull Гиподинамия либо перегрузкиbull Неадекватное дыханиеbull Неадекватность мироощущения (стресс дефицит мотивации подавленность- депрессия)bull ИНТОКСИКАЦИЯbull ПОДАВЛЕННОСТЬ ИММУНИТЕТА

      Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

      Курс оздоровления направленный на восстановление иммунной системы

      Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

      М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

      Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

      () Курс относится к категории SPA

      • Slide 1
      • Slide 2
      • Slide 5
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        () очевидно применение вакцин 3-го и 4-го поколений для иммунизации подростков ранее привитых по стандартной схеме для новорожденных по причинам - снижения уровня anti-HBs часто до недетектируемого уровня через 10-12 лет - особой важности достоточности иммунитета в критическом для заражения возрасте 13-16 лет

        Поколе

        ния

        Состав

        антигенов

        Особенности Назначение

        I HBsAg

        (S preS2)

        Была разработана в конце 70-х годов XX века на основе HBsAg выделяемого и очищенного из плазмы крови пациентов хронических носителей вируса гепатита В

        Более не применяется в качестве профилактической вакцины

        II HBsAg

        (S)

        Рекомбинантная на основе экспрессии S- области в клетках дрожжей

        В настоящее время применяется для массовой иммунизации населения

        III HBsAg

        (S preS1 preS2)

        Рекомбинантная на основе экспрессии preS-S области в дрожжах или перевиваемых клетках млекопитающих

        Разработана для массовой иммунизации не иммунизированных II поколением как более эффективная

        IVa HBsAg (S)

        HBcAg (core)

        Рекомбинантная на основе экспрессии в дрожжах Hansenula HBsAg и HBcAg вируса геапатита В

        Предлагается для лечения хронических вирусоносителей

        IVb HBsAg

        (S preS1 preS2)

        HBcAg (core)

        Рекомбинантная на основе экспрессии в дрожжах Hansenula всех структурных белков вируса геапатита В

        Предлагается как наиболее эффективная для массовой иммунизации не вакцинированных II поколением и лечения вирусоносителей

        NLB

        Классификация вакцин на основе вирусспецифического антигенного состава

        HBV-дикий вирус

        Anti-HBs пресс в результате массовой вакцинации Исходно5-7 мутантовЧерез 20 лет22 мутантов

        Мутантные формы прогрессивно накапливаются у привитыхУ невакцинированных это случайные мутации а у привитых ndash MHR HBsAg

        Анти-вирусная терапияс помощью нуклеозидных аналоговМутации происходят направленно в Pol-последовательности но фактически меняют аа последовательность в MHR HBsAg что приводит к неузнаванию anti-HBs

        Мутанты иммунно-происхождения

        Мутанты Pol-происхождения

        Не узнают anti-HBs

        Узнают anti-preS1 anti-preS2 anti-HBc

        Вакцина 3-го пок

        Вакцина 4в - пок

        Drug-resistant mutations rtM204I (sI195M) and rtM204V (sW196S) caused significant reduction in antigenicity for the immune-escaped HBsAg mutants sG145K and sG145R which may hamper HBV diagnosis and disease controlVirology Journal 2013 10292

        Due to the overlap between the polymerase and envelope genes drug-resistant mutants are accompanied by amino acid changes in the envelope proteins as well

        Ito K et al J Virol 20108412850-12861

        The HBV polymerase gene overlaps completely with the genes of the 3 surface (S) antigen proteins The area boxed by dashed lines indicates the area of the HBsAg immunodominant area and the HBV reverse transcription area indicates the genome area most likely to produce mutants in both genesHBsAg mutations selected during antiviral therapy can lead to a virus escaping HBV vaccination

        Horvat RT Lab Med 201142(8)488-496

        Several conditions have been recognized in which HBV escape mutants arise in clinical practice bulltreatment with anti-HBs immunoglobulin eg after liver transplantation to avoid reinfection of the graft (2332) bullantiviral therapy by itself as the reading frames of the envelope and polymerase genes overlap

        and several resistance mutations in the polymerase selected during antiviral therapy simultaneously alter the antigenicity of HBsAg (2021 31) bullde novo infection of vaccinated individuals with escape mutants (19)

        Moreover Datta et al recently reported that HBV variants with the sG145R immune escape mutation are frequently ldquohiderdquo in the peripheral blood leukocyte compartment of infected individuals and may then serve as a source of reactivation or transmission (7)

        J Virol 2010 vol 84 no 2 1026-1033

        По современным оценкам частота мутаций HBsAg среди вакцинированных колеблется от 2 до 28

        Из-за повсеместной вакцинации частота мутаций будет возрастать

        Математическая модель предсказывает исчезновение ВГВ дикого типа в областях с HBsAg-эндемичностью и появление S генных мутаций в течение 100 лет как следствия универсальной ВГВ-вакцинации

        Гилязова ДГ руководитель отдела Иммунохимия ООО Текан

        httpwwwlabmedicinarufilesPREZENTACII20-2020122320Gilyazovapdf

        HBV-дикий вирус

        Anti-HBs пресс в результате массовой вакцинации Исходно5-7 мутантовЧерез 20 лет22 мутантов

        Мутантные формы прогрессивно накапливаются у привитыхУ невакцинированных это случайные мутации а у привитых ndash MHR HBsAg

        Анти-вирусная терапияс помощью нуклеозидных аналоговМутации происходят направленно в Pol-последовательности но фактически меняют аа последовательность в MHR HBsAg что приводит к неузнаванию anti-HBs

        Мутанты иммунно-происхождения

        Мутанты Pol-происхождения

        Не узнают anti-HBs

        Узнают anti-preS1 anti-preS2 anti-HBc

        Вакцина 3-го пок

        Вакцина 4в - пок

        Drug-resistant mutations rtM204I (sI195M) and rtM204V (sW196S) caused significant reduction in antigenicity for the immune-escaped HBsAg mutants sG145K and sG145R which may hamper HBV diagnosis and disease controlVirology Journal 2013 10292

        Type of Vaccine Vaccine Antigen Adjuvant Host Cell Target Current Status References

        Peptide

        (a) Palmitolylated TT830-843 HTL

        epitope covalently linked to the HBcAg 18 ndash27 CTL epitope

        NACytotoxic T Lymphocyt

        e

        Phase II clinical trial

        Livingston et al 1999 [22]

        (b) HBV core antigen 18-27

        peptide + tetanus taxoid peptide 830

        843+palmic acid molecules

        NACytotoxic T Lymphocyt

        e

        Pre-clinical amp clinical

        Vitiello et al 1995 [23]

        ProteinHBsAganti-

        HBsIgAlum

        Cytotoxic T Lymphocyt

        e

        Phase II clinical trial

        Wen et al 2003

        Xu et al 2008 [28]

        DNA

        Small(S) and middle (preS2S) proteins of the HBV envelope

        (HBsAg)

        NACD8+ T

        Lymphocyte

        Phase I clinical trial

        Mancini et al 2004

        Vector-basedModified

        prHBV13HBVcore protein

        NA

        CD4+ and CD8+ T

        Lymphocyte

        Pre-clinicalDeng et al

        2009 [8]

        Cell-based

        DCs pulsed with HBs28-39 peptide or

        recombinant preS2S particles

        NACytotoxic T Lymphocyt

        ePre-clinical

        Akbar et al 2004 [36]

        Therapeutic Vaccine for Hepatitis B virusJ Infect Dis Immunol Tech 2012 11

        Release Summary February 12 2014httpwwwbusinesswirecomnewshome20140212005051enCreation-ABIVAX---Leader-Therapeutic-Vaccines-FrenchU3PoW_ldW8AAbivax creation of ABIVAX - a leader in therapeutic vaccines and the first French company to sign an exclusive partnering agreement with Cuba in healthcareABIVAX specializes in therapeutic vaccines and antivirals combining the technologies and the product portfolios of three French biotech companies financed by Truffle CapitaABIVAX already has two therapeutic vaccines in development one in a Phase IIb clinical trial in patients with chronic hepatitis B

        The HBsAgndashHBcAg vaccine candidate was safe well tolerated and immunogenic in this phase I study in healthy adults To our knowledge this is the first demonstration of safety and immunogenicity for a nasal vaccine candidate comprising HBV antigensThe vaccine elicited anti-HBc seroconversion in 100 of subjects as early as day 30 of the immunization schedule while a seroprotective anti-HBs titer (ge10 IUl) was at a maximum at day 90 (75) International Journal of Infectious DiseasesVolume 11 Issue 5 September 2007

        A novel therapeutic hepatitis B vaccine induces cellular and humoral immune responses and breaks tolerance in hepatitis B virus (HBV) transgenic miceBuchmann P1 Dembek C Kuklick L Jaumlger C Tedjokusumo R von Freyend MJ Drebber U Janowicz Z Melber K Protzer U

        1Rhein Biotech GmbH Duesseldorf Germany pbuchmanneudynavaxcomVaccine 2013 631(8)A paradigm of therapeutic vaccination is the potent induction of T-cell responses against key viral antigens ndash besides activation of a humoral immune response We have evaluated the potential of a novel vaccine formulation comprising particulate hepatitis B surface (HBsAg) and core antigen (HBcAg) and the saponin-based ISCOMATRIXtrade adjuvant for its ability to stimulate T and B cell responses in C57BL6 mice and its ability to break tolerance in HBV transgenic (HBVtg) mice The vaccine induced multifunctional HBsAg- and HBcAg-specific CD8+ T cells detected by staining for IFNγ TNFα and IL-2 as well as high antibody titers against both antigens Vaccination of HBVtg animals induced potent HBsAg- and HBcAg-specific CD8+ T-cell responses in spleens and HBcAg-specific CD8+ T-cell responses in livers as well as anti-HBs seroconversion two weeks post injection Vaccination further reduced HBcAg expression in livers of HBVtg mice without causing liver damage In summary this study demonstrates therapeutic efficacy of a novel vaccine formulation in a mouse model of immunotolerant chronic HBV infection

        HBsAg-HBcAg vaccine version - IV generation

        PreS1 is the priority target antigen for the new HBV vaccines because PreS1 has a greater number of immunogenic T cell and B cell epitopes than the S protein (9 12 15) including a strong T cell epitope (aa 21 to 28) and an effective B cell epitope (aa 12 to 32 and 32 to 53) The PreS1 protein has binding sites for liver cells (aa 21 to 47) that play an important role in viral attachment and entry (13 15) Neurath et al have shown that direct immunization with a PreS1 polypeptide (aa 21 to 47) can protect against HBV infection in chimpanzees (21) Additionally the PreS1 antibody is produced earlier than the S antibody and the PreS1-specific cell-mediated immunity may help overcome immune unresponsiveness to the S protein in certain individuals (19 24) Therefore the PreS1 antigen may play an important role in the neutralization blockade and clearance of HBV infections

        Clin Vaccine Immun 2011 18(11) 1789-1795

        Inclusion of PreS2S antigen in vaccine formulation could also mitigate the chances of non-responsiveness of vaccines against escape variants (Yamada et al 2001) The PreS2S gene is comprises of S gene with an extra 165 nucleotides at 5rsquo end (Tai et al 1997) and antigen is involved in nucleocapsid interaction (Poisson et al 1997) and extra cellular secretion of HBV particles (Le Seyec et al 1998) playing an important role in full stimulation of humoral and cellular immune responses In addition the PreS2S protein is also important for immunological responses at T-cell level and has T-cell and B-cell recognition sites spanning amino acids 1-25 of the protein (Neurath et al 1986) making it most suitable candidate antigen for HBV vaccine development This study describes the heterologous expression of a characterized PreS2S gene from genotype D of HBV in P pastoris The antigen will help to increase the efficacy of HBV recombinant vaccines

        Pak J Bot 2012 44 355-359

        Use of Pre-S Protein-Containing Hepatitis B Virus Surface Antigens and a Powerful Adjuvant To Develop an Immune Therapy for Chronic Hepatitis B Virus InfectionJung Sun Yum Byung Cheol Ahn [] and Hong Mo Moon

        Clin Vaccine Immun 19(2) 2012

        Роль preS-областей

        J Hep 2011 54 1286-1296

        НИИ вакцин и сывороток им И И Мечникова РАМН Москва

        Сочетанная терапия laquoвакцина + альфа-2 бета-интерферонraquo позволила получить подавление вирусной репликации в первые 1ndash2 месяца от начала лечения у 786 больных сероконверсию HВsAg на анти-HВs mdash у 964 Исчезновение HВеAg наблюдалось через 6 месяца у всех больных а анти-HВе через 2ndash3 месяца от начала лечения появились у всех больных Наблюдение за пациентами в течение трех лет и более показало что стойкий ответ на лечение отмечался у 24 (857) К концу лечения нормализовались все популяции лимфоцитов высоким оставался только уровень лимфоцитов экспрессирующих рецептор к ИЛ-2 (CD25+) оставались сниженными резервы фагоцитоза и кислородзависимого киллинга [5]Таким образом вакцинация против ГВ является актуальной и необходимой больным с ХЗП пациентам с ХГВ иили ХГС носителям ВГВ иили ВГС поскольку способствует подавлению вирусной репликации у хронических вирусоносителей может играть существенную роль в контроле над виремией значительно повышает эффективность лечения ХВГ

        Афигенова ВП Костинов МП 2011

        Study Calls Into Question Effectiveness of Hepatitis B Vaccine for NewbornsDecember 17 2013httparticlesmercolacomsitesarticlesarchive20131217newborn-hepatitis-b-vaccineaspxBy Dr JM Mercola

        New Study Hepatitis B Vaccination at Birth May Not Prevent Hidden InfectionsA new study is raising another red flag that the practice of universally vaccinating all newborn babies for hepatitis B is seriously flawed The researchers followed 259 babies born to hepatitis-B-positive mothers for two years in order to determine whether vaccinating such babies prevents asymptomatic occult HBV (hepatitis B virus) infectionThe researchers found that while the vaccine may help prevent overt HBV transmission it was not effective in preventing occult HBV infection in babies which may occur in up to 40 percent of babies born to hepatitis B-positive mothersHepatitis B Shot May Be Ineffective by the Time Your Child Is a TeenagerAnother issue to consider if you are weighing the benefits and risks of giving your newborn infant or young child hepatitis B vaccine is that vaccine acquired immunity often does not persist until a child reaches his or her teenage years ndash the time when acquiring a hepatitis B infection may be more likely Research shows that by that time the protection from the childhood vaccine may have long since wanedOne study found that about 15 percent of teens who received the full series of hepatitis B shots as infants tested positive for hepatitis B surface antigen (HBsAg) which is an early indicator of infection or a sign that the person is a chronic carrier of the virus3This percentage was even higher among teens who had received the hepatitis B vaccine off schedule or whose mothers were high risk meaning they tested positive for hepatitis B e antigen (HBeAg) In other words it appears that in many children hepatitis B vaccine acquired immunity does NOT provide lasting protection A Healthy Immune System Can Resolve Hepatitis B InfectionEven if you have been vaccinated as a child itrsquos important to remember that you may not be protected from these risks and could still be infected via IV drug abuse sexual activity with an infected partner a blood transfusion with contaminated blood or even getting a manicure or pedicurehellipFortunately in most cases the hepatitis B infection will resolve on its own provided you have a well-functioning immune system Symptoms can be relieved bybullRestingbullAvoiding foods that weaken your immune function such as sugarsfructose grains and processed foods Healthful foods that help boost your immune system include fermented foods and organic vegetablesbullOptimizing your vitamin D levelsbullDrinking plenty of pure waterbullAvoiding alcohol and drugs

        Причинно-следственныеbull Перееданиеbull Неадекватное питаниеbull Вредные привычкиbull Гиподинамия либо перегрузкиbull Неадекватное дыханиеbull Неадекватность мироощущения (стресс дефицит мотивации подавленность- депрессия)bull ИНТОКСИКАЦИЯbull ПОДАВЛЕННОСТЬ ИММУНИТЕТА

        Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

        Курс оздоровления направленный на восстановление иммунной системы

        Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

        М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

        Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

        () Курс относится к категории SPA

        • Slide 1
        • Slide 2
        • Slide 5
        • Slide 6
        • Slide 7
        • Slide 8
        • Slide 9
        • Slide 10
        • Slide 11
        • Slide 12
        • Slide 13
        • Slide 14
        • Slide 15
        • Slide 16
        • Slide 17
        • Slide 18
        • Slide 19
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        • Slide 21
        • Slide 22
        • Slide 23
        • Slide 24
        • Slide 25
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        • Slide 27
        • Slide 28
        • Slide 29

          HBV-дикий вирус

          Anti-HBs пресс в результате массовой вакцинации Исходно5-7 мутантовЧерез 20 лет22 мутантов

          Мутантные формы прогрессивно накапливаются у привитыхУ невакцинированных это случайные мутации а у привитых ndash MHR HBsAg

          Анти-вирусная терапияс помощью нуклеозидных аналоговМутации происходят направленно в Pol-последовательности но фактически меняют аа последовательность в MHR HBsAg что приводит к неузнаванию anti-HBs

          Мутанты иммунно-происхождения

          Мутанты Pol-происхождения

          Не узнают anti-HBs

          Узнают anti-preS1 anti-preS2 anti-HBc

          Вакцина 3-го пок

          Вакцина 4в - пок

          Drug-resistant mutations rtM204I (sI195M) and rtM204V (sW196S) caused significant reduction in antigenicity for the immune-escaped HBsAg mutants sG145K and sG145R which may hamper HBV diagnosis and disease controlVirology Journal 2013 10292

          Due to the overlap between the polymerase and envelope genes drug-resistant mutants are accompanied by amino acid changes in the envelope proteins as well

          Ito K et al J Virol 20108412850-12861

          The HBV polymerase gene overlaps completely with the genes of the 3 surface (S) antigen proteins The area boxed by dashed lines indicates the area of the HBsAg immunodominant area and the HBV reverse transcription area indicates the genome area most likely to produce mutants in both genesHBsAg mutations selected during antiviral therapy can lead to a virus escaping HBV vaccination

          Horvat RT Lab Med 201142(8)488-496

          Several conditions have been recognized in which HBV escape mutants arise in clinical practice bulltreatment with anti-HBs immunoglobulin eg after liver transplantation to avoid reinfection of the graft (2332) bullantiviral therapy by itself as the reading frames of the envelope and polymerase genes overlap

          and several resistance mutations in the polymerase selected during antiviral therapy simultaneously alter the antigenicity of HBsAg (2021 31) bullde novo infection of vaccinated individuals with escape mutants (19)

          Moreover Datta et al recently reported that HBV variants with the sG145R immune escape mutation are frequently ldquohiderdquo in the peripheral blood leukocyte compartment of infected individuals and may then serve as a source of reactivation or transmission (7)

          J Virol 2010 vol 84 no 2 1026-1033

          По современным оценкам частота мутаций HBsAg среди вакцинированных колеблется от 2 до 28

          Из-за повсеместной вакцинации частота мутаций будет возрастать

          Математическая модель предсказывает исчезновение ВГВ дикого типа в областях с HBsAg-эндемичностью и появление S генных мутаций в течение 100 лет как следствия универсальной ВГВ-вакцинации

          Гилязова ДГ руководитель отдела Иммунохимия ООО Текан

          httpwwwlabmedicinarufilesPREZENTACII20-2020122320Gilyazovapdf

          HBV-дикий вирус

          Anti-HBs пресс в результате массовой вакцинации Исходно5-7 мутантовЧерез 20 лет22 мутантов

          Мутантные формы прогрессивно накапливаются у привитыхУ невакцинированных это случайные мутации а у привитых ndash MHR HBsAg

          Анти-вирусная терапияс помощью нуклеозидных аналоговМутации происходят направленно в Pol-последовательности но фактически меняют аа последовательность в MHR HBsAg что приводит к неузнаванию anti-HBs

          Мутанты иммунно-происхождения

          Мутанты Pol-происхождения

          Не узнают anti-HBs

          Узнают anti-preS1 anti-preS2 anti-HBc

          Вакцина 3-го пок

          Вакцина 4в - пок

          Drug-resistant mutations rtM204I (sI195M) and rtM204V (sW196S) caused significant reduction in antigenicity for the immune-escaped HBsAg mutants sG145K and sG145R which may hamper HBV diagnosis and disease controlVirology Journal 2013 10292

          Type of Vaccine Vaccine Antigen Adjuvant Host Cell Target Current Status References

          Peptide

          (a) Palmitolylated TT830-843 HTL

          epitope covalently linked to the HBcAg 18 ndash27 CTL epitope

          NACytotoxic T Lymphocyt

          e

          Phase II clinical trial

          Livingston et al 1999 [22]

          (b) HBV core antigen 18-27

          peptide + tetanus taxoid peptide 830

          843+palmic acid molecules

          NACytotoxic T Lymphocyt

          e

          Pre-clinical amp clinical

          Vitiello et al 1995 [23]

          ProteinHBsAganti-

          HBsIgAlum

          Cytotoxic T Lymphocyt

          e

          Phase II clinical trial

          Wen et al 2003

          Xu et al 2008 [28]

          DNA

          Small(S) and middle (preS2S) proteins of the HBV envelope

          (HBsAg)

          NACD8+ T

          Lymphocyte

          Phase I clinical trial

          Mancini et al 2004

          Vector-basedModified

          prHBV13HBVcore protein

          NA

          CD4+ and CD8+ T

          Lymphocyte

          Pre-clinicalDeng et al

          2009 [8]

          Cell-based

          DCs pulsed with HBs28-39 peptide or

          recombinant preS2S particles

          NACytotoxic T Lymphocyt

          ePre-clinical

          Akbar et al 2004 [36]

          Therapeutic Vaccine for Hepatitis B virusJ Infect Dis Immunol Tech 2012 11

          Release Summary February 12 2014httpwwwbusinesswirecomnewshome20140212005051enCreation-ABIVAX---Leader-Therapeutic-Vaccines-FrenchU3PoW_ldW8AAbivax creation of ABIVAX - a leader in therapeutic vaccines and the first French company to sign an exclusive partnering agreement with Cuba in healthcareABIVAX specializes in therapeutic vaccines and antivirals combining the technologies and the product portfolios of three French biotech companies financed by Truffle CapitaABIVAX already has two therapeutic vaccines in development one in a Phase IIb clinical trial in patients with chronic hepatitis B

          The HBsAgndashHBcAg vaccine candidate was safe well tolerated and immunogenic in this phase I study in healthy adults To our knowledge this is the first demonstration of safety and immunogenicity for a nasal vaccine candidate comprising HBV antigensThe vaccine elicited anti-HBc seroconversion in 100 of subjects as early as day 30 of the immunization schedule while a seroprotective anti-HBs titer (ge10 IUl) was at a maximum at day 90 (75) International Journal of Infectious DiseasesVolume 11 Issue 5 September 2007

          A novel therapeutic hepatitis B vaccine induces cellular and humoral immune responses and breaks tolerance in hepatitis B virus (HBV) transgenic miceBuchmann P1 Dembek C Kuklick L Jaumlger C Tedjokusumo R von Freyend MJ Drebber U Janowicz Z Melber K Protzer U

          1Rhein Biotech GmbH Duesseldorf Germany pbuchmanneudynavaxcomVaccine 2013 631(8)A paradigm of therapeutic vaccination is the potent induction of T-cell responses against key viral antigens ndash besides activation of a humoral immune response We have evaluated the potential of a novel vaccine formulation comprising particulate hepatitis B surface (HBsAg) and core antigen (HBcAg) and the saponin-based ISCOMATRIXtrade adjuvant for its ability to stimulate T and B cell responses in C57BL6 mice and its ability to break tolerance in HBV transgenic (HBVtg) mice The vaccine induced multifunctional HBsAg- and HBcAg-specific CD8+ T cells detected by staining for IFNγ TNFα and IL-2 as well as high antibody titers against both antigens Vaccination of HBVtg animals induced potent HBsAg- and HBcAg-specific CD8+ T-cell responses in spleens and HBcAg-specific CD8+ T-cell responses in livers as well as anti-HBs seroconversion two weeks post injection Vaccination further reduced HBcAg expression in livers of HBVtg mice without causing liver damage In summary this study demonstrates therapeutic efficacy of a novel vaccine formulation in a mouse model of immunotolerant chronic HBV infection

          HBsAg-HBcAg vaccine version - IV generation

          PreS1 is the priority target antigen for the new HBV vaccines because PreS1 has a greater number of immunogenic T cell and B cell epitopes than the S protein (9 12 15) including a strong T cell epitope (aa 21 to 28) and an effective B cell epitope (aa 12 to 32 and 32 to 53) The PreS1 protein has binding sites for liver cells (aa 21 to 47) that play an important role in viral attachment and entry (13 15) Neurath et al have shown that direct immunization with a PreS1 polypeptide (aa 21 to 47) can protect against HBV infection in chimpanzees (21) Additionally the PreS1 antibody is produced earlier than the S antibody and the PreS1-specific cell-mediated immunity may help overcome immune unresponsiveness to the S protein in certain individuals (19 24) Therefore the PreS1 antigen may play an important role in the neutralization blockade and clearance of HBV infections

          Clin Vaccine Immun 2011 18(11) 1789-1795

          Inclusion of PreS2S antigen in vaccine formulation could also mitigate the chances of non-responsiveness of vaccines against escape variants (Yamada et al 2001) The PreS2S gene is comprises of S gene with an extra 165 nucleotides at 5rsquo end (Tai et al 1997) and antigen is involved in nucleocapsid interaction (Poisson et al 1997) and extra cellular secretion of HBV particles (Le Seyec et al 1998) playing an important role in full stimulation of humoral and cellular immune responses In addition the PreS2S protein is also important for immunological responses at T-cell level and has T-cell and B-cell recognition sites spanning amino acids 1-25 of the protein (Neurath et al 1986) making it most suitable candidate antigen for HBV vaccine development This study describes the heterologous expression of a characterized PreS2S gene from genotype D of HBV in P pastoris The antigen will help to increase the efficacy of HBV recombinant vaccines

          Pak J Bot 2012 44 355-359

          Use of Pre-S Protein-Containing Hepatitis B Virus Surface Antigens and a Powerful Adjuvant To Develop an Immune Therapy for Chronic Hepatitis B Virus InfectionJung Sun Yum Byung Cheol Ahn [] and Hong Mo Moon

          Clin Vaccine Immun 19(2) 2012

          Роль preS-областей

          J Hep 2011 54 1286-1296

          НИИ вакцин и сывороток им И И Мечникова РАМН Москва

          Сочетанная терапия laquoвакцина + альфа-2 бета-интерферонraquo позволила получить подавление вирусной репликации в первые 1ndash2 месяца от начала лечения у 786 больных сероконверсию HВsAg на анти-HВs mdash у 964 Исчезновение HВеAg наблюдалось через 6 месяца у всех больных а анти-HВе через 2ndash3 месяца от начала лечения появились у всех больных Наблюдение за пациентами в течение трех лет и более показало что стойкий ответ на лечение отмечался у 24 (857) К концу лечения нормализовались все популяции лимфоцитов высоким оставался только уровень лимфоцитов экспрессирующих рецептор к ИЛ-2 (CD25+) оставались сниженными резервы фагоцитоза и кислородзависимого киллинга [5]Таким образом вакцинация против ГВ является актуальной и необходимой больным с ХЗП пациентам с ХГВ иили ХГС носителям ВГВ иили ВГС поскольку способствует подавлению вирусной репликации у хронических вирусоносителей может играть существенную роль в контроле над виремией значительно повышает эффективность лечения ХВГ

          Афигенова ВП Костинов МП 2011

          Study Calls Into Question Effectiveness of Hepatitis B Vaccine for NewbornsDecember 17 2013httparticlesmercolacomsitesarticlesarchive20131217newborn-hepatitis-b-vaccineaspxBy Dr JM Mercola

          New Study Hepatitis B Vaccination at Birth May Not Prevent Hidden InfectionsA new study is raising another red flag that the practice of universally vaccinating all newborn babies for hepatitis B is seriously flawed The researchers followed 259 babies born to hepatitis-B-positive mothers for two years in order to determine whether vaccinating such babies prevents asymptomatic occult HBV (hepatitis B virus) infectionThe researchers found that while the vaccine may help prevent overt HBV transmission it was not effective in preventing occult HBV infection in babies which may occur in up to 40 percent of babies born to hepatitis B-positive mothersHepatitis B Shot May Be Ineffective by the Time Your Child Is a TeenagerAnother issue to consider if you are weighing the benefits and risks of giving your newborn infant or young child hepatitis B vaccine is that vaccine acquired immunity often does not persist until a child reaches his or her teenage years ndash the time when acquiring a hepatitis B infection may be more likely Research shows that by that time the protection from the childhood vaccine may have long since wanedOne study found that about 15 percent of teens who received the full series of hepatitis B shots as infants tested positive for hepatitis B surface antigen (HBsAg) which is an early indicator of infection or a sign that the person is a chronic carrier of the virus3This percentage was even higher among teens who had received the hepatitis B vaccine off schedule or whose mothers were high risk meaning they tested positive for hepatitis B e antigen (HBeAg) In other words it appears that in many children hepatitis B vaccine acquired immunity does NOT provide lasting protection A Healthy Immune System Can Resolve Hepatitis B InfectionEven if you have been vaccinated as a child itrsquos important to remember that you may not be protected from these risks and could still be infected via IV drug abuse sexual activity with an infected partner a blood transfusion with contaminated blood or even getting a manicure or pedicurehellipFortunately in most cases the hepatitis B infection will resolve on its own provided you have a well-functioning immune system Symptoms can be relieved bybullRestingbullAvoiding foods that weaken your immune function such as sugarsfructose grains and processed foods Healthful foods that help boost your immune system include fermented foods and organic vegetablesbullOptimizing your vitamin D levelsbullDrinking plenty of pure waterbullAvoiding alcohol and drugs

          Причинно-следственныеbull Перееданиеbull Неадекватное питаниеbull Вредные привычкиbull Гиподинамия либо перегрузкиbull Неадекватное дыханиеbull Неадекватность мироощущения (стресс дефицит мотивации подавленность- депрессия)bull ИНТОКСИКАЦИЯbull ПОДАВЛЕННОСТЬ ИММУНИТЕТА

          Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

          Курс оздоровления направленный на восстановление иммунной системы

          Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

          М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

          Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

          () Курс относится к категории SPA

          • Slide 1
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          • Slide 8
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          • Slide 29

            Due to the overlap between the polymerase and envelope genes drug-resistant mutants are accompanied by amino acid changes in the envelope proteins as well

            Ito K et al J Virol 20108412850-12861

            The HBV polymerase gene overlaps completely with the genes of the 3 surface (S) antigen proteins The area boxed by dashed lines indicates the area of the HBsAg immunodominant area and the HBV reverse transcription area indicates the genome area most likely to produce mutants in both genesHBsAg mutations selected during antiviral therapy can lead to a virus escaping HBV vaccination

            Horvat RT Lab Med 201142(8)488-496

            Several conditions have been recognized in which HBV escape mutants arise in clinical practice bulltreatment with anti-HBs immunoglobulin eg after liver transplantation to avoid reinfection of the graft (2332) bullantiviral therapy by itself as the reading frames of the envelope and polymerase genes overlap

            and several resistance mutations in the polymerase selected during antiviral therapy simultaneously alter the antigenicity of HBsAg (2021 31) bullde novo infection of vaccinated individuals with escape mutants (19)

            Moreover Datta et al recently reported that HBV variants with the sG145R immune escape mutation are frequently ldquohiderdquo in the peripheral blood leukocyte compartment of infected individuals and may then serve as a source of reactivation or transmission (7)

            J Virol 2010 vol 84 no 2 1026-1033

            По современным оценкам частота мутаций HBsAg среди вакцинированных колеблется от 2 до 28

            Из-за повсеместной вакцинации частота мутаций будет возрастать

            Математическая модель предсказывает исчезновение ВГВ дикого типа в областях с HBsAg-эндемичностью и появление S генных мутаций в течение 100 лет как следствия универсальной ВГВ-вакцинации

            Гилязова ДГ руководитель отдела Иммунохимия ООО Текан

            httpwwwlabmedicinarufilesPREZENTACII20-2020122320Gilyazovapdf

            HBV-дикий вирус

            Anti-HBs пресс в результате массовой вакцинации Исходно5-7 мутантовЧерез 20 лет22 мутантов

            Мутантные формы прогрессивно накапливаются у привитыхУ невакцинированных это случайные мутации а у привитых ndash MHR HBsAg

            Анти-вирусная терапияс помощью нуклеозидных аналоговМутации происходят направленно в Pol-последовательности но фактически меняют аа последовательность в MHR HBsAg что приводит к неузнаванию anti-HBs

            Мутанты иммунно-происхождения

            Мутанты Pol-происхождения

            Не узнают anti-HBs

            Узнают anti-preS1 anti-preS2 anti-HBc

            Вакцина 3-го пок

            Вакцина 4в - пок

            Drug-resistant mutations rtM204I (sI195M) and rtM204V (sW196S) caused significant reduction in antigenicity for the immune-escaped HBsAg mutants sG145K and sG145R which may hamper HBV diagnosis and disease controlVirology Journal 2013 10292

            Type of Vaccine Vaccine Antigen Adjuvant Host Cell Target Current Status References

            Peptide

            (a) Palmitolylated TT830-843 HTL

            epitope covalently linked to the HBcAg 18 ndash27 CTL epitope

            NACytotoxic T Lymphocyt

            e

            Phase II clinical trial

            Livingston et al 1999 [22]

            (b) HBV core antigen 18-27

            peptide + tetanus taxoid peptide 830

            843+palmic acid molecules

            NACytotoxic T Lymphocyt

            e

            Pre-clinical amp clinical

            Vitiello et al 1995 [23]

            ProteinHBsAganti-

            HBsIgAlum

            Cytotoxic T Lymphocyt

            e

            Phase II clinical trial

            Wen et al 2003

            Xu et al 2008 [28]

            DNA

            Small(S) and middle (preS2S) proteins of the HBV envelope

            (HBsAg)

            NACD8+ T

            Lymphocyte

            Phase I clinical trial

            Mancini et al 2004

            Vector-basedModified

            prHBV13HBVcore protein

            NA

            CD4+ and CD8+ T

            Lymphocyte

            Pre-clinicalDeng et al

            2009 [8]

            Cell-based

            DCs pulsed with HBs28-39 peptide or

            recombinant preS2S particles

            NACytotoxic T Lymphocyt

            ePre-clinical

            Akbar et al 2004 [36]

            Therapeutic Vaccine for Hepatitis B virusJ Infect Dis Immunol Tech 2012 11

            Release Summary February 12 2014httpwwwbusinesswirecomnewshome20140212005051enCreation-ABIVAX---Leader-Therapeutic-Vaccines-FrenchU3PoW_ldW8AAbivax creation of ABIVAX - a leader in therapeutic vaccines and the first French company to sign an exclusive partnering agreement with Cuba in healthcareABIVAX specializes in therapeutic vaccines and antivirals combining the technologies and the product portfolios of three French biotech companies financed by Truffle CapitaABIVAX already has two therapeutic vaccines in development one in a Phase IIb clinical trial in patients with chronic hepatitis B

            The HBsAgndashHBcAg vaccine candidate was safe well tolerated and immunogenic in this phase I study in healthy adults To our knowledge this is the first demonstration of safety and immunogenicity for a nasal vaccine candidate comprising HBV antigensThe vaccine elicited anti-HBc seroconversion in 100 of subjects as early as day 30 of the immunization schedule while a seroprotective anti-HBs titer (ge10 IUl) was at a maximum at day 90 (75) International Journal of Infectious DiseasesVolume 11 Issue 5 September 2007

            A novel therapeutic hepatitis B vaccine induces cellular and humoral immune responses and breaks tolerance in hepatitis B virus (HBV) transgenic miceBuchmann P1 Dembek C Kuklick L Jaumlger C Tedjokusumo R von Freyend MJ Drebber U Janowicz Z Melber K Protzer U

            1Rhein Biotech GmbH Duesseldorf Germany pbuchmanneudynavaxcomVaccine 2013 631(8)A paradigm of therapeutic vaccination is the potent induction of T-cell responses against key viral antigens ndash besides activation of a humoral immune response We have evaluated the potential of a novel vaccine formulation comprising particulate hepatitis B surface (HBsAg) and core antigen (HBcAg) and the saponin-based ISCOMATRIXtrade adjuvant for its ability to stimulate T and B cell responses in C57BL6 mice and its ability to break tolerance in HBV transgenic (HBVtg) mice The vaccine induced multifunctional HBsAg- and HBcAg-specific CD8+ T cells detected by staining for IFNγ TNFα and IL-2 as well as high antibody titers against both antigens Vaccination of HBVtg animals induced potent HBsAg- and HBcAg-specific CD8+ T-cell responses in spleens and HBcAg-specific CD8+ T-cell responses in livers as well as anti-HBs seroconversion two weeks post injection Vaccination further reduced HBcAg expression in livers of HBVtg mice without causing liver damage In summary this study demonstrates therapeutic efficacy of a novel vaccine formulation in a mouse model of immunotolerant chronic HBV infection

            HBsAg-HBcAg vaccine version - IV generation

            PreS1 is the priority target antigen for the new HBV vaccines because PreS1 has a greater number of immunogenic T cell and B cell epitopes than the S protein (9 12 15) including a strong T cell epitope (aa 21 to 28) and an effective B cell epitope (aa 12 to 32 and 32 to 53) The PreS1 protein has binding sites for liver cells (aa 21 to 47) that play an important role in viral attachment and entry (13 15) Neurath et al have shown that direct immunization with a PreS1 polypeptide (aa 21 to 47) can protect against HBV infection in chimpanzees (21) Additionally the PreS1 antibody is produced earlier than the S antibody and the PreS1-specific cell-mediated immunity may help overcome immune unresponsiveness to the S protein in certain individuals (19 24) Therefore the PreS1 antigen may play an important role in the neutralization blockade and clearance of HBV infections

            Clin Vaccine Immun 2011 18(11) 1789-1795

            Inclusion of PreS2S antigen in vaccine formulation could also mitigate the chances of non-responsiveness of vaccines against escape variants (Yamada et al 2001) The PreS2S gene is comprises of S gene with an extra 165 nucleotides at 5rsquo end (Tai et al 1997) and antigen is involved in nucleocapsid interaction (Poisson et al 1997) and extra cellular secretion of HBV particles (Le Seyec et al 1998) playing an important role in full stimulation of humoral and cellular immune responses In addition the PreS2S protein is also important for immunological responses at T-cell level and has T-cell and B-cell recognition sites spanning amino acids 1-25 of the protein (Neurath et al 1986) making it most suitable candidate antigen for HBV vaccine development This study describes the heterologous expression of a characterized PreS2S gene from genotype D of HBV in P pastoris The antigen will help to increase the efficacy of HBV recombinant vaccines

            Pak J Bot 2012 44 355-359

            Use of Pre-S Protein-Containing Hepatitis B Virus Surface Antigens and a Powerful Adjuvant To Develop an Immune Therapy for Chronic Hepatitis B Virus InfectionJung Sun Yum Byung Cheol Ahn [] and Hong Mo Moon

            Clin Vaccine Immun 19(2) 2012

            Роль preS-областей

            J Hep 2011 54 1286-1296

            НИИ вакцин и сывороток им И И Мечникова РАМН Москва

            Сочетанная терапия laquoвакцина + альфа-2 бета-интерферонraquo позволила получить подавление вирусной репликации в первые 1ndash2 месяца от начала лечения у 786 больных сероконверсию HВsAg на анти-HВs mdash у 964 Исчезновение HВеAg наблюдалось через 6 месяца у всех больных а анти-HВе через 2ndash3 месяца от начала лечения появились у всех больных Наблюдение за пациентами в течение трех лет и более показало что стойкий ответ на лечение отмечался у 24 (857) К концу лечения нормализовались все популяции лимфоцитов высоким оставался только уровень лимфоцитов экспрессирующих рецептор к ИЛ-2 (CD25+) оставались сниженными резервы фагоцитоза и кислородзависимого киллинга [5]Таким образом вакцинация против ГВ является актуальной и необходимой больным с ХЗП пациентам с ХГВ иили ХГС носителям ВГВ иили ВГС поскольку способствует подавлению вирусной репликации у хронических вирусоносителей может играть существенную роль в контроле над виремией значительно повышает эффективность лечения ХВГ

            Афигенова ВП Костинов МП 2011

            Study Calls Into Question Effectiveness of Hepatitis B Vaccine for NewbornsDecember 17 2013httparticlesmercolacomsitesarticlesarchive20131217newborn-hepatitis-b-vaccineaspxBy Dr JM Mercola

            New Study Hepatitis B Vaccination at Birth May Not Prevent Hidden InfectionsA new study is raising another red flag that the practice of universally vaccinating all newborn babies for hepatitis B is seriously flawed The researchers followed 259 babies born to hepatitis-B-positive mothers for two years in order to determine whether vaccinating such babies prevents asymptomatic occult HBV (hepatitis B virus) infectionThe researchers found that while the vaccine may help prevent overt HBV transmission it was not effective in preventing occult HBV infection in babies which may occur in up to 40 percent of babies born to hepatitis B-positive mothersHepatitis B Shot May Be Ineffective by the Time Your Child Is a TeenagerAnother issue to consider if you are weighing the benefits and risks of giving your newborn infant or young child hepatitis B vaccine is that vaccine acquired immunity often does not persist until a child reaches his or her teenage years ndash the time when acquiring a hepatitis B infection may be more likely Research shows that by that time the protection from the childhood vaccine may have long since wanedOne study found that about 15 percent of teens who received the full series of hepatitis B shots as infants tested positive for hepatitis B surface antigen (HBsAg) which is an early indicator of infection or a sign that the person is a chronic carrier of the virus3This percentage was even higher among teens who had received the hepatitis B vaccine off schedule or whose mothers were high risk meaning they tested positive for hepatitis B e antigen (HBeAg) In other words it appears that in many children hepatitis B vaccine acquired immunity does NOT provide lasting protection A Healthy Immune System Can Resolve Hepatitis B InfectionEven if you have been vaccinated as a child itrsquos important to remember that you may not be protected from these risks and could still be infected via IV drug abuse sexual activity with an infected partner a blood transfusion with contaminated blood or even getting a manicure or pedicurehellipFortunately in most cases the hepatitis B infection will resolve on its own provided you have a well-functioning immune system Symptoms can be relieved bybullRestingbullAvoiding foods that weaken your immune function such as sugarsfructose grains and processed foods Healthful foods that help boost your immune system include fermented foods and organic vegetablesbullOptimizing your vitamin D levelsbullDrinking plenty of pure waterbullAvoiding alcohol and drugs

            Причинно-следственныеbull Перееданиеbull Неадекватное питаниеbull Вредные привычкиbull Гиподинамия либо перегрузкиbull Неадекватное дыханиеbull Неадекватность мироощущения (стресс дефицит мотивации подавленность- депрессия)bull ИНТОКСИКАЦИЯbull ПОДАВЛЕННОСТЬ ИММУНИТЕТА

            Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

            Курс оздоровления направленный на восстановление иммунной системы

            Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

            М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

            Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

            () Курс относится к категории SPA

            • Slide 1
            • Slide 2
            • Slide 5
            • Slide 6
            • Slide 7
            • Slide 8
            • Slide 9
            • Slide 10
            • Slide 11
            • Slide 12
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            • Slide 27
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            • Slide 29

              Several conditions have been recognized in which HBV escape mutants arise in clinical practice bulltreatment with anti-HBs immunoglobulin eg after liver transplantation to avoid reinfection of the graft (2332) bullantiviral therapy by itself as the reading frames of the envelope and polymerase genes overlap

              and several resistance mutations in the polymerase selected during antiviral therapy simultaneously alter the antigenicity of HBsAg (2021 31) bullde novo infection of vaccinated individuals with escape mutants (19)

              Moreover Datta et al recently reported that HBV variants with the sG145R immune escape mutation are frequently ldquohiderdquo in the peripheral blood leukocyte compartment of infected individuals and may then serve as a source of reactivation or transmission (7)

              J Virol 2010 vol 84 no 2 1026-1033

              По современным оценкам частота мутаций HBsAg среди вакцинированных колеблется от 2 до 28

              Из-за повсеместной вакцинации частота мутаций будет возрастать

              Математическая модель предсказывает исчезновение ВГВ дикого типа в областях с HBsAg-эндемичностью и появление S генных мутаций в течение 100 лет как следствия универсальной ВГВ-вакцинации

              Гилязова ДГ руководитель отдела Иммунохимия ООО Текан

              httpwwwlabmedicinarufilesPREZENTACII20-2020122320Gilyazovapdf

              HBV-дикий вирус

              Anti-HBs пресс в результате массовой вакцинации Исходно5-7 мутантовЧерез 20 лет22 мутантов

              Мутантные формы прогрессивно накапливаются у привитыхУ невакцинированных это случайные мутации а у привитых ndash MHR HBsAg

              Анти-вирусная терапияс помощью нуклеозидных аналоговМутации происходят направленно в Pol-последовательности но фактически меняют аа последовательность в MHR HBsAg что приводит к неузнаванию anti-HBs

              Мутанты иммунно-происхождения

              Мутанты Pol-происхождения

              Не узнают anti-HBs

              Узнают anti-preS1 anti-preS2 anti-HBc

              Вакцина 3-го пок

              Вакцина 4в - пок

              Drug-resistant mutations rtM204I (sI195M) and rtM204V (sW196S) caused significant reduction in antigenicity for the immune-escaped HBsAg mutants sG145K and sG145R which may hamper HBV diagnosis and disease controlVirology Journal 2013 10292

              Type of Vaccine Vaccine Antigen Adjuvant Host Cell Target Current Status References

              Peptide

              (a) Palmitolylated TT830-843 HTL

              epitope covalently linked to the HBcAg 18 ndash27 CTL epitope

              NACytotoxic T Lymphocyt

              e

              Phase II clinical trial

              Livingston et al 1999 [22]

              (b) HBV core antigen 18-27

              peptide + tetanus taxoid peptide 830

              843+palmic acid molecules

              NACytotoxic T Lymphocyt

              e

              Pre-clinical amp clinical

              Vitiello et al 1995 [23]

              ProteinHBsAganti-

              HBsIgAlum

              Cytotoxic T Lymphocyt

              e

              Phase II clinical trial

              Wen et al 2003

              Xu et al 2008 [28]

              DNA

              Small(S) and middle (preS2S) proteins of the HBV envelope

              (HBsAg)

              NACD8+ T

              Lymphocyte

              Phase I clinical trial

              Mancini et al 2004

              Vector-basedModified

              prHBV13HBVcore protein

              NA

              CD4+ and CD8+ T

              Lymphocyte

              Pre-clinicalDeng et al

              2009 [8]

              Cell-based

              DCs pulsed with HBs28-39 peptide or

              recombinant preS2S particles

              NACytotoxic T Lymphocyt

              ePre-clinical

              Akbar et al 2004 [36]

              Therapeutic Vaccine for Hepatitis B virusJ Infect Dis Immunol Tech 2012 11

              Release Summary February 12 2014httpwwwbusinesswirecomnewshome20140212005051enCreation-ABIVAX---Leader-Therapeutic-Vaccines-FrenchU3PoW_ldW8AAbivax creation of ABIVAX - a leader in therapeutic vaccines and the first French company to sign an exclusive partnering agreement with Cuba in healthcareABIVAX specializes in therapeutic vaccines and antivirals combining the technologies and the product portfolios of three French biotech companies financed by Truffle CapitaABIVAX already has two therapeutic vaccines in development one in a Phase IIb clinical trial in patients with chronic hepatitis B

              The HBsAgndashHBcAg vaccine candidate was safe well tolerated and immunogenic in this phase I study in healthy adults To our knowledge this is the first demonstration of safety and immunogenicity for a nasal vaccine candidate comprising HBV antigensThe vaccine elicited anti-HBc seroconversion in 100 of subjects as early as day 30 of the immunization schedule while a seroprotective anti-HBs titer (ge10 IUl) was at a maximum at day 90 (75) International Journal of Infectious DiseasesVolume 11 Issue 5 September 2007

              A novel therapeutic hepatitis B vaccine induces cellular and humoral immune responses and breaks tolerance in hepatitis B virus (HBV) transgenic miceBuchmann P1 Dembek C Kuklick L Jaumlger C Tedjokusumo R von Freyend MJ Drebber U Janowicz Z Melber K Protzer U

              1Rhein Biotech GmbH Duesseldorf Germany pbuchmanneudynavaxcomVaccine 2013 631(8)A paradigm of therapeutic vaccination is the potent induction of T-cell responses against key viral antigens ndash besides activation of a humoral immune response We have evaluated the potential of a novel vaccine formulation comprising particulate hepatitis B surface (HBsAg) and core antigen (HBcAg) and the saponin-based ISCOMATRIXtrade adjuvant for its ability to stimulate T and B cell responses in C57BL6 mice and its ability to break tolerance in HBV transgenic (HBVtg) mice The vaccine induced multifunctional HBsAg- and HBcAg-specific CD8+ T cells detected by staining for IFNγ TNFα and IL-2 as well as high antibody titers against both antigens Vaccination of HBVtg animals induced potent HBsAg- and HBcAg-specific CD8+ T-cell responses in spleens and HBcAg-specific CD8+ T-cell responses in livers as well as anti-HBs seroconversion two weeks post injection Vaccination further reduced HBcAg expression in livers of HBVtg mice without causing liver damage In summary this study demonstrates therapeutic efficacy of a novel vaccine formulation in a mouse model of immunotolerant chronic HBV infection

              HBsAg-HBcAg vaccine version - IV generation

              PreS1 is the priority target antigen for the new HBV vaccines because PreS1 has a greater number of immunogenic T cell and B cell epitopes than the S protein (9 12 15) including a strong T cell epitope (aa 21 to 28) and an effective B cell epitope (aa 12 to 32 and 32 to 53) The PreS1 protein has binding sites for liver cells (aa 21 to 47) that play an important role in viral attachment and entry (13 15) Neurath et al have shown that direct immunization with a PreS1 polypeptide (aa 21 to 47) can protect against HBV infection in chimpanzees (21) Additionally the PreS1 antibody is produced earlier than the S antibody and the PreS1-specific cell-mediated immunity may help overcome immune unresponsiveness to the S protein in certain individuals (19 24) Therefore the PreS1 antigen may play an important role in the neutralization blockade and clearance of HBV infections

              Clin Vaccine Immun 2011 18(11) 1789-1795

              Inclusion of PreS2S antigen in vaccine formulation could also mitigate the chances of non-responsiveness of vaccines against escape variants (Yamada et al 2001) The PreS2S gene is comprises of S gene with an extra 165 nucleotides at 5rsquo end (Tai et al 1997) and antigen is involved in nucleocapsid interaction (Poisson et al 1997) and extra cellular secretion of HBV particles (Le Seyec et al 1998) playing an important role in full stimulation of humoral and cellular immune responses In addition the PreS2S protein is also important for immunological responses at T-cell level and has T-cell and B-cell recognition sites spanning amino acids 1-25 of the protein (Neurath et al 1986) making it most suitable candidate antigen for HBV vaccine development This study describes the heterologous expression of a characterized PreS2S gene from genotype D of HBV in P pastoris The antigen will help to increase the efficacy of HBV recombinant vaccines

              Pak J Bot 2012 44 355-359

              Use of Pre-S Protein-Containing Hepatitis B Virus Surface Antigens and a Powerful Adjuvant To Develop an Immune Therapy for Chronic Hepatitis B Virus InfectionJung Sun Yum Byung Cheol Ahn [] and Hong Mo Moon

              Clin Vaccine Immun 19(2) 2012

              Роль preS-областей

              J Hep 2011 54 1286-1296

              НИИ вакцин и сывороток им И И Мечникова РАМН Москва

              Сочетанная терапия laquoвакцина + альфа-2 бета-интерферонraquo позволила получить подавление вирусной репликации в первые 1ndash2 месяца от начала лечения у 786 больных сероконверсию HВsAg на анти-HВs mdash у 964 Исчезновение HВеAg наблюдалось через 6 месяца у всех больных а анти-HВе через 2ndash3 месяца от начала лечения появились у всех больных Наблюдение за пациентами в течение трех лет и более показало что стойкий ответ на лечение отмечался у 24 (857) К концу лечения нормализовались все популяции лимфоцитов высоким оставался только уровень лимфоцитов экспрессирующих рецептор к ИЛ-2 (CD25+) оставались сниженными резервы фагоцитоза и кислородзависимого киллинга [5]Таким образом вакцинация против ГВ является актуальной и необходимой больным с ХЗП пациентам с ХГВ иили ХГС носителям ВГВ иили ВГС поскольку способствует подавлению вирусной репликации у хронических вирусоносителей может играть существенную роль в контроле над виремией значительно повышает эффективность лечения ХВГ

              Афигенова ВП Костинов МП 2011

              Study Calls Into Question Effectiveness of Hepatitis B Vaccine for NewbornsDecember 17 2013httparticlesmercolacomsitesarticlesarchive20131217newborn-hepatitis-b-vaccineaspxBy Dr JM Mercola

              New Study Hepatitis B Vaccination at Birth May Not Prevent Hidden InfectionsA new study is raising another red flag that the practice of universally vaccinating all newborn babies for hepatitis B is seriously flawed The researchers followed 259 babies born to hepatitis-B-positive mothers for two years in order to determine whether vaccinating such babies prevents asymptomatic occult HBV (hepatitis B virus) infectionThe researchers found that while the vaccine may help prevent overt HBV transmission it was not effective in preventing occult HBV infection in babies which may occur in up to 40 percent of babies born to hepatitis B-positive mothersHepatitis B Shot May Be Ineffective by the Time Your Child Is a TeenagerAnother issue to consider if you are weighing the benefits and risks of giving your newborn infant or young child hepatitis B vaccine is that vaccine acquired immunity often does not persist until a child reaches his or her teenage years ndash the time when acquiring a hepatitis B infection may be more likely Research shows that by that time the protection from the childhood vaccine may have long since wanedOne study found that about 15 percent of teens who received the full series of hepatitis B shots as infants tested positive for hepatitis B surface antigen (HBsAg) which is an early indicator of infection or a sign that the person is a chronic carrier of the virus3This percentage was even higher among teens who had received the hepatitis B vaccine off schedule or whose mothers were high risk meaning they tested positive for hepatitis B e antigen (HBeAg) In other words it appears that in many children hepatitis B vaccine acquired immunity does NOT provide lasting protection A Healthy Immune System Can Resolve Hepatitis B InfectionEven if you have been vaccinated as a child itrsquos important to remember that you may not be protected from these risks and could still be infected via IV drug abuse sexual activity with an infected partner a blood transfusion with contaminated blood or even getting a manicure or pedicurehellipFortunately in most cases the hepatitis B infection will resolve on its own provided you have a well-functioning immune system Symptoms can be relieved bybullRestingbullAvoiding foods that weaken your immune function such as sugarsfructose grains and processed foods Healthful foods that help boost your immune system include fermented foods and organic vegetablesbullOptimizing your vitamin D levelsbullDrinking plenty of pure waterbullAvoiding alcohol and drugs

              Причинно-следственныеbull Перееданиеbull Неадекватное питаниеbull Вредные привычкиbull Гиподинамия либо перегрузкиbull Неадекватное дыханиеbull Неадекватность мироощущения (стресс дефицит мотивации подавленность- депрессия)bull ИНТОКСИКАЦИЯbull ПОДАВЛЕННОСТЬ ИММУНИТЕТА

              Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

              Курс оздоровления направленный на восстановление иммунной системы

              Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

              М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

              Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

              () Курс относится к категории SPA

              • Slide 1
              • Slide 2
              • Slide 5
              • Slide 6
              • Slide 7
              • Slide 8
              • Slide 9
              • Slide 10
              • Slide 11
              • Slide 12
              • Slide 13
              • Slide 14
              • Slide 15
              • Slide 16
              • Slide 17
              • Slide 18
              • Slide 19
              • Slide 20
              • Slide 21
              • Slide 22
              • Slide 23
              • Slide 24
              • Slide 25
              • Slide 26
              • Slide 27
              • Slide 28
              • Slide 29

                По современным оценкам частота мутаций HBsAg среди вакцинированных колеблется от 2 до 28

                Из-за повсеместной вакцинации частота мутаций будет возрастать

                Математическая модель предсказывает исчезновение ВГВ дикого типа в областях с HBsAg-эндемичностью и появление S генных мутаций в течение 100 лет как следствия универсальной ВГВ-вакцинации

                Гилязова ДГ руководитель отдела Иммунохимия ООО Текан

                httpwwwlabmedicinarufilesPREZENTACII20-2020122320Gilyazovapdf

                HBV-дикий вирус

                Anti-HBs пресс в результате массовой вакцинации Исходно5-7 мутантовЧерез 20 лет22 мутантов

                Мутантные формы прогрессивно накапливаются у привитыхУ невакцинированных это случайные мутации а у привитых ndash MHR HBsAg

                Анти-вирусная терапияс помощью нуклеозидных аналоговМутации происходят направленно в Pol-последовательности но фактически меняют аа последовательность в MHR HBsAg что приводит к неузнаванию anti-HBs

                Мутанты иммунно-происхождения

                Мутанты Pol-происхождения

                Не узнают anti-HBs

                Узнают anti-preS1 anti-preS2 anti-HBc

                Вакцина 3-го пок

                Вакцина 4в - пок

                Drug-resistant mutations rtM204I (sI195M) and rtM204V (sW196S) caused significant reduction in antigenicity for the immune-escaped HBsAg mutants sG145K and sG145R which may hamper HBV diagnosis and disease controlVirology Journal 2013 10292

                Type of Vaccine Vaccine Antigen Adjuvant Host Cell Target Current Status References

                Peptide

                (a) Palmitolylated TT830-843 HTL

                epitope covalently linked to the HBcAg 18 ndash27 CTL epitope

                NACytotoxic T Lymphocyt

                e

                Phase II clinical trial

                Livingston et al 1999 [22]

                (b) HBV core antigen 18-27

                peptide + tetanus taxoid peptide 830

                843+palmic acid molecules

                NACytotoxic T Lymphocyt

                e

                Pre-clinical amp clinical

                Vitiello et al 1995 [23]

                ProteinHBsAganti-

                HBsIgAlum

                Cytotoxic T Lymphocyt

                e

                Phase II clinical trial

                Wen et al 2003

                Xu et al 2008 [28]

                DNA

                Small(S) and middle (preS2S) proteins of the HBV envelope

                (HBsAg)

                NACD8+ T

                Lymphocyte

                Phase I clinical trial

                Mancini et al 2004

                Vector-basedModified

                prHBV13HBVcore protein

                NA

                CD4+ and CD8+ T

                Lymphocyte

                Pre-clinicalDeng et al

                2009 [8]

                Cell-based

                DCs pulsed with HBs28-39 peptide or

                recombinant preS2S particles

                NACytotoxic T Lymphocyt

                ePre-clinical

                Akbar et al 2004 [36]

                Therapeutic Vaccine for Hepatitis B virusJ Infect Dis Immunol Tech 2012 11

                Release Summary February 12 2014httpwwwbusinesswirecomnewshome20140212005051enCreation-ABIVAX---Leader-Therapeutic-Vaccines-FrenchU3PoW_ldW8AAbivax creation of ABIVAX - a leader in therapeutic vaccines and the first French company to sign an exclusive partnering agreement with Cuba in healthcareABIVAX specializes in therapeutic vaccines and antivirals combining the technologies and the product portfolios of three French biotech companies financed by Truffle CapitaABIVAX already has two therapeutic vaccines in development one in a Phase IIb clinical trial in patients with chronic hepatitis B

                The HBsAgndashHBcAg vaccine candidate was safe well tolerated and immunogenic in this phase I study in healthy adults To our knowledge this is the first demonstration of safety and immunogenicity for a nasal vaccine candidate comprising HBV antigensThe vaccine elicited anti-HBc seroconversion in 100 of subjects as early as day 30 of the immunization schedule while a seroprotective anti-HBs titer (ge10 IUl) was at a maximum at day 90 (75) International Journal of Infectious DiseasesVolume 11 Issue 5 September 2007

                A novel therapeutic hepatitis B vaccine induces cellular and humoral immune responses and breaks tolerance in hepatitis B virus (HBV) transgenic miceBuchmann P1 Dembek C Kuklick L Jaumlger C Tedjokusumo R von Freyend MJ Drebber U Janowicz Z Melber K Protzer U

                1Rhein Biotech GmbH Duesseldorf Germany pbuchmanneudynavaxcomVaccine 2013 631(8)A paradigm of therapeutic vaccination is the potent induction of T-cell responses against key viral antigens ndash besides activation of a humoral immune response We have evaluated the potential of a novel vaccine formulation comprising particulate hepatitis B surface (HBsAg) and core antigen (HBcAg) and the saponin-based ISCOMATRIXtrade adjuvant for its ability to stimulate T and B cell responses in C57BL6 mice and its ability to break tolerance in HBV transgenic (HBVtg) mice The vaccine induced multifunctional HBsAg- and HBcAg-specific CD8+ T cells detected by staining for IFNγ TNFα and IL-2 as well as high antibody titers against both antigens Vaccination of HBVtg animals induced potent HBsAg- and HBcAg-specific CD8+ T-cell responses in spleens and HBcAg-specific CD8+ T-cell responses in livers as well as anti-HBs seroconversion two weeks post injection Vaccination further reduced HBcAg expression in livers of HBVtg mice without causing liver damage In summary this study demonstrates therapeutic efficacy of a novel vaccine formulation in a mouse model of immunotolerant chronic HBV infection

                HBsAg-HBcAg vaccine version - IV generation

                PreS1 is the priority target antigen for the new HBV vaccines because PreS1 has a greater number of immunogenic T cell and B cell epitopes than the S protein (9 12 15) including a strong T cell epitope (aa 21 to 28) and an effective B cell epitope (aa 12 to 32 and 32 to 53) The PreS1 protein has binding sites for liver cells (aa 21 to 47) that play an important role in viral attachment and entry (13 15) Neurath et al have shown that direct immunization with a PreS1 polypeptide (aa 21 to 47) can protect against HBV infection in chimpanzees (21) Additionally the PreS1 antibody is produced earlier than the S antibody and the PreS1-specific cell-mediated immunity may help overcome immune unresponsiveness to the S protein in certain individuals (19 24) Therefore the PreS1 antigen may play an important role in the neutralization blockade and clearance of HBV infections

                Clin Vaccine Immun 2011 18(11) 1789-1795

                Inclusion of PreS2S antigen in vaccine formulation could also mitigate the chances of non-responsiveness of vaccines against escape variants (Yamada et al 2001) The PreS2S gene is comprises of S gene with an extra 165 nucleotides at 5rsquo end (Tai et al 1997) and antigen is involved in nucleocapsid interaction (Poisson et al 1997) and extra cellular secretion of HBV particles (Le Seyec et al 1998) playing an important role in full stimulation of humoral and cellular immune responses In addition the PreS2S protein is also important for immunological responses at T-cell level and has T-cell and B-cell recognition sites spanning amino acids 1-25 of the protein (Neurath et al 1986) making it most suitable candidate antigen for HBV vaccine development This study describes the heterologous expression of a characterized PreS2S gene from genotype D of HBV in P pastoris The antigen will help to increase the efficacy of HBV recombinant vaccines

                Pak J Bot 2012 44 355-359

                Use of Pre-S Protein-Containing Hepatitis B Virus Surface Antigens and a Powerful Adjuvant To Develop an Immune Therapy for Chronic Hepatitis B Virus InfectionJung Sun Yum Byung Cheol Ahn [] and Hong Mo Moon

                Clin Vaccine Immun 19(2) 2012

                Роль preS-областей

                J Hep 2011 54 1286-1296

                НИИ вакцин и сывороток им И И Мечникова РАМН Москва

                Сочетанная терапия laquoвакцина + альфа-2 бета-интерферонraquo позволила получить подавление вирусной репликации в первые 1ndash2 месяца от начала лечения у 786 больных сероконверсию HВsAg на анти-HВs mdash у 964 Исчезновение HВеAg наблюдалось через 6 месяца у всех больных а анти-HВе через 2ndash3 месяца от начала лечения появились у всех больных Наблюдение за пациентами в течение трех лет и более показало что стойкий ответ на лечение отмечался у 24 (857) К концу лечения нормализовались все популяции лимфоцитов высоким оставался только уровень лимфоцитов экспрессирующих рецептор к ИЛ-2 (CD25+) оставались сниженными резервы фагоцитоза и кислородзависимого киллинга [5]Таким образом вакцинация против ГВ является актуальной и необходимой больным с ХЗП пациентам с ХГВ иили ХГС носителям ВГВ иили ВГС поскольку способствует подавлению вирусной репликации у хронических вирусоносителей может играть существенную роль в контроле над виремией значительно повышает эффективность лечения ХВГ

                Афигенова ВП Костинов МП 2011

                Study Calls Into Question Effectiveness of Hepatitis B Vaccine for NewbornsDecember 17 2013httparticlesmercolacomsitesarticlesarchive20131217newborn-hepatitis-b-vaccineaspxBy Dr JM Mercola

                New Study Hepatitis B Vaccination at Birth May Not Prevent Hidden InfectionsA new study is raising another red flag that the practice of universally vaccinating all newborn babies for hepatitis B is seriously flawed The researchers followed 259 babies born to hepatitis-B-positive mothers for two years in order to determine whether vaccinating such babies prevents asymptomatic occult HBV (hepatitis B virus) infectionThe researchers found that while the vaccine may help prevent overt HBV transmission it was not effective in preventing occult HBV infection in babies which may occur in up to 40 percent of babies born to hepatitis B-positive mothersHepatitis B Shot May Be Ineffective by the Time Your Child Is a TeenagerAnother issue to consider if you are weighing the benefits and risks of giving your newborn infant or young child hepatitis B vaccine is that vaccine acquired immunity often does not persist until a child reaches his or her teenage years ndash the time when acquiring a hepatitis B infection may be more likely Research shows that by that time the protection from the childhood vaccine may have long since wanedOne study found that about 15 percent of teens who received the full series of hepatitis B shots as infants tested positive for hepatitis B surface antigen (HBsAg) which is an early indicator of infection or a sign that the person is a chronic carrier of the virus3This percentage was even higher among teens who had received the hepatitis B vaccine off schedule or whose mothers were high risk meaning they tested positive for hepatitis B e antigen (HBeAg) In other words it appears that in many children hepatitis B vaccine acquired immunity does NOT provide lasting protection A Healthy Immune System Can Resolve Hepatitis B InfectionEven if you have been vaccinated as a child itrsquos important to remember that you may not be protected from these risks and could still be infected via IV drug abuse sexual activity with an infected partner a blood transfusion with contaminated blood or even getting a manicure or pedicurehellipFortunately in most cases the hepatitis B infection will resolve on its own provided you have a well-functioning immune system Symptoms can be relieved bybullRestingbullAvoiding foods that weaken your immune function such as sugarsfructose grains and processed foods Healthful foods that help boost your immune system include fermented foods and organic vegetablesbullOptimizing your vitamin D levelsbullDrinking plenty of pure waterbullAvoiding alcohol and drugs

                Причинно-следственныеbull Перееданиеbull Неадекватное питаниеbull Вредные привычкиbull Гиподинамия либо перегрузкиbull Неадекватное дыханиеbull Неадекватность мироощущения (стресс дефицит мотивации подавленность- депрессия)bull ИНТОКСИКАЦИЯbull ПОДАВЛЕННОСТЬ ИММУНИТЕТА

                Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

                Курс оздоровления направленный на восстановление иммунной системы

                Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

                М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

                Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

                () Курс относится к категории SPA

                • Slide 1
                • Slide 2
                • Slide 5
                • Slide 6
                • Slide 7
                • Slide 8
                • Slide 9
                • Slide 10
                • Slide 11
                • Slide 12
                • Slide 13
                • Slide 14
                • Slide 15
                • Slide 16
                • Slide 17
                • Slide 18
                • Slide 19
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                • Slide 21
                • Slide 22
                • Slide 23
                • Slide 24
                • Slide 25
                • Slide 26
                • Slide 27
                • Slide 28
                • Slide 29

                  HBV-дикий вирус

                  Anti-HBs пресс в результате массовой вакцинации Исходно5-7 мутантовЧерез 20 лет22 мутантов

                  Мутантные формы прогрессивно накапливаются у привитыхУ невакцинированных это случайные мутации а у привитых ndash MHR HBsAg

                  Анти-вирусная терапияс помощью нуклеозидных аналоговМутации происходят направленно в Pol-последовательности но фактически меняют аа последовательность в MHR HBsAg что приводит к неузнаванию anti-HBs

                  Мутанты иммунно-происхождения

                  Мутанты Pol-происхождения

                  Не узнают anti-HBs

                  Узнают anti-preS1 anti-preS2 anti-HBc

                  Вакцина 3-го пок

                  Вакцина 4в - пок

                  Drug-resistant mutations rtM204I (sI195M) and rtM204V (sW196S) caused significant reduction in antigenicity for the immune-escaped HBsAg mutants sG145K and sG145R which may hamper HBV diagnosis and disease controlVirology Journal 2013 10292

                  Type of Vaccine Vaccine Antigen Adjuvant Host Cell Target Current Status References

                  Peptide

                  (a) Palmitolylated TT830-843 HTL

                  epitope covalently linked to the HBcAg 18 ndash27 CTL epitope

                  NACytotoxic T Lymphocyt

                  e

                  Phase II clinical trial

                  Livingston et al 1999 [22]

                  (b) HBV core antigen 18-27

                  peptide + tetanus taxoid peptide 830

                  843+palmic acid molecules

                  NACytotoxic T Lymphocyt

                  e

                  Pre-clinical amp clinical

                  Vitiello et al 1995 [23]

                  ProteinHBsAganti-

                  HBsIgAlum

                  Cytotoxic T Lymphocyt

                  e

                  Phase II clinical trial

                  Wen et al 2003

                  Xu et al 2008 [28]

                  DNA

                  Small(S) and middle (preS2S) proteins of the HBV envelope

                  (HBsAg)

                  NACD8+ T

                  Lymphocyte

                  Phase I clinical trial

                  Mancini et al 2004

                  Vector-basedModified

                  prHBV13HBVcore protein

                  NA

                  CD4+ and CD8+ T

                  Lymphocyte

                  Pre-clinicalDeng et al

                  2009 [8]

                  Cell-based

                  DCs pulsed with HBs28-39 peptide or

                  recombinant preS2S particles

                  NACytotoxic T Lymphocyt

                  ePre-clinical

                  Akbar et al 2004 [36]

                  Therapeutic Vaccine for Hepatitis B virusJ Infect Dis Immunol Tech 2012 11

                  Release Summary February 12 2014httpwwwbusinesswirecomnewshome20140212005051enCreation-ABIVAX---Leader-Therapeutic-Vaccines-FrenchU3PoW_ldW8AAbivax creation of ABIVAX - a leader in therapeutic vaccines and the first French company to sign an exclusive partnering agreement with Cuba in healthcareABIVAX specializes in therapeutic vaccines and antivirals combining the technologies and the product portfolios of three French biotech companies financed by Truffle CapitaABIVAX already has two therapeutic vaccines in development one in a Phase IIb clinical trial in patients with chronic hepatitis B

                  The HBsAgndashHBcAg vaccine candidate was safe well tolerated and immunogenic in this phase I study in healthy adults To our knowledge this is the first demonstration of safety and immunogenicity for a nasal vaccine candidate comprising HBV antigensThe vaccine elicited anti-HBc seroconversion in 100 of subjects as early as day 30 of the immunization schedule while a seroprotective anti-HBs titer (ge10 IUl) was at a maximum at day 90 (75) International Journal of Infectious DiseasesVolume 11 Issue 5 September 2007

                  A novel therapeutic hepatitis B vaccine induces cellular and humoral immune responses and breaks tolerance in hepatitis B virus (HBV) transgenic miceBuchmann P1 Dembek C Kuklick L Jaumlger C Tedjokusumo R von Freyend MJ Drebber U Janowicz Z Melber K Protzer U

                  1Rhein Biotech GmbH Duesseldorf Germany pbuchmanneudynavaxcomVaccine 2013 631(8)A paradigm of therapeutic vaccination is the potent induction of T-cell responses against key viral antigens ndash besides activation of a humoral immune response We have evaluated the potential of a novel vaccine formulation comprising particulate hepatitis B surface (HBsAg) and core antigen (HBcAg) and the saponin-based ISCOMATRIXtrade adjuvant for its ability to stimulate T and B cell responses in C57BL6 mice and its ability to break tolerance in HBV transgenic (HBVtg) mice The vaccine induced multifunctional HBsAg- and HBcAg-specific CD8+ T cells detected by staining for IFNγ TNFα and IL-2 as well as high antibody titers against both antigens Vaccination of HBVtg animals induced potent HBsAg- and HBcAg-specific CD8+ T-cell responses in spleens and HBcAg-specific CD8+ T-cell responses in livers as well as anti-HBs seroconversion two weeks post injection Vaccination further reduced HBcAg expression in livers of HBVtg mice without causing liver damage In summary this study demonstrates therapeutic efficacy of a novel vaccine formulation in a mouse model of immunotolerant chronic HBV infection

                  HBsAg-HBcAg vaccine version - IV generation

                  PreS1 is the priority target antigen for the new HBV vaccines because PreS1 has a greater number of immunogenic T cell and B cell epitopes than the S protein (9 12 15) including a strong T cell epitope (aa 21 to 28) and an effective B cell epitope (aa 12 to 32 and 32 to 53) The PreS1 protein has binding sites for liver cells (aa 21 to 47) that play an important role in viral attachment and entry (13 15) Neurath et al have shown that direct immunization with a PreS1 polypeptide (aa 21 to 47) can protect against HBV infection in chimpanzees (21) Additionally the PreS1 antibody is produced earlier than the S antibody and the PreS1-specific cell-mediated immunity may help overcome immune unresponsiveness to the S protein in certain individuals (19 24) Therefore the PreS1 antigen may play an important role in the neutralization blockade and clearance of HBV infections

                  Clin Vaccine Immun 2011 18(11) 1789-1795

                  Inclusion of PreS2S antigen in vaccine formulation could also mitigate the chances of non-responsiveness of vaccines against escape variants (Yamada et al 2001) The PreS2S gene is comprises of S gene with an extra 165 nucleotides at 5rsquo end (Tai et al 1997) and antigen is involved in nucleocapsid interaction (Poisson et al 1997) and extra cellular secretion of HBV particles (Le Seyec et al 1998) playing an important role in full stimulation of humoral and cellular immune responses In addition the PreS2S protein is also important for immunological responses at T-cell level and has T-cell and B-cell recognition sites spanning amino acids 1-25 of the protein (Neurath et al 1986) making it most suitable candidate antigen for HBV vaccine development This study describes the heterologous expression of a characterized PreS2S gene from genotype D of HBV in P pastoris The antigen will help to increase the efficacy of HBV recombinant vaccines

                  Pak J Bot 2012 44 355-359

                  Use of Pre-S Protein-Containing Hepatitis B Virus Surface Antigens and a Powerful Adjuvant To Develop an Immune Therapy for Chronic Hepatitis B Virus InfectionJung Sun Yum Byung Cheol Ahn [] and Hong Mo Moon

                  Clin Vaccine Immun 19(2) 2012

                  Роль preS-областей

                  J Hep 2011 54 1286-1296

                  НИИ вакцин и сывороток им И И Мечникова РАМН Москва

                  Сочетанная терапия laquoвакцина + альфа-2 бета-интерферонraquo позволила получить подавление вирусной репликации в первые 1ndash2 месяца от начала лечения у 786 больных сероконверсию HВsAg на анти-HВs mdash у 964 Исчезновение HВеAg наблюдалось через 6 месяца у всех больных а анти-HВе через 2ndash3 месяца от начала лечения появились у всех больных Наблюдение за пациентами в течение трех лет и более показало что стойкий ответ на лечение отмечался у 24 (857) К концу лечения нормализовались все популяции лимфоцитов высоким оставался только уровень лимфоцитов экспрессирующих рецептор к ИЛ-2 (CD25+) оставались сниженными резервы фагоцитоза и кислородзависимого киллинга [5]Таким образом вакцинация против ГВ является актуальной и необходимой больным с ХЗП пациентам с ХГВ иили ХГС носителям ВГВ иили ВГС поскольку способствует подавлению вирусной репликации у хронических вирусоносителей может играть существенную роль в контроле над виремией значительно повышает эффективность лечения ХВГ

                  Афигенова ВП Костинов МП 2011

                  Study Calls Into Question Effectiveness of Hepatitis B Vaccine for NewbornsDecember 17 2013httparticlesmercolacomsitesarticlesarchive20131217newborn-hepatitis-b-vaccineaspxBy Dr JM Mercola

                  New Study Hepatitis B Vaccination at Birth May Not Prevent Hidden InfectionsA new study is raising another red flag that the practice of universally vaccinating all newborn babies for hepatitis B is seriously flawed The researchers followed 259 babies born to hepatitis-B-positive mothers for two years in order to determine whether vaccinating such babies prevents asymptomatic occult HBV (hepatitis B virus) infectionThe researchers found that while the vaccine may help prevent overt HBV transmission it was not effective in preventing occult HBV infection in babies which may occur in up to 40 percent of babies born to hepatitis B-positive mothersHepatitis B Shot May Be Ineffective by the Time Your Child Is a TeenagerAnother issue to consider if you are weighing the benefits and risks of giving your newborn infant or young child hepatitis B vaccine is that vaccine acquired immunity often does not persist until a child reaches his or her teenage years ndash the time when acquiring a hepatitis B infection may be more likely Research shows that by that time the protection from the childhood vaccine may have long since wanedOne study found that about 15 percent of teens who received the full series of hepatitis B shots as infants tested positive for hepatitis B surface antigen (HBsAg) which is an early indicator of infection or a sign that the person is a chronic carrier of the virus3This percentage was even higher among teens who had received the hepatitis B vaccine off schedule or whose mothers were high risk meaning they tested positive for hepatitis B e antigen (HBeAg) In other words it appears that in many children hepatitis B vaccine acquired immunity does NOT provide lasting protection A Healthy Immune System Can Resolve Hepatitis B InfectionEven if you have been vaccinated as a child itrsquos important to remember that you may not be protected from these risks and could still be infected via IV drug abuse sexual activity with an infected partner a blood transfusion with contaminated blood or even getting a manicure or pedicurehellipFortunately in most cases the hepatitis B infection will resolve on its own provided you have a well-functioning immune system Symptoms can be relieved bybullRestingbullAvoiding foods that weaken your immune function such as sugarsfructose grains and processed foods Healthful foods that help boost your immune system include fermented foods and organic vegetablesbullOptimizing your vitamin D levelsbullDrinking plenty of pure waterbullAvoiding alcohol and drugs

                  Причинно-следственныеbull Перееданиеbull Неадекватное питаниеbull Вредные привычкиbull Гиподинамия либо перегрузкиbull Неадекватное дыханиеbull Неадекватность мироощущения (стресс дефицит мотивации подавленность- депрессия)bull ИНТОКСИКАЦИЯbull ПОДАВЛЕННОСТЬ ИММУНИТЕТА

                  Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

                  Курс оздоровления направленный на восстановление иммунной системы

                  Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

                  М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

                  Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

                  () Курс относится к категории SPA

                  • Slide 1
                  • Slide 2
                  • Slide 5
                  • Slide 6
                  • Slide 7
                  • Slide 8
                  • Slide 9
                  • Slide 10
                  • Slide 11
                  • Slide 12
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                  • Slide 25
                  • Slide 26
                  • Slide 27
                  • Slide 28
                  • Slide 29

                    Type of Vaccine Vaccine Antigen Adjuvant Host Cell Target Current Status References

                    Peptide

                    (a) Palmitolylated TT830-843 HTL

                    epitope covalently linked to the HBcAg 18 ndash27 CTL epitope

                    NACytotoxic T Lymphocyt

                    e

                    Phase II clinical trial

                    Livingston et al 1999 [22]

                    (b) HBV core antigen 18-27

                    peptide + tetanus taxoid peptide 830

                    843+palmic acid molecules

                    NACytotoxic T Lymphocyt

                    e

                    Pre-clinical amp clinical

                    Vitiello et al 1995 [23]

                    ProteinHBsAganti-

                    HBsIgAlum

                    Cytotoxic T Lymphocyt

                    e

                    Phase II clinical trial

                    Wen et al 2003

                    Xu et al 2008 [28]

                    DNA

                    Small(S) and middle (preS2S) proteins of the HBV envelope

                    (HBsAg)

                    NACD8+ T

                    Lymphocyte

                    Phase I clinical trial

                    Mancini et al 2004

                    Vector-basedModified

                    prHBV13HBVcore protein

                    NA

                    CD4+ and CD8+ T

                    Lymphocyte

                    Pre-clinicalDeng et al

                    2009 [8]

                    Cell-based

                    DCs pulsed with HBs28-39 peptide or

                    recombinant preS2S particles

                    NACytotoxic T Lymphocyt

                    ePre-clinical

                    Akbar et al 2004 [36]

                    Therapeutic Vaccine for Hepatitis B virusJ Infect Dis Immunol Tech 2012 11

                    Release Summary February 12 2014httpwwwbusinesswirecomnewshome20140212005051enCreation-ABIVAX---Leader-Therapeutic-Vaccines-FrenchU3PoW_ldW8AAbivax creation of ABIVAX - a leader in therapeutic vaccines and the first French company to sign an exclusive partnering agreement with Cuba in healthcareABIVAX specializes in therapeutic vaccines and antivirals combining the technologies and the product portfolios of three French biotech companies financed by Truffle CapitaABIVAX already has two therapeutic vaccines in development one in a Phase IIb clinical trial in patients with chronic hepatitis B

                    The HBsAgndashHBcAg vaccine candidate was safe well tolerated and immunogenic in this phase I study in healthy adults To our knowledge this is the first demonstration of safety and immunogenicity for a nasal vaccine candidate comprising HBV antigensThe vaccine elicited anti-HBc seroconversion in 100 of subjects as early as day 30 of the immunization schedule while a seroprotective anti-HBs titer (ge10 IUl) was at a maximum at day 90 (75) International Journal of Infectious DiseasesVolume 11 Issue 5 September 2007

                    A novel therapeutic hepatitis B vaccine induces cellular and humoral immune responses and breaks tolerance in hepatitis B virus (HBV) transgenic miceBuchmann P1 Dembek C Kuklick L Jaumlger C Tedjokusumo R von Freyend MJ Drebber U Janowicz Z Melber K Protzer U

                    1Rhein Biotech GmbH Duesseldorf Germany pbuchmanneudynavaxcomVaccine 2013 631(8)A paradigm of therapeutic vaccination is the potent induction of T-cell responses against key viral antigens ndash besides activation of a humoral immune response We have evaluated the potential of a novel vaccine formulation comprising particulate hepatitis B surface (HBsAg) and core antigen (HBcAg) and the saponin-based ISCOMATRIXtrade adjuvant for its ability to stimulate T and B cell responses in C57BL6 mice and its ability to break tolerance in HBV transgenic (HBVtg) mice The vaccine induced multifunctional HBsAg- and HBcAg-specific CD8+ T cells detected by staining for IFNγ TNFα and IL-2 as well as high antibody titers against both antigens Vaccination of HBVtg animals induced potent HBsAg- and HBcAg-specific CD8+ T-cell responses in spleens and HBcAg-specific CD8+ T-cell responses in livers as well as anti-HBs seroconversion two weeks post injection Vaccination further reduced HBcAg expression in livers of HBVtg mice without causing liver damage In summary this study demonstrates therapeutic efficacy of a novel vaccine formulation in a mouse model of immunotolerant chronic HBV infection

                    HBsAg-HBcAg vaccine version - IV generation

                    PreS1 is the priority target antigen for the new HBV vaccines because PreS1 has a greater number of immunogenic T cell and B cell epitopes than the S protein (9 12 15) including a strong T cell epitope (aa 21 to 28) and an effective B cell epitope (aa 12 to 32 and 32 to 53) The PreS1 protein has binding sites for liver cells (aa 21 to 47) that play an important role in viral attachment and entry (13 15) Neurath et al have shown that direct immunization with a PreS1 polypeptide (aa 21 to 47) can protect against HBV infection in chimpanzees (21) Additionally the PreS1 antibody is produced earlier than the S antibody and the PreS1-specific cell-mediated immunity may help overcome immune unresponsiveness to the S protein in certain individuals (19 24) Therefore the PreS1 antigen may play an important role in the neutralization blockade and clearance of HBV infections

                    Clin Vaccine Immun 2011 18(11) 1789-1795

                    Inclusion of PreS2S antigen in vaccine formulation could also mitigate the chances of non-responsiveness of vaccines against escape variants (Yamada et al 2001) The PreS2S gene is comprises of S gene with an extra 165 nucleotides at 5rsquo end (Tai et al 1997) and antigen is involved in nucleocapsid interaction (Poisson et al 1997) and extra cellular secretion of HBV particles (Le Seyec et al 1998) playing an important role in full stimulation of humoral and cellular immune responses In addition the PreS2S protein is also important for immunological responses at T-cell level and has T-cell and B-cell recognition sites spanning amino acids 1-25 of the protein (Neurath et al 1986) making it most suitable candidate antigen for HBV vaccine development This study describes the heterologous expression of a characterized PreS2S gene from genotype D of HBV in P pastoris The antigen will help to increase the efficacy of HBV recombinant vaccines

                    Pak J Bot 2012 44 355-359

                    Use of Pre-S Protein-Containing Hepatitis B Virus Surface Antigens and a Powerful Adjuvant To Develop an Immune Therapy for Chronic Hepatitis B Virus InfectionJung Sun Yum Byung Cheol Ahn [] and Hong Mo Moon

                    Clin Vaccine Immun 19(2) 2012

                    Роль preS-областей

                    J Hep 2011 54 1286-1296

                    НИИ вакцин и сывороток им И И Мечникова РАМН Москва

                    Сочетанная терапия laquoвакцина + альфа-2 бета-интерферонraquo позволила получить подавление вирусной репликации в первые 1ndash2 месяца от начала лечения у 786 больных сероконверсию HВsAg на анти-HВs mdash у 964 Исчезновение HВеAg наблюдалось через 6 месяца у всех больных а анти-HВе через 2ndash3 месяца от начала лечения появились у всех больных Наблюдение за пациентами в течение трех лет и более показало что стойкий ответ на лечение отмечался у 24 (857) К концу лечения нормализовались все популяции лимфоцитов высоким оставался только уровень лимфоцитов экспрессирующих рецептор к ИЛ-2 (CD25+) оставались сниженными резервы фагоцитоза и кислородзависимого киллинга [5]Таким образом вакцинация против ГВ является актуальной и необходимой больным с ХЗП пациентам с ХГВ иили ХГС носителям ВГВ иили ВГС поскольку способствует подавлению вирусной репликации у хронических вирусоносителей может играть существенную роль в контроле над виремией значительно повышает эффективность лечения ХВГ

                    Афигенова ВП Костинов МП 2011

                    Study Calls Into Question Effectiveness of Hepatitis B Vaccine for NewbornsDecember 17 2013httparticlesmercolacomsitesarticlesarchive20131217newborn-hepatitis-b-vaccineaspxBy Dr JM Mercola

                    New Study Hepatitis B Vaccination at Birth May Not Prevent Hidden InfectionsA new study is raising another red flag that the practice of universally vaccinating all newborn babies for hepatitis B is seriously flawed The researchers followed 259 babies born to hepatitis-B-positive mothers for two years in order to determine whether vaccinating such babies prevents asymptomatic occult HBV (hepatitis B virus) infectionThe researchers found that while the vaccine may help prevent overt HBV transmission it was not effective in preventing occult HBV infection in babies which may occur in up to 40 percent of babies born to hepatitis B-positive mothersHepatitis B Shot May Be Ineffective by the Time Your Child Is a TeenagerAnother issue to consider if you are weighing the benefits and risks of giving your newborn infant or young child hepatitis B vaccine is that vaccine acquired immunity often does not persist until a child reaches his or her teenage years ndash the time when acquiring a hepatitis B infection may be more likely Research shows that by that time the protection from the childhood vaccine may have long since wanedOne study found that about 15 percent of teens who received the full series of hepatitis B shots as infants tested positive for hepatitis B surface antigen (HBsAg) which is an early indicator of infection or a sign that the person is a chronic carrier of the virus3This percentage was even higher among teens who had received the hepatitis B vaccine off schedule or whose mothers were high risk meaning they tested positive for hepatitis B e antigen (HBeAg) In other words it appears that in many children hepatitis B vaccine acquired immunity does NOT provide lasting protection A Healthy Immune System Can Resolve Hepatitis B InfectionEven if you have been vaccinated as a child itrsquos important to remember that you may not be protected from these risks and could still be infected via IV drug abuse sexual activity with an infected partner a blood transfusion with contaminated blood or even getting a manicure or pedicurehellipFortunately in most cases the hepatitis B infection will resolve on its own provided you have a well-functioning immune system Symptoms can be relieved bybullRestingbullAvoiding foods that weaken your immune function such as sugarsfructose grains and processed foods Healthful foods that help boost your immune system include fermented foods and organic vegetablesbullOptimizing your vitamin D levelsbullDrinking plenty of pure waterbullAvoiding alcohol and drugs

                    Причинно-следственныеbull Перееданиеbull Неадекватное питаниеbull Вредные привычкиbull Гиподинамия либо перегрузкиbull Неадекватное дыханиеbull Неадекватность мироощущения (стресс дефицит мотивации подавленность- депрессия)bull ИНТОКСИКАЦИЯbull ПОДАВЛЕННОСТЬ ИММУНИТЕТА

                    Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

                    Курс оздоровления направленный на восстановление иммунной системы

                    Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

                    М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

                    Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

                    () Курс относится к категории SPA

                    • Slide 1
                    • Slide 2
                    • Slide 5
                    • Slide 6
                    • Slide 7
                    • Slide 8
                    • Slide 9
                    • Slide 10
                    • Slide 11
                    • Slide 12
                    • Slide 13
                    • Slide 14
                    • Slide 15
                    • Slide 16
                    • Slide 17
                    • Slide 18
                    • Slide 19
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                    • Slide 21
                    • Slide 22
                    • Slide 23
                    • Slide 24
                    • Slide 25
                    • Slide 26
                    • Slide 27
                    • Slide 28
                    • Slide 29

                      Release Summary February 12 2014httpwwwbusinesswirecomnewshome20140212005051enCreation-ABIVAX---Leader-Therapeutic-Vaccines-FrenchU3PoW_ldW8AAbivax creation of ABIVAX - a leader in therapeutic vaccines and the first French company to sign an exclusive partnering agreement with Cuba in healthcareABIVAX specializes in therapeutic vaccines and antivirals combining the technologies and the product portfolios of three French biotech companies financed by Truffle CapitaABIVAX already has two therapeutic vaccines in development one in a Phase IIb clinical trial in patients with chronic hepatitis B

                      The HBsAgndashHBcAg vaccine candidate was safe well tolerated and immunogenic in this phase I study in healthy adults To our knowledge this is the first demonstration of safety and immunogenicity for a nasal vaccine candidate comprising HBV antigensThe vaccine elicited anti-HBc seroconversion in 100 of subjects as early as day 30 of the immunization schedule while a seroprotective anti-HBs titer (ge10 IUl) was at a maximum at day 90 (75) International Journal of Infectious DiseasesVolume 11 Issue 5 September 2007

                      A novel therapeutic hepatitis B vaccine induces cellular and humoral immune responses and breaks tolerance in hepatitis B virus (HBV) transgenic miceBuchmann P1 Dembek C Kuklick L Jaumlger C Tedjokusumo R von Freyend MJ Drebber U Janowicz Z Melber K Protzer U

                      1Rhein Biotech GmbH Duesseldorf Germany pbuchmanneudynavaxcomVaccine 2013 631(8)A paradigm of therapeutic vaccination is the potent induction of T-cell responses against key viral antigens ndash besides activation of a humoral immune response We have evaluated the potential of a novel vaccine formulation comprising particulate hepatitis B surface (HBsAg) and core antigen (HBcAg) and the saponin-based ISCOMATRIXtrade adjuvant for its ability to stimulate T and B cell responses in C57BL6 mice and its ability to break tolerance in HBV transgenic (HBVtg) mice The vaccine induced multifunctional HBsAg- and HBcAg-specific CD8+ T cells detected by staining for IFNγ TNFα and IL-2 as well as high antibody titers against both antigens Vaccination of HBVtg animals induced potent HBsAg- and HBcAg-specific CD8+ T-cell responses in spleens and HBcAg-specific CD8+ T-cell responses in livers as well as anti-HBs seroconversion two weeks post injection Vaccination further reduced HBcAg expression in livers of HBVtg mice without causing liver damage In summary this study demonstrates therapeutic efficacy of a novel vaccine formulation in a mouse model of immunotolerant chronic HBV infection

                      HBsAg-HBcAg vaccine version - IV generation

                      PreS1 is the priority target antigen for the new HBV vaccines because PreS1 has a greater number of immunogenic T cell and B cell epitopes than the S protein (9 12 15) including a strong T cell epitope (aa 21 to 28) and an effective B cell epitope (aa 12 to 32 and 32 to 53) The PreS1 protein has binding sites for liver cells (aa 21 to 47) that play an important role in viral attachment and entry (13 15) Neurath et al have shown that direct immunization with a PreS1 polypeptide (aa 21 to 47) can protect against HBV infection in chimpanzees (21) Additionally the PreS1 antibody is produced earlier than the S antibody and the PreS1-specific cell-mediated immunity may help overcome immune unresponsiveness to the S protein in certain individuals (19 24) Therefore the PreS1 antigen may play an important role in the neutralization blockade and clearance of HBV infections

                      Clin Vaccine Immun 2011 18(11) 1789-1795

                      Inclusion of PreS2S antigen in vaccine formulation could also mitigate the chances of non-responsiveness of vaccines against escape variants (Yamada et al 2001) The PreS2S gene is comprises of S gene with an extra 165 nucleotides at 5rsquo end (Tai et al 1997) and antigen is involved in nucleocapsid interaction (Poisson et al 1997) and extra cellular secretion of HBV particles (Le Seyec et al 1998) playing an important role in full stimulation of humoral and cellular immune responses In addition the PreS2S protein is also important for immunological responses at T-cell level and has T-cell and B-cell recognition sites spanning amino acids 1-25 of the protein (Neurath et al 1986) making it most suitable candidate antigen for HBV vaccine development This study describes the heterologous expression of a characterized PreS2S gene from genotype D of HBV in P pastoris The antigen will help to increase the efficacy of HBV recombinant vaccines

                      Pak J Bot 2012 44 355-359

                      Use of Pre-S Protein-Containing Hepatitis B Virus Surface Antigens and a Powerful Adjuvant To Develop an Immune Therapy for Chronic Hepatitis B Virus InfectionJung Sun Yum Byung Cheol Ahn [] and Hong Mo Moon

                      Clin Vaccine Immun 19(2) 2012

                      Роль preS-областей

                      J Hep 2011 54 1286-1296

                      НИИ вакцин и сывороток им И И Мечникова РАМН Москва

                      Сочетанная терапия laquoвакцина + альфа-2 бета-интерферонraquo позволила получить подавление вирусной репликации в первые 1ndash2 месяца от начала лечения у 786 больных сероконверсию HВsAg на анти-HВs mdash у 964 Исчезновение HВеAg наблюдалось через 6 месяца у всех больных а анти-HВе через 2ndash3 месяца от начала лечения появились у всех больных Наблюдение за пациентами в течение трех лет и более показало что стойкий ответ на лечение отмечался у 24 (857) К концу лечения нормализовались все популяции лимфоцитов высоким оставался только уровень лимфоцитов экспрессирующих рецептор к ИЛ-2 (CD25+) оставались сниженными резервы фагоцитоза и кислородзависимого киллинга [5]Таким образом вакцинация против ГВ является актуальной и необходимой больным с ХЗП пациентам с ХГВ иили ХГС носителям ВГВ иили ВГС поскольку способствует подавлению вирусной репликации у хронических вирусоносителей может играть существенную роль в контроле над виремией значительно повышает эффективность лечения ХВГ

                      Афигенова ВП Костинов МП 2011

                      Study Calls Into Question Effectiveness of Hepatitis B Vaccine for NewbornsDecember 17 2013httparticlesmercolacomsitesarticlesarchive20131217newborn-hepatitis-b-vaccineaspxBy Dr JM Mercola

                      New Study Hepatitis B Vaccination at Birth May Not Prevent Hidden InfectionsA new study is raising another red flag that the practice of universally vaccinating all newborn babies for hepatitis B is seriously flawed The researchers followed 259 babies born to hepatitis-B-positive mothers for two years in order to determine whether vaccinating such babies prevents asymptomatic occult HBV (hepatitis B virus) infectionThe researchers found that while the vaccine may help prevent overt HBV transmission it was not effective in preventing occult HBV infection in babies which may occur in up to 40 percent of babies born to hepatitis B-positive mothersHepatitis B Shot May Be Ineffective by the Time Your Child Is a TeenagerAnother issue to consider if you are weighing the benefits and risks of giving your newborn infant or young child hepatitis B vaccine is that vaccine acquired immunity often does not persist until a child reaches his or her teenage years ndash the time when acquiring a hepatitis B infection may be more likely Research shows that by that time the protection from the childhood vaccine may have long since wanedOne study found that about 15 percent of teens who received the full series of hepatitis B shots as infants tested positive for hepatitis B surface antigen (HBsAg) which is an early indicator of infection or a sign that the person is a chronic carrier of the virus3This percentage was even higher among teens who had received the hepatitis B vaccine off schedule or whose mothers were high risk meaning they tested positive for hepatitis B e antigen (HBeAg) In other words it appears that in many children hepatitis B vaccine acquired immunity does NOT provide lasting protection A Healthy Immune System Can Resolve Hepatitis B InfectionEven if you have been vaccinated as a child itrsquos important to remember that you may not be protected from these risks and could still be infected via IV drug abuse sexual activity with an infected partner a blood transfusion with contaminated blood or even getting a manicure or pedicurehellipFortunately in most cases the hepatitis B infection will resolve on its own provided you have a well-functioning immune system Symptoms can be relieved bybullRestingbullAvoiding foods that weaken your immune function such as sugarsfructose grains and processed foods Healthful foods that help boost your immune system include fermented foods and organic vegetablesbullOptimizing your vitamin D levelsbullDrinking plenty of pure waterbullAvoiding alcohol and drugs

                      Причинно-следственныеbull Перееданиеbull Неадекватное питаниеbull Вредные привычкиbull Гиподинамия либо перегрузкиbull Неадекватное дыханиеbull Неадекватность мироощущения (стресс дефицит мотивации подавленность- депрессия)bull ИНТОКСИКАЦИЯbull ПОДАВЛЕННОСТЬ ИММУНИТЕТА

                      Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

                      Курс оздоровления направленный на восстановление иммунной системы

                      Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

                      М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

                      Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

                      () Курс относится к категории SPA

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                        PreS1 is the priority target antigen for the new HBV vaccines because PreS1 has a greater number of immunogenic T cell and B cell epitopes than the S protein (9 12 15) including a strong T cell epitope (aa 21 to 28) and an effective B cell epitope (aa 12 to 32 and 32 to 53) The PreS1 protein has binding sites for liver cells (aa 21 to 47) that play an important role in viral attachment and entry (13 15) Neurath et al have shown that direct immunization with a PreS1 polypeptide (aa 21 to 47) can protect against HBV infection in chimpanzees (21) Additionally the PreS1 antibody is produced earlier than the S antibody and the PreS1-specific cell-mediated immunity may help overcome immune unresponsiveness to the S protein in certain individuals (19 24) Therefore the PreS1 antigen may play an important role in the neutralization blockade and clearance of HBV infections

                        Clin Vaccine Immun 2011 18(11) 1789-1795

                        Inclusion of PreS2S antigen in vaccine formulation could also mitigate the chances of non-responsiveness of vaccines against escape variants (Yamada et al 2001) The PreS2S gene is comprises of S gene with an extra 165 nucleotides at 5rsquo end (Tai et al 1997) and antigen is involved in nucleocapsid interaction (Poisson et al 1997) and extra cellular secretion of HBV particles (Le Seyec et al 1998) playing an important role in full stimulation of humoral and cellular immune responses In addition the PreS2S protein is also important for immunological responses at T-cell level and has T-cell and B-cell recognition sites spanning amino acids 1-25 of the protein (Neurath et al 1986) making it most suitable candidate antigen for HBV vaccine development This study describes the heterologous expression of a characterized PreS2S gene from genotype D of HBV in P pastoris The antigen will help to increase the efficacy of HBV recombinant vaccines

                        Pak J Bot 2012 44 355-359

                        Use of Pre-S Protein-Containing Hepatitis B Virus Surface Antigens and a Powerful Adjuvant To Develop an Immune Therapy for Chronic Hepatitis B Virus InfectionJung Sun Yum Byung Cheol Ahn [] and Hong Mo Moon

                        Clin Vaccine Immun 19(2) 2012

                        Роль preS-областей

                        J Hep 2011 54 1286-1296

                        НИИ вакцин и сывороток им И И Мечникова РАМН Москва

                        Сочетанная терапия laquoвакцина + альфа-2 бета-интерферонraquo позволила получить подавление вирусной репликации в первые 1ndash2 месяца от начала лечения у 786 больных сероконверсию HВsAg на анти-HВs mdash у 964 Исчезновение HВеAg наблюдалось через 6 месяца у всех больных а анти-HВе через 2ndash3 месяца от начала лечения появились у всех больных Наблюдение за пациентами в течение трех лет и более показало что стойкий ответ на лечение отмечался у 24 (857) К концу лечения нормализовались все популяции лимфоцитов высоким оставался только уровень лимфоцитов экспрессирующих рецептор к ИЛ-2 (CD25+) оставались сниженными резервы фагоцитоза и кислородзависимого киллинга [5]Таким образом вакцинация против ГВ является актуальной и необходимой больным с ХЗП пациентам с ХГВ иили ХГС носителям ВГВ иили ВГС поскольку способствует подавлению вирусной репликации у хронических вирусоносителей может играть существенную роль в контроле над виремией значительно повышает эффективность лечения ХВГ

                        Афигенова ВП Костинов МП 2011

                        Study Calls Into Question Effectiveness of Hepatitis B Vaccine for NewbornsDecember 17 2013httparticlesmercolacomsitesarticlesarchive20131217newborn-hepatitis-b-vaccineaspxBy Dr JM Mercola

                        New Study Hepatitis B Vaccination at Birth May Not Prevent Hidden InfectionsA new study is raising another red flag that the practice of universally vaccinating all newborn babies for hepatitis B is seriously flawed The researchers followed 259 babies born to hepatitis-B-positive mothers for two years in order to determine whether vaccinating such babies prevents asymptomatic occult HBV (hepatitis B virus) infectionThe researchers found that while the vaccine may help prevent overt HBV transmission it was not effective in preventing occult HBV infection in babies which may occur in up to 40 percent of babies born to hepatitis B-positive mothersHepatitis B Shot May Be Ineffective by the Time Your Child Is a TeenagerAnother issue to consider if you are weighing the benefits and risks of giving your newborn infant or young child hepatitis B vaccine is that vaccine acquired immunity often does not persist until a child reaches his or her teenage years ndash the time when acquiring a hepatitis B infection may be more likely Research shows that by that time the protection from the childhood vaccine may have long since wanedOne study found that about 15 percent of teens who received the full series of hepatitis B shots as infants tested positive for hepatitis B surface antigen (HBsAg) which is an early indicator of infection or a sign that the person is a chronic carrier of the virus3This percentage was even higher among teens who had received the hepatitis B vaccine off schedule or whose mothers were high risk meaning they tested positive for hepatitis B e antigen (HBeAg) In other words it appears that in many children hepatitis B vaccine acquired immunity does NOT provide lasting protection A Healthy Immune System Can Resolve Hepatitis B InfectionEven if you have been vaccinated as a child itrsquos important to remember that you may not be protected from these risks and could still be infected via IV drug abuse sexual activity with an infected partner a blood transfusion with contaminated blood or even getting a manicure or pedicurehellipFortunately in most cases the hepatitis B infection will resolve on its own provided you have a well-functioning immune system Symptoms can be relieved bybullRestingbullAvoiding foods that weaken your immune function such as sugarsfructose grains and processed foods Healthful foods that help boost your immune system include fermented foods and organic vegetablesbullOptimizing your vitamin D levelsbullDrinking plenty of pure waterbullAvoiding alcohol and drugs

                        Причинно-следственныеbull Перееданиеbull Неадекватное питаниеbull Вредные привычкиbull Гиподинамия либо перегрузкиbull Неадекватное дыханиеbull Неадекватность мироощущения (стресс дефицит мотивации подавленность- депрессия)bull ИНТОКСИКАЦИЯbull ПОДАВЛЕННОСТЬ ИММУНИТЕТА

                        Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

                        Курс оздоровления направленный на восстановление иммунной системы

                        Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

                        М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

                        Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

                        () Курс относится к категории SPA

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                          J Hep 2011 54 1286-1296

                          НИИ вакцин и сывороток им И И Мечникова РАМН Москва

                          Сочетанная терапия laquoвакцина + альфа-2 бета-интерферонraquo позволила получить подавление вирусной репликации в первые 1ndash2 месяца от начала лечения у 786 больных сероконверсию HВsAg на анти-HВs mdash у 964 Исчезновение HВеAg наблюдалось через 6 месяца у всех больных а анти-HВе через 2ndash3 месяца от начала лечения появились у всех больных Наблюдение за пациентами в течение трех лет и более показало что стойкий ответ на лечение отмечался у 24 (857) К концу лечения нормализовались все популяции лимфоцитов высоким оставался только уровень лимфоцитов экспрессирующих рецептор к ИЛ-2 (CD25+) оставались сниженными резервы фагоцитоза и кислородзависимого киллинга [5]Таким образом вакцинация против ГВ является актуальной и необходимой больным с ХЗП пациентам с ХГВ иили ХГС носителям ВГВ иили ВГС поскольку способствует подавлению вирусной репликации у хронических вирусоносителей может играть существенную роль в контроле над виремией значительно повышает эффективность лечения ХВГ

                          Афигенова ВП Костинов МП 2011

                          Study Calls Into Question Effectiveness of Hepatitis B Vaccine for NewbornsDecember 17 2013httparticlesmercolacomsitesarticlesarchive20131217newborn-hepatitis-b-vaccineaspxBy Dr JM Mercola

                          New Study Hepatitis B Vaccination at Birth May Not Prevent Hidden InfectionsA new study is raising another red flag that the practice of universally vaccinating all newborn babies for hepatitis B is seriously flawed The researchers followed 259 babies born to hepatitis-B-positive mothers for two years in order to determine whether vaccinating such babies prevents asymptomatic occult HBV (hepatitis B virus) infectionThe researchers found that while the vaccine may help prevent overt HBV transmission it was not effective in preventing occult HBV infection in babies which may occur in up to 40 percent of babies born to hepatitis B-positive mothersHepatitis B Shot May Be Ineffective by the Time Your Child Is a TeenagerAnother issue to consider if you are weighing the benefits and risks of giving your newborn infant or young child hepatitis B vaccine is that vaccine acquired immunity often does not persist until a child reaches his or her teenage years ndash the time when acquiring a hepatitis B infection may be more likely Research shows that by that time the protection from the childhood vaccine may have long since wanedOne study found that about 15 percent of teens who received the full series of hepatitis B shots as infants tested positive for hepatitis B surface antigen (HBsAg) which is an early indicator of infection or a sign that the person is a chronic carrier of the virus3This percentage was even higher among teens who had received the hepatitis B vaccine off schedule or whose mothers were high risk meaning they tested positive for hepatitis B e antigen (HBeAg) In other words it appears that in many children hepatitis B vaccine acquired immunity does NOT provide lasting protection A Healthy Immune System Can Resolve Hepatitis B InfectionEven if you have been vaccinated as a child itrsquos important to remember that you may not be protected from these risks and could still be infected via IV drug abuse sexual activity with an infected partner a blood transfusion with contaminated blood or even getting a manicure or pedicurehellipFortunately in most cases the hepatitis B infection will resolve on its own provided you have a well-functioning immune system Symptoms can be relieved bybullRestingbullAvoiding foods that weaken your immune function such as sugarsfructose grains and processed foods Healthful foods that help boost your immune system include fermented foods and organic vegetablesbullOptimizing your vitamin D levelsbullDrinking plenty of pure waterbullAvoiding alcohol and drugs

                          Причинно-следственныеbull Перееданиеbull Неадекватное питаниеbull Вредные привычкиbull Гиподинамия либо перегрузкиbull Неадекватное дыханиеbull Неадекватность мироощущения (стресс дефицит мотивации подавленность- депрессия)bull ИНТОКСИКАЦИЯbull ПОДАВЛЕННОСТЬ ИММУНИТЕТА

                          Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

                          Курс оздоровления направленный на восстановление иммунной системы

                          Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

                          М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

                          Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

                          () Курс относится к категории SPA

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                            НИИ вакцин и сывороток им И И Мечникова РАМН Москва

                            Сочетанная терапия laquoвакцина + альфа-2 бета-интерферонraquo позволила получить подавление вирусной репликации в первые 1ndash2 месяца от начала лечения у 786 больных сероконверсию HВsAg на анти-HВs mdash у 964 Исчезновение HВеAg наблюдалось через 6 месяца у всех больных а анти-HВе через 2ndash3 месяца от начала лечения появились у всех больных Наблюдение за пациентами в течение трех лет и более показало что стойкий ответ на лечение отмечался у 24 (857) К концу лечения нормализовались все популяции лимфоцитов высоким оставался только уровень лимфоцитов экспрессирующих рецептор к ИЛ-2 (CD25+) оставались сниженными резервы фагоцитоза и кислородзависимого киллинга [5]Таким образом вакцинация против ГВ является актуальной и необходимой больным с ХЗП пациентам с ХГВ иили ХГС носителям ВГВ иили ВГС поскольку способствует подавлению вирусной репликации у хронических вирусоносителей может играть существенную роль в контроле над виремией значительно повышает эффективность лечения ХВГ

                            Афигенова ВП Костинов МП 2011

                            Study Calls Into Question Effectiveness of Hepatitis B Vaccine for NewbornsDecember 17 2013httparticlesmercolacomsitesarticlesarchive20131217newborn-hepatitis-b-vaccineaspxBy Dr JM Mercola

                            New Study Hepatitis B Vaccination at Birth May Not Prevent Hidden InfectionsA new study is raising another red flag that the practice of universally vaccinating all newborn babies for hepatitis B is seriously flawed The researchers followed 259 babies born to hepatitis-B-positive mothers for two years in order to determine whether vaccinating such babies prevents asymptomatic occult HBV (hepatitis B virus) infectionThe researchers found that while the vaccine may help prevent overt HBV transmission it was not effective in preventing occult HBV infection in babies which may occur in up to 40 percent of babies born to hepatitis B-positive mothersHepatitis B Shot May Be Ineffective by the Time Your Child Is a TeenagerAnother issue to consider if you are weighing the benefits and risks of giving your newborn infant or young child hepatitis B vaccine is that vaccine acquired immunity often does not persist until a child reaches his or her teenage years ndash the time when acquiring a hepatitis B infection may be more likely Research shows that by that time the protection from the childhood vaccine may have long since wanedOne study found that about 15 percent of teens who received the full series of hepatitis B shots as infants tested positive for hepatitis B surface antigen (HBsAg) which is an early indicator of infection or a sign that the person is a chronic carrier of the virus3This percentage was even higher among teens who had received the hepatitis B vaccine off schedule or whose mothers were high risk meaning they tested positive for hepatitis B e antigen (HBeAg) In other words it appears that in many children hepatitis B vaccine acquired immunity does NOT provide lasting protection A Healthy Immune System Can Resolve Hepatitis B InfectionEven if you have been vaccinated as a child itrsquos important to remember that you may not be protected from these risks and could still be infected via IV drug abuse sexual activity with an infected partner a blood transfusion with contaminated blood or even getting a manicure or pedicurehellipFortunately in most cases the hepatitis B infection will resolve on its own provided you have a well-functioning immune system Symptoms can be relieved bybullRestingbullAvoiding foods that weaken your immune function such as sugarsfructose grains and processed foods Healthful foods that help boost your immune system include fermented foods and organic vegetablesbullOptimizing your vitamin D levelsbullDrinking plenty of pure waterbullAvoiding alcohol and drugs

                            Причинно-следственныеbull Перееданиеbull Неадекватное питаниеbull Вредные привычкиbull Гиподинамия либо перегрузкиbull Неадекватное дыханиеbull Неадекватность мироощущения (стресс дефицит мотивации подавленность- депрессия)bull ИНТОКСИКАЦИЯbull ПОДАВЛЕННОСТЬ ИММУНИТЕТА

                            Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

                            Курс оздоровления направленный на восстановление иммунной системы

                            Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

                            М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

                            Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

                            () Курс относится к категории SPA

                            • Slide 1
                            • Slide 2
                            • Slide 5
                            • Slide 6
                            • Slide 7
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                              Study Calls Into Question Effectiveness of Hepatitis B Vaccine for NewbornsDecember 17 2013httparticlesmercolacomsitesarticlesarchive20131217newborn-hepatitis-b-vaccineaspxBy Dr JM Mercola

                              New Study Hepatitis B Vaccination at Birth May Not Prevent Hidden InfectionsA new study is raising another red flag that the practice of universally vaccinating all newborn babies for hepatitis B is seriously flawed The researchers followed 259 babies born to hepatitis-B-positive mothers for two years in order to determine whether vaccinating such babies prevents asymptomatic occult HBV (hepatitis B virus) infectionThe researchers found that while the vaccine may help prevent overt HBV transmission it was not effective in preventing occult HBV infection in babies which may occur in up to 40 percent of babies born to hepatitis B-positive mothersHepatitis B Shot May Be Ineffective by the Time Your Child Is a TeenagerAnother issue to consider if you are weighing the benefits and risks of giving your newborn infant or young child hepatitis B vaccine is that vaccine acquired immunity often does not persist until a child reaches his or her teenage years ndash the time when acquiring a hepatitis B infection may be more likely Research shows that by that time the protection from the childhood vaccine may have long since wanedOne study found that about 15 percent of teens who received the full series of hepatitis B shots as infants tested positive for hepatitis B surface antigen (HBsAg) which is an early indicator of infection or a sign that the person is a chronic carrier of the virus3This percentage was even higher among teens who had received the hepatitis B vaccine off schedule or whose mothers were high risk meaning they tested positive for hepatitis B e antigen (HBeAg) In other words it appears that in many children hepatitis B vaccine acquired immunity does NOT provide lasting protection A Healthy Immune System Can Resolve Hepatitis B InfectionEven if you have been vaccinated as a child itrsquos important to remember that you may not be protected from these risks and could still be infected via IV drug abuse sexual activity with an infected partner a blood transfusion with contaminated blood or even getting a manicure or pedicurehellipFortunately in most cases the hepatitis B infection will resolve on its own provided you have a well-functioning immune system Symptoms can be relieved bybullRestingbullAvoiding foods that weaken your immune function such as sugarsfructose grains and processed foods Healthful foods that help boost your immune system include fermented foods and organic vegetablesbullOptimizing your vitamin D levelsbullDrinking plenty of pure waterbullAvoiding alcohol and drugs

                              Причинно-следственныеbull Перееданиеbull Неадекватное питаниеbull Вредные привычкиbull Гиподинамия либо перегрузкиbull Неадекватное дыханиеbull Неадекватность мироощущения (стресс дефицит мотивации подавленность- депрессия)bull ИНТОКСИКАЦИЯbull ПОДАВЛЕННОСТЬ ИММУНИТЕТА

                              Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

                              Курс оздоровления направленный на восстановление иммунной системы

                              Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

                              М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

                              Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

                              () Курс относится к категории SPA

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                                Предлагаемая схема клинического эксперимента на хронических носителях гепатитов В и С для изучения лечебных курсов

                                Курс оздоровления направленный на восстановление иммунной системы

                                Тераперапевтическая Вакцинация Курс анти-Вирусной ТерапииСовместное применение Вакцины и анти-Вирусного Курса

                                М О Н И Т О Р И Н Г по всем иммуно-параметрам ДНКРНК печеночные ферменты др

                                Ожидаемые результатыbull Влияние оздоровления-восстановления на течение хронического ГВbull Роль предварительного оздоровления-восстановления на каждый из методов леченияbull Сравнительная эффективность вакцины анти-вирусного курса и комбинации на фоне предварительного оздоровления-восстановления и без фона

                                () Курс относится к категории SPA

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