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Journal of Virology, May 2003, p. 6087-6092, Vol. 77, No. 10
0022-538X/03/$08.00+0 DOI: 10.1128/JVI.77.10.6087-6092.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
Induction of Broad and Potent Anti-Human Immunodeficiency Virus Immune Responses in Rhesus Macaques by Priming with a DNA Vaccine and Boosting with Protein-Adsorbed Polylactide Coglycolide Microparticles
Gillis Otten,* Mary Schaefer, Catherine Greer, Maria Calderon-Cacia, Doris Coit, Jina Kazzaz, Angelica Medina-Selby, Mark Selby,
Manmohan Singh, Mildred Ugozzoli, Jan zur Megede, Susan W. Barnett, Derek O'Hagan, John Donnelly, and Jeffrey Ulmer
Vaccines Research, Chiron Corporation, Emeryville, California 94608
Received 26 June 2002/
Accepted 29 January 2003

ABSTRACT
Several vaccine technologies were evaluated for their abilities
to induce anti-human immunodeficiency virus Gag immune responses
in rhesus macaques. While no vaccine alone was able to induce
broad and strong immune responses, these were achieved by priming
with Gag DNA and boosting with Gag protein adsorbed to polylactide
coglycolide microparticles. This regimen elicited strong antibodies,
helper T cells, and cytotoxic T lymphocytes and thus holds promise
as an effective vaccination scheme.

TEXT
Various immune effector mechanisms are considered to be important
for protection against human immunodeficiency virus (HIV). Neutralizing
antibodies are thought to be sufficient for protection against
challenge in primate models, as passive transfer of various
human monoclonal antibodies protects animals from subsequent
challenge (
16-
18). In addition, partial protection of macaques
was achieved by vaccination with DNA and adjuvant protein vaccines
in a priming-boosting regimen, despite depletion of CD8
+ T cells
at the time of challenge (
5). Similarly, cytotoxic T lymphocyte
(CTL) responses are sufficient for partial protection in these
models. Such protective CTL responses have been conferred by
various vaccine technologies, without the induction of detectable
neutralizing antibodies (
1,
2,
9,
14,
19,
25,
29). In addition,
certain vaccines based on Gag and/or Pol, which would not be
expected to induce virus-neutralizing activity, are partially
protective (
7,
33,
34). Finally, depletion of CD8
+ T cells through
infusion of anti-CD8 antibodies decreases the control of viremia
in infected macaques (
11,
20,
32). Thus, both humoral and cellular
immunity seem to play a role in protection in primate disease
models. The importance of CTLs in protection from AIDS in humans
is suggested by the inverse correlation between anti-HIV CTLs
and virus load (
3,
4,
15,
39) and the high levels of CTLs in
chronically exposed, but protected, individuals (
8). In addition
to antibodies and CTLs, a robust helper-T-cell response is likely
important for the expansion of antigen-specific B-cell and CTL
populations and possibly also for provision of antiviral cytokines.
Thus, an effective preventative HIV vaccine will likely require
the ability to induce broad and potent immune responses, including
neutralizing antibodies, CD4
+-T-cell responses, and CTLs.
To this end, various vaccine technologies have been tested as potential HIV vaccines, with various results. In this study, we have compared several distinct vaccine technologies for their abilities to induce anti-HIV immune responses. First, recombinant proteins, by themselves, are not usually particularly immunogenic and require adjuvants for effectiveness. We have found recently that particle-based delivery systems, such as polylactide coglycolide (PLG), are very effective in small-animal models at enhancing immune responses induced by protein-based vaccines (13). Specifically, anti-HIV Gag antibody responses were increased and, interestingly, CTL responses were induced, which is not typically seen with protein-based vaccines alone. Second, virus-like particles have been found to be effective for inducing antibody and CTL responses in various animal models, including primate models of HIV (21, 23, 26). To enhance these responses, we have incorporated the adjuvant LTK63, which is a mutated form of Escherichia coli heat-labile enterotoxin that retains adjuvant activity while eliminating toxicity (27). We have recently shown this adjuvant to be effective at inducing CTLs in mice when it was administered in combination with HIV Gag protein (22). Finally, DNA vaccines have been demonstrated to be very effective at priming CTL responses in species ranging from mice (6, 10, 36) to humans (31, 37). Thus, we evaluated each of these distinct technologies (Table 1) for the induction of immune responses in rhesus macaques.
Priming immune responses.
First, as one indicator of vaccine potency, anti-Gag antibodies
were measured by enzyme-linked immunosorbent assay. As shown
in Table
2, two vaccinations with p55
Gag adsorbed to PLG microparticles
(Gag-PLG) (group 2) induced high Gag-specific plasma antibody
titers in all four macaques (geometric mean titer [GMT], 16,200).
After a third dose of Gag-PLG, Gag-specific titers exceeded
100,000 in two of four animals. As expected, Gag protein alone
(group 1) was only weakly immunogenic, indicating that the PLG
microparticle formulation conferred a substantial benefit (
P = 0.03; one-tailed
t test), as was seen previously for small
animals (
31,
35). Gag virus-like particles (VLP) (group 3) induced
low to moderate antibody titers (the GMT was 2,300 at 2 weeks
after the second immunization) that were not increased by coadministration
of LTK63 (for group 4, the GMT was 400). A third vaccination
with VLP or VLP plus LTK63 did not increase Gag-specific antibody
titers, indicating the relatively modest immunogenicity of VLP.
As has been observed with various other DNA vaccines, vaccination
with the pCMVgagmod plasmid DNA (group 5) induced a low level
of Gag-specific antibody in only one of four rhesus macaques.
Second, to determine the magnitude of T-cell responses and the
spectrum of p55
Gag epitopes recognized by T cells, we utilized
recombinant Gag protein and synthetic peptides that were 20
amino acids (aa) in length, overlapped each other by 10 aa,
and derived from p55
Gag of HIV-1
SF2. Beginning 6 weeks after
the third immunization, we determined Gag-specific lymphoproliferative
responses as a measure of antigen-specific CD4
+8
--T-cell activity
(Table
3). All four rhesus macaques given Gag-PLG plus LTK63
(group 2) demonstrated proliferative responses to p55
Gag (stimulation
index [SI] range, 4 to 138) that were maintained for at least
14 weeks after the third immunization (SI range, 4 to 68). Interestingly,
those with the highest proliferative responses (macaques 67
and 72) also had the highest titers of anti-Gag antibodies (Table
2). Gag-specific proliferation was not observed in animals immunized
with Gag protein alone (group 1) or VLP (group 3), and only
weak responses were observed in two animals immunized with VLP
plus LTK63 (group 4) (macaques 65 and 70). Marginal Gag-specific
lymphoproliferation was observed in the plasmid DNA-immunized
rhesus macaque 14 weeks after the third immunization, with the
exception of rhesus macaque 63, which had an SI of 22. Interestingly,
this animal was the only one of its group to show a consistently
positive antibody titer (Table
2).
Beginning 2 weeks after the second immunization, animals were
evaluated for CTL activity by a
51Cr release assay using peripheral
blood mononuclear cells (PBMC) cultured for 8 days in the presence
of autologous recombinant vaccinia virus (rVV)
gag-
pol-infected
PBMC or individual pools of overlapping Gag peptides. The cultures
were harvested and assayed for cytolytic activity against autologous
51Cr-labeled B-lymphoblastoid cell line (B-LCL) targets that
were pulsed with Gag peptide pools. As shown in Table
4, immunization
with Gag protein (alone) did not induce CTLs, with the exception
of a weak response (macaque 74) (19% Gag-specific
51Cr release
maximum) in a single instance. Likewise, only one of the four
animals (macaque 72) that was vaccinated with Gag-PLG microparticles
plus LTK63 showed CTL activity and only after the third immunization;
however, this animal had mistakenly also received a dose of
VLP at the time of its third immunization. Hence, we cannot
be certain that any CTLs were induced by the p55
Gag-PLG plus
LTK63 vaccine alone. Gag-specific CTL activity was detected
in approximately half of the animals vaccinated with VLP or
VLP plus LTK63 and in all four rhesus macaques vaccinated with
plasmid DNA. With the exception of macaque 72, all animals that
showed CTL activity 2 weeks after the third immunization maintained
that activity for at least 12 additional weeks (14 weeks after
the third immunization) (Table
4). Moreover, when the DNA-immunized
rhesus macaques were evaluated 23 to 24 weeks after the third
dose, all four animals remained CTL positive. In general, it
appears that CTL activity was boosted by the third immunization,
as was seen by higher levels of lytic activity at 6 and 14 weeks
after the third immunization than at 2 weeks after the second
immunization (Fig.
1). However, CTL responses eventually declined,
as was seen by lower levels of lytic activity by 23 weeks after
the third immunization. Because the
51Cr-labeled B-LCL targets
were pulsed with peptide pools spanning distinct portions of
the entire Gag protein sequence, we could determine whether
Gag vaccines induced CTL populations that reacted with single
or multiple discrete epitopes. As shown in Table
5, Gag peptide
pools 1, 2, 4, 5, and 8 contained epitopes recognized by one
or more of the CTL-positive rhesus macaques. In addition, two
of the plasmid-immunized rhesus macaques (macaque 63 and macaque
77) contained CTLs that reacted with three separate Gag peptide
pools. Further analysis using target cells pulsed with individual
peptides revealed the presence of multiple epitopes. Three peptides
in pool 1 (p55
Gag aa 1 to 80) and at least two peptides in pool
5 (p55
Gag aa 194 to 263) were recognized; however, only a single
peptide in pool 4 (p55
Gag aa 254 to 323) was identified. In
the case of DNA immunization, priming of Gag-specific CTLs in
vivo resulted from the CTL precursor recognition of Gag epitopes
derived from the processing and presentation of endogenously
synthesized Gag. However, CTL effectors were derived by culture
with synthetic Gag peptides and were assayed against peptide-pulsed
autologous target cells. Nevertheless, peptide-stimulated CTLs
derived from the PBMC of DNA-immunized rhesus macaques were
also able to recognize and lyse target cells that expressed
Gag endogenously (data not shown).
Broadening of immune responses by priming with DNA and boosting with Gag-PLG.
Although plasmid DNA was the best of the vaccines at inducing
CTLs, it is likely that a successful HIV vaccine must also induce
CD4
+ T cells with the capacity for providing help for proliferation
and differentiation of HIV-reactive CTLs and B cells (
12,
28,
30). To determine if lymphoproliferative and antibody responses
could be increased in the plasmid DNA-immunized rhesus macaques,
the animals were given a single dose of Gag protein adsorbed
to PLG microparticles at week 41. In this case, the LTK63 adjuvant
was not included since it did not enhance the proliferative
or antibody responses after immunization with VLP. Lymphoproliferation
assays were performed at 2 and 6 weeks after the booster dose.
After protein boosting, four DNA-primed animals had increased
Gag-specific lymphoproliferation and concomitant increases in
antibodies. For the group, the geometric mean SI (Table
3) increased
from 5 (week 22) to 15 to 17 (weeks 43 and 49) (
P = 0.07; one-tailed
t test). Likewise, Gag antibody titers (Table
2) increased 16-
to 90-fold (
P = 0.004; one-tailed
t test). Interestingly, animal
63, the only one to exhibit Gag-specific antibodies after DNA
immunization alone, showed the highest levels of antigen-specific
proliferation and antibodies after the boosting.
Because the animals primed with the Gag-PLG plus LTK63 protein-adjuvant combination had strong lymphoproliferative and antibody responses, they were given a boosting dose at week 41. As shown in Tables 2 and 3, 2 weeks after the fourth immunization with Gag-PLG plus LTK63, all four animals showed strong proliferative responses (SI range, 13 to 110) and high antibody titers (5,800 to 51,700). These responses changed very little by 6 weeks after the fourth immunization. Using the Gag peptide pools to elicit lymphoproliferation, we identified several stimulatory peptide pools, and in animals 67 and 72 we observed proliferation in response to several distinct pools, indicating a polyepitope-specific repertoire (data not shown). A limited analysis of the frequency and phenotype of the Gag-specific T-cell response by flow cytometry demonstrated gamma interferon and tumor necrosis factor alpha production with a frequency of up to 0.8% of CD4 T cells (data not shown).
The vaccine technologies that we evaluated for this rhesus macaque study included recombinant protein administered with a microparticle-based delivery system (PLG), LTK63 adjuvant, VLP, and plasmid DNA. Each of these technologies was chosen for its potential to overcome the hurdle of priming CTL responses without the use of a live vector system (based on results of small-animal studies) (13, 21-24, 26, 35, 40), thereby providing broad immune responses with a relatively simple vaccine. However, as is clear from the data reported here, these technologies had very different abilities to prime immune responses in rhesus macaques, with none of them alone being able to prime broad and strong immune responses. Gag DNA was the most potent technology for CTL induction, while Gag protein adsorbed to PLG microparticles was best for antibody and helper-T-cell responses. These results suggested possible synergy between the DNA and Gag-PLG vaccine technologies for providing strong and broad immune responses. Indeed, priming with Gag DNA and boosting with Gag-PLG achieved high levels of anti-Gag antibodies, helper T cells, and CTLs. It is likely that these broad responses were due, at least in part, to the complementary nature of the two technologies. DNA vaccines produce small amounts of antigen expressed appropriately for efficient priming of CTLs, and Gag-PLG provides a bolus of antigen delivered efficiently for the induction of robust antibodies and helper T cells. The strong synergy with Gag DNA priming and boosting with Gag protein adsorbed to PLG microparticles suggests the utility of this vaccine strategy for providing broad and strong immune responses without the need for a live vector system. Furthermore, this strategy is amenable to additional enhancement with improved DNA vaccine delivery, as has been recently observed (24, 35, 38).

ACKNOWLEDGMENTS
We thank Steve Hardy for recombinant adenovirus, Barbara Doe
for assistance with CTL assays, and Robert Geiger and Kathy
Brasky (Southwest Foundation for Biomedical Research) for vaccinations,
phlebotomy, and animal care.

FOOTNOTES
* Corresponding author. Mailing address: Vaccines Research, Chiron Corporation, 4560 Horton St., Mail Stop 4.3, Emeryville, CA 94608. Phone: (510) 923-2965. Fax: (510) 923-2586. E-mail:
Gillis_Otten{at}chiron.com.

Present address: Medarex, Milpitas, CA 95035. 

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Journal of Virology, May 2003, p. 6087-6092, Vol. 77, No. 10
0022-538X/03/$08.00+0 DOI: 10.1128/JVI.77.10.6087-6092.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
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