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Beyond clinical trials: Evolutionary and epidemiological considerations for development of a universal influenza vaccine

The prospect of universal influenza vaccines is generating much interest and research at the intersection of immunology, epidemiology, and viral evolution. While the current focus is on developing a vaccine that elicits a broadly cross-reactive immune response in clinical trials, there are important...

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Autores principales: Viboud, Cécile, Gostic, Katelyn, Nelson, Martha I., Price, Graeme E., Perofsky, Amanda, Sun, Kaiyuan, Sequeira Trovão, Nídia, Cowling, Benjamin J., Epstein, Suzanne L., Spiro, David J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7514029/
https://www.ncbi.nlm.nih.gov/pubmed/32970783
http://dx.doi.org/10.1371/journal.ppat.1008583
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author Viboud, Cécile
Gostic, Katelyn
Nelson, Martha I.
Price, Graeme E.
Perofsky, Amanda
Sun, Kaiyuan
Sequeira Trovão, Nídia
Cowling, Benjamin J.
Epstein, Suzanne L.
Spiro, David J.
author_facet Viboud, Cécile
Gostic, Katelyn
Nelson, Martha I.
Price, Graeme E.
Perofsky, Amanda
Sun, Kaiyuan
Sequeira Trovão, Nídia
Cowling, Benjamin J.
Epstein, Suzanne L.
Spiro, David J.
author_sort Viboud, Cécile
collection PubMed
description The prospect of universal influenza vaccines is generating much interest and research at the intersection of immunology, epidemiology, and viral evolution. While the current focus is on developing a vaccine that elicits a broadly cross-reactive immune response in clinical trials, there are important downstream questions about global deployment of a universal influenza vaccine that should be explored to minimize unintended consequences and maximize benefits. Here, we review and synthesize the questions most relevant to predicting the population benefits of universal influenza vaccines and discuss how existing information could be mined to begin to address these questions. We review three research topics where computational modeling could bring valuable evidence: immune imprinting, viral evolution, and transmission. We address the positive and negative consequences of imprinting, in which early childhood exposure to influenza shapes and limits immune responses to future infections via memory of conserved influenza antigens. However, the mechanisms at play, their effectiveness, breadth of protection, and the ability to “reprogram” already imprinted individuals, remains heavily debated. We describe instances of rapid influenza evolution that illustrate the plasticity of the influenza virus in the face of drug pressure and discuss how novel vaccines could introduce new selective pressures on the evolution of the virus. We examine the possible unintended consequences of broadly protective (but infection-permissive) vaccines on the dynamics of epidemic and pandemic influenza, compared to conventional vaccines that have been shown to provide herd immunity benefits. In conclusion, computational modeling offers a valuable tool to anticipate the benefits of ambitious universal influenza vaccine programs, while balancing the risks from endemic influenza strains and unpredictable pandemic viruses. Moving forward, it will be important to mine the vast amount of data generated in clinical studies of universal influenza vaccines to ensure that the benefits and consequences of these vaccine programs have been carefully modeled and explored.
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spelling pubmed-75140292020-10-01 Beyond clinical trials: Evolutionary and epidemiological considerations for development of a universal influenza vaccine Viboud, Cécile Gostic, Katelyn Nelson, Martha I. Price, Graeme E. Perofsky, Amanda Sun, Kaiyuan Sequeira Trovão, Nídia Cowling, Benjamin J. Epstein, Suzanne L. Spiro, David J. PLoS Pathog Review The prospect of universal influenza vaccines is generating much interest and research at the intersection of immunology, epidemiology, and viral evolution. While the current focus is on developing a vaccine that elicits a broadly cross-reactive immune response in clinical trials, there are important downstream questions about global deployment of a universal influenza vaccine that should be explored to minimize unintended consequences and maximize benefits. Here, we review and synthesize the questions most relevant to predicting the population benefits of universal influenza vaccines and discuss how existing information could be mined to begin to address these questions. We review three research topics where computational modeling could bring valuable evidence: immune imprinting, viral evolution, and transmission. We address the positive and negative consequences of imprinting, in which early childhood exposure to influenza shapes and limits immune responses to future infections via memory of conserved influenza antigens. However, the mechanisms at play, their effectiveness, breadth of protection, and the ability to “reprogram” already imprinted individuals, remains heavily debated. We describe instances of rapid influenza evolution that illustrate the plasticity of the influenza virus in the face of drug pressure and discuss how novel vaccines could introduce new selective pressures on the evolution of the virus. We examine the possible unintended consequences of broadly protective (but infection-permissive) vaccines on the dynamics of epidemic and pandemic influenza, compared to conventional vaccines that have been shown to provide herd immunity benefits. In conclusion, computational modeling offers a valuable tool to anticipate the benefits of ambitious universal influenza vaccine programs, while balancing the risks from endemic influenza strains and unpredictable pandemic viruses. Moving forward, it will be important to mine the vast amount of data generated in clinical studies of universal influenza vaccines to ensure that the benefits and consequences of these vaccine programs have been carefully modeled and explored. Public Library of Science 2020-09-24 /pmc/articles/PMC7514029/ /pubmed/32970783 http://dx.doi.org/10.1371/journal.ppat.1008583 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication.
spellingShingle Review
Viboud, Cécile
Gostic, Katelyn
Nelson, Martha I.
Price, Graeme E.
Perofsky, Amanda
Sun, Kaiyuan
Sequeira Trovão, Nídia
Cowling, Benjamin J.
Epstein, Suzanne L.
Spiro, David J.
Beyond clinical trials: Evolutionary and epidemiological considerations for development of a universal influenza vaccine
title Beyond clinical trials: Evolutionary and epidemiological considerations for development of a universal influenza vaccine
title_full Beyond clinical trials: Evolutionary and epidemiological considerations for development of a universal influenza vaccine
title_fullStr Beyond clinical trials: Evolutionary and epidemiological considerations for development of a universal influenza vaccine
title_full_unstemmed Beyond clinical trials: Evolutionary and epidemiological considerations for development of a universal influenza vaccine
title_short Beyond clinical trials: Evolutionary and epidemiological considerations for development of a universal influenza vaccine
title_sort beyond clinical trials: evolutionary and epidemiological considerations for development of a universal influenza vaccine
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7514029/
https://www.ncbi.nlm.nih.gov/pubmed/32970783
http://dx.doi.org/10.1371/journal.ppat.1008583
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