Promising opportunities to improve polio vaccines

Polioviruses belong to Enterovirus C species and cause severe lesions of the nervous system. In the post-polio eradication era, the World Health Organisation recommends inactivated polio vaccines for effective long-term protection of the population. In order to meet the needs of global health, it is planned to increase the use of traditional and optimised inactivated polio vaccines and introduce new types of vaccines that are being developed based on the current understanding of RNA-containing viruses. The aim of the study was to analyse ways of improving vaccine preparations and to review promising areas for polio immunoprophylaxis development. The authors considered innovations across all stages of the technological process, aimed at obtaining optimised vaccines, as well as vaccine delivery systems. The article presents information on new vaccine strains and cell lines for vaccine production. The authors summarised the results of clinical studies of inactivated vaccines, new vaccines based on genetically stable vaccine strains of poliovirus, and vaccines containing virus-like particles. The most likely candidates for introduction are the vaccines based on virus-like particles obtained from genetically modified strains of poliovirus. At the moment, many issues related to current trends in improving the immunoprophylaxis of poliomyelitis are debatable and need to be addressed in the near future

Перспективные направления в совершенствовании вакцин для профилактики полиомиелита

Polioviruses belong to Enterovirus C species and cause severe lesions of the nervous system. In the post-polio eradication era, the World Health Organisation recommends inactivated polio vaccines for effective long-term protection of the population. In order to meet the needs of global health, it is planned to increase the use of traditional and optimised inactivated polio vaccines and introduce new types of vaccines that are being developed based on the current understanding of RNA-containing viruses. The aim of the study was to analyse ways of improving vaccine preparations and to review promising areas for polio immunoprophylaxis development. The authors considered innovations across all stages of the technological process, aimed at obtaining optimised vaccines, as well as vaccine delivery systems. The article presents information on new vaccine strains and cell lines for vaccine production. The authors summarised the results of clinical studies of inactivated vaccines, new vaccines based on genetically stable vaccine strains of poliovirus, and vaccines containing virus-like particles. The most likely candidates for introduction are the vaccines based on virus-like particles obtained from genetically modified strains of poliovirus. At the moment, many issues related to current trends in improving the immunoprophylaxis of poliomyelitis are debatable and need to be addressed in the near future.Полиовирусы, принадлежащие к энтеровирусам группы С, являются причиной тяжелых поражений нервной системы. В эпоху после ликвидации полиомиелита Всемирная организация здравоохранения рекомендует для длительной эффективной защиты населения инактивированные вакцины против полиомиелита. Для обеспечения потребностей глобального здравоохранения предполагается увеличить применение традиционных и оптимизированных инактивированных вакцин против полиомиелита, а также внедрить вакцины нового типа, которые разрабатываются на основе современных представлений о РНК-содержащих вирусах. Цель работы — анализ аспектов усовершенствования вакцинных препаратов и обзор перспективных направлений развития иммунопрофилактики полиомиелита. Рассмотрены инновационные разработки на всех этапах технологического процесса, выполненные с целью получения оптимизированных вакцин, а также системы доставки вакцин. Представлена информация о новых вакцинных штаммах и клеточных линиях для производства вакцины. Обобщены результаты клинических исследований инактивированных вакцин, новых вакцин на основе генетически стабильных вакцинных штаммов вируса полиомиелита и вакцин, содержащих вирусоподобные частицы. Наиболее вероятно внедрение вакцин на основе вирусоподобных частиц генетически модифицированных штаммов вируса полиомиелита. В настоящее время многие вопросы, касающиеся актуальных направлений совершенствования иммунопрофилактики полиомиелита, являются дискуссионными и требуют решения в ближайшем будущем

Эпидемиология ротавирусной инфекции и тактика вакцинопрофилактики

Rotavirus infection is a widespread cause of severe gastroenteritis in children in low-income countries. Specific prophylaxis in young children has become the most important means of combating severe rotavirus gastroenteritis. The review presents current data on the molecular biology and genetic diversity of rotaviruses, interaction of viral proteins with host cell receptors, molecular aspects of infectivity and pathogenesis of rotavirus infection, and the development of immunity. It addresses a new approach to the epidemiology of rotavirus infection which regards it as a manageable infection, it illustrates the specificity of the epidemic process based on data gained from extensive experience in vaccination, and summarises relevant information on the introduction of rotavirus vaccines into the international healthcare practice. The paper summarises risks associated with the use of vaccines based on the analysis of WHO statistics, scientific publications on the epidemiology of rotavirus infection, and the results of vaccination. It analyses approaches of the competent authorities of some countries to the tactics of vaccination against rotavirus infection and the WHO stance on the use of existing vaccines for the prevention of rotavirus infection. A conclusion was made that it is necessary to further improve the tactics of vaccine prevention of rotavirus infection in Russia, to study the incidence of idiopathic intussusception, and to conduct further studies aimed at characterisation of existing and newly emerging genotypes of rotavirus.Ротавирусная инфекция повсеместно является причиной тяжелого гастроэнтерита, приводящего к смерти детей в странах с низким бюджетом. Специфическая профилактика среди детей младшего возраста стала важнейшим средством борьбы с тяжелой формой ротавирусного гастроэнтерита. В обзоре приведены актуальные данные о молекулярной биологии и генетическом разнообразии ротавирусов, взаимодействии вирусных белков с рецепторами клеток организма-хозяина, изучении молекулярных аспектов инфекционности и патогенеза ротавирусной инфекции и развитии иммунитета. Отражен новый подход к пониманию эпидемиологии ротавирусной инфекции как контролируемой инфекции, показаны особенности эпидемического процесса с учетом многолетнего опыта вакцинопрофилактики, обобщена актуальная информация о внедрении в практику здравоохранения вакцин против ротавирусной инфекции в мире. Уделено внимание рискам применения вакцин на основе анализа статистических материалов ВОЗ и научных публикаций об эпидемиологии ротавирусной инфекции и результатов применения вакцин. Рассмотрены подходы уполномоченных органов в области здравоохранения отдельных государств к тактике вакцинопрофилактики ротавирусной инфекции и позиция ВОЗ в отношении применения существующих вакцин для профилактики ротавирусной инфекции. Сделан вывод о необходимости дальнейшего совершенствования тактики вакцинопрофилактики ротавирусной инфекции в России, изучения уровня идиопатической инвагинации, проведения дальнейших исследований по характеристике существующих и вновь появляющихся генотипов ротавирусов

Внесение изменений в документы регистрационных досье на вакцины: анализ нормативно-методических подходов в Российской Федерации и за рубежом

The management of post-approval changes to registration dossiers for medicinal products is one of the most important factors for ensuring sustainable quality, safety and efficacy of medicines. Competent authorities that use the module format of the registration dossier, i.e. the regulatory authorities of the European Union, USA and other members of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH), and the Eurasian Economic Union (EEU), issue guidelines on changes to registration dossiers for pharmaceuticals and biologicals (immunological products). Vaccines (finished dosage forms) and vaccine antigens (active ingredients) are a specific group of immunobiological products which have great prophylactic importance for healthcare, and which are associated with challenging development and specific methods of manufacturing and quality control. The procedure of introducing post-approval variations to dossiers for immunobiological medicinal products is poorly reflected in the current Russian and EEU regulations. The World Health Organization (WHO) established a procedure described in the «Guidelines on procedures and data requirements for changes to approved vaccines». The purpose of the present study was to compare current Russian and international legislation in terms of regulatory requirements for post-approval сhanges to dossiers for immunobiological products. The Federal State Budgetary Institution «Scientific Centre for Expert Evaluation of Medicinal Products» of the Ministry of Health of the Russian Federation is drafting Guideline on introducing post-approval changes into dossiers for immunobiological medicines. The draft includes a detailed review of various categories of changes based on their importance, and a list of conditions and required documents for specific groups of medicines. This article summarises scientific and methodological approaches to evaluation of changes introduced in registration dossiers for vaccines in order to further improve the regulatory framework of the Russian Federation and the EEU.Регулирование процесса внесения изменений в документы регистрационного  досье является одним из важных факторов обеспечения стабильности качества, безопасности и эффективности лекарственных препаратов. Уполномоченные органы государств, поддерживающих модульный формат регистрационного досье: Европейского Союза, США, других стран-участниц Международного совета по гармонизации технических требований к лекарственным средствам для медицинского применения и Евразийского экономического союза (ЕАЭС), издают руководящие документы о внесении изменений в документы регистрационных досье на химико-фармацевтические и биологические (иммунологические) лекарственные средства. Вакцины (готовые формы) и вакцинные антигены (действующие вещества) представляют собой особую группу иммунобиологических лекарственных средств, характеризующихся высокой профилактической значимостью для здравоохранения, сложностью разработки, особыми методами производства и контроля. Порядок внесения изменений в документы регистрационного досье на иммунобиологическое лекарственное средство недостаточно отражен в действующих нормативно-правовых документах Российской Федерации и ЕАЭС. Всемирная организация здравоохранения рекомендует процедуру, описанную в документе «Руководство по процедурам и требованиям к данным, связанным с внесением изменений в зарегистрированные вакцины». Цель работы – проведение сравнительного анализа действующих отечественных и международных нормативно-методических документов в части регуляторных требований к процедуре внесения изменений в регистрационные досье зарегистрированных иммунобиологических лекарственных препаратов. В ФГБУ «НЦЭСМП» Минздрава России разрабатывается Проект методических рекомендаций по внесению изменений в регистрационные досье на зарегистрированные иммунобиологические препараты, который включает в себя детальное рассмотрение категорий значимости вносимых изменений, содержит условия и перечень необходимых документов для данной группы препаратов. В статье обобщены научно-методические подходы к экспертизе изменений, вносимых в регистрационное досье вакцины с целью дальнейшего совершенствования нормативно-правовой базы Российской Федерации и ЕАЭС

Rotavirus Epidemiology and Vaccination Tactics

Rotavirus infection is a widespread cause of severe gastroenteritis in children in low-income countries. Specific prophylaxis in young children has become the most important means of combating severe rotavirus gastroenteritis. The review presents current data on the molecular biology and genetic diversity of rotaviruses, interaction of viral proteins with host cell receptors, molecular aspects of infectivity and pathogenesis of rotavirus infection, and the development of immunity. It addresses a new approach to the epidemiology of rotavirus infection which regards it as a manageable infection, it illustrates the specificity of the epidemic process based on data gained from extensive experience in vaccination, and summarises relevant information on the introduction of rotavirus vaccines into the international healthcare practice. The paper summarises risks associated with the use of vaccines based on the analysis of WHO statistics, scientific publications on the epidemiology of rotavirus infection, and the results of vaccination. It analyses approaches of the competent authorities of some countries to the tactics of vaccination against rotavirus infection and the WHO stance on the use of existing vaccines for the prevention of rotavirus infection. A conclusion was made that it is necessary to further improve the tactics of vaccine prevention of rotavirus infection in Russia, to study the incidence of idiopathic intussusception, and to conduct further studies aimed at characterisation of existing and newly emerging genotypes of rotavirus

Vaccine Safety and Efficacy in Preventing Rotavirus Infection

The rotavirus infection causes acute gastroenteritis and is a major cause of lethal severe dehydrating diarrhoea in children under 5 years of age worldwide. Live attenuated rotavirus vaccines are the only means of preventing severe forms of the disease. The aim of the study was to analyse the twenty-year international experience of prophylactic immunisation against rotavirus infection. The paper summarises safety and efficacy data on the long-term use of Rotarix® (Belgium) and RotaTeq® (USA) for the prevention of rotavirus infection in the WHO European Region, the European Union and other countries. It addresses the development of correlates of immune protection for vaccines as well as evaluation of efficacy and safety of the new vaccines Rotavac® and Rotasiil® (India) in clinical trials. The authors analysed international experience of using the vaccines in countries that do not keep records of infant mortality from diarrhoea. The study summarises the results of clinical studies on the use of new vaccines prequalified by WHO in 2018 in regions with high rates of infant mortality from diarrhoea. It was demonstrated that vaccination not only reduces the rates of hospital admission of immunised children, but also contributes to the development of herd immunity. Rotarix® and RotaTeq® vaccines are authorised or included in the national immunisation schedules of many countries, but this type of vaccination is not mandatory in most of these countries. Vaccination coverage in the EU countries is about 24 %. Alternative vaccination schemes using live attenuated vaccines based on strains derived from newborn children, and parenteral rotavirus vaccines which do not replicate in the intestine may help reduce existing risks. It was concluded that the introduction of live rotavirus vaccines in immunisation schedules should be accompanied by the analysis of incidence of intussusception of the small intestine before and after the introduction of mass immunisation, and by active pharmacovigilance

Post-approval variations to dossiers for vaccines: analysis of regulatory and methodological approaches used in the Russian Federation and abroad

The management of post-approval changes to registration dossiers for medicinal products is one of the most important factors for ensuring sustainable quality, safety and efficacy of medicines. Competent authorities that use the module format of the registration dossier, i.e. the regulatory authorities of the European Union, USA and other members of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH), and the Eurasian Economic Union (EEU), issue guidelines on changes to registration dossiers for pharmaceuticals and biologicals (immunological products). Vaccines (finished dosage forms) and vaccine antigens (active ingredients) are a specific group of immunobiological products which have great prophylactic importance for healthcare, and which are associated with challenging development and specific methods of manufacturing and quality control. The procedure of introducing post-approval variations to dossiers for immunobiological medicinal products is poorly reflected in the current Russian and EEU regulations. The World Health Organization (WHO) established a procedure described in the «Guidelines on procedures and data requirements for changes to approved vaccines». The purpose of the present study was to compare current Russian and international legislation in terms of regulatory requirements for post-approval сhanges to dossiers for immunobiological products. The Federal State Budgetary Institution «Scientific Centre for Expert Evaluation of Medicinal Products» of the Ministry of Health of the Russian Federation is drafting Guideline on introducing post-approval changes into dossiers for immunobiological medicines. The draft includes a detailed review of various categories of changes based on their importance, and a list of conditions and required documents for specific groups of medicines. This article summarises scientific and methodological approaches to evaluation of changes introduced in registration dossiers for vaccines in order to further improve the regulatory framework of the Russian Federation and the EEU

Fluorescently Labeled Gadolinium Ferrate/Trigadolinium Pentairon(III) Oxide Nanoparticles: Synthesis, Characterization, In Vivo Biodistribution, and Application for Visualization of Myocardial Ischemia–Reperfusion Injury

Various gadolinium compounds have been proposed as contrasting agents for magnetic resonance imaging (MRI). In this study, we suggested a new synthesis method of gadolinium ferrate/trigadolinium pentairon(III) oxide nanoparticles (GF/TPO NPs). The specific surface area of gadolinium ferrate (GdFeO3) and trigadolinium pentairon(III) oxide (Gd3Fe5O12) nanoparticles was equal to 42 and 66 m2/g, respectively. The X-ray diffraction analysis confirmed that the synthesized substances were GdFeO3 and Gd3Fe5O12. The gadolinium content in the samples was close to the theoretically calculated value. The free gadolinium content was negligible. Biodistribution of the GF/TPO NPs was studied in rats by fluorescent imaging and Fe2+/Fe3+ quantification demonstrating predominant accumulation in such organs as lung, kidney, and liver. We showed in the in vivo rat model of myocardial ischemia–reperfusion injury that GF/TPO NPs are able to target the area of myocardial infarction as evidenced by the significantly greater level of fluorescence. In perspective, the use of fluorescently labeled GF/TPO NPs in multimodal imaging may provide basis for high-resolution 3D reconstruction of the infarcted heart, thereby serving as unique theranostic platform

Theranostic Platforms Based on Silica and Magnetic Nanoparticles Containing Quinacrine, Chitosan, Fluorophores, and Quantum Dots

In this paper, we describe the synthesis of multilayer nanoparticles as a platform for the diagnosis and treatment of ischemic injuries. The platform is based on magnetite (MNP) and silica (SNP) nanoparticles, while quinacrine is used as an anti-ischemic agent. The synthesis includes the surface modification of nanoparticles with (3-glycidyloxypropyl)trimethoxysilane (GPMS), the immobilization of quinacrine, and the formation of a chitosan coating, which is used to fix the fluorophore indocyanine green (ICG) and colloidal quantum dots AgInS2/ZnS (CQDs), which serve as secondary radiation sources. The potential theranostic platform was studied in laboratory animals