2023-12-01 10:24:56
Vaccines, one of the great advances in Medicine, allow us to prevent and eradicate diseases. Now, with precision vaccines, based on a better knowledge of the individual and the pathogen, a greater immune response is sought and other fields of application beyond infectious diseases, such as oncology or allergy, can be explored.
Cover of the report Anticipating Precision Vaccines. Photo provided
A new Anticipating Report on Precision Vaccinespublished by the Roche Institute Foundation and prepared by Observatory of Trends in Future Medicinedelves into both the characteristics of these more personalized vaccines and the challenges that must be addressed for their application to clinical practice since they are still in the early stages of development.
This report is coordinated by Luis Enjuanesboss of Coronavirus Laboratory of the National Biotechnology Center of the Higher Council for Scientific Research (CSIC)in Madrid, and, precisely, a researcher on a coronavirus vaccine project.
Luis Enjuanes in the Coronavirus Laboratory of the National Center for Biotechnology (CNB). EFE/ Emilio Naranjo
The basis of precision vaccines
Precision vaccines take into account different factors, such as the genetic characteristics of the disease or pathogen in question; age; pathologies associated with immunodeficiencies; the routes of administration or the agents that enhance the immune response that can be used in order to optimize and personalize the vaccine as much as possible for each individual.
According to the report, “precision vaccines are expected to change the paradigm of preventing and addressing both infectious and non-infectious diseases.”
Types of vaccines
Las classic vaccines They have been classified into:
Lives: based on attenuated microorganisms, capable of generating a strong immune response, but may pose a risk in immunocompromised people.
Do not live: based on inactivated microorganisms, on subunits of microorganisms (such as proteins, polysaccharides, etc.), toxoids or virus-like particles, which sometimes must be combined to enhance their immunogenicity.
In recent years there have been developed new more precise vaccines based on:
Nucleic acids: This is the case of vaccines ADN (they are based on the introduction of a circular DNA molecule that codes for the antigen of interest) and ARNAmong the latter, those of messenger RNA that mitigate the effect of the SARS-CoV-2 virus stand out.
Recombinant vectors: They are based on the use of viruses or bacteria whose genome is altered so that they express the target pathogenic antigen, which simulates a natural infection and induces a strong immune response.
Routes of administration
The report explains that there is a wide variety of infectious agents that access our body through different entry routes and affect different tissues of the body, which do not necessarily have to coincide, triggering an immune response that presents specific physical, chemical and immunological mechanisms. .
Most of the vaccines developed to date are administered parenterally (intramuscular, intradermal or subcutaneous) and induce robust immunity at the systemic level, but do not induce robust protection at the mucosal level, which constitute the main route of entry. of most pathogens.
Therefore, the use of other administration routes that can be used in the development of classic vaccines can also be used to improve the effectiveness of precision vaccines.
Between these ways stand out:
Orally: It stimulates the immune system in the gastrointestinal tract and mammary glands, being important for those pathogens that give rise to diseases with gastrointestinal involvement.
Intranasal route: Mucosal immunization is not limited only to the location where it is administered, but also generates immunity in other mucous membranes and at a systemic level. It is being explored not only in respiratory infections, but also because it induces immunity in the lower and upper respiratory tract, in salivary glands and the genital mucosa, being proposed as a route of administration of vaccines that may target these locations.
Sublingual route: generates immunity at the level of the respiratory tract and gastrointestinal tract. PHOTO EFE/Alejandro García
Precision vaccines in oncology
Vaccines now focus on preventing diseases caused by infectious agents such as viruses, bacteria and parasites. But a path is opening up to design vaccines for the treatment of oncological diseases.
According to the report on precision vaccines, “cancer cells suffer genetic mutations that alter the normal expression of proteins and present characteristic antigens or neoantigens on their cell membrane that can be recognized by T lymphocytes and activate the immune system.”
“However,” he adds, “cancer cells also develop mechanisms that allow them to evade or even silence the immune system, which is why this recognition “It doesn’t usually happen in most cases.”
This presents a great opportunity for the development of precision vaccines in the area of oncology that allow patients to induce an immune response against specific antigens of their tumor.
In addition, the vast majority of mutations presented by cancer cells are specific to each tumor, making it possible to develop personalized precision vaccines for each patient, according to the report.
It is already being evaluated in phase I clinical trials for the treatment of melanoma with precision vaccines where, in some cases, complete remission of the cancer was observed.
Allergy shots
Therapeutic allergen vaccination consists of the administration of small, controlled doses of the allergen to the person suffering from the allergy for long periods of time to prevent an exacerbation of the immune response, reducing inflammation and the progression of symptoms.
Today, the molecular characterization of the allergens that cause disease in different individuals is allowing the development of new vaccines based on DNA that encodes the allergen wrapped in a virus-like particle, or vaccines based on recombinant allergens linked to different types of carriers “with results “promising” for preventive vaccination against allergies.
Expert recommendations
Precision vaccines are still limited in clinical practice and in order to advance their implementation, the experts in the report from the Roche Institute Foundationcoordinated by scientist Luis Enjuanes, advise:
Generate information that allows stratify the population.
Evaluate patients before administering vaccines and achieving a better immune response. Incorporate and integrate new technologies that allow the expansion of the vaccine repertoire to increase the precision and suitability of vaccines for each case. Favor the vaccine design with a simple composition that facilitates the development and adaptation of new vaccines.
Apply the knowledge generated in precision vaccines to the improvement of vaccines already available.
Raise awareness about vaccines and its importance for the prevention and control of diseases and epidemics at different levels and avoiding mistrust. Increase the investment in R&D to generate precision vaccines. Roche Institute Foundation Infographic
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