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Introducción: Quimi-Hib®, una vacuna cubana obtenida por síntesis química y única en el mundo, requirió una estrategia regulatoria específica, porque no hay guía con las pautas requeridas para su producción y control. Objetivo: Caracterizar la estrategia regulatoria de la etapa precomercialización de Quimi-Hib® en Cuba. Material y Métodos: Estudio descriptivo-retrospectivo de requisitos para el registro sanitario de la vacuna cubana. Se establecieron siete pasos estratégicos para abarcar los estándares reguladores vigentes y futuros, con base en opiniones de expertos para la adopción de decisiones. El punto de partida fue la guía de la OMS, aplicable a vacunas anti-Hib de origen natural. Resultados: La estrategia regulatoria se desarrolló a partir de las 15 recomendaciones de esta guía, 11 de ellas se extrapolaron a la vacuna cubana y cuatro no, pero se consideraron sus fundamentos para desarrollar cuatro requerimientos aplicables a la vacuna semisintética. Se adicionaron otros seis, tres a solicitud de la Autoridad Reguladora Nacional de Cuba y tres obtenidos de la literatura relevante disponible. Estos 21 requerimientos completan el paquete regulador, resultado de la estrategia desarrollada para esta vacuna y la posterior aprobación de su registro sanitario y comercialización. Conclusiones: La estrategia regulatoria desarrollada en este trabajo permitió definir un conjunto de recomendaciones que suple la carencia de regulaciones internacionales y contribuyó a la obtención segura del registro sanitario de la vacuna Quim-Hib® que podría generalizarse a otras vacunas con características similares.
Introduction: Quimi-Hib®, a Cuban vaccine obtained by chemical synthesis and unique in the world, required its own regulatory strategy because there is no guideline on the requirements for its production and control. Objective: To characterize the regulatory strategy of the pre-launch phase of Quimi-Hib® in Cuba. Material and Methods: Descriptive-retrospective study of the requirements for the approval of the Cuban vaccine. Seven strategic steps were established to cover current and future regulatory standards based on expert advice for decision making. The starting point was the WHO´s guideline, which applies to anti-Hib vaccines of natural origin. Results: The regulatory strategy was developed based on the 15 recommendations of the aforementioned guideline, 11 of which were extrapolated to the Cuban vaccine and four of which were not, but served as the basis for the development of four requirements with similar rationale that apply to the semisynthetic vaccine. Six additional requirements were added, three of which were requested from the Cuba's National Regulatory Authority and three of which were obtained from the available relevant literature. These 21 requirements complete the regulatory package, the result of the strategy developed for this vaccine and the subsequent approval for marketing authorization and commercialization. Conclusions: The regulatory strategy compensates for the lack of specific guidelines for synthetic Haemophilus influenzae type b vaccines and thus contributed to the approval of the first vaccine of this type. The regulatory strategy is flexible because it includes update requirements throughout the vaccine life cycle, and expert consensus was considered in its development.
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The breakthrough discovery of cardiac natriuretic peptides provided the first direct demonstration of the connection between the heart and the kidneys for the maintenance of sodium and volume homeostasis in health and disease. Yet, little is still known about how the heart and other organs cross-talk. Here, we review three physiological mechanisms of communication linking the heart to other organs through: i) cardiac natriuretic peptides, ii) the microRNA-208a/mediator complex subunit-13 axis and iii) the matrix metalloproteinase-2 (MMP-2)/C-C motif chemokine ligand-7/cardiac secreted phospholipase A2 (sPLA2) axis - a pathway which likely applies to the many cytokines, which are cleaved and regulated by MMP-2. We also suggest experimental strategies to answer still open questions on the latter pathway. In short, we review evidence showing how the cardiac secretome influences the metabolic and inflammatory status of non-cardiac organs as well as the heart.
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BACKGROUND: Interleukin-15 is an immunostimulatory cytokine overexpressed in several autoimmune and inflammatory diseases such as Rheumatoid Arthritis, psoriasis and ulcerative colitis; thus, inhibition of IL-15-induced signaling could be clinically beneficial in these disorders. Our approach to neutralize IL-15 consisted in active immunization with structurally modified human IL-15 (mhIL-15) with the aim to induce neutralizing antibodies against native IL-15. In the present study, we characterized the antibody response in Macaca fascicularis, non-human primates that were immunized with a vaccine candidate containing mhIL-15 in Aluminum hydroxide (Alum), Montanide and Incomplete Freund's Adjuvant. RESULTS: Immunization with mhIL-15 elicited a specific antibodies response that neutralized native IL-15-dependent biologic activity in a CTLL-2 cell proliferation assay. The highest neutralizing response was obtained in macaques immunized with mhIL-15 adjuvanted in Alum. This response, which was shown to be transient, also inhibited the activity of simian IL-15 and did not affect the human IL-2-induced proliferation of CTLL-2 cells. Also, in a pool of synovial fluid cells from two Rheumatoid Arthritis patients, the immune sera slightly inhibited TNF-α secretion. Finally, it was observed that this vaccine candidate neither affect animal behavior, clinical status, blood biochemistry nor the percentage of IL-15-dependent cell populations, specifically CD56+ NK and CD8+ T cells. CONCLUSION: Our results indicate that vaccination with mhIL-15 induced neutralizing antibodies to native IL-15 in non-human primates. Based on this fact, we propose that this vaccine candidate could be potentially beneficial for treatment of diseases where IL-15 overexpression is associated with their pathogenesis.
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The development of parenteral solution dosage forms of interferon alpha 2 (rhIFN-alpha2) without human albumin may significantly diminish the problem of forming highly immunogenic rhIFN-alpha 2b aggregates and the potential risk of blood-transmitted diseases caused by infectious viruses and often living pathogens that may be present in the plasma. With this purpose, we evaluated the compatibility of type I borosilicate glass vials and chlorobutyl stoppers with rhIFN-alpha 2b in an aqueous solution. At the same time, we carried out a targeted formulation screen at 37 degrees C of single or combined (e.g. polysorbate 80, EDTA Na(2), PEG 400) potentially stabilizing excipients. Quantified biochemical results from 12 independent batches of rhIFN-alpha 2b in a polysorbate/benzyl alcohol-based vehicle formulated at pH 7.4 were all found within the limits established by the World Health Organization for this cytokine. Real-time storage data confirmed the excellent biochemical long-term (30 months) stability of rhIFN-alpha 2b in this aqueous solution formulation. Analyses were performed at intervals throughout the time period using reverse-phase high-performance liquid chromatography, a sandwich-type enzyme-linked immunosorbent assay, and antiviral activity as stability-indicating assays. Furthermore, both the physical stability (color, odor, appearance, pH, and absence of particulate material) and the sterility of this formulation were maintained under the proposed shelf conditions.