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Frontiers of Medicine

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ISSN 2095-0225(Online)

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Front Med    2014, Vol. 8 Issue (1) : 17-23    https://doi.org/10.1007/s11684-014-0313-7
REVIEW
Vaccine therapies for chronic hepatitis B: can we go further?
Yumei Wen1(), Xuanyi Wang1,2, Bin Wang1, Zhenhong Yuan1
1. Key Laboratory Medical Molecular Virology of Ministry of Education/ Ministry of Health, Shanghai Medical College, Fudan University, Shanghai 200032, China; 2. Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University, Shanghai 200032, China
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Abstract

Chronic hepatitis B is a major health burden worldwide. In addition to the recent progress in antiviral treatment, therapeutic vaccination is a promising new strategy for the control of chronic hepatitis B. On the basis of the major specific and non-specific immune dysregulations and defects in chronic hepatitis B patients, this paper presents the peptide and protein-based, DNA-based, cell-based, and antigen-antibody-based therapeutic vaccines, which have undergone clinical trials. The advantages, disadvantages, and future perspectives for these therapeutic vaccines are discussed.
Keywords chronic hepatitis B      therapeutic      antigen-antibody complexes      DNA      vaccine     
Corresponding Author(s): Wen Yumei,Email:ymwen@shmu.edu.cn   
Issue Date: 26 April 2014
 Cite this article:   
Yumei Wen,Xuanyi Wang,Bin Wang, et al. Vaccine therapies for chronic hepatitis B: can we go further?[J]. Front Med, 2014, 8(1): 17-23.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-014-0313-7
https://academic.hep.com.cn/fmd/EN/Y2014/V8/I1/17
Fig.1  Mechanisms of immune disorders in CHB. In this diagram, the immune disorders in the liver tissue of CHB patients are divided into innate and acquired immunity. Defects in NK cells, DCs, and KCs are shown as defects in innate immunity, whereas defects in APCs, CD8 T cells, and immune inhibitory cells (Treg), and inhibitory PD1 are shown as defects in acquired immunity. Details of these defects are listed in the text.
TechnologiesAdvantagesDisadvantages
Protein- or peptide-basedInduces high titers of antibody response with specificity, easy to produce, and can be combined with other agents for co-administrationLarge doses required, relative weak cell-mediated responses, and needs adjuvant and repeated administrations
Antigen-antibody complex- basedInduces speci?c immune response, enhances uptake by APC via Fc receptors, enhances DC-T cell interactions, breaks immune tolerance, and activates complement reactionsNeed to optimize the ratio of antibody and antigen and antibody species should match with the recipient
Antibody-basedBlocks important negative signaling pathways, effective passive immunotherapy, and can be conjugated with drugsLarge and repeated doses needed for administrations, mainly functions with antigens on cell surface or circulating antigens, and short-life in vivo
DNA-basedEasy to design and produce, thermo stable, and activates cell-mediated responsesInduces weak humoral immune responses, requires electroporation or other devices for administration, and safety concern
Cell-basedInduces high level of speci?c immune response and can be individualized for patientsPassive immunotherapy, needs multiple administration, expensive production, and risk of contamination
Tab.1  Advantages and disadvantages of the approaches in activating immune responses in CHB patients
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