Abstract

SummaryBackgroundA recombinant vesicular stomatitis virus vector expressing the Zaire Ebola virus glycoprotein (rVSVΔG-ZEBOV-GP) vaccine has been reported as safe, immunogenic, and highly protective in a ring vaccination trial. We aimed to identify transcriptomic immune response biomarker signatures induced by vaccination and associated signatures with its immunogenicity and reactogenicity to better understand the potential mechanisms of action of the vaccine.Methods354 healthy adult volunteers were vaccinated in randomised, double-blind, placebo-controlled trials in Europe (Geneva, Switzerland [November, 2014, to January, 2015]) and North America (USA [Dec 5, 2014, to June 23, 2015]), and dose-escalation trials in Africa (Lambaréné, Gabon [November, 2014, to January, 2015], and Kilifi, Kenya [December, 2014, to January, 2015]) using different doses of the recombinant vesicular stomatitis virus vector expressing the Zaire Ebola virus glycoprotein (rVSVΔG-ZEBOV-GP; 3 × 105 to 1 × 108 plaque-forming units [pfu]). Longitudinal transcriptomic responses (days 0, 1, 2, 3, 7, 14, and 28) were measured in whole blood using a targeted gene expression profiling platform (dual-colour reverse-transcriptase multiplex ligation-dependent probe amplification) focusing on 144 immune-related genes. The effect of time and dose on transcriptomic response was also assessed. Logistic regression with lasso regularisation was applied to identify host signatures with optimal discriminatory capability of vaccination at day 1 or day 7 versus baseline, whereas random-effects models and recursive feature elimination combined with regularised logistic regression were used to associate signatures with immunogenicity and reactogenicity.FindingsOur results indicated that perturbation of gene expression peaked on day 1 and returned to baseline levels between day 7 and day 28. The magnitude of the response was dose-dependent, with vaccinees receiving a high dose (≥9 × 106 pfu) of rVSVΔG-ZEBOV-GP exhibiting the largest amplitude. The most differentially expressed genes that were significantly upregulated following vaccination consisted of type I and II interferon-related genes and myeloid cell-associated markers, whereas T cell, natural killer cell, and cytotoxicity-associated genes were downregulated. A gene signature associated with immunogenicity (common to all four cohorts) was identified correlating gene expression profiles with ZEBOV-GP antibody titres and a gene signatures associated with reactogenicity (Geneva cohort) was identified correlating gene expression profiles with an adverse event (ie, arthritis).InterpretationCollectively, our results identify and cross-validate immune-related transcriptomic signatures induced by rVSVΔG-ZEBOV-GP vaccination in four cohorts of adult participants from different genetic and geographical backgrounds. These signatures will aid in the rational development, testing, and evaluation of novel vaccines and will allow evaluation of the effect of host factors such as age, co-infection, and comorbidity on responses to vaccines.FundingInnovative Medicines Initiative 2 Joint Undertaking.

Highlights

  • Ebola virus disease is a rare but severe infectious disease which is caused by Ebola virus

  • Interpretation Collectively, our results identify and cross-validate immune-related transcriptomic signatures induced by rVSVΔG-ZEBOV-GP vaccination in four cohorts of adult participants from different genetic and geographical backgrounds

  • To further unravel the mode of action of the rVSVΔG-ZEBOV-GP vaccine, we investigated at the transcriptional level the longitudinal and dose-dependent kinetics of the innate and adaptive immune responses following vaccination of healthy volunteers in Europe, North America, and Africa

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Summary

Introduction

Ebola virus disease is a rare but severe infectious disease which is caused by Ebola virus. The severe 2014–16 Ebola virus disease outbreak in west Africa registered more than 11 300 deaths among 30 000 suspected, probable, and confirmed cases. Republic of Congo, with an approximate 65% fatality rate among more than 3000 confirmed Ebola virus disease cases, confirms the urgency for protective vaccines to prevent disease spread.[1]. Evidence before this study Ebola virus disease outbreaks have high mortality rates and can be difficult to contain, such as during the large epidemic in west Africa (2014–16) and the most recent outbreak in the Democratic Republic of the Congo, which is still ongoing. The recombinant vesicular stomatitis virus vector expressing the Zaire Ebola virus glycoprotein vaccine (rVSVΔG-ZEBOV-GP) was considered the leading candidate showing very safe, fast, and robust protective immunogenic profiles after a single injection in a phase 3 ring vaccination trial in Guinea during an outbreak in 2015. Few studies have explored the mechanisms underlying these responses

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