Vaccination with mRNA-coded antigens
The present invention relates to vaccines comprising at least one mRNA encoding at least one antigen for use in the treatment of a disease in an elderly patient preferably exhibiting an age of at least 50 years, more preferably of at least 55 years, 60 years, 65 years, 70 years, or older, wherein the treatment comprises vaccination of the patient and eliciting an immune response in said patient. The present invention is furthermore directed to kits and kits of parts comprising such a vaccine and/or its components and to methods applying such a vaccine or kit.
1. A method for stimulating a protective anti-influenza immune response in a patient, the method comprising administering an effective amount of a composition comprising at least two RNA molecules, wherein the RNA molecules encode influenza haemagglutinin (HA) antigens from at least four different strains of influenza, wherein the RNA comprises a G/C content in the coding sequence that is elevated relative to wild type RNA encoding the HA antigen, wherein the method stimulates a protective immune response in the patient, wherein said immune response is enhanced as compared to an inactivated influenza vaccine, wherein said immune response comprises a T cell-mediated immune response in the patient, and wherein the method stimulates a CD8+ T cell-mediated immune response in the patient.
2. The method of claim 1 , wherein the composition is administered by intradermal or intramuscular injection.
3. The method of claim 1 , wherein the HA antigens are each independently a H2, H3, H4, H5, H6, H7, H8, H9, H10, H11, H12, H13, H14 or H15 subtype.
4. The method of claim 1 , wherein at least one of the HA antigens is a H1 subtype.
5. The method of claim 1 , further comprising administering an effective amount of a composition comprising an RNA encoding at least a second influenza antigen.
6. The method of claim 5 , wherein the at least a second influenza antigen is an influenza neuraminidase, matrix protein, or nucleoprotein antigen.
7. The method of claim 1 , wherein the RNA molecules each comprise at least one nucleotide substituted with an analog of the naturally occurring nucleotide.
8. The method of claim 1 , wherein the RNA molecules are mRNA molecules and comprise a 5′ cap structure.
9. The method of claim 8 , wherein the mRNA molecules further comprise a poly-A sequence positioned 3′ of the coding region.
10. The method of claim 9 , wherein the mRNA molecules comprise a 5′ non-translated region and/or a 3′ non-translated region.
11. The method of claim 1 , wherein the RNA molecules comprise a G/C content in the coding sequence that is increased at least 7% relative to a wild type mRNA encoding the HA antigen.
12. The method of claim 9 , wherein the mRNA molecules comprise at least three of the following features:
(i) a 5′ cap structure;
(ii) a 5′ non-translated region;
(iii) a 3′ non-translated region;
(iv) a poly-A positioned 3′ of the coding region; and
(v) optionally, a poly-C sequence positioned 3′ of the coding region.
13. The method of claim 1 , further comprising administering the composition at least two times.
14. The method of claim 9 , wherein the HA antigens from at least four different strains of influenza comprise an HA antigen from at least one H1N1 strain and an HA antigen from at least one H3N2 strain.
15. The method of claim 9 , wherein the HA antigens from at least four different strains of influenza comprise an HA antigen from at least one Influenza A strain and an HA antigen from at least one Influenza B strain.
16. The method of claim 15 , wherein the HA antigens from at least four different strains of influenza comprise HA antigens from at least one H1N1 strain, at least one H3N2 strain, and at least one Influenza B strain.
17. The method of claim 5 , comprising administering an RNA encoding an influenza haemagglutinin (HA) antigen and an RNA encoding an influenza neuraminidase (NA) antigen.
18. The method of claim 17 , comprising administering RNAs encoding HA antigens and NA antigens from at least one H1N1 strain, at least one H3N2 strain, and at least one Influenza B strain.
19. The method of claim 1 , wherein each of the influenza HA antigens is encoded on a separate RNA molecule.
20. The method of claim 9 , wherein the mRNA molecules are associated with a vehicle, transfection, or complexation agent suitable for increasing the transfection efficiency of the mRNA molecules.
21. The method of claim 20 , wherein the vehicle, transfection, or complexation agent comprises cationic or polycationic compounds selected from cationic or polycationic peptides or polypeptides, cationic or polycationic polymers, or cationic or polycationic lipids.
22. The method of claim 20 , wherein the vehicle, transfection, or complexation agent are lipid particles.
23. The method of claim 20 , wherein the vehicle, transfection, or complexation agent is protamine.
24. The method of claim 7 , wherein the at least one nucleotide substituted with an analog of the naturally occurring nucleotide comprises a backbone modification, a sugar modification, or a base modification.