A Review on Modern Use of Intranasal Vaccination in the Treatment of SARS-COV-2
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has highlighted the urgent need for efficient SARS coronavirus 2 (SARS-CoV-2) preventative vaccines to limit the burden and spread of SARS-CoV-2 in humans. Intranasal immunization is a promising technique for preventing COVID-19 because the nasal mucosa acts as a first line of defense against SARS-CoV-2 entrance before the virus spreads to the lungs. Nasal vaccination has many advantages over traditional vaccine administration methods. These include the simplicity of administration without the use of needles, which decreases the risks of needle stick injuries and disposal. This channel also provides simple access to a crucial portion of the immune system that can stimulate other mucosal sites throughout the body. By targeting immunoglobulin A (IgA), antibodies found only in the mucosa, an intranasal vaccination would elicit immunological responses in the nose, throat, and lungs. Potential pathogens are trapped by the mucosa, which acts as a physical barrier to prevent them from entering the body. Given this, the intranasal vaccine would prevent virus transmission via exhaled droplets or aerosols because there would be no virus in the body to expel .There are several intranasal vaccines for protection against sars-cov2 are under preclinical and clinical trials .The key challenge is in Designing delivery strategies that take into account the wide range of diseases, populations, and healthcare delivery settings that stand to benefit from this unique mucosal route should be prioritized.
Keywords: COVID-19, Intranasal vaccine, Immunoglobulin A, Permeation
Keywords:
COVID-19, Intranasal vaccine, Immunoglobulin A, PermeationDOI
https://doi.org/10.22270/jddt.v11i4-S.4942References
Cheng M, Papenburg J, Desjardins M, Kanjilal S, Quach C, Libman M et al. Diagnostic Testing for Severe Acute Respiratory Syndrome-Related Coronavirus 2. Annals of Internal Medicine. 2020; 172(11):726-734. https://doi.org/10.7326/M20-1301
Rowaiye A, Okpalefe O, Onuh Adejoke O, Ogidigo J, Hannah Oladipo O, Ogu A et al. Attenuating the Effects of Novel COVID-19 (SARS-CoV-2) Infection-Induced Cytokine Storm and the Implications. Journal of Inflammation Research. 2021; 14:1487-1510. https://doi.org/10.2147/JIR.S301784
Abdellatif A, Tawfeek H, Abdelfattah A, El-Saber Batiha G, Hetta H. Recent updates in COVID-19 with emphasis on inhalation therapeutics: Nanostructured and targeting systems. Journal of Drug Delivery Science and Technology. 2021; 63:102435 https://doi.org/10.1016/j.jddst.2021.102435
Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020; 382(8):727-733. doi:10.1056/NEJMoa2001017 https://doi.org/10.1056/NEJMoa2001017
Coronavirus disease (COVID-19) - World Health Organization [Internet]. Who.int. 2021 [cited 18 May 2021]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
World Health Organization. Novel coronavirus (COVID-19) situation. Accessed at https://experience.arcgis.com/experience/685d0ace521648f8a5beeeee1b9125cd on 24 March 2020
WHO announces COVID-19 outbreak a pandemic [Internet]. Euro.who.int. 2021 [cited 18 May 2021]. Available from: https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/who-announces-covid-19-outbreak-a-pandemic
Cao Y, Li L, Feng Z, Wan S, Huang P, Sun X et al. Comparative genetic analysis of the novel coronavirus (2019-nCoV/SARS-CoV-2) receptor ACE2 in different populations. Cell Discovery. 2020; 6(1).
Lu R, Zhao X, Li J, Niu P, Yang B, Wu H et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. The Lancet. 2020; 395(10224):565-574. https://doi.org/10.1016/S0140-6736(20)30251-8
Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia | NEJM [Internet]. New England Journal of Medicine. 2021 [cited 18 May 2021]. Available from: https://www.nejm.org/doi/full/10.1056/NEJMoa2001316
Mizumoto K, Kagaya K, Chowell G. Early epidemiological assessment of the transmission potential and virulence of coronavirus disease 2019 (COVID-19) in Wuhan City, China, January-February, 2020. BMC Medicine. 2020; 18(1).
Bai Y, Yao L, Wei T, Tian F, Jin D, Chen L et al. Presumed Asymptomatic Carrier Transmission of COVID-19. JAMA. 2020; 323(14):1406. https://doi.org/10.1001/jama.2020.2565
Li R, Pei S, Chen B, Song Y, Zhang T, Yang W et al. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2). Science. 2020; 368(6490):489-493. https://doi.org/10.1126/science.abb3221
Wells C, Sah P, Moghadas S, Pandey A, Shoukat A, Wang Y et al. Impact of international travel and border control measures on the global spread of the novel 2019 coronavirus outbreak. Proceedings of the National Academy of Sciences. 2020; 117(13):7504-7509 https://doi.org/10.1073/pnas.2002616117
Tuite A, Bogoch I, Sherbo R, Watts A, Fisman D, Khan K. Estimation of Coronavirus Disease 2019 (COVID-19) Burden and Potential for International Dissemination of Infection From Iran. Annals of Internal Medicine. 2020; 172(10):699-701. https://doi.org/10.7326/M20-0696
Lee V, Chiew C, Khong W. Interrupting transmission of COVID-19: lessons from containment efforts in Singapore. Journal of Travel Medicine. 2020; 27(3).
Rowaiye A, Onuh O, Oli A, Okpalefe O, Oni S, Nwankwo E. The pandemic COVID-19: a tale of viremia, cellular oxidation and immune dysfunction. Pan African Medical Journal. 2020; 36.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020; 395(10229):1054-1062. https://doi.org/10.1016/S0140-6736(20)30566-3
Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. JAMA. 2020.
Sun X, Wang T, Cai D, Hu Z, Chen J, Liao H et al. Cytokine storm intervention in the early stages of COVID-19 pneumonia. Cytokine & Growth Factor Reviews. 2020; 53:38-42. https://doi.org/10.1016/j.cytogfr.2020.04.002
Ragab D, Salah Eldin H, Taeimah M, Khattab R, Salem R. The COVID-19 Cytokine Storm; What We Know So Far. Frontiers in Immunology. 2020; 11.
Bhaskar S, Sinha A, Banach M, Mittoo S, Weissert R, Kass J et al. Cytokine Storm in COVID-19-Immunopathological Mechanisms, Clinical Considerations, and Therapeutic Approaches: The REPROGRAM Consortium Position Paper. Frontiers in Immunology. 2020; 11.
Kim J, Lee J, Yang J, Lee K, Effenberger M, Szpirt W et al. Immunopathogenesis and treatment of cytokine storm in COVID-19. Theranostics. 2021; 11(1):316-329. https://doi.org/10.7150/thno.49713
Tawfeek H, Evans A, Iftikhar A, Mohammed A, Shabir A, Somavarapu S et al. Dry powder inhalation of macromolecules using novel PEG-co-polyester microparticle carriers. International Journal of Pharmaceutics. 2013; 441(1-2):611-619.
Xu Y, Yuen P, Lam J. Intranasal DNA Vaccine for Protection against Respiratory Infectious Diseases: The Delivery Perspectives. 2021.
Intranasal Vaccine For Covid-19 | Bharat Biotech [Internet]. Bharatbiotech.com. 2021. Available from: https://www.bharatbiotech.com/intranasal-vaccine.html
Suman J. Nasal Drug Delivery .Expert Opinion on Biological Therapy [Internet]. 2003 ;3(3):519-523. Available from: http://Suman J.D. Nasal drug delivery. Expert Opin Biol Ther. 2003; 3:519 -523. [PubMed] [Google Scholar]
Sharma M, Sharma N, Sharma A. RIZATRIPTAN BENZOATE LOADED NATURAL POLYSACCHARIDE BASED MICROSPHERES FOR NASAL DRUG DELIVERY SYSTEM. International Journal of Applied Pharmaceutics [Internet] . 2018 [cited 22 May 2021];10(5):261. Available from: http://Sharma R.P.K., Garg G., Salim M. Review on nasal drug delivery system with recent advancement. Int J Pharm Pharm Sci. 2011; 3 :1-5. [Google Scholar]
LeCluyse E, Sutton S. In vitro models for selection of development candidate. Permeability studies to define mechanisms of absorption enhancement. Advanced Drug Delivery Reviews [Internet]. 1997 [cited 22 May 2021]; 23(1-3):163-183. Available from: http://Ehrhardt C., Kim K.J. Drug absorption studies: in situ, in vitro and in silico models. In: Kom D., editor. In vitro cellular models for nasal drug absorption studies New York (NY, USA): Springer; 2008. pp. 221-222. [Google Scholar]
Nuhn L. Micro- and Nanotechnology in Vaccine Development . Edited by Mariusz Skwarczynski and Istvan Toth ChemMedChem [Internet] 2017 [cited 22 May 2021];13(1):126-126. Available from: https://www.sciencedirect.com/topics/medicine-and-dentistry/nasal-vaccine
Koopmeiners S, Turnbull J. Incidence of "flipped" lactate dehydrogenase isoenzyme pattern (LD1 greater than LD2) in specimens with normal total lactate dehydrogenase from coronary-care patients. Clinical Chemistry. 1984; 30(4):586-586. https://doi.org/10.1093/clinchem/30.4.586
Türker S, Onur E, Ózer Y. Nasal route and drug delivery systems. Pharmacy World & Science [Internet] 2004; 26 (3):137-142. Available from: http://cholar.google.com/scholar_lookup?journal=World+J+Pharm+Sci&title=Review+on+nasal+drug+delivery+system&author=S.+Mittal&author=J.+Jobin&author=S.+Kawale&volume=2&issue=9&publication_year=2014&pages=1058-1070&
Jones N. The nose and paranasal sinuses physiology and anatomy . Advanced Drug Delivery Reviews [Internet]. 2001 [cited 22 May 2021];51(1-3):5-19. Available from: http://Jones N. The nose and paranasal sinuses physiology and anatomy Adv Drug Deliv Rev. 2001;51:5-19. [PubMed] [Google Scholar]
Muggetti L, Martini A, Civaroli P, De Ponti R. P18 Evaluation of a new unidose device for nasal delivery. Journal of Controlled Release [Internet] .1994; 29 (3):393. Available from: https://www.aptar.com/products/pharmaceutical/uds/
Aptar Pharma's Bidose Nasal Drug Delivery Device Approved by U.S. FDA for Breakthrough Treatment of Depression | Aptar [Internet] Aptar. 2021 [cited 22 May 2021]. Available from: https://www.aptar.com/news-events/aptar-pharmas-bidose-nasal-drug-delivery-device-approved-by-u-s-fda-for-breakthrough-treatment-of-depression/
PMC E. Europe PMC [Internet]. Europepmc.org. 2021 [cited 1 June 2021]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846493/
Available from: https://pharmeasy.in/blog/what-are-intranasal-vaccines-all-about/
Zaman M, Chandrudu S, Toth I. Strategies for intranasal delivery of vaccines. Drug Delivery and Translational Research [Internet]. 2012; 3 (1):100-109. Available from: https://link.springer.com/article/10.1007/s13346-012-0085-z
Business Process Minded. Queue [Internet]. 2006;4(8). Available from: http://Advantages of Intranasal Vaccination and Considerations on Device Selection M. Birkhoff, Vice President Marketing, M. Leitz, Product Manager,1 and D. Marx, Business Development Manager2
Arya V. International publications of interest from India (September-November 2009). Indian Journal of Rheumatology [Internet]. 2009;4(4):176-178. Available from: https://go.gale.com/ps/anonymous?id=GALE%7CA219365476&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=0250474X&p=AONE&sw=w
udor Grashoff , Vice President-Business Information, SilverPlatter Information. Business Information Review [Internet]. 1992;9(1):50-55. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846493/
Guo C. Oxford-AstraZeneca COVID-19 Vaccine (AZD1222), an Approved, Non-Replicating Chimpanzee Adenovirus-Vectored Vaccine for the COVID-19 Pandemic. Journal of Applied Medical Sciences [Internet]. 2021; 1-12. Available from: https://www.bharatbiotech.com/intranasal-vaccine.html
Zaman M, Chandrudu S, Toth I. Strategies for intranasal delivery of vaccines. Drug Delivery and Translational Research [Internet]. 2012;3(1):100-109. Available from: http://ink.springer.com/article/10.1007/s13346-012-0085-z
Almeida A, Alpar H. Nasal Delivery of Vaccines. Journal of Drug Targeting. 1996; 3(6):455-467. https://doi.org/10.3109/10611869609015965
Boyaka P, Tafaro A, Fischer R, Leppla S, Fujihashi K, McGhee J. Effective Mucosal Immunity to Anthrax: Neutralizing Antibodies and Th Cell Responses Following Nasal Immunization with Protective Antigen. The Journal of Immunology. 2003; 170(11):5636-5643. https://doi.org/10.4049/jimmunol.170.11.5636
Lycke N. Recent progress in mucosal vaccine development: potential and limitations. Nature Reviews Immunology [Internet]. 2012; 12(8):592-605. Available from: https://www.nature.com/articles/nri3251
Xu Y, Yuen P, Lam J. Intranasal DNA Vaccine for Protection against Respiratory Infectious Diseases: The Delivery Perspectives. Pharmaceutics [Internet]. 2014; 6(3):378-415. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4190526/#:~:text=Intranasal%20DNA%20vaccination%20has%20become,respiratory%20syncytial%20virus%20(RSV)
Neutra M, Kozlowski P. Mucosal vaccines: the promise and the challenge. Nature Reviews Immunology [Internet]. 2006; 6(2):148-158. Available from: https://www.nature.com/articles/nri1777
Brandtzaeg P. Function of Mucosa-Associated Lymphoid Tissue in Antibody Formation. Immunological Investigations [Internet]. 2010; 39(4-5):303-355. Available from: https://www.tandfonline.com/doi/abs/10.3109/08820131003680369
Igietseme J, Murdin A. Induction of Protective Immunity against Chlamydia trachomatis Genital Infection by a Vaccine Based on Major Outer Membrane Protein-Lipophilic Immune Response-Stimulating Complexes. Infection and Immunity. 2000; 68(12):6798-6806. https://doi.org/10.1128/IAI.68.12.6798-6806.2000
u Y, Wang X, Csencsits K, Haddad A, Walters N, Pascual D. M cell-targeted DNA vaccination [Internet]. 2021 [cited 19 May 2021]. Available from: https://pubmed.ncbi.nlm.nih.gov/11459939/
Woodrow K, Bennett K, Lo D. Mucosal Vaccine Design and Delivery. Annual Review of Biomedical Engineering [Internet]. 2012; 14(1):17-46. Available from: https://www.annualreviews.org/doi/10.1146/annurev-bioeng-071811-150054
Fujimura Y. Evidence of M cells as portals of entry for antigens in the nasopharyngeal lymphoid tissue of humans. Virchows Archiv [Internet]. 2000; 436(6):560-566. Available from: https://link.springer.com/article/10.1007/s004289900177
Ogasawara N, Kojima T, Go M, Takano K, Kamekura R, Ohkuni T et al. Epithelial barrier and antigen uptake in lymphoepithelium of human adenoids. Acta Oto-Laryngologica [Internet]. 2010; 131(2):116-123. Available from: https://www.tandfonline.com/doi/abs/10.3109/00016489.2010.520022
Johansen F, Kaetzel C. Regulation of the polymeric immunoglobulin receptor and IgA transport: new advances in environmental factors that stimulate pIgR expression and its role in mucosal immunity. Mucosal Immunology [Internet]. 2011;4(6):598-602. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3196803/
Lamm M. INTERACTION OF ANTIGENS AND ANTIBODIES AT MUCOSAL SURFACES. Annual Review of Microbiology [Internet]. 1997; 51(1):311-340. Available from: https://www.annualreviews.org/doi/abs/10.1146/annurev.micro.51.1.311
Neutra M, Kozlowski P. Mucosal vaccines: the promise and the challenge. Nature Reviews Immunology [Internet]. 2006; 6(2):148-158. Available from: https://www.nature.com/articles/nri1777
Kiyono H, Fukuyama S. NALT- versus PEYER'S-patch-mediated mucosal immunity. Nature Reviews Immunology [Internet]. 2004; 4(9):699-710. Available from: https://www.nature.com/articles/nri1439
Moldoveanu Z, Clements M, Prince S, Murphy B, Mestecky J. Human immune responses to influenza virus vaccines administered by systemic or mucosal routes. Vaccine [Internet]. 1995; 13(11):1006-1012. Available from: https://www.sciencedirect.com/science/article/pii/0264410X9500016T
Tech2. 2021. Bharat Biotech's intranasal vaccine for COVID-19: Everything we know so far about BBV154- Technology News, Firstpost. [online] Available at: <https://www.firstpost.com/tech/science/bharat-biotechs-intranasal-vaccine-for-covid-19-everything-we-know-so-far-about-bbv154-9408701.html>
Clinicaltrials.gov. 2021. Safety and Immunogenicity of an Intranasal SARS-CoV-2 Vaccine (BBV154) for COVID-19 - Tabular View - ClinicalTrials.gov. [online] Available at: <https://clinicaltrials.gov/ct2/show/record/NCT04751682>
Altimmune.com. 2021. AdCOVID™ - Single-Dose Intranasal COVID-19 Vaccine | Altimmune. [online] Available at: < https://altimmune.com/adcovid/>
Promega Connections. 2021. Intranasal COVID-19 Vaccines: What the Nose Knows - Promega Connections. [online] Available at:<https://www.promegaconnections.com/intranasal-covid-19-vaccines-coronavirus/>
https://www.biorxiv.org/content/10.1101/2020.10.10.331348v1.full
Clinicaltrials.gov. 2021. Safety and Immunogenicity of AdCOVID in Healthy Adults (COVID-19 Vaccine Study) - Full Text View - ClinicalTrials.gov. [online] Available at: <https://clinicaltrials.gov/ct2/show/study/NCT04679909#armgroup>
Codagenix, I., 2021. Codagenix and Serum Institute of India Announce Commencement of First-in-Human Trial of COVI-VAC, A Single Dose, Intranasal Live Attenuated Vaccine for COVID-19. [online] Prnewswire.com. Available at: < https://www.prnewswire.com/news-releases/codagenix-and-serum-institute-of-india-announce-commencement-of-first-in-human-trial-of-covi-vac-a-single-dose-intranasal-live-attenuated-vaccine-for-covid-19-301191756.html>
https://clinicaltrials.gov/ct2/show/NCT04619628
B.V., I., 2021. Intravacc Partners With Wageningen Bioveterinary Research and Utrecht University to Develop an Intranasal COVID-19 Vaccine. [online] Prnewswire.com. Available at: <https://www.prnewswire.com/news-releases/intravacc-partners-with-wageningen-bioveterinary-research-and-utrecht-university-to-develop-an-intranasal-covid-19-vaccine-301070721.html>
Intravacc. 2021. Home - Intravacc. [online] Available at: <https://www.intravacc.nl/>
Intravacc. 2021. Intravacc announces positive pre-clinical data for its SARS-CoV-2 nose spray vaccine - Intravacc. [online] Available at: <https://www.intravacc.nl/news/intravacc-announces-positive-pre-clinical-data-intranasal-sars-cov-2-candidate-vaccine/>
ETHealthworld.com. 2021. Wantai's nasal spray Covid-19 vaccine to begin mid-stage trial in China - ET HealthWorld. [online] Available at: <https://health.economictimes.indiatimes.com/news/pharma/wantais-nasal-spray-covid-19-vaccine-to-begin-mid-stage-trial-in-china/79122514>
Staff, R., 2021. Wantai's nasal spray COVID-19 vaccine to begin mid-stage trial in China. [online] U.S. Available at: <https://www.reuters.com/article/health-coronavirus-vaccine-wantai/wantais-nasal-spray-covid-19-vaccine-to-begin-mid-stage-trial-in-china-idUSL4N2HV0KO>
European Pharmaceutical Review. 2021. Is intranasal drug delivery best to administer COVID-19 therapeutics?. [online] Available at: <https://www.europeanpharmaceuticalreview.com/article/141663/is-intranasal-drug-delivery-the-best-way-to-administer-covid-19-therapeutics/>
Eurekatherapeutics.com. 2021. Eureka Therapeutics Announces Successful Preclinical Results of InvisiMask™ Human Antibody Nasal Spray Against SARS-CoV-2 Infection. [online] Available at: <https://www.eurekatherapeutics.com/media/press-releases/121420/>
Eurekatherapeutics.com. 2021. InvisiMask™ | COVID-19 nasal spray | Eureka Therapeutics. [online] Available at: <https://www.eurekatherapeutics.com/COVID19/>
Fdanews.com. 2021. Zeteo Biomedical Partners With Iowa State University on Nasal COVID-19 Vaccine. [online] Available at: < https://www.fdanews.com/articles/200180-zeteo-biomedical-partners-with-iowa-state-university-on-nasal-covid-19-vaccine>
Biomedical, Z., 2021. Zeteo Biomedical to Collaborate with Iowa State University Nanovaccine Institute to Study a COVID 19 Vaccine Under Fast Track CARES Act Funded Program | Zeteo Biomedical. [online] Zeteo Biomedical. Available at: < https://zeteobiomed.com/2020/11/zeteo-biomedical-to-collaborate-with-iowa-state-university-nanovaccine-institute-to-study-a-covid-19-vaccine-under-fast-track-cares-act-funded-program/>
MobiHealthNews. 2021. Finnish academics developing intranasal COVID-19 vaccine. [online] Available at: <https://www.mobihealthnews.com/news/emea/finnish-academics-developing-intranasal-covid-19-vaccine >
News Powered by Cision. 2021. Finnish researchers introduce a nasal COVID vaccine. [online] Available at: <https://news.cision.com/university-of-eastern-finland/r/finnish-researchers-introduce-a-nasal-covid-vaccine,c3301696>
University of Helsinki. 2021. Finnish COVID vaccine company founded by University of Helsinki, University of Eastern Finland and collaborators | University of Helsinki. [online] Available at: < https://www2.helsinki.fi/en/news/health-news/university-of-helsinki-and-university-of-eastern-finland-shareholders-in-a-finnish-covid-vaccine-company>
EurekAlert!. 2021. Finnish researchers introduce a nasal COVID vaccine. [online] Available at: <https://www.eurekalert.org/pub_releases/2021-03/uoef-fri030821.php >
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