For decades, developing a safe and effective HIV vaccine has been a critical scientific goal. One major hurdle is the virus’s rapid mutation rate, creating a vast array of strains within a single infected person. However, recent research by a collaborative team offers promising new insights into an immunization strategy that could overcome this challenge.
New research represents a significant step forward in an immunization approach for HIV, that targets the body’s production of broadly neutralizing antibodies (bnAbs) (Figure 1).
BnAbs are the immune system’s elite soldiers against HIV, capable of blocking a wide range of viral variants. Unfortunately, the human body naturally produces very few bnAbs in response to HIV infection. The IAVI trial focused on stimulating the immune system to generate the specific precursor B cells that can eventually evolve into these coveted bnAbs.
The strategy involves a two-step process: priming and boosting. The priming step utilizes a customized molecule, called an immunogen, to activate the correct B cell precursors. However, these precursors require further development towards bnAbs. This is where booster immunogens come in. These additional immunogens, some utilizing mRNA technology, further guide the primed B cells along the path towards becoming mature bnAbs.
Four studies explored different aspects of this approach. One successfully primed exceptionally rare BG18 precursors in animal models. Subsequent structural analysis confirmed the development of the desired BG18-class antibodies. This finding suggests a high probability of success in human trials.
The second, built upon the priming concept. Here, they used a combination of priming and RNA-based boosting to nudge the primed B cells towards recognizing more natural forms of HIV. This demonstrates the feasibility of guiding B cell development towards bnAbs. The third study focused on VRC01-class bnAbs, another potent weapon against HIV.
The final study, delved deeper into the immunological processes within germinal centers, specialized structures where B cells refine their antibody response.
Collectively, these studies offer compelling evidence for the effectiveness of the priming step in activating the desired bnAb precursors. Moreover, three of the studies demonstrate the possibility of guiding these precursors towards becoming mature bnAbs capable of fighting HIV infection.
Journal article: Wang, X., et al. 2024. mRNA-LNP prime boost evolves precursors toward VRC01-like broadly neutralizing antibodies in preclinical humanized mouse models. Science Immunology.
Summary by Stefan Botha