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Anti-infective agents are a distinct class of pharmacologically important molecules that have served mankind in different capacities to combat life-threatening pathological conditions. They include antibacterial, antifungal, antiviral, antituberculosis, antimalarial and urinary anti-infective agents. However, evolutionary changes, adaptations and development of new strains of pathogenic microorganisms that have reduced the therapeutic efficacy of existing drugs, thus, limiting their clinical utility over the years. Frontiers in Anti-Infective Agents Volume 6 is a collection of notable research efforts, successful anti-infective drug development programmes and a comprehensive overview of successful and unsuccessful clinical trials conducted in this domain. This volume continues from the last one with interesting reviews on: 1) “Reverse Vaccinology” for vaccination design using computational data to identify vaccine targets, 2) leptospirosis, 3) phage therapy for bacterial infections, 4) quorum sensing inhibitors from natural products, and 5) nitrogen and oxygen based heterocyclic compounds that can act as anti-infective agents. The volume, therefore, covers a range of frontier topics on anti-infective research and development.This compilation is a timely reference for postgraduate scholars and researchers seeking updates in specific areas of anti-infective drug development. Allied healthcare professionals (clinical and public healthcare professionals) can also benefit from the information presented within.
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Veröffentlichungsjahr: 2006
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Pathogens have historically affected human populations worldwide, resulting in epidemics and pandemics of different origins and epidemiology, as well as high mortality rates. Despite advancements in detection mechanisms and treatment of many known diseases through the development of novel drugs, the increase in the pace of evolution of drug resistance remains the greatest obstacle in drug design and discovery. The most recent threat to mankind is the SARS-coronavirus-2 (COVID-19), a viral zoonosis, which is difficult to diagnose due to many symptomatic similarities to influenza. Approaching the virus via a standardised treatment protocol has been inefficacious due to its rapid mutation, either being more virulent or becoming drug-resistant. The viral infection has engulfed the world in a fight response, in search of an appropriate vaccine or treatment to reduce the risk of infection and loss of human life. Biomolecular engineering and molecular bio-computing have been our greatest tools in drug discovery and development. It has enabled the repurposing of existing drugs by understanding the structure-activity relationship and pharmacokinetic properties against new targets or biological systems.
The book offers an insightful perspective on the most up-to-date developments and research engaged in the combat against pathogens and COVID-19. The contributions from distinguished researchers and leaders in their field are a critical analysis of vaccine development strategies, novel heterocyclic drug scaffolds, the history and biology of infection, and natural products as quorum sensors.
The chapter by Arindam Mitra emphasises reverse vaccinology approaches in vaccine design, intuitively targeting multiple pathogens, including the novel coronavirus, to combat the current pandemic of COVID-19. It also highlights the major advantages of reverse vaccinology for the discovery of novel vaccines with reduced time and cost in development. The second chapter by N. Ramalakshmi et al. is a critical review of leptospirosis and its treatment. The current remedies for milder cases of leptospirosis involve antibiotic administration viz penicillin, ampicillin, cefmetazole, oxalactam, ceftizoxime, and cefotaxime. This review summarizes the most recent literature on synthetic lead molecules, natural product chemotherapies, and drug targets. The third chapter by Nachimuthu Ramesh et al. sheds light on phage therapy and its evolution from lab to bedside endpoints in treating patients. The history and fundamentals of phage biology and its significance in treating infectious diseases have been provided, with commercialization strategies undertaken by the pharmaceutical industry. The fourth chapter by Debaprasad Parai et al. focuses on quorum sensing inhibitors (QSIs) from natural products. Quorum sensing is a signalling process, which regulates the expression of several virulence factors in both gram-negative and gram-positive bacteria via an autoinducing loop. When a critical bacterial cell density is reached, a complex of regulatory proteins and specific signalling molecules enable the autoinduction of the quorum sensor and the expression of the target genes. This chapter provides a literature review describing the various QSIs obtained from natural sources and their role as anti-infective agents. The fifth chapter by Shaik Baji Baba et al. reveals the importance of nitrogen and oxygen-based heterocycles as potential anti-infective agents. It details the development of 1,2,4-triazoles, isatin, and coumarin-based anti-infective agents. Structure-activity relationship studies provide scope for future researchers to develop the most effective and least toxic anti-infective agents.
We would like to acknowledge the expert contributions of the authors mentioned in the review articles in accomplishing this book, which forms an updated base platform for novel drug discovery and development against infective agents. Each author has been recognised as a dynamic leader in their field and we wish them well for their future research. We reserve a special recognition for the Bentham Science Publishing team, particularly Mrs. Fariya Zulfiqar (Manager Publications) and Mr. Mahmood Alam (Editorial Director), for the timely production of the 6th volume and promotion of this scientific collaboration.
Reverse vaccinology uses computational approaches to identify potential vaccine candidates. With the increasing pace of genome sequencing, it is possible to identify all potential antigens from any sequenced pathogen. Reverse vaccinology uses computational data to identify potential antigens, express those potential antigens, and then screen them further for protective immune response. Thus, reverse vaccinology offers several advantages and enables identifying novel antigens even if the expression level is low or not abundant. Besides, reverse vaccinology approaches offer reduced time and reduced cost for the development of vaccines compared to conventional vaccination methods. Such a timely, speedy, and economical process for developing vaccines without compromising safety and immunogenicity is the urgent need of the hour to combat many emerging pathogens, including SARS-CoV-2. This chapter summarizes approaches and challenges in developing vaccines against many emerging pathogens, including SARS-CoV-2, by employing this innovative strategy.
Vaccines are one of the most successful and cost-effective prophylactic measures for improving the quality of health and saving lives from a wide range of infectious diseases worldwide [1, 2]. Eradication of smallpox and significant reduction of global polio cases are outstanding examples of successful vaccination programs where vaccines have significantly reduced mortality and the global burden of infectious diseases. Vaccines are weakened or attenuated from microorganisms or components, which, when introduced into an individual, stimulates the body's immune response and protects against an infectious disease
caused by the pathogen or similar pathogens. Vaccinology focuses on vaccine development and the effect of vaccines on public health [3]. The classical steps of vaccine development include isolation, culture, and the weakening of a pathogen. Inoculation of a weakened or killed pathogen or a microbe component stimulates a protective immune response in the host. Purified components, such as capsules, recombinant proteins, or weakened toxins also confer protective immunity. Louis Pasteur designed this vaccinology approach of isolation, inactivation, and injection of the agent responsible for the disease. By reducing the pathogen's virulence or inhibiting the replication of a pathogen, the pathogen would be safer for hosts without compromising the immunogenicity of the pathogen. Targeting microbial components, such as capsules, toxins, and surface proteins, reduces the virulence of a given pathogen. This kind of vaccine strategy depends on the body's immune response to combat infectious diseases. It was successful against many infectious diseases such as smallpox, polio, mumps, measles, and rubella. Convalescent plasma therapy (CBT), also known as serum therapy or passive immune therapy, is another proven age-old therapeutic strategy. It depends on protective antibody responses from blood (sera and lymphocytes) from convalescent patients [4]. CBT treatment was successful against diphtheria, tetanus, pneumonia, anthrax, plague, tularemia, among many others [5]. In addition, this therapeutic strategy is employed against many emerging viral diseases, such as Ebola, SARS-CoV, and more recently against SARS-CoV-2 [6, 7]. Fig. (1) highlights classical approaches for vaccine development and convalescent plasma therapy against infectious diseases.
Fig. (1)) Classical approaches for the development of vaccines and therapeutics.However, there are certain limitations in the traditional approach for developing vaccines. Many infectious diseases such as tuberculosis, HIV, malaria, and others do not have an effective vaccine yet. In many cases, the development of a vaccine by the classical method is not feasible due to the lack of proper media for growing a given pathogen. It is difficult or not possible to express a given target antigen, as in meningitis and AIDS. The classical method is also not helpful in developing vaccines based on antigens that elicit strong autoimmune reactions or strains that are highly variable or where the mechanisms of pathogenesis are not well understood. Sometimes, the most expressed proteins may not be ideal vaccine candidates, or the antigens expressed in vitro are different from those expressed in vivo. Besides, the traditional method of developing vaccines can be time-consuming, and not all antigens can be made pure in adequate amounts for vaccine testing. Conventional vaccine development would not be effective against pathogens that do not induce immunity post-infection. The approach would not apply in cases of chronic diseases including AIDS, tuberculosis, gastritis and hepatitis [8].
The sequencing of the first microbe, Haemophilus influenzae, in 1995 opened up new possibilities for vaccine design [9]. With the availability of whole-genome sequence of many pathogens at an incredible speed using next-generation sequencing platforms, it is now possible to identify all potential protein antigens in silico that may be antigenic or immunogenic without actually culturing the pathogen. Using specific criteria of predictive algorithms and combining tools of bioinformatics and biotechnology, it is also possible to screen the exhaustive list of all potential antigens down to few candidate antigens that can eventually move to safety and immunogenicity testing. In many cases, secreted or extracellular antigens are more likely to be exposed to antibodies than intracellular protein antigens and are likely to be potential vaccine candidates.
Reverse Vaccinology (RV), a term coined by Rino Rappuoli, uses genomics and bioinformatics tools to develop vaccine candidates [10]. This approach enables the identification of all potential protective antigens from sequenced genomes. It facilitates the development of a safe and effective vaccine against any infectious disease that requires a protein antigen to stimulate an immune response [11-19]. Choice of algorithms, appropriate criteria for proper selection of antigens, and critical evaluation of the information often determine the success of the RV strategies. Genome-based approaches facilitate identifying novel antigens or unique virulence factors in pathogens, thereby enabling a better understanding of pathogenesis and developing better vaccines. RV-based vaccines are typically targeted based on specific purified components or subunit vaccines and not based on whole microbes. As a result, such vaccines do not elicit virulence or side effects, or adverse immune reactions from other microbial components. The conformations of epitopes designed by RV fold correctly due to the natural form of protein, and such epitopes can neutralize pathogens better than linear epitopes. RV approaches have reduced dependence on animal testing and clinical trials and are considered an economical approach to developing vaccines [20-22]. Fig. (2) outlines steps in reverse vaccinology.
Fig. (2)) Reverse vaccinology steps for vaccine design.Reverse vaccinology successfully created a vaccine against Neisseria meningitidis serogroup B (Men B), causative agent of bacterial meningitis and sepsis, a lethal disease in children. It was extremely challenging to develop a vaccine against MenB because of the following reasons: the capsular polysaccharide of the pathogen was identical to human self-antigen, and the outer surface protein antigens were variable. However, with the availability of the genome sequence information, potential candidate antigens were screened based on the sequence information of Neisseria to develop vaccine candidates [23]. Based on predictive algorithms and a filtering approach using bioinformatics programs such as PSORTB, ProDorm, and Blocks database, 570 candidate membrane proteins or outer surface-exposed proteins have been identified. Out of those 570 candidates, recombinant DNA techniques could eventually clone 350 putative extracellular or surface-expressed proteins in Escherichia coli. Enzyme-Linked Immunosorbent Assay (ELISA) and Fluorescent-Activated Cell Sorting (FACS) confirmed the surface expressions of those candidate proteins. Subsequently, three hundred and fifty putative candidate antigens were injected into mice to raise antibodies against those antigens.
The researchers then evaluated the serum from immunized mice for bactericidal activity and complement activation. Antigen candidates were further screened based on conservation in multiple MenB strains to ensure broad protection against those strains, narrowing down to seven-candidate proteins. Eventually, three of seven proteins were used in the approved vaccine, BEXSERO, developed by Novartis to prevent the invasive disease caused by Neisseria meningitidis serogroup B [24]. Neisseria Heparin Binding Antigen, factor H binding protein, Neisseria adhesin A, and the outer membrane vesicles expressing porin A and porin B made into the vaccine, BEXSERO. Even though the initial assumption was that the vaccine would take a short period, but in reality, it took more than a decade to develop this vaccine. Also, an experimental vaccine based only on recombinant antigens was not successful. Hence, the final human vaccine is a combination of DNA technology and conventional vaccine technology. Nevertheless, the vaccine reduced the mortality and morbidity associated with the disease in European Union, Canada, and Australia and established the field of reverse vaccinology [25].
With this success, reverse vaccinology approaches were employed to design vaccines for many pathogens. Often appropriate modifications were made to RV strategies to meet specific objectives. For example, a multi-genome RV approach identified protective antigens from Group B streptococcus (GBS) instead of a single genome [26]. A subtractive RV approach identified unique antigens present in pathogenic E. coli but not in commensal E. coli [27]. Reverse vaccinology also helped develop vaccines against Hepatitis B, which is now routinely used to immunize children worldwide [28]. Furthermore, this technology successfully developed vaccines against emerging antibiotic-resistant pathogens such as Staphylococcus aureus and Streptococcus pneumoniae [19, 26, 29-32]. Tools, such as identifying open reading frames, homology searches, screening for cellular localization of proteins that span from the inner membrane to outside, and identifying surface-associated features, are used to pinpoint protective antigens based on genome analysis in silico. Usually, the genes encoding selected antigens are amplified, expressed in a heterologous system, and purified to generate a high level of potential protective antigens. Subsequently, the purified recombinant proteins are injected into mice. Later, the sera from animals are analyzed post-vaccination to verify the predicted surface association of antigens, and the protective immune response of those antigens is also analyzed. Table 1 summarizes recent reverse vaccinology approaches for vaccine design to combat many bacterial and viral pathogens [17, 19, 33-48].
Rickettsia is an intracellular bacterium that infects animals and humans worldwide and cannot be grown in vitro. The use of RV and molecular docking studies have facilitated the identification of vaccine candidates and drug targets against Rickettsia [49]. Another RV strategy identifies five MHC class 1 consensus epitopes of ornithine decarboxylase from Leishmania donovani [50]. In silico approach was used to predict protective antigens against melioidosis caused by Burkholderia pseudomallei [45, 51, 52]. State-of-the-art RV approaches could be employed to design vaccines against various neglected tropical diseases in resource-limited regions. These strategies could address biological complexity and low developmental costs associated with vaccine manufacturing [53].
The sequence information of many viruses due to enhanced next-generation sequencing methods made it possible to apply reverse vaccinology strategies towards viral vaccine development. The traditional method of selecting protective antigens against viral diseases relies on the notion that such antigens are typically expressed on the surface or secreted. As a result, many viral vaccines are being developed based on envelope and core proteins. Such a conventional strategy would fail to identify or ignore antigens expressed at insignificant levels or may not be part of the viral particle. RV strategies screen for protective antigens in the entire genome and minimize the inherent bias of using only specific available antigens. RV approaches also create a possibility of developing viral vaccines that are efficacious and timely, particularly for viruses relevant to public health as applicable in the current scenario [54].
Designing speedy and timely vaccines against SARS-CoV-2 via Reverse Vaccinology approaches opens up another practical approach for vaccine development in the context of the current pandemic of COVID-19. The current pandemic of Coronavirus Disease 2019, COVID-19, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), causes severe pneumonia-like symptoms and shows high sequence similarity with SARS-CoV, which caused an earlier outbreak in 2002-03 [55]. The coronavirus is an enveloped, single-stranded, positive-sense RNA virus that causes severe respiratory diseases in humans. SARS-CoV-2 is a part of a family of beta Coronavirus and belongs to Coronaviridae, with characteristic crown-like projections on its surface, and its genome is fully sequenced [56]. The virus usually infects respiratory tracts in the human and other animals. The virus is thought to have a zoonotic origin in animals such as bats and later transmitted from humans to humans with a high reproductive number between 2 and 3. As of March 19, 2021, the pandemic resulted in 122M cases and 2.69M mortality globally. Several vaccine trials are currently in progress and few vaccines are in use. Still, a safe and efficacious vaccine to contain the SARS-CoV-2 would be desirable and bring normalcy. In this regard, reverse vaccinology strategies can offer a timely novel vaccine for a pathogen that may be difficult to grow in the lab. RV strategies can quickly develop a subunit vaccine against an emerging pathogen in a pandemic such as the one caused by SARS-CoV-2.
The complete genome sequence information of SARS-COV-2 is accessible (https://virological.org/t/novel-2019-coronavirus-genome/319).
Moreover, sequences of several other strains of the novel Coronavirus from different parts of the world are also available [57-59]. Various studies on vaccine development against SARS-CoV-2 using predictive tools are currently under investigation. Prediction of B cell epitope within the Spike Protein and T cell epitope within nucleocapsid protein using bioinformatics and immunoinformatic-based approaches has uncovered potential vaccine candidates against SARS-CoV- 2 [60]. Utilizing mass spectrometric-based predictive binding for HLA alleles, another study reported CD4+ and CD8+T cell-binding epitopes to HLA-1 and HLA-2 alleles across the entire SARS-CoV-2 [61]. A Q-UEL language identifies a synthetic vaccine epitope and a peptidomimetic agent as potential candidates [62]. Structure-based immunoinformatic analysis of the S protein predicted multiple linear and non-linear B cell epitopes and T-cell epitopes [63, 64]. Investigators have also computationally predicted a stable multiple epitope vaccine using the spike protein of SARS-CoV-2 [65, 66]. E protein as a potential vaccine candidate is predicted based on bioinformatics approaches and modeling studies [67, 68]. Using in silico approaches, investigators have also designed multiple epitope fusion vaccine candidates that could elicit both humoral and cell-mediated immune responses against the novel Coronavirus [48]. A multi-epitope mRNA-based vaccine targets the spike protein based on immunoinformatic analysis for B and T cell epitopes, filtering, and molecular docking studies [69].
Several bioinformatics analysis tools are available in the public domain to predict potential vaccine candidates using reverse vaccinology approaches. These tools typically use filtering or machine learning algorithms to make predictions. Vaxign was the first RV-based user-friendly web platform to predict antigens based on subcellular location and conservation and predict binding to MHC Class I and II [70, 71]. Machine learning has been applied to Vaxign further to create Vaxign-ML to predict better bacterial protective protein antigens [72, 73]. VirGen platform is a comprehensive viral genome resource with the structured organization of the genomic data [74]. EpiMatrix platform identifies and predicts epitopes [75]. Another platform, VIOLIN, is a vaccine-related database that stores, analyses, and integrates data on vaccine research [76, 77]. Vaceed is a high throughput platform to explore vaccine candidates against eukaryotic pathogens in silico [78]. VacSol is yet another high throughput platform to determine vaccine candidates against bacterial pathogens [79]. Jenner Predict server predicts vaccine candidates based on host-pathogen interactions and filters out cytosolic proteins [80]. VaxiJen is the first server-based immunogen prediction tool that relies solely on the physicochemical properties of proteins and is not dependent on the sequence alignment of proteins [81, 82]. ReVac is an RV-based predictive computational tool for protein-based bacterial vaccine candidates [83]. NERVE or New Enhanced Reverse Vaccinology Environment filters out proteins that may cause autoimmune reactions in humans [84]. Table 2 summarizes representative tools or web-based software programs used in Reverse vaccinology.
The whole-genome sequence data of a pathogen is a prerequisite to reverse vaccinology. RV strategies also require an antibody-dependent response to a pathogen. The filtering approach in the selection of candidate antigen proteins introduces biases. Often, filtering predicts many surface-associated proteins as potential vaccine candidates, which then needs to be characterized and evaluated in the lab. In contrast, potential subcellular proteins are usually not considered as vaccine candidates. RV strategy is helpful if the vaccine candidate is protein-based and would not be effective if the vaccine is carbohydrate or lipid-based. The subunit vaccine candidates generated by RV approaches would specifically target against a component or components of a pathogen and not towards the whole pathogen. This strategy would provide a moderate level of immune response and may not offer long-term immunity, and might require the addition of adjuvants to boost the protective immunity in subunit vaccines.
Several advances in human immunology and structural biology have been a major driving force for novel vaccine development and helped usher into a new era of Reverse Vaccinology 2.0 [85, 86]. A majority of vaccines confer a protective immune response by stimulation of pathogen-specific antibodies by B cells. Hence mechanisms of identifying pathogen-specific antibodies could assist the development of modern vaccines. Cloning B cells and producing recombinant monoclonal antibodies and antigen-binding fragments, screening most potent antibodies have enabled correct assessment of protective immune response. Structural vaccinology can improve the biochemical aspects and immunogenicity of vaccine candidates. Structure-based antigen design is the new frontier in vaccinology, and with this innovation, it is now possible to deliver antigens that were previously impossible. X-ray crystallography and NMR spectroscopy have greatly improved protein structure resolution and helped elucidate the structure and epitopes of most available vaccines [87]. Newer computational programming and approaches based on structural biology and immunology have greatly facilitated the identification of novel protective antigens [88]. Such advances in tools and technology have led us to an era of reverse vaccinology 2.0. Fig. (3) summarizes reverse vaccinology 2.0 approaches.
Fig. (3)) Outline of Reverse Vaccinology 2.0.Reverse vaccinology offers novel ways to develop an efficacious vaccine in a relatively short period. It also enables high throughput expression of potential antigens and even circumvents pathogens' uncultivability problems. Many RV approaches are successful, and many vaccines are currently under development using such strategies. In the current pandemic, several researchers have used RV-based bioinformatics tools to predict potential antigens for developing vaccines to combat COVID-19. Newer strategies and technological developments supporting RV approaches include cloning B cells, high throughput expression of proteins, animal models, proteomics, antigen design, and structure-based design in vaccinology. Machine learning, deep learning, and molecular dynamics studies are also increasingly used to better construct protein antigens in the new era of Reverse Vaccinology 2.0. These technological innovations involving reverse vaccinology-based approaches are increasingly making a significant impact on designing vaccines to protect against diverse infectious diseases and emerging pathogens.
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