The need and challenges for development of an epstein-barr virus vaccine

Jeffrey I. Cohen, Edward S. Mocarski, Nancy Raab-Traub, Lawrence Corey, Gary J. Nabel

Research output: Contribution to journalArticle

Abstract

Epstein-Barr virus (EBV) is the major cause of infectious mononucleosis and is associated with several malignancies including nasopharyngeal carcinoma, gastric carcinoma, Hodgkin lymphoma, Burkitt lymphoma, and lymphoma after organ or stem cell transplant. A candidate vaccine containing soluble EBV glycoprotein gp350 protected cottontop tamarins from EBV lymphoma after challenge with EBV. In the only phase 2 trial of an EBV vaccine in humans, soluble gp350 in alum and monophosphoryl lipid A adjuvant reduced the rate of infectious mononucleosis in EBV seronegative adults, but did not affect the rate of EBV infection. A peptide vaccine corresponding to EBV latency proteins has been tested in a small number of adults to prevent infectious mononucleosis. Some of the barriers to development of an EBV vaccine include (a) whether viral proteins in addition to gp350 would be more effective for preventing mononucleosis or EBV malignancies, (b) the difficulty of performing clinical trials to prevent EBV associated malignancies in the absence of good surrogate markers for tumor development, and the long period of time between primary EBV infection and development of many EBV tumors, (c) the lack of knowledge of immune correlates for protection against EBV infection and disease, (d) the limitations in animal models to study protection against EBV infection and disease, and (e) the need for additional information on the economic and societal burden of infectious mononucleosis to assess the cost-benefit of a prophylactic vaccine.

Original languageEnglish (US)
JournalVaccine
Volume31
Issue numberSUPPL2
DOIs
StatePublished - Apr 18 2013
Externally publishedYes

Keywords

  • Burkitt lymphoma
  • Epstein-Barr virus
  • Gastric carcinoma
  • Hodgkin lymphoma
  • Infectious mononucleosis
  • Nasopharyngeal carcinoma

ASJC Scopus subject areas

  • Immunology and Microbiology(all)
  • Infectious Diseases
  • Public Health, Environmental and Occupational Health
  • veterinary(all)
  • Molecular Medicine

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  • Cite this

    Cohen, J. I., Mocarski, E. S., Raab-Traub, N., Corey, L., & Nabel, G. J. (2013). The need and challenges for development of an epstein-barr virus vaccine. Vaccine, 31(SUPPL2). https://doi.org/10.1016/j.vaccine.2012.09.041