This application claims the benefit of U.S. Provisional Application No. 61/466,974, filed on March 24, 2011, the entire contents of which are incorporated herein by reference for all purposes.

TECHNICAL FIELD

The invention is in the field of emulsions which are useful for delivering amphiphilic pharmacological agents, such as immunopotentiators.

BACKGROUND ART

Pharmacological agents can require formulation in order to optimise their in vivo effects. For instance, they might be encapsulated or adsorbed. Appropriate formulation can provide, for instance, homogeneous dosing, improved efficacy, better pharmacokinetics, or simpler manufacturing. For example, reference 1 encapsulated indomethacin in polymeric nanoparticles, and reference 2 formulated a lipophilic muramyl dipeptide immunopotentiator with polylactide microspheres.

It is an object of the invention to provide further and improved ways of formulating amphiphilic pharmacological agents for in vivo use.

DISCLOSURE OF THE INVENTION

The inventors attempted to formulate amphiphilic pharmacological agents (in particular, amphiphilic immunopotentiators) in oil-in-water emulsions, but the emulsions could accommodate only low concentrations of agent. Higher loading was achieved by including phospholipids in the emulsions. This combination provides emulsions which can be loaded with high levels of amphiphilic pharmacological agents.

Thus the invention provides an oil-in-water emulsion comprising an aqueous phase, an oil phase, a surfactant, and a phospholipid, provided that the phospholipid (i) does not include an amino acid residue and/or (ii) is not a cationic phospholipid. These emulsions are useful for formulating amphiphilic pharmacological agents for in vivo use, and the invention also provides an oil-in-water emulsion comprising an aqueous phase, an oil phase, a surfactant, a phospholipid, and an amphiphilic pharmacological agent.

The invention also provides an immunogenic composition comprising (a) an oil-in-water emulsion of the invention and (b) an immunogen. This composition is particularly useful when the emulsion includes an amphiphilic SMIP (see below).

The invention also provides a process for preparing an oil-in-water emulsion, comprising a step of homogenising a mixture comprising an aqueous component, an oil component, and a surfactant component, wherein the oil component includes a phospholipid. An amphiphilic pharmacological agent may be added (i) to the mixture before during or after homogenisation, or preferably (ii) to the oil component before homogenisation. The homogenisation may comprise microfluidisation. The invention also provides a process for preparing an oil-in-water emulsion, comprising a step of homogenising a mixture comprising an aqueous component, an oil component, and a surfactant component, wherein a phospholipid is added to the mixture before, during or after homogenisation (preferably before). An amphiphilic pharmacological agent may be added (i) to the mixture before during or after homogenisation, or (ii) to the emulsion before or after addition of the phospholipid; it is preferably added to the mixture before homogenisation. The homogenisation may comprise microfluidisation.

The invention also provides a process for preparing an immunogenic composition, comprising a step of mixing an immunogen with an emulsion of the invention.

Amphiphilic pharmacological agents

Emulsions of the invention are useful for formulating amphiphilic pharmacological agents (APAs) for in vivo use. Such APAs include, but are not limited to, amines {e.g. amiodarone, chlorpromazine, imipramine, trimipramine, promethazine), non-steroidal anti-inflammatories {e.g. flufenamic acid), carcinostatic agents {e.g. zinostatin stimalamer) and immunopotentiators {e.g. lipopeptides, such as those disclosed below). The APA has both hydrophilic and lipophilic groups. The hydrophilic group can be charged {e.g. a carboxylate, sulfate, sulfonate, phosphate, amine) or uncharged {e.g. an alcohol). The lipophilic group will often be a long chain alkyl comprising— (CH ₂ ) _n — where n>4.

Preferred APAs for use with the invention are small molecule immune potentiators (SMIPs). These SMIPs have a molecular weight of less than 5000 Da {e.g. <4000 Da, <3000 Da, <2000 Da, or <1000 Da). They may function as agonists of one or more of human toll-like receptors TLR1, TLR2, TLR3, TLR4, TLR5, TLR6, TLR7, TLR8, TLR9 and/or TLR11. SMIPs useful with the invention may function as agonists of C-type lectin receptors (CLRs). SMIPs useful with the invention may function as agonists of CD Id. In some embodiments the SMIP is not a phospholipid; if the SMIP is a phospholipid, the emulsion should include the SMIP in addition to the phospholipid as defined herein {e.g. both SMIP and DOPE).

Amphiphilic agonists of TLR1 include lipopeptides. Amphiphilic agonists of TLR2 include glycolipids and lipoteichoic acid, and also lipopeptides {e.g. comprising >1 fatty acid residues and >2 amino acid residues). Amphiphilic agonists of multiple TLR receptors include Pam3Cys (tripalmitoyl-S-glyceryl cysteine; agonises TLR1 and TLR2) and Pam2Cys (dipalmitoyl-S-glyceryl cysteine; agonises TLR2 and TLR6) and their TLR agonist derivatives. Amphiphilic CLR agonists include, but are not limited to, trehalose-6,6-dimycolate (TDM) and its synthetic analog D-(+)-trehalose 6,6'-dibehenate, as well as lipoarabinomannan and MAN-lipoarabinomannan. Amphiphilic CD Id agonists include, but are not limited to, a-galactosylceramide and its derivatives, including its amphiphilic anionic analogues disclosed in reference 3.

Specific amphiphilic SMIPs for use with the invention include, but are not limited to compounds of formula (I), formula (II) and formula (III). Formula (I) is:

wherein: the chiral center labeled * and the one labeled *** are both in the R configuration; the chiral center labeled ** is either in the R or S configuration; each R ^la and R ^lb is independently an aliphatic or cycloaliphatic-aliphatic hydrocarbon group having 7-21 carbon atoms, optionally substituted by oxygen functions, or one of R ^la and R ^lb , but not both, is H; R ² is an aliphatic or cycloaliphatic hydrocarbon group having 1-21 carbon atoms and is optionally substituted by oxygen functions; n is 0 or 1; (As) represents -O-Kw-CO- or -NH-Kw-CO- , where Kw is an aliphatic hydrocarbon group having 1-12 carbon atoms; As ¹ is a D- or L-alpha-amino acid; Z ¹ and Z ² each independently represent -OH, or the N-terminal radical of a D- or L-alpha amino acid, the N-terminal radical of an amino-(lower alkane)-sulfonic acid, or the N-terminal radical of a peptide having up to 6 amino acids selected from the D- and L-alpha aminocarboxylic acids and amino- lower alkyl-sulfonic acids; and Z ³ is H or -CO-Z ⁴ ; Z ⁴ is -OH or the N-terminal radical of a D- or L-alpha amino acid, the N-terminal radical of an amino-(lower alkane)-sulfonic acid, or the N- terminal radical of a peptide having up to 6 amino acids selected from the D and L-alpha aminocarboxylic acids and amino-lower alkyl- sulfonic acids; or an ester or amide formed from the carboxylic acid of such compounds and salts thereof.

Formula (II) is:

O—CH

I I

CH; CH:. wherein: each of R ¹ and R ² separately represents a saturated or unsaturated, aliphatic or mixed aliphatic-cycloaliphatic, hydrocarbon radical having from 8 to 30 (preferably 11 to 21) carbon atoms that is optionally also substituted by oxygen functions: R ³ represents hydrogen or the radical R ¹ -CO-0-CH ₂ -; and X represents an amino acid bonded by a peptide linkage and having a free, esterified or amidated carboxy group, or an amino acid sequence of from 2 to 10 amino acids of which the terminal carboxy group is in free, esterified or amidated form; the chiral centre marked * is in R form; each chiral centre marked ** can be in R or S form. In certain embodiments, the amino acid sequence comprises a D-amino acid, for example, D-glutamic acid (D-Glu) or D-gamma-carboxyglutamic acid (D-Gla).

Suitable amides of formula (I) include -NH ₂ and NH(Ci-C ₈ alkyl, preferably Ci-C ₆ or Ci to C ₄ ), and suitable esters include alkyl esters (Ci-Cs alkyl esters, preferably C ₁ -C6 or Ci to C ₄ ).

Such compounds are disclosed in reference 4. Another suitable lipopeptide is "LP40" as disclosed in reference 5. See also references 6 and 7.

A preferred lipopeptide TLR2 agonist is palmitoyl-Cys(2[R],3-dilauroyloxy-propyl)-Abu-D-Glu- NH ₂ . Cys is a cysteine residue, Abu is an aminobutyric acid residue and Glu is a glutamic acid residue: see exam le 16 of reference 4 (compound 'L' herein, of formula III):

or a pharmaceutically acceptable salt thereof.

Emulsions of the invention may include only one APA or may include multiple APAs.

The concentration of APA in an emulsion of the invention can vary over a wide range e.g. between 10μg/ml to 50mg/ml, between O. lmg/ml to 5mg/ml, between O. lmg/ml to 2mg/ml, or between 0.5mg/ml to 2mg/ml.

Phospholipids

Emulsions of the invention include a phospholipid. Suitable classes of phospholipid include, but are not limited to, phosphatidylethanolamines, phosphatidylcholines, phosphatidylserines, phosphatidylglycerols, etc. Useful phospholipids are listed in Table 1 , including zwitterionic phospholipids and anionic phospholipids (when measured at pH 7). The phospholipid is preferably not a cationic phospholipid (at pH 7), or if a cationic phospholipid is included then it is preferably not the sole phospholipid in the emulsion e.g. the emulsion should also include a neutral, zwitterionic or anionic phospholipid. Thus in some embodiments the emulsion is not a cationic emulsion.

In some embodiments the phospholipid does not include an amino acid residue (although the APA may include an amino acid residue).

In some embodiments the phospholipid is not a SMIP e.g. is not ER804057 or ER804053 [8]. If the phospholipid is a SMIP, the emulsion should include the SMIP in addition to a second phospholipid as defined herein {e.g. both the SMIP-phospholipid and DOPE). In some embodiments the phospholipid is not l,2-dioleoyl-sn-glycero-3-phosphatidylethanolamine (DOPE), l,2-diphytanoyl-sn-glycero-3-phosphoethanolamine (DPyPE), or phosphatidylcholine (PC).

In some embodiments the phospholipid is not DOPE, DPyPE, PC, palmitoyl oleoyl phosphatidylcholine (POPC), dimyristoyl phosphatidylcholine (DMPC), dioleoyl phosphatidylcholine (DOPC), DPPC, dipalmitoyl phosphatidylcholine (DPPC), or palmitoyl linoleyl phosphatidylcholine (PLPC).

Two useful phospholipids for use with the invention are DSPC and DOPC, but the skilled person can select other suitable phospholipids according to their needs and to the other components in the emulsion. The phospholipid can be mixed with an oil to form an oily component which can then be used for formation of an emulsion.

Oil-in-water emulsions

Emulsions of the invention comprise oil droplets in an aqueous bulk phase. The emulsions include a surfactant and this can facilitate formation and stabilisation of the emulsion.

The emulsion may comprise one or more oils. Suitable oil(s) include those from, for example, an animal (such as fish) or a vegetable source. The oil is ideally biodegradable (metabolisable) and biocompatible. Sources for vegetable oils include nuts, seeds and grains. Peanut oil, soybean oil, coconut oil, and olive oil, the most commonly available, exemplify the nut oils. Jojoba oil can be used e.g. obtained from the jojoba bean. Seed oils include safflower oil, cottonseed oil, sunflower seed oil, sesame seed oil and the like. In the grain group, corn oil is the most readily available, but the oil of other cereal grains such as wheat, oats, rye, rice, teff, triticale and the like may also be used. 6-10 carbon fatty acid esters of glycerol and 1 ,2-propanediol, while not occurring naturally in seed oils, may be prepared by hydrolysis, separation and esterification of the appropriate materials starting from the nut and seed oils. Fats and oils from mammalian milk are metabolizable and so may be used. The procedures for separation, purification, saponification and other means necessary for obtaining pure oils from animal sources are well known in the art.

Most fish contain metabolizable oils which may be readily recovered. For example, cod liver oil, shark liver oils, and whale oil such as spermaceti exemplify several of the fish oils which may be used herein. A number of branched chain oils are synthesized biochemically in 5-carbon isoprene units and are generally referred to as terpenoids. Squalane, the saturated analog to squalene, can also be used. Fish oils, including squalene and squalane, are readily available from commercial sources or may be obtained by methods known in the art.

Other useful oils are the tocopherols, particularly in combination with squalene. Where the oil phase of an emulsion includes a tocopherol, any of the α, β, γ, δ, ε or ξ tocopherols can be used, but a-tocopherols are preferred. D-a-tocopherol and DL-a-tocopherol can both be used. A preferred a-tocopherol is DL-a-tocopherol. An oil combination comprising squalene and a tocopherol {e.g. DL-a-tocopherol) can be used. Preferred emulsions comprise squalene, a branched, unsaturated terpenoid (C ₃₀ H5 ₀ ; [(CH ₃ ) ₂ C[=CHCH ₂ CH ₂ C(CH ₃ )] ₂ =CHCH ₂ -] ₂ ; 2,6,10,15,19,23-hexamethyl-2,6, 10,14, 18,22- tetracosahexaene; CAS RN 7683-64-9).

The oil in the emulsion may comprise a combination of oils e.g. squalene and at least one further oil. The aqueous component of the emulsion can be plain water {e.g. w.f.i.) or can include further components e.g. solutes. For instance, it may include salts to form a buffer e.g. citrate or phosphate salts, such as sodium salts. Typical buffers include: a phosphate buffer; a Tris buffer; a borate buffer; a succinate buffer; a histidine buffer; or a citrate buffer. A buffered aqueous phase is preferred, and buffers will typically be included in the 5-20mM range.

The surfactant in the emulsion is preferably biodegradable (metabolisable) and biocompatible. Surfactants can be classified by their 'HLB' (hydrophile/lipophile balance), where a HLB in the range 1-10 generally means that the surfactant is more soluble in oil than in water, and a HLB in the range 10-20 are more soluble in water than in oil. Emulsions preferably comprise at least one surfactant that has a HLB of at least 10 e.g. at least 15, or preferably at least 16.

The invention can be used with surfactants including, but not limited to: the polyoxyethylene sorbitan esters surfactants (commonly referred to as the Tweens), especially polysorbate 20 and polysorbate 80; copolymers of ethylene oxide (EO), propylene oxide (PO), and/or butylene oxide (BO), sold under the DOWFAX™ tradename, such as linear EO/PO block copolymers; octoxynols, which can vary in the number of repeating ethoxy (oxy- 1 ,2-ethanediyl) groups, with octoxynol-9 (Triton X-100, or t-octylphenoxypolyethoxyethanol) being of particular interest; (octylphenoxy)polyethoxyethanol (IGEPAL CA-630/NP-40); phospholipids such as phosphatidylcholine (lecithin); polyoxyethylene fatty ethers derived from lauryl, cetyl, stearyl and oleyl alcohols (known as Brij surfactants), such as triethyleneglycol monolauryl ether (Brij 30); polyoxyethylene-9-lauryl ether; and sorbitan esters (commonly known as the Spans), such as sorbitan trioleate (Span 85) and sorbitan monolaurate. Preferred surfactants for including in the emulsion are polysorbate 80 (Tween 80; polyoxyethylene sorbitan monooleate), Span 85 (sorbitan trioleate), lecithin and Triton X-100.

Mixtures of surfactants can be included in the emulsion e.g. Tween 80/Span 85 mixtures, or Tween 80/Triton-X 100 mixtures. A combination of a polyoxyethylene sorbitan ester such as polyoxyethylene sorbitan monooleate (Tween 80) and an octoxynol such as t-octylphenoxy- polyethoxyethanol (Triton X-100) is also suitable. Another useful combination comprises laureth 9 plus a polyoxyethylene sorbitan ester and/or an octoxynol. Useful mixtures can comprise a surfactant with a HLB value in the range of 10-20 (e.g.polysorbate 80, with a HLB of 15.0) and a surfactant with a HLB value in the range of 1-10 {e.g. sorbitan trioleate, with a HLB of 1.8).

In addition to the oil, aqueous and surfactant components, an emulsion can include further components. For instance, an emulsion can include cholesterol. Preferred amounts of oil (% by volume) in the final emulsion are between 2-20% e.g. 5-15%, 6-14%, 7-13%), 8-12%). A squalene content of about 4-6% or about 9-11% is particularly useful.

Preferred amounts of surfactants (% by weight) in the final emulsion are between 0.001%) and 8%. For example: polyoxyethylene sorbitan esters (such as polysorbate 80) 0.2 to 4%, in particular between 0.4-0.6%, between 0.45-0.55%, about 0.5% or between 1.5-2%, between 1.8-2.2%, between 1.9-2.1%), about 2%, or 0.85-0.95%), or about 1%; sorbitan esters (such as sorbitan trioleate) 0.02 to 2%, in particular about 0.5% or about \%; octyl- or nonylphenoxy polyoxyethanols (such as Triton X-100) 0.001 to 0.1%, in particular 0.005 to 0.02%; polyoxyethylene ethers (such as laureth 9) 0.1 to 8%, preferably 0.1 to 10% and in particular 0.1 to 1% or about 0.5%.

The absolute amounts of oil and surfactant, and their ratio, can be varied within wide limits while still forming an emulsion. A skilled person can easily vary the relative proportions of the components to obtain a desired emulsion, but a weight ratio of between 4: 1 and 5: 1 for oil and surfactant is typical (excess oil). The amounts of these various components may be selected to provide a useful formulation of the relevant APA e.g. to ensure that there is sufficient oil to dissolve the desired dose of APA, etc. , while giving a stable emulsion with high APA loading.

An important parameter for ensuring immunostimulatory activity of an emulsion, particularly in large animals, is the oil droplet size (diameter). The most effective emulsions have a droplet size in the submicron range. Suitably the droplet sizes will be in the range 50-750nm. Most usefully the average droplet size is less than 250nm e.g. less than 200nm, less than 150nm. The average droplet size is usefully in the range of 80-180nm. Ideally, at least 80%o (by number) of the emulsion's oil droplets are less than 250 nm in diameter, and preferably at least 90%. Apparatuses for determining the average droplet size in an emulsion, and the size distribution, are commercially available. These these typically use the techniques of dynamic light scattering and/or single-particle optical sensing e.g. the Accusizer™ and Nicomp™ series of instruments available from Particle Sizing Systems (Santa Barbara, USA), or the Zetasizer™ instruments from Malvern Instruments (UK), or the Particle Size Distribution Analyzer instruments from Horiba (Kyoto, Japan).

Ideally, the distribution of droplet sizes (by number) has only one maximum i. e. there is a single population of droplets distributed around an average (mode), rather than having two maxima. Preferred emulsions have a polydispersity of <0.4 e.g. 0.3, 0.2, or less.

Suitable emulsions with submicron droplets and a narrow size distribution can be obtained by the use of microfluidisation. This technique reduces average oil droplet size by propelling streams of input components through geometrically fixed channels at high pressure and high velocity. These streams contact channel walls, chamber walls and each other. The results shear, impact and cavitation forces cause a reduction in droplet size. Repeated steps of microfluidisation can be performed until an emulsion with a desired droplet size average and distribution are achieved. As an alternative to microfluidisation, thermal methods can be used to cause phase inversion, as disclosed in reference 9. These methods can also provide a submicron emulsion with a tight particle size distribution.

Preferred emulsions can be filter sterilised i. e. their droplets can pass through a 220nm filter. As well as providing a sterilisation, this procedure also removes any large droplets in the emulsion.

Preferred emulsions are adjuvant emulsions i.e. they can provide an in vivo immunostimulatory effect in a mammal even if administered without the amphiphilic agent. Known adjuvant emulsions, in which a amphiphilic agent can be incorporated, include:

• An emulsion comprising squalene, polysorbate 80 (Tween 80), and sorbitan trioleate (Span 85). The composition of the emulsion by volume can be about 5% squalene, about 0.5% polysorbate 80 and about 0.5% sorbitan trioleate. In weight terms, these amounts become 4.3%) squalene, 0.5%) polysorbate 80 and 0.48%> sorbitan trioleate. This adjuvant is known as 'MF59'. The MF59 emulsion advantageously includes citrate ions e.g. lOmM sodium citrate buffer.

• Emulsions comprising squalene, an a-tocopherol (ideally DL-a-tocopherol), and polysorbate 80. These emulsions may have (by weight) from 2 to 10%> squalene, from 2 to 10%> a-tocopherol and from 0.3 to 3% polysorbate 80 e.g. 4.3% squalene, 4.7%o a-tocopherol, 1.9%o polysorbate 80. The weight ratio of squalene:tocopherol is preferably <1 {e.g. 0.90) as this provides a more stable emulsion. Squalene and polysorbate 80 may be present volume ratio of about 5:2, or at a weight ratio of about 11 :5. One such emulsion can be made by dissolving polysorbate 80 in PBS to give a 2%o solution, then mixing 90ml of this solution with a mixture of (5g of DL-a-tocopherol and 5ml squalene), then microfluidizing the mixture. The resulting emulsion may have submicron oil droplets e.g. with an average diameter of between 100 and 250nm, preferably about 180nm.

• An emulsion comprising squalene, a polysorbate {e.g. polysorbate 80), a Triton detergent {e.g.

Triton X-100) and a tocopherol {e.g. an α-tocopherol succinate). The emulsion may include these three components at a mass ratio of about 75: 11 : 10 {e.g. 750μg/ml polysorbate 80, 110μg/ml Triton X-100 and 100μg/ml α-tocopherol succinate), and these concentrations should include any contribution of these components from antigens. The emulsion may also include a 3d-MPL. The emulsion may also include a saponin, such as QS21. The aqueous phase may contain a phosphate buffer.

• An emulsion comprising squalene, an aqueous solvent, a polyoxyethylene alkyl ether hydrophilic nonionic surfactant {e.g. polyoxyethylene (12) cetostearyl ether) and a hydrophobic nonionic surfactant {e.g. a sorbitan ester or mannide ester, such as sorbitan monoleate or 'Span 80'). The emulsion is preferably thermoreversible and/or has at least 90%o of the oil droplets (by volume) with a size less than 200 nm [9]. The emulsion may also include one or more of: alditol; a cryoprotective agent {e.g. a sugar, such as dodecylmaltoside and/or sucrose); and/or an alkylpolyglycoside. It may also include a TLR4 agonist, such as one whose chemical structure does not include a sugar ring [10]. Such emulsions may be lyophilized.

Immunogens

Where the APA is an immune potentiator, emulsions of the invention are useful for co-delivery with immunogens, thereby providing enhanced immunogenicity. Thus an immunogenic composition of the invention can comprise a SMIP-containing emulsion of the invention and an immunogen.

The immunogen may elicit an immune response against a bacterium, a virus, a fungus or a parasite. As an alternative to eliciting an immune response against a pathogen, the immunogen may be a self antigen for immunotherapy e.g. a cancer antigen.

Bacterial immunogens can comprise proteins, saccharides, and/or lipopolysaccharides. They may be live bacteria, inactivated bacteria, or bacterial subunits. Examples of useful immunogens elicit an immune response against:

Neisseria meningitidis: useful immunogens include, but are not limited to, membrane proteins and/or capsular saccharides. Capsular saccharides from serogroups A, C, W135, and/or Y are useful. Adhesins, autotransporters, toxins, iron acquisition proteins, and factor H binding proteins are useful membrane protein immunogens. A preferred vaccine includes the protein antigens disclosed in reference 11.

Streptococcus pneumoniae: useful immunogens include, but are not limited to, proteins and/or capsular saccharides. For example, capsular saccharides from any of pneumococcal serotypes 1, 2, 3, 4, 5, 6A, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19A, 19F, 20, 22F,

23F, and/or 33F can be used.

Streptococcus pyogenes: useful immunogens include, but are not limited to, proteins and/or capsular saccharides. Useful proteins are disclosed in references 12 and 13.

Moraxella catarrhalis.

Bordetella pertussis: Useful pertussis immunogens include, but are not limited to, pertussis toxin or toxoid (PT), filamentous haemagglutinin (FHA), pertactin, and agglutinogens 2 and 3.

Staphylococcus aureus: Useful immunogens include, but are not limited to, proteins and/or capsular saccharides. For example, type 5 and/or type 8 capsular saccharides can be used.

Clostridium tetani: The typical immunogen is tetanus toxoid.

Cornynebacterium diphtheriae: the typical immunogen is diphtheria toxoid.

Haemophilus influenzae type B: the typical Hib immunogen is its capsular saccharide, PRP.

Pseudomonas aeruginosa Streptococcus agalactiae: useful immunogens include, but are not limited to, proteins and/or capsular saccharides. Useful proteins are disclosed in reference 14. Capsular saccharides from one or more of serotypes la, lb, Ia/c, II, III, IV, V, VI, VII and VIII can be used.

Chlamydia trachomatis: Useful immunogens include, but are not limited to, PepA, LcrE, ArtJ, DnaK, CT398, OmpH-like, L7/L12, OmcA, AtoS, CT547, Eno, HtrA and MurG (e.g. as disclosed in reference 15. LcrE [16] and HtrA [17] are two preferred immunogens.

Chlamydia pneumoniae: Useful immunogens include, but are not limited to, the proteins disclosed in reference 18.

Helicobacter pylori: Useful immunogens include, but are not limited to, CagA, VacA, NAP, and/or urease [19].

Escherichia coli: Useful immunogens include, but are not limited to, immunogens derived from enterotoxigenic E. coli (ETEC), enteroaggregative E. coli (EAggEC), diffusely adhering E. coli (DAEC), enteropathogenic E. coli (EPEC), extraintestinal pathogenic E. coli (ExPEC) and/or enterohemorrhagic E. coli (EHEC). ExPEC strains include uropathogenic E.coli (UPEC) and meningitis/sepsis-associated E.coli (MNEC). Useful UPEC immunogens are disclosed in references 20 and 21. Useful MNEC immunogens are disclosed in reference 22. A useful immunogen for several E.coli types is AcfD [23].

Bacillus anthracis

Yersinia pestis: Useful immunogens include, but are not limited to, those disclosed in references 24 and 25.

Salmonella typhi: the typical S. typhi immunogen is its capsular saccharide, Vi.

Where the immunogen is a saccharide, it will usually be conjugated to a carrier protein. For example, pneumococcal, Hib, S.aureus, S. typhi and meningococcal saccharide conjugate vaccines are known in the art. Carrier proteins are typically a bacterial toxin or toxoid (e.g. a diphtheria or tetanus toxoid, or a non-toxic mutant form thereof e.g. CRM197 [26]), but other carriers can be used. For example, suitable carrier proteins include but are not limited to: N. meningitidis outer membrane protein complex [27], synthetic peptides [28,29], heat shock proteins [30,31], pertussis proteins [32,33], cytokines [34], lymphokines [34], hormones [34], growth factors [34], artificial proteins comprising multiple human CD4 ⁺ T cell epitopes from various pathogen-derived antigens [35] such as N19 [36], protein D from H.influenzae [37-39], iron-uptake proteins [40], toxin A or B from C. difficile [41], recombinant P. aeruginosa exoprotein A (rEPA) [42], pneumolysin [43] or its non-toxic derivatives [44], pneumococcal surface protein PspA [45], etc.

Viral immunogens can comprise proteins. They may be live viruses, inactivated viruses, or viral subunits. Examples of useful immunogens elicit an immune response against: Orthomyxovirus: Useful immunogens can be from an influenza A, B or C virus. A live attenuated virus or an inactivated virus can be used, including a whole inactivated virus, a split virus, or viral surface glycoproteins (including hemagglutinin). The vaccine may be monovalent, 2-valent, 3-valent, 4-valent or more.

Paramyxoviridae viruses: Viral immunogens include, but are not limited to, those derived from Pneumoviruses {e.g. respiratory syncytial virus), Paramyxoviruses {e.g. parainfluenza virus), Metapneumoviruses and Morbilliviruses {e.g. measles).

Poxviridae: Viral immunogens include, but are not limited to, those derived from Orthopoxvirus such as Variola vera, including but not limited to, Variola major and Variola minor.

Picornavirus: Viral immunogens include, but are not limited to, those derived from Picornaviruses, such as Enteroviruses, Rhinoviruses, Heparnavirus, Cardioviruses and Aphthoviruses. In one embodiment, the enterovirus is a poliovirus e.g. a type 1, type 2 and/or type 3 poliovirus.

Bunyavirus: Viral immunogens include, but are not limited to, those derived from an Orthobunyavirus, such as California encephalitis virus, a Phlebovirus, such as Rift Valley Fever virus, or a Nairovirus, such as Crimean-Congo hemorrhagic fever virus.

Heparnavirus: Viral immunogens include, but are not limited to, those derived from a Heparnavirus, such as hepatitis A virus (HAV).

Togavirus: Viral immunogens include, but are not limited to, those derived from a Togavirus, such as a Rubivirus, an Alphavirus, or an Arterivirus. This includes rubella virus.

Flavivirus: Viral immunogens include, but are not limited to, those derived from a Flavivirus, such as Tick-borne encephalitis (TBE) virus, Dengue (types 1, 2, 3 or 4) virus, Yellow Fever virus, Japanese encephalitis virus, Kyasanur Forest Virus, West Nile encephalitis virus, St. Louis encephalitis virus, Russian spring-summer encephalitis virus, Powassan encephalitis virus.

Pestivirus: Viral immunogens include, but are not limited to, those derived from a Pestivirus, such as Bovine viral diarrhea (BVDV), Classical swine fever (CSFV) or Border disease (BDV).

Hepadnavirus: Viral immunogens include, but are not limited to, those derived from a Hepadnavirus, such as Hepatitis B virus. A composition can include hepatitis B virus surface antigen (HBsAg).

Other hepatitis viruses: A composition can include an immunogen from a hepatitis C virus, delta hepatitis virus, hepatitis E virus, or hepatitis G virus. Rhabdovirus Viral immunogens include, but are not limited to, those derived from a Rhabdovirus, such as a Lyssavirus (Rabies virus) and Vesiculovirus (VSV).

Caliciviridae: Viral immunogens include, but are not limited to, those derived from Calciviridae, such as Norwalk virus, and Norwalk-like Viruses, such as Hawaii Virus and Snow Mountain Virus.

Coronavirus: Viral immunogens include, but are not limited to, those derived from a SARS coronavirus, avian infectious bronchitis (IBV), Mouse hepatitis virus (MHV), and Porcine transmissible gastroenteritis virus (TGEV). The coronavirus antigens may comprise spike protein.

Retrovirus: Viral immunogens include, but are not limited to, those derived from an Oncovirus, a Lentivirus or a Spumavirus.

Reovirus: Viral immunogens include, but are not limited to, those derived from an Orthoreovirus, a Rotavirus, an Orbivirus, or a Coltivirus.

Parvovirus: Viral immunogens include, but are not limited to, those derived from Parvovirus B19.

Herpesvirus: Viral immunogens include, but are not limited to, those derived from a human herpesvirus, such as, by way of example only, Herpes Simplex Viruses (HSV), Varicella- zoster virus (VZV), Epstein-Barr virus (EBV), Cytomegalovirus (CMV), Human Herpesvirus 6 (HHV6), Human Herpesvirus 7 (HHV7), and Human Herpesvirus 8 (HHV8).

Papovaviruses: Viral immunogens include, but are not limited to, those derived from Papillomaviruses and Polyomaviruses. The Papillomavirus may be of serotype 1, 2, 4, 5, 6, 8, 11, 13, 16, 18, 31, 33, 35, 39, 41, 42, 47, 51, 57, 58, 63 or 65 e.g. from one or more of serotypes 6, 11, 16 and/or 18.

Adenovirus: Viral immunogens include those derived from adenovirus serotype 36 (Ad-36).

Fungal immunogens may be derived from Dermatophytres, including: Epidermophyton floccusum, Microsporum audouini, Microsporum canis, Microsporum distortum, Microsporum equinum, Microsporum gypsum, Microsporum nanum, Trichophyton concentricum, Trichophyton equinum, Trichophyton gallinae, Trichophyton gypseum, Trichophyton megnini, Trichophyton mentagrophytes, Trichophyton quinckeanum, Trichophyton rubrum, Trichophyton schoenleini, Trichophyton tonsurans, Trichophyton verrucosum, T. verrucosum var. album, var. discoides, var. ochraceum, Trichophyton violaceum, and/or Trichophyton faviforme; or from Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger, Aspergillus nidulans, Aspergillus terreus, Aspergillus sydowi, Aspergillus flavatus, Aspergillus glaucus, Blastoschizomyces capitatus, Candida albicans, Candida enolase, Candida tropicalis, Candida glabrata, Candida krusei, Candida parapsilosis, Candida stellatoidea, Candida kusei, Candida parakwsei, Candida lusitaniae, Candida pseudotropicalis, Candida guilliermondi, Cladosporium carrionii, Coccidioides immitis, Blastomyces dermatidis, Cryptococcus neoformans, Geotrichum clavatum, Histoplasma capsulatum, Klebsiella pneumoniae, Microsporidia, Encephalitozoon spp., Septata intestinalis and Enterocytozoon bieneusi; the less common are Brachiola spp, Microsporidium spp., Nosema spp., Pleistophora spp., Trachipleistophora spp., Vittaforma spp Paracoccidioides brasiliensis, Pneumocystis carinii, Pythiumn insidiosum, Pityrosporum ovale, Sacharomyces cerevisae, Saccharomyces boulardii, Saccharomyces pombe, Scedosporium apiosperum, Sporothrix schenckii, Trichosporon beigelii, Toxoplasma gondii, Penicillium marneffei, Malassezia spp., Fonsecaea spp., Wangiella spp., Sporothrix spp., Basidiobolus spp., Conidiobolus spp., Rhizopus spp, Mucor spp, Absidia spp, Mortierella spp, Cunninghamella spp, Saksenaea spp., Alternaria spp, Curvularia spp, Helminthosporium spp, Fusarium spp, Aspergillus spp, Penicillium spp, Monolinia spp, Rhizoctonia spp, Paecilomyces spp, Pithomyces spp, and Cladosporium spp.

Emulsion formation

Emulsions of the invention can be made by various methods. As mentioned above, microfluidisation or phase inversion can be used to provide emulsions with small oil droplets. Ideally the emulsion's components are combined before these techniques are used e.g. such that all of components are microfluidised together. In other embodiments, though, an emulsion may be formed from the aqueous, surfactant and oil components, and then the APA and phospholipid can be added. Usually the APA and phospholipid are added to the oil, and this oily mixture is combined with the aqueous component prior to microfluidisation, with surfactant being added either as a third component or as part of the oily or aqueous component. Other orders of mixing can also be used. In general, an immunogen will be added after an emulsion is formed e.g. after microfluidisation.

One method for forming the emulsion comprises combining aqueous, oil and surfactant components with an organic solution of the APA e.g. in a volatile organic solvent such as dichloromethane or methylene chloride. The mixture volatile solvent can then be evaporated e.g. after can be homogenisation of the mixture. After evaporation the homogenised mixture can be microfluidised.

Pharmaceutical compositions and products

Emulsions and immunogenic compositions of the invention are for in vivo use (in humans or animals) and so should include only pharmaceutically acceptable components. Useful pharmaceutical components, such as carrier(s) and/or excipient(s), are discussed in reference 46.

Pharmaceutical compositions may include one or more preservatives, such as thiomersal or 2-phenoxyethanol. Mercury- free compositions are preferred, and preservative-free vaccines can be prepared.

Pharmaceutical compositions can have an osmolality of between 200 mOsm/kg and 400 mOsm/kg, e.g. between 240-360 mOsm/kg, or between 290-310 mOsm/kg. Pharmaceutical compositions typically have a pH between 5.0 and 9.5 e.g. between 6.0 and 8.0.

Pharmaceutical compositions are preferably sterile.

Pharmaceutical compositions preferably non-pyrogenic e.g. containing <1 EU (endotoxin unit, a standard measure) per dose, and preferably <0.1 EU per dose.

Pharmaceutical compositions are preferably gluten free.

Pharmaceutical compositions of the invention may be prepared in unit dose form. In some embodiments a unit dose may have a volume of between 0.1-1.0ml e.g. about 0.5ml.

The compositions may be prepared as injectables e.g. for intramuscular injection.

Methods of treatment and medical uses

The invention provides a method for raising an immune response in a mammal comprising the step of administering an effective amount of an immunogenic composition of the invention. The immune response is preferably protective and preferably involves antibodies and/or cell-mediated immunity. The method may raise a booster response.

The invention also provides an emulsion or immunogenic composition of the invention for use in raising an immune response in a mammal.

The invention also provides the use of an emulsion or immunogenic composition of the invention in the manufacture of a medicament for raising an immune response in a mammal.

By raising an immune response in the mammal by these uses and methods, the mammal can be protected against various diseases and/or infections e.g. against bacterial and/or viral diseases as discussed above.

The invention also provides a delivery device containing an immunogenic composition of the invention. This device can be used to administer the composition to a mammalian subject.

The mammal is preferably a human. Where the vaccine is for prophylactic use, the human is preferably a child {e.g. a toddler or infant) or a teenager; where the vaccine is for therapeutic use, the human is preferably a teenager or an adult. A vaccine intended for children may also be administered to adults e.g. to assess safety, dosage, immunogenicity, etc.

Compositions of the invention will generally be administered directly to a patient. Direct delivery may be accomplished by parenteral injection {e.g. subcutaneously, intraperitoneally, intravenously, intramuscularly, or to the interstitial space of a tissue), or mucosally, such as by rectal, oral {e.g. tablet, spray), vaginal, topical, transdermal or transcutaneous, intranasal, ocular, aural, pulmonary or other mucosal administration.

The invention may be used to elicit systemic and/or mucosal immunity, preferably to elicit an enhanced systemic and/or mucosal immunity. Preferably the enhanced systemic and/or mucosal immunity is reflected in an enhanced TH1 and/or TH2 immune response. Preferably, the enhanced immune response includes an increase in the production of IgGl and/or IgG2a and/or IgA.

Dosage can be by a single dose schedule or a multiple dose schedule. Multiple doses may be used in a primary immunisation schedule and/or in a booster immunisation schedule. In a multiple dose schedule the various doses may be given by the same or different routes e.g. a parenteral prime and mucosal boost, a mucosal prime and parenteral boost, etc. Multiple doses will typically be administered at least 1 week apart {e.g. about 2 weeks, about 3 weeks, about 4 weeks, about 6 weeks, about 8 weeks, about 10 weeks, about 12 weeks, about 16 weeks, etc.). In one embodiment, multiple doses may be administered approximately 6 weeks, 10 weeks and 14 weeks after birth, e.g. at an age of 6 weeks, 10 weeks and 14 weeks, as often used in the World Health Organisation's Expanded Program on Immunisation ("EPI"). In an alternative embodiment, two primary doses are administered about two months apart, e.g. about 7, 8 or 9 weeks apart, followed by one or more booster doses about 6 months to 1 year after the second primary dose, e.g. about 6, 8, 10 or 12 months after the second primary dose. In a further embodiment, three primary doses are administered about two months apart, e.g. about 7, 8 or 9 weeks apart, followed by one or more booster doses about 6 months to 1 year after the third primary dose, e.g. about 6, 8, 10, or 12 months after the third primary dose.

Vaccines prepared according to the invention may be used to treat both children and adults. Thus a human patient may be less than 1 year old, less than 5 years old, 1-5 years old, 5-15 years old, 15-55 years old, or at least 55 years old. Preferred patients for receiving the vaccines are the elderly {e.g. >50 years old, >60 years old, and preferably >65 years), the young {e.g. <5 years old), hospitalised patients, healthcare workers, armed service and military personnel, pregnant women, the chronically ill, or immunodeficient patients. The vaccines are not suitable solely for these groups, however, and may be used more generally in a population.

General

The term "comprising" encompasses "including" as well as "consisting" e.g. a composition "comprising" X may consist exclusively of X or may include something additional e.g. X + Y.

The word "substantially" does not exclude "completely" e.g. a composition which is "substantially free" from Y may be completely free from Y. Where necessary, the word "substantially" may be omitted from the definition of the invention.

The term "about" in relation to a numerical value x is optional and means, for example, x+10%.

Unless specifically stated, a process comprising a step of mixing two or more components does not require any specific order of mixing. Thus components can be mixed in any order. Where there are three components then two components can be combined with each other, and then the combination may be combined with the third component, etc. Where animal (and particularly bovine) materials are used in the culture of cells, they should be obtained from sources that are free from transmissible spongiform encaphalopathies (TSEs), and in particular free from bovine spongiform encephalopathy (BSE). Overall, it is preferred to culture cells in the total absence of animal-derived materials.

Where a compound is administered to the body as part of a composition then that compound may alternatively be replaced by a suitable prodrug.

MODES FOR CARRYING OUT THE INVENTION

Reference 6 uses amphiphilic TLR2 agonists for stimulating immune responses. Although these compounds have lipophilic tails they are not soluble in oil at concentrations which would be desirable for in vivo use. For example, adding compound 'L' to MF59 (emulsion "ANE04" or "ANE25") at a concentration of 0.5mg/ml gave an emulsion with only 50% loading.

The emulsion's capacity for solubilising the agonist was increased to 100% by adding DSPC to the emulsion. DSPC is a CI 8 phospholipid and it was conveniently incorporated by mixing it with squalene prior to microfluidisation of the emulsion components. Although the emulsion's loading was increased its droplet size remained consistent, indicating that the addition of phospholipid did not have a negative impact on its stability.

Loading of 'L' in emulsions ANE29, ANE30 and ANE26 was as follows, with a simple monodispersion of 'L' included for comparison:

Thus the low loading seen with ANE29 (similar to ANE04 and ANE25) was addressed by adding phospholipid.

Emulsion details and characterisation

Specific emulsions which were tested are as follows, with a 20ml volume:

T80 = Tween 80; S85 = Span 85; PC = egg phosphatidylcholine; sq = squalene

These emulsions were generally prepared as follows. Lipophilic components (squalene, span 85, phospholipids) were combined in a beaker. 'L' was sonicated in trichloromethane to form a suspension of 'L' and this suspension was then added to the beaker. The oil phase was then combined with the aqueous phase and immediately homogenized for 2 minutes using an IKA T25 homogenizer at 24K RPM in order to provide a homogeneous feedstock. Emulsions were immediately emulsified and then allowed to sit at room temperature on a stirplate for 2-3 hours after primary homogenization in a fume hood. The primary emulsions were passed three to five times through a Microfluidizer MHOS homogenizer with an ice bath cooling coil at a homogenization pressure of approximately 15k - 20k PSI (Microfluidics, Newton, MA). The 20ml batch samples were removed from the unit and stored at 4°C, and 5ml aliquots were stored at room temperature to assess stability.

Particle size of emulsions was measured using a Zetasizer Nano ZS (Malvern Instruments,) and a LA-920 Particle Distribution Analyzer (Horiba), according to the manufacturers' guidelines. Particles were diluted in deionised water. The Horiba instrument provides dlO, d50 and d90 values i.e. the diameters which divide the droplets in the sample into 10%, 50% and 90% (respectively) by mass. Results were as follows:

It will be understood that the invention has been described by way of example only and modifications may be made whilst remaining within the scope and spirit of the invention.

TABLE 1: useful phospholipids

DDPC 1,2- Didecanoyl-sn-Glycero-3-phosphatidylcholine

DEPA-NA 1,2- Dierucoyl-sn-Glycero-3-Phosphate(Sodium Salt)

DEPC 1,2- Erucoyl-sn-Glycero-3-phosphatidylcholine

DEPE 1,2- Dierucoyl-sn-Glycero-3-phosphatidylethanolamine

DEPG-NA 1,2- Dierucoyl-sn-Glycero-3 [Phosphatidyl-rac-( 1 -glycerol...)

DLOPC 1,2- Linoleoyl-sn-Glycero-3-phosphatidylcholine

DLPA-NA 1,2- Dilauroyl-sn-Glycero-3-Phosphate(Sodium Salt)

DLPC 1,2- Dilauroyl-sn-Glycero-3-phosphatidylcholine

DLPE 1,2- Dilauroyl-sn-Glycero-3-phosphatidylethanolamine

DLPG-NA 1,2- Dilauroyl-sn-Glycero-3[Phosphatidyl-rac-(l -glycerol...) (Sodium Salt)

DLPG-NH4 1,2- Dilauroyl-sn-Glycero-3 [Phosphatidyl-rac-( 1 -glycerol...)

DLPS-NA 1,2- Dilauroyl-sn-Glycero-3-phosphatidylserine(Sodium Salt)

DMPA-NA 1,2- Diimyristoyl-sn-Glycero-3-Phosphate(Sodium Salt)

DMPC 1,2- Dimyristoyl-sn-Glycero-3-phosphatidylcholine

DMPE 1,2- Dimyristoyl-sn-Glycero-3-phosphatidylethanolamine

DMPG-NA 1,2- Myristoyl-sn-Glycero-3 [Phosphatidyl-rac-( 1 -glycerol...)

DMPG-NH4 1,2- Myristoyl-sn-Glycero-3 [Phosphatidyl-rac-( 1 -glycerol...)

DMPG-NH4/NA 1 ,2-Myristoyl-sn-Glycero-3 [Phosphatidyl-rac-( 1 -glycerol...)

DMPS-NA 1,2- Dimyristoyl-sn-Glycero-3-phosphatidylserine(Sodium Salt)

DOPA-NA 1,2- Dioleoyl-sn-Glycero-3-Phosphate(Sodium Salt)

DOPC 1,2- Dioleoyl-sn-Glycero-3-phosphatidylcholine

DOPE 1,2- Dioleoyl-sn-Glycero-3-phosphatidylethanolamine

DOPG-NA 1,2- Dioleoyl-sn-Glycero-3 [Phosphatidyl-rac-( 1 -glycerol...)

DOPS-NA 1,2- Dioleoyl-sn-Glycero-3-phosphatidylserine(Sodium Salt)

DPPA-NA 1,2- Dipalmitoyl-sn-Glycero-3-Phosphate(Sodium Salt)

DPPC 1,2- Dipalmitoyl-sn-Glycero-3-phosphatidylcholine

DPPE 1,2- Dipalmitoyl-sn-Glycero-3-phosphatidylethanolamine

DPPG-NA 1,2- Dipalmitoyl-sn-Glycero-3 [Phosphatidyl-rac-( 1 -glycerol...)

DPPG-NH4 1,2- Dipalmitoyl-sn-Glycero-3 [Phosphatidyl-rac-( 1 -glycerol...)

DPPS-NA 1,2- Dipalmitoyl-sn-Glycero-3-phosphatidylserine(Sodium Salt)

DPyPE 1,2- diphytanoyl-sn-glycero-3-phosphoethanolamine

DSPA-NA 1,2- Distearoyl-sn-Glycero-3-Phosphate(Sodium Salt)

DSPC 1,2- Distearoyl-sn-Glycero-3-phosphatidylcholine

DSPE 1,2- Diostearpyl-sn-Glycero-3-phosphatidylethanolamine

DSPG-NA 1,2- Distearoyl-sn-Glycero-3 [Phosphatidyl-rac-( 1 -glycerol...)

DSPG-NH4 1,2- Distearoyl-sn-Glycero-3 [Phosphatidyl-rac-( 1 -glycerol...)

DSPS-NA 1,2- Distearoyl-sn-Glycero-3-phosphatidylserine(Sodium Salt)

EPC Εεε phosphatidylcholine HEPC Hydrogenated Egg phosphatidylcholine

HSPC High purity Hydrogenated Soy phosphatidylcholine

HSPC Hydrogenated Soy phosphatidylcholine

LYSOPC MYRISTIC 1 -Myristoyl-sn-Glycero-3 -phosphatidylcholine

LYSOPC PALMITIC l-Palmitoyl-sn-Glycero-3-phosphatidylcholine

LYSOPC STEARIC l-Stearoyl-sn-Glycero-3-phosphatidylcholine

Milk Sphingomyelin MPPC l-Myristoyl,2-palmitoyl-sn-Glycero 3 -phosphatidylcholine

MSPC l-Myristoyl,2-stearoyl-sn-Glycero-3-phosphatidylcholine

PMPC l-Palmitoyl,2-myristoyl-sn-Glycero-3-phosphatidylcholine

POPC l-Palmitoyl,2-oleoyl-sn-Glycero-3 -phosphatidylcholine

POPE l-Palmitoyl-2-oleoyl-sn-Glycero-3 -phosphatidyl ethanolamine

POPG-NA l ,2-Dioleoyl-sn-Glycero-3[Phosphatidyl-rac-(l -glycerol)...](Sodium Salt)

PSPC l-Palmitoyl,2-stearoyl-sn-Glycero-3-phosphatidylcholine

SMPC l-Stearoyl,2-myristoyl-sn-Glycero-3-phosphatidylcholine

SOPC l-Stearoyl,2-oleoyl-sn-Glycero-3-phosphatidylcholine

SPPC l-Stearoyl,2-palmitoyl-sn-Glycero-3-phosphatidylcholine

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