1.1 Progress and challenges in the new age of engineering immunity
The immune system plays a critical role in our health. No other component of human physiology plays a decisive role in as diverse an array of maladies, from deadly diseases with which we are all familiar to equally terrible esoteric conditions: HIV, malaria, pneumococcal and influenza infections; cancer; atherosclerosis; autoimmune diseases such as lupus, diabetes, and multiple sclerosis. The importance of understanding the function of the immune system and learning how to modulate immunity to protect against or treat disease thus cannot be overstated. Fortunately, we are entering an exciting era where the science of immunology is defining pathways for the rational manipulation of the immune system at the cellular and molecular level, and this understanding is leading to dramatic advances in the clinic that are transforming the future of medicine.1,2 These initial advances are being made primarily through biologic drugs– recombinant proteins (especially antibodies) or patient-derived cell therapies– but exciting data from preclinical studies suggest that a marriage of approaches based in biotechnology with the materials science and chemistry of nanomaterials, especially nanoparticles, could enable more effective and safer immune engineering strategies. This review will examine these nanoparticle-based strategies to immune modulation in detail, and discuss the promise and outstanding challenges facing the field of immune engineering from a chemical biology/materials engineering perspective.



1.1.1 Key cellular actors in the immune system 
A brief summary of the cellular players in the immune response is worthwhile to preface the many immunomodulatory approaches described in this review. The immune system can be viewed at a high level as a collection of mobile cells that include members that traffic throughout the body in search of invading pathogens as well as cells that reside as sentinels at portals of entry (i.e. the airways, skin, gastrointestinal tract, etc.).3 These cells belong to one of two major arms, the innate immune system and adaptive immune system. Innate immune cells such as neutrophils and macrophages are poised to rapidly respond to pathogen invasion, expressing receptors that recognize conserved molecular motifs characteristic of bacteria, viruses, and fungi, to quickly phagocytose (internalize) microbes and secrete reactive oxygen species or cytokines that provide an immediate response to invading pathogens. The adaptive immune system is comprised of T-cells and B-cells, including CD4+ helper T-cells that secrete cytokines to direct the functions of innate cells, killer cells, and B-cells; and CD8+ killer T-cells that recognize and destroy infected or transformed cells. B-cells play a canonical role in vaccine responses by producing antibodies that bind to and neutralize the ability of microbes to invade host cells and/or promote their phagocytosis. The adaptive immune system is so named because of the clonal nature of T and B lymphocytes– each T-cell and B-cell expresses a unique T-cell receptor or B-cell receptor, respectively, which is generated in part by a process of stochastic DNA recombination, enabling the pool of lymphocytes the potential to recognize any microbial antigen they may encounter.4 When a T- or B-cell binds an antigen (essentially, any biological molecule from a microbe that is recognized by a T-cell receptor (TCR) or B-cell receptor (BCR)), this triggers massive proliferation of the antigen-specific cell, generating a pool of effectors within ~7 days following exposure. These effector T-cells and B-cells play an important role in backing up innate immune defenses to clear the invading pathogen. Following pathogen clearance, the majority of these cells (~90%) undergo programmed cell death, leaving a small pool of differentiated memory cells that can remain for the lifetime of the individual, to provide rapid recall protection if the same microbe is ever encountered again.5 A final key group of immune cells are the antigen presenting cells (APCs), and particularly a critical APC known as the dendritic cell, which is responsible for activating naive T-cells (and in some cases B-cells).6,7 Dendritic cells (DCs) are innate-like cells that reside in all peripheral tissues, and which act as sentinels, collecting antigens from the surrounding fluid and staying on constant alert for “danger signals”- molecular motifs signifying tissue damage or pathogen invasion. DCs and other immune cells express a host of receptors that specifically recognize danger signals to trigger their activation; the most studied among these receptors are the Toll-like receptors.8 If activated by danger signals, DCs migrate from their home tissue through the lymphatic vessels to local draining lymph nodes, where they physically present antigen to T-cells and B-cells. For T-cell activation, this is through the loading of short (8–15 amino acids) peptide fragments of antigens into the cleft of major histocompatibility complex (MHC) molecules displayed on the DC surface. These peptides are surveyed by the TCRs of T-cells, and on finding a cognate peptide, T-cells become activated by the DC to proliferate and carry out their effector functions.

The vastly complex set of cellular interactions summarized above (greatly oversimplified) is the network of interest to those interested in immune engineering, and in this review we aim to summarize the myriad ways in which materials scientists, chemical engineers, bioengineers, chemists, and physicists (often in collaboration with immunologists) are using nanomaterials as powerful tools to probe or manipulate immune responses for therapeutic ends. To set the stage for the rest of the review, we will briefly discuss two of the areas where synthetic nanoparticles have the prospect to play a significant role in the ongoing revolution of immunology in medicine– vaccines and active immunotherapy.

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Synthetic Nanoparticles for Vaccines and Immunotherapy

Adjuvants are vaccine components that enhance the magnitude, breadth and durability of the immune response. Following its introduction in the 1920s, alum remained the only adjuvant licensed for human use for the next 70 years. Since the 1990s, a further five adjuvants have been included in licensed vaccines, but the molecular mechanisms by which these adjuvants work remain only partially understood. However, a revolution in our understanding of the activation of the innate immune system through pattern recognition receptors (PRRs) is improving the mechanistic understanding of adjuvants, and recent conceptual advances highlight the notion that tissue damage, different forms of cell death, and metabolic and nutrient sensors can all modulate the innate immune system to activate adaptive immunity. Furthermore, recent advances in the use of systems biology to probe the molecular networks driving immune response to vaccines ('systems vaccinology') are revealing mechanistic insights and providing a new paradigm for the vaccine discovery and development process. Here, we review the 'known knowns' and 'known unknowns' of adjuvants, discuss these emerging concepts and highlight how our expanding knowledge about innate immunity and systems vaccinology are revitalizing the science and development of novel adjuvants for use in vaccines against COVID-19 and future pandemics.

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Emerging concepts in the science of vaccine adjuvants.

mRNA vaccines elicit a potent immune response including antibodies and cytotoxic T cells. mRNA vaccines are currently evaluated in clinical trials for cancer immunotherapy applications, but also have great potential as prophylactic vaccines. Efficient delivery of mRNA vaccines will be key for their success and translation to the clinic. Among potential nonviral vectors, lipid nanoparticles are particularly promising. Indeed, lipid nanoparticles can be synthesized with relative ease in a scalable manner, protect the mRNA against degradation, facilitate endosomal escape, can be targeted to the desired cell type by surface decoration with ligands, and as needed, can be codelivered with adjuvants.

mRNA vaccine delivery using lipid nanoparticles.

The efficacy of vaccine adjuvants such as Toll-like receptor agonists (TLRa) can be improved through formulation and delivery approaches. Here, we attached small molecule TLR-7/8a to polymer scaffolds (polymer-TLR-7/8a) and evaluated how different physicochemical properties of the TLR-7/8a and polymer carrier influenced the location, magnitude and duration of innate immune activation in vivo. Particle formation by polymer-TLR-7/8a was the most important factor for restricting adjuvant distribution and prolonging activity in draining lymph nodes. The improved pharmacokinetic profile by particulate polymer-TLR-7/8a was also associated with reduced morbidity and enhanced vaccine immunogenicity for inducing antibodies and T cell immunity. We extended these findings to the development of a modular approach in which protein antigens are site-specifically linked to temperature-responsive polymer-TLR-7/8a adjuvants that self-assemble into immunogenic particles at physiologic temperatures in vivo. Our findings provide a chemical and structural basis for optimizing adjuvant design to elicit broad-based antibody and T cell responses with protein antigens.

In vivo characterization of the physicochemical properties of polymer-linked TLR agonists that enhance vaccine immunogenicity

The need to optimize vaccine potency while minimizing toxicity in healthy recipients has motivated studies of the formulation of vaccines to control how, when, and where antigens and adjuvants encounter immune cells and other cells/tissues following administration. An effective subunit vaccine must traffic to lymph nodes (LNs), activate both the innate and adaptive arms of the immune system, and persist for a sufficient time to promote a mature immune response. Here, we review approaches to tailor these three aspects of vaccine function through optimized formulations. Traditional vaccine adjuvants activate innate immune cells, promote cell-mediated transport of antigen to lymphoid tissues, and promote antigen retention in LNs. Recent studies using nanoparticles and other lymphatic-targeting strategies suggest that direct targeting of antigens and adjuvant compounds to LNs can also enhance vaccine potency without sacrificing safety. The use of formulations to regulate biodistribution and promote antigen and inflammatory cue co-uptake in immune cells may be important for next-generation molecular adjuvants. Finally, strategies to program vaccine kinetics through novel formulation and delivery strategies provide another means to enhance immune responses independent of the choice of adjuvant. These technologies offer the prospect of enhanced efficacy while maintaining high safety profiles necessary for successful vaccines.

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Beyond antigens and adjuvants: formulating future vaccines

Adjuvants increase vaccine potency largely by activating innate immunity and promoting inflammation. Limiting the side effects of this inflammation is a major hurdle for adjuvant use in vaccines for humans. It has been difficult to improve on adjuvant safety because of a poor understanding of adjuvant mechanism and the empirical nature of adjuvant discovery and development historically. We describe new principles for the rational optimization of small-molecule immune potentiators (SMIPs) targeting Toll-like receptor 7 as adjuvants with a predicted increase in their therapeutic indices. Unlike traditional drugs, SMIP-based adjuvants need to have limited bioavailability and remain localized for optimal efficacy. These features also lead to temporally and spatially restricted inflammation that should decrease side effects. Through medicinal and formulation chemistry and extensive immunopharmacology, we show that in vivo potency can be increased with little to no systemic exposure, localized innate immune activation and short in vivo residence times of SMIP-based adjuvants. This work provides a systematic and generalizable approach to engineering small molecules for use as vaccine adjuvants.

Rational design of small molecules as vaccine adjuvants

The present disclosure relates to a class of pyrimidine derivatives of formula (I) having immunomodulating properties that act via TLR7 which are useful in the treatment of lung cancer and other respiratory conditions.

Pyrimidine compounds containing acidic groups useful to treat diseases connected to the modulation of tlr7

The invention provided herein includes pharmaceutical compositions comprising a TLR7 agonist having the structure of Formula (A), aluminum-containing particles, and one or more pharmaceutically acceptable excipient. The invention further provides the use of such compositions in the treatment of solid tumors either alone or in combination with one or more additional pharmaceutical compositions.

Miller Andrew T

Papers

Rational design of small molecules as vaccine adjuvants

Pyrimidine compounds containing acidic groups useful to treat diseases connected to the modulation of tlr7

Compositions comprising naphthyridine derivatives and aluminium adjuvant for use in treating solid tumors