<p>Therapeutic vaccination for chronic hepatitis B (CHB) remains challenging, as persistent immune tolerance to hepatitis B surface antigen (HBsAg) impedes anti-HBsAg seroconversion. Here we show that screening antigen combinations incorporating HBsAg identifies preS1-HBsAg as the optimal pairing. The resulting dual-antigen mRNA vaccine elicits robust hepatitis B virus (HBV)-specific immune responses in chronic HBV mouse models, leading to near-complete viral genome clearance, marked reduction of multiple HBV antigens, and serological conversion. Mechanistic analyses reveal that preS1 serves as the primary driver of HBV-specific T cell responses, while HBsAg contributes to both anti-HBsAg seroconversion and intrinsic adjuvant activity. Specifically, when delivered in mRNA form, HBsAg promotes antigen-presenting cell (APC) activation, enhances antigen presentation, and amplifies preS1-specific CD8⁺ T cell responses. Furthermore, combining the preS1-HBsAg vaccine with interferon-α (IFN-α) enhances antiviral efficacy and immune memory while maintaining a favorable safety profile. These findings establish preS1-HBsAg mRNA vaccination as a promising and translatable therapeutic strategy for functional cure of CHB.</p>

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Engineering a dual-antigen mRNA vaccine to restore immune control in chronic hepatitis B

  • Baowen Zhang,
  • Yiyuan Wang,
  • Da Chen,
  • Mingyang Li,
  • Jiachen Zhang,
  • Yi Wu,
  • Jinxing Xia,
  • Xianyong Meng,
  • Yucai Wang,
  • Min Li

摘要

Therapeutic vaccination for chronic hepatitis B (CHB) remains challenging, as persistent immune tolerance to hepatitis B surface antigen (HBsAg) impedes anti-HBsAg seroconversion. Here we show that screening antigen combinations incorporating HBsAg identifies preS1-HBsAg as the optimal pairing. The resulting dual-antigen mRNA vaccine elicits robust hepatitis B virus (HBV)-specific immune responses in chronic HBV mouse models, leading to near-complete viral genome clearance, marked reduction of multiple HBV antigens, and serological conversion. Mechanistic analyses reveal that preS1 serves as the primary driver of HBV-specific T cell responses, while HBsAg contributes to both anti-HBsAg seroconversion and intrinsic adjuvant activity. Specifically, when delivered in mRNA form, HBsAg promotes antigen-presenting cell (APC) activation, enhances antigen presentation, and amplifies preS1-specific CD8⁺ T cell responses. Furthermore, combining the preS1-HBsAg vaccine with interferon-α (IFN-α) enhances antiviral efficacy and immune memory while maintaining a favorable safety profile. These findings establish preS1-HBsAg mRNA vaccination as a promising and translatable therapeutic strategy for functional cure of CHB.