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Viewpoint | Scientific Discovery and the Future of Medicine

Broadly Neutralizing Antibodies and the Development of Vaccines

Barton F. Haynes, MD1,2,3; Todd Bradley, PhD1,3
[+] Author Affiliations
1Duke Human Vaccine Institute, Duke University School of Medicine, Durham, North Carolina
2Department of Medicine, Duke University School of Medicine, Durham, North Carolina
3Department of Immunology, Duke University School of Medicine, Durham, North Carolina
JAMA. 2015;313(24):2419-2420. doi:10.1001/jama.2015.2427.
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This Viewpoint discusses the importance and progress of neutralizing human immunodeficiency virus through efforts to induce broadly reactive neutralizing antibodies.

Human immunodeficiency virus (HIV) infects 2.5 million people worldwide and accounts for more than 1 million deaths every year. Thus, an HIV vaccine is desperately needed. One roadblock to development of an effective HIV vaccine is the extraordinary ability of HIV to mutate and evolve into myriad quasi-species. Therefore, a key goal in developing a successful HIV vaccine is the induction of antibodies that can recognize and neutralize the majority of HIV quasi-species, called broadly reactive neutralizing antibodies (bnAbs). The search for an HIV vaccine has led to a greater understanding of bnAbs.

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Figure 1.
B-Cell Lineage Immunogen Design for Vaccine Development

For human immunodeficiency virus (HIV) infection, envelopes of optimal binding affinity for the germline B-cell antibody of the broadly reactive neutralizing antibody (bnAb) lineage can be designed to start off the bnAb lineage. Additional selected envelope variants that are optimal for binding to subsequent B-cell lineage members would be used as boosts to drive the desired lineage progression to bnAb-producing B-cells.

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