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  1. Article ; Online: Evaluation of bird-adapted self-amplifying mRNA vaccine formulations in chickens.

    Comes, Jerome D G / Doets, Kristel / Zegers, Thijmen / Kessler, Merel / Slits, Irene / Ballesteros, Natalia A / van de Weem, Noortje M P / Pouwels, Henk / van Oers, Monique M / van Hulten, Marielle C W / Langereis, Martijn / Pijlman, Gorben P

    Vaccine

    2024  Volume 42, Issue 11, Page(s) 2895–2908

    Abstract: Each year, millions of poultry succumb to highly pathogenic avian influenza A virus (AIV) and infectious bursal disease virus (IBDV) infections. Conventional vaccines based on inactivated or live-attenuated viruses are useful tools for disease prevention ...

    Abstract Each year, millions of poultry succumb to highly pathogenic avian influenza A virus (AIV) and infectious bursal disease virus (IBDV) infections. Conventional vaccines based on inactivated or live-attenuated viruses are useful tools for disease prevention and control, yet, they often fall short in terms of safety, efficacy, and development times. Therefore, versatile vaccine platforms are crucial to protect poultry from emerging viral pathogens. Self-amplifying (replicon) RNA vaccines offer a well-defined and scalable option for the protection of both animals and humans. The best-studied replicon platform, based on the Venezuelan equine encephalitis virus (VEEV; family Togaviridae) TC-83 vaccine strain, however, displays limited efficacy in poultry, warranting the exploration of alternative, avian-adapted, replicon platforms. In this study, we engineered two Tembusu virus (TMUV; family Flaviviridae) replicons encoding varying capsid gene lengths and compared these to the benchmark VEEV replicon in vitro. The TMUV replicon system exhibited a robust and prolonged transgene expression compared to the VEEV replicon system in both avian and mammalian cells. Moreover, the TMUV replicon induced a lesser cytopathic effect compared to the VEEV replicon RNA in vitro. DNA-launched versions of the TMUV and VEEV replicons (DREP) were also developed. The replicons successfully expressed the AIV haemagglutinin (HA) glycoproteins and the IBDV capsid protein (pVP2). To assess the immune responses elicited by the TMUV replicon system in chickens, a prime-boost vaccination trial was conducted using lipid nanoparticle (LNP)-formulated replicon RNA and DREP encoding the viral (glyco)proteins of AIV or IBDV. Both TMUV and VEEV replicon RNAs were unable to induce a humoral response against AIV. However, TMUV replicon RNA induced IBDV-specific seroconversion in vaccinated chickens, in contrast to VEEV replicon RNA, which showed no significant humoral response. In both AIV and IBDV immunization studies, VEEV DREP generated the highest (neutralizing) antibody responses, which underscores the potential for self-amplifying mRNA vaccine technology to combat emerging poultry diseases.
    MeSH term(s) Humans ; Animals ; Chickens ; mRNA Vaccines ; Viral Vaccines/genetics ; Antibodies, Viral ; Antibodies, Neutralizing ; RNA ; Capsid Proteins ; Poultry Diseases/prevention & control ; Mammals/genetics
    Chemical Substances mRNA Vaccines ; Viral Vaccines ; Antibodies, Viral ; Antibodies, Neutralizing ; RNA (63231-63-0) ; Capsid Proteins
    Language English
    Publishing date 2024-03-23
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 605674-x
    ISSN 1873-2518 ; 0264-410X
    ISSN (online) 1873-2518
    ISSN 0264-410X
    DOI 10.1016/j.vaccine.2024.03.032
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Efficacy of a turkey herpesvirus double construct vaccine (HVT-ND-IBD) against challenge with different strains of Newcastle disease, infectious bursal disease and Marek’s disease viruses

    van Hulten, Marielle C.W / Cruz-Coy, Julio / Gergen, Linda / Pouwels, Henk / ten Dam, Gerdy B / Verstegen, Iwan / de Groof, Ad / Morsey, Mo / Tarpey, Ian

    Avian pathology. 2021 Jan. 02, v. 50, no. 1

    2021  

    Abstract: A double construct vaccine of turkey herpesvirus (HVT) was prepared that contains the fusion (F) gene from Newcastle disease virus (NDV) and the viral protein 2 (VP2) gene from infectious bursal disease virus (IBDV). Safety of the vaccine (HVT-ND-IBD) ... ...

    Abstract A double construct vaccine of turkey herpesvirus (HVT) was prepared that contains the fusion (F) gene from Newcastle disease virus (NDV) and the viral protein 2 (VP2) gene from infectious bursal disease virus (IBDV). Safety of the vaccine (HVT-ND-IBD) was confirmed and efficacy was evaluated after subcutaneous (SC) vaccination at 1 day of age or the in ovo route of vaccination. Challenges were performed with velogenic NDV strains (Texas GB and Herts Weybridge 33/56), with different strains of IBDV (classical strain STC; very virulent strain CS89 and variant E strain) and with Marek’s disease virus (MDV) strain RB1B. Vaccination with HVT-ND-IBD induced a high level of protection against these challenges. Vaccination with HVT is often combined with Rispens CVI988 vaccine and live ND vaccines for higher and earlier, MD and ND protection, respectively. HVT-ND-IBD vaccination in combination with these vaccines showed MD protection as early as 4 days post vaccination and ND protection as early as 2 weeks post vaccination. The long protection as seen with HVT vaccination was confirmed by demonstrating protection against NDV up to 60 weeks. Finally, to evaluate the performance of the vaccine in commercial birds with maternally-derived antibodies, two field trials were performed, using in ovo vaccination in broilers and SC vaccination in combination with Rispens CVI988 vaccine in layer-type birds. The efficacy was confirmed for all components by challenges. These results demonstrate that HVT-ND-IBD is a safe and highly efficacious vaccine for simultaneous control of ND, IBD and MD. RESEARCH HIGHLIGHTS A double construct HVT vaccine with the NDV F and the IBDV VP2 genes was prepared. The vaccine protects against three important diseases: MDV, NDV and IBDV. In ovo and sub-cutaneous vaccination was evaluated in the field in commercial chickens.
    Keywords Avian orthoavulavirus 1 ; Infectious bursal disease virus ; Meleagrid alphaherpesvirus 1 ; Newcastle disease ; genes ; infectious bursal disease ; vaccination ; vaccines ; virulent strains
    Language English
    Dates of publication 2021-0102
    Size p. 18-30.
    Publishing place Taylor & Francis
    Document type Article
    Note NAL-light
    ZDB-ID 1476380-1
    ISSN 1465-3338 ; 0307-9457
    ISSN (online) 1465-3338
    ISSN 0307-9457
    DOI 10.1080/03079457.2020.1828567
    Database NAL-Catalogue (AGRICOLA)

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  3. Article: Reduction in intestinal colonization and invasion of internal organs after challenge by homologous and heterologous serovars of Salmonella enterica following vaccination of chickens with a novel trivalent inactivated Salmonella vaccine

    Crouch, Colin F / Pugh, Chris / Patel, Amit / Brink, Helen / Wharmby, Chris / Watts, Anna / van Hulten, Marielle C. W / de Vries, Stefan P. W

    Avian pathology. 2020 Nov. 01, v. 49, no. 6

    2020  

    Abstract: A novel inactivated vaccine, comprising three serovars of Salmonella enterica (Enteritidis, serogroup O:9; Typhimurium, serogroup O:4; Infantis, serogroup O:7) grown under conditions of iron restriction and adjuvanted with aluminium hydroxide, was ... ...

    Abstract A novel inactivated vaccine, comprising three serovars of Salmonella enterica (Enteritidis, serogroup O:9; Typhimurium, serogroup O:4; Infantis, serogroup O:7) grown under conditions of iron restriction and adjuvanted with aluminium hydroxide, was evaluated for efficacy following challenge by homologous and heterologous serovars. Chickens were vaccinated at 6 and 10 weeks of age by the intramuscular route and challenged 4 to 9 weeks after the second vaccination with serovars belonging to serogroup O:9 (Enteritidis), O:4 (Typhimurium and Heidelberg), O:7 (Infantis and Virchow), and O:8 (Hadar). All vaccinated birds produced a marked systemic antibody response against each of the component vaccine antigens by the time of challenge. Significant reductions in both colonization of the intestinal tract and invasion of internal organs were observed in vaccinated birds compared with non-vaccinated controls, irrespective of the challenge serovar. The findings suggest that broad serovar protection within the constitutive serogroups of an inactivated multi-valent vaccine is possible and could, therefore, play an important role in future Salmonella control programmes. RESEARCH HIGHLIGHTS Novel inactivated trivalent Salmonella chicken vaccine was developed and tested. Vaccine induced marked systemic antibody response against all vaccine antigens. Significant reductions in intestinal tract colonization and internal organ invasion. Vaccine efficacy demonstrated against homologous and heterologous serovars.
    Keywords Salmonella enterica ; aluminum hydroxide ; antibody formation ; chickens ; inactivated vaccines ; intestines ; serotypes ; vaccination
    Language English
    Dates of publication 2020-1101
    Size p. 666-677.
    Publishing place Taylor & Francis
    Document type Article
    Note NAL-light
    ZDB-ID 1476380-1
    ISSN 1465-3338 ; 0307-9457
    ISSN (online) 1465-3338
    ISSN 0307-9457
    DOI 10.1080/03079457.2020.1814200
    Database NAL-Catalogue (AGRICOLA)

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  4. Article: Safety and efficacy of a novel inactivated trivalent Salmonella enterica vaccine in chickens

    Crouch, Colin F / Nell, Tom / Reijnders, Martine / Donkers, Ton / Pugh, Chris / Patel, Amit / Davis, Phil / van Hulten, Marielle C.W / de Vries, Stefan P.W

    Vaccine. 2020 Oct. 07, v. 38, no. 43

    2020  

    Abstract: Food poisoning in humans caused by Salmonella enterica remains a significant global public health concern, with the majority of infections associated with the consumption of contaminated eggs or poultry products. The safety and efficacy of a novel ... ...

    Abstract Food poisoning in humans caused by Salmonella enterica remains a significant global public health concern, with the majority of infections associated with the consumption of contaminated eggs or poultry products. The safety and efficacy of a novel inactivated trivalent Salmonella enterica vaccine containing in addition to Salmonella serovars Enteritidis (O:9, serogroup D) and Typhimurium (O:4, serogroup B) also serovar Infantis (O:7, serogroup C1) formulated with an aluminium hydroxide-gel adjuvant was evaluated under field conditions. A total of 10,229 broiler breeder pullets, housed under commercial conditions, were vaccinated at 10 and 17 weeks of age by the intramuscular route in the breast muscle. The vaccine was safe with no local or systemic reactions or adverse effects on bird performance related to the vaccine detected. Vaccination resulted in notable increases in serovar specific antibodies that were maintained until at least 56 weeks of age. Vaccinated birds subjected to homologous challenges around onset of lay showed significantly reduced faecal shedding and organ invasion. Following heterologous challenge with S. Hadar (O:8, serogroup C2) faecal shedding was significantly reduced. These results demonstrate that this novel vaccine could play a significant role in a comprehensive Salmonella control programme intended to reduce both the incidence of food poisoning in humans and the use of antibiotics during poultry production.
    Keywords Salmonella enterica ; adjuvants ; aluminum ; breast muscle ; broiler breeders ; poultry production ; public health ; serotypes ; vaccination ; vaccines
    Language English
    Dates of publication 2020-1007
    Size p. 6741-6750.
    Publishing place Elsevier Ltd
    Document type Article
    Note NAL-AP-2-clean
    ZDB-ID 605674-x
    ISSN 1873-2518 ; 0264-410X
    ISSN (online) 1873-2518
    ISSN 0264-410X
    DOI 10.1016/j.vaccine.2020.08.033
    Database NAL-Catalogue (AGRICOLA)

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  5. Article ; Online: Safety and efficacy of a novel inactivated trivalent Salmonella enterica vaccine in chickens.

    Crouch, Colin F / Nell, Tom / Reijnders, Martine / Donkers, Ton / Pugh, Chris / Patel, Amit / Davis, Phil / van Hulten, Marielle C W / de Vries, Stefan P W

    Vaccine

    2020  Volume 38, Issue 43, Page(s) 6741–6750

    Abstract: Food poisoning in humans caused by Salmonella enterica remains a significant global public health concern, with the majority of infections associated with the consumption of contaminated eggs or poultry products. The safety and efficacy of a novel ... ...

    Abstract Food poisoning in humans caused by Salmonella enterica remains a significant global public health concern, with the majority of infections associated with the consumption of contaminated eggs or poultry products. The safety and efficacy of a novel inactivated trivalent Salmonella enterica vaccine containing in addition to Salmonella serovars Enteritidis (O:9, serogroup D) and Typhimurium (O:4, serogroup B) also serovar Infantis (O:7, serogroup C1) formulated with an aluminium hydroxide-gel adjuvant was evaluated under field conditions. A total of 10,229 broiler breeder pullets, housed under commercial conditions, were vaccinated at 10 and 17 weeks of age by the intramuscular route in the breast muscle. The vaccine was safe with no local or systemic reactions or adverse effects on bird performance related to the vaccine detected. Vaccination resulted in notable increases in serovar specific antibodies that were maintained until at least 56 weeks of age. Vaccinated birds subjected to homologous challenges around onset of lay showed significantly reduced faecal shedding and organ invasion. Following heterologous challenge with S. Hadar (O:8, serogroup C2) faecal shedding was significantly reduced. These results demonstrate that this novel vaccine could play a significant role in a comprehensive Salmonella control programme intended to reduce both the incidence of food poisoning in humans and the use of antibiotics during poultry production.
    MeSH term(s) Animals ; Chickens ; Female ; Humans ; Poultry Diseases/prevention & control ; Salmonella Infections, Animal/prevention & control ; Salmonella Vaccines ; Salmonella enterica ; Salmonella enteritidis ; Vaccines, Inactivated
    Chemical Substances Salmonella Vaccines ; Vaccines, Inactivated
    Language English
    Publishing date 2020-09-02
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 605674-x
    ISSN 1873-2518 ; 0264-410X
    ISSN (online) 1873-2518
    ISSN 0264-410X
    DOI 10.1016/j.vaccine.2020.08.033
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Efficacy of a turkey herpesvirus double construct vaccine (HVT-ND-IBD) against challenge with different strains of Newcastle disease, infectious bursal disease and Marek's disease viruses.

    van Hulten, Marielle C W / Cruz-Coy, Julio / Gergen, Linda / Pouwels, Henk / Ten Dam, Gerdy B / Verstegen, Iwan / de Groof, Ad / Morsey, Mo / Tarpey, Ian

    Avian pathology : journal of the W.V.P.A

    2020  Volume 50, Issue 1, Page(s) 18–30

    Abstract: A double construct vaccine of turkey herpesvirus (HVT) was prepared that contains the fusion (F) gene from Newcastle disease virus (NDV) and the viral protein 2 (VP2) gene from infectious bursal disease virus (IBDV). Safety of the vaccine (HVT-ND-IBD) ... ...

    Abstract A double construct vaccine of turkey herpesvirus (HVT) was prepared that contains the fusion (F) gene from Newcastle disease virus (NDV) and the viral protein 2 (VP2) gene from infectious bursal disease virus (IBDV). Safety of the vaccine (HVT-ND-IBD) was confirmed and efficacy was evaluated after subcutaneous (SC) vaccination at 1 day of age or the
    MeSH term(s) Animals ; Birnaviridae Infections/prevention & control ; Birnaviridae Infections/veterinary ; Birnaviridae Infections/virology ; Chickens/immunology ; Female ; Herpesvirus 2, Gallid/immunology ; Infectious bursal disease virus/immunology ; Male ; Marek Disease/prevention & control ; Marek Disease/virology ; Newcastle Disease/prevention & control ; Newcastle Disease/virology ; Newcastle disease virus/immunology ; Poultry Diseases/prevention & control ; Poultry Diseases/virology ; Specific Pathogen-Free Organisms ; Vaccination/veterinary ; Vaccines, Attenuated/immunology ; Viral Vaccines/immunology
    Chemical Substances Vaccines, Attenuated ; Viral Vaccines
    Language English
    Publishing date 2020-11-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 1476380-1
    ISSN 1465-3338 ; 0307-9457
    ISSN (online) 1465-3338
    ISSN 0307-9457
    DOI 10.1080/03079457.2020.1828567
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Reduction in intestinal colonization and invasion of internal organs after challenge by homologous and heterologous serovars of

    Crouch, Colin F / Pugh, Chris / Patel, Amit / Brink, Helen / Wharmby, Chris / Watts, Anna / van Hulten, Marielle C W / de Vries, Stefan P W

    Avian pathology : journal of the W.V.P.A

    2020  Volume 49, Issue 6, Page(s) 666–677

    Abstract: A novel inactivated vaccine, comprising three serovars ... ...

    Abstract A novel inactivated vaccine, comprising three serovars of
    MeSH term(s) Animals ; Chickens/immunology ; Chickens/microbiology ; Poultry Diseases/microbiology ; Poultry Diseases/prevention & control ; Salmonella Infections, Animal/microbiology ; Salmonella Infections, Animal/prevention & control ; Salmonella Vaccines/immunology ; Salmonella enterica/immunology ; Serogroup ; Vaccination/veterinary ; Vaccines, Inactivated
    Chemical Substances Salmonella Vaccines ; Vaccines, Inactivated
    Language English
    Publishing date 2020-10-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 1476380-1
    ISSN 1465-3338 ; 0307-9457
    ISSN (online) 1465-3338
    ISSN 0307-9457
    DOI 10.1080/03079457.2020.1814200
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: "Vaccination" of shrimp against viral pathogens: phenomenology and underlying mechanisms.

    Johnson, Karyn N / van Hulten, Marielle C W / Barnes, Andrew C

    Vaccine

    2008  Volume 26, Issue 38, Page(s) 4885–4892

    Abstract: The global shrimp aquaculture industry is worth in excess of US $10 billion annually, but continues to be beset by endemic viral diseases. The ability to vaccinate shrimp and other crustaceans against specific viral diseases is therefore of global ... ...

    Abstract The global shrimp aquaculture industry is worth in excess of US $10 billion annually, but continues to be beset by endemic viral diseases. The ability to vaccinate shrimp and other crustaceans against specific viral diseases is therefore of global economic and biosecurity significance. Higher vertebrates, including humans, have an adaptive immunity that enables them to specifically "remember" exposure to pathogens and respond with increased efficiency on subsequent encounters, forming the basis of vaccination. It has been widely accepted that invertebrates do not have such a system. However, there is mounting evidence for specific immune memory in crustaceans, including shrimp. This review explores the phenomenon of antiviral immunity in shrimp and explores this paradigm shift in the context of potential vaccination strategies for shrimp aquaculture.
    MeSH term(s) Animals ; Aquaculture ; Decapoda (Crustacea)/immunology ; Decapoda (Crustacea)/virology ; Invertebrates/immunology ; Vaccination ; Viral Vaccines/immunology ; Viruses/immunology
    Chemical Substances Viral Vaccines
    Language English
    Publishing date 2008-09-08
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 605674-x
    ISSN 1873-2518 ; 0264-410X
    ISSN (online) 1873-2518
    ISSN 0264-410X
    DOI 10.1016/j.vaccine.2008.07.019
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Pathogenicity of gill-associated virus and Mourilyan virus during mixed infections of black tiger shrimp (Penaeus monodon).

    Oanh, Dang T H / van Hulten, Marielle C W / Cowley, Jeff A / Walker, Peter J

    The Journal of general virology

    2011  Volume 92, Issue Pt 4, Page(s) 893–901

    Abstract: Gill-associated virus (GAV) and Mourilyan virus (MoV) can occur at very high prevalence in healthy black tiger shrimp (Penaeus monodon) in eastern Australia, and both have been detected in moribund shrimp collected from mid-crop mortality syndrome (MCMS) ...

    Abstract Gill-associated virus (GAV) and Mourilyan virus (MoV) can occur at very high prevalence in healthy black tiger shrimp (Penaeus monodon) in eastern Australia, and both have been detected in moribund shrimp collected from mid-crop mortality syndrome (MCMS) outbreaks. Experimental evidence presented here indicates that GAV, but not MoV, is the cause of MCMS. Firstly, in healthy P. monodon used for experimental infections, pre-existing MoV genetic loads were very high (mean >10(9) viral RNA copies μg(-1) total RNA) and did not increase significantly following lethal challenge with an inoculum containing both GAV and MoV. In contrast, GAV genetic loads prior to challenge were low (mean ∼10(5) RNA copies μg(-1) total RNA) and increased >10(4)-fold in moribund shrimp. Secondly, dsRNAs targeted to the GAV RNA-dependent RNA polymerase (RdRp) or helicase gene regions reduced GAV genetic loads, delayed the onset of mortalities and improved survival following challenge. In contrast, dsRNA targeted to the MoV RdRp gene (L RNA) was highly effective in reducing MoV genetic loads, but mortality rates were unaffected. Targeting of the MoV S2 RNA, encoding a small non-structural protein (NSs2), a putative supressor of RNA interference, did not reduce the MoV genetic loads or enhance knockdown of GAV when administered simultaneously with dsRNA targeted to the GAV helicase gene. Overall, the data show that P. monodon can tolerate a high-level MoV infection and that mortalities are associated with GAV infection.
    MeSH term(s) Animal Structures/virology ; Animals ; Australia ; Penaeidae/virology ; Roniviridae/isolation & purification ; Roniviridae/pathogenicity ; Survival Analysis ; Viral Load ; Viruses, Unclassified/isolation & purification ; Viruses, Unclassified/pathogenicity
    Language English
    Publishing date 2011-04
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 219316-4
    ISSN 1465-2099 ; 0022-1317
    ISSN (online) 1465-2099
    ISSN 0022-1317
    DOI 10.1099/vir.0.026724-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Increased tolerance of Litopenaeus vannamei to white spot syndrome virus (WSSV) infection after oral application of the viral envelope protein VP28.

    Witteveldt, Jeroen / Vlak, Just M / van Hulten, Mariëlle C W

    Diseases of aquatic organisms

    2006  Volume 70, Issue 1-2, Page(s) 167–170

    Abstract: It has been generally accepted that invertebrates such as shrimp do not have an adaptive immune response system comparable to that of vertebrates. However, in the last few years, several studies have suggested the existence of such a response in ... ...

    Abstract It has been generally accepted that invertebrates such as shrimp do not have an adaptive immune response system comparable to that of vertebrates. However, in the last few years, several studies have suggested the existence of such a response in invertebrates. In one of these studies, the shrimp Penaeus monodon showed increased protection against white spot syndrome virus (WSSV) using a recombinant VP28 envelope protein of WSSV. In an effort to further investigate whether this increased protection is limited to P. monodon or can be extended to other penaeid shrimp, experiments were performed using the Pacific white shrimp Litopenaeus vannamei. As found with P. monodon, a significantly lower cumulative mortality for VP28-fed shrimp was found compared to the controls. These experiments demonstrate that there is potential to use oral application of specific proteins to protect the 2 most important cultured shrimp species, P. monodon and L. vannamei, against WSSV. Most likely, this increased protection is based on a shared and, therefore, general defence mechanism present in all shrimp species. This makes the design of intervention strategies against pathogens based on defined proteins a viable option for shrimp culture.
    MeSH term(s) Animals ; Bacterial Vaccines/administration & dosage ; Bacterial Vaccines/immunology ; Mortality ; Penaeidae/immunology ; Penaeidae/virology ; Specific Pathogen-Free Organisms ; Time Factors ; Vaccines, Synthetic/administration & dosage ; Vaccines, Synthetic/immunology ; Viral Envelope Proteins/administration & dosage ; Viral Envelope Proteins/pharmacology ; White spot syndrome virus 1/pathogenicity
    Chemical Substances Bacterial Vaccines ; Vaccines, Synthetic ; Viral Envelope Proteins
    Language English
    Publishing date 2006-06-12
    Publishing country Germany
    Document type Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 0177-5103
    ISSN 0177-5103
    DOI 10.3354/dao070167
    Database MEDical Literature Analysis and Retrieval System OnLINE

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