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3 Carbohydrate-Based Antiviral Vaccines
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this system appear to be critical for the stimulation and activation of antigenspecific
cellular and humoral immune responses. The proprietary, saponinbased Matrix
M™ adjuvant has shown potent and welltolerated immunostimulatory effects by
inducing the influx of APCs into the site of injection and enhancing antigen presentation in the lymph nodes[200, 201]. Notably, MatrixM has been licensed as part of
Novavax recombinant nanoparticle subunit vaccine (NVAXCoV2373) derived from
the Sprotein, acting by boosting Bcell and Tcell immunity for elicitation of more
potent immune responses while also enabling dosesparing[202]. NVXCoV2373has
been successfully evaluated in clinical trials, demonstrating high vaccine efficacy
against several SARSCoV2 variants with an acceptable safety profile [203, 204],
which has led to its recent approval by the European Medicines Agency. This saponin
adjuvanted proteinbased vaccine highlights the promise of saponin adjuvants and
subunit vaccines to prevent not only traditional but also emerging viral diseases,
including COVID19 and potential new pandemics associated with further coronavirus infections.
3.7 Conclusions and Outlook
Viral glycosylation is a process mediated by the hostcell machinery that decorates
the surface proteins of several pathogens with cell glycans, including the envelope
glycoprotein (Env) of HIV1, hemagglutinin glycoprotein (HA) of influenza virus,
the envelope glycoproteins (E1 and E2) of HCV, the glycoprotein (GP) of EBOV,
the coronavirus glycoprotein spike (S), and others. This protein glycosylation is
characterized by high structural variation and is essential for the viral lifecycle
and pathogenesis, playing a key role in specific viral functions such as hostcell
attachment and entry, infectivity, and replication. Moreover, these viral carbohydrates form a glycan shield that has important implications for host immune
responses to infection, protecting internal protein epitopes from immune recognition while also exposing potential targets for vaccine and drug development. For
instance, the conserved oligomannosetype Nglycans of some envelope glycoproteins involved in transinfection and immune evasion also serve as neutralizing
antibody epitopes or binding receptors for CBAs to fight against viral infection.
Despite significant recent research on the development of carbohydrate vaccines
and therapies against viral diseases, much further work is needed for the translation
of additional glycanbased candidates into clinical applications in humans.
Increased knowledge of viral glycobiology and sitespecific protein glycosylation, as
well as a better understanding of the immunological basis that drives viral diversity,
will aid in guiding the rational design of nextgeneration vaccines and antiviral therapeutics in the future.
Acknowledgments
Funding from the European Research Council (ERC2016STG716878 “ADJUV
ANT VACCINES”) and the Spanish Ministry of Science and Innovation/State

References
Research Agency (MCIN/AEI) (CTQ201787530R, RYC201517888 to A.F.T.;
PRE2018085772 to A.P.) is gratefully acknowledged. We thank Dr. Iñaki Bastida for
assistance with the preparation of the manuscript. A F.T. thanks Raquel Fernández
for inspiration.
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