Journal of eISSN: 2373-4469 JIG

Investigative Genomics
Mini Review
Volume 2 Issue 3

Recent advances and current status of gm-Csf as an adjuvant in DNA vaccines for viral diseases

Chandra Somasundaram
University of Houston- Victoria, Texas Biomedical Institute, Missouri City, USA
Received: May 31, 2015 | Published: June 16, 2015

Correspondence: Chandra Somasundaram, University of Houston-Victoria, Texas Biomedical Institute, Missouri City, Texas, USA, Email

Citation: Somasundaram C . Recent advances and current status of gm-Csf as an adjuvant in DNA vaccines for viral diseases. J Investig Genomics. 2015;2(3):54‒56. DOI: 10.15406/jig.2015.02.00025


Here, I update the recent advances and current status of Granulocyte macrophage colony-stimulating factor (GM-CSF), since we have reported for the first time that porcine GM-CSF gene in a DNA vaccine formulation exerted immuno-adjuvant and protective effects against Aujeszky's (Pseudorabies)viral disease to the natural host pigs with a single vaccination. GM-CSF has been broadly used as an adjuvant in preclinical DNA vaccine studies for cancer and viral diseases. Currently, GeoVax Labs, Inc. reported a recombinant HIV vaccine (GEO-D03) that co-expresses the human GM-CSF and non-infectious HIV-1 virus-like particles (VLPs) is being evaluated in HIV infected young adults in several Phase I studies (NCT01571960). In addition, we summarized here the outcomes of the use of GM-CSF in DNA vaccine for other viral diseases. Further, phase 3 studies reported that GM-CSF showed an improvement in patient outcome when applied in combination with suitable anti-tumor vaccines. However, GM-CSF in excessive levels may expand myeloid suppressor cells that were shown to dampen adaptive immune responses.

Keywords: granulocyte macrophage colony-stimulating factor, gm-Csf, genetic adjuvant, DNA vaccine, viral disease, cancer, clinical trial


GM-CSF, granulocyte macrophage colony-stimulating factor; HIV, human immunodeficiency virus; SIV, simian immunodeficiency virus


Here, I update the recent advances and current status of Granulocyte macrophage colony-stimulating factor (GM-CSF), since we have reported for the first time1,2 that a DNA vaccine formulation with porcine GM-CSF gene exerted immuno-adjuvant effects and protected the natural host pigs against Aujeszky's (Pseudorabies) viral disease with single vaccination. The hematopoietic cytokine GM-CSF has been shown as an efficient adjuvant in DNA vaccine preclinical studies for cancer and viral diseases. Xiang Z et al.3 first reported that GM-CSF is a genetic adjuvant for DNA vaccine.

GM-CSF as a genetic adjuvant for HIV DNA vaccine in human clinical trials

A recombinant HIV vaccine (GEO-D03) that co-expresses the human GM-CSF and non-infectious HIV-1 virus-like particles (VLPs) is being currently evaluated in HIV infected young adults in several Phase I studies (NCT01571960- 2015).4,5 This trial will determine whether this vaccine will provide excellent protection in humans as in macaques by simian immunodeficiency virus (SIV)-prototype (NCT01909414-2013).6 Lai et al.7 2011 reported that the SIV vaccine co-expressing GM-CSF achieved significantly higher reduction in risk of infection and protected more SIV challenged macaques in preclinical studies. In addition, this vaccine elicited both anti-viral T cells and antibody. The vaccine-induced prevention of infection was shown to increase from 25% to 71% in the presence of GM-CSF.7 The Outcomes of the use of GM-CSF as genetic adjuvant in DNA vaccine for other viral diseases is given in Table 1.


Efficacy/Outcome of GM-CSF


Porcine Circovirus Type-2

Pigs immunized with Cap-GM-CSF subunit vaccine showed significantly higher levels of PCV2-specific antibodies and neutralizing antibodies and higher average daily weight gain than pigs receiving immunized with the Cap subunit vaccine and a commercial vaccine (Ingelvac CircoFLEX; P<0.05) after wild-type PCV2 challenge.


Flaviviridae Virus

Reported as complex and diverse, ranging from enhancement to suppression, depending on the immunogen of Flaviviridae virus DNA vaccine candidates.


Simian ImmunoDeficiency Virus

The co-expressed GM-CSF increased vaccine-induced prevention of infection from 25% to 71% in simian immunodeficiency virus in macaques.


GEO-D03, a DNA vaccine that expresses human GM-CSF and non-infectious HIV-1 virus-like particles .entered into human trials.



A phase 1 study of the safety and immunogenicity of DNA/MVA immunizations with co-expressed GM-CSF in HIV-1 infected young adults with suppressed viremia on HAART.


Foot and Mouth Disease

Efficacy of the DNA vaccine with GM-CSF was improved further in reducing the clinical disease and virus excretions by electroporation.


Japanese Encephalitis Virus

Reported no protection



Induced long-lived humoral and cell mediated immune memory responses.


Dengue Virus

DV1 challenged mice showed long-term IgG response, strong cytotoxic T lymphocyte activity, produced high levels of splenocyte-secreted interferon-γ and interleukin-2 and sufficient protection after immunization with pCAG-DV1-GM-CSF immunization than pCAG-DV1/E alone


Induced stronger immunogenicity and protection from virus challenge in Aotus monkeys.


Influenza Virus

GM-CSF gene enhanced systemic and mucosal immunogenicity of the HA DNA vaccine in Rhesus macaque


Hepatitis B Virus

HBV-S gene fused with GM-CSF strengthened the immune effects of the HBV DNA vaccine in HBV-transgenic mice


Bronchitis Virus

pVAX-chGM-CSF and pVAX-S1 provided more protection against IBV challenge in chickens than pVAX-S1 vaccination alone.


Feline Immuno Deficiency Virus

Preserved global CD4 T lymphocyte function after the challenge..


Porcine Reproductive and Respiratory Syndrome Virus

Significantly enhanced the humoral and cellular immune responses and protection against PRRSV challenge in pigs


Hepatitis C Virus

Reported no change in the Th1/Th2 balance as compared with simultaneous IL-23 administration.


Co-immunization with Flt3-L and GM-CSF shown promise in the development of an effective
antiviral HCV vaccine


Simian-Human Immuno Deficiency Virus

Enhanced IgA response was associated with the best protection, but did not achieve significance.


HIV-1 Gag

Demonstrated strong antibody and CTL responses and a protective response against infection with recombinant vaccinia virus expressing HIV-1 Gag.


Equine Herpes Virus

DNA vaccine with GM-CSF, formulated in DMRIE-DOPE significantly improved virus neutralizing antibody responses to EHV-1.


HIV-1 Env

The adjuvant treated group showed significantly better control to the challenge than the non-GMCSF group.


Bicistronic DNA vaccines containing GM-CSF elicited remarkably potent CD4(+) T cell responses


Aujeszky's (Pseudorabies) Viral Disease.

We demonstrated that the Porcine GM-CSF gene in a DNA vaccine formulation exerted immuno-adjuvant and protective effects with single vaccination in the natural host pigs against Aujeszky's disease.


Table 1 Efficacy and outcomes of GM-CSF as genetic adjuvant in DNA vaccines for viral diseases

Use of GM-CSF in cancer

GM-CSF was found the most efficient adjuvant for cancer cell vaccines in early preclinical screens of retroviral-expressed cytokines.27 Further, the ability of the fused GM-CSF to elicit anti-tumor immune responses and boost vaccine efficiency is found in the first licensed cancer vaccine, Provenge.28 Despite, a number of studies demonstrating cytokines can act as adjuvants in tumor vaccines, the cost prevent their widespread use, except for the GM-CSF. More recently, GM-CSF has shown improved patient outcome in phase 3 studies when applied in combination with suitable anti-tumor vaccines.29 In addition, GM-CSF is licensed to use as an adjuvant in a fusion protein for a dendritic cell therapy for prostate cancer and for recovery and replacement of white blood cells following bone marrow transplantation and chemotherapy.30 However, GM-CSF in excessive levels may expand myeloid suppressor cells that were shown to dampen adaptive immune responses.31‒33



Conflict of interest

Author declares that there is no conflict of interest.


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