Polysaccharide conjugate vaccines for the prevention of gram-positive bacterial infections

Biologic properties and vaccine potential of the staphylococcal poly-N-acetyl glucosamine surface polysaccharide

Staphylococci have become the most common causes of nosocomial bacterial infections, and this fact, along with increasing problems associated with antimicrobial resistance, spurs the need for finding immunotherapeutic alternatives to prevent and possibly treat these infections. Most virulent, clinical isolates of both coagulase-negative staphylococci (CoNS) and Staphylococcus aureus carry the ica locus which encodes proteins that synthesize a polymer of beta-1-6 linked N-acetyl glucosamine residues (PNAG). Animal studies have shown purified PNAG can elicit protective immunity against both CoNS and S. aureus, suggesting its potential as a broadly protective vaccine for many clinically important strains of staphylococci.

Staphylococcus aureus capsular polysaccharides

Serotype 5 and 8 capsular polysaccharides predominate among clinical isolates of Staphylococcus aureus. The results of experiments in animal models of infection have revealed that staphylococcal capsules are important in the pathogenesis of S. aureus infections. The capsule enhances staphylococcal virulence by impeding phagocytosis, resulting in bacterial persistence in the bloodstream of infected hosts. S. aureus capsules also promote abscess formation in rats. Although the capsule has been shown to modulate S. aureus adherence to endothelial surfaces in vitro, animal studies suggest that it also promotes bacterial colonization and persistence on mucosal surfaces. S. aureus capsular antigens are surface associated, limited in antigenic specificity, and highly conserved among clinical isolates. With the emergence of vancomycin-resistant S. aureus in the United States in 2002, new strategies are needed to combat staphylococcal infections. Purified serotype 5 and 8 capsular polysaccharides offer promise as target antigens for a vaccine to prevent staphylococcal infections, although the inclusion of other antigens is likely to be essential in the development of an effective S. aureus vaccine. The genetics and mechanisms of capsule biosynthesis are complex, and much work remains to enhance our understanding of capsule biosynthesis and its regulation.

Development of Antistaphylococcal Vaccines

Staphylococcus aureus is frequently isolated from both hospital-acquired and community-acquired infections, and the emergence of antibiotic resistance among clinical isolates has made treatment of staphylococcal infections difficult. This scenario has sparked renewed interest in the development of a vaccine for individuals at high risk for staphylococcal infections. As part of the effort to develop a multicomponent vaccine against S. aureus, several vaccine candidates are currently being evaluated in animal models of staphylococcal infection or in human clinical trials. The most promising candidates to date include adhesins (fibronectin-binding protein, collagen-binding protein, and fibrinogen-binding protein ), a nontoxic alpha toxin mutant, and capsular polysaccharides type 5 and 8.

Autoinducer of virulence as a target for vaccine and therapy against Staphylococcus aureus

Staphylococcus aureus causes pathologies ranging from minor skin infections to life-threatening diseases. Pathogenic effects are largely due to production of bacterial toxin, which is regulated by an RNA molecule, RNAIII. The S. aureus protein called RAP (RNAIII activating protein) activates RNAIII, and a peptide called RIP (RNAIII inhibiting peptide), produced by a nonpathogenic bacteria, inhibits RNAIII. Mice vaccinated with RAP or treated with purified or synthetic RIP were protected from S. aureus pathology. Thus, these two molecules may provide useful approaches for the prevention and treatment of diseases caused by S. aureus.