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Wang P, Ramadan S, Dubey P, Deora R, Huang X. Development of carbohydrate based next-generation anti-pertussis vaccines. Bioorg Med Chem 2022; 74:117066. [PMID: 36283250 PMCID: PMC9925305 DOI: 10.1016/j.bmc.2022.117066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 02/04/2023]
Abstract
Pertussis is a highly contagious respiratory disease caused by the Gram-negative bacterial pathogen, Bordetella pertussis. Despite high global vaccination rates, pertussis is resurging worldwide. Here we discuss the development of current pertussis vaccines and their limitations, which highlight the need for new vaccines that can protect against the disease and prevent development of the carrier state, thereby reducing transmission. The lipo-oligosaccharide of Bp is an attractive antigen for vaccine development as the anti-glycan antibodies could have bactericidal activities. The structure of the lipo-oligosaccharide has been determined and its immunological properties analyzed. Strategies enabling the expression, isolation, and bioconjugation have been presented. However, obtaining the saccharide on a large scale with high purity remains one of the main obstacles. Chemical synthesis provides a complementary approach to accessing the carbohydrate epitopes in a pure and structurally well-defined form. The first total synthesis of the non-reducing end pertussis pentasaccharide is discussed. The conjugate of the synthetic glycan with a powerful immunogenic carrier, bacteriophage Qβ, results in high levels and long-lasting anti-glycan IgG antibodies, paving the way for the development of a new generation of anti-pertussis vaccines with high bactericidal activities and biocompatibilities.
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Affiliation(s)
- Peng Wang
- Department of Chemistry, Michigan State University, 578 S. Shaw Lane, East Lansing, MI 48824, USA
| | - Sherif Ramadan
- Department of Chemistry, Michigan State University, 578 S. Shaw Lane, East Lansing, MI 48824, USA; Chemistry Department, Faculty of Science, Benha University, Benha, Qaliobiya 13518, Egypt
| | - Purnima Dubey
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH 43210, USA
| | - Rajendar Deora
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH 43210, USA; Department of Microbiology, The Ohio State University, Columbus, OH 43210, USA
| | - Xuefei Huang
- Department of Chemistry, Michigan State University, 578 S. Shaw Lane, East Lansing, MI 48824, USA; Institute for Quantitative Health Science and Engineering, East Lansing, MI 48824, USA; Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA.
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Fu P, Wang C, Tian H, Kang Z, Zeng M. Bordetella pertussis Infection in Infants and Young Children in Shanghai, China, 2016-2017: Clinical Features, Genotype Variations of Antigenic Genes and Macrolides Resistance. Pediatr Infect Dis J 2019; 38:370-376. [PMID: 30882726 DOI: 10.1097/inf.0000000000002160] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The global resurgence of pertussis in countries with high vaccination coverage has been a concern of public health. METHODS Nasopharyngeal swabs were collected for Bordetella pertussis culture from children with suspected pertussis. Clinical and vaccination information were reviewed through electronic medical chart and immunization record. Antibiotics susceptibility was evaluated using E-test for erythromycin, azithromycin, clarithromycin and sulfamethoxazole/trimethoprim. The MLST genotypes and 7 antigenic genes (ptxP, ptxA, ptxC, Prn, fim3, fim2 and tcfA) of Bordetella pertussis were identified by polymerase chain reaction amplification and sequencing. RESULTS During January 2016 to September 2017, a total of 141 children 1-48 months of age were culture-confirmed with pertussis, of whom 98 (69.5%) were younger than 6 months, 25 (17.7%) had completed at least 3 doses of DTaP and 75 (53.2%) had a clear exposure to household members with persistent cough. Fully vaccinated cases manifested milder disease than unvaccinated and not-fully vaccinated cases. All strains were MLST2. High-virulent strains characteristic of ptxP3/prn2/ptxC2 constituted 41.1% (58/141) and were all susceptible to macrolides while low-virulent strains characteristic of ptxP1/prn1/ptxC1 constituted 58.9% (83/141) and 97.6% (81/83), respectively, were highly resistant to macrolides. CONCLUSIONS Pertussis is resurging among infants and young children in Shanghai, and household transmission is the main exposure pathway. The high-virulent strains harboring ptxP3/prn2/ptxC2 and the macrolide-resistant Bordetella pertussis strains are quite prevalent. These issues impose a public health concern in Shanghai. Our findings are important to modify the DTaP vaccination strategy and the management guideline of pertussis in China.
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Affiliation(s)
- Pan Fu
- From the Department of Clinical Microbiology Laboratory, Clinical Laboratory Medicine, Children's Hospital of Fudan University, Shanghai, China
| | - Chuanqing Wang
- From the Department of Clinical Microbiology Laboratory, Clinical Laboratory Medicine, Children's Hospital of Fudan University, Shanghai, China
- Department of Nosocomial Infection Control, Children's Hospital of Fudan University, Shanghai, China
| | - He Tian
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China
| | - Zhihua Kang
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Mei Zeng
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, China
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Maertens K, Braeckman T, Blaizot S, Theeten H, Roelants M, Hoppenbrouwers K, Leuridan E, Van Damme P, Vandermeulen C. Coverage of recommended vaccines during pregnancy in Flanders, Belgium. Fairly good but can we do better? Vaccine 2018; 36:2687-2693. [PMID: 29627238 DOI: 10.1016/j.vaccine.2018.03.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 03/08/2018] [Accepted: 03/13/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND In Flanders, Belgium, pertussis vaccination is recommended since 2013 and available free-of-charge in every pregnancy between 24 and 32 weeks of gestation. Influenza vaccination is recommended for more than 10 years with a co-payment system in the second or third trimester of pregnancy, when pregnancy coincides with the influenza season. This study aims to estimate the coverage of pertussis and influenza vaccination during pregnancy in 2016 and to determine predictors for missing vaccination. METHODS Postpartum women were visited at home for a vaccination coverage survey using an Expanded Program on Immunization (EPI)-based two-stage cluster sampling design. Predictors for missed vaccination were identified using a multiple logistic regression model. RESULTS Among 481 participating women, 69.3% were vaccinated against pertussis and 47.2% were vaccinated against influenza. Moreover, 65.3% of pertussis vaccine recipients and 96.9% of influenza vaccine recipients were vaccinated within the recommended gestational window. Surprisingly, among women who were completely informed (i.e. on disease-associated risks, maternal vaccination costs and recommendations), still 12.4% were unvaccinated against pertussis and 23.9% against influenza. In the final models, the only common predictor of missing maternal pertussis and influenza vaccination was multiparity. Significant predictors of maternal pertussis vaccination were family income (less likely if unknown or low (< €3000) than if moderate (€3001-€4000)) and hospital of delivery (less likely if >800 annual deliveries than <800). Significant predictors of maternal influenza vaccination, though with less straight-forward associations, were maternal ethnicity and educational level, involvement of a gynaecologist in pregnancy follow-up, and characteristics of the hospital of delivery. CONCLUSION In Flanders, more than two-third of pregnant women receives pertussis vaccination but less than half of them receives the influenza vaccine. Further improvement for both maternal vaccination programs can be achieved by targeting the underserved populations and diminishing vaccination hurdles.
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Affiliation(s)
- Kirsten Maertens
- Centre for the Evaluation of Vaccination, VAXINFECTIO, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Tessa Braeckman
- Centre for the Evaluation of Vaccination, VAXINFECTIO, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Stéphanie Blaizot
- Centre for Health Economics Research and Modelling Infectious Diseases, VAXINFECTIO, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Heidi Theeten
- Centre for the Evaluation of Vaccination, VAXINFECTIO, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Mathieu Roelants
- Environment and Health, KU Leuven, Kapucijnenvoer 35 blok d, 3000 Leuven, Belgium
| | - Karel Hoppenbrouwers
- Environment and Health, KU Leuven, Kapucijnenvoer 35 blok d, 3000 Leuven, Belgium
| | - Elke Leuridan
- Centre for the Evaluation of Vaccination, VAXINFECTIO, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, VAXINFECTIO, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Corinne Vandermeulen
- Leuven University Vaccinology Center, KU Leuven, Campus Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
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Evered J, Pfeifer E, Gracianette M. Caffeine to prevent respiratory failure and improve outcome in infant pertussis. BMJ Case Rep 2018; 2018:bcr-2017-223102. [PMID: 29592985 PMCID: PMC5878332 DOI: 10.1136/bcr-2017-223102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2018] [Indexed: 11/03/2022] Open
Abstract
Pertussis remains a dangerous disease for children around the world, especially for infants less than 6 months old. In this age group, high mortality and morbidity have been linked to the effects of the pertussis toxin, including lymphocytosis, pulmonary hyperviscosity and pulmonary hypertension. This paper reports on an infant with pertussis who received therapeutic caffeine. Caffeine might improve outcomes in pertussis by preventing apnoea, improving respiratory drive and decreasing pulmonary complications.
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Affiliation(s)
- John Evered
- Department of Pediatrics, Oregon Health and Science University, Portland, Oregon, USA
| | - Eric Pfeifer
- Neonatal Intensive Care Unit, PeaceHealth Southwest Medical Center, Vancouver, Washington, USA
| | - Matthew Gracianette
- Randall Children’s Hospital, Legacy Emanuel Medical Center, Portland, Oregon, USA
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Fatal Pertussis in the Neonatal Mouse Model Is Associated with Pertussis Toxin-Mediated Pathology beyond the Airways. Infect Immun 2017; 85:IAI.00355-17. [PMID: 28784932 DOI: 10.1128/iai.00355-17] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 08/03/2017] [Indexed: 01/28/2023] Open
Abstract
In infants, Bordetella pertussis can cause severe disease, manifested as pronounced leukocytosis, pulmonary hypertension, and even death. The exact cause of death remains unknown, and no effective therapies for treating fulminant pertussis exist. In this study, a neonatal mouse model of critical pertussis is characterized, and a central role for pertussis toxin (PT) is described. PT promoted colonization, leukocytosis, T cell phenotypic changes, systemic pathology, and death in neonatal but not adult mice. Surprisingly, PT inhibited lung inflammatory pathology in neonates, a result which contrasts dramatically with observed PT-promoted pathology in adult mice. Infection with a PT-deficient strain induced severe pulmonary inflammation but not mortality in neonatal mice, suggesting that death in these mice was not associated with impaired lung function. Dissemination of infection beyond the lungs was also detected in neonatal mice, which may contribute to the observed systemic effects of PT. We propose that it is the systemic activity of pertussis toxin and not pulmonary pathology that promotes mortality in critical pertussis. In addition, we observed transmission of infection between neonatal mice, the first report of B. pertussis transmission in mice. This model will be a valuable tool to investigate causes of pertussis pathogenesis and identify potential therapies for critical pertussis.
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