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Roe SK, Zhu T, Slepenkin A, Berges A, Fairman J, de la Maza LM, Massari P. Structural Assessment of Chlamydia trachomatis Major Outer Membrane Protein (MOMP)-Derived Vaccine Antigens and Immunological Profiling in Mice with Different Genetic Backgrounds. Vaccines (Basel) 2024; 12:789. [PMID: 39066427 PMCID: PMC11281497 DOI: 10.3390/vaccines12070789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/13/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
Chlamydia trachomatis (Ct) is the most common cause of bacterial sexually transmitted infections (STIs) worldwide. Ct infections are often asymptomatic in women, leading to severe reproductive tract sequelae. Development of a vaccine against Chlamydia is crucial. The Chlamydia major outer membrane protein (MOMP) is a prime vaccine antigen candidate, and it can elicit both neutralizing antibodies and protective CD4+ T cell responses. We have previously designed chimeric antigens composed of immunogenic variable regions (VDs) and conserved regions (CDs) of MOMP from Chlamydia muridarum (Cm) expressed into a carrier protein (PorB), and we have shown that these were protective in a mouse model of Cm respiratory infection. Here, we generated corresponding constructs based on MOMP from Ct serovar F. Preliminary structure analysis of the three antigens, PorB/VD1-3, PorB/VD1-4 and PorB/VD1-2-4, showed that they retained structure features consistent with those of PorB. The antigens induced robust humoral and cellular responses in mice with different genetic backgrounds. The antibodies were cross-reactive against Ct, but only anti-PorB/VD1-4 and anti-PorB/VD1-2-4 IgG antibodies were neutralizing, likely due to the antigen specificity. The cellular responses included proliferation in vitro and production of IFN-γ by splenocytes following Ct re-stimulation. Our results support further investigation of the PorB/VD antigens as potential protective candidates for a Chlamydia subunit vaccine.
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Affiliation(s)
- Shea K. Roe
- Department of Immunology, Tufts University School of Medicine, Boston, MA 02111, USA; (S.K.R.)
| | - Tianmou Zhu
- Department of Immunology, Tufts University School of Medicine, Boston, MA 02111, USA; (S.K.R.)
| | - Anatoli Slepenkin
- Department of Pathology and Laboratory Medicine, University of California, Irvine, CA 92697, USA (L.M.d.l.M.)
| | - Aym Berges
- Vaxcyte Inc., 825 Industrial Road, Suite 300, San Carlos, CA 94070, USA (J.F.)
| | - Jeff Fairman
- Vaxcyte Inc., 825 Industrial Road, Suite 300, San Carlos, CA 94070, USA (J.F.)
| | - Luis M. de la Maza
- Department of Pathology and Laboratory Medicine, University of California, Irvine, CA 92697, USA (L.M.d.l.M.)
| | - Paola Massari
- Department of Immunology, Tufts University School of Medicine, Boston, MA 02111, USA; (S.K.R.)
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Gopalakrishnan A, Richard K, Wahid R, Harley R, Sztein MB, Hawkins LD, Vogel SN. E6020, a TLR4 Agonist Adjuvant, Enhances Both Antibody Titers and Isotype Switching in Response to Immunization with Hapten-Protein Antigens and Is Diminished in Mice with TLR4 Signaling Insufficiency. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2022; 209:1950-1959. [PMID: 36426935 PMCID: PMC9643654 DOI: 10.4049/jimmunol.2200495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/14/2022] [Indexed: 12/30/2022]
Abstract
The mechanisms by which TLR4-based adjuvants enhance immunogenicity are not fully understood. We have taken advantage of a novel knock-in mouse strain that homozygously expresses two single-nucleotide polymorphisms (SNPs) that are homologous to human TLR4 (rs4986790 and rs4986791) and have been associated with LPS hyporesponsiveness in vivo and in vitro. TLR4-SNP (coexpressing mutations D298G/N397I in TLR4) mice that recapitulate the human phenotype were compared with wild-type (WT) mice for their hapten-specific Ab responses after immunization with hapten 4-hydroxy-3-nitrophenyl acetyl (NP) NP-Ficoll or NP-OVA in the absence or presence of a water-soluble TLR4 analog adjuvant, E6020. IgM and IgG anti-NP responses were comparable in WT and TLR4-SNP mice after immunization with either NP-Ficoll or NP-OVA only. E6020 significantly yet transiently improved the IgM and IgG anti-NP responses of both WT and TLR4-SNP mice to NP-Ficoll (T-independent), with modestly enhanced Ab production in WT mice. In contrast, T-dependent (NP-OVA), adjuvant-enhanced responses showed sustained elevation of NP-specific Ab titers in WT mice, intermediate responses in TLR4-SNP mice, and negligible enhancement in TLR4-/- mice. E6020-enhanced early humoral responses in WT and TLR4-SNP mice to NP-OVA favored an IgG1 response. After a second immunization, however, the immune responses of TLR4-SNP mice remained IgG1 dominant, whereas WT mice reimmunized with NP-OVA and E6020 exhibited increased anti-NP IgG2c titers and a sustained increase in the IgG1 and IgG2c production by splenocytes. These findings indicate that E6020 increases and sustains Ab titers and promotes isotype class switching, as evidenced by reduced titers and IgG1-dominant immune responses in mice with TLR4 insufficiency.
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Affiliation(s)
- Archana Gopalakrishnan
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD
| | - Katharina Richard
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD
| | - Rezwanul Wahid
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD
| | - Regina Harley
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD
| | - Marcelo B. Sztein
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD
| | | | - Stefanie N. Vogel
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD
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Duprez J, Kalbfleisch K, Deshmukh S, Payne J, Haer M, Williams W, Durowoju I, Kirkitadze M. Structure and compositional analysis of aluminum oxyhydroxide adsorbed pertussis vaccine. Comput Struct Biotechnol J 2020; 19:439-447. [PMID: 33489011 PMCID: PMC7804342 DOI: 10.1016/j.csbj.2020.12.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 01/11/2023] Open
Abstract
PURPOSE The goal of this study was to characterize an acellular pertussis vaccine (Tdap) containing genetically modified pertussis toxin (gdPT) and TLR agonist adsorbed to AlOOH adjuvant. METHODS Several analytical tools including nanoDSF, FTIR, and LD were used to examine the conformation of novel gdPT and the composition of AlOOH adjuvant formulations adsorbed to pertussis vaccine. RESULTS DLS particle size results were 9.3 nm and 320 nm for gdPT. For pertussis toxoid (PT), the DLS particle size results were larger at ~440 nm. After adsorption to AlOOH, which was driven by the protein antigen, the size distribution ranged from 3.5 to 22 µm. Two thermal transitions were observed by DSC for gdPT at 70 °C and 102 °C. The main thermal transition was confirmed to be at 72 °C by nanoDSF. All three vaccine formulations showed one thermal transition: Tdap-AlOOH had a thermal transition of 74.6 °C, Tdap-E6020-AlOOH had a thermal transition at 74.2 °C, and Tdap-CpG-AlOOH had a thermal transition at 77.0 °C. Analysis of pertussis toxin (PTx) and gdPT was also performed by FTIR spectroscopy for the purpose of comparison. The second derivative of the FTIR spectra showed an additional feature for PTx at 1685 cm-1 compared to gdPT. The antigen's amide I and II regions were largely unchanged after adsorption to AlOOH adjuvant as shown by FTIR, suggesting that there were no significant changes in the secondary structure. CONCLUSION gdPT conformation was successfully characterized using an array of analytical methods. All three Tdap formulations have similar thermal stability as shown by nanoDSF, similar size distribution as shown by LD, and similar overall secondary structure as shown by FTIR. In-line particle sizing and IR can be used as in-process characterization tools to monitor consistency of adsorbed vaccine and to confirm product identity.
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Affiliation(s)
- Jessica Duprez
- Analytical Sciences, Sanofi Pasteur Canada, 1755 Steeles Avenue West, Toronto, Ontario, Canada
- Department of Biology, York University, 4700 Keele Street, Toronto, Ontario, Canada
| | - Kristen Kalbfleisch
- Department of Physiology & Pharmacology, and Paediatrics, University of Calgary, 2500 University Drive NW, Calgary, Alberta, Canada
| | - Sasmit Deshmukh
- SGS Canada, Biopharmaceutical Services, 6490 Vipond Drive, Mississauga, Ontario, Canada
| | - Jessie Payne
- Analytical Sciences, Sanofi Pasteur Canada, 1755 Steeles Avenue West, Toronto, Ontario, Canada
| | - Manjit Haer
- Analytical Sciences, Sanofi Pasteur Canada, 1755 Steeles Avenue West, Toronto, Ontario, Canada
| | - Wayne Williams
- Analytical Sciences, Sanofi Pasteur Canada, 1755 Steeles Avenue West, Toronto, Ontario, Canada
| | - Ibrahim Durowoju
- Analytical Sciences, Sanofi Pasteur Canada, 1755 Steeles Avenue West, Toronto, Ontario, Canada
| | - Marina Kirkitadze
- Analytical Sciences, Sanofi Pasteur Canada, 1755 Steeles Avenue West, Toronto, Ontario, Canada
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Malburet C, Leclercq L, Cotte JF, Thiebaud J, Cottet H. Study of Interactions between Antigens and Polymeric Adjuvants in Vaccines by Frontal Analysis Continuous Capillary Electrophoresis. Biomacromolecules 2020; 21:3364-3373. [PMID: 32609507 DOI: 10.1021/acs.biomac.0c00782] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Vaccine adjuvants are used to enhance the immune response induced by antigens that have insufficient immunostimulatory capabilities. The present work aims at developing a frontal analysis continuous capillary electrophoresis (FACCE) methodology for the study of antigen-adjuvant interactions in vaccine products. After method optimization using three cationic model proteins, namely lysozyme, cytochrome c, and ribonuclease A, FACCE was successfully implemented to quantify the free antigen and thus to determine the interaction parameters (stoichiometry and binding constant) between an anionic polymeric adjuvant (polyacrylic acid, SPA09) and a cationic vaccine antigen in development for the treatment for Staphylococcus aureus. The influence of the ionic strength of the medium on the interactions was investigated. A strong dependence of the binding parameters with the ionic strength was observed. The concentration of the polymeric adjuvant was also found to significantly modify the ionic strength of the formulation, the extent of which could be estimated and corrected.
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Affiliation(s)
- Camille Malburet
- IBMM, University of Montpellier, CNRS, ENSCM, Montpellier, France.,Analytical Sciences, Sanofi Pasteur, 1541 Avenue Marcel Mérieux, Marcy-l'Étoile 69280, France
| | - Laurent Leclercq
- IBMM, University of Montpellier, CNRS, ENSCM, Montpellier, France
| | - Jean-François Cotte
- Analytical Sciences, Sanofi Pasteur, 1541 Avenue Marcel Mérieux, Marcy-l'Étoile 69280, France
| | - Jérôme Thiebaud
- Analytical Sciences, Sanofi Pasteur, 1541 Avenue Marcel Mérieux, Marcy-l'Étoile 69280, France
| | - Hervé Cottet
- IBMM, University of Montpellier, CNRS, ENSCM, Montpellier, France
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Richard K, Perkins DJ, Harberts EM, Song Y, Gopalakrishnan A, Shirey KA, Lai W, Vlk A, Mahurkar A, Nallar S, Hawkins LD, Ernst RK, Vogel SN. Dissociation of TRIF bias and adjuvanticity. Vaccine 2020; 38:4298-4308. [PMID: 32389496 PMCID: PMC7302928 DOI: 10.1016/j.vaccine.2020.04.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/03/2020] [Accepted: 04/18/2020] [Indexed: 02/08/2023]
Abstract
Toll-like receptors (TLRs), a family of "pattern recognition receptors," bind microbial and host-derived molecules, leading to intracellular signaling and proinflammatory gene expression. TLR4 is unique in that ligand-mediated activation requires the co-receptor myeloid differentiation 2 (MD2) to initiate two signaling cascades: the MyD88-dependent pathway is initiated at the cell membrane, and elicits rapid MAP kinase and NF-κB activation, while the TIR-domain containing adaptor inducing interferon-β (TRIF)-dependent pathway is initiated from TLR4-containing endosomes and results in IRF3 activation. Previous studies associated inflammation with the MyD88 pathway and adjuvanticity with the TRIF pathway. Gram-negative lipopolysaccharide (LPS) is a potent TLR4 agonist, and structurally related molecules signal through TLR4 to differing extents. Herein, we compared monophosphoryl lipid A (sMPL) and E6020, two synthetic, non-toxic LPS lipid A analogs used as vaccine adjuvants, for their capacities to activate TLR4-mediated innate immune responses and to enhance antibody production. In mouse macrophages, high dose sMPL activates MyD88-dependent signaling equivalently to E6020, while E6020 exhibits significantly more activation of the TRIF pathway (a "TRIF bias") than sMPL. Eritoran, a TLR4/MD2 antagonist, competitively inhibited sMPL more strongly than E6020. Despite these differences, sMPL and E6020 adjuvants enhanced antibody responses to comparable extents, with balanced immunoglobulin (Ig) isotypes in two immunization models. These data indicate that a TRIF bias is not necessarily predictive of superior adjuvanticity.
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Affiliation(s)
- Katharina Richard
- Department of Microbiology and Immunology, University of Maryland School of Medicine (UMSOM), Baltimore, MD, United States
| | - Darren J Perkins
- Department of Microbiology and Immunology, University of Maryland School of Medicine (UMSOM), Baltimore, MD, United States
| | - Erin M Harberts
- Department of Microbial Pathogenesis, University of Maryland School of Dentistry (UMSOD), Baltimore, MD, United States
| | - Yang Song
- Genome Informatics Core, Institute for Genome Sciences (IGS), UMSOM, Baltimore, MD, United States
| | - Archana Gopalakrishnan
- Department of Microbiology and Immunology, University of Maryland School of Medicine (UMSOM), Baltimore, MD, United States
| | - Kari Ann Shirey
- Department of Microbiology and Immunology, University of Maryland School of Medicine (UMSOM), Baltimore, MD, United States
| | - Wendy Lai
- Department of Microbiology and Immunology, University of Maryland School of Medicine (UMSOM), Baltimore, MD, United States
| | - Alexandra Vlk
- Department of Microbiology and Immunology, University of Maryland School of Medicine (UMSOM), Baltimore, MD, United States
| | - Anup Mahurkar
- Genome Informatics Core, Institute for Genome Sciences (IGS), UMSOM, Baltimore, MD, United States
| | - Shreeram Nallar
- Department of Microbiology and Immunology, University of Maryland School of Medicine (UMSOM), Baltimore, MD, United States
| | | | - Robert K Ernst
- Department of Microbial Pathogenesis, University of Maryland School of Dentistry (UMSOD), Baltimore, MD, United States
| | - Stefanie N Vogel
- Department of Microbiology and Immunology, University of Maryland School of Medicine (UMSOM), Baltimore, MD, United States.
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Pal S, Ausar SF, Tifrea DF, Cheng C, Gallichan S, Sanchez V, de la Maza LM, Visan L. Protection of outbred mice against a vaginal challenge by a Chlamydia trachomatis serovar E recombinant major outer membrane protein vaccine is dependent on phosphate substitution in the adjuvant. Hum Vaccin Immunother 2020; 16:2537-2547. [PMID: 32118511 PMCID: PMC7644203 DOI: 10.1080/21645515.2020.1717183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2022] Open
Abstract
Chlamydia trachomatis is the most common bacterial sexually-transmitted pathogen for which there is no vaccine. We previously demonstrated that the degree of phosphate substitution in an aluminum hydroxide adjuvant in a TLR-4-based C. trachomatis serovar E (Ser E) recombinant major outer membrane protein (rMOMP) formulation had an impact on the induced antibody titers and IFN-γ levels. Here, we have extended these observations using outbreed CD-1 mice immunized with C. trachomatis Ser E rMOMP formulations to evaluate the impact on bacterial challenge. The results confirmed that the rMOMP vaccine containing the adjuvant with the highest phosphate substitution induced the highest neutralizing antibody titers while the formulation with the lowest phosphate substitution induced the highest IFN-γ production. The most robust protection was observed in mice vaccinated with the formulation containing the adjuvant with the lowest phosphate substitution, as shown by the number of mice with positive vaginal cultures, number of positive cultures and number of C. trachomatis inclusion forming units recovered. This is the first report showing that vaccination of an outbred strain of mice with rMOMP induces protection against a vaginal challenge with C. trachomatis.
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Affiliation(s)
- Sukumar Pal
- Department of Pathology and Laboratory Medicine, University of California , Irvine, CA, USA
| | | | - Delia F Tifrea
- Department of Pathology and Laboratory Medicine, University of California , Irvine, CA, USA
| | - Chunmei Cheng
- Department of Pathology and Laboratory Medicine, University of California , Irvine, CA, USA
| | - Scott Gallichan
- Analytical Research and Development Department, Sanofi Pasteur , Toronto, Ontario, Canada
| | - Violette Sanchez
- Research & Non Clinical Safety Department, Sanofi Pasteur , Marcy l'Etoile, France
| | - Luis M de la Maza
- Department of Pathology and Laboratory Medicine, University of California , Irvine, CA, USA
| | - Lucian Visan
- Research & Non Clinical Safety Department, Sanofi Pasteur , Marcy l'Etoile, France
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Rudicell RS, Garinot M, Kanekiyo M, Kamp HD, Swanson K, Chou TH, Dai S, Bedel O, Simard D, Gillespie RA, Yang K, Reardon M, Avila LZ, Besev M, Dhal PK, Dharanipragada R, Zheng L, Duan X, Dinapoli J, Vogel TU, Kleanthous H, Mascola JR, Graham BS, Haensler J, Wei CJ, Nabel GJ. Comparison of adjuvants to optimize influenza neutralizing antibody responses. Vaccine 2019; 37:6208-6220. [PMID: 31493950 DOI: 10.1016/j.vaccine.2019.08.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/26/2019] [Accepted: 08/17/2019] [Indexed: 12/14/2022]
Abstract
Seasonal influenza vaccines represent a positive intervention to limit the spread of the virus and protect public health. Yet continual influenza evolution and its ability to evade immunity pose a constant threat. For these reasons, vaccines with improved potency and breadth of protection remain an important need. We previously developed a next-generation influenza vaccine that displays the trimeric influenza hemagglutinin (HA) on a ferritin nanoparticle (NP) to optimize its presentation. Similar to other vaccines, HA-nanoparticle vaccine efficacy is increased by the inclusion of adjuvants during immunization. To identify the optimal adjuvants to enhance influenza immunity, we systematically analyzed TLR agonists for their ability to elicit immune responses. HA-NPs were compatible with nearly all adjuvants tested, including TLR2, TLR4, TLR7/8, and TLR9 agonists, squalene oil-in-water mixtures, and STING agonists. In addition, we chemically conjugated TLR7/8 and TLR9 ligands directly to the HA-ferritin nanoparticle. These TLR agonist-conjugated nanoparticles induced stronger antibody responses than nanoparticles alone, which allowed the use of a 5000-fold-lower dose of adjuvant than traditional admixtures. One candidate, the oil-in-water adjuvant AF03, was also tested in non-human primates and showed strong induction of neutralizing responses against both matched and heterologous H1N1 viruses. These data suggest that AF03, along with certain TLR agonists, enhance strong neutralizing antibody responses following influenza vaccination and may improve the breadth, potency, and ultimately vaccine protection in humans.
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Affiliation(s)
| | | | - Masaru Kanekiyo
- Vaccine Research Center, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | | | | | | | - Rebecca A Gillespie
- Vaccine Research Center, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | | | | | | | | | | | | | | | | | - John R Mascola
- Vaccine Research Center, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Barney S Graham
- Vaccine Research Center, National Institute for Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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Nosratababadi R, Bagheri V, Zare-Bidaki M, Hakimi H, Zainodini N, Kazemi Arababadi M. Toll like receptor 4: an important molecule in recognition and induction of appropriate immune responses against Chlamydia infection. Comp Immunol Microbiol Infect Dis 2017; 51:27-33. [PMID: 28504091 DOI: 10.1016/j.cimid.2017.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 02/06/2017] [Accepted: 03/12/2017] [Indexed: 01/09/2023]
Abstract
Chlamydia species are obligate intracellular pathogens causing different infectious diseases particularly asymptomatic genital infections and are also responsible for a wide range of complications. Previous studies showed that there are different immune responses to Chlamydia species and their infections are limited to some cases. Moreover, Chlamydia species are able to alter immune responses through modulating the expression of some immune system related molecules including cytokines. Toll like receptors (TLRs) belonge to pathogen recognition receptors (PRRs) and play vital roles in recognition of microbes and stimulation of appropriate immune responses. Therefore, it appears that TLRs may be considered as important sensors for recognition of Chlamydia and promotion of immune responses against these bacterial infections. Accordingly, TLR4 detects several microbial PAMPs such as bacterial lipopolysacharide (LPS) and subsequently activates transcription from pro-inflammatory cytokines in both MYD88 and TRIF pathways dependent manner. The purpose of this review is to provide the recent data about the status and major roles played by TLR4 in Chlamydia species recognition and promotion of immune responses against these infections and also the relationship between TLR4 activities and pathogenesis of Chlamydia infections.
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Affiliation(s)
- Reza Nosratababadi
- Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Department of Immunology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Vahid Bagheri
- Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mohammad Zare-Bidaki
- Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Department of Microbiology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Hamid Hakimi
- Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Department of Microbiology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Nahid Zainodini
- Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Department of Microbiology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mohammad Kazemi Arababadi
- Immunology of Infectious Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; Department of Immunology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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