1
|
El Hayek P, Boueri M, Nasr L, Aoun C, Sayad E, Jallad K. Cholera Infection Risks and Cholera Vaccine Safety in Pregnancy. Infect Dis Obstet Gynecol 2023; 2023:4563797. [PMID: 37260611 PMCID: PMC10228220 DOI: 10.1155/2023/4563797] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/05/2023] [Accepted: 04/26/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction Discuss the impact of cholera infection on pregnant women, fetus, and neonates and review the safety of cholera vaccines in pregnancy. Methods This study was carried out as a narrative review during November 2022. A thorough literature review was conducted on the following databases: PubMed, Scopus, SciELO, CINAHL, Web of Science, and ScienceDirect. The following parameters were assessed from the included studies: type of cholera vaccine, cholera symptoms, cholera treatment, effect of cholera on pregnancy, effect of cholera treatment on pregnancy, effect of cholera vaccine on pregnancy, risk factors for fetuses and neonates, and prevention of cholera. The authors independently extracted data from the 24 included studies. Results Cholera infection is a serious threat on pregnancy as it could lead to increased stillbirths and neonatal death. Fetal death was shown to occur mainly in the third trimester as most of the pregnant women infected with cholera had spontaneous abortions even after controlling for other confounding variables such as maternal age, dehydration level, and vomiting. Neonatal death was attributed mainly to congenital malformations and low Apgar scores with no improvements. Besides, cholera vaccines have shown to be safe in pregnancy and have proven to lower fetal and neonatal malformations among vaccinated compared to nonvaccinated pregnant women. Conclusion This narrative summarizes the different complications due to cholera infection in pregnancy. It also reviews the safety of cholera vaccine administration in pregnant women.
Collapse
Affiliation(s)
- Pamela El Hayek
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Lebanese American University School of Medicine, Lebanon
- Department of Obstetrics and Gynecology, Lebanese American University School of Medicine, Lebanon
| | - Myriam Boueri
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Lebanese American University School of Medicine, Lebanon
| | - Leah Nasr
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Lebanese American University School of Medicine, Lebanon
| | - Christine Aoun
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Lebanese American University School of Medicine, Lebanon
| | - Edouard Sayad
- Department of Pediatrics, Division of General Pediatrics, Division of Pediatric Pulmonology, Lebanese American University Medical Center LAUMCRH, Beirut, Lebanon
| | - Karl Jallad
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Lebanese American University School of Medicine, Lebanon
- Department of Obstetrics and Gynecology, Lebanese American University School of Medicine, Lebanon
| |
Collapse
|
2
|
Manhas KR, Marshall PA, Wagner CE, Jurutka PW, Mancenido MV, Debray HZ, Blattman JN. Rexinoids Modulate Effector T Cell Expression of Mucosal Homing Markers CCR9 and α4β7 Integrin and Direct Their Migration In Vitro. Front Immunol 2022; 13:746484. [PMID: 35154092 PMCID: PMC8829570 DOI: 10.3389/fimmu.2022.746484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 01/03/2022] [Indexed: 11/19/2022] Open
Abstract
Altering T cell trafficking to mucosal regions can enhance immune responses towards pathogenic infections and cancers at these sites, leading to better outcomes. All-trans-retinoic acid (ATRA) promotes T cell migration to mucosal surfaces by inducing transcription of the mucosal-homing receptors CCR9 and α4β7 via binding to retinoic acid receptors (RARs), which heterodimerize with retinoid X receptors (RXRs) to function. However, the unstable nature and toxicity of ATRA limit its use as a widespread treatment modality for mucosal diseases. Therefore, identifying alternatives that could reduce or eliminate the use of ATRA are needed. Rexinoids are synthetically derived compounds structurally similar to ATRA. Originally named for their ability to bind RXRs, rexinoids can enhance RAR-mediated gene transcription. Furthermore, rexinoids are more stable than ATRA and possess an improved safety profile, making them attractive candidates for use in clinical settings. Here we show that select novel rexinoids act as ATRA mimics, as they cause increased CCR9 and α4β7 expression and enhanced migration to the CCR9 ligand, CCL25 in vitro, even in the absence of ATRA. Conversely, other rexinoids act synergistically with ATRA, as culturing cells with suboptimal doses of both compounds resulted in CCR9 expression and migration to CCL25. Overall, our findings show that rexinoids can be used independently or synergistically with ATRA to promote mucosal homing of T cells in vitro, and lends support for the prospective clinical use of these compounds in immunotherapeutic approaches for pathogenic infections or cancers at mucosal surfaces.
Collapse
Affiliation(s)
- Kavita R. Manhas
- Biodesign Center for Immunotherapy, Vaccines, and Virotherapy, Arizona State University, Tempe, AZ, United States
| | - Pamela A. Marshall
- School of Mathematical and Natural Sciences, Arizona State University West Campus, Glendale, AZ, United States
| | - Carl E. Wagner
- School of Mathematical and Natural Sciences, Arizona State University West Campus, Glendale, AZ, United States
| | - Peter W. Jurutka
- School of Mathematical and Natural Sciences, Arizona State University West Campus, Glendale, AZ, United States
| | - Michelle V. Mancenido
- School of Mathematical and Natural Sciences, Arizona State University West Campus, Glendale, AZ, United States
| | - Hannah Z. Debray
- Biodesign Center for Immunotherapy, Vaccines, and Virotherapy, Arizona State University, Tempe, AZ, United States
| | - Joseph N. Blattman
- Biodesign Center for Immunotherapy, Vaccines, and Virotherapy, Arizona State University, Tempe, AZ, United States
| |
Collapse
|
3
|
Sant AJ. Overview of T-Cell Recognition. Clin Immunol 2019. [DOI: 10.1016/b978-0-7020-6896-6.00006-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
4
|
Dasaklis TK, Pappis CP. Critical success factors for implementing cholera vaccination campaigns in humanitarian emergencies: a DEMATEL-based approach. EURO JOURNAL ON DECISION PROCESSES 2018. [DOI: 10.1007/s40070-017-0062-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
5
|
Teshome S, Desai S, Kim JH, Belay D, Mogasale V. Feasibility and costs of a targeted cholera vaccination campaign in Ethiopia. Hum Vaccin Immunother 2018; 14:2427-2433. [PMID: 29648523 PMCID: PMC6290934 DOI: 10.1080/21645515.2018.1460295] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 03/14/2018] [Accepted: 03/28/2018] [Indexed: 11/04/2022] Open
Abstract
Shanchol™, a WHO-prequalified oral cholera vaccine (OCV), has been used to control endemic cholera in Asia, as well as in emergencies and outbreaks elsewhere. The vaccine has not been used by public health systems in cholera-endemic settings of Africa although several outbreak response campaigns have been conducted. Here we present experiences from a mass vaccination campaign in a cholera-endemic setting of Ethiopia in which Shanchol™ was introduced through the public health system. The vaccination site was selected based on cholera cases reported in previous years. Social mobilization involved sensitization of community leaders, household visits, and mass distribution of banners, posters and leaflets. The vaccination was implemented after careful microplanning of logistics and cold chain, manpower, transportation, vaccine supply and supervision and monitoring of adverse events. Vaccine administration was recorded on individual vaccination cards. Vaccine delivery costs were collected and analyzed after vaccination. As there was no experience with Shanchol™ in Ethiopia, a bridging trial was conducted to demonstrate safety and immunogenicity of the vaccine in the local population prior to the mass vaccination. Oral cholera vaccination was conducted in two rounds of four days each in February 2015 and March 2015 in 10 selected villages of Shashemenae rural district of Ethiopia. A total of 62,161 people targeted. 47,137 people (76%) received the first dose, and 40,707 (65%) received two doses. The financial cost of the vaccination campaign was estimated at US $2·60 per dose or US $5·64 per fully immunized person. The cost of vaccine delivery excluding vaccine procurement was $0·68 per dose or $1·48 per fully immunized person. The study demonstrates that mass cholera vaccination administered through the public health system in Ethiopia is feasible, can be implemented through the existing health system at an affordable cost, and the vaccine is acceptable to the community. The lessons from this study are useful for deploying OCV in other African endemic settings through the public health system and may guide future immunization policy decisions.
Collapse
Affiliation(s)
- Samuel Teshome
- International Vaccine Institute, Clinical Development & Regulatory Department, SNU Research Park, Seoul, South Korea
| | - Sachin Desai
- International Vaccine Institute, Clinical Development & Regulatory Department, SNU Research Park, Seoul, South Korea
| | - Jerome H. Kim
- International Vaccine Institute, Clinical Development & Regulatory Department, SNU Research Park, Seoul, South Korea
| | - Dires Belay
- Shashemene Rural District Office, Shashemene District, Oromia, Ethiopia
| | - Vittal Mogasale
- International Vaccine Institute, Policy and Economic Research Department, SNU Research Park, Seoul, South Korea
| |
Collapse
|
6
|
Khan AI, Islam MT, Qadri F. Safety of oral cholera vaccines during pregnancy in developing countries. Hum Vaccin Immunother 2017; 13:2245-2246. [PMID: 28825876 PMCID: PMC5647996 DOI: 10.1080/21645515.2017.1356525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 07/08/2017] [Indexed: 10/19/2022] Open
Affiliation(s)
- Ashraful Islam Khan
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Taufiqul Islam
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Firdausi Qadri
- International Centre for Diarrheal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| |
Collapse
|
7
|
Moro PL, Sukumaran L. Cholera vaccination: pregnant women excluded no more. THE LANCET. INFECTIOUS DISEASES 2017; 17:469-470. [PMID: 28161571 DOI: 10.1016/s1473-3099(17)30055-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 01/03/2017] [Indexed: 10/20/2022]
Affiliation(s)
- Pedro L Moro
- Immunization Safety Office, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
| | - Lakshmi Sukumaran
- Immunization Safety Office, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| |
Collapse
|
8
|
Mégraud F, Musso D, Drancourt M, Lehours P. Curved and Spiral Bacilli. Infect Dis (Lond) 2017. [DOI: 10.1016/b978-0-7020-6285-8.00182-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
9
|
Hamorsky KT, Kouokam JC, Jurkiewicz JM, Nelson B, Moore LJ, Husk AS, Kajiura H, Fujiyama K, Matoba N. N-glycosylation of cholera toxin B subunit in Nicotiana benthamiana: impacts on host stress response, production yield and vaccine potential. Sci Rep 2015; 5:8003. [PMID: 25614217 PMCID: PMC4303877 DOI: 10.1038/srep08003] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 12/16/2014] [Indexed: 01/01/2023] Open
Abstract
Plant-based transient overexpression systems enable rapid and scalable production of subunit vaccines. Previously, we have shown that cholera toxin B subunit (CTB), an oral cholera vaccine antigen, is N-glycosylated upon expression in transgenic Nicotiana benthamiana. Here, we found that overexpression of aglycosylated CTB by agroinfiltration of a tobamoviral vector causes massive tissue necrosis and poor accumulation unless retained in the endoplasmic reticulum (ER). However, the re-introduction of N-glycosylation to its original or an alternative site significantly relieved the necrosis and provided a high CTB yield without ER retention. Quantitative gene expression analysis of PDI, BiP, bZIP60, SKP1, 26Sα proteasome and PR1a, and the detection of ubiquitinated CTB polypeptides revealed that N-glycosylation significantly relieved ER stress and hypersensitive response, and facilitated the folding/assembly of CTB. The glycosylated CTB (gCTB) was characterized for potential vaccine use. Glycan profiling revealed that gCTB contained approximately 38% plant-specific glycans. gCTB retained nanomolar affinity to GM1-ganglioside with only marginal reduction of physicochemical stability and induced an anti-cholera holotoxin antibody response comparable to native CTB in a mouse oral immunization study. These findings demonstrated gCTB's potential as an oral immunogen and point to a potential role of N-glycosylation in increasing recombinant protein yields in plants.
Collapse
Affiliation(s)
- Krystal Teasley Hamorsky
- 1] Owensboro Cancer Research Program of James Graham Brown Cancer Center at University of Louisville School of Medicine, Owensboro, KY, USA [2] Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - J Calvin Kouokam
- 1] Owensboro Cancer Research Program of James Graham Brown Cancer Center at University of Louisville School of Medicine, Owensboro, KY, USA [2] Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY, USA
| | - Jessica M Jurkiewicz
- Owensboro Cancer Research Program of James Graham Brown Cancer Center at University of Louisville School of Medicine, Owensboro, KY, USA
| | - Bailey Nelson
- Owensboro Cancer Research Program of James Graham Brown Cancer Center at University of Louisville School of Medicine, Owensboro, KY, USA
| | - Lauren J Moore
- Owensboro Cancer Research Program of James Graham Brown Cancer Center at University of Louisville School of Medicine, Owensboro, KY, USA
| | - Adam S Husk
- Owensboro Cancer Research Program of James Graham Brown Cancer Center at University of Louisville School of Medicine, Owensboro, KY, USA
| | - Hiroyuki Kajiura
- The International Center for Biotechnology, Osaka University, Osaka, Japan
| | - Kazuhito Fujiyama
- The International Center for Biotechnology, Osaka University, Osaka, Japan
| | - Nobuyuki Matoba
- 1] Owensboro Cancer Research Program of James Graham Brown Cancer Center at University of Louisville School of Medicine, Owensboro, KY, USA [2] Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, KY, USA
| |
Collapse
|
10
|
Carraro N, Sauvé M, Matteau D, Lauzon G, Rodrigue S, Burrus V. Development of pVCR94ΔX from Vibrio cholerae, a prototype for studying multidrug resistant IncA/C conjugative plasmids. Front Microbiol 2014; 5:44. [PMID: 24567731 PMCID: PMC3915882 DOI: 10.3389/fmicb.2014.00044] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 01/21/2014] [Indexed: 01/02/2023] Open
Abstract
Antibiotic resistance has grown steadily in Vibrio cholerae over the last few decades to become a major threat in countries affected by cholera. Multi-drug resistance (MDR) spreads among clinical and environmental V. cholerae strains by lateral gene transfer often mediated by integrative and conjugative elements (ICEs) of the SXT/R391 family. However, in a few reported but seemingly isolated cases, MDR in V. cholerae was shown to be associated with other self-transmissible genetic elements such as conjugative plasmids. IncA/C conjugative plasmids are often found associated with MDR in isolates of Enterobacteriaceae. To date, IncA/C plasmids have not been commonly found in V. cholerae or other species of Vibrio. Here we present a detailed analysis of pVCR94ΔX derived from pVCR94, a novel IncA/C conjugative plasmid identified in a V. cholerae clinical strain isolated during the 1994 Rwandan cholera outbreak. pVCR94 was found to confer resistance to sulfamethoxazole, trimethoprim, ampicillin, streptomycin, tetracycline, and chloramphenicol and to transfer at very high frequency. Sequence analysis revealed its mosaic nature as well as high similarity of the core genes responsible for transfer and maintenance with other IncA/C plasmids and ICEs of the SXT/R391 family. Although IncA/C plasmids are considered a major threat in antibiotics resistance, their basic biology has received little attention, mostly because of the difficulty to genetically manipulate these MDR conferring elements. Therefore, we developed a convenient derivative from pVCR94, pVCR94Δ X, a 120.5-kb conjugative plasmid which only codes for sulfamethoxazole resistance. Using pVCR94Δ X, we identified the origin of transfer (oriT) and discovered an essential gene for transfer, both located within the shared backbone, allowing for an annotation update of all IncA/C plasmids. pVCR94Δ X may be a useful model that will provide new insights on the basic biology of IncA/C conjugative plasmids.
Collapse
Affiliation(s)
- Nicolas Carraro
- Département de Biologie, Université de Sherbrooke Sherbrooke, QC, Canada
| | - Maxime Sauvé
- Département de Biologie, Université de Sherbrooke Sherbrooke, QC, Canada
| | - Dominick Matteau
- Département de Biologie, Université de Sherbrooke Sherbrooke, QC, Canada
| | - Guillaume Lauzon
- Département de Biologie, Université de Sherbrooke Sherbrooke, QC, Canada
| | - Sébastien Rodrigue
- Département de Biologie, Université de Sherbrooke Sherbrooke, QC, Canada
| | - Vincent Burrus
- Département de Biologie, Université de Sherbrooke Sherbrooke, QC, Canada
| |
Collapse
|
11
|
Valcin CL, Severe K, Riche CT, Anglade BS, Moise CG, Woodworth M, Charles M, Li Z, Joseph P, Pape JW, Wright PF. Predictors of disease severity in patients admitted to a cholera treatment center in urban Haiti. Am J Trop Med Hyg 2013; 89:625-632. [PMID: 24106188 PMCID: PMC3795091 DOI: 10.4269/ajtmh.13-0170] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cholera, previously unrecognized in Haiti, spread through the country in the fall of 2010. An analysis was performed to understand the epidemiological characteristics, clinical management, and risk factors for disease severity in a population seen at the GHESKIO Cholera Treatment Center in Port-au-Prince. A comprehensive review of the medical records of patients admitted during the period of October 28, 2010–July 10, 2011 was conducted. Disease severity on admission was directly correlated with older age, more prolonged length of stay, and presentation during the two epidemic waves seen in the observation period. Although there was a high seroprevalence of human immunodeficiency virus (HIV), severity of cholera was not greater with HIV infection. This study documents the correlation of cholera waves with rainfall and its reduction in settings with improved sanitary conditions and potable water when newly introduced cholera affects all ages equally so that interventions must be directed throughout the population.
Collapse
Affiliation(s)
- Claude-Lyne Valcin
- *Address correspondence to Claude-Lyne Valcin, Dartmouth Medical School, Division of Infectious Diseases and International Health, 1 Medical Center Drive, Lebanon, NH 03756. E-mail:
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Merten S, Schaetti C, Manianga C, Lapika B, Hutubessy R, Chaignat CL, Weiss M. Sociocultural determinants of anticipated vaccine acceptance for acute watery diarrhea in early childhood in Katanga Province, Democratic Republic of Congo. Am J Trop Med Hyg 2013; 89:419-25. [PMID: 23878187 DOI: 10.4269/ajtmh.12-0643] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Rotavirus and oral cholera vaccines have the potential to reduce diarrhea-related child mortality in low-income settings and are recommended by the World Health Organization. Uptake of vaccination depends on community support, and is based on local priorities. This study investigates local perceptions of acute watery diarrhea in childhood and anticipated vaccine acceptance in two sites in the Democratic Republic of Congo. In 2010, 360 randomly selected non-affected adults were interviewed by using a semi-structured questionnaire. Witchcraft and breastfeeding were perceived as potential cause of acute watery diarrhea by 51% and 48% of respondents. Despite misperceptions, anticipated vaccine acceptance at no cost was 99%. The strongest predictor of anticipated vaccine acceptance if costs were assumed was the educational level of the respondents. Results suggest that the introduction of vaccines is a local priority and local (mis)perceptions of illness do not compromise vaccine acceptability if the vaccine is affordable.
Collapse
Affiliation(s)
- Sonja Merten
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
| | | | | | | | | | | | | |
Collapse
|
13
|
Lipopolysaccharide modifications of a cholera vaccine candidate based on outer membrane vesicles reduce endotoxicity and reveal the major protective antigen. Infect Immun 2013; 81:2379-93. [PMID: 23630951 DOI: 10.1128/iai.01382-12] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The causative agent of the life-threatening gastrointestinal infectious disease cholera is the Gram-negative, facultative human pathogen Vibrio cholerae. We recently started to investigate the potential of outer membrane vesicles (OMVs) derived from V. cholerae as an alternative approach for a vaccine candidate against cholera and successfully demonstrated the induction of a long-lasting, high-titer, protective immune response upon immunization with OMVs using the mouse model. In this study, we present immunization data using lipopolysaccharide (LPS)-modified OMVs derived from V. cholerae, which allowed us to improve and identify the major protective antigen of the vaccine candidate. Our results indicate that reduction of endotoxicity can be achieved without diminishing the immunogenic potential of the vaccine candidate by genetic modification of lipid A. Although the protective potential of anti-LPS antibodies has been suggested many times, this is the first comprehensive study that uses defined LPS mutants to characterize the LPS-directed immune response of a cholera vaccine candidate in more detail. Our results pinpoint the O antigen to be the essential immunogenic structure and provide a protective mechanism based on inhibition of motility, which prevents a successful colonization. In a detailed analysis using defined antisera, we can demonstrate that only anti-O antigen antibodies, but not antibodies directed against the major flagellar subunit FlaA or the most abundant outer membrane protein, OmpU, are capable of effectively blocking the motility by binding to the sheathed flagellum and provide protection in a passive immunization assay.
Collapse
|
14
|
Grandjean C, Wade TK, Ropartz D, Ernst L, Wade WF. Acid-detoxified Inaba lipopolysaccharide (pmLPS) is a superior cholera conjugate vaccine immunogen than hydrazine-detoxified lipopolysaccharide and induces vibriocidal and protective antibodies. Pathog Dis 2013; 67:136-58. [PMID: 23620159 DOI: 10.1111/2049-632x.12022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 01/07/2013] [Accepted: 01/07/2013] [Indexed: 11/30/2022] Open
Abstract
Worldwide, in endemic areas of cholera, the group most burdened with cholera is children. This is especially vexing as young children (2-5 years of age) do not respond as well, or for as long as adults do, to the current killed oral cholera vaccines (OCV). Conjugate vaccines based on the hapten-carrier paradigm have been developed for several bacterial pathogens that cause widespread and severe diseases in young children. We and others have studied different formulations of Vibrio cholerae (Vc) O1 lipopolysaccharide (LPS, a T-independent antigen) conjugates. Detoxified LPS is a central component of a LPS-based conjugate vaccine. pmLPS, which is detoxified by acid treatment, is a superior immunogen compared with hydrazine-detoxified LPS (DetAcLPS) that has altered lipid A acyl chains. The other feature of pmLPS is the ability to link carrier proteins to a core region of sugar. pmLPS readily induced vibriocidal antibodies following one intraperitoneal dose in a MPL-type adjuvant One dose of the pmLPS conjugate was suggestive of being protective; a booster resulted in protective antibodies for infant mice challenged with virulent cholera.
Collapse
Affiliation(s)
- Cyrille Grandjean
- LUNAM Université, Unité Fonctionnalité et Ingénierie des Protéines, Nantes, France
| | | | | | | | | |
Collapse
|
15
|
|
16
|
Holmgren J, Svennerholm AM. Vaccines against mucosal infections. Curr Opin Immunol 2012; 24:343-53. [PMID: 22580196 DOI: 10.1016/j.coi.2012.03.014] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Accepted: 03/27/2012] [Indexed: 01/05/2023]
Abstract
There remains a great need to develop vaccines against many of the pathogens that infect mucosal tissues or have a mucosal port of entry. Parenteral vaccination may protect in some instances, but usually a mucosal vaccination route is necessary. Mucosal vaccines also have logistic advantages over injectable vaccines by being easier to administer, having less risk of transmitting infections and potentially being easier to manufacture. Still, however, only relatively few vaccines for human use are available: oral vaccines against cholera, typhoid, polio, and rotavirus, and a nasal vaccine against influenza. For polio, typhoid and influenza, in which the pathogens reach the blood stream, there is also an injectable vaccine alternative. A problem with available oral live vaccines is their reduced immunogenicity when used in developing countries; for instance, the efficacy of rotavirus vaccines correlates closely with the national per capita income. Research is needed to define the impact of factors such as malnutrition, aberrant intestinal microflora, concomitant infections, and preexisting immunity as well as of host genetic factors on the immunogenicity of these vaccines.
Collapse
Affiliation(s)
- Jan Holmgren
- University of Gothenburg Vaccine Research Institute (GUVAX) & Department of Microbiology and Immunology, The Sahlgrenska Academy at University of Gothenburg, Sweden.
| | | |
Collapse
|