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Takahashi R, J-Khemlani AH, Loh JMS, Radcliff FJ, Proft T, Tsai CJY. Different Group A Streptococcus pili lead to varying proinflammatory cytokine responses and virulence. Immunol Cell Biol 2024; 102:21-33. [PMID: 37795567 DOI: 10.1111/imcb.12692] [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: 06/20/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023]
Abstract
The human pathogen Streptococcus pyogenes, or Group A Streptococcus (GAS), is associated with a variety of diseases ranging from mild skin and soft tissue infections to invasive diseases and immune sequelae such as rheumatic heart disease. We have recently reported that one of the virulence factors of this pathogen, the pilus, has inflammatory properties and strongly stimulates the innate immune system. Here we used a range of nonpathogenic Lactococcus lactis gain-of-function mutants, each expressing one of the major pilus types of GAS, to compare the immune responses generated by various types of fully assembled pili. In vitro assays indicated variability in the inflammatory response induced by different pili, with the fibronectin-binding, collagen-binding, T antigen (FCT)-1-type pilus from GAS serotype M6/T6 inducing significantly stronger cytokine secretion than other pili. Furthermore, we established that the same trend of pili-mediated immune response could be modeled in Galleria mellonella larvae, which possess a similar innate immune system to vertebrates. Counterintuitively, across the panel of pili types examined in this study, we observed a negative correlation between the intensity of the immune response demonstrated in our experiments and the disease severity observed clinically in the GAS strains associated with each pilus type. This observation suggests that pili-mediated inflammation is more likely to promote bacterial clearance instead of causing disruptive damages that intensify pathogenesis. This also indicates that pili may not be the main contributor to the inflammatory symptoms seen in GAS diseases. Rather, the immune-potentiating properties of the pilus components could potentially be exploited as a vaccine adjuvant.
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Affiliation(s)
- Risa Takahashi
- Department of Molecular Medicine & Pathology, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
| | - Adrina Hema J-Khemlani
- Department of Molecular Medicine & Pathology, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
| | - Jacelyn Mei San Loh
- Department of Molecular Medicine & Pathology, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Fiona Jane Radcliff
- Department of Molecular Medicine & Pathology, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Thomas Proft
- Department of Molecular Medicine & Pathology, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
| | - Catherine Jia-Yun Tsai
- Department of Molecular Medicine & Pathology, School of Medical Sciences, The University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
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2
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Abstract
Recent efforts have re-invigorated the Streptococcus pyogenes (Group A Streptococcus) vaccine development field, though scientific, regulatory and commercial barriers persist, and the vaccine pipeline remains sparse. There is an ongoing need to accelerate all aspects of development to address the large global burden of disease caused by the pathogen. Building on over 100 years of S. pyogenes vaccine development, there are currently eight candidates on a product development track, including four M protein-based candidates and four candidates designed around non-M protein antigens. These candidates have demonstrated proof of concept for protection against S. pyogenes in preclinical models, one has demonstrated safety and immunogenicity in a Phase 1 trial and at least four others are poised to soon enter clinical trials. To maintain momentum, the Strep A Vaccine Global Consortium (SAVAC) was established to bring together experts to accelerate global S. pyogenes vaccine development. This article highlights the past, present and future of S. pyogenes vaccine development and emphasizes key priorities, and the role of SAVAC, in advancing the field.
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3
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Ong BS, Dotel R, Ngian VJJ. Recurrent Cellulitis: Who is at Risk and How Effective is Antibiotic Prophylaxis? Int J Gen Med 2022; 15:6561-6572. [PMID: 35983462 PMCID: PMC9379124 DOI: 10.2147/ijgm.s326459] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/27/2022] [Indexed: 11/23/2022] Open
Abstract
Recurrent cellulitis following successful treatment is common and prevention should be a major component in the management of cellulitis. Conditions that increase the risk of recurrence include chronic edema, venous disease, dermatomycosis and obesity. These risk factors should be actively managed as further episodes of cellulitis increases the risk of recurrence. The role of non-antibiotic measures is important and should be first-line in prevention. Antibiotic prophylaxis is effective, but its role is limited to non-purulent cellulitis where risk factors are appropriately managed.
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Affiliation(s)
- Bin S Ong
- Department of Ambulatory Care, Division of Medicine, Bankstown-Lidcombe Hospital, Sydney, New South Wales, Australia.,University of New South Wales, Sydney, New South Wales, Australia
| | - Ravindra Dotel
- Department of Ambulatory Care, Division of Medicine, Bankstown-Lidcombe Hospital, Sydney, New South Wales, Australia
| | - Vincent Jiu Jong Ngian
- Department of Ambulatory Care, Division of Medicine, Bankstown-Lidcombe Hospital, Sydney, New South Wales, Australia.,University of New South Wales, Sydney, New South Wales, Australia
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4
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Azuar A, Shibu MA, Adilbish N, Marasini N, Hung H, Yang J, Luo Y, Khalil ZG, Capon RJ, Hussein WM, Toth I, Skwarczynski M. Poly(hydrophobic amino acid) Conjugates for the Delivery of Multiepitope Vaccine against Group A Streptococcus. Bioconjug Chem 2021; 32:2307-2317. [PMID: 34379392 DOI: 10.1021/acs.bioconjchem.1c00333] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Peptide-based vaccines are composed of small, defined, antigenic peptide epitopes. They are designed to induce well-controlled immune responses. Multiple epitopes are often employed in these vaccines to cover strain variability of a pathogen. However, peptide epitopes cannot stimulate adequate immune responses on their own and require an adjuvant (immune stimulant) and/or delivery system. Here, we designed and synthesized a multiepitope vaccine candidate against Group A Streptococcus (GAS) composed of several B-cell epitopes (J8, PL1, and 88/30) derived from GAS M-protein, universal PADRE T-helper cell epitope, and a polyleucine self-adjuvanting unit. The vaccine components were conjugated together (using mercapto-maleimide and azide-alkyne Huisgen cycloaddition reactions) or delivered as a mixture. The conjugated multiepitope vaccine candidate self-assembled into small nanoparticles and chain-like aggregated nanoparticles (CLANs) that were able to induce the production of J8-, PL1-, and 88/30-specific antibodies in mice. The multiepitope conjugate and the physical mixture of conjugates bearing the individual epitopes produced similar nanoparticles and induced comparable immune responses. Hence, simple physical mixing can replace complex chemical conjugation to produce multiepitope nanoparticles with equivalent morphology and immunological efficacy. This greatly simplifies vaccine production.
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Affiliation(s)
- Armira Azuar
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Mohini A Shibu
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Nomin Adilbish
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Nirmal Marasini
- School of Biomedical Sciences, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Hong Hung
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Jieru Yang
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Yacheng Luo
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Zeinab G Khalil
- Institute of Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Robert J Capon
- Institute of Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Waleed M Hussein
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Queensland 4072, Australia
| | - Istvan Toth
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Queensland 4072, Australia
- Institute of Molecular Bioscience, The University of Queensland, St. Lucia, Queensland 4072, Australia
- School of Pharmacy, The University of Queensland, Woolloongabba, Queensland 4102, Australia
| | - Mariusz Skwarczynski
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Queensland 4072, Australia
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Kuo CF, Chen WY, Yu HH, Tsai YH, Chang YC, Chang CP, Tsao N. IL-33/ST2 Axis Plays a Protective Effect in Streptococcus pyogenes Infection through Strengthening of the Innate Immunity. Int J Mol Sci 2021; 22:10566. [PMID: 34638904 PMCID: PMC8509005 DOI: 10.3390/ijms221910566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 09/23/2021] [Accepted: 09/26/2021] [Indexed: 12/21/2022] Open
Abstract
Group A Streptococcus (GAS) causes invasive human diseases with the cytokine storm. Interleukin-33 (IL-33)/suppression of tumorigenicity 2 (ST2) axis is known to drive TH2 response, while its effect on GAS infection is unclear. We used an air pouch model to examine the effect of the IL-33/ST2 axis on GAS-induced necrotizing fasciitis. GAS infection induced IL-33 expression in wild-type (WT) C57BL/6 mice, whereas the IL-33- and ST2-knockout mice had higher mortality rates, more severe skin lesions and higher bacterial loads in the air pouches than those of WT mice after infection. Surveys of infiltrating cells in the air pouch of GAS-infected mice at the early stage found that the number and cell viability of infiltrating cells in both gene knockout mice were lower than those of WT mice. The predominant effector cells in GAS-infected air pouches were neutrophils. Absence of the IL-33/ST2 axis enhanced the expression of inflammatory cytokines, but not TH1 or TH2 cytokines, in the air pouch after infection. Using in vitro assays, we found that the IL-33/ST2 axis not only enhanced neutrophil migration but also strengthened the bactericidal activity of both sera and neutrophils. These results suggest that the IL-33/ST2 axis provided the protective effect on GAS infection through enhancing the innate immunity.
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Affiliation(s)
- Chih-Feng Kuo
- School of Medicine, I-Shou University, Kaohsiung City 824005, Taiwan;
- Department of Nursing, College of Medicine, I-Shou University, Kaohsiung City 824005, Taiwan
| | - Wei-Yu Chen
- Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City 833401, Taiwan;
| | - Hai-Han Yu
- Department of Biological Science and Technology, College of Medical Science and Technology, I-Shou University, Kaohsiung City 824005, Taiwan; (H.-H.Y.); (Y.-H.T.)
| | - Yu-Hsuan Tsai
- Department of Biological Science and Technology, College of Medical Science and Technology, I-Shou University, Kaohsiung City 824005, Taiwan; (H.-H.Y.); (Y.-H.T.)
| | - Ya-Chu Chang
- Department of Medical Laboratory Science, College of Medical Science and Technology, I-Shou University, Kaohsiung City 824005, Taiwan;
| | - Chih-Peng Chang
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan;
- The Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Nina Tsao
- Department of Biological Science and Technology, College of Medical Science and Technology, I-Shou University, Kaohsiung City 824005, Taiwan; (H.-H.Y.); (Y.-H.T.)
- Department of Medical Laboratory Science, College of Medical Science and Technology, I-Shou University, Kaohsiung City 824005, Taiwan;
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6
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Mahdevar E, Safavi A, Abiri A, Kefayat A, Hejazi SH, Miresmaeili SM, Iranpur Mobarakeh V. Exploring the cancer-testis antigen BORIS to design a novel multi-epitope vaccine against breast cancer based on immunoinformatics approaches. J Biomol Struct Dyn 2021; 40:6363-6380. [PMID: 33599191 DOI: 10.1080/07391102.2021.1883111] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Recently, cancer immunotherapy has gained lots of attention to replace the current chemoradiation approaches and multi-epitope cancer vaccines are manifesting as the next generation of cancer immunotherapy. Therefore, in this study, we used multiple immunoinformatics approaches along with other computational approaches to design a novel multi-epitope vaccine against breast cancer. The most immunogenic regions of the BORIS cancer-testis antigen were selected according to the binding affinity to MHC-I and II molecules as well as containing multiple cytotoxic T lymphocyte (CTL) epitopes by multiple immunoinformatics servers. The selected regions were linked together by GPGPG linker. Also, a T helper epitope (PADRE) and the TLR-4/MD-2 agonist (L7/L12 ribosomal protein from mycobacterium) were incorporated by A(EAAAK)3A linker to form the final vaccine construct. Then, its physicochemical properties, cleavage sites, TAP transport efficiency, B cell epitopes, IFN-γ inducing epitopes and population coverage were predicted. The final vaccine construct was reverse translated, codon-optimized and inserted into pcDNA3.1 to form the DNA vaccine. The final vaccine construct was a stable, immunogenic and non-allergenic protein that contained numerous CTL epitopes, IFN-γ inducing epitopes and several linear and conformational B cell epitopes. Also, the final vaccine construct formed stable and significant interactions with TLR-4/MD-2 complex according to molecular docking and dynamics simulations. Moreover, its world population coverage for HLA-I and HLA-II were about 93% and 96%, respectively. Taking together, these preliminary results can be used as an appropriate platform for further experimental investigations.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Elham Mahdevar
- Department of Biology, Faculty of Science and Engineering, Science and Arts University, Yazd, Iran
| | - Ashkan Safavi
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Ardavan Abiri
- Department of Medicinal Chemistry, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Amirhosein Kefayat
- Department of Oncology, Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Hossein Hejazi
- Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Mohsen Miresmaeili
- Department of Biology, Faculty of Science and Engineering, Science and Arts University, Yazd, Iran
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7
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Wang G, Zhao J, Zhao Y, Wang S, Feng S, Gu G. Immunogenicity Assessment of Different Segments and Domains of Group a Streptococcal C5a Peptidase and Their Application Potential as Carrier Protein for Glycoconjugate Vaccine Development. Vaccines (Basel) 2021; 9:vaccines9020139. [PMID: 33572233 PMCID: PMC7915350 DOI: 10.3390/vaccines9020139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 12/28/2022] Open
Abstract
Group A streptococcal C5a peptidase (ScpA) is a highly conserved surface virulence factor present on group A streptococcus (GAS) cell surfaces. It has attracted much more attention as a promising antigenic target for GAS vaccine development due to its high antigenicity to stimulate specific and immunoprotective antibodies. In this study, a series of segments of ScpA were rationally designed according to the functional domains described in its crystal structure, efficiently prepared and immunologically evaluated so as to assess their potential as antigens for the development of subunit vaccines. Immunological studies revealed that Fn, Fn2, and rsScpA193 proteins were promising antigen candidates worthy for further exploration. In addition, the potential of Fn and Fn2 as carrier proteins to formulate effective glycoconjugate vaccine was also investigated.
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Affiliation(s)
| | | | | | | | | | - Guofeng Gu
- Correspondence: ; Tel.: +86-532-5863-1408
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8
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Nakata M, Kreikemeyer B. Genetics, Structure, and Function of Group A Streptococcal Pili. Front Microbiol 2021; 12:616508. [PMID: 33633705 PMCID: PMC7900414 DOI: 10.3389/fmicb.2021.616508] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/18/2021] [Indexed: 12/12/2022] Open
Abstract
Streptococcus pyogenes (Group A Streptococcus; GAS) is an exclusively human pathogen. This bacterial species is responsible for a large variety of infections, ranging from purulent but mostly self-limiting oropharynx/skin diseases to streptococcal sequelae, including glomerulonephritis and rheumatic fever, as well as life-threatening streptococcal toxic-shock syndrome. GAS displays a wide array of surface proteins, with antigenicity of the M protein and pili utilized for M- and T-serotyping, respectively. Since the discovery of GAS pili in 2005, their genetic features, including regulation of expression, and structural features, including assembly mechanisms and protein conformation, as well as their functional role in GAS pathogenesis have been intensively examined. Moreover, their potential as vaccine antigens has been studied in detail. Pilus biogenesis-related genes are located in a discrete section of the GAS genome encoding fibronectin and collagen binding proteins and trypsin-resistant antigens (FCT region). Based on the heterogeneity of genetic composition and DNA sequences, this region is currently classified into nine distinguishable forms. Pili and fibronectin-binding proteins encoded in the FCT region are known to be correlated with infection sites, such as the skin and throat, possibly contributing to tissue tropism. As also found for pili of other Gram-positive bacterial pathogens, GAS pilin proteins polymerize via isopeptide bonds, while intramolecular isopeptide bonds present in the pilin provide increased resistance to degradation by proteases. As supported by findings showing that the main subunit is primarily responsible for T-serotyping antigenicity, pilus functions and gene expression modes are divergent. GAS pili serve as adhesins for tonsillar tissues and keratinocyte cell lines. Of note, a minor subunit is considered to have a harpoon function by which covalent thioester bonds with host ligands are formed. Additionally, GAS pili participate in biofilm formation and evasion of the immune system in a serotype/strain-specific manner. These multiple functions highlight crucial roles of pili during the onset of GAS infection. This review summarizes the current state of the art regarding GAS pili, including a new mode of host-GAS interaction mediated by pili, along with insights into pilus expression in terms of tissue tropism.
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Affiliation(s)
- Masanobu Nakata
- Department of Oral Microbiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Bernd Kreikemeyer
- Institute of Medical Microbiology, Virology and Hygiene, University of Rostock, Rostock, Germany
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Faruck MO, Zhao L, Hussein WM, Khalil ZG, Capon RJ, Skwarczynski M, Toth I. Polyacrylate-Peptide Antigen Conjugate as a Single-Dose Oral Vaccine against Group A Streptococcus. Vaccines (Basel) 2020; 8:E23. [PMID: 31941060 PMCID: PMC7157655 DOI: 10.3390/vaccines8010023] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 12/15/2022] Open
Abstract
Group A Streptococcus (GAS)-associated rheumatic heart disease is a leading cause of death caused by GAS infection. While antibiotics can treat the infection in most cases, growing antibiotic resistance, late medical intervention, and recurrent infection are major obstacles to the effective treatment of GAS-associated diseases. As GAS infection typically originates from the bacterial colonization of mucosal tissue in the throat, an oral vaccine that can generate both systemic and mucosal immune responses would solve problems associated with traditional medical interventions. Moreover, orally delivered vaccines are more easily administered and less expensive for mass immunization. In this study, the B-cell epitope J8, derived from GAS M protein, and universal T-helper Pan HLA-DR-binding epitope peptide (PADRE), were conjugated to poly (methyl acrylate) (PMA) to form a self-assembled nanoparticle vaccine candidate (PMA-P-J8). Strong systemic and mucosal immune responses were induced upon single oral immunization of mice with the conjugate. The antibodies generated were opsonic against GAS clinical isolates as measured after boost immunization. Thus, we developed a simple conjugate as an effective, adjuvant-free oral peptide-based vaccine.
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Affiliation(s)
- Mohammad Omer Faruck
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Brisbane, QLD 4072, Australia; (M.O.F.); (L.Z.); (W.M.H.)
| | - Lili Zhao
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Brisbane, QLD 4072, Australia; (M.O.F.); (L.Z.); (W.M.H.)
| | - Waleed M. Hussein
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Brisbane, QLD 4072, Australia; (M.O.F.); (L.Z.); (W.M.H.)
- Pharmaceutical Organic Chemistry Department, Faculty of Pharmacy, Helwan University, Helwan 11795, Egypt
| | - Zeinab G. Khalil
- Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD 4072, Australia; (Z.G.K.); (R.J.C.)
| | - Robert J. Capon
- Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD 4072, Australia; (Z.G.K.); (R.J.C.)
| | - Mariusz Skwarczynski
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Brisbane, QLD 4072, Australia; (M.O.F.); (L.Z.); (W.M.H.)
| | - Istvan Toth
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Brisbane, QLD 4072, Australia; (M.O.F.); (L.Z.); (W.M.H.)
- Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD 4072, Australia; (Z.G.K.); (R.J.C.)
- School of Pharmacy, The University of Queensland, Woolloongabba, Brisbane, QLD 4102, Australia
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10
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Affiliation(s)
- Stewart Sell
- Wadsworth Center, New York State Department of Health, Empire State Plaza, Albany, NY, USA
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11
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Azuar A, Zhao L, Hei TT, Nevagi RJ, Bartlett S, Hussein WM, Khalil ZG, Capon RJ, Toth I, Skwarczynski M. Cholic Acid-based Delivery System for Vaccine Candidates against Group A Streptococcus. ACS Med Chem Lett 2019; 10:1253-1259. [PMID: 31531193 DOI: 10.1021/acsmedchemlett.9b00239] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 07/24/2019] [Indexed: 01/08/2023] Open
Abstract
Peptide-based subunit vaccines require an immunostimulant (adjuvant) and/or delivery system to protect the antigenic peptide from degradation and induce the desired immunity. Currently available adjuvants are either too toxic for human use (experimental adjuvants) or they are limited for use in particular vaccines or licensed countries (commercial adjuvants). Therefore, there is an immediate need for novel adjuvants that are both safe and effective. Herein, we assessed the ability of cholic acid (a major bile acid) as a nontoxic, biodegradable, human-derived, potent vaccine delivery system. An antigenic peptide derived from Group A Streptococcus was conjugated to hydrophobic cholic acid via solid phase peptide synthesis to produce lipopeptide that self-assembled into rod-like nanoparticles under aqueous conditions. Following intranasal immunization in mice, this lipopeptide was capable of inducing the production of opsonic epitope-specific antibodies on its own and in liposomal formulation. The cholic acid-based conjugate induced significantly stronger humoral immune responses than cholera toxin-based adjuvant. Thus, we demonstrated, for the first time, capability of the human-derived lipid to act as a built-in immunoadjuvant for vaccines.
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Affiliation(s)
- Armira Azuar
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Lili Zhao
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Tsui Ting Hei
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Reshma J. Nevagi
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Stacey Bartlett
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Waleed M. Hussein
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD, Australia
- Pharmaceutical Organic Chemistry Department, Faculty of Pharmacy, Helwan University, Helwan, Egypt
| | - Zeinab G. Khalil
- Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD, Australia
| | - Robert J. Capon
- Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD, Australia
| | - Istvan Toth
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD, Australia
- Institute for Molecular Bioscience, The University of Queensland, St. Lucia, QLD, Australia
- School of Pharmacy, The University of Queensland, Woolloongabba, QLD, Australia
| | - Mariusz Skwarczynski
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD, Australia
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12
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Azuar A, Jin W, Mukaida S, Hussein WM, Toth I, Skwarczynski M. Recent Advances in the Development of Peptide Vaccines and Their Delivery Systems Against Group A Streptococcus. Vaccines (Basel) 2019; 7:E58. [PMID: 31266253 PMCID: PMC6789462 DOI: 10.3390/vaccines7030058] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/21/2019] [Accepted: 06/25/2019] [Indexed: 02/07/2023] Open
Abstract
Group A Streptococcus (GAS) infection can cause a variety of diseases in humans, ranging from common sore throats and skin infections, to more invasive diseases and life-threatening post-infectious diseases, such as rheumatic fever and rheumatic heart disease. Although research has been ongoing since 1923, vaccines against GAS are still not available to the public. Traditional approaches taken to develop vaccines for GAS failed due to poor efficacy and safety. Fortunately, headway has been made and modern subunit vaccines that administer minimal bacterial components provide an opportunity to finally overcome previous hurdles in GAS vaccine development. This review details the major antigens and strategies used for GAS vaccine development. The combination of antigen selection, peptide epitope modification and delivery systems have resulted in the discovery of promising peptide vaccines against GAS; these are currently in preclinical and clinical studies.
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Affiliation(s)
- Armira Azuar
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Wanli Jin
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Saori Mukaida
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Waleed M Hussein
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD 4072, Australia
- Pharmaceutical Organic Chemistry Department, Faculty of Pharmacy, Helwan University, Helwan, Cairo 11795, Egypt
| | - Istvan Toth
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD 4072, Australia
- School of Pharmacy, Woolloongabba, The University of Queensland, QLD 4072, Australia
- Institute of Molecular Bioscience, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Mariusz Skwarczynski
- School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, QLD 4072, Australia.
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13
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Gherardi G, Vitali LA, Creti R. Prevalent emm Types among Invasive GAS in Europe and North America since Year 2000. Front Public Health 2018; 6:59. [PMID: 29662874 PMCID: PMC5890186 DOI: 10.3389/fpubh.2018.00059] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 02/14/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Streptococcus pyogenes or group A streptococcus (GAS) is an important human pathogen responsible for a broad range of infections, from uncomplicated to more severe and invasive diseases with high mortality and morbidity. Epidemiological surveillance has been crucial to detect changes in the geographical and temporal variation of the disease pattern; for this purpose the M protein gene (emm) gene typing is the most widely used genotyping method, with more than 200 emm types recognized. Molecular epidemiological data have been also used for the development of GAS M protein-based vaccines. METHODS The aim of this paper was to provide an updated scenario of the most prevalent GAS emm types responsible for invasive infections in developed countries as Europe and North America (US and Canada), from 1st January 2000 to 31st May 2017. The search, performed in PubMed by the combined use of the terms ("emm") and ("invasive") retrieved 264 articles, of which 38 articles (31 from Europe and 7 from North America) met the inclusion criteria and were selected for this study. Additional five papers cited in the European articles but not retrieved by the search were included. RESULTS emm1 represented the dominant type in both Europe and North America, replaced by other emm types in only few occasions. The seven major emm types identified (emm1, emm28, emm89, emm3, emm12, emm4, and emm6) accounted for approximately 50-70% of the total isolates; less common emm types accounted for the remaining 30-50% of the cases. Most of the common emm types are included in either one or both the 26-valent and 30-valent vaccines, though some well-represented emm types found in Europe are not. CONCLUSION This study provided a picture of the prevalent emm types among invasive GAS (iGAS) in Europe and North America since the year 2000 onward. Continuous surveillance on the emm-type distribution among iGAS infections is strongly encouraged also to determine the potential coverage of the developing multivalent vaccines.
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Affiliation(s)
- Giovanni Gherardi
- Microbiology Unit, Department of Medicine, Campus Bio-Medico University, Rome, Italy
| | | | - Roberta Creti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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14
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Raynes JM, Young PG, Proft T, Williamson DA, Baker EN, Moreland NJ. Protein adhesins as vaccine antigens for Group A Streptococcus. Pathog Dis 2018; 76:4919728. [DOI: 10.1093/femspd/fty016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 03/01/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
- J M Raynes
- School of Medical Sciences, The University of Auckland, 85 Park Road, Auckland 1023, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, 3A Symonds Street, Auckland 1010, New Zealand
| | - P G Young
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, 3A Symonds Street, Auckland 1010, New Zealand
- School of Biological Sciences, University of Auckland, 5 Symonds Street, Auckland 1010, New Zealand
| | - T Proft
- School of Medical Sciences, The University of Auckland, 85 Park Road, Auckland 1023, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, 3A Symonds Street, Auckland 1010, New Zealand
| | - D A Williamson
- Microbiological Diagnostic Unit Public Health Laboratory, Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Victoria 3000, Australia
| | - E N Baker
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, 3A Symonds Street, Auckland 1010, New Zealand
- School of Biological Sciences, University of Auckland, 5 Symonds Street, Auckland 1010, New Zealand
| | - N J Moreland
- School of Medical Sciences, The University of Auckland, 85 Park Road, Auckland 1023, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, 3A Symonds Street, Auckland 1010, New Zealand
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15
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Schulze K, Ebensen T, Chandrudu S, Skwarczynski M, Toth I, Olive C, Guzman CA. Bivalent mucosal peptide vaccines administered using the LCP carrier system stimulate protective immune responses against Streptococcus pyogenes infection. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2017; 13:2463-2474. [PMID: 28887213 DOI: 10.1016/j.nano.2017.08.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 07/11/2017] [Accepted: 08/15/2017] [Indexed: 11/18/2022]
Abstract
Despite the broad knowledge about the pathogenicity of Streptococcus pyogenes there is still a controversy about the correlate of protection in GAS infections. We aimed in further improving the immune responses stimulated against GAS comparing different vaccine formulations including bis-(3',5')-cyclic dimeric adenosine monophosphate (c-di-AMP) and BPPCysMPEG, a derivative of the macrophage-activating lipopeptide (MALP-2), as adjuvants, respectively, to be administered with and without the universal T helper cell epitope P25 along with the optimized B cell epitope J14 of the M protein and B and T cell epitopes of SfbI. Lipopeptide based nano carrier systems (LCP) were used for efficient antigen delivery across the mucosal barrier. The stimulated immune responses were efficient in protecting mice against a respiratory challenge with a lethal dose of a heterologous S. pyogenes strain. Moreover, combination of the LCP based peptide vaccine with c-di-AMP allowed reduction of antigen dose at the same time maintaining vaccine efficacy.
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Affiliation(s)
- Kai Schulze
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Braunschweig, Germany.
| | - Thomas Ebensen
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Saranya Chandrudu
- The University of Queensland, School of Chemistry & Molecular Biosciences, St Luc ia, QLD, Australia
| | - Mariusz Skwarczynski
- The University of Queensland, School of Chemistry & Molecular Biosciences, St Luc ia, QLD, Australia
| | - Istvan Toth
- The University of Queensland, School of Chemistry & Molecular Biosciences, St Luc ia, QLD, Australia; The University of Queensland, Institute for Molecular Bioscience, St Lucia, QLD, Australia; The University of Queensland, School of Pharmacy, Woolloongabba, QLD, Australia
| | - Colleen Olive
- Central Laboratory, Pathology Queensland, Health Support Queensland, Department of Health, Queensland Government, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia
| | - Carlos A Guzman
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
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16
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Parks T, Mirabel MM, Kado J, Auckland K, Nowak J, Rautanen A, Mentzer AJ, Marijon E, Jouven X, Perman ML, Cua T, Kauwe JK, Allen JB, Taylor H, Robson KJ, Deane CM, Steer AC, Hill AVS. Association between a common immunoglobulin heavy chain allele and rheumatic heart disease risk in Oceania. Nat Commun 2017; 8:14946. [PMID: 28492228 PMCID: PMC5437274 DOI: 10.1038/ncomms14946] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 02/15/2017] [Indexed: 12/19/2022] Open
Abstract
The indigenous populations of the South Pacific experience a high burden of rheumatic heart disease (RHD). Here we report a genome-wide association study (GWAS) of RHD susceptibility in 2,852 individuals recruited in eight Oceanian countries. Stratifying by ancestry, we analysed genotyped and imputed variants in Melanesians (607 cases and 1,229 controls) before follow-up of suggestive loci in three further ancestral groups: Polynesians, South Asians and Mixed or other populations (totalling 399 cases and 617 controls). We identify a novel susceptibility signal in the immunoglobulin heavy chain (IGH) locus centring on a haplotype of nonsynonymous variants in the IGHV4-61 gene segment corresponding to the IGHV4-61*02 allele. We show each copy of IGHV4-61*02 is associated with a 1.4-fold increase in the risk of RHD (odds ratio 1.43, 95% confidence intervals 1.27–1.61, P=4.1 × 10−9). These findings provide new insight into the role of germline variation in the IGH locus in disease susceptibility. Rheumatic heart disease (RHD) is a chronic auto-inflammatory reaction to group A streptococcal infection, and frequently occurs in individuals from the South Pacific. This study finds a novel association between an immunoglobulin heavy chain allele and risk of RHD in Pacific Islanders and South Asians.
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Affiliation(s)
- Tom Parks
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Mariana M Mirabel
- Paris Centre de Recherche Cardiovasculaire, Institut National de la Santé et de la Recherche Médicale, Hôpital Européen Georges Pompidou, 56, rue Leblanc, 75908 Paris, France
| | - Joseph Kado
- Department of Paediatrics, Ministry of Health and Medical Services, Colonial War Memorial Hospital, Brown Street, Suva, Fiji.,College of Medicine, Nursing &Health Sciences, Fiji National University, Brown Street, Suva, Fiji
| | - Kathryn Auckland
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Jaroslaw Nowak
- Department of Statistics, University of Oxford, Peter Medawar Building for Pathogen Research, Oxford OX1 3S, UK
| | - Anna Rautanen
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Alexander J Mentzer
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Eloi Marijon
- Paris Centre de Recherche Cardiovasculaire, Institut National de la Santé et de la Recherche Médicale, Hôpital Européen Georges Pompidou, 56, rue Leblanc, 75908 Paris, France.,Faculté de Médecine Paris Descartes, Université Paris Descartes, 15, rue de l'école de medicine, 75006 Paris, France
| | - Xavier Jouven
- Paris Centre de Recherche Cardiovasculaire, Institut National de la Santé et de la Recherche Médicale, Hôpital Européen Georges Pompidou, 56, rue Leblanc, 75908 Paris, France.,Faculté de Médecine Paris Descartes, Université Paris Descartes, 15, rue de l'école de medicine, 75006 Paris, France
| | - Mai Ling Perman
- College of Medicine, Nursing &Health Sciences, Fiji National University, Brown Street, Suva, Fiji
| | - Tuliana Cua
- Rheumatic Heart Disease Control Programme, Ministry of Health and Medical Services, Colonial War Memorial Hospital, Brown Street, Suva, Fiji
| | - John K Kauwe
- College of Life Sciences, Brigham Young University, 4146 Life Sciences Building, Provo, Utah 84602, USA
| | - John B Allen
- College of Life Sciences, Brigham Young University, 4146 Life Sciences Building, Provo, Utah 84602, USA
| | - Henry Taylor
- Rheumatic Heart Disease Control Programme, Samoa Ministry of Health, Moto'otua, Ifiifi Street, Apia, Samoa
| | - Kathryn J Robson
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Headington, Oxford OX3 9DS, UK
| | - Charlotte M Deane
- Department of Statistics, University of Oxford, Peter Medawar Building for Pathogen Research, Oxford OX1 3S, UK
| | - Andrew C Steer
- Centre for International Child Health, University of Melbourne, 50 Flemington Road, Parkville, Melbourne Victoria 3052, Australia.,Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia
| | - Adrian V S Hill
- Wellcome Trust Centre for Human Genetics, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
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17
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Mortensen R, Christensen D, Hansen LB, Christensen JP, Andersen P, Dietrich J. Local Th17/IgA immunity correlate with protection against intranasal infection with Streptococcus pyogenes. PLoS One 2017; 12:e0175707. [PMID: 28414746 PMCID: PMC5393599 DOI: 10.1371/journal.pone.0175707] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 03/30/2017] [Indexed: 01/11/2023] Open
Abstract
Streptococcus pyogenes (group A streptococcus, GAS) is responsible for a wide array of infections. Respiratory transmission via droplets is the most common mode of transmission but it may also infect the host via other routes such as lesions in the skin. To advance the development of a future vaccine against GAS, it is therefore important to investigate how protective immunity is related to the route of vaccine administration. To explore this, we examined whether a parenterally administered anti-GAS vaccine could protect against an intranasal GAS infection or if this would require locally primed immunity. We foundd that a parenteral CAF01 adjuvanted GAS vaccine offered no protection against intranasal infection despite inducing strong systemic Th1/Th17/IgG immunity that efficiently protected against an intraperitoneal GAS infection. However, the same vaccine administered via the intranasal route was able to induce protection against repeated intranasal GAS infections in a murine challenge model. The lack of intranasal protection induced by the parenteral vaccine correlated with a reduced mucosal recall response at the site of infection. Taken together, our results demonstrate that locally primed immunity is important for the defense against intranasal infection with Streptococcus pyogenes.
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Affiliation(s)
- Rasmus Mortensen
- Statens Serum Institut, Department of Infectious Disease Immunology, Copenhagen, Denmark
- University of Copenhagen, Department of Immunology and Microbiology, Copenhagen, Denmark
| | - Dennis Christensen
- Statens Serum Institut, Department of Infectious Disease Immunology, Copenhagen, Denmark
| | - Lasse Bøllehuus Hansen
- Rigshospitalet, Department of Growth and Reproduction, University of Copenhagen, Copenhagen, Denmark
| | | | - Peter Andersen
- Statens Serum Institut, Department of Infectious Disease Immunology, Copenhagen, Denmark
| | - Jes Dietrich
- Statens Serum Institut, Department of Infectious Disease Immunology, Copenhagen, Denmark
- * E-mail:
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18
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Schödel F, Moreland NJ, Wittes JT, Mulholland K, Frazer I, Steer AC, Fraser JD, Carapetis J. Clinical development strategy for a candidate group A streptococcal vaccine. Vaccine 2017; 35:2007-2014. [DOI: 10.1016/j.vaccine.2017.02.060] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 02/21/2017] [Accepted: 02/27/2017] [Indexed: 12/30/2022]
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19
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Gandhi GD, Krishnamoorthy N, Motal UMA, Yacoub M. Towards developing a vaccine for rheumatic heart disease. Glob Cardiol Sci Pract 2017; 2017:e201704. [PMID: 28971103 PMCID: PMC5621712 DOI: 10.21542/gcsp.2017.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Rheumatic heart disease (RHD) is the most serious manifestations of rheumatic fever, which is caused by group A Streptococcus (GAS or Streptococcus pyogenes) infection. RHD is an auto immune sequelae of GAS pharyngitis, rather than the direct bacterial infection of the heart, which leads to chronic heart valve damage. Although antibiotics like penicillin are effective against GAS infection, improper medical care such as poor patient compliance, overcrowding, poverty, and repeated exposure to GAS, leads to acute rheumatic fever and RHD. Thus, efforts have been put forth towards developing a vaccine. However, a potential global vaccine is yet to be identified due to the widespread diversity of S. pyogenes strains and cross reactivity of streptococcal proteins with host tissues. In this review, we discuss the available vaccine targets of S. pyogenes and the significance of in silico approaches in designing a vaccine for RHD.
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Affiliation(s)
- Geethanjali Devadoss Gandhi
- Division of Cardiovascular Research, Sidra Medical and Research Center, Qatar Foundation, Doha, Qatar.,Division of Experimental Genetics, Sidra Medical and Research Center, Doha, Qatar
| | - Navaneethakrishnan Krishnamoorthy
- Division of Cardiovascular Research, Sidra Medical and Research Center, Qatar Foundation, Doha, Qatar.,Division of Experimental Genetics, Sidra Medical and Research Center, Doha, Qatar.,Heart Science Centre, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Ussama M Abdel Motal
- Division of Cardiovascular Research, Sidra Medical and Research Center, Qatar Foundation, Doha, Qatar
| | - Magdi Yacoub
- Division of Cardiovascular Research, Sidra Medical and Research Center, Qatar Foundation, Doha, Qatar.,Heart Science Centre, National Heart and Lung Institute, Imperial College London, London, United Kingdom
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20
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Kuo CF, Tsao N, Hsieh IC, Lin YS, Wu JJ, Hung YT. Immunization with a streptococcal multiple-epitope recombinant protein protects mice against invasive group A streptococcal infection. PLoS One 2017; 12:e0174464. [PMID: 28355251 PMCID: PMC5371370 DOI: 10.1371/journal.pone.0174464] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 03/09/2017] [Indexed: 12/11/2022] Open
Abstract
Streptococcus pyogenes (group A Streptococcus; GAS) causes clinical diseases, including pharyngitis, scarlet fever, impetigo, necrotizing fasciitis and streptococcal toxic shock syndrome. A number of group A streptococcus vaccine candidates have been developed, but only one 26-valent recombinant M protein vaccine has entered clinical trials. Differing from the design of a 26-valent recombinant M protein vaccine, we provide here a vaccination using the polyvalence epitope recombinant FSBM protein (rFSBM), which contains four different epitopes, including the fibronectin-binding repeats domain of streptococcal fibronectin binding protein Sfb1, the C-terminal immunogenic segment of streptolysin S, the C3-binding motif of streptococcal pyrogenic exotoxin B, and the C-terminal conserved segment of M protein. Vaccination with the rFSBM protein successfully prevented mortality and skin lesions caused by several emm strains of GAS infection. Anti-FSBM antibodies collected from the rFSBM-immunized mice were able to opsonize at least six emm strains and can neutralize the hemolytic activity of streptolysin S. Furthermore, the internalization of GAS into nonphagocytic cells is also reduced by anti-FSBM serum. These findings suggest that rFSBM can be applied as a vaccine candidate to prevent different emm strains of GAS infection.
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Affiliation(s)
- Chih-Feng Kuo
- Department of Nursing, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Nina Tsao
- Department of Biological Science and Technology, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - I-Chen Hsieh
- Department of Biological Science and Technology, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yee-Shin Lin
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jiunn-Jong Wu
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Biotechnology and Laboratory Science in Medicine, School of Biomedical Science and Engineering, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Ting Hung
- Department of Biological Science and Technology, College of Medicine, I-Shou University, Kaohsiung, Taiwan
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21
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Burlet E, HogenEsch H, Dunham A, Morefield G. Evaluation of the Potency, Neutralizing Antibody Response, and Stability of a Recombinant Fusion Protein Vaccine for Streptococcus pyogenes. AAPS JOURNAL 2017; 19:875-881. [DOI: 10.1208/s12248-017-0069-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 02/25/2017] [Indexed: 11/30/2022]
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22
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Acar H, Srivastava S, Chung EJ, Schnorenberg MR, Barrett JC, LaBelle JL, Tirrell M. Self-assembling peptide-based building blocks in medical applications. Adv Drug Deliv Rev 2017; 110-111:65-79. [PMID: 27535485 PMCID: PMC5922461 DOI: 10.1016/j.addr.2016.08.006] [Citation(s) in RCA: 148] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 07/01/2016] [Accepted: 08/05/2016] [Indexed: 12/22/2022]
Abstract
Peptides and peptide-conjugates, comprising natural and synthetic building blocks, are an increasingly popular class of biomaterials. Self-assembled nanostructures based on peptides and peptide-conjugates offer advantages such as precise selectivity and multifunctionality that can address challenges and limitations in the clinic. In this review article, we discuss recent developments in the design and self-assembly of various nanomaterials based on peptides and peptide-conjugates for medical applications, and categorize them into two themes based on the driving forces of molecular self-assembly. First, we present the self-assembled nanostructures driven by the supramolecular interactions between the peptides, with or without the presence of conjugates. The studies where nanoassembly is driven by the interactions between the conjugates of peptide-conjugates are then presented. Particular emphasis is given to in vivo studies focusing on therapeutics, diagnostics, immune modulation and regenerative medicine. Finally, challenges and future perspectives are presented.
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Affiliation(s)
- Handan Acar
- Institute for Molecular Engineering, University of Chicago, Chicago, IL 60637, USA; Department of Pediatrics, Section of Hematology/Oncology, University of Chicago, Chicago, IL 60637, USA.
| | - Samanvaya Srivastava
- Institute for Molecular Engineering, University of Chicago, Chicago, IL 60637, USA; Institute for Molecular Engineering, Argonne National Laboratory, Argonne, IL 60439, USA.
| | - Eun Ji Chung
- Institute for Molecular Engineering, University of Chicago, Chicago, IL 60637, USA; Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA
| | - Mathew R Schnorenberg
- Institute for Molecular Engineering, University of Chicago, Chicago, IL 60637, USA; Department of Pediatrics, Section of Hematology/Oncology, University of Chicago, Chicago, IL 60637, USA; Medical Scientist Training Program, University of Chicago, Chicago, IL 60637, USA.
| | - John C Barrett
- Biophysical Sciences Graduate Program, University of Chicago, Chicago, IL 60637, USA.
| | - James L LaBelle
- Department of Pediatrics, Section of Hematology/Oncology, University of Chicago, Chicago, IL 60637, USA.
| | - Matthew Tirrell
- Institute for Molecular Engineering, University of Chicago, Chicago, IL 60637, USA; Institute for Molecular Engineering, Argonne National Laboratory, Argonne, IL 60439, USA.
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23
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Lorenz N, Loh JMS, Moreland NJ, Proft T. Development of a high-throughput opsonophagocytic assay for the determination of functional antibody activity against Streptococcus pyogenes using bioluminescence. J Microbiol Methods 2017; 134:58-61. [PMID: 28115206 DOI: 10.1016/j.mimet.2017.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 01/19/2017] [Accepted: 01/19/2017] [Indexed: 10/20/2022]
Abstract
The lack of standardised protocols for the assessment of functional antibodies has hindered Streptococcus pyogenes research and the development of vaccines. A robust, high throughput opsonophagocytic bactericidal assay to determine protective antibodies in human and rabbit serum has been developed that utilises bioluminescence as a rapid read out.
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Affiliation(s)
- Natalie Lorenz
- Department of Molecular Medicine & Pathology, School of Medical Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand; Maurice Wilkins Centre, The University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Jacelyn M S Loh
- Department of Molecular Medicine & Pathology, School of Medical Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand; Maurice Wilkins Centre, The University of Auckland, Private Bag 92019, Auckland, New Zealand.
| | - Nicole J Moreland
- Department of Molecular Medicine & Pathology, School of Medical Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand; Maurice Wilkins Centre, The University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Thomas Proft
- Department of Molecular Medicine & Pathology, School of Medical Sciences, The University of Auckland, Private Bag 92019, Auckland, New Zealand; Maurice Wilkins Centre, The University of Auckland, Private Bag 92019, Auckland, New Zealand.
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24
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Li H, Wang S, Zhao Y, Chen Z, Gu G, Guo Z. Mutagenesis and immunological evaluation of group A streptococcal C5a peptidase as an antigen for vaccine development and as a carrier protein for glycoconjugate vaccine design. RSC Adv 2017. [DOI: 10.1039/c7ra07923k] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A non-enzymatic recombinant ScpA mutant (H193A) was prepared and investigated to probe its application potential in the development of GAS vaccines and as a carrier protein of glycoconjugate vaccines.
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Affiliation(s)
- Hui Li
- National Glycoengineering Research Center
- School of Life Science
- Shandong University
- China
| | - Subo Wang
- National Glycoengineering Research Center
- School of Life Science
- Shandong University
- China
| | - Yisheng Zhao
- National Glycoengineering Research Center
- School of Life Science
- Shandong University
- China
| | - Zonggang Chen
- National Glycoengineering Research Center
- School of Life Science
- Shandong University
- China
| | - Guofeng Gu
- National Glycoengineering Research Center
- School of Life Science
- Shandong University
- China
| | - Zhongwu Guo
- National Glycoengineering Research Center
- School of Life Science
- Shandong University
- China
- Department of Chemistry
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25
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Excler JL, Kim JH. Accelerating the development of a group A Streptococcus vaccine: an urgent public health need. Clin Exp Vaccine Res 2016; 5:101-7. [PMID: 27489799 PMCID: PMC4969273 DOI: 10.7774/cevr.2016.5.2.101] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 06/14/2016] [Accepted: 06/20/2016] [Indexed: 11/23/2022] Open
Abstract
Group A Streptococcus (GAS) infections cause substantial worldwide morbidity and mortality, mostly associated with suppurative complications such as pharyngitis, impetigo, and non-suppurative immune syndromes such as acute rheumatic fever, rheumatic heart disease, and acute post-streptococcal glomerulonephritis. Deaths occur mostly in children, adolescents, and young adults in particular pregnant women in low- and middle-income countries. GAS strains are highly variable, and a GAS vaccine would need to overcome the issue of multiple strains. Several approaches have been used multivalent vaccines using N-terminal polypeptides of different M protein; conserved M protein vaccines with antigens from the conserved C-repeat portion of the M protein; incorporation selected T- and B-cell epitopes from the C-repeat region in a synthetic polypeptide or shorter single minimal B-cell epitopes from this same region; and non-M protein approaches utilizing highly conserved motives of streptococcal C5a peptidase, GAS carbohydrate and streptococcal fibronectin-binding proteins. A GAS vaccine represents urgent need for this neglected disease and should therefore deserve the greatest attention of international organizations, donors, and vaccine manufacturers.
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26
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Differing Efficacies of Lead Group A Streptococcal Vaccine Candidates and Full-Length M Protein in Cutaneous and Invasive Disease Models. mBio 2016; 7:mBio.00618-16. [PMID: 27302756 PMCID: PMC4916377 DOI: 10.1128/mbio.00618-16] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Group A Streptococcus (GAS) is an important human pathogen responsible for both superficial infections and invasive diseases. Autoimmune sequelae may occur upon repeated infection. For this reason, development of a vaccine against GAS represents a major challenge, since certain GAS components may trigger autoimmunity. We formulated three combination vaccines containing the following: (i) streptolysin O (SLO), interleukin 8 (IL-8) protease (Streptococcus pyogenes cell envelope proteinase [SpyCEP]), group A streptococcal C5a peptidase (SCPA), arginine deiminase (ADI), and trigger factor (TF); (ii) the conserved M-protein-derived J8 peptide conjugated to ADI; and (iii) group A carbohydrate lacking the N-acetylglucosamine side chain conjugated to ADI. We compared these combination vaccines to a “gold standard” for immunogenicity, full-length M1 protein. Vaccines were adjuvanted with alum, and mice were immunized on days 0, 21, and 28. On day 42, mice were challenged via cutaneous or subcutaneous routes. High-titer antigen-specific antibody responses with bactericidal activity were detected in mouse serum samples for all vaccine candidates. In comparison with sham-immunized mice, all vaccines afforded protection against cutaneous challenge. However, only full-length M1 protein provided protection in the subcutaneous invasive disease model. This set of experiments demonstrates the inherent variability of mouse models for the characterization of GAS vaccine candidate protective efficacy. Such variability poses an important challenge for GAS vaccine development, as advancement of candidates to human clinical trials requires strong evidence of efficacy. This study highlights the need for an open discussion within the field regarding standardization of animal models for GAS vaccine development.
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27
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Status of research and development of vaccines for Streptococcus pyogenes. Vaccine 2016; 34:2953-2958. [DOI: 10.1016/j.vaccine.2016.03.073] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 03/09/2016] [Indexed: 11/23/2022]
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28
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HogenEsch H, Dunham A, Burlet E, Lu F, Mosley YYC, Morefield G. Preclinical safety study of a recombinant Streptococcus pyogenes vaccine formulated with aluminum adjuvant. J Appl Toxicol 2016; 37:222-230. [PMID: 27241723 DOI: 10.1002/jat.3349] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 04/21/2016] [Accepted: 04/22/2016] [Indexed: 11/08/2022]
Abstract
A recombinant vaccine composed of a fusion protein formulated with aluminum hydroxide adjuvant is under development for protection against diseases caused by Streptococcus pyogenes. The safety and local reactogenicity of the vaccine was assessed by a comprehensive series of clinical, pathologic and immunologic tests in preclinical experiments. Outbred mice received three intramuscular injections of 1/5th of the human dose (0.1 ml) and rabbits received two injections of the full human dose. Control groups received adjuvant or protein antigen. The vaccine did not cause clinical evidence of systemic toxicity in mice or rabbits. There was a transient increase of peripheral blood neutrophils after the third vaccination of mice. In addition, the concentration of acute phase proteins serum amyloid A and haptoglobin was significantly increased 1 day after injection of the vaccine in mice. There was mild transient swelling and erythema of the injection site in both mice and rabbits. Treatment-related pathology was limited to inflammation at the injection site and accumulation of adjuvant-containing macrophages in the draining lymph nodes. In conclusion, the absence of clinical toxicity in two animal species suggest that the vaccine is safe for use in a phase I human clinical trial. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Harm HogenEsch
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA.,Purdue Institute for Immunology, Inflammation and Infectious Diseases, Purdue University, West Lafayette, IN, USA
| | - Anisa Dunham
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | | | - Fangjia Lu
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Yung-Yi C Mosley
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
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Why Don't We Have a Vaccine Against……….? Part 3. Bacteria, Too. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2016. [DOI: 10.1097/ipc.0000000000000363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Identifying protective Streptococcus pyogenes vaccine antigens recognized by both B and T cells in human adults and children. Sci Rep 2016; 6:22030. [PMID: 26911649 PMCID: PMC4766568 DOI: 10.1038/srep22030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 02/04/2016] [Indexed: 01/01/2023] Open
Abstract
No commercial vaccine exists against Group A streptococci (GAS; Streptococcus pyogenes) and only little is known about anti-GAS protective immunity. In our effort to discover new protective vaccine candidates, we selected 21 antigens based on an in silico evaluation. These were all well-conserved among different GAS strains, upregulated in host-pathogen interaction studies, and predicted to be extracellular or associated with the surface of the bacteria. The antigens were tested for both antibody recognition and T cell responses in human adults and children. The antigenicity of a selected group of antigens was further validated using a high-density peptide array technology that also identified the linear epitopes. Based on immunological recognition, four targets were selected and tested for protective capabilities in an experimental GAS infection model in mice. Shown for the first time, three of these targets (spy0469, spy1228 and spy1801) conferred significant protection whereas one (spy1643) did not.
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Skwarczynski M, Toth I. Peptide-based synthetic vaccines. Chem Sci 2015; 7:842-854. [PMID: 28791117 PMCID: PMC5529997 DOI: 10.1039/c5sc03892h] [Citation(s) in RCA: 372] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/14/2015] [Indexed: 01/18/2023] Open
Abstract
Classically all vaccines were produced using live or attenuated microorganisms or parts of them. However, the use of whole organisms, their components or the biological process for vaccine production has several weaknesses. The presence of immunologically redundant biological components or biological impurities in such vaccines might cause major problems. All the disadvantageous of traditional vaccines might be overcome via the development of fully synthetic peptide-based vaccines. However, once minimal antigenic epitopes only are applied for immunisation, the immune responses are poor. The use of an adjuvant can overcome this obstacle; however, it may raise new glitches. Here we briefly summarise the current stand on peptide-based vaccines, discuss epitope and adjuvant design, and multi-epitope and nanoparticle-based vaccine approaches. This mini review discusses also the disadvantages and benefits associated with peptide-based vaccines. It proposes possible methods to overcome the weaknesses of the synthetic vaccine strategy and suggests future directions for its development.
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Affiliation(s)
- Mariusz Skwarczynski
- The University of Queensland , School of Chemistry and Molecular Biosciences , St Lucia 4072 , Australia .
| | - Istvan Toth
- The University of Queensland , School of Chemistry and Molecular Biosciences , St Lucia 4072 , Australia . .,The University of Queensland , Institute for Molecular Bioscience , St Lucia 4072 , Australia.,The University of Queensland , School of Pharmacy , Brisbane , QLD 4072 , Australia
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Sheel M, Moreland NJ, Fraser JD, Carapetis J. Development of Group A streptococcal vaccines: an unmet global health need. Expert Rev Vaccines 2015; 15:227-38. [DOI: 10.1586/14760584.2016.1116946] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Meru Sheel
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Nicole J Moreland
- Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand
- School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - John D Fraser
- Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand
- School of Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Jonathan Carapetis
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
- Princess Margaret Hospital for Children, Perth, Australia
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Epidemiology Analysis of Streptococcus pyogenes in a Hospital in Southern Taiwan by Use of the Updated emm Cluster Typing System. J Clin Microbiol 2015; 54:157-62. [PMID: 26560544 DOI: 10.1128/jcm.02089-15] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 11/05/2015] [Indexed: 12/14/2022] Open
Abstract
emm typing is the most widely used molecular typing method for the human pathogen Streptococcus pyogenes (group A streptococcus [GAS]). emm typing is based on a small variable region of the emm gene; however, the emm cluster typing system defines GAS types according to the nearly complete sequence of the emm gene. Therefore, emm cluster typing is considered to provide more information regarding the functional and structural properties of M proteins in different emm types of GAS. In the present study, 677 isolates collected between 1994 and 2008 in a hospital in southern Taiwan were analyzed by the emm cluster typing system. emm clusters A-C4, E1, E6, and A-C3 were the most prevalent emm cluster types and accounted for 67.4% of total isolates. emm clusters A-C4 and E1 were associated with noninvasive diseases, whereas E6 was significantly associated with both invasive and noninvasive manifestations. In addition, emm clusters D4, E2, and E3 were significantly associated with invasive manifestations. Furthermore, we found that the functional properties of M protein, including low fibrinogen-binding and high IgG-binding activities, were correlated significantly with invasive manifestations. In summary, the present study provides updated epidemiological information on GAS emm cluster types in southern Taiwan.
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Good MF, Pandey M, Batzloff MR, Tyrrell GJ. Strategic development of the conserved region of the M protein and other candidates as vaccines to prevent infection with group A streptococci. Expert Rev Vaccines 2015; 14:1459-70. [DOI: 10.1586/14760584.2015.1081817] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
BACKGROUND Group A streptococci (GAS) and other β-hemolytic streptococci (BHS) cause pharyngitis, severe invasive disease and serious nonsuppurative sequelae including rheumatic heart disease and post streptococcal glomerulonephritis. The aim of this study was to assess carriage rates and anti-streptococcal C5a peptidase (anti-SCP) IgG levels and identify epidemiologic factors related to carriage or seropositivity in Australian children. METHODS A throat swab and blood sample were collected for microbiological and serological analysis (anti-SCP IgG) in 542 healthy children aged 0-10 years. Sequence analysis of the SCP gene was performed. Serological analysis used a competitive Luminex Immunoassay designed to preferentially detect functional antibody. RESULTS GAS-positive culture prevalence in throat swabs was 5.0% (range 0-10%), with the highest rate in 5 and 9 years old children. The rate of non-GAS BHS carriage was low (<1%). The scp gene was present in all 22 isolates evaluated. As age of child increased, the rate of carriage increased; odds ratio, 1.14 (1.00, 1.29); P = 0.50. Geometric mean anti-SCP titers increased with each age-band from 2 to 7 years, then plateaued. Age, geographic location and number of children within the household were significantly associated with the presence of anti-SCP antibodies. CONCLUSIONS Children are exposed to GAS and other BHS at a young age, which is important for determining the target age for vaccination to protect before the period of risk.
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36
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Kuo CF, Tsao N, Cheng MH, Yang HC, Wang YC, Chen YP, Lin KJ. Application of the C3-binding motif of streptococcal pyrogenic exotoxin B to protect mice from invasive group a streptococcal infection. PLoS One 2015; 10:e0117268. [PMID: 25629609 PMCID: PMC4309557 DOI: 10.1371/journal.pone.0117268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 12/22/2014] [Indexed: 12/27/2022] Open
Abstract
Group A streptococcus (GAS) is an important human pathogen that produces several extracellular exotoxins to facilitate invasion and infection. Streptococcal pyrogenic exotoxin B (SPE B) has been demonstrated to be an important virulence factor of GAS. Our previous studies indicate that SPE B cleaves complement 3 (C3) and inhibits the activation of complement pathways. In this study, we constructed and expressed recombinant fragments of SPE B to examine the C3-binding site of SPE B. Using enzyme-linked immunosorbent assays and pull-down assays, we found that the C-terminal domain, containing amino-acid residues 345–398, of SPE B was the major binding site of human serum C3. We further identified a major, Ala376-Pro398, and a minor C3-binding motif, Gly346-Gly360, that both mediated the binding of C3 complement. Immunization with the C3-binding motifs protected mice against challenge with a lethal dose of non-invasive M49 strain GAS but not invasive M1 strains. To achieve higher efficiency against invasive M1 GAS infection, a combination of synthetic peptides derived from C-terminal epitope of streptolysin S (SLSpp) and from the major C3-binding motif of SPE B (PP6, Ala376-Pro398) was used to elicit specific immune response to those two important streptococcal exotoxins. Death rates and the severity of skin lesions decreased significantly in PP6/SLSpp-immunized mice that were infected with invasive M1 strains of GAS. These results indicate a combination of the C3-binding motif of SPE B and the protective epitope of SLS could be used as a subunit vaccine against invasive M1 strains group A streptococcal infection.
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Affiliation(s)
- Chih-Feng Kuo
- Department of Nursing, I-Shou University, Kaohsiung City, Taiwan
- * E-mail:
| | - Nina Tsao
- Department of Biological Science and Technology, I-Shou University, Kaohsiung City, Taiwan
| | - Miao-Hui Cheng
- Department of Biological Science and Technology, I-Shou University, Kaohsiung City, Taiwan
| | - Hsiu-Chen Yang
- Department of Biological Science and Technology, I-Shou University, Kaohsiung City, Taiwan
| | - Yu-Chieh Wang
- Department of Biological Science and Technology, I-Shou University, Kaohsiung City, Taiwan
| | - Ying-Pin Chen
- Department of Biological Science and Technology, I-Shou University, Kaohsiung City, Taiwan
| | - Kai-Jen Lin
- Department of Pathology, E-DA Hospital, Kaohsiung City, Taiwan
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Abstract
Few diseases have experienced such a remarkable change in their epidemiology over the past century, without the influence of a vaccine, than rheumatic fever. Rheumatic fever has all but disappeared from industrialised countries after being a frequent problem in the 1940s and 1950s. That the disease still occurs at high incidence in resource limited settings and in Indigenous populations in industrialised countries, particularly in Australia and New Zealand, is an indication of the profound effect of socio-economic factors on the disease. Although there have been major changes in the epidemiology of rheumatic fever, diagnosis remains reliant on careful clinical judgement and management is remarkably similar to that 50 years ago. Over the past decade, increasing attention has been given to rheumatic fever and rheumatic heart disease as public health issues, including in Australia and particularly in New Zealand, as well as in selected low and middle income countries. Perhaps the greatest hope for public health control of rheumatic fever is the development of a vaccine against Streptococcus pyogenes, and there are encouraging initiatives in this area. However, an effective vaccine is some time away and in the meantime public health efforts need to focus on effective translation of the known evidence around primary and secondary prophylaxis into policy and practice.
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Affiliation(s)
- Andrew C Steer
- Centre for International Child Health, Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia; Group A Streptococcal Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
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38
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Trent A, Ulery BD, Black MJ, Barrett JC, Liang S, Kostenko Y, David NA, Tirrell MV. Peptide amphiphile micelles self-adjuvant group A streptococcal vaccination. AAPS JOURNAL 2014; 17:380-8. [PMID: 25527256 DOI: 10.1208/s12248-014-9707-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 11/27/2014] [Indexed: 11/30/2022]
Abstract
Delivery system design and adjuvant development are crucially important areas of research for improving vaccines. Peptide amphiphile micelles are a class of biomaterials that have the unique potential to function as both vaccine delivery vehicles and self-adjuvants. In this study, peptide amphiphiles comprised of a group A streptococcus B cell antigen (J8) and a dialkyl hydrophobic moiety (diC16) were synthesized and organized into self-assembled micelles, driven by hydrophobic interactions among the alkyl tails. J8-diC16 formed cylindrical micelles with highly α-helical peptide presented on their surfaces. Both the micelle length and secondary structure were shown to be enhanced by annealing. When injected into mice, J8-diC16 micelles induced a strong IgG1 antibody response that was comparable to soluble J8 peptide supplemented with two classical adjuvants. It was discovered that micelle adjuvanticity requires the antigen be a part of the micelle since separation of J8 and the micelle was insufficient to induce an immune response. Additionally, the diC16 tail appears to be non-immunogenic since it does not stimulate a pathogen recognition receptor whose agonist (Pam3Cys) possesses a very similar chemical structure. The research presented in this paper demonstrates the promise peptide amphiphile micelles have in improving the field of vaccine engineering.
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Affiliation(s)
- Amanda Trent
- Biomolecular Science and Engineering Program, University of California, Santa Barbara, California, 93106, USA
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39
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Waddington CS, Snelling TL, Carapetis JR. Management of invasive group A streptococcal infections. J Infect 2014; 69 Suppl 1:S63-9. [PMID: 25307276 DOI: 10.1016/j.jinf.2014.08.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2014] [Indexed: 02/08/2023]
Abstract
Invasive group A streptococcal (GAS) disease in children includes deep soft tissue infection, bacteraemia, bacteraemic pneumonia, meningitis and osteomyelitis. The expression of toxins and super antigens by GAS can complicate infection by triggering an overwhelming systemic inflammatory response, referred to as streptococcal toxic shock syndrome (STSS). The onset and progression of GAS disease can be rapid, and the associated mortality high. Prompt antibiotics therapy and early surgical debridement of infected tissue are essential. Adjunctive therapy with intravenous immunoglobulin and hyperbaric therapy may improve outcomes in severe disease. Nosocomial outbreaks and secondary cases in close personal contacts are not uncommon; infection control measures and consideration of prophylactic antibiotics to those at high risk are important aspects of disease control. To reduce a substantial part of the global burden of GAS disease, an affordable GAS vaccine with efficacy against a broad number of strains is needed.
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Affiliation(s)
- Claire S Waddington
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, PO Box West Perth, WA 6872, Australia; Princess Margaret Hospital, 100 Roberts Road, Subiaco, Perth 6008, Western Australia, Australia.
| | - Thomas L Snelling
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, PO Box West Perth, WA 6872, Australia; Princess Margaret Hospital, 100 Roberts Road, Subiaco, Perth 6008, Western Australia, Australia.
| | - Jonathan R Carapetis
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, PO Box West Perth, WA 6872, Australia; Princess Margaret Hospital, 100 Roberts Road, Subiaco, Perth 6008, Western Australia, Australia.
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40
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Vaccination with Streptococcus pyogenes nuclease A stimulates a high antibody response but no protective immunity in a mouse model of infection. Med Microbiol Immunol 2014; 204:185-91. [DOI: 10.1007/s00430-014-0353-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 08/04/2014] [Indexed: 12/26/2022]
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41
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Gallotta M, Gancitano G, Pietrocola G, Mora M, Pezzicoli A, Tuscano G, Chiarot E, Nardi-Dei V, Taddei AR, Rindi S, Speziale P, Soriani M, Grandi G, Margarit I, Bensi G. SpyAD, a moonlighting protein of group A Streptococcus contributing to bacterial division and host cell adhesion. Infect Immun 2014; 82:2890-901. [PMID: 24778116 PMCID: PMC4097626 DOI: 10.1128/iai.00064-14] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 04/15/2014] [Indexed: 11/20/2022] Open
Abstract
Group A streptococcus (GAS) is a human pathogen causing a wide repertoire of mild and severe diseases for which no vaccine is yet available. We recently reported the identification of three protein antigens that in combination conferred wide protection against GAS infection in mice. Here we focused our attention on the characterization of one of these three antigens, Spy0269, a highly conserved, surface-exposed, and immunogenic protein of unknown function. Deletion of the spy0269 gene in a GAS M1 isolate resulted in very long bacterial chains, which is indicative of an impaired capacity of the knockout mutant to properly divide. Confocal microscopy and immunoprecipitation experiments demonstrated that the protein was mainly localized at the cell septum and could interact in vitro with the cell division protein FtsZ, leading us to hypothesize that Spy0269 is a member of the GAS divisome machinery. Predicted structural domains and sequence homologies with known streptococcal adhesins suggested that this antigen could also play a role in mediating GAS interaction with host cells. This hypothesis was confirmed by showing that recombinant Spy0269 could bind to mammalian epithelial cells in vitro and that Lactococcus lactis expressing Spy0269 on its cell surface could adhere to mammalian cells in vitro and to mice nasal mucosa in vivo. On the basis of these data, we believe that Spy0269 is involved both in bacterial cell division and in adhesion to host cells and we propose to rename this multifunctional moonlighting protein as SpyAD (Streptococcus pyogenes Adhesion and Division protein).
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Affiliation(s)
| | | | - Giampiero Pietrocola
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | | | | | | | | | | | - Anna Rita Taddei
- Centre for High Instruments, Electron Microscopy Section, University of Tuscia, Viterbo, Italy
| | - Simonetta Rindi
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | - Pietro Speziale
- Department of Molecular Medicine, Institute of Biochemistry, University of Pavia, Pavia, Italy
| | | | - Guido Grandi
- Novartis Vaccines and Diagnostics Srl, Siena, Italy
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Moreland NJ, Waddington CS, Williamson DA, Sriskandan S, Smeesters PR, Proft T, Steer AC, Walker MJ, Baker EN, Baker MG, Lennon D, Dunbar R, Carapetis J, Fraser JD. Working towards a Group A Streptococcal vaccine: Report of a collaborative Trans-Tasman workshop. Vaccine 2014; 32:3713-20. [DOI: 10.1016/j.vaccine.2014.05.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 05/01/2014] [Indexed: 11/25/2022]
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43
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Moyle PM, Dai W, Zhang Y, Batzloff MR, Good MF, Toth I. Site-Specific Incorporation of Three Toll-Like Receptor 2 Targeting Adjuvants into Semisynthetic, Molecularly Defined Nanoparticles: Application to Group A Streptococcal Vaccines. Bioconjug Chem 2014; 25:965-78. [DOI: 10.1021/bc500108b] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Peter M. Moyle
- School
of Pharmacy, The University of Queensland, Woolloongabba 4102, Queensland, Australia
- School
of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia 4072, Queensland, Australia
| | - Wei Dai
- School
of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia 4072, Queensland, Australia
| | - Yingkai Zhang
- School
of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia 4072, Queensland, Australia
| | - Michael R. Batzloff
- Institute
for Glycomics, Griffith University, Southport 4222, Queensland, Australia
| | - Michael F. Good
- Institute
for Glycomics, Griffith University, Southport 4222, Queensland, Australia
| | - Istvan Toth
- School
of Pharmacy, The University of Queensland, Woolloongabba 4102, Queensland, Australia
- School
of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia 4072, Queensland, Australia
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Anderson EL, Cole JN, Olson J, Ryba B, Ghosh P, Nizet V. The fibrinogen-binding M1 protein reduces pharyngeal cell adherence and colonization phenotypes of M1T1 group A Streptococcus. J Biol Chem 2013; 289:3539-46. [PMID: 24356958 DOI: 10.1074/jbc.m113.529537] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Group A Streptococcus (GAS) is a leading human pathogen producing a diverse array of infections from simple pharyngitis ("strep throat") to invasive conditions, including necrotizing fasciitis and toxic shock syndrome. The surface-anchored GAS M1 protein is a classical virulence factor that promotes phagocyte resistance and exaggerated inflammation by binding host fibrinogen (Fg) to form supramolecular networks. In this study, we used a virulent WT M1T1 GAS strain and its isogenic M1-deficient mutant to examine the role of M1-Fg binding in a proximal step in GAS infection-interaction with the pharyngeal epithelium. Expression of the M1 protein reduced GAS adherence to human pharyngeal keratinocytes by 2-fold, and this difference was increased to 4-fold in the presence of Fg. In stationary phase, surface M1 protein cleavage by the GAS cysteine protease SpeB eliminated Fg binding and relieved its inhibitory effect on GAS pharyngeal cell adherence. In a mouse model of GAS colonization of nasal-associated lymphoid tissue, M1 protein expression was associated with an average 6-fold decreased GAS recovery in isogenic strain competition assays. Thus, GAS M1 protein-Fg binding reduces GAS pharyngeal cell adherence and colonization in a fashion that is counterbalanced by SpeB. Inactivation of SpeB during the shift to invasive GAS disease allows M1-Fg binding, increasing pathogen phagocyte resistance and proinflammatory activities.
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45
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Ralph AP, Fittock M, Schultz R, Thompson D, Dowden M, Clemens T, Parnaby MG, Clark M, McDonald MI, Edwards KN, Carapetis JR, Bailie RS. Improvement in rheumatic fever and rheumatic heart disease management and prevention using a health centre-based continuous quality improvement approach. BMC Health Serv Res 2013; 13:525. [PMID: 24350582 PMCID: PMC3878366 DOI: 10.1186/1472-6963-13-525] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 11/29/2013] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Rheumatic heart disease (RHD) remains a major health concern for Aboriginal Australians. A key component of RHD control is prevention of recurrent acute rheumatic fever (ARF) using long-term secondary prophylaxis with intramuscular benzathine penicillin (BPG). This is the most important and cost-effective step in RHD control. However, there are significant challenges to effective implementation of secondary prophylaxis programs. This project aimed to increase understanding and improve quality of RHD care through development and implementation of a continuous quality improvement (CQI) strategy. METHODS We used a CQI strategy to promote implementation of national best-practice ARF/RHD management guidelines at primary health care level in Indigenous communities of the Northern Territory (NT), Australia, 2008-2010. Participatory action research methods were employed to identify system barriers to delivery of high quality care. This entailed facilitated discussion with primary care staff aided by a system assessment tool (SAT). Participants were encouraged to develop and implement strategies to overcome identified barriers, including better record-keeping, triage systems and strategies for patient follow-up. To assess performance, clinical records were audited at baseline, then annually for two years. Key performance indicators included proportion of people receiving adequate secondary prophylaxis (≥80% of scheduled 4-weekly penicillin injections) and quality of documentation. RESULTS Six health centres participated, servicing approximately 154 people with ARF/RHD. Improvements occurred in indicators of service delivery including proportion of people receiving ≥40% of their scheduled BPG (increasing from 81/116 [70%] at baseline to 84/103 [82%] in year three, p = 0.04), proportion of people reviewed by a doctor within the past two years (112/154 [73%] and 134/156 [86%], p = 0.003), and proportion of people who received influenza vaccination (57/154 [37%] to 86/156 [55%], p = 0.001). However, the proportion receiving ≥80% of scheduled BPG did not change. Documentation in medical files improved: ARF episode documentation increased from 31/55 (56%) to 50/62 (81%) (p = 0.004), and RHD risk category documentation from 87/154 (56%) to 103/145 (76%) (p < 0.001). Large differences in performance were noted between health centres, reflected to some extent in SAT scores. CONCLUSIONS A CQI process using a systems approach and participatory action research methodology can significantly improve delivery of ARF/RHD care.
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Affiliation(s)
- Anna P Ralph
- Menzies School of Health Research, Darwin, Northern Territory (NT), Australia
- Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
| | - Marea Fittock
- Menzies School of Health Research, Darwin, Northern Territory (NT), Australia
| | - Rosalie Schultz
- Nyangirru Piliyi-ngara Kurantta, Anyinginyi Health Aboriginal Corporation, Tennant Creek, NT, Australia
| | - Dale Thompson
- Menzies School of Health Research, Darwin, Northern Territory (NT), Australia
| | | | - Tom Clemens
- Northern Territory Department of Health and Community Services, Townsville, Australia
| | - Matthew G Parnaby
- Northern Territory Department of Health and Community Services, Townsville, Australia
| | - Michele Clark
- Queensland Health, Queensland Government, Townsville, Queensland, Australia
| | - Malcolm I McDonald
- School of Medicine and Dentistry, Cairns Campus, James Cook University, Townsville, QLD, Australia
| | - Keith N Edwards
- Northern Territory Department of Health and Community Services, Townsville, Australia
| | - Jonathan R Carapetis
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia
| | - Ross S Bailie
- Menzies School of Health Research, Darwin, Northern Territory (NT), Australia
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Guilherme L, Postol E, Ferreira FM, DeMarchi LMF, Kalil J. StreptInCor: a model of anti-Streptococcus pyogenes vaccine reviewed. AUTO- IMMUNITY HIGHLIGHTS 2013; 4:81-5. [PMID: 26000146 PMCID: PMC4389027 DOI: 10.1007/s13317-013-0053-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 07/13/2013] [Indexed: 11/25/2022]
Abstract
Streptococcus pyogenes infections remain a health problem in multiple countries because of poststreptococcal sequelae, such as rheumatic fever and rheumatic heart disease. The epidemiological growth of streptococcal diseases in undeveloped and developing countries has encouraged many groups to study vaccine candidates for preventing group A streptococcus infections. We developed a vaccine epitope (StreptInCor) composed of 55 amino acid residues of the C-terminal portion of the M protein that encompasses both T and B cell protective epitopes. Using human blood samples, we showed that the StreptInCor epitope is recognized by individuals bearing different HLA class II molecules and could be considered a universal vaccine epitope. In addition, the StreptInCor molecular structure was solved by nuclear magnetic resonance spectroscopy, and a series of structural stability experiments was performed to elucidate its folding/unfolding mechanism. Using BALB-c and HLA class II transgenic mice, we evaluated the immune response over an extended period and found that StreptInCor was able to induce a robust immune response in both models. No cross-reaction was observed against cardiac proteins. The safety of the vaccine epitope was evaluated by analyzing histopathology, and no autoimmune or pathological reactions were observed in the heart or other organs. Vaccinated BALB/c mice challenged with a virulent strain of S. pyogenes had 100 % survival over 30 days. Taking all results into account, StreptInCor could be a safe and effective vaccine against streptococcus-induced disease.
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Affiliation(s)
- Luiza Guilherme
- Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, Brazil
- Institute for Immunology Investigation, National Institute of Science and Technology, University of São Paulo, São Paulo, Brazil
- Laboratório de Imunologia, Instituto do Coração (HC-FMUSP), Av. Dr. Eneas de Carvalho Aguiar, 44, São Paulo, SP 05403–903 Brazil
| | - Edilberto Postol
- Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, Brazil
- Institute for Immunology Investigation, National Institute of Science and Technology, University of São Paulo, São Paulo, Brazil
| | - Frederico Moraes Ferreira
- Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, Brazil
- Institute for Immunology Investigation, National Institute of Science and Technology, University of São Paulo, São Paulo, Brazil
| | - Lea M. F. DeMarchi
- Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Jorge Kalil
- Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, Brazil
- Institute for Immunology Investigation, National Institute of Science and Technology, University of São Paulo, São Paulo, Brazil
- Clinical Immunology and Allergy Division, School of Medicine, University of São Paulo, São Paulo, Brazil
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Alam FM, Bateman C, Turner CE, Wiles S, Sriskandan S. Non-invasive monitoring of Streptococcus pyogenes vaccine efficacy using biophotonic imaging. PLoS One 2013; 8:e82123. [PMID: 24278474 PMCID: PMC3835743 DOI: 10.1371/journal.pone.0082123] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2013] [Accepted: 10/21/2013] [Indexed: 11/18/2022] Open
Abstract
Streptococcus pyogenes infection of the nasopharynx represents a key step in the pathogenic cycle of this organism and a major focus for vaccine development, requiring robust models to facilitate the screening of potentially protective antigens. One antigen that may be an important target for vaccination is the chemokine protease, SpyCEP, which is cell surface-associated and plays a role in pathogenesis. Biophotonic imaging (BPI) can non-invasively characterize the spatial location and abundance of bioluminescent bacteria in vivo. We have developed a bioluminescent derivative of a pharyngeal S. pyogenes strain by transformation of an emm75 clinical isolate with the luxABCDE operon. Evaluation of isogenic recombinant strains in vitro and in vivo confirmed that bioluminescence conferred a growth deficit that manifests as a fitness cost during infection. Notwithstanding this, bioluminescence expression permitted non-invasive longitudinal quantitation of S. pyogenes within the murine nasopharynx albeit with a detection limit corresponding to approximately 105 bacterial colony forming units (CFU) in this region. Vaccination of mice with heat killed streptococci, or with SpyCEP led to a specific IgG response in the serum. BPI demonstrated that both vaccine candidates reduced S. pyogenes bioluminescence emission over the course of nasopharyngeal infection. The work suggests the potential for BPI to be used in the non-invasive longitudinal evaluation of potential S. pyogenes vaccines.
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Affiliation(s)
- Faraz M. Alam
- Infectious Diseases and Immunity, Department of Medicine, Imperial College London, London, United Kingdom
| | - Colin Bateman
- Infectious Diseases and Immunity, Department of Medicine, Imperial College London, London, United Kingdom
| | - Claire E. Turner
- Infectious Diseases and Immunity, Department of Medicine, Imperial College London, London, United Kingdom
| | - Siouxsie Wiles
- Infectious Diseases and Immunity, Department of Medicine, Imperial College London, London, United Kingdom
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
- * E-mail: (SS); (SW)
| | - Shiranee Sriskandan
- Infectious Diseases and Immunity, Department of Medicine, Imperial College London, London, United Kingdom
- * E-mail: (SS); (SW)
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Guilherme L, Kalil J. Rheumatic Heart Disease: Molecules Involved in Valve Tissue Inflammation Leading to the Autoimmune Process and Anti-S. pyogenes Vaccine. Front Immunol 2013; 4:352. [PMID: 24198818 PMCID: PMC3812567 DOI: 10.3389/fimmu.2013.00352] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 10/15/2013] [Indexed: 12/21/2022] Open
Abstract
The major events leading to both rheumatic fever (RF) and rheumatic heart disease (RHD) are reviewed. Several genes are involved in the development of RF and RHD. The inflammatory process that results from S. pyogenes infection involves the activation of several molecules such as VCAM and ICAM, which play a role in the migration of leukocytes to the heart, particularly to the valves. Specific chemokines, such as CXCL3/MIP1α as well as CCL1/I-309 and CXCL9/Mig, attract T cells to the myocardium and valves, respectively. The autoimmune reactions are mediated by both the B- and T-cell responses that begin at the periphery, followed by the migration of T cell clones to the heart and the infiltration of heart lesions in RHD patients. These cells recognize streptococcal antigens and human-tissue proteins. Molecular mimicry between streptococcal M protein and human proteins has been proposed as the triggering factor leading to autoimmunity in RF and RHD. The production of cytokines from peripheral and heart-infiltrating mononuclear cells suggests that T helper 1 and Th17 cytokines are the mediators of RHD heart lesions. The low numbers of IL-4 producing cells in the valvular tissue might contribute to the maintenance and progression of the valve lesions. The identification of a vaccine epitope opens a perspective of development of an effective and safe vaccine to prevent S. pyogenes infections, consequently RF and RHD.
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Affiliation(s)
- Luiza Guilherme
- Heart Institute (InCor), School of Medicine, University of São Paulo , São Paulo , Brazil ; Immunology Investigation Institute, National Institute for Science and Technology, University of São Paulo , São Paulo , Brazil
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De Amicis KM, Freschi de Barros S, Alencar RE, Postól E, Martins CDO, Arcuri HA, Goulart C, Kalil J, Guilherme L. Analysis of the coverage capacity of the StreptInCor candidate vaccine against Streptococcus pyogenes. Vaccine 2013; 32:4104-10. [PMID: 23994376 DOI: 10.1016/j.vaccine.2013.08.043] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 08/02/2013] [Accepted: 08/13/2013] [Indexed: 12/01/2022]
Abstract
Streptococcus pyogenes is responsible for infections as pharyngitis, sepsis, necrotizing fasciitis and streptococcal toxic shock syndrome. The M protein is the major bacterial antigen and consists of both polymorphic N-terminal portion and a conserved region. In the present study, we analyzed the in vitro ability of StreptInCor a C-terminal candidate vaccine against S. pyogenes to induce antibodies to neutralize/opsonize the most common S. pyogenes strains in Sao Paulo by examining the recognition by sera from StreptInCor immunized mice. We also evaluated the presence of cross-reactive antibodies against human heart valve tissue. Anti-StreptInCor antibodies were able to neutralize/opsonize at least 5 strains, showing that immunization with StreptInCor is effective against several S. pyogenes strains and can prevent infection and subsequent sequelae without causing autoimmune reactions.
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Affiliation(s)
- Karine M De Amicis
- Heart Institute (InCor), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Immunology Investigation Institute, National Institute for Science and Technology, University of Sao Paulo, Sao Paulo, Brazil
| | - Samar Freschi de Barros
- Heart Institute (InCor), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Immunology Investigation Institute, National Institute for Science and Technology, University of Sao Paulo, Sao Paulo, Brazil
| | - Raquel E Alencar
- Heart Institute (InCor), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Immunology Investigation Institute, National Institute for Science and Technology, University of Sao Paulo, Sao Paulo, Brazil
| | - Edilberto Postól
- Heart Institute (InCor), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Immunology Investigation Institute, National Institute for Science and Technology, University of Sao Paulo, Sao Paulo, Brazil
| | - Carlo de Oliveira Martins
- Heart Institute (InCor), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Immunology Investigation Institute, National Institute for Science and Technology, University of Sao Paulo, Sao Paulo, Brazil
| | - Helen Andrade Arcuri
- Heart Institute (InCor), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Immunology Investigation Institute, National Institute for Science and Technology, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Jorge Kalil
- Heart Institute (InCor), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Immunology Investigation Institute, National Institute for Science and Technology, University of Sao Paulo, Sao Paulo, Brazil; Clinical Immunology and Allergy Division, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Luiza Guilherme
- Heart Institute (InCor), School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Immunology Investigation Institute, National Institute for Science and Technology, University of Sao Paulo, Sao Paulo, Brazil.
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50
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Kallistatin modulates immune cells and confers anti-inflammatory response to protect mice from group A streptococcal infection. Antimicrob Agents Chemother 2013; 57:5366-72. [PMID: 23959316 DOI: 10.1128/aac.00322-13] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Group A streptococcus (GAS) infection may cause severe life-threatening diseases, including necrotizing fasciitis and streptococcal toxic shock syndrome. Despite the availability of effective antimicrobial agents, there has been a worldwide increase in the incidence of invasive GAS infection. Kallistatin (KS), originally found to be a tissue kallikrein-binding protein, has recently been shown to possess anti-inflammatory properties. However, its efficacy in microbial infection has not been explored. In this study, we transiently expressed the human KS gene by hydrodynamic injection and investigated its anti-inflammatory and protective effects in mice via air pouch inoculation of GAS. The results showed that KS significantly increased the survival rate of GAS-infected mice. KS treatment reduced local skin damage and bacterial counts compared with those in mice infected with GAS and treated with a control plasmid or saline. While there was a decrease in immune cell infiltration of the local infection site, cell viability and antimicrobial factors such as reactive oxygen species actually increased after KS treatment. The efficiency of intracellular bacterial killing in neutrophils was directly enhanced by KS administration. Several inflammatory cytokines, including tumor necrosis factor alpha, interleukin 1β, and interleukin 6, in local infection sites were reduced by KS. In addition, KS treatment reduced vessel leakage, bacteremia, and liver damage after local infection. Therefore, our study demonstrates that KS provides protection in GAS-infected mice by enhancing bacterial clearance, as well as reducing inflammatory responses and organ damage.
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