1
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Auladell M, Phuong HVM, Mai LTQ, Tseng YY, Carolan L, Wilks S, Thai PQ, Price D, Duong NT, Hang NLK, Thanh LT, Thuong NTH, Huong TTK, Diep NTN, Bich VTN, Khvorov A, Hensen L, Duong TN, Kedzierska K, Anh DD, Wertheim H, Boyd SD, Good-Jacobson KL, Smith D, Barr I, Sullivan S, van Doorn HR, Fox A. Influenza virus infection history shapes antibody responses to influenza vaccination. Nat Med 2022; 28:363-372. [PMID: 35177857 DOI: 10.1038/s41591-022-01690-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 01/10/2022] [Indexed: 02/06/2023]
Abstract
Studies of successive vaccination suggest that immunological memory against past influenza viruses may limit responses to vaccines containing current strains. The impact of memory induced by prior infection is rarely considered and is difficult to ascertain, because infections are often subclinical. This study investigated influenza vaccination among adults from the Ha Nam cohort (Vietnam), who were purposefully selected to include 72 with and 28 without documented influenza A(H3N2) infection during the preceding 9 years (Australian New Zealand Clinical Trials Registry 12621000110886). The primary outcome was the effect of prior influenza A(H3N2) infection on hemagglutinin-inhibiting antibody responses induced by a locally available influenza vaccine administered in November 2016. Baseline and postvaccination sera were titrated against 40 influenza A(H3N2) strains spanning 1968-2018. At each time point (baseline, day 14 and day 280), geometric mean antibody titers against 2008-2018 strains were higher among participants with recent infection (34 (29-40), 187 (154-227) and 86 (72-103)) than among participants without recent infection (19 (17-22), 91 (64-130) and 38 (30-49)). On days 14 and 280, mean titer rises against 2014-2018 strains were 6.1-fold (5.0- to 7.4-fold) and 2.6-fold (2.2- to 3.1-fold) for participants with recent infection versus 4.8-fold (3.5- to 6.7-fold) and 1.9-fold (1.5- to 2.3-fold) for those without. One of 72 vaccinees with recent infection versus 4 of 28 without developed symptomatic A(H3N2) infection in the season after vaccination (P = 0.021). The range of A(H3N2) viruses recognized by vaccine-induced antibodies was associated with the prior infection strain. These results suggest that recall of immunological memory induced by prior infection enhances antibody responses to inactivated influenza vaccine and is important to attain protective antibody titers.
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Affiliation(s)
- Maria Auladell
- Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | | | | | - Yeu-Yang Tseng
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.,Department of Infectious Diseases, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Louise Carolan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Sam Wilks
- Centre for Pathogen Evolution, Department of Zoology, University of Cambridge, Cambridge, UK
| | - Pham Quang Thai
- National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
| | - David Price
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.,Victorian Infectious Diseases Reference Laboratory Epidemiology Unit and The Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | | | | | - Le Thi Thanh
- National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
| | - Nguyen Thi Hong Thuong
- Oxford University Clinical Research Unit, Wellcome Africa Asia Programme, National Hospital of Tropical Diseases, Ha Noi, Vietnam
| | - Tran Thi Kieu Huong
- Oxford University Clinical Research Unit, Wellcome Africa Asia Programme, National Hospital of Tropical Diseases, Ha Noi, Vietnam
| | - Nguyen Thi Ngoc Diep
- Oxford University Clinical Research Unit, Wellcome Africa Asia Programme, National Hospital of Tropical Diseases, Ha Noi, Vietnam
| | - Vu Thi Ngoc Bich
- Oxford University Clinical Research Unit, Wellcome Africa Asia Programme, National Hospital of Tropical Diseases, Ha Noi, Vietnam
| | - Arseniy Khvorov
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.,Department of Infectious Diseases, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Luca Hensen
- Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Tran Nhu Duong
- National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
| | - Katherine Kedzierska
- Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Ha Noi, Vietnam
| | - Heiman Wertheim
- Oxford University Clinical Research Unit, Wellcome Africa Asia Programme, National Hospital of Tropical Diseases, Ha Noi, Vietnam.,Department of Medical Microbiology, Radboudumc Center for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
| | - Scott D Boyd
- Stanford University Medical Centre, Stanford University, Stanford, CA, USA
| | - Kim L Good-Jacobson
- Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, Australia.,Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Derek Smith
- Centre for Pathogen Evolution, Department of Zoology, University of Cambridge, Cambridge, UK
| | - Ian Barr
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - Sheena Sullivan
- WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.,Department of Infectious Diseases, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - H Rogier van Doorn
- Oxford University Clinical Research Unit, Wellcome Africa Asia Programme, National Hospital of Tropical Diseases, Ha Noi, Vietnam.,Centre of Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Annette Fox
- Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia. .,WHO Collaborating Centre for Reference and Research on Influenza, Royal Melbourne Hospital, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia. .,Department of Infectious Diseases, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
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2
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Yegorov S, Celeste DB, Gomes KB, Ang JC, Vandenhof C, Wang J, Rybkina K, Tsui V, Stacey HD, Loeb M, Miller MS. Inactivated and live-attenuated seasonal influenza vaccines boost broadly neutralizing antibodies in children. Cell Rep Med 2022; 3:100509. [PMID: 35243417 PMCID: PMC8861809 DOI: 10.1016/j.xcrm.2022.100509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 11/16/2021] [Accepted: 01/07/2022] [Indexed: 12/12/2022]
Abstract
The induction of broadly neutralizing antibodies (bNAbs) that target the hemagglutinin stalk domain is a promising strategy for the development of “universal” influenza virus vaccines. bNAbs can be boosted in adults by sequential exposure to heterosubtypic viruses through natural infection or vaccination. However, little is known about if or how bNAbs are induced by vaccination in more immunologically naive children. Here, we describe the impact of repeated seasonal influenza vaccination and vaccine type on induction of bNAbs against group 1 influenza viruses in a pediatric cohort enrolled in randomized controlled trials of seasonal influenza vaccination. Repeated seasonal vaccination results in significant boosting of a durable bNAb response. Boosting of serological bNAb titers is comparable within inactivated and live attenuated (LAIV) vaccinees and declines with age. These data provide insights into vaccine-elicited bNAb induction in children, which have important implications for the design of universal influenza vaccine modalities in this critical population. Repeated inactivated influenza vaccination boosts bNAbs Inactivated and live attenuated vaccines are similarly efficient at boosting bNAbs The magnitude of IIV and LAIV vaccine-elicited bNAb boosting declines with age
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Affiliation(s)
- Sergey Yegorov
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster Immunology Research Centre, Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | - Daniel B. Celeste
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster Immunology Research Centre, Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | - Kimberly Braz Gomes
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster Immunology Research Centre, Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | - Jann C. Ang
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster Immunology Research Centre, Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | - Colin Vandenhof
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster Immunology Research Centre, Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | - Joanne Wang
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster Immunology Research Centre, Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | - Ksenia Rybkina
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster Immunology Research Centre, Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | - Vanessa Tsui
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster Immunology Research Centre, Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | - Hannah D. Stacey
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster Immunology Research Centre, Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | - Mark Loeb
- Michael G. DeGroote Institute for Infectious Disease Research, Health Research Methodology, Evidence, and Impact, Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Matthew S. Miller
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster Immunology Research Centre, Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
- Corresponding author
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3
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Immune-mediated attenuation of influenza illness after infection: opportunities and challenges. THE LANCET MICROBE 2021; 2:e715-e725. [DOI: 10.1016/s2666-5247(21)00180-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/01/2021] [Accepted: 07/01/2021] [Indexed: 01/04/2023] Open
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4
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Challenges for the Newborn Immune Response to Respiratory Virus Infection and Vaccination. Vaccines (Basel) 2020; 8:vaccines8040558. [PMID: 32987691 PMCID: PMC7712002 DOI: 10.3390/vaccines8040558] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/19/2020] [Accepted: 09/21/2020] [Indexed: 12/14/2022] Open
Abstract
The initial months of life reflect an extremely challenging time for newborns as a naïve immune system is bombarded with a large array of pathogens, commensals, and other foreign entities. In many instances, the immune response of young infants is dampened or altered, resulting in increased susceptibility and disease following infection. This is the result of both qualitative and quantitative changes in the response of multiple cell types across the immune system. Here we provide a review of the challenges associated with the newborn response to respiratory viral pathogens as well as the hurdles and advances for vaccine-mediated protection.
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5
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Tanishita S, Ukawa M, Tomono T, Yoshida Y, Tsujioka T, Miyata K, Tobita E, Uto T, Baba M, Sakuma S. Cross-Protective Abilities of Hyaluronic Acid Modified with Tetraglycine-l-octaarginine as a Mucosal Adjuvant against Infection with Heterologous Influenza Viruses. Bioconjug Chem 2019; 30:3028-3037. [PMID: 31738536 DOI: 10.1021/acs.bioconjchem.9b00644] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Mucosal vaccination, which secretion of immunoglobulin A (IgA) on the mucosa is accompanied by induction of immunoglobulin G (IgG) in the blood, is one of the most effective ways to circumvent influenza epidemics caused by incorrect prediction of epidemic viral strains or viral mutation. Secreted IgA is expected to prevent hosts from being infected with heterologous viruses because this antibody cross-reacts to strains other than those used for immunization. Our previous mouse experiments revealed that intranasal IgA with cross-reactivity was induced through nasal inoculation with inactivated whole viral particles of the H1N1 A/New Caledonia/20/99 IVR116 (NCL) strain in the presence of hyaluronic acid modified with tetraglycine-l-octaarginine. In the present study, heterologous influenza virus challenge was performed to validate a potential of the hyaluronic acid derivative as a mucosal adjuvant with cross-protective abilities. Serious weight loss was observed when mice were nasally inoculated with inactivated NCL viruses alone and subsequently exposed to mouse-adapted infectious viruses of the H1N1 A/Puerto Rico/8/34 (PR8) strain. The symptom associated with virus infection was hardly ever observed for mice inoculated with a mixture of the viral antigens and tetraglycine-l-octaarginine-linked hyaluronic acid, presumably due to high induction of IgG and IgA capable of cross-reacting to PR8 viruses. Less proliferation of PR8 viruses in those mice was also supported by an insignificant elevation of antibody levels through virus exposure. Our polysaccharide derivative enabled hosts to acquire adaptive immunity with cross-protective abilities against heterologous virus infection.
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Affiliation(s)
- Sohei Tanishita
- Faculty of Pharmaceutical Sciences , Setsunan University , 45-1, Nagaotoge-cho , Hirakata, Osaka 573-0101 , Japan
| | - Masami Ukawa
- Faculty of Pharmaceutical Sciences , Setsunan University , 45-1, Nagaotoge-cho , Hirakata, Osaka 573-0101 , Japan
| | - Takumi Tomono
- Faculty of Pharmaceutical Sciences , Setsunan University , 45-1, Nagaotoge-cho , Hirakata, Osaka 573-0101 , Japan
| | - Yuki Yoshida
- Faculty of Pharmaceutical Sciences , Setsunan University , 45-1, Nagaotoge-cho , Hirakata, Osaka 573-0101 , Japan
| | - Takumi Tsujioka
- Faculty of Pharmaceutical Sciences , Setsunan University , 45-1, Nagaotoge-cho , Hirakata, Osaka 573-0101 , Japan
| | - Kohei Miyata
- Life Science Materials Laboratory , ADEKA Company, Limited , 7-2-34, Higashiogu , Arakawa-ku, Tokyo 116-8553 , Japan
| | - Etsuo Tobita
- Life Science Materials Laboratory , ADEKA Company, Limited , 7-2-34, Higashiogu , Arakawa-ku, Tokyo 116-8553 , Japan
| | - Tomofumi Uto
- Faculty of Medicine , University of Miyazaki , Kihara 5200, Kiyotake , Miyazaki 889-1692 , Japan
| | - Masanori Baba
- Division of Antiviral Chemotherapy, Joint Research Center for Human Retrovirus Infection , Kagoshima University , 8-35-1, Sakuragaoka , Kagoshima 890-8544 , Japan
| | - Shinji Sakuma
- Faculty of Pharmaceutical Sciences , Setsunan University , 45-1, Nagaotoge-cho , Hirakata, Osaka 573-0101 , Japan
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6
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Sato M, Hashimoto K, Kawasaki Y, Hosoya M. Immune response after a single intravenous peramivir administration in children with influenza. Antivir Ther 2019; 23:435-441. [PMID: 29372885 DOI: 10.3851/imp3222] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Immune response after intravenous peramivir administration, which is approved for children with influenza infection in Japan, is unclear. METHODS Kinetics of viral load and serum cytokine levels before and after peramivir therapy were analysed in 17 and 8 hospitalized children infected with influenza A and B, respectively. Additionally, haemagglutination inhibition (HI) titre was measured. The first day of hospital admission was defined as day 0. RESULTS Serum interleukin (IL)-6 levels in influenza-A-infected children significantly decreased after peramivir administration, unlike in those with influenza B where a decrease on day 1 was followed by an increase on day 2. Serum IL-6 kinetics were similar to viral load kinetics in both influenza-A- and B-infected children between days 0 and 2. Serum IL-8 levels gradually decreased after peramivir therapy in influenza-A-infected children but increased between days 1 and 2 in influenza-B-infected children. Conversely, serum IL-10 levels gradually decreased over time. Serum interferon-γ and granulocyte macrophage colony-stimulating factor levels remained low until day 5. Day 0-4 serum HI titres were <4-fold in all children infected with influenza A or B. Additionally, day 5 HI titres were positive in 4 of 6 influenza A cases and all 3 influenza B cases. CONCLUSIONS Our results suggest that viral load and inflammatory cytokine kinetics were associated with the antiviral therapy used and that second peramivir administration should be considered in influenza B. The results also highlight antiviral agents as key determinants of the clinical course of influenza virus infection in children.
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Affiliation(s)
- Masatoki Sato
- Department of Paediatrics, Fukushima Medical University, Fukushima, Japan
| | - Koichi Hashimoto
- Department of Paediatrics, Fukushima Medical University, Fukushima, Japan
| | - Yukihiko Kawasaki
- Department of Paediatrics, Fukushima Medical University, Fukushima, Japan
| | - Mitsuaki Hosoya
- Department of Paediatrics, Fukushima Medical University, Fukushima, Japan
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7
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Sherman AC, Mehta A, Dickert NW, Anderson EJ, Rouphael N. The Future of Flu: A Review of the Human Challenge Model and Systems Biology for Advancement of Influenza Vaccinology. Front Cell Infect Microbiol 2019; 9:107. [PMID: 31065546 PMCID: PMC6489464 DOI: 10.3389/fcimb.2019.00107] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 03/28/2019] [Indexed: 11/21/2022] Open
Abstract
Objectives: Novel approaches to advance the field of vaccinology must be investigated, and are particularly of importance for influenza in order to produce a more effective vaccine. A systematic review of human challenge studies for influenza was performed, with the goal of assessing safety and ethics and determining how these studies have led to therapeutic and vaccine development. A systematic review of systems biology approaches for the study of influenza was also performed, with a focus on how this technology has been utilized for influenza vaccine development. Methods: The PubMed database was searched for influenza human challenge studies, and for systems biology studies that have addressed both influenza infection and immunological effects of vaccination. Results: Influenza human challenge studies have led to important advancements in therapeutics and influenza immunization, and can be performed safely and ethically if certain criteria are met. Many studies have investigated the use of systems biology for evaluating immune response to influenza vaccine, and several promising molecular signatures may help advance our understanding of pathogenesis and be used as targets for influenza interventions. Combining these methodologies has the potential to lead to significant advances in the field of influenza vaccinology and therapeutics. Conclusions: Human challenge studies and systems biology approaches are important tools that should be used in concert to advance our understanding of influenza infection and provide targets for novel therapeutics and immunizations.
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Affiliation(s)
- Amy Caryn Sherman
- Department of Medicine, Division of Infectious Diseases, Emory University, Atlanta, GA, United States
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8
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Trombetta CM, Remarque EJ, Mortier D, Montomoli E. Comparison of hemagglutination inhibition, single radial hemolysis, virus neutralization assays, and ELISA to detect antibody levels against seasonal influenza viruses. Influenza Other Respir Viruses 2018; 12:675-686. [PMID: 30019448 PMCID: PMC6185893 DOI: 10.1111/irv.12591] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 07/01/2018] [Accepted: 07/09/2018] [Indexed: 12/16/2022] Open
Abstract
Background The immunological response to influenza vaccine and/or natural infection is evaluated by serological techniques, the most common being hemagglutination inhibition (HI), single radial hemolysis (SRH), and virus neutralization assays, which is commonly used in a micro‐neutralization (MN) format. ELISA is not officially required; however, this assay is able to measure different class‐specific antibodies. The four assays identify different sets or subsets of antibodies. Objectives The aim of this study was to establish the correlation among four serological assays using four seasonal influenza strains. Methods The HI, SRH, MN assays, and ELISA were performed on four seasonal influenza strains. Results A strong positive correlation was found between HI and MN and between SRH and MN assays for influenza A strains. The B strains also showed good correlations among the three assays. A positive correlation was also found between ELISA and the “classical” assays for all strains. Concerning the correlates of protection, as defined by HI ≥ 40 and SRH ≥ 25 mm2, good agreement was observed for the influenza A strains. By contrast, the agreement for the B strains was very low. Conclusions There is a positive strong correlation among the four serological assays for both A and B strains, especially for the HI and MN assays. There is good agreement on correlates of protection between HI and SRH assays for the A strains, but very low agreement for the B strains, suggesting higher sensitivity of SRH than HI assay in detecting antibodies against the influenza B viruses.
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Affiliation(s)
| | - Edmond J Remarque
- Department of Virology, Biomedical Primate Research Centre, Rijswijk, The Netherlands
| | - Daniella Mortier
- Department of Virology, Biomedical Primate Research Centre, Rijswijk, The Netherlands
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.,VisMederi srl, Siena, Italy
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9
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Abstract
Influenza viruses undergo rapid antigenic evolution and reassortment, resulting in annual epidemics and the occasional pandemics. Exposure to influenza virus hemagglutinin (HA) and neuraminidase (NA) antigen, either through vaccination or infection, induces an antibody response able to recognize only the homologous antigenic subtype. However, atypical antibody responses recognizing non-homologous influenza subtypes have been reported during infection and vaccination. Here, we review the incidence of these phenomena in published literature and discuss the potential mechanisms underlying them.
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Affiliation(s)
- Dalton Hermans
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI 53715, USA
| | - Richard J Webby
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Sook-San Wong
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
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10
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Detrimental Influence of Alveolar Macrophages on Protective Humoral Immunity during Francisella tularensis SchuS4 Pulmonary Infection. Infect Immun 2018; 86:IAI.00787-17. [PMID: 29311236 DOI: 10.1128/iai.00787-17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 01/02/2018] [Indexed: 01/08/2023] Open
Abstract
Opsonizing antibody is a critical component of the host protective immune response against many respiratory pathogens. However, the role of antibodies in protection against pulmonary infection with highly virulent Francisella tularensis strain SchuS4 is unclear, and the mechanism that allows F. tularensis to evade antibody-mediated bacterial clearance is not fully understood. We have now found that depletion of alveolar macrophages reveals an otherwise cryptic protective effect of opsonizing antibody. While antibody opsonization alone failed to confer any survival benefit against SchuS4 lung infection, significant protection was observed when mice were depleted of alveolar macrophages prior to infection. Blood immune signature analyses and bacterial burden measurements indicated that the treatment regimen blocked establishment of productive, systemic infection. In addition, protection was found to be dependent upon neutrophils. The results show for the first time a protective effect of opsonizing antibodies against highly virulent F. tularensis SchuS4 pulmonary infection through depletion of alveolar macrophages, the primary bacterial reservoir, and prevention of systemic dissemination. These findings have important implications for the potential use of therapeutic antibodies against intracellular pathogens that may escape clearance by residing within mucosal macrophages.
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11
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Mendoza M, Ballesteros A, Qiu Q, Pow Sang L, Shashikumar S, Casares S, Brumeanu TD. Generation and testing anti-influenza human monoclonal antibodies in a new humanized mouse model (DRAGA: HLA-A2. HLA-DR4. Rag1 KO. IL-2Rγc KO. NOD). Hum Vaccin Immunother 2017; 14:345-360. [PMID: 29135340 DOI: 10.1080/21645515.2017.1403703] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Pandemic outbreaks of influenza type A viruses have resulted in numerous fatalities around the globe. Since the conventional influenza vaccines (CIV) provide less than 20% protection for individuals with weak immune system, it has been considered that broadly cross-neutralizing antibodies may provide a better protection. Herein, we showed that a recently generated humanized mouse (DRAGA mouse; HLA-A2. HLA-DR4. Rag1KO. IL-2Rgc KO. NOD) that lacks the murine immune system and expresses a functional human immune system can be used to generate cross-reactive, human anti-influenza monoclonal antibodies (hu-mAb). DRAGA mouse was also found to be suitable for influenza virus infection, as it can clear a sub-lethal infection and sustain a lethal infection with PR8/A/34 influenza virus. The hu-mAbs were designed for targeting a human B-cell epitope (180WGIHHPPNSKEQ QNLY195) of hemagglutinin (HA) envelope protein of PR8/A/34 (H1N1) virus with high homology among seven influenza type A viruses. A single administration of HA180-195 specific hu-mAb in PR8-infected DRAGA mice significantly delayed the lethality by reducing the lung damage. The results demonstrated that DRAGA mouse is a suitable tool to (i) generate heterotype cross-reactive, anti-influenza human monoclonal antibodies, (ii) serve as a humanized mouse model for influenza infection, and (iii) assess the efficacy of anti-influenza antibody-based therapeutics for human use.
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Affiliation(s)
- Mirian Mendoza
- a Uniformed Services University of the Health Sciences , Department of Medicine , Division of Immunology , Bethesda , MD , U.S.A
| | - Angela Ballesteros
- b National Institute of Neurological Disorders and Stroke, Molecular Physiology and Biophysics Section , Bethesda , MD
| | - Qi Qiu
- a Uniformed Services University of the Health Sciences , Department of Medicine , Division of Immunology , Bethesda , MD , U.S.A
| | - Luis Pow Sang
- a Uniformed Services University of the Health Sciences , Department of Medicine , Division of Immunology , Bethesda , MD , U.S.A
| | - Soumya Shashikumar
- c Naval Medical Research Center/Walter Reed Army Institute of Research, US Military Malaria Vaccine Development , Silver Spring , MD , U.S.A
| | - Sofia Casares
- a Uniformed Services University of the Health Sciences , Department of Medicine , Division of Immunology , Bethesda , MD , U.S.A.,c Naval Medical Research Center/Walter Reed Army Institute of Research, US Military Malaria Vaccine Development , Silver Spring , MD , U.S.A
| | - Teodor-D Brumeanu
- a Uniformed Services University of the Health Sciences , Department of Medicine , Division of Immunology , Bethesda , MD , U.S.A
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Esmagambetov IB, Alekseeva SV, Sayadyan KS, Shmarov MM. CURRENT APPROACHES TO UNIVERSAL VACCINE AGAINST INFLUENZA VIRUS. RUSSIAN JOURNAL OF INFECTION AND IMMUNITY 2016. [DOI: 10.15789/2220-7619-2016-2-117-132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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13
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Benson RA, MacLeod MKL, Hale BG, Patakas A, Garside P, Brewer JM. Antigen presentation kinetics control T cell/dendritic cell interactions and follicular helper T cell generation in vivo. eLife 2015; 4. [PMID: 26258879 PMCID: PMC4558563 DOI: 10.7554/elife.06994] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 08/08/2015] [Indexed: 12/30/2022] Open
Abstract
The production of high affinity, class switched antibodies produced by B cells hinges on the effective differentiation of T follicular helper (Tfh) cells. Here we define conditions specifically enhancing Tfh differentiation and providing protection in a model of influenza infection. Tfh responses were associated with prolonged antigen presentation by dendritic cells (DCs), which maintained T cell/DC interactions into stage 3 (>72 hr) of activation. Blocking stage 3 interactions ablated Tfh generation, demonstrating a causal link between T cell-DC behaviour and functional outcomes. The current data therefore explain how duration of antigen presentation affects the dynamics of T cell-DC interactions and consequently determine Tfh cell differentiation in the developing immune response. DOI:http://dx.doi.org/10.7554/eLife.06994.001 The immune system protects the body from infections, cancer and other diseases. Invading microbes and cancerous cells exhibit proteins that are not normally found in the healthy cells of the body. Fragments of these molecules—known as antigens—may be detected by the immune system, which can then respond by producing antibodies and other responses that try to destroy the threat. Antibodies are produced by one type of immune cell (known as B cells) with the help of other cells called follicular helper T (Tfh) cells. During an immune response, Tfh cells form from ‘naïve’ T cells that have not encountered an antigen before. This process has several stages and is activated when the naïve T cells interact with antigens that are displayed on the surface of dendritic cells and other immune cells. However, it is not clear exactly how this process works. Here, Benson et al. studied the formation of Tfh cells in mice in response to antigens of different sizes. The experiments show that the dendritic cells displayed larger antigens for longer periods of time than they displayed the smaller antigens. Both the small and large antigens allowed dendritic cells to interact with T cells. However, only the dendritic cells that displayed the larger antigens maintained the interaction with T cells for longer periods of time (into the last stage of Tfh cell formation). This enhanced the production of Tfh cells, which boosted the production of antibodies against the antigens to generate immunity to infection. Further experiments found that blocking the interaction between dendritic cells and T cells during the final stage of Tfh cell formation reduced the production of Tfh cells. Benson et al.'s findings show that the length of time that dendritic cells present antigens on their surface affects the production of Tfh cells and subsequent immune responses. Since Tfh cells are critical to the formation of long-lasting immunity against a virus, these findings could aid efforts to develop more effective vaccines against influenza and other diseases. DOI:http://dx.doi.org/10.7554/eLife.06994.002
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Affiliation(s)
- Robert A Benson
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Megan K L MacLeod
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Benjamin G Hale
- Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Agapitos Patakas
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Paul Garside
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - James M Brewer
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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Immunologic characterization of a rhesus macaque H1N1 challenge model for candidate influenza virus vaccine assessment. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2014; 21:1668-80. [PMID: 25298110 DOI: 10.1128/cvi.00547-14] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Despite the availability of annually formulated vaccines, influenza virus infection remains a worldwide public health burden. Therefore, it is important to develop preclinical challenge models that enable the evaluation of vaccine candidates while elucidating mechanisms of protection. Here, we report that naive rhesus macaques challenged with 2009 pandemic H1N1 (pH1N1) influenza virus do not develop observable clinical symptoms of disease but develop a subclinical biphasic fever on days 1 and 5 to 6 postchallenge. Whole blood microarray analysis further revealed that interferon activity was associated with fever. We then tested whether type I interferon activity in the blood is a correlate of vaccine efficacy. The animals immunized with candidate vaccines carrying hemagglutinin (HA) or nucleoprotein (NP) exhibited significantly reduced interferon activity on days 5 to 6 postchallenge. Supported by cellular and serological data, we conclude that blood interferon activity is a prominent marker that provides a convenient metric of influenza virus vaccine efficacy in the subclinical rhesus macaque model.
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IgM, IgG, and IgA antibody responses to influenza A(H1N1)pdm09 hemagglutinin in infected persons during the first wave of the 2009 pandemic in the United States. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2014; 21:1054-60. [PMID: 24872516 DOI: 10.1128/cvi.00129-14] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The novel influenza A(H1N1)pdm09 virus caused an influenza pandemic in 2009. IgM, IgG, and IgA antibody responses to A(H1N1)pdm09 hemagglutinin (HA) following A(H1N1)pdm09 virus infection were analyzed to understand antibody isotype responses. Age-matched control sera collected from U.S. residents in 2007 and 2008 were used to establish baseline levels of cross-reactive antibodies. IgM responses often used as indicators of primary virus infection were mainly detected in young patient groups (≤5 years and 6 to 15 years old), not in older age groups, despite the genetic and antigenic differences between the HA of A(H1N1)pdm09 virus and pre-2009 seasonal H1N1 viruses. IgG and IgA responses to A(H1N1)pdm09 HA were detected in all age groups of infected persons. In persons 17 to 80 years old, paired acute- and convalescent-phase serum samples demonstrated ≥4-fold increases in the IgG and IgA responses to A(H1N1)pdm09 HA in 80% and 67% of A(H1N1)pdm09 virus-infected persons, respectively. The IgG antibody response to A(H1N1)pdm09 HA was cross-reactive with HAs from H1, H3, H5, and H13 subtypes, suggesting that infections with subtypes other than A(H1N1)pdm09 might result in false positives by enzyme-linked immunosorbent assay (ELISA). Lower sensitivity compared to hemagglutination inhibition and microneutralization assays and the detection of cross-reactive antibodies against homologous and heterologous subtype are major drawbacks for the application of ELISA in influenza serologic studies.
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16
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Talaat KR, Karron RA, Thumar B, McMahon BA, Schmidt AC, Collins PL, Buchholz UJ. Experimental infection of adults with recombinant wild-type human metapneumovirus. J Infect Dis 2013; 208:1669-78. [PMID: 23908489 DOI: 10.1093/infdis/jit356] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Human metapneumovirus (HMPV) causes lower respiratory tract infections in young children. rHMPV-SHs is a recombinant HMPV (rHMPV) based on a biologically derived wild-type HMPV strain. We characterized its infectivity and immunogenicity in healthy adults to determine whether it would be suitable for use as the parent virus for the development of live attenuated rHMPV vaccines. METHODS Twenty-one healthy adults were inoculated intranasally with 10(6) plaque-forming units of rHMPV-SHs. Respiratory symptoms and shedding of challenge virus were assessed. Neutralizing antibody responses, serum immunoglobulin G and A, and nasal wash specimen immunoglobulin A antibody responses to the HMPV F protein were also measured. Induction of nasal cytokines was assessed with electrochemiluminescence assays. RESULTS Nine subjects (43%) were infected with challenge virus as determined by virus detection and/or ≥4-fold rise in serum antibody titers. Peak viral shedding occurred on days 7-9 after infection. Four weeks after inoculation, 35% of subjects had any antibody response. Six of 9 infected subjects had respiratory symptoms, and 3 had headache after inoculation. Cytokine patterns differed considerably between subjects with similar illness severity and viral shedding. CONCLUSIONS The rHMPV-SHs virus is infectious and is a suitable parent virus for development of live-attenuated HMPV vaccine candidates. Clinical Trials Registration. NCT01109329.
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Affiliation(s)
- Kawsar R Talaat
- Center for Immunization Research, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore
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17
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Couch RB, Atmar RL, Franco LM, Quarles JM, Wells J, Arden N, Niño D, Belmont JW. Antibody correlates and predictors of immunity to naturally occurring influenza in humans and the importance of antibody to the neuraminidase. J Infect Dis 2013; 207:974-81. [PMID: 23307936 DOI: 10.1093/infdis/jis935] [Citation(s) in RCA: 180] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Serum antibody to the hemagglutinin (HA) of influenza viruses is a correlate and predictor of immunity to influenza in humans; the relative values of other correlates are uncertain. METHODS Serum and nasal secretions (NS) were collected in fall and spring of 2009-2011 from healthy adults who were monitored for acute respiratory illness (ARI). Serum samples were tested for hemagglutination-inhibition (HAI) antibody increase and secretions for virus if ill; enrollment sera were also tested for neuraminidase-inhibiting (NI) antibody and NS for neutralizing (neut), NI, immunoglobulin A (IgA), and immunoglobulin G (IgG) anti-HA antibody. RESULTS Serum anti-HA and anti-neuraminidase (NA) antibody titers to 2009(H1N1) pandemic influenza virus (pH1N1) correlated with titers in NS (including IgA and IgG antibody). Increasing anti-HA and anti-NA titers in serum and NS tests all correlated with reducing infection and infection-associated illness. Multivariate analyses indicated serum HAI and NI each independently predicted immunity to infection and infection-associated illness. Only serum NI independently predicted reduced illness among infected subjects. CONCLUSIONS Increasing anti-HA and NA antibody in serum and secretions correlated with reducing pH1N1 influenza virus infection and illness in healthy young adults. Both anti-HA and anti-NA antibody are independent predictors of immunity to influenza; ensuring induction of both by vaccination is desirable.
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Affiliation(s)
- Robert B Couch
- Departments of Molecular Virology and Microbiology and Medicine, Baylor College of Medicine, One Baylor Plaza, MS BCM280, Houston, TX 77030, USA.
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18
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Kim SY, Kim YK, Eun BW, Kim NH, Kang EK, Lee BS, Lim JS, Lee JA, Kim DH. Evaluation of immunogenicity of the 2008-2009 seasonal influenza vaccines by microneutralization test. KOREAN JOURNAL OF PEDIATRICS 2012; 55:474-80. [PMID: 23300503 PMCID: PMC3534161 DOI: 10.3345/kjp.2012.55.12.474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 10/02/2012] [Accepted: 10/18/2012] [Indexed: 12/05/2022]
Abstract
Purpose For evaluating the immunogenicity of an influenza vaccine, the microneutralization (MN) test has a higher sensitivity and specificity as compared to the hemagglutination inhibition (HI) test. However, the MN test is more time consuming and is difficult to standardize. We performed the MN test to determine its usefulness as an alternative or complementary test to the HI test for evaluating the immunogenicity of influenza vaccines. Methods We compared the MN test with the HI test using 50 paired samples taken from a previous clinical study (2008-2009) in Korean children under 18 years of age. Results The linear correlation coefficients of the 2 tests for H3N2, H1N1, and influenza B were 0.69, 0.70, and 0.66, respectively. We identified a high index of coincidence between the 2 tests. For an influenza vaccine, the postvaccination seroprotection rates and seroconversion rates determined by the MN test were 78.0% and 96.0%, 90% and 42.0%, and 42.0% and 48.0% for H3N2, H1N1, and influenza B, respectively. Geometric mean titer fold increases of H3N2, H1N1, and influenza B were 2.89, 5.04, and 4.29, respectively, and were 2.5-fold higher. We obtained good results in the evaluation of the immunogenicity of the 2008-2009 seasonal influenza vaccines. Conclusion We found that the MN test was as effective as the HI test. Therefore, we suggest that the MN test can be used as an alternative or complementary test to the HI test for evaluating the immunogenicity of influenza vaccines.
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Affiliation(s)
- Seung Youn Kim
- Department of Pediatrics, Korean Cancer Center Hospital, Seoul, Korea
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19
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Testa JS, Shetty V, Hafner J, Nickens Z, Kamal S, Sinnathamby G, Philip R. MHC class I-presented T cell epitopes identified by immunoproteomics analysis are targets for a cross reactive influenza-specific T cell response. PLoS One 2012; 7:e48484. [PMID: 23144892 PMCID: PMC3492461 DOI: 10.1371/journal.pone.0048484] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 10/02/2012] [Indexed: 12/22/2022] Open
Abstract
Influenza virus infection and the resulting complications are a significant global public health problem. Improving humoral immunity to influenza is the target of current conventional influenza vaccines, however, these are generally not cross-protective. On the contrary, cell-mediated immunity generated by primary influenza infection provides substantial protection against serologically distinct viruses due to recognition of cross-reactive T cell epitopes, often from internal viral proteins conserved between viral subtypes. Efforts are underway to develop a universal flu vaccine that would stimulate both the humoral and cellular immune responses leading to long-lived memory. Such a universal vaccine should target conserved influenza virus antibody and T cell epitopes that do not vary from strain to strain. In the last decade, immunoproteomics, or the direct identification of HLA class I presented epitopes, has emerged as an alternative to the motif prediction method for the identification of T cell epitopes. In this study, we used this method to uncover several cross-specific MHC class I specific T cell epitopes naturally presented by influenza A-infected cells. These conserved T cell epitopes, when combined with a cross-reactive antibody epitope from the ectodomain of influenza M2, generate cross-strain specific cell mediated and humoral immunity. Overall, we have demonstrated that conserved epitope-specific CTLs could recognize multiple influenza strain infected target cells and, when combined with a universal antibody epitope, could generate virus specific humoral and T cell responses, a step toward a universal vaccine concept. These epitopes also have potential as new tools to characterize T cell immunity in influenza infection, and may serve as part of a universal vaccine candidate complementary to current vaccines.
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Affiliation(s)
- James S. Testa
- Immunotope, Inc., Doylestown, Pennsylvania, United States of America
| | | | - Julie Hafner
- Immunotope, Inc., Doylestown, Pennsylvania, United States of America
| | - Zacharie Nickens
- Immunotope, Inc., Doylestown, Pennsylvania, United States of America
| | - Shivali Kamal
- Immunotope, Inc., Doylestown, Pennsylvania, United States of America
| | | | - Ramila Philip
- Immunotope, Inc., Doylestown, Pennsylvania, United States of America
- * E-mail:
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20
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Fujimoto C, Takeda N, Matsunaga A, Sawada A, Tanaka T, Kimoto T, Shinahara W, Sawabuchi T, Yamaguchi M, Hayama M, Yanagawa H, Yano M, Kido H. Induction and maintenance of anti-influenza antigen-specific nasal secretory IgA levels and serum IgG levels after influenza infection in adults. Influenza Other Respir Viruses 2012; 6:396-403. [PMID: 22226319 DOI: 10.1111/j.1750-2659.2011.00330.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To determine the induction and changes in anti-influenza virus secretory IgA (s-IgA) levels in nasal washes and serum IgG levels in patients with influenza. METHODS The study recruited 16 patients with influenza aged 35.6 ± 9.6 years in 2007/2008 and 2008/2009 seasons. Nasal washes and serum were obtained throughout the first year. Anti-viral s-IgA levels and neutralization activities in nasal washes, and serum anti-viral IgG levels and hemagglutination inhibition (HI) titers were measured. RESULTS Anti-viral(H1N1) s-IgA to total IgA ratio and neutralizing antibody titer were low in nasal washes of all patients, whereas serum levels of anti-viral IgG and HI titers varied widely at day 1.4 ± 1.0 postinfection. Both nasal s-IgA and serum IgG levels later increased significantly, reaching peak levels at day 9.6 ± 3.3 postinfection. The induced nasal s-IgA then returned toward the initial levels within 300 days, although the levels at day 143 ± 70 were 3.03-fold of the initial. Individual serum IgG levels also returned toward the initial levels within 300 days, although the mean levels remained high probably because of re-infection in a subgroup of patients. Although influenza A (H3N2) was a minor epidemic subtype in both flu seasons, a significant rise in nasal anti-viral (H3N2) s-IgA levels and a slightly increase in serum IgG levels were noted. CONCLUSION Low levels of nasal anti-viral s-IgA and neutralizing antibody were noted compared with a wide range of serum anti-viral IgG and HI titers at the onset of infection. Elevated s-IgA and IgG returned toward the initial levels within 300 days of infection with minor exceptions.
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Affiliation(s)
- Chisa Fujimoto
- Department of Otolaryngology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
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21
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Kapikian AZ, Morens DM, Fauci AS. In Memoriam: Robert M. Chanock, MD, 1924–2010. J Infect Dis 2011; 203:3-5. [PMID: 21998882 DOI: 10.1093/infdis/jiq019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Albert Z Kapikian
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA
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22
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Kreijtz JHCM, Fouchier RAM, Rimmelzwaan GF. Immune responses to influenza virus infection. Virus Res 2011; 162:19-30. [PMID: 21963677 DOI: 10.1016/j.virusres.2011.09.022] [Citation(s) in RCA: 227] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Revised: 09/15/2011] [Accepted: 09/15/2011] [Indexed: 10/17/2022]
Abstract
Influenza viruses cause annual outbreaks of respiratory tract infection with attack rates of 5-10%. This means that humans are infected repeatedly with intervals of, on average, 10-20 years. Upon each infection subjects develop innate and adaptive immune responses which aim at clearing the infection. Strain-specific antibody responses are induced, which exert selective pressure on circulating influenza viruses and which drive antigenic drift of seasonal influenza viruses, especially in the hemagglutinin molecule. This antigenic drift necessitates updating of seasonal influenza vaccines regularly in order to match the circulating strains. Upon infection also virus-specific T cell responses are induced, including CD4+ T helper cells and CD8+ cytotoxic T cells. These cells are mainly directed to conserved proteins and therefore display cross-reactivity with a variety of influenza A viruses of different subtypes. T cell mediated immunity therefore may contribute to so-called heterosubtypic immunity and may afford protection against antigenically distinct, potentially pandemic influenza viruses. At present, novel viral targets are identified that may help to develop broad-protective vaccines. Here we review the various arms of the immune response to influenza virus infections and their viral targets and discuss the possibility of developing universal vaccines. The development of such novel vaccines would imply that also new immune correlates of protection need to be established in order to facilitate assessment of vaccine efficacy.
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Affiliation(s)
- J H C M Kreijtz
- Department of Virology, Erasmus MC, Rotterdam, The Netherlands
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Abstract
The genetic attributes of the influenza virus lead to unique problems in vaccination. First, a highly mutable RNA genome, resulting in sequential antigenic variation, could potentially manifest as a vaccine failure or epidemic influenza. Second, a segmented genome that engenders the virus with the capacity for genetic reassortment and the introduction of new antigens into a host population could possibly result in a pandemic. The core problem in combating influenza is the need for continual vaccine revision and induction of broader heterovariant immunity. Current vaccines – the conventional inactivated vaccine and the live attenuated vaccine – rely on technology of strain selection and production methods that is decades old. The immunity induced by these vaccines is dominated by the response to hemagglutinin (HA) and, therefore, the vaccines are most effective when there is sufficient antigenic relatedness between the vaccine strain HA and the circulating wild-type virus HA. Consequently, these vaccines are susceptible to failure when an antigenically distinct virus emerges after the selection of the vaccine candidate strain. New vaccine strategies need to include immunization with other viral antigens in addition to HA, thereby broadening the immune response against influenza. Inclusion of the more slowly evolving neuraminidase and/or M2e in a vaccine against influenza could reduce the vulnerability to antigenic changes, and conserved antigens from internal proteins – nucleoprotein and M1 – delivered to induce T-cell helper and cytotoxic T cells, could ensure the presence of activated T cells that facilitate clearance of pandemic strains. Alternative production technologies, such as recombinant baculovirus and yeast, and different delivery methods, such as virus-like particles, should be explored to decrease vaccine production times and reduce reliance on embryonated eggs.
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Affiliation(s)
- Bert E Johansson
- Center of Excellence of Infectious Diseases & Department of Pediatrics, Texas Tech University Health Sciences Center, Paul H Foster School of Medicine, MSB1 5001 El Paso Dr, El Paso, TX 79922, USA
| | - Maryna C Eichelberger
- Division of Viral Products, Center for Biologics Evaluation & Research, Food & Drug Administration, Building 29A room 1D24, 8800 Rockville Pike, Bethesda, MD 20852, USA
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Lester SR, Brown JR, Aycock JE, Grubbs SL, Johnson RB. Use of saliva for assessment of stress and its effect on the immune system prior to gross anatomy practical examinations. ANATOMICAL SCIENCES EDUCATION 2010; 3:160-167. [PMID: 20607858 DOI: 10.1002/ase.161] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The objective of this study was to determine the longitudinal effects of a series of stressful gross anatomy tests on the immune system. Thirty-six freshman occupational therapy students completed a written stress evaluation survey, and saliva samples were obtained at baseline and prior to each of three timed-practical gross anatomy tests. Cortisol, secretory IgA (sIgA), and IL-12 concentrations were measured within the salivary samples by enzyme-linked immunosorbent assay. The total scores from the stress surveys were used as markers for environmental stress. Data were compiled for each student at baseline and prior to each examination and were compared by repeated-measures MANOVA and Pearson's correlation test. Following normalization for protein concentration and flow rate, the concentrations of IL-2, IL-6, IL-12, and sIgA progressively increased from baseline to the third test. Cortisol concentrations, following normalization for flow rate, were highest prior to the first test and became significantly reduced prior to second and third test. Prior to second and third test, salivary concentrations of IL-6, IL-2, IL-12, and sIgA were significantly correlated (P < 0.05). In contrast, prior to third test, there was a negative correlation between salivary concentrations of cortisol and IL-12 (P < 0.05). Progressive increases in salivary sIgA, IL-6, IL-2, and IL-12 concentrations from the first to the third test coincident to decreased salivary cortisol suggest that the initial examination stressors precede significant effects on the immune system. These data suggest that there may be latent effects of examination stress on the immune system and that saliva can be used to predict these effects.
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Affiliation(s)
- S Reid Lester
- Department of Periodontics and Preventive Sciences, School of Dentistry, University of Mississippi Medical Center, Jackson, Mississippi 39216-4505, USA
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25
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De Groot AS, Ardito M, McClaine EM, Moise L, Martin WD. Immunoinformatic comparison of T-cell epitopes contained in novel swine-origin influenza A (H1N1) virus with epitopes in 2008-2009 conventional influenza vaccine. Vaccine 2009; 27:5740-7. [PMID: 19660593 DOI: 10.1016/j.vaccine.2009.07.040] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2009] [Revised: 07/06/2009] [Accepted: 07/10/2009] [Indexed: 10/20/2022]
Abstract
In March 2009 a novel swine-origin influenza A (H1N1) virus (S-OIV) emerged in Mexico and the Western United States. Vaccination with conventional influenza vaccine (CIV) does not result in cross-reactive antibodies, however, the disproportionate number of cases (37%) occurring among persons younger than 50 years old suggested that adaptive immune memory might be responsible for the relative lack of virulence in older, healthy adults. Using EpiMatrix, a T-cell epitope prediction and comparison tool, we compared the sequences of the three hemagglutinin (HA) and neuraminidase (NA) proteins contained in 2008-2009 CIV to their counterparts in A/California/04/2009 (H1N1) looking for cross-conserved T-cell epitope sequences. We found greater than 50% conservation of T helper and CTL epitopes between novel S-OIV and CIV HA for selected HLA. Conservation was lower among NA epitopes. Sixteen promiscuous helper T-cell epitopes are contained in the S-OIV H1N1 HA sequence, of which nine (56%) were 100% conserved in the 2008-2009 influenza vaccine strain; 81% were either identical or had one conservative amino acid substitution. Fifty percent of predicted CTL epitopes found in S-OIV H1N1 HA were also found in CIV HA sequences. Based on historical performance, we expect these epitope predictions to be 93-99% accurate. This in silico analysis supports the proposition that T-cell response to cross-reactive T-cell epitopes, due to vaccination or exposure, may have the capacity to attenuate the course of S-OIV H1N1 induced disease-in the absence of cross-reactive antibody response. The value of the CIV or live-attenuated influenza vaccine containing the 2008-2009 vaccine strains, as defense against H1N1, could be further tested by evaluating human immune responses to the conserved T-cell epitopes using PBMC from individuals infected with H1N1 and from CIV vaccinees.
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Prolonged protection against Intranasal challenge with influenza virus following systemic immunization or combinations of mucosal and systemic immunizations with a heat-labile toxin mutant. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2009; 16:471-8. [PMID: 19193829 DOI: 10.1128/cvi.00311-08] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Seasonal influenza virus infections cause considerable morbidity and mortality in the world, and there is a serious threat of a pandemic influenza with the potential to cause millions of deaths. Therefore, practical influenza vaccines and vaccination strategies that can confer protection against intranasal infection with influenza viruses are needed. In this study, we demonstrate that using LTK63, a nontoxic mutant of the heat-labile toxin from Escherichia coli, as an adjuvant for both mucosal and systemic immunizations, systemic (intramuscular) immunization or combinations of mucosal (intranasal) and intramuscular immunizations protected mice against intranasal challenge with a lethal dose of live influenza virus at 3.5 months after the second immunization.
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27
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York JJ, Young JG, Fahey KJ. The appearance of viral antigen and antibody in the trachea of naive and vaccinated chickens infected with infectious laryngotracheitis virus. Avian Pathol 2008; 18:643-58. [PMID: 18679897 DOI: 10.1080/03079458908418639] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In chickens vaccinated with SA-2 infectious laryngotracheitis (ILT) virus, viral antigen could no longer be detected in tracheal washings from day 7 post infection (pi). Total specific antibody was detected in tracheal washings from day 5 pi, IgA antibody appeared at day 6 pi, but neutralising antibody could not be detected until day 14. In the serum of vaccinated chickens, total antibody appeared on day 5 pi and neutralising antibody on day 7. However, no IgA antibody could be detected in serum. There was a substantial increase in the numbers of IgA- and IgG-synthesising cells in the trachea by day 3 pi, with a marked increase in the numbers of IgA-positive cells at day 7 pi. Following challenge with virulent CSW-1 ILT virus, no virus could be detected in the trachea of vaccinated chickens. There was also no evidence of an anamnestic antibody response in the trachea or in serum up to day 10 post challenge, and there was no significant change in the numbers of IgA- or IgG-synthesising cells in the tracheas of vaccinated chickens up to day 7 post challenge.
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Affiliation(s)
- J J York
- CSIRO Division of Animal Health, Animal Health Research Laboratory, Parkville, Victoria, Australia
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28
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Engler RJ, Kurman CC, Nelson DL. Induction and measurement of in vivo antibody responses. CURRENT PROTOCOLS IN IMMUNOLOGY 2008; Chapter 7:Unit 7.16. [PMID: 18432830 DOI: 10.1002/0471142735.im07016s00] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The capacity of the human immune system to mount an antibody response following in vivo immunization with a protein or polysaccharide antigen is a revealing indication of the overall integrity of both the B and T cell arms of the immune system. As such, in vivo immunization followed by measurement of the antibody response is an appropriate test of immune function in the various acquired and congenital immunodeficiencies and in a host of other conditions affecting the immune system. This unit describes procedures for in vivo immunization and for the measurement of the subsequent immune response using an ELISA technique.
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Affiliation(s)
- R J Engler
- Walter Reed Army Institute of Research, Washington, DC, USA
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Abstract
The American Academy of Pediatrics recommends annual influenza immunization for all children with high-risk conditions who are 6 months of age and older, for all healthy children ages 6 through 59 months, for all household contacts and out-of-home caregivers of children with high-risk conditions and of healthy children younger than 5 years, and for all health care professionals. To more fully protect against the morbidity and mortality of influenza, increased efforts are needed to identify and immunize all children at high risk and all healthy children ages 6 through 59 months and to inform their parents when annual immunizations are due. Previously unimmunized children who are at least 6 months of age but younger than 9 years should receive 2 doses of influenza vaccine, given 1 month apart, beginning as soon as possible on the basis of local availability during the influenza season. If children in this cohort received only 1 dose for the first time in the previous season, it is recommended that 2 doses be administered in the current season. This recommendation applies only to the influenza season that follows the first year that a child younger than 9 years receives influenza vaccine. A child who then also fails to receive 2 doses the next year should be given only 1 dose per year from that point on. Influenza vaccine should also continue to be offered throughout the influenza season, even after influenza activity has been documented in a community. On the basis of global surveillance of circulating virus strains, the influenza vaccine may change from year to year; indeed, 1 of the 3 strains in the 2007-2008 vaccine is different from the previous year's vaccine. All health care professionals, influenza campaign organizers, and public health agencies should develop plans for expanding outreach and infrastructure to immunize all children for whom influenza vaccine is recommended. Appropriate prioritization of administering influenza vaccine will also be necessary when vaccine supplies are delayed or limited. Because the influenza season often extends into March, immunization against influenza is recommended to continue through late winter and early spring. Lastly, it is recommended that for the 2007-2008 season, and likely beyond, health care professionals do not prescribe amantadine or rimantadine for influenza treatment or chemoprophylaxis, because widespread resistance to these antiviral medications now exists among influenza A viral strains. However, oseltamivir and zanamivir can be prescribed for treatment or chemoprophylaxis, because influenza A and B strains remain susceptible.
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Common Respiratory Viruses and Pulmonary Mucosal Immunology. MUCOSAL IMMUNOLOGY AND VIROLOGY 2006. [PMCID: PMC7123111 DOI: 10.1007/978-1-84628-206-5_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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31
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Alcon V, Baca-Estrada M, Vega-Lopez M, Willson P, Babiuk LA, Kumar P, Hecker R, Foldvari M. Mucosal delivery of bacterial antigens and CpG oligonucleotides formulated in biphasic lipid vesicles in pigs. AAPS JOURNAL 2005; 7:E566-71. [PMID: 16353934 PMCID: PMC2751259 DOI: 10.1208/aapsj070357] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The ineffectiveness of simple delivery of soluble antigens to mucosal membranes for immunization has stimulated extensive studies of strategies for appropriate delivery systems and adjuvants. Biphasic lipid vesicles are formulations suitable for the delivery of proteins, peptides, and oligo/polynucleotides. The purpose of these studies was to investigate the ability of biphasic lipid vesicles (as vaccine-targeting adjuvants) containing a bacterial antigen and unmethylated oligonucleotides containing CGdinucleotides - CpG motifs (CpG ODNs) to induce systemic and mucosal immune responses in pigs. Results showed that while the protein, either alone or with CpG ODNs, did not induce mucosal immune responses, administration of antigen and CpG ODNs in biphasic lipid vesicles resulted in induction of both systemic and local antibody responses after immunization using a combined mucosal/systemic approach.
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Affiliation(s)
- Valeria Alcon
- />Department of Pharmaceutics/Pharmacy, College of Pharmacy and Nutrition, University of Saskatchewan, 110 Science Place, S7N 5C9 Saskatoon, Saskatchewan Canada
- />Vaccine and Infectious Disease Organization, Saskatoon, SK Canada
| | | | - Marco Vega-Lopez
- />Vaccine and Infectious Disease Organization, Saskatoon, SK Canada
| | - Philip Willson
- />Vaccine and Infectious Disease Organization, Saskatoon, SK Canada
| | - Lorne A. Babiuk
- />Vaccine and Infectious Disease Organization, Saskatoon, SK Canada
| | - Praveen Kumar
- />PharmaDerm Laboratories Ltd, Innovation Place Research Park, Saskatoon, SK Canada
| | | | - Marianna Foldvari
- />Department of Pharmaceutics/Pharmacy, College of Pharmacy and Nutrition, University of Saskatchewan, 110 Science Place, S7N 5C9 Saskatoon, Saskatchewan Canada
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Sweet TM, Maassab HF, Herlocher ML. Reverse genetics studies of attenuation of the ca A/AA/6/60 influenza virus: the role of the matrix gene. Biomed Pharmacother 2004; 58:509-15. [PMID: 15511608 DOI: 10.1016/j.biopha.2004.08.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2004] [Accepted: 04/16/2004] [Indexed: 11/16/2022] Open
Abstract
The matrix (M) gene of influenza virus has been implicated in the attenuation phenotype of the cold adapted (ca) A/AA/6/60 vaccine. Previous studies have evaluated the ca M from A/AA/6/60 in different wild type (wt) virus backgrounds with varying results. In experiments described here, the ca M gene was transfected into the background of its own wt A/AA/6/60 to eliminate the possibility of confounding gene constellation effects. Comparison of the sequence of the wt and the ca A/AA/6/60 revealed one substitution in the nucleotide sequence of M. The molecular techniques of reverse genetics were used to rescue the ca M gene into the virulent wt A/AA/6/60 virus. The selection system used to identify the desired transfectant virus was amantadine resistance, which was introduced into the M2 gene using mutagenesis. The ca A/AA/6/60, the wt A/AA/6/60, a virus which contained wt M and was wt in the remaining seven genes and amantadine resistant (wt/969), a virus which contained the ca M but wt in the other seven genes (ca/969) were all evaluated in mice determine the effect of the ca M. The ca/969 virus was not attenuated in the mouse model when compared to the wt/969 virus, indicating that the ca A/AA/6/60 M does not independently contribute to the attenuation phenotype attributed to the ca A/AA/6/60 vaccine virus.
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Affiliation(s)
- T M Sweet
- Center for NeuroVirology and Cancer Biology, Temple University, College of Science and Technology, Biology Life Sciences Building (015-96), 2400 North 12th Street, Philadelphia, PA 19122, USA.
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Abstract
Influenza viruses cause annual epidemics and occasional pandemics of acute respiratory disease. Vaccination is the primary means to prevent and control the disease. However, influenza viruses undergo continual antigenic variation, which requires the annual reformulation of trivalent influenza vaccines, making influenza unique among pathogens for which vaccines have been developed. The segmented nature of the influenza virus genome allows for the traditional reassortment between two viruses in a coinfected cell. This technique has long been used to generate strains for the preparation of either inactivated or live attenuated influenza vaccines. Recent advancements in reverse genetics techniques now make it possible to generate influenza viruses entirely from cloned plasmid DNA by cotransfection of appropriate cells with 8 or 12 plasmids encoding the influenza virion sense RNA and/or mRNA. Once regulatory issues have been addressed, this technology will enable the routine and rapid generation of strains for either inactivated or live attenuated influenza vaccine. In addition, the technology offers the potential for new vaccine strategies based on the generation of genetically engineered donors attenuated through directed mutation of one or more internal genes. Reverse genetics techniques are also proving to be important for the development of pandemic influenza vaccines, because the technology provides a means to modify genes to remove virulence determinants found in highly pathogenic avian strains. The future of influenza prevention and control lies in the application of this powerful technology for the generation of safe and more effective influenza vaccines.
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Affiliation(s)
- K Subbarao
- Influenza Branch, Centers for Disease Control and Prevention, Mailstop G-16, 1600 Clifton Road, Atlanta, GA 30333, USA
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Renegar KB, Small PA, Boykins LG, Wright PF. Role of IgA versus IgG in the Control of Influenza Viral Infection in the Murine Respiratory Tract. THE JOURNAL OF IMMUNOLOGY 2004; 173:1978-86. [PMID: 15265932 DOI: 10.4049/jimmunol.173.3.1978] [Citation(s) in RCA: 318] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The roles of IgG and secretory IgA in the protection of the respiratory tract (RT) against influenza infection remain unclear. Passive immunization with Ab doses resulting in serum IgG anti-influenza virus Ab titers far in excess of those observed in immune mice has compounded the problem. We compared the effects of i.v. anti-influenza virus IgG and i.v. anti-influenza virus polymeric IgA (pIgA) mAb administered in amounts designed to replicate murine convalescent serum or nasal Ab titers, respectively. A serum anti-influenza virus IgG titer 2.5 times the normal convalescent serum anti-influenza virus IgG titer was required for detectible Ab transudation into nasal secretions, and a serum IgG titer 7 times normal was needed to lower nasal viral shedding by 98%. Anti-influenza virus pIgA at a nasal Ab titer comparable to that seen in convalescent mice eliminated nasal viral shedding. The RT of influenza-infected pIgA- or IgG-protected mice were studied by scanning electron microscopy. Only pIgA was found to prevent virally induced pathology in the upper RT, suggesting that IgG did not prevent viral infection of the nose, but neutralized newly replicated virus after infection had been initiated. In contrast, IgG, but not pIgA, was found to prevent viral pathology in the murine lung. Our results help to resolve the controversy of IgA- vs IgG-mediated protection of the RT; both Abs are important, with plasma IgG Ab serving as the back-up for secretory IgA-mediated protection in the nasal compartment, and IgG being the dominant Ab in protection of the lung.
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MESH Headings
- Animals
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Viral/analysis
- Antibodies, Viral/immunology
- Antibodies, Viral/therapeutic use
- Bronchi/immunology
- Bronchi/ultrastructure
- Bronchi/virology
- Convalescence
- Female
- Immunization, Passive
- Immunoglobulin A/immunology
- Immunoglobulin A, Secretory/analysis
- Immunoglobulin A, Secretory/immunology
- Immunoglobulin G/analysis
- Immunoglobulin G/immunology
- Immunoglobulin G/therapeutic use
- Influenza A virus/immunology
- Influenza A virus/physiology
- Lung/immunology
- Lung/ultrastructure
- Lung/virology
- Mice
- Mice, Inbred BALB C
- Microscopy, Electron, Scanning
- Mucus/immunology
- Nasal Mucosa/immunology
- Nasal Mucosa/ultrastructure
- Nasal Mucosa/virology
- Neutralization Tests
- Orthomyxoviridae Infections/immunology
- Orthomyxoviridae Infections/pathology
- Orthomyxoviridae Infections/prevention & control
- Trachea/immunology
- Trachea/ultrastructure
- Trachea/virology
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Affiliation(s)
- Kathryn B Renegar
- Division of Infectious Diseases, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
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Infección por el virus influenza en la infancia. ¿Deberían ampliarse las indicaciones de la vacuna antigripal? Arch Bronconeumol 2004. [DOI: 10.1016/s0300-2896(04)75510-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Epidemiologic studies have shown that children of all ages with certain chronic conditions, such as asthma, and otherwise healthy children younger than 24 months (6 through 23 months) are hospitalized for influenza and its complications at high rates similar to those experienced by the elderly. Annual influenza immunization is already recommended for all children 6 months and older with high-risk conditions. By contrast, influenza immunization has not been recommended for healthy young children. To protect children against the complications of influenza, increased efforts are needed to identify and recall high-risk children. In addition, immunization of children between 6 through 23 months of age and their close contacts is now encouraged to the extent feasible. Children younger than 6 months may be protected by immunization of their household contacts and out-of-home caregivers. The ultimate goal is universal immunization of children 6 to 24 months of age. Issues that need to be addressed before institution of routine immunization of healthy young children include education of physicians and parents about the morbidity caused by influenza, adequate vaccine supply, and appropriate reimbursement of practitioners for influenza immunization. This report contains a summary of the influenza virus, protective immunity, disease burden in children, diagnosis, vaccines, and antiviral agents.
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Abstract
Influenza is a common disease of childhood. Young children and children with high-risk medical conditions are at increased risk of being hospitalized when infected with influenza virus. Children of all ages have excess physician visits and receive excess antibiotic prescriptions during influenza season. The safety, immunogenicity, and efficacy of influenza vaccines in children are described in this review. Clinical trials and postlicensure experience have demonstrated that trivalent inactivated influenza vaccine is well-tolerated in children. Efficacy of the inactivated vaccine also has been demonstrated in numerous clinical trials. In comparison to trivalent inactivated influenza vaccine, investigational cold-adapted, live-attenuated influenza vaccine (LAIV) has the advantage of an intranasal route of administration. A large clinical trial demonstrated the tolerability and efficacy of the trivalent live, attenuated product in children 15 to 71 months of age. Pending information on safety and coadministration of this vaccine with other childhood vaccines will determine if it is licensed and recommended for use in children, including possible expanded indications for routine yearly administration to young children.
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Affiliation(s)
- Kathleen M Neuzil
- Division of Allergy and Infectious Diseases, University of Washington School of Medicine, Seattle, USA
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39
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Abstract
Influenza infection is an acute respiratory disease with a high morbidity and significant mortality, particularly among the elderly and individuals with chronic diseases. The majority of countries now recommend annual influenza vaccination for all people aged 65 years or older, and for those with high risk conditions. Most commercially available influenza vaccines are administered systemically and while these are effective in children and young adults, efficacy levels in elderly individuals have been reported to be much lower. Mucosal vaccines may offer an improved vaccine strategy for protection of the elderly. As the influenza virus causes a respiratory infection, it is potentially more beneficial to administer a vaccine that will boost protection in the mucosal surfaces of the upper and lower respiratory tract. Mucosal influenza vaccines are aimed at stimulating protective immunity in the respiratory tract via oral or intranasal immunisation. This review examines our present knowledge of mucosal immunity and current strategies for mucosal vaccination. It also stresses that the use of serum antibody levels as a 'surrogate marker' for protection against influenza is potentially misleading; serum antibody, for example, may be a quite inappropriate marker to assess a mucosal vaccine. This marker does not reflect other immune responses to vaccination that are crucial for protection.
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Affiliation(s)
- E M Corrigan
- The Australian Institute of Mucosal Immunology, Royal Newcastle Hospital, New South Wales
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Glenn GM, Scharton-Kersten T, Vassell R, Matyas GR, Alving CR. Transcutaneous immunization with bacterial ADP-ribosylating exotoxins as antigens and adjuvants. Infect Immun 1999; 67:1100-6. [PMID: 10024549 PMCID: PMC96435 DOI: 10.1128/iai.67.3.1100-1106.1999] [Citation(s) in RCA: 113] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Transcutaneous immunization (TCI) is a new technique that uses the application of vaccine antigens in a solution on the skin to induce potent antibody responses without systemic or local toxicity. We have previously shown that cholera toxin (CT), a potent adjuvant for oral and nasal immunization, can induce both serum and mucosal immunoglobulin G (IgG) and IgA and protect against toxin-mediated mucosal disease when administered by the transcutaneous route. Additionally, CT acts as an adjuvant for coadministered antigens such as tetanus and diphtheria toxoids when applied to the skin. CT, a member of the bacterial ADP-ribosylating exotoxin (bARE) family, is most potent as an adjuvant when the A-B subunits are present and functional. We now show that TCI induces secondary antibody responses to coadministered antigens as well as to CT in response to boosting immunizations. IgG antibodies to coadministered antigens were also found in the stools and lung washes of immunized mice, suggesting that TCI may target mucosal pathogens. Mice immunized by the transcutaneous route with tetanus fragment C and CT developed anti-tetanus toxoid antibodies and were protected against systemic tetanus toxin challenge. We also show that bAREs, similarly organized as A-B subunits, as well as the B subunit of CT alone, induced antibody responses to themselves when given via TCI. Thus, TCI appears to induce potent, protective immune responses to both systemic and mucosal challenge and offers significant potential practical advantages for vaccine delivery.
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Affiliation(s)
- G M Glenn
- Department of Membrane Biochemistry, Walter Reed Army Institute of Research, Washington, D.C. 20307-5100, USA.
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41
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Yasui H, Kiyoshima J, Hori T, Shida K. Protection against influenza virus infection of mice fed Bifidobacterium breve YIT4064. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 1999; 6:186-92. [PMID: 10066652 PMCID: PMC95685 DOI: 10.1128/cdli.6.2.186-192.1999] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Mice fed Bifidobacterium breve YIT4064 and immunized orally with influenza virus were more strongly protected against influenza virus infection of the lower respiratory tract than ones immunized with influenza virus only. The number of mice with enhanced anti-influenza virus immunoglobulin G (IgG) in serum upon oral administration of B. breve YIT4064 and oral immunization with influenza virus was significantly greater than that upon oral immunization with influenza virus only. These findings demonstrated that the oral administration of B. breve YIT4064 increased anti-influenza virus IgG antibodies in serum and protected against influenza virus infection. The oral administration of B. breve YIT4064 may enhance antigen-specific IgG against various pathogenic antigens taken orally and induce protection against various virus infections.
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Affiliation(s)
- H Yasui
- Yakult Central Institute for Microbiological Research and Department of Microbiology, 1796 Yaho, Kunitachi-shi, Tokyo 186-8650, Japan
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42
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Voeten JT, Groen J, van Alphen D, Claas EC, de Groot R, Osterhaus AD, Rimmelzwaan GF. Use of recombinant nucleoproteins in enzyme-linked immunosorbent assays for detection of virus-specific immunoglobulin A (IgA) and IgG antibodies in influenza virus A- or B-infected patients. J Clin Microbiol 1998; 36:3527-31. [PMID: 9817867 PMCID: PMC105234 DOI: 10.1128/jcm.36.12.3527-3531.1998] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The nucleoprotein genes of influenza virus A/Netherlands/018/94 (H3N2) and influenza virus B/Harbin/7/94 were cloned into the bacterial expression vector pMalC to yield highly purified recombinant influenza virus A and B nucleoproteins. With these recombinant influenza nucleoproteins, enzyme-linked immunosorbent assays (ELISAs) were developed for the detection of influenza virus A- and B-specific immunoglobulin A (IgA) and IgG serum antibodies. Serum samples were collected at consecutive time points after the onset of clinical symptoms from patients with confirmed influenza virus A or B infections. Nucleoprotein-specific IgA antibodies were detected in 41.2% of influenza virus A-infected patients and in 66. 7% of influenza virus B-infected patients on day 6 after the onset of clinical symptoms. In serum samples taken on day 21 (influenza virus A-infected patients) or day 28 (influenza virus B-infected patients), nucleoprotein-specific IgA antibodies could be detected in 58.8 and 58.3% of influenza virus A- and B-infected patients, respectively. At the same time, IgG antibody rises were detected in 88.2% of influenza virus A-infected patients and in 95.8% of influenza virus B-infected patients. On comparison, hemagglutination inhibition assays detected antibody titer rises in 81.3 and 72.7% of patients infected with influenza viruses A and B, respectively. In contrast to the detection of nucleoprotein-specific IgG antibodies or hemagglutination-inhibiting antibodies, the detection of nucleoprotein-specific IgA antibodies does not require paired serum samples and therefore can be considered an attractive alternative for the rapid serological diagnosis of influenza.
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Affiliation(s)
- J T Voeten
- WHO National Influenza Centre and Institute of Virology, Erasmus University Rotterdam, 3000 DR Rotterdam, The Netherlands.
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Gorse GJ, Otto EE, Daughaday CC, Newman FK, Eickhoff CS, Powers DC, Lusk RH. Influenza virus vaccination of patients with chronic lung disease. Chest 1997; 112:1221-33. [PMID: 9367461 DOI: 10.1378/chest.112.5.1221] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
STUDY OBJECTIVES To evaluate the safety of, and mucosal and systemic immune responses induced by two influenza virus vaccine regimens in subjects with COPD. DESIGN Single-center, blinded, randomized, prospective clinical trial evaluating two vaccine regimens. SETTING Outpatient clinics of St. Louis Department of Veterans Affairs Medical Center. PARTICIPANTS Volunteers (age range, 42 to 88 years) had preexisting COPD with severe obstruction to airflow on average, were male, and were not receiving immunosuppressive medication. INTERVENTIONS Twenty-nine volunteers were randomly assigned to receive either bivalent live attenuated influenza A virus vaccine (CAV) or saline solution placebo intranasally. All subjects also received an i.m. injection of trivalent inactivated influenza virus vaccine (TVV) simultaneously. MEASUREMENTS AND RESULTS Clinical status and pulmonary function measured by spirometry did not change significantly after vaccination. Using hemagglutinins (H1 and H3 HA) which more closely resembled those in CAV, mean levels of anti-HA immunoglobulin A (IgA) antibodies in nasal washings increased significantly after vaccination with CAV and TVV compared to prevaccination, but they did not increase significantly after TVV and intranasal placebo. Mean levels of influenza A virus-stimulated interleukin-2 and -4 produced by peripheral blood mononuclear cells in vitro increased significantly after administration of the combination vaccine regimen and to a lesser extent after TVV and intranasal placebo compared to respective prevaccination levels. The timing of the cytokine response appeared different following CAV and TVV compared to TVV and intranasal placebo. CONCLUSIONS Intranasally administered CAV was safe when given with i.m. administered TVV and there may be an immunologic advantage to administration of the combination vaccine regimen compared to TVV with intranasal placebo.
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MESH Headings
- Administration, Intranasal
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Viral/analysis
- Cytokines/biosynthesis
- Double-Blind Method
- Humans
- Immunoglobulin A/analysis
- Influenza A virus/immunology
- Influenza A virus/isolation & purification
- Influenza Vaccines/administration & dosage
- Influenza Vaccines/adverse effects
- Influenza, Human/immunology
- Influenza, Human/physiopathology
- Influenza, Human/prevention & control
- Injections, Intramuscular
- Lung Diseases, Obstructive/complications
- Lung Diseases, Obstructive/immunology
- Lung Diseases, Obstructive/physiopathology
- Male
- Middle Aged
- Prospective Studies
- Respiratory Function Tests
- Safety
- Treatment Outcome
- Vaccination
- Vaccines, Attenuated/administration & dosage
- Vaccines, Attenuated/adverse effects
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Affiliation(s)
- G J Gorse
- Section of Infectious Diseases, St. Louis Department of Veterans Affairs Medical Center, Saint Louis University School of Medicine, MO 63110, USA
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Herlocher ML, Clavo AC, Maassab HF. Sequence comparisons of A/AA/6/60 influenza viruses: mutations which may contribute to attenuation. Virus Res 1996; 42:11-25. [PMID: 8806171 DOI: 10.1016/0168-1702(96)01292-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Influenza virus infection is a worldwide public health threat. Cold-adaptation was used to develop a vaccine line (ca A/AA/6/60 H2N2) which promised to reduce the morbidity and mortality associated with influenza and to serve as a model for other live virus vaccines. This study establishes that two distinct lines of wt A/AA/6/60 viruses exist with different phenotypic and genotypic characteristics. The two virus lines have the same parent but different passage histories. The first line is both temperature sensitive (ts) and attenuated in ferrets and the second line (after multiple passages in chick kidney cells, eggs and mice) is non-ts and virulent in ferrets. Both lines of viruses have been further differentiated by sequence analysis. We have identified point mutations common to all virulent viruses but absent from the attenuated viruses. This was accomplished by comparing the nucleotide sequences of the six internal genes in three different attenuated passages of A/AA/6/60 with those of five different virulent passages of the same virus. The corresponding nucleotides of the attenuated viruses, therefore, represent candidate attenuating lesions: 6 in the basic polymerase genes (5 in PB1, 1 in PB2), 2 in the acidic polymerase gene (PA), 1 in the matrix (M) gene, 2 in the non-structural (NS) gene, and none in the nucleoprotein (NP) gene. Two of the 5 attenuating lesions in PB1 are silent; 1/2 in PA is silent; and 1/2 in NS is silent. Further changes which might be identified by comparing nucleotide and amino acid sequences of the A/AA/6/60 viruses with those of other influenza viruses may also contribute to the attenuation of the ca virus. Our study identifies nucleotides which more precisely define virulence for this virus and suggests that growth of the virus at low temperature may have preserved a non-virulent virus population rather than attenuating a virulent one.
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Affiliation(s)
- M L Herlocher
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor 48109, USA
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Moreno de Alborán I, Martínéz-alonso C, Barbas CF, Burton DR, Ditzel HJ. Human monoclonal Fab fragments specific for viral antigens from combinatorial IgA libraries. IMMUNOTECHNOLOGY : AN INTERNATIONAL JOURNAL OF IMMUNOLOGICAL ENGINEERING 1995; 1:21-8. [PMID: 9373330 DOI: 10.1016/1380-2933(95)00002-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND IgA constitutes the first line of immune defense, interacting with a variety of environmental antigens. Following infection with respiratory syncytial virus (RSV) individuals frequently exhibit elevated serum IgA titers specific for the virus. Previously combinatorial IgG libraries have successfully been used to clone such human antibody responses. OBJECTIVES Here we evaluate the possibility of constructing combinatorial IgA libraries on the surface of filamentous phage to retrieve human viral-specific IgA Fab fragments. STUDY DESIGN Bone marrow from an HIV-1 seropositive donor was used as RNA source to construct combinatorial IgA kappa and lambda libraries of approximately 10(7) clones. RESULTS By affinity selection using an immobilized recombinant RSV FG protein, two unique IgA Fab fragments producing clones (AD5 and AD23) reactive with the selecting antigen were isolated. One of the Fab fragments was found to be specific for RSV F glycoprotein and bind with high apparent affinity (2 x 10(8) M-1). The other binds with lower affinity and exhibits cross-reactivity with other antigens. CONCLUSION The strategy described, involving construction of combinatorial IgA libraries on the surface of filamentous phage, should be generally applicable to the investigation of both mucosal and systemic human IgA immune responses, and may become an important tool for evaluation of mucosal vaccine regimes.
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Affiliation(s)
- I Moreno de Alborán
- Department of Immunology, Scripps Research Institute, La Jolla, CA 92037, USA
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46
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Santiago N, Milstein S, Rivera T, Garcia E, Zaidi T, Hong H, Bucher D. Oral immunization of rats with proteinoid microspheres encapsulating influenza virus antigens. Pharm Res 1993; 10:1243-7. [PMID: 8415415 DOI: 10.1023/a:1018992924025] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Influenza virus antigen microspheres were prepared by a pH-dependent process using a protein-like polymer (proteinoid) made by thermal condensation of amino acids. The efficacy of these preparations to induce specific IgG responses when used as oral vaccines in rats was evaluated. A single enteric dose of M1 entrapped in proteinoid microspheres was able to induce a significant IgG response to M1 as early as 2 weeks postdosing, while rats dosed orally with the same M1 total dose (no microspheres) showed no detectable antibody response. An unencapsulated hemagglutinin and neuraminidase (HA-NA) preparation induced a moderate anti HA-NA IgG response. A single enteric dose of HA-NA spheres induced a response in 33% of the rats; this response was up to eight times higher than that observed in the rats dosed with unencapsulated antigen.
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Affiliation(s)
- N Santiago
- Emisphere Technologies, Inc., Hawthorne, New York 10532
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Mackinnon LT, Ginn E, Seymour GJ. Decreased salivary immunoglobulin A secretion rate after intense interval exercise in elite kayakers. EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY AND OCCUPATIONAL PHYSIOLOGY 1993; 67:180-4. [PMID: 8223526 DOI: 10.1007/bf00376664] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Endurance athletes have been shown to suffer a high incidence of upper respiratory tract infection (URTI; e.g. colds, sore throat) during intense training and after competition. Previous studies have shown that concentrations of secretory immunoglobulin A (IgA), the major effector of host defense against micro-organisms causing URTI, decrease after intense endurance exercise. Many athletes perform intense interval exercise as part of their normal training. The purpose of this study was to determine whether salivary IgA concentrations also decrease after intense interval exercise during the normal training regime in elite athletes. Timed saliva samples were obtained from eight elite male kayakers immediately before and after three on-water training sessions during a 3-week period. The concentrations of IgA, IgG and IgM were determined separately by enzyme-linked immunosorbent assay, and secretion rates calculated for each Ig. The IgA secretion rate (micrograms.min-1) decreased 27%-38% after all three training sessions (P = 0.007); the largest decrease (38%) was noted after the most intense session at the end of an especially intense week of training. The IgA concentration relative to total protein (micrograms.mg protein-1) was significantly lower (P < 0.05) on this training day compared with the other 2 days. Concentrations and secretion rates of IgG and IgM did not change after exercise, indicating a specific effect on IgA. These data would suggest that, in elite athletes, IgA concentration and secretion rate are reduced by intense interval exercise, and that exercise-induced changes in IgA output may be one mechanism contributing to URTI in elite athletes.
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Affiliation(s)
- L T Mackinnon
- Department of Human Movement Studies, University of Queensland, Brisbane, Australia
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Herlocher ML, Maassab HF, Webster RG. Molecular and biological changes in the cold-adapted "master strain" A/AA/6/60 (H2N2) influenza virus. Proc Natl Acad Sci U S A 1993; 90:6032-6. [PMID: 8327480 PMCID: PMC46861 DOI: 10.1073/pnas.90.13.6032] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The live cold-adapted (ca) A/AA/6/60 influenza vaccine is being commercially developed for worldwide use in children and is being used as a model for other live vaccines. Although it has been proven safe and immunogenic, the molecular basis of cold adaptation has never been determined. To identify sequence changes responsible for cold adaptation, we have compared the sequence of the master ca vaccine strain to its progenitor wild-type virus, wt A/AA/6/60 E2 (wt2). Only 4 nt differences encoding 2 aa differences were found in three gene segments. Computer-predicted RNA folds project different secondary structures between the ca and wt2 molecules based on the two silent differences between them. Genes coding for the acidic polymerase, matrix, and nonstructural proteins are identical between the two viruses. The few differences found in the ca A/AA/6/60 virus after its long stepwise passage at 25 degrees C in primary chicken kidney cells suggest that cold adaptation resulted in greater genetic stability for the highly variable RNA genome.
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Affiliation(s)
- M L Herlocher
- Department of Virology and Molecular Biology, St. Jude Children's Research Hospital, Memphis, TN 38101
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Powers DC, Murphy BR, Fries LF, Adler WH, Clements ML. Reduced infectivity of cold-adapted influenza A H1N1 viruses in the elderly: correlation with serum and local antibodies. J Am Geriatr Soc 1992; 40:163-7. [PMID: 1740601 DOI: 10.1111/j.1532-5415.1992.tb01938.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To compare young and elderly adults in terms of their immune responses and rates of infection following intranasal vaccination with a live attenuated influenza virus. DESIGN Time series, comparing outcomes in young and elderly convenience sample. METHOD Retrospective laboratory analysis of serum and nasal wash specimens collected during prior studies in which young or elderly volunteers had been inoculated with cold-adapted influenza A/Kawasaki/86 (H1N1) reassortant virus. SETTING Johns Hopkins Center for Immunization Research. PARTICIPANTS Healthy young and elderly adults with pre-vaccination serum hemagglutination inhibition (HAI) antibody titers less than or equal to 1:8. OUTCOME MEASUREMENTS Antibody responses in serum and nasal washes. MAIN RESULTS The proportion of vaccinees who developed any serum or local antibody response was higher in young compared with elderly subjects (20/20 vs 5/14, P less than 0.0005). Resistance to infection with cold-adapted virus correlated with pre-vaccination levels of serum immunoglobulin G (IgG), serum IgA, and nasal wash IgA antibody to whole virus antigen. Age was highly correlated with a lack of response to vaccine by simple regression, but not when data were adjusted for pre-existing antibody levels. CONCLUSIONS Cold-adapted reassortant influenza A H1N1 viruses achieve lower rates of infection in elderly than young adults, primarily due to age-related differences in preexisting levels of immunity which may not be reflected by HAI titer.
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Affiliation(s)
- D C Powers
- Gerontology Research Education and Clinical Center, Saint Louis Veterans Administration Medical Center, Missouri
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Affiliation(s)
- D C Powers
- Geriatric Research Education and Clinical Center, Saint Louis VA Medical Center, Missouri
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