Investigations towards an efficacious and safe strangles vaccine: submucosal vaccination with a live attenuated Streptococcus equi

Untangling the stranglehold through mathematical modelling of Streptococcus equi subspecies equi transmission

Strangles, a disease caused by infection with Streptococccus equi subspecies equi (S. equi), is endemic worldwide and one of the most frequently diagnosed infectious diseases of horses. Recent work has improved our knowledge of key parameters of transmission dynamics, but important knowledge gaps remain. Our aim was to apply mathematical modelling of S. equi transmission dynamics to prioritise future research areas, and add precision to estimates of transmission parameters thereby improving understanding of S. equi epidemiology and quantifying the control effort required. A compartmental deterministic model was constructed. Parameter values were estimated from current literature wherever possible. We assessed the sensitivity of estimates for the basic reproduction number on the population scale to varying assumptions for the unknown or uncertain parameters of: (mean) duration of carriership (1∕γC), relative infectiousness of carriers (f), proportion of infections that result in carriership (p), and (mean) duration of immunity after natural infection (1∕γR). Available incidence and (sero-)prevalence data were compared to model outputs to improve point estimates and ranges for these currently unknown or uncertain transmission-related parameters. The required vaccination coverage of an ideal vaccine to prevent major outbreaks under a range of control scenarios was estimated, and compared available data on existing vaccines. The relative infectiousness of carriers (as compared to acutely ill horses) and the duration of carriership were identified as key knowledge gaps. Deterministic compartmental simulations, combined with seroprevalence data, suggest that 0.05 Collapse

Key Words

• Epidemiology
• Infectious disease modelling
• Streptococcus equi

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MESH Headings

• Animals
• Horses
• Streptococcal Infections/veterinary
• Streptococcal Infections/epidemiology
• Streptococcal Infections/transmission
• Horse Diseases/transmission
• Horse Diseases/epidemiology
• Horse Diseases/microbiology
• Models, Theoretical
• Prevalence
• Incidence
• Streptococcus equi
• Models, Biological
• Streptococcus

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Affiliation(s)

R M A C Houben Department of Clinical Sciences, faculty of Veterinary medicine, Utrecht University, the Netherlands.
J R Newton Equine Infectious Disease Surveillance (EIDS), Department of Veterinary Medicine, Cambridge, UK
C van Maanen Royal GD, Deventer, the Netherlands
A S Waller Intervacc AB, Stockholm, Sweden; Department of Biomedical Science and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
M M Sloet van Oldruitenborgh-Oosterbaan Department of Clinical Sciences, faculty of Veterinary medicine, Utrecht University, the Netherlands
J A P Heesterbeek Department of Population Health Sciences, faculty of Veterinary Medicine, Utrecht University, the Netherlands

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Strangles in equines: An overview

Strangles, caused by Streptococcus equi subspecies equi, is a highly infectious respiratory disease affecting horses and other equines. The disease is economically important and compromises the productivity of equine farm significantly. The disease is characterized by pyrexia, mucopurulent nasal discharge, and abscess formation in the lymph nodes of the head and neck of horses. The disease transmission occurs either directly by coming in contact with infectious exudates or indirectly via fomite transmission. Besides this, carrier animals are the primary and most problematic source of disease infection. The organism not only initiates outbreaks but also makes the control and prevention of the disease difficult. The diagnosis of strangles is best done by isolating and characterizing the bacteria from nasal discharge, pus from abscesses, and lymphoid tissues or by using PCR. ELISA can also be used to detect serum protein M (SeM) antibodies for diagnosis. The most popular treatment for strangles is with penicillin; however, the treatment is affected by the stage, feature and severity of the disease. Prevention and control of strangles can be achieved through vaccination and good hygiene practices. Basically, this review describes the global prevalence of S. equi, as well as general aspects of the disease, like pathogenesis, diagnosis, treatment, prevention, control and management of the disease.

Voluntary Biosurveillance of Streptococcus equi Subsp. equi in Nasal Secretions of 9409 Equids with Upper Airway Infection in the USA

This study aimed to describe selected epidemiological aspects of horses with acute onset of fever and respiratory signs testing qPCR-positive for S. equi and to determine the effect of vaccination against S. equi on qPCR status. Horses with acute onset of fever and respiratory signs from all regions of the United States were included in a voluntary biosurveillance program from 2008 to 2020 and nasal secretions were tested via qPCR for S. equi and common respiratory viruses. A total of 715/9409 equids (7.6%) tested qPCR-positive for S. equi, with 226 horses showing coinfections with EIV, EHV-1, EHV-4, and ERBV. The median age for the S. equi qPCR-positive horses was 8 ± 4 years and there was significant difference when compared to the median age of the S. equi qPCR-negative horses (6 ± 2 years; p = 0.004). Quarter Horse, Warmblood, and Thoroughbred were the more frequent breed in this horse population, and these breeds were more likely to test qPCR-positive for S. equi compared to other breeds. There was not statistical difference for sex between S. equi qPCR-positive and qPCR-negative horses. Horses used for competition and ranch/farm use were more likely to test qPCR-positive for S. equi (p = 0.006). Horses that tested S. equi qPCR-positive were more likely to display nasal discharge, fever, lethargy, anorexia, and ocular discharge compared to horses that tested S. equi qPCR-negative (p = 0.001). Vaccination against S. equi was associated with a lower frequency of S. equi qPCR-positive status.

Conservation of vaccine antigen sequences encoded by sequenced strains of Streptococcus equi subsp. equi

BACKGROUND

Streptococcus equi subspecies equi (S equi) is the cause of Strangles, one of the most prevalent diseases of horses worldwide. Variation within the immunodominant SeM protein has been documented, but a new eight-component fusion protein vaccine, Strangvac, does not contain live S equi or SeM and conservation of the antigens it contains have not been reported.

OBJECTIVE

To define the diversity of the eight Strangvac antigens across a diverse S equi population.

STUDY DESIGN

Genomic description.

METHODS

Antigen sequences from the genomes of 759 S equi isolates from 19 countries, recovered between 1955 and 2018, were analysed. Predicted amino acid sequences in the antigen fragments of SEQ0256(Eq5), SEQ0402(Eq8), SEQ0721(EAG), SEQ0855(SclF), SEQ0935(CNE), SEQ0999(IdeE), SEQ1817(SclI) and SEQ2101(SclC) in Strangvac and SeM were extracted from the 759 assembled genomes and compared.

RESULTS

The predicted amino acid sequences of SclC, SclI and IdeE were identical across all 759 genomes. CNE was truncated in the genome of five (0.7%) isolates. SclF was absent from one genome and another encoded a single amino acid substitution. EAG was truncated in two genomes. Eq5 was truncated in four genomes and 123 genomes encoded a single amino acid substitution. Eq8 was truncated in three genomes, one genome encoded four amino acid substitutions and 398 genomes encoded a single amino acid substitution at the final amino acid of the Eq8 antigen fragment. Therefore, at least 1579 (99.9%) of 1580 amino acids in Strangvac were identical in 743 (97.9%) genomes, and all genomes encoded identical amino acid sequences for at least six of the eight Strangvac antigens.

MAIN LIMITATIONS

Three hundred and seven (40.4%) isolates in this study were recovered from horses in the UK.

CONCLUSIONS

The predicted amino acid sequences of antigens in Strangvac were highly conserved across this collection of S equi.

Estimation of the basic reproduction number for Streptococcus equi spp equi outbreaks by meta-analysis of strangles outbreak reports

BACKGROUND

Streptococcus equi spp equi (S. equi), the cause of strangles in horses, is considered a highly contagious pathogen affecting equines and the equine industry worldwide. Fundamental epidemiological characteristics of outbreaks, such as the basic reproduction number (R₀ ), are not well described.

OBJECTIVES

Estimate R₀ for S. equi in equine populations from outbreak data.

STUDY DESIGN

Systematic review and meta-analysis of published and unpublished data.

METHODS

A literature search for outbreak reports was carried out. Depending on data available in the reports, the early epidemic growth rate or final attack rate (AR) approach was used to estimate the basic reproduction number for that outbreak. Other recorded outbreak characteristics were the type of housing (group vs individual). An overall estimate for R₀ was computed by meta-analysis.

RESULTS

Data from 8 outbreaks were extracted from peer-reviewed publications. Data from two additional, non-published outbreaks was also included in the meta-analysis. A conservative estimate for R₀ was 2.2 (95% CI 1.9- 2.5). A less conservative estimate, including outbreaks with a 100% AR for which a lower limit R₀ was estimated, was 2.7 (95% CI 2.1- 3.3).

MAIN LIMITATIONS

Few papers describing longitudinal incidence data were found so most estimates were based on the outbreaks' final size. Several outbreaks had a 100% attack rate and could therefore only be included as a lower limit estimate in the meta-analysis. The reported result therefore may be an underestimation.

CONCLUSIONS

This estimate for R₀ for S. equi informs parameters for future mathematical modelling, quantifies desired preventive vaccine coverage and helps evaluate the effect of prevention strategies through future modelling studies.

Streptococcus equi-derived extracellular vesicles as a vaccine candidate against Streptococcus equi infection

Streptococcus equi subspecies equi is a pathogenic bacterium that causes strangles, a highly contagious respiratory infection in horses and other equines. The limitations of current vaccines against S. equi infection warrants the development of an affordable, safe, and effective vaccine. Because gram-positive extracellular vesicles (EVs) transport various immunogenic antigens, they are attractive vaccine candidates. Here, we purified the EVs of S. equi ATCC 39506 and evaluated them as a vaccine candidate against S. equi infection in mice. As an initial step, comparative proteomic analysis was performed to characterize the functional features of the EVs. Reverse vaccinology and knowledge-based annotations were then used to screen potential vaccine candidates (PVCs) for S. equi ATCC 39506. Finally, 32 PVCs were found to be enriched in the EV fraction, suggesting the usefulness of this fraction as a vaccine. Importantly, a significantly higher survival rate after S. equi infection was detected in mice immunized with S. equi-derived EVs via the intraperitoneal route than in mice immunized with heat-killed bacteria. Of note, immunoprecipitation-mass spectrometry results validated various immunogenic antigens within the EV proteome. In conclusion, our results suggest that S. equi-derived EVs can serve as a vaccine candidate against S. equi infection.

Enhanced immune effects and protection conferred by simultaneously targeting GAPDH, SeM, and EAG of S. equi via TLR4

Strangles, which is caused by Streptococcus equi subspecies equi, is one of the most prevalent equine infectious diseases and poses heavy economic losses worldwide. Although various vaccines have been used for decades, they seemed to be sub-optimal to demonstrate effective protection, and the antigen component of vaccines against S. equi remains to be optimized. In the present study, three target antigens (M-like protein, α2-macroglobulin and IgG-binding protein, and glyceraldehyde-3-phosphate dehydrogenase) were selected and expressed. Mice were immunized and challenged, and their immune response and efficacy were evaluated. The results revealed that this optimized multi-antigen treatment elicited a high expression level of T-cell receptor, major histocompatibility complex I, toll-like receptor TLR-4, and increased specific antibody. In addition, the challenge experiment showed an evidently improved protection efficacy. The present work demonstrated that these three proteins might be used as a promising multicomponent subunit vaccine candidate against S. equi infection.

Globetrotting strangles: the unbridled national and international transmission of Streptococcus equi between horses

The equine disease strangles, which is characterized by the formation of abscesses in the lymph nodes of the head and neck, is one of the most frequently diagnosed infectious diseases of horses around the world. The causal agent, Streptococcus equi subspecies equi, establishes a persistent infection in approximately 10 % of animals that recover from the acute disease. Such 'carrier' animals appear healthy and are rarely identified during routine veterinary examinations pre-purchase or transit, but can transmit S. equi to naïve animals initiating new episodes of disease. Here, we report the analysis and visualization of phylogenomic and epidemiological data for 670 isolates of S. equi recovered from 19 different countries using a new core-genome multilocus sequence typing (cgMLST) web bioresource. Genetic relationships among all 670 S. equi isolates were determined at high resolution, revealing national and international transmission events that drive this endemic disease in horse populations throughout the world. Our data argue for the recognition of the international importance of strangles by the Office International des Épizooties to highlight the health, welfare and economic cost of this disease. The Pathogenwatch cgMLST web bioresource described herein is available for tailored genomic analysis of populations of S. equi and its close relative S. equi subspecies zooepidemicus that are recovered from horses and other animals, including humans, throughout the world. This article contains data hosted by Microreact.

Effects of srtA variation on phagocytosis resistance and immune response of Streptococcus equi

Strangles, which is caused by Streptococcus equi subspecies equi (S. equi), is one of the most prevalent equine infectious diseases with worldwide distribution and leads to serious economic loss in the horse industry. Sortase A (srtA) is a transpeptidase that anchors multiple virulence-associated surface proteins to the cell surface of S. equi. srtA plays a major role in S. equi infection and colonization of the host cell. In this study, we aimed to investigate the effects of srtA mutation on the phagocytic activity and immunogenicity of S. equi. The point-mutated recombinant sortases, including srtA-HT1112 (I88V), srtA-5012 (R147G), and srtA-ZZM17 (control), were expressed, purified, and used to immunize the mouse models. Phagocytic activity was assessed using equine polymorphonuclear cells, whereas opsonophagocytic function and adherence inhibition were measured using the antiserum of these mutants. Mouse serum antibody, bacterial load, and weight gain were also measured. The srtA-HT1112 (I88V) mutant showed significantly enhanced antiphagocytic capability, and its antiserum exhibited increased adherence inhibition activity. In addition, the srtA-HT1112 (I88V) mutant presented the highest lung bacterial load and lowest protection rate (50%) after the challenge with S. equi ZZM17. The srtA-5012 (R147G) mutant exhibited a high IgG2a level and protection rate (62.5%-75%) and the lowest lung bacterial load. These results indicate that the I88V mutation is associated with a high antiphagocytic activity, whereas R147G mutation is associated with the decreased lung bacterial load. Our findings may be useful for the evaluation and development of vaccines.

Optimized GAPDH-truncated immunogen of Streptococcus equi elicits an enhanced immune response and provides effective protection in a mouse model

Strangles is an acute and frequently diagnosed infectious disease caused by Streptococcus equi subsp. equi. Infection with this pathogen can cause grave losses to the equine industry. The present work investigates glyceraldehyde-3-phosphate dehydrogenase (GAPDH), an important surface-localized virulence factor of S. equi, to determine whether it could be developed into an efficacious and suitable subunit vaccine against strangles. Two different recombinant fragments of S. equi GAPDH, namely, GAPDH-L and GAPDH-S, were constructed and expressed. Further, the antigenicity and immunogenicity of these two recombinant proteins were compared and evaluated in a mouse model. Our results revealed that immune responses were efficiently induced by the proteins in immunized mice. Remarkably, higher survival rates and significantly lower bacterial loads in the lung, liver, kidney, and spleen were observed in the GAPDH-S group compared with the GAPDH-L group after challenge with S. equi. High levels of specific antibodies, elevated antibody titers, and increased proportions of CD8 + T cells further indicated that GAPDH-S elicited better humoral and cellular immune responses than GAPDH-L. Furthermore, the induction of TCR, TLR-2, TLR-3, and TLR-4 significantly increased in the GAPDH-S group compared with those in the GAPDH-L and negative control groups. In summary, our results indicate that the optimized recombinant protein GAPDH-S is a promising candidate construct that may be further developed into a multivalent subunit vaccine for strangles.

Intramuscular vaccination with Strangvac is safe and induces protection against equine strangles caused by Streptococcus equi

The equine disease strangles, caused by Streptococcus equi, remains a major cause of welfare and economic cost to the global horse industry. Here we report the safety, immunogenicity and efficacy of a novel multi-component chimeric fusion protein vaccine, called Strangvac, when administered to ponies via the intramuscular route. Across the four studies, Strangvac was safe and induced robust antibody responses towards the vaccine components in blood serum and the nasopharynx, which were boosted by revaccination up to 12 months after a primary course of 2 vaccinations 4 weeks apart. The vaccine response did not cross-react with a commercial strangles iELISA, which identifies horses that have been exposed to S. equi, demonstrating that it was possible to differentiate infected from vaccinated animals (DIVA). Following challenge with S. equi strain 4047 (Se4047), all 36 control ponies that had received an adjuvant-only placebo vaccine developed clinical signs of strangles. In contrast, intramuscular vaccination with Strangvac protected ponies significantly from challenge with Se4047 at two weeks (5 of 16 ponies protected (31%), P = 0.04) and two months (7 of 12 ponies protected (58%), P = 0.0046 (including pooled control data) after second vaccination. Optimal protection (15 of 16 ponies protected (94%), P < 0.0001) was observed following challenge at two weeks post-third vaccination. Our data demonstrate that Strangvac is safe, has DIVA capability and provides a rapid onset of protective immunity against strangles. We conclude that Strangvac is a valuable tool with which to protect horses from strangles, particularly during high-risk periods, whilst maintaining the mobility of horse populations as required by the global equine industry.

Identification of genes required for the fitness of Streptococcus equi subsp. equi in whole equine blood and hydrogen peroxide

The availability of next-generation sequencing techniques provides an unprecedented opportunity for the assignment of gene function. Streptococcus equi subspecies equi is the causative agent of strangles in horses, one of the most prevalent and important diseases of equids worldwide. However, the live attenuated vaccines that are utilized to control this disease cause adverse reactions in some animals. Here, we employ transposon-directed insertion-site sequencing (TraDIS) to identify genes that are required for the fitness of S. equi in whole equine blood or in the presence of H2O2 to model selective pressures exerted by the equine immune response during infection. We report the fitness values of 1503 and 1471 genes, representing 94.5 and 92.5 % of non-essential genes in S. equi, following incubation in whole blood and in the presence of H2O2, respectively. Of these genes, 36 and 15 were identified as being important to the fitness of S. equi in whole blood or H2O2, respectively, with 14 genes being important in both conditions. Allelic replacement mutants were generated to validate the fitness results. Our data identify genes that are important for S. equi to resist aspects of the immune response in vitro, which can be exploited for the development of safer live attenuated vaccines to prevent strangles.

Antibody kinetics and immune profile analysis of a Streptococcus equi DNA vaccine expressing the FljB and SeM fusion protein in murine and equine models

Strangles is a highly prevalent, extremely contagious, and occasionally lethal infectious disease affecting horses worldwide. Prophylactic antibiotics are ineffective in prevention of disease but are recommended for exposed horses at the first sign of fever and any horse obviously ill from strangles or with complications and there is an urgent need of a cost-effective, safe, efficacious vaccine. In the present study, we sought to develop effective vaccines by fusing the Streptococcus equi subspecies equi (S. equi) antigen SeM with the flagellin of Salmonella abortus equi FljB. We also explored the immunogenicity and efficacy of this candidate vaccine in mice and horses by intramuscular injection. Mice and horses immunized with FljB-SeM DNA vaccine showed high levels of specific antibody and increased production of IFN-γ and IL-4. This confirmed that both Th1 and Th2 type responses were induced. The mice survival rate was significantly higher after immunization with FljB-SeM than with SeM alone. The FljB-SeM DNA could strengthen both the Th1 and Th2 immune responses compared to SeM and could provide better protection against S. equi. This technique could help develop a candidate vaccine for S. equi infection.

Streptococcus equi Infections in Horses: Guidelines for Treatment, Control, and Prevention of Strangles-Revised Consensus Statement

This consensus statement update reflects our current published knowledge and opinion about clinical signs, pathogenesis, epidemiology, treatment, complications, and control of strangles. This updated statement emphasizes varying presentations in the context of existing underlying immunity and carrier states of strangles in the transmission of disease. The statement redefines the “gold standard” for detection of possible infection and reviews the new technologies available in polymerase chain reaction diagnosis and serology and their use in outbreak control and prevention. We reiterate the importance of judicious use of antibiotics in horses with strangles. This updated consensus statement reviews current vaccine technology and the importance of linking vaccination with currently advocated disease control and prevention programs to facilitate the eradication of endemic infections while safely maintaining herd immunity. Differentiation between immune responses to primary and repeated exposure of subclinically infected animals and responses induced by vaccination is also addressed.

“Cell ELISA” como ferramenta auxiliar no controle da adenite equina

RESUMO Este trabalho relata o desenvolvimento e a avaliação de um ensaio imunoenzimático (ELISA) como ferramenta auxiliar no controle da adenite equina. Foi avaliada a presença de anticorpos anti-Streptococcus equi subsp. equi em equinos com doença clínica de garrotilho, portadores assintomáticos e potros vacinados. Equinos doentes demonstraram absorbâncias médias superiores (P<0,05) às médias observadas nas demais categorias examinadas. Equinos portadores assintomáticos apresentaram valores médios de absorbância superiores (P<0,05) aos animais com cultura negativa. Logo após a vacinação, potros apresentaram elevação nos níveis de anticorpos, seguida de um decréscimo nos níveis 90 dias após a segunda vacinação. O “Cell ELISA” foi eficiente para a detecção de anticorpos em equinos expostos a antígenos de S. equi, diferenciando-se de infecções por S. zooepidemicus. O “Cell ELISA” mostrou-se uma alternativa clínica para o diagnóstico indireto da adenite equina, diferenciando-se, entre equinos assintomáticos, os potenciais portadores da infecção. Os resultados observados em potros vacinados confirmam o potencial de utilização desse teste como ferramenta em programas de vacinação contra garrotilho pelo monitoramento de rebanhos pós-vacinação. Esses resultados sugerem que o “Cell ELISA” é uma promissora ferramenta auxiliar no controle da adenite equina.

Genome specialization and decay of the strangles pathogen, Streptococcus equi, is driven by persistent infection

Strangles, the most frequently diagnosed infectious disease of horses worldwide, is caused by Streptococcus equi. Despite its prevalence, the global diversity and mechanisms underlying the evolution of S. equi as a host-restricted pathogen remain poorly understood. Here, we define the global population structure of this important pathogen and reveal a population replacement in the late 19th or early 20th Century. Our data reveal a dynamic genome that continues to mutate and decay, but also to amplify and acquire genes despite the organism having lost its natural competence and become host-restricted. The lifestyle of S. equi within the horse is defined by short-term acute disease, strangles, followed by long-term infection. Population analysis reveals evidence of convergent evolution in isolates from post-acute disease samples as a result of niche adaptation to persistent infection within a host. Mutations that lead to metabolic streamlining and the loss of virulence determinants are more frequently found in persistent isolates, suggesting that the pathogenic potential of S. equi reduces as a consequence of long-term residency within the horse post-acute disease. An example of this is the deletion of the equibactin siderophore locus that is associated with iron acquisition, which occurs exclusively in persistent isolates, and renders S. equi significantly less able to cause acute disease in the natural host. We identify several loci that may similarly be required for the full virulence of S. equi, directing future research toward the development of new vaccines against this host-restricted pathogen.

Vaccination with a live multi-gene deletion strain protects horses against virulent challenge with Streptococcus equi

Strangles, caused by Streptococcus equi subspecies equi (S. equi) is one of the most frequently diagnosed infectious diseases of horses and there remains a significant need to develop new preventative vaccines. We generated a live vaccine strain of S. equi containing deletions in six genes: sagA, hasA, aroB, pyrC, seM and recA, which was administered to nine Welsh mountain ponies via the intramuscular route. Four vaccinated ponies developed adverse reactions following the first vaccination from which the live vaccine strain was isolated. Two of these ponies were withdrawn from the study and seven ponies received a second vaccination, one of which then developed an adverse reaction. Nine control ponies injected with culture media alone developed no adverse reactions. Following challenge with a virulent strain of S. equi, none of the seven vaccinated ponies had developed clinical signs of strangles eleven days post-challenge, compared to six of nine control ponies over the same period (P=0.0114). A lymph node abscess was identified in one of the seven vaccinated ponies at post-mortem examination, whilst all nine control ponies had at least one lymph node abscess (P=0.0009). Three of the six vaccinated ponies that were protected from strangles had not developed an adverse reaction following vaccination, suggesting that a better understanding of the pro-inflammatory responses to S. equi could lead to the development of a live attenuated vaccine against strangles that is safe for administration via intramuscular injection.

Vaccines and Vaccination

Livestock vaccines aim to increase livestock product and improve the health and welfare of livestock animals in a cost-efficient manner and prevent disease transmission. Successful livestock vaccines have been generated for pathogens including bacterial, viral, protozoan, and multicellular pathogens. These livestock vaccines have a significant effect on animal health and products and on human health through growing safe food procurement and preventing zoonotic diseases. There are successful production of biotechnological-based animal vaccines licensed for use that include virus-like particle vaccines, gene-deleted marker vaccines, subunit vaccines, DIVA vaccines, and DNA vaccines.

New perspectives for the diagnosis, control, treatment, and prevention of strangles in horses

Strangles, characterized by abscessation of the lymph nodes of the head and neck, is the most frequently diagnosed infectious disease of horses worldwide. The persistence of the causative agent, Streptococcus equi, in a proportion of convalescent horses plays a critical role in the recurrence and spread of disease. Recent research has led to the development of effective diagnostic tests that assist the eradication of S equi from local horse populations. This article describes how these advances have been made and provides advice to assist the resolution and prevention of outbreaks. New perspectives on preventative vaccines and therapeutic interventions are discussed.

Strangles: taking steps towards eradication

Strangles, caused by the host adapted Lancefield group C bacterium Streptococcus equi sub-species equi (S. equi), is one of the oldest recognised infectious diseases of horses and continues to cause significant welfare and economic cost throughout the world. The ability of S. equi to establish sub-clinical persistent infections primarily in the guttural pouches of convalescent horses has been instrumental to its success. However, the implementation of simple control measures that permit the identification and treatment of persistently infected carriers can prevent further outbreaks of disease at a local level. This review summarises some of the molecular mechanisms exploited by S. equi to cause disease. New qPCR and iELISA diagnostic tests replace culture methodologies as the gold standard for the detection of infected animals. A strategy to maximise the effective application of these tests to direct management methods for the eradication of S. equi infection is presented and the role of preventative vaccines is discussed. In contrast to current understanding, emerging data illustrates the dynamism of the global S. equi population and potential consequences for the effectiveness of currently available vaccines. The ability to use modern vaccines alongside conventional biosecurity and screening procedures will be critical to the large-scale prevention and even eradication of strangles, providing an opportunity to finally break the stranglehold that this disease has on the world's equine industry.

Intranasal immunisation of mice against Streptococcus equi using positively charged nanoparticulate carrier systems

In order to potentiate a strong immune response after mucosal vaccination with a low immunogenic S. equi enzymatic extract, two positively charged particulate delivery systems (liposomes and nanoparticles) were created. Positively surface charged particles were expected to efficiently bind to negatively charged cell membranes and facilitate antigen uptake. Phosphatidylcholine-cholesterol-stearylamine liposomes encapsulating S. equi antigens were prepared and dimensionated to 0.22±0.01μm with a polydispersity index <0.242, zeta potential of +12±4mV and an encapsulation efficiency of 13±3% (w/w). Chitosan nanoparticles were prepared by ionotropic gelation with sodium tripolyphosphate, presenting a particle size of 0.17±0.01μm with polydispersity index <0.362, zeta potential of +23±8mV and an encapsulation efficiency of 53±6% (w/w). Both encapsulation methods were recognised as innocuous once antigens structure remained intact after incorporation as assessed by SDS-PAGE. Intranasal immunisation of mice with both formulations successfully elicited mucosal, humoral and cellular immune responses. Mucosal stimulation was confirmed by increased sIgA levels in the lungs, being the chitosan nanoparticles more successful in this achievement probably due to their different mucoadhesive properties. Both formulations share the ability to induce Th1-mediated immune responses characterised by IFN-γ production and high IgG2a antibody titers as well as a Th2 immune response characterised mainly by IL-4 production and IgG1 antibodies.

Efficacy of intranasal and spray delivery of adjuvanted live vaccine against infectious bronchitis virus in experimentally infected poultry

Live vaccines are widely used in the avian industry. Such vaccines can be either injected or delivered on animal mucosa and are usually not adjuvanted. In this study we show that live vaccines efficacy can be improved by formulation with adjuvants in a model of mucosal delivery of live infectious bronchitis vaccine in chicken. Three adjuvant technologies have been tested using intranasal and spray delivery methods to poultry. Those technologies are water in oil in water emulsion, nanoparticles and polymer adjuvants. Intranasal delivery of polymer and nanoparticles adjuvanted live vaccines improved significantly the antibody titer and protection to challenge observed compared to a commercial non-adjuvanted reference. Moreover, spray delivery of the polymer adjuvanted vaccine showed a significantly higher protection compared to the non-adjuvanted reference. Our data demonstrates that the use of MontanideTM adjuvants in the formulation of live poultry vaccines for mucosal delivery can confer to vaccinated animals a significantly improved protection against pathogens.

Load reduction in live PRRS vaccines using oil and polymer adjuvants

PRRSV live vaccines are widely used in pig farming practice and are usually not adjuvanted. For safety issues, it would be useful to reduce the antigenic load of such vaccines while preserving their efficacy. In this study we show that the addition of polymer or oil adjuvants in a PRRS live vaccine enhanced the protection to challenge of vaccinated animals compared to a non-adjuvanted commercial reference. Moreover, for both types of adjuvants, despite lower antibody titers, the protection to challenge given by the adjuvanted vaccine containing only 50% of the antigen load was equivalent to the protection given by the non-adjuvanted vaccine. These results demonstrate that the addition of relevant adjuvants can enhance the efficacy of the protection conferred to animals by live vaccines.

Temperature-sensitive bacterial pathogens generated by the substitution of essential genes from cold-loving bacteria: potential use as live vaccines

Temperature-sensitive (TS) viruses have been used for decades as vaccines capable of limited replication in their hosts. Although attenuated bacteria, such as the Bacille Calmette-Guérin anti-tuberculosis vaccine, have been used for almost a century, it is only recently that there has been progress in using TS bacterial strains as live vaccines. Decades of work on essential bacterial genes and the recent explosion in the number of available bacterial genomic sequences set the groundwork for the identification of essential genes from diverse bacteria. This knowledge has allowed for the substitution of essential genes from cold-loving bacteria into the chromosomes of pathogenic bacteria. Many of these gene substitutions generated TS pathogenic bacterial strains, and some were demonstrated to provide protective immunity in mice. This work opens the possibility of engineering many pathogenic bacteria to create TS strains that can be used as vaccines.

Needlestick and infection with horse vaccine

This report describes a case of accidental needlestick injury involving a live equine vaccination, Equilis StrepE. A vet presented herself to the Emergency Department having accidentally injected herself with an equine vaccination. Her left thumb (injury site) was inflamed and had lymphangitis progressing proximally along her left arm. Her inflammatory markers were not raised. The swelling, erythma and lymphangitis had improved markedly with intravenous antibiotics. She had no sequelae at follow-up. Equilis StrepE is a vaccine for submucosal administration containing a modified live avirulent strain of Streptococcus equi subspecies equi (Strain TW). Group C streptococci infections are pathogenic in horses and uncommon in humans. A search of the literature revealed no prior case report of similar adverse reaction to this vaccine. The vaccine may have harmful effect on human health, if injected accidentally but more evidence needs to be collected.

Getting to grips with strangles: an effective multi-component recombinant vaccine for the protection of horses from Streptococcus equi infection

Streptococcus equi subspecies equi (S. equi) is a clonal, equine host-adapted pathogen of global importance that causes a suppurative lymphodendopathy of the head and neck, more commonly known as Strangles. The disease is highly prevalent, can be severe and is highly contagious. Antibiotic treatment is usually ineffective. Live attenuated vaccine strains of S. equi have shown adverse reactions and they suffer from a short duration of immunity. Thus, a safe and effective vaccine against S. equi is highly desirable. The bacterium shows only limited genetic diversity and an effective vaccine could confer broad protection to horses throughout the world. Welsh mountain ponies (n = 7) vaccinated with a combination of seven recombinant S. equi proteins were significantly protected from experimental infection by S. equi, resembling the spontaneous disease. Vaccinated horses had significantly reduced incidence of lymph node swelling (p = 0.0013) lymph node abscessation (p = 0.00001), fewer days of pyrexia (p = 0.0001), reduced pathology scoring (p = 0.005) and lower bacterial recovery from lymph nodes (p = 0.004) when compared with non-vaccinated horses (n = 7). Six of 7 vaccinated horses were protected whereas all 7 non-vaccinated became infected. The protective antigens consisted of five surface localized proteins and two IgG endopeptidases. A second vaccination trial (n = 7+7), in which the IgG endopeptidases were omitted, demonstrated only partial protection against S. equi, highlighting an important role for these vaccine components in establishing a protective immune response. S. equi shares >80% sequence identity with Streptococcus pyogenes. Several of the components utilized here have counterparts in S. pyogenes, suggesting that our findings have broader implications for the prevention of infection with this important human pathogen. This is one of only a few demonstrations of protection from streptococcal infection conferred by a recombinant multi-component subunit vaccine in a natural host.

Numerous research groups have vaccinated, using recombinant antigens, against streptococcal infections in mouse model systems and shown protection. We have here demonstrated efficient protective vaccination of the natural host, the horse, using recombinant antigens. Streptococcus equi subspecies equi (S. equi) is an equine host-adapted and highly contagious pathogen of global importance. Six out of seven Welsh mountain ponies vaccinated with a combination of seven recombinant S. equi proteins were protected from experimental infection as assessed by clinical examination, pyrexia, lymph node swelling, inflammation, bacterial recovery, and post mortem examination. The protective antigens consisted of five surface localized proteins and two endopeptidases that are specific for IgG; the latter were shown to be of major importance for efficacy. Several of the antigens used here have similarities in Streptococcus pyogenes, implying that our findings are of importance for development of a vaccine against this important human pathogen.

Proline-glutamic acid-proline-lysine repetition peptide as an antigen for the serological diagnosis of strangles

The reactivity of the proline-glutamic acid-proline-lysine (PEPK) repetition peptide antigen in 3176 serum samples was investigated to evaluate its utility as an antigen for the serological diagnosis of strangles. The reactivity of the sera of horses infected with Streptococcus equi subspecies equi was high when the peptide had several PEPK repetitions. However, as the number of PEPK repetitions increased, the reactivity of the antigen with the sera of horses infected with Streptococcus equi subspecies zooepidemicus also increased. In horses infected experimentally with S equi, the reactivity of the PEPK antigen with five repetitions increased one week after inoculation and continued to increase during the following four weeks. The optical density (OD) values of test sera from horses infected experimentally with S equi and sera from horses that had recovered from strangles were high. The od values of sera from horses that had recovered from an experimental infection with S zooepidemicus and of sera from healthy horses were comparatively low.

Current status of veterinary vaccines

The major goals of veterinary vaccines are to improve the health and welfare of companion animals, increase production of livestock in a cost-effective manner, and prevent animal-to-human transmission from both domestic animals and wildlife. These diverse aims have led to different approaches to the development of veterinary vaccines from crude but effective whole-pathogen preparations to molecularly defined subunit vaccines, genetically engineered organisms or chimeras, vectored antigen formulations, and naked DNA injections. The final successful outcome of vaccine research and development is the generation of a product that will be available in the marketplace or that will be used in the field to achieve desired outcomes. As detailed in this review, successful veterinary vaccines have been produced against viral, bacterial, protozoal, and multicellular pathogens, which in many ways have led the field in the application and adaptation of novel technologies. These veterinary vaccines have had, and continue to have, a major impact not only on animal health and production but also on human health through increasing safe food supplies and preventing animal-to-human transmission of infectious diseases. The continued interaction between animals and human researchers and health professionals will be of major importance for adapting new technologies, providing animal models of disease, and confronting new and emerging infectious diseases.

Evidence-Based Immunization in Horses

Evidence of vaccine efficacy is essential for practitioners when giving advice to clients about the relative merits of different vaccines or when trying to evaluate the economic benefits of instituting a vaccine program. In equine veterinary medicine, this sort of data, which are necessary to make informed decisions about vaccine use and effectiveness, are often not available. Veterinarians need to consider the epidemiology of the disease in question, the type of vaccine that they are administering to the animal, the immunologic constraints of the vaccine technology, and the available evidence of efficacy when they are evaluating which vaccine to use or whether to vaccinate at all.

Vaccination of horses against strangles using recombinant antigens from Streptococcus equi

Strangles is an upper respiratory tract infection in horses, which is highly contagious and one of the more costly diseases of the horse. Three recombinant antigens were used to vaccinate horses, which were then experimentally challenged with Streptococcus equi, the causative agent for strangles. The vaccinated horses showed significantly reduced bacterial growth (p=0.02) and nasal discharge (p=0.0004), a typical symptom of strangles. Other clinical signs of strangles were also reduced and at post mortem examination, lower rate of empyaema or scarring of the guttural pouches was found in the vaccinated group (p=0.01). The antigens used were EAG (alpha2-macroglobulin, albumin, and IgG-binding protein), CNE (a collagen-binding protein), and SclC (a collagen-like protein). The adjuvant used was Abisco, a saponin derived matrix. No adverse effects were observed following vaccination with the antigens and adjuvant.

Getting a grip on strangles: Recent progress towards improved diagnostics and vaccines

'Strangles', caused by infection with the bacterium Streptococcus equi, remains one of the most commonly diagnosed and important infectious diseases of horses world-wide. This review discusses the diagnosis and pathogenesis of strangles with particular attention to the significance of persistent infections in disease transmission and the rapid progress now being made towards the development of effective preventative vaccines. It is now possible combine recent sequence data from the N-terminal region of the SeM protein and reassign the SeM alleles using the on-line database http://pubmlst.org/szooepidemicus/seM/. Hypotheses concerning the origin of this variation and the potential for its exploitation for the epidemiological analysis of outbreaks are proposed. Advances in understanding of the molecular evolution of S. equi highlight the role played by phage-mediated acquisition of virulence factors and suggest new avenues for prophylactic intervention.

Vaccine potential of novel surface exposed and secreted proteins of Streptococcus equi

Streptococcus equi, a clonal descendent of an ancestral S. zooepidemicus, causes equine strangles, a highly contagious purulent lymphadenitis of the head and neck. The aim of this study was to evaluate as vaccine components novel surface exposed or secreted S. equi proteins identified in an expression gene library with sera from resistant horses. Six proteins expressed by S. equi CF32 but not by S. zooepidemicus 631 were used to vaccinate one group of eight ponies. A second pony group was immunized with five adhesin and other proteins encoded by genes of Linkage Gr 1. All ponies made strong serum antibody responses to each protein as measured by ELISA but none were resistant to subsequent comingling challenge with S. equi CF32. These results in combination with evidence that recovered horses rapidly clear intranasally inoculated S. equi and do not make detectable serum antibody responses to its surface proteins suggest that acquired immune-mediated tonsillar clearance and not serum antibody must be stimulated by an effective strangles vaccine.

Biological safety concepts of genetically modified live bacterial vaccines

Live vaccines possess the advantage of having access to induce cell-mediated and antibody-mediated immunity; thus in certain cases they are able to prevent infection, and not only disease. Furthermore, live vaccines, particularly bacterial live vaccines, are relatively cheap to produce and easy to apply. Hence they are suitable to immunize large communities or herds. The induction of both cell-mediated immunity as well as antibody-mediated immunity, which is particularly beneficial in inducing mucosal immune responses, is obtained by the vaccine-strain's ability to colonize and multiply in the host without causing disease. For this reason, live vaccines require attenuation of virulence of the bacterium to which immunity must be induced. Traditionally attenuation was achieved simply by multiple passages of the microorganism on growth medium, in animals, eggs or cell cultures or by chemical or physical mutagenesis, which resulted in random mutations that lead to attenuation. In contrast, novel molecular methods enable the development of genetically modified organisms (GMOs) targeted to specific genes that are particularly suited to induce attenuation or to reduce undesirable effects in the tissue in which the vaccine strains can multiply and survive. Since live vaccine strains (attenuated by natural selection or genetic engineering) are potentially released into the environment by the vaccinees, safety issues concerning the medical as well as environmental aspects must be considered. These involve (i) changes in cell, tissue and host tropism, (ii) virulence of the carrier through the incorporation of foreign genes, (iii) reversion to virulence by acquisition of complementation genes, (iv) exchange of genetic information with other vaccine or wild-type strains of the carrier organism and (v) spread of undesired genes such as antibiotic resistance genes. Before live vaccines are applied, the safety issues must be thoroughly evaluated case-by-case. Safety assessment includes knowledge of the precise function and genetic location of the genes to be mutated, their genetic stability, potential reversion mechanisms, possible recombination events with dormant genes, gene transfer to other organisms as well as gene acquisition from other organisms by phage transduction, transposition or plasmid transfer and cis- or trans-complementation. For this, GMOs that are constructed with modern techniques of genetic engineering display a significant advantage over random mutagenesis derived live organisms. The selection of suitable GMO candidate strains can be made under in vitro conditions using basic knowledge on molecular mechanisms of pathogenicity of the corresponding bacterial species rather than by in vivo testing of large numbers of random mutants. This leads to a more targeted safety testing on volunteers and to a reduction in the use of animal experimentation.

ADENITE EQÜINA – ASPECTOS CLÍNICOS, AGENTE ETIOLÓGICO E MÉTODOS DE DIAGNÓSTICO

RESUMO A criação de eqüinos no Brasil é uma atividade de grande importância econômica, e devido à sua intensificação, enfermidades respiratórias como a adenite eqüina também se exacerbam. Os prejuízos são relacionados à redução da performance, aos custos de tratamento e eventuais mortes. A adenite eqüina é uma enfermidade causada pelo Streptococcus equi subesp. equi, uma bactéria beta-hemolítica, pertencente ao grupo C de Lancefield. Esta revisão tem por objetivo relatar os principais aspectos da enfermidade e características fenotípicas e moleculares do agente e de outras espécies relacionadas ao gênero Streptococcus, bem como relatar as técnicas descritas para o diagnóstico da adenite eqüina.

Sequence variation of the SeM gene of Streptococcus equi allows discrimination of the source of strangles outbreaks

Improved understanding of the epidemiology of Streptococcus equi transmission requires sensitive and portable subtyping methods that can rationally discriminate between strains. S. equi is highly homogeneous and cannot be distinguished by multilocus enzyme electrophoretic or multilocus sequence-typing methods that utilize housekeeping genes. However, on sequence analysis of the N-terminal region of the SeM genes of 60 S. equi isolates from 27 strangles outbreaks, we identified 21 DNA codon changes. These resulted in the nonsynonymous substitution of 18 amino acids and allowed the assignment of S. equi strains to 15 distinct subtypes. Our data suggest the presence of multiple epitopes across this region that are subjected to selective immune pressure (nonsynonymous-synonymous substitution rate [d(N)/d(S)] ratio = 3.054), particularly during the establishment of long-term S. equi infection. We further report the application of SeM gene subtyping as a method to investigate potential cases of disease related to administration of a live attenuated S. equi vaccine. SeM gene subtyping successfully differentiated between the vaccine strain and field strains of S. equi responsible for concurrent disease. These results were confirmed by the development and application of a PCR diagnostic test, which identifies the aroA partial gene deletion present in the Equilis StrepE vaccine strain. Although the vaccine strain was found to be responsible for injection site lesions, all seven outbreaks of strangles investigated in recently vaccinated horses were found to be due to concurrent infection with wild-type S. equi and not due to reversion of the vaccine strain.

Recombinant Streptococcus equi proteins protect mice in challenge experiments and induce immune response in horses

Horses that have undergone infection caused by Streptococcus equi subspecies equi (strangles) were found to have significantly increased serum antibody titers against three previously characterized proteins, FNZ (cell surface-bound fibronectin binding protein), SFS (secreted fibronectin binding protein), and EAG (alpha2-macroglobulin, albumin, and immunoglobulin G [IgG] binding protein) from S. equi. To assess the protective efficacy of vaccination with these three proteins, a mouse model of equine strangles was utilized. Parts of the three recombinant proteins were used to immunize mice, either subcutaneously or intranasally, prior to nasal challenge with S. equi subsp. equi. The adjuvant used was EtxB, a recombinant form of the B subunit of Escherichia coli heat-labile enterotoxin. It was shown that nasal colonization of S. equi subsp. equi and weight loss due to infection were significantly reduced after vaccination compared with a mock-vaccinated control group. This effect was more pronounced after intranasal vaccination than after subcutaneous vaccination; nearly complete eradication of nasal colonization was obtained after intranasal vaccination (P < 0.001). When the same antigens were administered both intranasally and subcutaneously to healthy horses, significant mucosal IgA and serum IgG antibody responses against FNZ and EAG were obtained. The antibody response was enhanced when EtxB was used as an adjuvant. No adverse effects of the antigens or EtxB were observed. Thus, FNZ and EAG in conjunction with EtxB are promising candidates for an efficacious and safe vaccine against strangles.

The molecular basis of Streptococcus equi infection and disease

Streptococcus equi is the aetiological agent of strangles, one of the most prevalent diseases of the horse. The animal suffering and economic burden associated with this disease necessitate effective treatment. Current antibiotic therapy is often ineffective and thus recent attention has focused on vaccine development. A systematic understanding of S. equi virulence, leading to the identification of targets to which protective immunity can be directed, is a prerequisite of the development of such a vaccine. Here, the virulence factors of S. equi are reviewed.