1
|
Asturias EJ, Bai X, Bettinger JA, Borrow R, Castillo DN, Caugant DA, Chacon GC, Dinleyici EC, Echaniz-Aviles G, Garcia L, Glennie L, Harrison LH, Howie RL, Itsko M, Lucidarme J, Marin JEO, Marjuki H, McNamara LA, Mustapha MM, Robinson JL, Romeu B, Sadarangani M, Sáez-Llorens X, Sáfadi MAP, Stephens DS, Stuart JM, Taha MK, Tsang RSW, Vazquez J, De Wals P. Meningococcal disease in North America: Updates from the Global Meningococcal Initiative. J Infect 2022; 85:611-622. [PMID: 36273639 PMCID: PMC11091909 DOI: 10.1016/j.jinf.2022.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/11/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
This review summarizes the recent Global Meningococcal Initiative (GMI) regional meeting, which explored meningococcal disease in North America. Invasive meningococcal disease (IMD) cases are documented through both passive and active surveillance networks. IMD appears to be decreasing in many areas, such as the Dominican Republic (2016: 18 cases; 2021: 2 cases) and Panama (2008: 1 case/100,000; 2021: <0.1 cases/100,000); however, there is notable regional and temporal variation. Outbreaks persist in at-risk subpopulations, such as people experiencing homelessness in the US and migrants in Mexico. The recent emergence of β-lactamase-positive and ciprofloxacin-resistant meningococci in the US is a major concern. While vaccination practices vary across North America, vaccine uptake remains relatively high. Monovalent and multivalent conjugate vaccines (which many countries in North America primarily use) can provide herd protection. However, there is no evidence that group B vaccines reduce meningococcal carriage. The coronavirus pandemic illustrates that following public health crises, enhanced surveillance of disease epidemiology and catch-up vaccine schedules is key. Whole genome sequencing is a key epidemiological tool for identifying IMD strain emergence and the evaluation of vaccine strain coverage. The Global Roadmap on Defeating Meningitis by 2030 remains a focus of the GMI.
Collapse
Affiliation(s)
- Edwin J Asturias
- University of Colorado School of Medicine and Colorado School of Public Health, Aurora, CO, USA
| | - Xilian Bai
- Meningococcal Reference Unit, UK Health Security Agency, Manchester, UK
| | - Julie A Bettinger
- Vaccine Evaluation Center, British Colombia Children's Hospital Research Institute, and Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ray Borrow
- Meningococcal Reference Unit, UK Health Security Agency, Manchester, UK.
| | | | | | | | | | - Gabriela Echaniz-Aviles
- Center for Research on Infectious Diseases, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Luis Garcia
- Center for State Control of Drugs, Medical Devices and Equipment, Cuba
| | | | - Lee H Harrison
- Center for Genomic Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rebecca L Howie
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, USA
| | - Mark Itsko
- WDS Inc., Contractor to Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, USA
| | - Jay Lucidarme
- Meningococcal Reference Unit, UK Health Security Agency, Manchester, UK
| | | | - Henju Marjuki
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, USA
| | - Lucy A McNamara
- Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, USA
| | | | | | - Belkis Romeu
- Center for State Control of Drugs, Medical Devices and Equipment, Cuba
| | - Manish Sadarangani
- Vaccine Evaluation Center, British Colombia Children's Hospital Research Institute, and Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Xavier Sáez-Llorens
- Hospital del Niño - Dr José Renán Esquivel, Distinguished Investigator at Senacyt (SNI) and Cevaxin, Panama City, Panama
| | - Marco A P Sáfadi
- Department of Pediatrics, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil
| | - David S Stephens
- Robert W. Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA
| | | | - Muhamed-Kheir Taha
- Institut Pasteur, National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France
| | - Raymond S W Tsang
- National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Julio Vazquez
- National Centre of Microbiology, Institute of Health Carlos III, Madrid, Spain
| | | |
Collapse
|
2
|
BOCCALINI SARA, PANATTO DONATELLA, MENNINI FRANCESCOSAVERIO, MARCELLUSI ANDREA, BINI CHIARA, AMICIZIA DANIELA, LAI PIEROLUIGI, MICALE ROSANNATINDARA, FRUMENTO DAVIDE, AZZARI CHIARA, RICCI SILVIA, BONITO BENEDETTA, DI PISA GIULIA, IOVINE MARIASILVIA, LODI LORENZO, GIOVANNINI MATTIA, MOSCADELLI ANDREA, PAOLI SONIA, PENNATI BEATRICEMARINA, PISANO LAURA, BECHINI ANGELA, BONANNI PAOLO. [ Health Technology Assessment (HTA) of the introduction of additional cohorts for anti-meningococcal vaccination with quadrivalent conjugate vaccines in Italy]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E1-E128. [PMID: 34622076 PMCID: PMC8452280 DOI: 10.15167/2421-4248/jpmh2021.62.1s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- SARA BOCCALINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
- Autore corrispondente: Sara Boccalini, Dipartimento di Scienze della Salute, Università degli Studi di Firenze, 50134 Firenze, Italia - Tel.: 055-2751084 E-mail:
| | - DONATELLA PANATTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - FRANCESCO SAVERIO MENNINI
- Economic Evaluation and HTA - CEIS (EEHTA - CEIS), Facoltà di Economia, Università di Roma "Tor Vergata"
- Institute for Leadership and Management in Health, Kingston University, London, UK
| | - ANDREA MARCELLUSI
- Economic Evaluation and HTA - CEIS (EEHTA - CEIS), Facoltà di Economia, Università di Roma "Tor Vergata"
| | - CHIARA BINI
- Economic Evaluation and HTA - CEIS (EEHTA - CEIS), Facoltà di Economia, Università di Roma "Tor Vergata"
| | - DANIELA AMICIZIA
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - PIERO LUIGI LAI
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | | | - DAVIDE FRUMENTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - CHIARA AZZARI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - SILVIA RICCI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - BENEDETTA BONITO
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - GIULIA DI PISA
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | | | - LORENZO LODI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - MATTIA GIOVANNINI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - ANDREA MOSCADELLI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - SONIA PAOLI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | | | - LAURA PISANO
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - ANGELA BECHINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - PAOLO BONANNI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| |
Collapse
|
3
|
Waśko I, Gołębiewska A, Kiedrowska M, Ronkiewicz P, Wróbel-Pawelczyk I, Kuch A, Hong E, Skoczyńska A. Genetic variability of Polish serogroup B meningococci (2010-2016) including the 4CMenB vaccine component genes. Vaccine 2020; 38:1943-1952. [PMID: 31980191 DOI: 10.1016/j.vaccine.2020.01.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 12/20/2019] [Accepted: 01/07/2020] [Indexed: 01/25/2023]
Abstract
Neisseria meningitidis serogroup B (MenB) has recently become the major cause of invasive meningococcal disease in Poland. Therefore, the purpose of this study was to characterize MenB isolates, responsible for invasive meningococcal disease in 2010-2016, by MLST and sequencing of genes encoding proteins used as 4CMenB vaccine antigens. Two methods of coverage estimation were performed: extrapolation of MATS results of Polish meningococci 2010-2011 (exMATS) and gMATS, which combines genotyping and MATS results. Among 662 isolates 20 clonal complexes (CC) were detected, of which the most frequent were CC32, CC41/44 and CC18, accounting for 31.9%, 16.5% and 12.7%, respectively. A total of 111 combinations of PorA variable regions (VR1/VR2) were found, with P1.7,16 (15.0%) and P1.22,14 (13.6%) being prevalent. Vaccine variant VR2:4 was detected in 7.3% of isolates, mainly representing CC41/44 and non-assigned CC. Eighty five fHbp alleles encoding 74 peptide subvariants were revealed. Subvariant 1.1, a component of 4CMenB, was prevalent (24.2%) and found generally in CC32. Typing of the nhba gene revealed 102 alleles encoding 87 peptides. The most frequent was peptide 3 (22.4%), whereas vaccine peptide 2 was detected in 9.8%, mostly among CC41/44. The nadA gene was detected in 34.0% of isolates and the most prevalent was peptide 1 (variant NadA-1; 71.6%), found almost exclusively in CC32 meningococci. Vaccine peptide 8 (variant NadA-2/3) was identified once. Consequently, 292 completed BAST profiles were revealed. Regarding vaccine coverage, 39.7% of isolates had at least one 4CMenB vaccine variant, but according to exMATS and gMATS the coverage was 83.3% and 86.6%, respectively. In conclusion, Polish MenB (2010-2016) was highly diverse according to MLST and gene alleles encoding 4CMenB vaccine antigens. Some correlations between clonal complexes and variants of examined proteins/BAST profiles were revealed and a high coverage of 4CMenB vaccine was estimated.
Collapse
Affiliation(s)
- Izabela Waśko
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
| | - Agnieszka Gołębiewska
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
| | - Marlena Kiedrowska
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
| | - Patrycja Ronkiewicz
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
| | - Izabela Wróbel-Pawelczyk
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
| | - Alicja Kuch
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
| | - Eva Hong
- Institute Pasteur, Invasive Bacterial Infections Unit, Paris, France
| | - Anna Skoczyńska
- National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland
| |
Collapse
|
4
|
Boccalini S, Bechini A, Sartor G, Paolini D, Innocenti M, Bonanni P, Panatto D, Lai PL, Zangrillo F, Marchini F, Lecini E, Iovine M, Amicizia D, Landa P. [Health Technology Assessment of meningococcal B vaccine (Trumenba ®) in adolescent in Italy]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E1-E94. [PMID: 32047867 PMCID: PMC7007189 DOI: 10.15167/2421-4248/jpmh2019.60.3s2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- S Boccalini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - A Bechini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - G Sartor
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - D Paolini
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - M Innocenti
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - P Bonanni
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - D Panatto
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - P L Lai
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - F Zangrillo
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - F Marchini
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - E Lecini
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - M Iovine
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - D Amicizia
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - P Landa
- Dipartimento di Economia, Università degli Studi di Genova
| |
Collapse
|
5
|
Continuous production of Neisseria meningitidis outer membrane vesicles. Appl Microbiol Biotechnol 2019; 103:9401-9410. [PMID: 31676919 PMCID: PMC6867985 DOI: 10.1007/s00253-019-10163-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 09/10/2019] [Accepted: 09/28/2019] [Indexed: 12/11/2022]
Abstract
Outer membrane vesicles (OMVs) are nanoparticles secreted by Gram-negative bacteria that can be used for diverse biotechnological applications. Interesting applications have been developed, where OMVs are the basis of drug delivery, enzyme carriers, adjuvants, and vaccines. Historically, OMV research has mainly focused on vaccines. Therefore, current OMV production processes have been based on batch processes. The production of OMVs in batch mode is characterized by relatively low yields and high costs. Transition of OMV production processes from batch to continuous processes could increase the volumetric productivity, reduce the production and capital costs, and result in a higher quality product. Here, we study the continuous production of Neisseria meningitidis OMVs to improve volumetric productivity. Continuous cultivation of N. meningitidis resulted in a steady state with similar high OMV concentrations as are reached in current batch processes. The steady state was reproducible and could be maintained for at least 600 h. The volumetric productivity of a continuous culture reached 4.0 × 1014 OMVs per liter culture per day, based on a dilution rate of 1/day. The tested characteristics of the OMVs did not change during the experiments showing feasibility of a continuous production process for the production of OMVs for any application.
Collapse
|
6
|
Ma J, Wang Y, Xu N, Jin L, Liu J, Xing S, Li X. Potential large scale production of meningococcal vaccines by stable overexpression of fHbp in the rice seeds. Protein Expr Purif 2018; 152:1-6. [PMID: 29953946 DOI: 10.1016/j.pep.2018.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 06/16/2018] [Accepted: 06/24/2018] [Indexed: 10/28/2022]
Abstract
Factor H binding protein (fHbp) is the most promising vaccine candidate against serogroup B of Neisseria meningitidis which is a major cause of morbidity and mortality in children. In order to facilitate large scale production of a commercial vaccine, we previously used transgenic Arabidopsis thaliana, but plant-derived fHbp is still far away from a commercial vaccine due to less biomass production. Herein, we presented an alternative route for the production of recombinant fHbp from the seeds of transgenic rice. The OsrfHbp gene encoding recombinant fHbp fused protein was introduced into the genome of rice via Agrobacterium-mediated transformation. The both stable integration and transcription of the foreign OsrfHbp were confirmed by Southern blotting and RT-PCR analysis respectively. Further, the expression of fHbp protein was measured by immunoblotting analysis and quantified by ELISA. The results indicated that fHbp was successfully expressed and the highest yield of fHbp was 0.52 ± 0.03% of TSP in the transgenic rice seeds. The purified fHbp protein showed good antigenicity and immunogenicity in the animal model. The results of this experiment offer a novel approach for large-scale production of plant-derived commercial vaccine fHbp.
Collapse
Affiliation(s)
- Jian Ma
- Faculty of Agronomy, Jilin Agricultural University, Changchun, 130118, Jilin, China.
| | - Yunpeng Wang
- Institute of Agricultural Biotechnology, Jilin Academy of Agricultural Sciences, Changchun, 130033, Jilin, China.
| | - Nuo Xu
- College of Life and Environmental Science, Wenzhou University, Wenzhou, 325035, Zhejiang, China.
| | - Libo Jin
- College of Life and Environmental Science, Wenzhou University, Wenzhou, 325035, Zhejiang, China.
| | - Jia Liu
- School of Pharmaceutical Sciences, Changchun University of Chinese Medicine, Changchun, 130117, Jilin, China.
| | - Shaochen Xing
- Institute of Agricultural Biotechnology, Jilin Academy of Agricultural Sciences, Changchun, 130033, Jilin, China; Faculty of Agronomy, Jilin Agricultural University, Changchun, 130118, Jilin, China.
| | - Xiaokun Li
- Faculty of Agronomy, Jilin Agricultural University, Changchun, 130118, Jilin, China; College of Life and Environmental Science, Wenzhou University, Wenzhou, 325035, Zhejiang, China.
| |
Collapse
|
7
|
Shaker R, Fayad D, Dbaibo G. Challenges and opportunities for meningococcal vaccination in the developing world. Hum Vaccin Immunother 2018; 14:1084-1097. [PMID: 29393729 DOI: 10.1080/21645515.2018.1434463] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Meningococcal disease continues to be a life threatening infection with high morbidity and mortality even in appropriately treated patients. Meningococcal vaccination plays a major role in the control of the disease; however, implementing vaccination remains problematic in the developing world. The objective of this review is to identify the challenges facing the use of meningococcal vaccines in the developing world in order to discuss the opportunities and available solutions to improve immunization in these countries. Inadequate epidemiologic information necessary to implement vaccination and financial challenges predominate. Multiple measures are needed to achieve the successful implementation of meningococcal conjugate vaccination programs that protect against circulating serogroups in developing countries including enhanced surveillance systems, financial support and aid through grants, product development partnerships that are the end result of effective collaboration and communication between different interdependent stakeholders to develop affordable vaccines, and demonstration of the cost-effectiveness of new meningococcal vaccines.
Collapse
Affiliation(s)
- Rouba Shaker
- a Department of Pediatrics and Adolescent Medicine, Division of Pediatric Infectious Diseases, and Center for Infectious Diseases Research , American University of Beirut Medical Center , Beirut , Lebanon
| | - Danielle Fayad
- a Department of Pediatrics and Adolescent Medicine, Division of Pediatric Infectious Diseases, and Center for Infectious Diseases Research , American University of Beirut Medical Center , Beirut , Lebanon
| | - Ghassan Dbaibo
- a Department of Pediatrics and Adolescent Medicine, Division of Pediatric Infectious Diseases, and Center for Infectious Diseases Research , American University of Beirut Medical Center , Beirut , Lebanon.,b Department of Biochemistry and Molecular Genetics , American University of Beirut , Beirut , Lebanon
| |
Collapse
|
8
|
Gasparini R, Landa P, Amicizia D, Icardi G, Ricciardi W, de Waure C, Tanfani E, Bonanni P, Lucioni C, Testi A, Panatto D. Vaccinating Italian infants with a new multicomponent vaccine (Bexsero®) against meningococcal B disease: A cost-effectiveness analysis. Hum Vaccin Immunother 2016; 12:2148-2161. [PMID: 27163398 PMCID: PMC4994748 DOI: 10.1080/21645515.2016.1160177] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The European Medicines Agency has approved a multicomponent serogroup B meningococcal vaccine (Bexsero®) for use in individuals of 2 months of age and older. A cost-effectiveness analysis (CEA) from the societal and Italian National Health Service perspectives was performed in order to evaluate the impact of vaccinating Italian infants less than 1 y of age with Bexsero®, as opposed to non-vaccination. The analysis was carried out by means of Excel Version 2011 and the TreeAge Pro® software Version 2012. Two basal scenarios that differed in terms of disease incidence (official and estimated data to correct for underreporting) were considered. In the basal scenarios, we considered a primary vaccination cycle with 4 doses (at 2, 4, 6 and 12 months of age) and 1 booster dose at the age of 11 y, the societal perspective and no cost for death. Sensitivity analyses were carried out in which crucial variables were changed over probable ranges. In Italy, on the basis of official data on disease incidence, vaccination with Bexsero® could prevent 82.97 cases and 5.61 deaths in each birth cohort, while these figures proved to be three times higher on considering the estimated incidence. The results of the CEA showed that the Incremental Cost Effectiveness Ratio (ICER) per QALY was €109,762 in the basal scenario if official data on disease incidence are considered and €26,599 if estimated data are considered. The tornado diagram indicated that the most influential factor on ICER was the incidence of disease. The probability of sequelae, the cost of the vaccine and vaccine effectiveness also had an impact. Our results suggest that vaccinating infants in Italy with Bexsero® has the ability to significantly reduce meningococcal disease and, if the probable underestimation of disease incidence is considered, routine vaccination is advisable.
Collapse
Affiliation(s)
- Roberto Gasparini
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Paolo Landa
- b Department of Economics , University of Genoa , Genoa , Italy.,c University of Exeter , Medical School , Exeter , UK
| | - Daniela Amicizia
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Giancarlo Icardi
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| | - Walter Ricciardi
- d Institute of Hygiene and Public Health , Catholic University of Sacred Heart , Rome , Italy
| | - Chiara de Waure
- d Institute of Hygiene and Public Health , Catholic University of Sacred Heart , Rome , Italy
| | - Elena Tanfani
- b Department of Economics , University of Genoa , Genoa , Italy
| | - Paolo Bonanni
- e Department of Health Sciences , University of Florence , Florence , Italy
| | | | - Angela Testi
- b Department of Economics , University of Genoa , Genoa , Italy
| | - Donatella Panatto
- a Department of Health Sciences , University of Genoa , Genoa , Italy
| |
Collapse
|
9
|
Abstract
BACKGROUND Invasive meningococcal disease remains a rare infectious disease not only with high mortality but also with important morbidity. Until recently no universal vaccine existed against serogroup B, which explains most of the cases in settings like Europe. The objective of this study was to analyze the clinical course and sequelae of meningococcal disease in Spain. METHODS Retrospective review of all children younger than 15 years admitted to any of the 36 hospitals in the MENDICOS Spanish network (www.mendicos.org) with confirmed or probable invasive meningococcal disease in children between January 2008 and December 2013. RESULTS A total of 458 cases were identified across the country, most of them occurring in previously healthy children (91.5%; n = 419/458). Median (interquartile range) age was 1.7 (0.7 and 4.6) years, with 53.1% of the cases occurring in children younger than 2 years; 82.1% (n = 368) were laboratory confirmed cases; 95.2% (n = 256) of those serogrouped were serogroup B. The diagnosis was meningitis in 24.9% (n = 114) of the cases, sepsis in 37.1% (n = 170) and both in 38.0% (n = 174). Mean hospital length of stay was 11.6 (10.9) days; 79.2% (n = 354) of the patients required pediatric intensive care unit admission, with a mean pediatric intensive care unit stay of 3.9 (4.9) days; 3.5% (n = 16) died; 12.9% (n = 59) of the survivors were discharged with some kind of physical sequelae, mainly neurological (n = 23). CONCLUSIONS Serogroup B invasive meningococcal infection explains substantial morbidity and mortality in Spain, occurring mainly in infants. The recent availability of a vaccine against serogroup B may change this scenario. Given that the vast majority of the cases occur in otherwise healthy children, inclusion of the meningococcal B vaccine in the national immunization program should be carefully considered.
Collapse
|
10
|
Vasquez AE, Manzo RA, Soto DA, Barrientos MJ, Maldonado AE, Mosqueira M, Avila A, Touma J, Bruce E, Harris PR, Venegas A. Oral administration of recombinant Neisseria meningitidis PorA genetically fused to H. pylori HpaA antigen increases antibody levels in mouse serum, suggesting that PorA behaves as a putative adjuvant. Hum Vaccin Immunother 2015; 11:776-88. [PMID: 25750999 PMCID: PMC4514328 DOI: 10.1080/21645515.2015.1011011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The Neisseria meningitidis outer membrane protein PorA from a Chilean strain was purified as a recombinant protein. PorA mixed with AbISCO induced bactericidal antibodies against N. meningitidis in mice. When PorA was fused to the Helicobacter pylori HpaA antigen gene, the specific response against H. pylori protein increased. Splenocytes from PorA-immunized mice were stimulated with PorA, and an increase in the secretion of IL-4 was observed compared with that of IFN-γ. Moreover, in an immunoglobulin sub-typing analysis, a substantially higher IgG1 level was found compared with IgG2a levels, suggesting a Th2-type immune response. This study revealed a peculiar behavior of the purified recombinant PorA protein per se in the absence of AbISCO as an adjuvant. Therefore, the resistance of PorA to proteolytic enzymes, such as those in the gastrointestinal tract, was analyzed, because this is an important feature for an oral protein adjuvant. Finally, we found that PorA fused to the H. pylori HpaA antigen, when expressed in Lactococcus lactis and administered orally, could enhance the antibody response against the HpaA antigen approximately 3 fold. These observations strongly suggest that PorA behaves as an effective oral adjuvant.
Collapse
Affiliation(s)
- Abel E Vasquez
- a Department of Biotechnology ; Instituto de Salud Pública de Chile ; Ñuñoa , Santiago , Chile
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
[Implementation of meningococcal B vaccination (Bexsero®) in France: Physicians' perceptions and experiences of a few months after marketing approval]. Arch Pediatr 2015; 23:27-33. [PMID: 26603630 DOI: 10.1016/j.arcped.2015.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 07/15/2015] [Accepted: 09/17/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND In December 2013, the French public health authorities recommended the use of Bexsero® (meningococcus B vaccine) in areas with endemic risk and for patients at risk for invasive meningococcal B disease. In this context, InfoVac-France performed a national survey a few months after the implementation of the vaccine to evaluate physicians' perceptions and experiences with this new vaccine. METHODS This survey was proposed by email in April 2014 to the InfoVac network. An initial email explained the purpose of this study and proposed an online questionnaire. RESULTS Between April 29 and May 16, 2014, 1502 physicians answered online: 502 GPs (33%), 939 pediatricians (63%), and 61 other specialists (4%). In response, 91% of physicians would like to use this vaccine and 87% of pediatricians versus 50% of GPs knew that the vaccine was marketed. Physicians had been informed of the vaccine mostly via the InfoVac network (61%). The immunization schedules for all ages were slightly known by physicians (9% for GPs and 43% of pediatricians). This vaccination was still rarely proposed (18%) more often because it was not reimbursed to patients (62%). Although 39% of physicians were planning to propose the vaccine to their patients, 54% remained undecided. A total of 9% of pediatricians and 2% of GPs had already used this vaccination. CONCLUSION This InfoVac-France survey shows that physicians would support the implementation of this vaccine, but questions persist as to its effectiveness, impact on carriage, and duration of protection.
Collapse
|
12
|
Mameli C, Galli E, Mantegazza C, Fabiano V, Zuccotti GV. The multicomponent meningococcal serogroup B vaccine (4CMenB): origin, composition, health impact and unknown aspects. Future Microbiol 2015; 10:1579-98. [DOI: 10.2217/fmb.15.91] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Neisseria meningitidis serogroup B is the main cause for meningococcal invasive disease in many parts of the world. Since 2013, a new multicomponent vaccine against meningococcal serogroup B (4CMenB) has been licensed in Europe, Australia, Canada, Chile, Uruguay, USA and Brazil with different immunization schedules. Clinical trials involving adults, adolescents, children and infants showed 4CMenB has a good immunogenicity and safety profile. Strain coverage estimates are similar to or better than other recently approved vaccines, ranging from 66% in Canada to 91% in Unites States. Some points still remain to be clarified such as the best immunization strategy, the effect of 4CMenB on carriage, the long-term persistence of protective bactericidal antibodies titers, long-term safety outcomes, the possible emergence of N. meningitidis escape mutants and the vaccine cost–effectiveness. In this review, we focus on the vaccine composition, clinical trials and suggested schedules, safety data, potential strain coverage and future challenges.
Collapse
Affiliation(s)
- Chiara Mameli
- Department of Pediatrics, Children's Hospital V. Buzzi, Via Castelvetro 32, University of Milan, Milan, Italy
| | - Erica Galli
- Department of Pediatrics, Children's Hospital V. Buzzi, Via Castelvetro 32, University of Milan, Milan, Italy
| | - Cecilia Mantegazza
- Department of Pediatrics, Children's Hospital V. Buzzi, Via Castelvetro 32, University of Milan, Milan, Italy
| | - Valentina Fabiano
- Department of Pediatrics, Children's Hospital V. Buzzi, Via Castelvetro 32, University of Milan, Milan, Italy
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics, Children's Hospital V. Buzzi, Via Castelvetro 32, University of Milan, Milan, Italy
| |
Collapse
|
13
|
Gasparini R, Panatto D, Bragazzi NL, Lai PL, Bechini A, Levi M, Durando P, Amicizia D. How the Knowledge of Interactions between Meningococcus and the Human Immune System Has Been Used to Prepare Effective Neisseria meningitidis Vaccines. J Immunol Res 2015; 2015:189153. [PMID: 26351643 PMCID: PMC4553322 DOI: 10.1155/2015/189153] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 06/09/2015] [Indexed: 01/17/2023] Open
Abstract
In the last decades, tremendous advancement in dissecting the mechanisms of pathogenicity of Neisseria meningitidis at a molecular level has been achieved, exploiting converging approaches of different disciplines, ranging from pathology to microbiology, immunology, and omics sciences (such as genomics and proteomics). Here, we review the molecular biology of the infectious agent and, in particular, its interactions with the immune system, focusing on both the innate and the adaptive responses. Meningococci exploit different mechanisms and complex machineries in order to subvert the immune system and to avoid being killed. Capsular polysaccharide and lipooligosaccharide glycan composition, in particular, play a major role in circumventing immune response. The understanding of these mechanisms has opened new horizons in the field of vaccinology. Nowadays different licensed meningococcal vaccines are available and used: conjugate meningococcal C vaccines, tetravalent conjugate vaccines, an affordable conjugate vaccine against the N. menigitidis serogroup A, and universal vaccines based on multiple antigens each one with a different and peculiar function against meningococcal group B strains.
Collapse
Affiliation(s)
- R. Gasparini
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - D. Panatto
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - N. L. Bragazzi
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - P. L. Lai
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - A. Bechini
- Department of Health Sciences, University of Florence, Viale G.B. Morgagni 48, 50134 Florence, Italy
| | - M. Levi
- Department of Health Sciences, University of Florence, Viale G.B. Morgagni 48, 50134 Florence, Italy
| | - P. Durando
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - D. Amicizia
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| |
Collapse
|
14
|
Rivero Calle I, Rodriguez-Tenreiro Sánchez C, Martinón-Torres F. [Meningococcal vaccines. Global epidemiological situation and strategies for prevention by vaccination]. Enferm Infecc Microbiol Clin 2015; 33:257-67. [PMID: 25795150 DOI: 10.1016/j.eimc.2015.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 02/28/2015] [Accepted: 03/02/2015] [Indexed: 11/24/2022]
Abstract
N. meningitidis is a major cause of meningitis and septicemia and a major public health problem in many countries. The disease, that can be fulminant, has a high mortality and may cause serious sequelae, even in cases of apparently optimal medical treatment. Chemoprophylaxis may prevent secondary cases among those in close contact with the ill, but, since secondary cases represent only 1%-2% of all meningococcal disease, chemoprophylaxis has a small impact when fighting most of endemic and epidemic forms. Given that al least 5% -15% of children and young adults are carriers, the fight against meningococcal disease based on chemotherapeutic elimination of nasopharyngeal colonization is virtually impossible. Therefore, immunization is the only rational way to combat this disease.
Collapse
Affiliation(s)
- Irene Rivero Calle
- Pediatría Clínica, Infectológica y Traslacional. Departamento de Pediatría, Hospital Clínico Universitario de Santiago, Unidad de Investigación en Vacunas, GENVIP, Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, La Coruña, España.
| | - Carmen Rodriguez-Tenreiro Sánchez
- Pediatría Clínica, Infectológica y Traslacional. Departamento de Pediatría, Hospital Clínico Universitario de Santiago, Unidad de Investigación en Vacunas, GENVIP, Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, La Coruña, España
| | - Federico Martinón-Torres
- Pediatría Clínica, Infectológica y Traslacional. Departamento de Pediatría, Hospital Clínico Universitario de Santiago, Unidad de Investigación en Vacunas, GENVIP, Instituto de Investigación Sanitaria de Santiago, Santiago de Compostela, La Coruña, España
| |
Collapse
|
15
|
Mizrahi A, Collignon A, Péchiné S. Passive and active immunization strategies against Clostridium difficile infections: State of the art. Anaerobe 2014; 30:210-9. [DOI: 10.1016/j.anaerobe.2014.07.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 07/07/2014] [Accepted: 07/18/2014] [Indexed: 02/04/2023]
|
16
|
Ying S, He J, Yu M, Zhang Y, Deng S, Zhang L, Xie M, Hu S. Recombinant Neisseria surface protein A is a potential vaccine candidate against Neisseria meningitides serogroup B. Mol Med Rep 2014; 10:1619-25. [PMID: 24926810 DOI: 10.3892/mmr.2014.2325] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 04/14/2014] [Indexed: 11/06/2022] Open
Abstract
Neisseria meningitidis is the pathogen of epidemic encephalomyelitis and is responsible for permanent damage to the brain and nervous system. In the present study, the prokaryotic expression vector pGEX-6p-1/neisseria surface protein A (NspA) was constructed and the immune protective effect was investigated with the purified recombinant rNspA. Female BALB/c mice were immunized by intraperitoneal inoculation of rNspA, glutathione S-transferase (GST) or phosphate-buffered saline (PBS). The protection experiment in mice demonstrated that the protection rate of the rNspA group was 85% against the N. meningitidis strain MC58, and a serum bactericidal assay in vitro revealed that the serum bactericidal titer of the rNspA group reached 1:64 following three immunizations. The levels of specific immunoglobulin (Ig) A (SIgA), IgG, IgG1, IgG2a, IgG2b and IgG3 of mice in the rNspA group peaked at week six and were higher than those in the mice in the GST and PBS groups. The levels of stimulation index, interleukin-4 and interferon-γ in the culture supernatant of the spleen lymphocytes of the rNspA group increased in a time-dependent manner and were higher than those of the mice in the GST and PBS groups over the same period. The results suggested that rNspA may induce increased specific humoral and cellular immune responses, and that it is effectively protective against N. meningitidis serogroup B in mice. The present study offered novel evidence that may lead to the development of a novel effective N. meningitidis serogroup B vaccine.
Collapse
Affiliation(s)
- Shangyun Ying
- Pathogenic Biology Institute, College of Basic Medicine, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Jun He
- Pathogenic Biology Institute, College of Basic Medicine, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Minjun Yu
- Pathogenic Biology Institute, College of Basic Medicine, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Yukuai Zhang
- Pathogenic Biology Institute, College of Basic Medicine, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Suhong Deng
- Pathogenic Biology Institute, College of Basic Medicine, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Lusi Zhang
- Pathogenic Biology Institute, College of Basic Medicine, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Meihua Xie
- Pathogenic Biology Institute, College of Basic Medicine, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Sihai Hu
- Pathogenic Biology Institute, College of Basic Medicine, University of South China, Hengyang, Hunan 421001, P.R. China
| |
Collapse
|
17
|
Gil A, Barranco D, Batalla J, Bayas J, Campins M, Gorrotxategi Gorrotxategi P, Lluch J, Martinón-Torres F, Mellado M, Moreno-Pérez D, Uriel B, Vázquez J. Prevención de la enfermedad meningocócica por el serogrupo B mediante una vacuna de 4 componentes. An Pediatr (Barc) 2014; 80:259.e1-23. [DOI: 10.1016/j.anpedi.2013.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 04/02/2013] [Accepted: 04/02/2013] [Indexed: 11/17/2022] Open
|
18
|
Clark SA, Lucidarme J, Newbold LS, Borrow R. Genotypic analysis of meningococcal factor h-binding protein from non-culture clinical specimens. PLoS One 2014; 9:e89921. [PMID: 24587125 PMCID: PMC3933679 DOI: 10.1371/journal.pone.0089921] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 01/29/2014] [Indexed: 12/03/2022] Open
Abstract
Factor H-Binding Protein (fHbp) is an outer membrane protein antigen included in two novel meningococcal group B vaccines and, as such, is an important typing target. Approximately 50% of meningococcal disease cases in England and Wales are confirmed using real-time PCR on non-culture clinical specimens only. Protocols for typing fHbp from this subset of cases have not yet been established. Here we present a nested PCR-based assay designed to amplify and sequence fHbp from non-culture clinical specimens. From analytical sensitivity experiments carried out using diluted DNA extracts, an estimated analytical sensitivity limit of 6 fg/µL of DNA (<3 genome copies/µL) was calculated. The sensitivity of the assay was shown to be comparable to the ctrA-directed real-time PCR assay currently used to confirm invasive disease diagnoses from submitted clinical specimens. A panel of 96 diverse, patient-matched clinical specimen/isolate pairs from invasive disease cases was used to illustrate the breadth of strain coverage for the assay. All fHbp alleles sequenced from the isolates matched those derived from previous whole genome analyses. The first-round PCR primer binding sites are highly conserved, however an exceptional second-round PCR primer site mismatch in one validation isolate prevented amplification. In this case, amplification from the corresponding clinical specimen was achieved, suggesting that the use of a nested PCR procedure may compensate for any minor mismatches in round-two primer sites. The assay was successful at typing 91/96 (94.8%) of the non-culture clinical specimens in this study and exhibits sufficient sensitivity to type fHbp from the vast majority of non-culture clinical specimens received by the Meningococcal Reference Unit, Public Health England.
Collapse
Affiliation(s)
- Stephen A. Clark
- Manchester Medical Microbiology Partnership, Public Health England, Clinical Sciences Buildings, Manchester Royal Infirmary, Manchester, United Kingdom
- * E-mail:
| | - Jay Lucidarme
- Manchester Medical Microbiology Partnership, Public Health England, Clinical Sciences Buildings, Manchester Royal Infirmary, Manchester, United Kingdom
| | - Lynne S. Newbold
- Manchester Medical Microbiology Partnership, Public Health England, Clinical Sciences Buildings, Manchester Royal Infirmary, Manchester, United Kingdom
| | - Ray Borrow
- Manchester Medical Microbiology Partnership, Public Health England, Clinical Sciences Buildings, Manchester Royal Infirmary, Manchester, United Kingdom
| |
Collapse
|
19
|
Gasparini R, Amicizia D, Domnich A, Lai PL, Panatto D. Neisseria meningitidis B vaccines: recent advances and possible immunization policies. Expert Rev Vaccines 2014; 13:345-64. [PMID: 24476428 DOI: 10.1586/14760584.2014.880341] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Since the development of the first-generation vaccines based on outer membrane vesicles (OMV), which were able to contain strain-specific epidemics, but were not suitable for universal use, enormous steps forward in the prevention of Neisseria meningitidis B have been made. The first multicomponent vaccine, Bexsero(®), has recently been authorized for use; other vaccines, bivalent rLP2086 and next-generation OMV vaccines, are under development. The new vaccines may substantially contribute to reducing invasive bacterial infections as they could cover most Neisseria meningitidis B strains. Moreover, other potentially effective serogroup B vaccine candidates are being studied in preclinical settings. It is therefore appropriate to review what has recently been achieved in the prevention of disease caused by serogroup B.
Collapse
|
20
|
Effectiveness of Immunoprophylaxis in Suppressing Carriage of Neisseria Meningitidis in the Military Environment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 836:19-28. [DOI: 10.1007/5584_2014_22] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
21
|
Abio A, Neal KR, Beck CR. An epidemiological review of changes in meningococcal biology during the last 100 years. Pathog Glob Health 2013; 107:373-80. [PMID: 24392681 PMCID: PMC4083158 DOI: 10.1179/2047773213y.0000000119] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
AIM The aim of this study was to assess changes in trends of meningococcal disease and strain diversity of Neisseria meningitidis in Europe, South America, and Africa over the last 100 years. METHODS Healthcare databases and sources of grey literature were searched in 2012 and records were screened against the protocol eligibility criteria using a three-stage sifting process. Studies included in the review were subject to data extraction. Results were summarised using a narrative approach. RESULTS Serogroup A was the dominant cause of invasive meningococcal disease in Europe before and during World Wars I and II. Whilst serogroup B has been dominant from the 1970s in Europe and the 1980s in South America, outbreaks have emerged associated with serogroups W135 and Y in the twenty-first century. There has been a shift in the age groups affected by invasive meningococcal disease with an increase in incidence among the elderly associated with serogroup Y and a decline in serogroup C among adolescent populations. Recent outbreaks of serogroup W135 have occurred in some countries in South America. The epidemiological trend of invasive meningococcal disease has remained largely static across Africa and dominated by serogroup A although recently serogroups X and W135 have accounted for a large proportion of morbidity and mortality. CONCLUSION The epidemiology of N. meningitidis has been dynamic in Europe and South America especially over the last 30 years. Routine vaccination with serogroup C vaccines has led to reduced carriage and incidence of invasive meningococcal disease and herd immunity.
Collapse
|
22
|
Zariri A, van Dijken H, Hamstra HJ, van der Flier M, Vidarsson G, van Putten JPM, Boog CJP, van den Dobbelsteen G, van der Ley P. Expression of human CEACAM1 in transgenic mice limits the Opa-specific immune response against meningococcal outer membrane vesicles. Vaccine 2013; 31:5585-93. [PMID: 23933369 DOI: 10.1016/j.vaccine.2013.07.069] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 07/18/2013] [Accepted: 07/25/2013] [Indexed: 10/26/2022]
Abstract
Outer membrane vesicles (OMVs) have been extensively investigated as meningococcal vaccine candidates. Among their major components are the opacity (Opa) proteins, a family of surface-exposed outer membrane proteins important for bacterial adherence and entry into host cells. Many Opa-dependent interactions are mediated through the carcinoembryonic antigen-related cell adhesion molecule (CEACAM) family of receptors. Importantly, binding of Opa to CEACAM1 has been reported to suppress human CD4 T cell proliferation in vitro in response to OMV preparations. This raises the question whether OMV vaccines should contain Opa proteins at all. Until now it has been difficult to answer this question, as the proposed immunosuppressive effect was only demonstrated with human cells in vitro, while immunization experiments in mice are not informative because the Opa interaction is specific for human CEACAM1. In the present study we have used Opa+ and Opa- OMVs for immunization experiments in a human CEACAM1 transgenic mouse model. OMVs were prepared from a meningococcal strain H44/76 variant expressing the CEACAM1-binding OpaJ protein, and from an isogenic variant in which all opa genes have been inactivated. Both the CEACAM1 expressing transgenic mice and their congenic littermates lacking it were immunized twice with the OMV preparations, and the sera were analyzed for bactericidal activity and ELISA antibody titres. Total IgG antibodies against the OMVs were similar in both mouse strains. Yet the titres for IgG antibodies specific for purified OpaJ protein were significantly lower in the mice expressing human CEACAM1 than in the nontransgenic mice. No significant differences were found in bactericidal titres among the four groups. Overall, these data indicate that expression of human CEACAM1 confers a reduced Opa-specific antibody response in vivo without affecting the overall immune response against other OMV antigens.
Collapse
Affiliation(s)
- Afshin Zariri
- Institute for Translational Vaccinology (InTraVacc), Antonie van Leeuwenhoeklaan 9, 3720 AL Bilthoven, The Netherlands; Department of Infectious Diseases and Immunology, Utrecht University, 3584 CL Utrecht, The Netherlands.
| | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Sáfadi MAP, de los Monteros LEE, López EL, Sàez-Llorens X, Lemos AP, Moreno-Espinosa S, Ayala SG, Torres JP, de Moraes JC, Vázquez JA. The current situation of meningococcal disease in Latin America and recommendations for a new case definition from the Global Meningococcal Initiative. Expert Rev Vaccines 2013; 12:903-15. [PMID: 23909747 DOI: 10.1586/14760584.2013.814879] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The Global Meningococcal Initiative (GMI) is an international group of scientists and clinicians with expertise in meningococcal disease (MD). It promotes MD prevention through education and research. Given geographic differences in disease epidemiology, prevention strategies (e.g., vaccination) should be country-specific to ensure local needs are met. However, regional policies/recommendations and standardized disease diagnostic criteria should be implemented to improve surveillance and control strategies, and allow for more robust data comparisons. Consequently, the GMI convened a meeting with Latin American representatives to discuss the burden of MD and vaccination practices/policies, and consider if the global GMI recommendations could be tailored. The group determined that as robust, uniform epidemiologic data are required to make informed health-policy decisions, it would be useful to first summarize the regional situation herein (including disease surveillance, case definitions, epidemiology, vaccination and outbreak control strategies) and then determine a consensus-based meningococcal case definition for use throughout the region.
Collapse
Affiliation(s)
- Marco Aurélio P Sáfadi
- FCM da Santa Casa de São Paulo, Alameda dos Indigenas, 228, ZIP 04059 060, São Paulo, Brazil.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Barra GN, Araya PA, Fernandez JO, Gabastou JM, Hormazábal JC, Seoane M, Pidal PC, Valenzuela MT, Ibarz-Pavón AB. Molecular characterization of invasive Neisseria meningitidis strains isolated in Chile during 2010-2011. PLoS One 2013; 8:e66006. [PMID: 23776590 PMCID: PMC3679051 DOI: 10.1371/journal.pone.0066006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 05/01/2013] [Indexed: 11/18/2022] Open
Abstract
Background With the upcoming licensure of Outer Membrane Protein-based vaccines against meningococcal disease, data on disease incidence and molecular characteristic of circulating N. meningitidis strains in Latin American countries is needed. Chile is, to date, one of the few countries in the region that has performed this type of work in a comprehensive collection of disease-associated strains from two consecutive years, 2010–2011. Methods A total of 119 N. meningitidis strains isolated from patients with invasive disease in Chile in 2010–2011 were characterized by the National Reference Laboratory. Serogroup determination, MLST and porA typing were performed. Results Serogroup B was predominant in both study years, but W135 experienced a noticeable increase in 2011 compared to 2010. ST-11 complex, ST-41/44 complex ST-32 complex were the most prevalent among the isolates, and were strongly associated with serogroups W135 (ST-11 Complex) and B (ST-41/44 and ST-32 complexes). Likewise, the major porA types detected were strongly associated with these three clonal complexes: P1.5,2 was found exclusively among W135:ST-11 isolates, whereas P1.7, 2–3 was only detected in C:ST-11. ST-41/44 isolates mainly had P1.10-8, and ST-32 complex were associated with a P1.18-8 porA. Conclusions Our data show disease-associated N. meningitidis circulating in Chile are similar to those found in other parts of the world. The increase on W135:ST-11 isolates observed in 2011 foretold the unusual epidemiological situation experienced in the country in 2012, and MLST data show that this strain is indistinguishable from the one linked to the global Hajj 2000-related outbreak that occurred in 2001. Finally, this work demonstrates the importance of maintaining a strong national surveillance program integrating clinical, epidemiological and laboratory data and incorporating gold standard diagnostic and characterization techniques that allow the data to be compared all over the world.
Collapse
Affiliation(s)
- Gisselle N. Barra
- Sub-Department of Molecular Genetics, Institute of Public Health, Santiago, Chile
| | - Pamela A. Araya
- Section of Bacteriology, Institute of Public Health, Santiago, Chile
| | - Jorge O. Fernandez
- Sub-Department of Molecular Genetics, Institute of Public Health, Santiago, Chile
- * E-mail: (ABIP); (JF)
| | - Jean-Marc Gabastou
- Pan American Health Organization, Washington, D.C., United States of America
| | | | - Mabel Seoane
- Section of Bacteriology, Institute of Public Health, Santiago, Chile
| | - Paola C. Pidal
- Biomedical laboratory department, Institute of Public Health, Santiago, Chile
| | - Maria T. Valenzuela
- Biomedical laboratory department, Institute of Public Health, Santiago, Chile
| | - Ana Belén Ibarz-Pavón
- Pan American Health Organization, Washington, D.C., United States of America
- * E-mail: (ABIP); (JF)
| |
Collapse
|
25
|
|
26
|
A randomized, controlled, phase 1/2 trial of a Neisseria meningitidis serogroup B bivalent rLP2086 vaccine in healthy children and adolescents. Pediatr Infect Dis J 2013; 32:364-71. [PMID: 23114369 DOI: 10.1097/inf.0b013e31827b0d24] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Neisseria meningitidis serogroup B (MnB) is a significant cause of invasive meningococcal disease. Factor H binding protein (also known as LP2086) is a conserved outer membrane neisserial lipoprotein that has emerged as a strong candidate protein antigen for MnB vaccination. This study examined the safety, tolerability and immunogenicity of an initial formulation of a bivalent recombinant LP2086 (rLP2086) vaccine in healthy children and adolescents. METHODS In this randomized, observer-blinded, parallel-group, multicenter trial conducted at 6 centers in Australia, 127 healthy participants aged 8-14 years were assigned to receive 20, 60 or 200 µg of the bivalent rLP2086 vaccine (n = 16, 45 and 45, respectively) or active control (Twinrix, n = 21) at 0, 1 and 6 months. Immunogenicity was assessed before the first dose and 1 month after doses 2 and 3. Local reactions, systemic events and other adverse events were recorded. The primary immunogenicity endpoint was the rate of seroconversion (≥4-fold rise in human complement serum bactericidal assay titer) against MnB strains expressing the homologous A05 or heterologous B02 LP2086 variants. RESULTS The bivalent rLP2086 vaccine was generally well-tolerated, with mostly mild to moderate local reactions. The most common adverse events, headache and upper respiratory tract infection, occurred with similar frequency in each group. Post-dose 3 seroconversion rates against strains expressing B02 and A05 variants were 68.8-95.3% for rLP2086 recipients and 0% for Twinrix recipients. CONCLUSIONS The bivalent rLP2086 vaccine was well-tolerated and immunogenic in healthy children and adolescents, supporting further evaluation as a broadly protective MnB vaccine.
Collapse
|
27
|
Sorhouet-Pereira C, Efron A, Gagetti P, Faccone D, Regueira M, Corso A, Gabastou JM, Ibarz-Pavón AB. Phenotypic and genotypic characteristics of Neisseria meningitidis disease-causing strains in Argentina, 2010. PLoS One 2013; 8:e58065. [PMID: 23483970 PMCID: PMC3587574 DOI: 10.1371/journal.pone.0058065] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 01/29/2013] [Indexed: 11/19/2022] Open
Abstract
Phenotypic and genotypic characterization of 133 isolates of Neisseria meningitidis obtained from meningococcal disease cases in Argentina during 2010 were performed by the National Reference Laboratory as part of a project coordinated by the PAHO within the SIREVA II network. Serogroup, serotype, serosubtype and MLST characterization were performed. Minimum Inhibitory Concentration to penicillin, ampicillin, ceftriaxone, rifampin, chloramphenicol, tetracycline and ciprofloxacin were determined and interpreted according to CLSI guidelines. Almost 49% of isolates were W135, and two serotype:serosubtype combinations, W135:2a:P1.5,2:ST-11 and W135:2a:P1.2:ST-11 accounted for 78% of all W135 isolates. Serogroup B accounted for 42.1% of isolates, and was both phenotypically and genotypically diverse. Serogroup C isolates represented 5.3% of the dataset, and one isolate belonging to the ST-198 complex was non-groupable. Isolates belonged mainly to the ST-11 complex (48%) and to a lesser extent to the ST-865 (18%), ST-32 (9,8%) and the ST-35 complexes (9%). Intermediate resistance to penicillin and ampicillin was detected in 35.4% and 33.1% of isolates respectively. Two W135:2a:P1.5,2:ST-11:ST-11 isolates presented resistance to ciprofloxacin associated with a mutation in the QRDR of gyrA gene Thr91-Ile. These data show serogroup W135 was the first cause of disease in Argentina in 2010, and was strongly associated with the W135:2a:P1.5,2:ST-11 epidemic clone. Serogroup B was the second cause of disease and isolates belonging to this serogroup were phenotypically and genotypically diverse. The presence of isolates with intermediate resistance to penicillin and the presence of fluorquinolone-resistant isolates highlight the necessity and importance of maintaining and strengthening National Surveillance Programs.
Collapse
Affiliation(s)
- Cecilia Sorhouet-Pereira
- Clinical Bacteriology Service, Department of Bacteriology, National Institute for Infectious Diseases (ANLIS-INEI), ‘Dr Carlos G. Malbrán’, Ministry of Health, Buenos Aires, Argentina
| | - Adriana Efron
- Clinical Bacteriology Service, Department of Bacteriology, National Institute for Infectious Diseases (ANLIS-INEI), ‘Dr Carlos G. Malbrán’, Ministry of Health, Buenos Aires, Argentina
| | - Paula Gagetti
- Antimicrobial Resistance Service, Department of Bacteriology, National Institute for Infectious Diseases (ANLIS-INEI), ‘Dr Carlos G. Malbrán’, Ministry of Health, Buenos Aires, Argentina
| | - Diego Faccone
- Antimicrobial Resistance Service, Department of Bacteriology, National Institute for Infectious Diseases (ANLIS-INEI), ‘Dr Carlos G. Malbrán’, Ministry of Health, Buenos Aires, Argentina
| | - Mabel Regueira
- Clinical Bacteriology Service, Department of Bacteriology, National Institute for Infectious Diseases (ANLIS-INEI), ‘Dr Carlos G. Malbrán’, Ministry of Health, Buenos Aires, Argentina
| | - Alejandra Corso
- Antimicrobial Resistance Service, Department of Bacteriology, National Institute for Infectious Diseases (ANLIS-INEI), ‘Dr Carlos G. Malbrán’, Ministry of Health, Buenos Aires, Argentina
| | | | - Jean-Marc Gabastou
- Pan American Health Organization, Washington, DC, United States of America
| | | |
Collapse
|
28
|
[What do pediatricians and general practitioners think about the implementation of meningococal B vaccination in France?]. Arch Pediatr 2012; 19:1379-85. [PMID: 23159343 DOI: 10.1016/j.arcped.2012.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 10/01/2012] [Accepted: 10/02/2012] [Indexed: 11/22/2022]
Abstract
BACKGROUND To assess the acceptability of a vaccine against meningococcus B by pediatricians and GP and to analyze how the vaccine could be implemented in France, InfoVac-France has set up a national survey. METHODS An email explained the purpose of this study and the practitioners of InfoVac-France network answered an online questionnaire (e-CRF). RESULTS Of the 6905 pediatricians and GP who saw the mail sent by InfoVac-France between 11 and 24 January, 2012, 1351 (13.5 %) completed the e-CERF : 361 GP (26.7%), 797 pediatricians (59%) and 193 other doctors (14.3%). The majority of practitioners (96.1%) believe that is important to implement a vaccine against meningococcus B in the French immunization schedule. In 80.5% of cases, practitioners do not want to vaccine three times routinely during a single consultation and more than half (53.5%) would prefer to use this vaccine alone. The best schedule of primary vaccination (80.6%) is the injection at 3, 5 and 6 months. The arguments considered likely to encourage parents to accept the vaccination would be the incidence of the disease, severity of meningitis (82.1%) and the rapid mortality (82.8%). CONCLUSION This survey by InfoVac-France shows that the practitioners know the epidemiology of meningococcal B invasive disease in children. They would support the implementation of this vaccine for children under 2 years with a primary vaccination at 3, 5 and 6 months.
Collapse
|
29
|
Hellenbrand W, Elias J, Wichmann O, Dehnert M, Frosch M, Vogel U. Epidemiology of invasive meningococcal disease in Germany, 2002-2010, and impact of vaccination with meningococcal C conjugate vaccine. J Infect 2012; 66:48-56. [PMID: 23043893 DOI: 10.1016/j.jinf.2012.09.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 09/04/2012] [Accepted: 09/11/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To analyse serogroup (Sg)- and finetype-specific invasive meningococcal disease burden (IMD) in Germany, 2002-2010, with emphasis on effects of vaccination with conjugate SgC vaccines targeting one-year old children since 2006, including individual-based catch-up to 17 years of age. METHODS Serogroup- and age-specific IMD incidence and trends were calculated using statutory surveillance data. The national reference laboratory performed genetic finetyping. Vaccination uptake data were obtained from school entry surveys and prescription monitoring. RESULTS In persons <25 years, SgB and SgC IMD incidence decreased significantly from 0.63 to 0.32/100,000 and 0.26 to 0.10/100,000, respectively. The decline was significantly steeper for SgC than SgB in 1-5 year-olds, the primary vaccination target group, but not other ages. The slope of the SgC incidence curves was similar before and after vaccination implementation in all age groups; however, the decrease in incidence was steeper in states with higher vaccination uptake. Declining SgC incidence was associated with decreased SgC finetype diversity. An increase in SgY incidence was limited to adults. CONCLUSIONS Results suggest effects of the German SgC vaccination strategy are limited, although interpretation is complicated by already low and decreasing incidence before vaccination. More effective use of vaccination resources might be achieved by rigorously targeting adolescents in addition to 1-year-olds.
Collapse
Affiliation(s)
- Wiebke Hellenbrand
- Immunization Unit, Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
| | | | | | | | | | | |
Collapse
|
30
|
Mapping the laminin receptor binding domains of Neisseria meningitidis PorA and Haemophilus influenzae OmpP2. PLoS One 2012; 7:e46233. [PMID: 23049988 PMCID: PMC3457995 DOI: 10.1371/journal.pone.0046233] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 08/28/2012] [Indexed: 12/31/2022] Open
Abstract
Neisseria meningitidis, Haemophilus influenzae and Streptococcus pneumoniae are major bacterial agents of meningitis. They each bind the 37/67-kDa laminin receptor (LamR) via the surface protein adhesins: meningococcal PilQ and PorA, H. influenzae OmpP2 and pneumococcal CbpA. We have previously reported that a surface-exposed loop of the R2 domain of CbpA mediates LamR-binding. Here we have identified the LamR-binding regions of PorA and OmpP2. Using truncated recombinant proteins we show that binding is dependent on amino acids 171-240 and 91-99 of PorA and OmpP2, respectively, which are predicted to localize to the fourth and second surface-exposed loops, respectively, of these proteins. Synthetic peptides corresponding to the loops bound LamR and could block LamR-binding to bacterial ligands in a dose dependant manner. Meningococci expressing PorA lacking the apex of loop 4 and H. influenzae expressing OmpP2 lacking the apex of loop 2 showed significantly reduced LamR binding. Since both loops are hyper-variable, our data may suggest a molecular basis for the range of LamR-binding capabilities previously reported among different meningococcal and H. influenzae strains.
Collapse
|
31
|
A bivalent Neisseria meningitidis recombinant lipidated factor H binding protein vaccine in young adults: results of a randomised, controlled, dose-escalation phase 1 trial. Vaccine 2012; 30:6163-74. [PMID: 22871351 DOI: 10.1016/j.vaccine.2012.07.065] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 07/23/2012] [Accepted: 07/25/2012] [Indexed: 02/06/2023]
Abstract
Neisseria meningitidis is a leading cause of meningitis and septicaemia, but a broadly-protective vaccine against endemic serogroup B disease is not licensed and available. The conserved, outer-membrane lipoprotein factor H binding protein (fHBP, also known as LP2086) is expressed as one of two subfamily variants in virtually all meningococci. This study investigated the safety, tolerability, and immunogenicity of a recombinant-expressed bivalent fHBP (r-fHBP) vaccine in healthy adults. Participants (N=103) aged 18-25 years were recruited into three ascending dose level cohorts of 20, 60, and 200μg of a bivalent r-fHBP vaccine formulation and randomised to receive vaccine or placebo at 0, 1, and 6 months. The vaccine was well tolerated. Geometric mean titres (GMTs) for r-fHBP subfamily-specific IgG antibodies increased 19-168-fold from pre-vaccination to post-dose 2 in a dose level-dependent manner. In addition, robust serum bactericidal assay using human complement (hSBA) responses for strains expressing both homologous and heterologous fHBP variants were observed. After three vaccinations, 16-52% of the placebo group and 47-90%, 75-100%, and 88-100%, of the 20, 60, and 200μg dose levels, respectively, had seroprotective (≥ 1:4) hSBA titres against six serogroup B strains. The bivalent r-fHBP vaccine was well tolerated and induced robust bactericidal activity against six diverse serogroup B strains in young adults at the 60 and 200μg dose levels.
Collapse
|
32
|
The early clinical development of a multicomponent vaccine against meningococcal serogroup B. ACTA ACUST UNITED AC 2012. [DOI: 10.4155/cli.12.41] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
33
|
Lu CY, Santosham M. Survey of national immunization programs and vaccine coverage rates in Asia Pacific countries. Vaccine 2011; 30:2250-5. [PMID: 22075085 DOI: 10.1016/j.vaccine.2011.10.070] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Revised: 10/20/2011] [Accepted: 10/26/2011] [Indexed: 11/28/2022]
Abstract
Children in the Asia Pacific region are still suffering from certain vaccine-preventable diseases. The current study surveyed the national immunization programs and vaccine uptake of traditional and newly developed vaccines in 12 countries in this area. The results showed children in most countries were well protected from conventional vaccine-preventable diseases, while immunization programs for certain diseases such as poliovirus or measles should be strengthened in certain countries. Protection against pneumococcus, rotavirus, and human papillomavirus infections were obviously inadequate in most of the countries in the region. Promoting coverage of newly developed vaccines will benefit a great number of children in this area.
Collapse
Affiliation(s)
- Chun-Yi Lu
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | | | | |
Collapse
|