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Santos-Peral A, Luppa F, Goresch S, Nikolova E, Zaucha M, Lehmann L, Dahlstroem F, Karimzadeh H, Thorn-Seshold J, Winheim E, Schuster EM, Dobler G, Hoelscher M, Kümmerer BM, Endres S, Schober K, Krug AB, Pritsch M, Barba-Spaeth G, Rothenfusser S. Prior flavivirus immunity skews the yellow fever vaccine response to cross-reactive antibodies with potential to enhance dengue virus infection. Nat Commun 2024; 15:1696. [PMID: 38402207 PMCID: PMC10894228 DOI: 10.1038/s41467-024-45806-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 02/05/2024] [Indexed: 02/26/2024] Open
Abstract
The yellow fever 17D vaccine (YF17D) is highly effective but is frequently administered to individuals with pre-existing cross-reactive immunity, potentially impacting their immune responses. Here, we investigate the impact of pre-existing flavivirus immunity induced by the tick-borne encephalitis virus (TBEV) vaccine on the response to YF17D vaccination in 250 individuals up to 28 days post-vaccination (pv) and 22 individuals sampled one-year pv. Our findings indicate that previous TBEV vaccination does not affect the early IgM-driven neutralizing response to YF17D. However, pre-vaccination sera enhance YF17D virus infection in vitro via antibody-dependent enhancement (ADE). Following YF17D vaccination, TBEV-pre-vaccinated individuals develop high amounts of cross-reactive IgG antibodies with poor neutralizing capacity. In contrast, TBEV-unvaccinated individuals elicit a non-cross-reacting neutralizing response. Using YF17D envelope protein mutants displaying different epitopes, we identify quaternary dimeric epitopes as the primary target of neutralizing antibodies. Additionally, TBEV-pre-vaccination skews the IgG response towards the pan-flavivirus fusion loop epitope (FLE), capable of mediating ADE of dengue and Zika virus infections in vitro. Together, we propose that YF17D vaccination conceals the FLE in individuals without prior flavivirus exposure but favors a cross-reactive IgG response in TBEV-pre-vaccinated recipients directed to the FLE with potential to enhance dengue virus infection.
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Affiliation(s)
- Antonio Santos-Peral
- Division of Clinical Pharmacology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Fabian Luppa
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Sebastian Goresch
- Division of Clinical Pharmacology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Elena Nikolova
- Division of Clinical Pharmacology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Magdalena Zaucha
- Division of Clinical Pharmacology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lisa Lehmann
- Division of Clinical Pharmacology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Frank Dahlstroem
- Division of Clinical Pharmacology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Hadi Karimzadeh
- Division of Clinical Pharmacology, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Veterinary Sciences, LMU Munich, Munich, Germany
| | - Julia Thorn-Seshold
- Division of Clinical Pharmacology, LMU University Hospital, LMU Munich, Munich, Germany
- Faculty of Chemistry and Pharmacy, LMU Munich, Munich, Germany
| | - Elena Winheim
- Institute for Immunology, Biomedical Center (BMC), Medical Faculty, LMU Munich, Munich, Germany
| | - Ev-Marie Schuster
- Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Gerhard Dobler
- Bundeswehr Institute of Microbiology, Neuherbergstrasse 11, 80937, Munich, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- German Centre for Infection Research, Partner Site Munich, 80799, Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology, Immunology, Infection and Pandemic Research, 80799, Munich, Germany
| | - Beate M Kümmerer
- Institute of Virology, Medical Faculty, University of Bonn, 53127, Bonn, Germany
- German Centre for Infection Research, Partner Site Bonn-Cologne, 53127, Bonn, Germany
| | - Stefan Endres
- Division of Clinical Pharmacology, LMU University Hospital, LMU Munich, Munich, Germany
- Einheit für Klinische Pharmakologie (EKLiP) Helmholtz Zentrum München German Research Center for Environmental Health (HMGU), Neuherberg, Germany
| | - Kilian Schober
- Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
- FAU Profile Center Immunomedicine, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Anne B Krug
- Institute for Immunology, Biomedical Center (BMC), Medical Faculty, LMU Munich, Munich, Germany
| | - Michael Pritsch
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Giovanna Barba-Spaeth
- Institut Pasteur, Université Paris Cité, CNRS UMR 3569, Unité de Virologie Structurale, Paris, France.
| | - Simon Rothenfusser
- Division of Clinical Pharmacology, LMU University Hospital, LMU Munich, Munich, Germany.
- Einheit für Klinische Pharmakologie (EKLiP) Helmholtz Zentrum München German Research Center for Environmental Health (HMGU), Neuherberg, Germany.
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