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Infection and Immunity, February 2000, p. 796-800, Vol. 68, No. 2
Department of
Microbiology1 and Department of
Pediatrics,2 University of Alabama at
Birmingham, Birmingham, Alabama; Centers for Disease Control
and Prevention, Atlanta, Georgia3;
Molecular Microbiology Unit, Women's and Children's
Hospital, North Adelaide, Australia4;
Pasteur Mérieux Connaught, Swiftwater,
Pennsylvania5; Haartman Institute,
Department of Bacteriology and Immunology, University of Helsinki,
Finland6; and Division of Infectious
Diseases, University of Mississippi Medical Center, Jackson,
Mississippi7
Received 20 October 1999/Returned for modification 12 November
1999/Accepted 17 November 1999
Acquisition of pneumococci is generally from carriers rather than
from infected individuals. Therefore, to induce herd immunity against
Streptococcus pneumoniae it will be necessary to elicit protection against carriage. Capsular polysaccharide-protein
conjugates, PspA, and PsaA are known to elicit some protection
against nasopharyngeal carriage of pneumococci but do not
always completely eliminate carriage. In this study, we observed
that PsaA elicited better protection than did PspA against carriage.
Pneumolysin elicited no protection against carriage. Immunization with
a mixture of PsaA and PspA elicited the best protection against
carriage. These results indicate that PspA and PsaA may be useful for
the elicitation of herd immunity in humans. As PspA and pneumolysin are
known to elicit immunity to bacteremia and pneumonia, their inclusion in a mucosal vaccine may enable such a vaccine to prevent invasive disease as well as carriage.
Infections with Streptococcus
pneumoniae are a major cause of otitis media, meningitis, and
fatal pneumonia worldwide (12). In the developing world,
pneumococci cause over one million fatal respiratory infections per
year in young children and infants (17, 24). Although the
polysaccharide-protein conjugate vaccine presently under development
appears to be efficacious against bacteremic infections with
pneumococci, it will not protect against capsular types not included
among the conjugates comprising the vaccine (S. Black, H. Shinefield,
P. Ray, L. Edwi, B. Fireman, T. K. P. V. S. Group, R. Auystrian, G. Siber, J. Hackell, K. Robert, and I. Chang, Late Breaker
Abstr. 38th Intersci. Conf. Antimicrob. Agents Chemother., abstr. LB-9,
1998) and the vaccine is likely to be too expensive for widespread use
in the developing world. Although the polysaccharide-protein conjugate
vaccines elicit modest protection against carriage, they have not been
reported to eliminate carriage in humans (27) or in a mouse
model (38). Moreover, there is evidence that reduction in
nasopharyngeal carriage of serotypes included in the conjugate vaccine
may be offset by an increase in carriage of potentially invasive
nonvaccine serotypes (27). To provide adequate herd immunity
and widespread protection in the developing world, a new, or modified,
vaccine will be needed. One possibility is to use protection-eliciting
cross-reactive pneumococcal proteins as immunogens (9, 29).
Several pneumococcal proteins are known to elicit protective immunity.
PspA has been shown to inhibit complement fixation in vivo and in vitro
(1, 25, 37) and to elicit protection against fatal
bacteremia and sepsis caused by a broad spectrum of pneumococcus
serotypes (20, 22, 36). Pneumolysin interferes with host
immunity and inflammatory responses by a variety of functions that
include complement fixation at inappropriate sites and inhibition of
appropriate phagocyte functions (3, 4, 28). Pneumolysin also
inhibits ciliary activity in the bronchus and is important in the
pathogenesis of pulmonary infections (1a, 16, 28).
Intranasal (i.n.) immunization of mice with either PspA or
polysaccharide-protein conjugates has been shown to elicit measurable protection against carriage of S. pneumoniae
(38). PspA has also been shown to elicit protection against
otherwise fatal intravenous, i.n., or intratracheal inoculation with
pneumococci (38). PsaA has also been shown to elicit
protection against carriage (B. K. De, J. S. Sampson, E. W. Ades, R. C. Huebner, D. L. Jue, S. E. Johnson, M. Espina, A. R. Stinson, D. E. Briles, and G. M. Carlone,
submitted for publication). It is the product of a gene in an ABC
transporter operon thought to be involved in the transport of manganese
into pneumococci (15). Mutations that block expression of
PsaA do not affect growth of pneumococci in vitro but completely eliminate virulence (5). Although PsaA has been shown to
elicit protection against fatal bacteremia (35), its
protection against sepsis is not as robust as that elicited by PspA
(D. E. Briles, unpublished data).
The present study compares the abilities of PspA and PsaA to elicit
protection against carriage and examines the possibility that an
immunization combining both PspA and PsaA might elicit even better
protection against carriage. The results obtained with PspA and PsaA
were also compared to those obtained with pneumolysin, since the latter
protein has been found to be especially important in the pathogenesis
of pulmonary infections (28). A relatively nontoxic variant
of pneumolysin, PdB, has been shown to elicit protection against fatal
sepsis (2, 30).
Antigens, immunization, and challenge.
Recombinant lipidated
PsaA was prepared as has been previously described by the expression in
Escherichia coli of an 830-bp fragment of pneumococcal DNA
from the psaA gene of the capsular-type 6B strain. The
recombinant PsaA protein is fused at the amino terminus to the 51-bp
signal sequence of Borrelia burgdorferi outer membrane
surface protein encoded by ospA (De et al., submitted). Recombinant PspA/Rx1 (amino acids 1 to 302) was isolated by nickel affinity chromatography from E. coli BL21(DE3) carrying
pUAB055. To construct pUAB055, a 909-bp fragment of pspA
from pneumococcal strain Rx1 was cloned into the pET20b vector of
Novagen, Inc. Between the NcoI and XhoI sites.
Recombinant PspA/Rx1 contains the first 302 amino acids of mature PspA
plus six polyhistidines added through protein fusion at the C-terminal
end. Recombinant protein was isolated by nickel affinity chromatography
as described in the Novagen manual with the exception that elution from
the column was performed in 60 mM imidazole buffer. The isolation of
the recombinant nontoxic pneumolysin (PdB) used in these studies has
been described previously (30).
0019-9567/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Intranasal Immunization of Mice with a Mixture of the
Pneumococcal Proteins PsaA and PspA Is Highly Protective
against Nasopharyngeal Carriage of Streptococcus
pneumoniae
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ABSTRACT
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References
![]()
INTRODUCTION
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References
![]()
MATERIALS AND METHODS
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References
Immune responses and levels of carriage and bacteremia. Saliva was collected from all mice 14 days after the last immunization by standard enzyme-linked immunosorbant assay procedures, where the microtitration plates were coated with the same recombinant proteins used for immunization (33). Serum was collected 17 days after the last immunization from a 75-µl retroorbital bleed (13), and the mice were challenged 18 days after the last immunization. Six days after challenge (42 days after the initial immunization), the pneumococci were washed from mouse nasal passages and were enumerated by plating on modified blood agar as described previously (38, 39). Antibody levels were determined by using an antiimmunoglobulin serum as previously described (38), except that pooled mouse serum containing a standardized amount of antibody to PspA was used as the standard for all three assays. The pooled serum was itself standardized by using purified monoclonal antibody to PspA (21). Thus, the optical density (OD) of antibody to PsaA or pneumolysin was assumed to have the same amount of antibody as an identical OD of antibody to PspA.
Statistics. Statistical comparisons of antibody levels and CFU levels were all carried out on log transformed data by the Wilcoxon and/or Student's t tests. The levels of antibodies to PsaA, PspA, and PdB were expressed as the geometric mean of antibody in micrograms with the standard error factor. The standard error factor is that number by which the geometric mean must be multiplied and divided to obtain, respectively, the upper and lower bounds of standard error. CFU data were expressed as average log10 CFU ± the standard error factor. The lower limit of CFU detected from nasal wash was 60 CFU. Mice with no detectable CFU were assigned a value of 45 CFU for the purposes of calculations.
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RESULTS |
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All three immunogens elicited antibody in the serum and saliva
(Table 1). The highest titers were those
to PsaA, which were almost 10-fold greater than serum antibody levels
to PspA and almost 100-fold higher than mucosal antibody levels to PdB.
The levels of antibodies to PsaA and PspA were higher than the levels of antibody to PdB, even though the mice were given 1/20th as much PsaA
or PspA as PdB.
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With both challenge strains, L82016 and E134, fewer pneumococci were
recovered from mice immunized with PspA than from those given CTB alone
(Tables 2 and
3). The effect of PspA immunization on
carriage was significant, however, only for L82016. Immunization with
PsaA resulted in a >10-fold decrease in E134 carriage and a >100-fold
decrease in L82016 carriage. In each case, the protection afforded by
immunization with PsaA was highly significant. In contrast to the
results with PsaA and PspA, immunization with PdB had no observable
effect on nasopharyngeal carriage.
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We also examined the effects on carriage of immunization with combinations of PspA and either PsaA or PdB. For both challenge strains, immunization with the mixture of PspA and PdB gave no greater protection against colonization than was achieved by immunization with PspA alone. Immunization with the mixture of PspA and PsaA, however, resulted in less carriage of L82016 or E134 than did immunization with either PspA or PsaA alone. In each case, the protection elicited by the mixture of PsaA and PspA was significantly better than that elicited by PsaA or PspA alone (P < 0.05 by both Student's t test and the Wilcoxon test). In the case of L82016, the reduction in the number of CFU resulting from immunization with the PsaA-PspA mixture was almost 1,000-fold. In the case of E134, the reduction was about 300-fold. It is noteworthy that the mixture of PsaA and PspA resulted in greater protection against carriage with E134 than did immunization with PsaA. This synergistic effect of the mixture was observed even though PspA alone resulted in no statistically significant protection against strain E134.
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DISCUSSION |
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This study demonstrated that immunization with both PspA and PsaA, compared to immunization with either protein alone, provided better protection against nasal colonization by pneumococci. This observation suggests that these two molecules play different, and additive, roles in the virulence of pneumococci.
Somewhat surprisingly, the recombinant PspA used in this study was observed to elicit significantly less protection against carriage with L82016 than had been observed in an earlier study in which full-length PspA (about 600 amino acids) was used as the immunogen. There are several possible explanations for this difference in results. The full-length molecule may have important epitopes in the proline-rich and/or choline-binding regions that elicit immunity against carriage but which are absent in the recombinant (amino acids 1 to 302) PspA fragment used here. In the earlier studies, the immunizing PspA was isolated from L82016, so it could also have had important L82016 epitopes lacking in the heterologous rRx1 PspA used here. Finally, although PspA isolated from pneumococci is at least 95% pure (8), it probably contains small amounts of other pneumococcal antigens, such as PspC (7, 11) (also called SpsA and CbpA [18, 31]), which is also thought to be involved in adherence and carriage (31).
PdB was not observed to elicit protection against carriage, even though pneumolysin has been shown to play an important role in pulmonary and systemic infections, and immunity against PdB can elicit protection against fatal challenge by either the i.n. or the intraperitoneal route (2). These results indicate that, with respect to anti-PdB-mediated protection, there must be critical differences between the pneumococcal airway environment in the lung and the mucosal surfaces of the nose. The failure of immunization with PdB to prevent carriage is also consistent with studies using defined, pneumolysin-negative pneumococci, which colonized the nasopharynx of mice as efficiently as did the wild-type parent (32).
In terms of the relative abilities of immunities to the three antigens to protect against carriage, we must bear in mind that much higher levels of antibody were observed in secretions from mice immunized with PsaA than were observed in the secretions of mice immunized with PspA or PdB. Thus, these results do not rule out the possibility that comparable levels of mucosal immunity to PspA or PdB might have elicited as much or more protection against carriage than did PsaA.
The question of how PsaA and PspA elicit protection against carriage remains unanswered. PspA is able to interfere with complement fixation (25, 37), which is important for virulence in invasive models of disease (23). Whether PspA-mediated inhibition of complement plays a role in carriage is not known. We have shown that although PspA can enhance carriage, it is not necessary for carriage (D. E. Briles and A. Virolainen, unpublished data). Thus, PspA most likely does not act as an essential adhesin.
Although PspAs are serologically variable, they can be divided into families (S. K. Hollingshead, R. S. Becker, and D. E. Briles, submitted for publication) which contain highly cross-reactive members (S. K. Hollingshead and D. E. Briles, unpublished data). Strains L82016 and E134 both express PspAs of family 1, the same family as the recombinant Rx1 PspA (S. K. Hollingshead et al., submitted) used for immunization. Family 1 can be further divided into clades 1 and 2 based on their sequence (S. K. Hollingshead et al., submitted), but the proteins in the two clades are so cross-reactive that they cannot be reliably distinguished serologically (S. K. Hollingshead and D. E. Briles, unpublished data).
PsaA is a member of a family of metal-binding lipoproteins and is part of an ABC transporter complex with specificity for manganese and possibly zinc (15). The crystal structure of pneumococcal surface antigen PsaA reveals a metal-binding site and a novel structure for a putative ABC-type binding protein (19). The presence of PsaA is necessary for carriage, but as with PspA, the precise mechanism by which it contributes to carriage is not known. One possibility is that PsaA is required to scavenge the Mn2+ needed for growth in the nasopharynx; alternatively, Mn2+ transported into the cell may act as a signal, resulting in the expression of candidate adhesins such as PspC/CbpA (26).
The best immunization route for elicitation of immunity to carriage of pneumococci is not known with certainty. In the case of Haemophilus influenzae, it is clear that intramuscular immunization of children with polysaccharide-protein conjugates elicits protection against both bacteremia and carriage. In the case of pneumococci, it is possible that optimal immunization against carriage needs to be carried out mucosally. Immunization with conjugate vaccines fails to elicit complete protection against carriage in children (14, 27). In animal studies, it has been shown that subcutaneous immunization with PspA is less able to elicit protection against carriage than is mucosal immunization, even though higher serum antibody titers were elicited by subcutaneous rather than mucosal immunization (38). Preliminary studies with PsaA, however, have demonstrated that parenteral immunization can elicit some immunity to carriage (De et al., submitted).
If mixtures of PsaA and PspA are found to be protective against carriage with most, or all, pneumococcal strains then these antigens could be added to other pneumococcal vaccines (9, 12, 34) to improve their ability to confer herd immunity. Mucosal immunization with pneumococcal proteins can also elicit significant serum antibody responses (38, 41). Moreover, both PspA and PdB have been shown to elicit immunity to bacteremia, sepsis, and/or lung infections (6, 29) (D. E. Briles and J. C. Paton, unpublished data). It is possible, therefore, that a mucosal vaccine containing PsaA, PspA, and possibly PdB could be a stand-alone vaccine that could elicit protection against systemic infection as well as carriage.
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ACKNOWLEDGMENTS |
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We gratefully acknowledge the excellent technical assistance of Robert Fulgham in the conduct of these experiments. These studies also benefited from the advice of Michael Russell.
These studies were conducted with support from the World Health Organization; NIH grants AI21548, AI40645, and HL54818; and the National Health and Medical Research Council of Australia.
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FOOTNOTES |
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* Corresponding author. Mailing address: Department of Microbiology, UAB,658 Bevill Building, 845 19th St. South, Birmingham, AL 35294. Phone: (205) 934-6595. Fax: (205) 934-0605. E-mail: dbriles{at}uab.edu.
Editor: E. I. Tuomanen
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