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Infection and Immunity, April 2002, p. 2022-2028, Vol. 70, No. 4
0019-9567/02/$04.00+0 DOI: 10.1128/IAI.70.4.2022-2028.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
Dstl, Chemical and Biological Sciences, Porton Down, Salisbury, Wiltshire, SP4 0JQ,1 School of Pharmacy, University of London, Bloomsbury, London, WC1N 1AX, United Kingdom2
Received 30 July 2001/ Returned for modification 9 October 2001/ Accepted 30 November 2001
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B. anthracis produces two virulence factors, a poly-D-glutamic acid capsule (8) and a tripartite toxin composed of PA plus either lethal factor or edema factor, resulting in lethal toxin or edema toxin (18). PA is the key component in existing vaccines that protect against anthrax infection. It is an 83-kDa protein, and when it binds to the host cell membrane receptor, it is cleaved and releases a 20-kDa fragment, which exposes the lethal factor-edema factor binding site (14). The resulting 63-kDa protein forms a heptameric pore, the lethal factor or edema factor binds, and the toxin complex is internalized by receptor-mediated endocytosis (6, 20). Therefore, it is clear that inhibition of PA binding to the host cell surface should be a strategy for protection against anthrax infection.
Antibodies to PA are essential for immunity to anthrax infection (22). To protect individuals from pulmonary anthrax infection, the immune effector mechanisms at the lung surface and in the respiratory tract may also need to be primed. This can be achieved by targeting future vaccines to the mucosal immune system. Intranasal (i.n.) immunization is particularly effective at inducing mucosal immunity in the lung (2). Nasal immunization with recombinant PA (rPA) could be facilitated by encapsulation of the protein in polymeric microspheres. This has several advantages compared with more traditional vaccine formulations: it protects the protein from protease degradation; it allows sustained release of the protein in the vaccine, thus reducing the need for frequent boosting; and by making the protein a particulate antigen, it maximizes the immunogenicity of the protein.
In the present study, we investigated the optimum format for presentation of rPA in the context of a microsphere-based formulation. The immunogenicities of formulations were assessed following i.m. and i.n. administration in a two-dose immunization regimen, and the subsequent protective efficacies against both injected and aerosol challenges with anthrax STI spores in the A/J mouse model were determined.
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Microencapsulation of rPA. rPA was entrapped in polymeric microparticles composed of poly-L-lactide (PLLA) (molecular mass, 100 kDa) by using a double emulsion solvent evaporation process. Briefly, lyophilized rPA was dissolved in 0.5 ml of an aqueous solution of 2.5% (wt/vol) polyvinyl alcohol (13 to 23 kDa; 88% hydrolyzed; Aldrich, Dorset, United Kingdom). This primary aqueous phase was vigorously mixed, using a Silverson homogenizer (Silverson Machines, Bucks, United Kingdom), with an oily phase consisting of 0.25 g of PLLA (Polysciences, Warrington, Pa.) dissolved in 5 ml of methylene chloride (CH2Cl2). The resultant water-in-oil emulsion was then added, during vigorous agitation, to 75 ml of 5% (wt/vol) polyvinyl alcohol (13 to 23 kDa; 88% hydrolyzed). Following solvent evaporation overnight, hardened polymeric microparticles were harvested by centrifugation prior to lyophilization. Microspheres were characterized with respect to rPA loading, morphology, and size. Bicinchoninic acid assay (Pierce, Rockford, Ill.) analysis of 1 M NaOH-digested particles was used to ascertain the loading of rPA. Scanning electron microscopy (Cambridge Instruments, Cambs, United Kingdom) and laser diffraction measurements (Malvern Instruments, Worcs, United Kingdom) were used to investigate microsphere size and morphology. The rPA loading of the microspheres was 2.629% ± 0.100% (wt/wt) (entrapment efficiency, 90%). The mean particle size was 9.5 ± 6.8 µm (volume mean) or 2.46 ± 1.53 µm (number mean). The morphology of the rPA-containing microspheres is shown in Fig. 1.
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FIG. 1. Morphology of rPA-containing PLLA microspheres, as viewed by scanning electron microscopy.
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TABLE 1. Adsorbtion of rPA onto empty and loaded 100-kDa PLLA microspheres
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Immunization and challenge studies. (i) Mucosal immune response to free rPA. To assess the immunogenicity of rPA when it was administered i.n., each mouse in groups of five BALB/c mice was given a 5-, 10-, or 20-µg dose of rPA either alone or with 10 µg of cholera toxin B subunit (CTB) (Sigma Chemical Co., Dorset, United Kingdom) in 50 µl of phosphate-buffered saline (PBS). The dose was administered as a mixed protein solution to the lightly anesthetized mouse (inhalational halothane) by direct instillation into the nares. After removal from the anesthetic gas, the mice revived almost immediately. The mice were immunized on days 1 and 28, and prior to booster immunization, blood samples were obtained on days 28 and 70.
(ii) Preliminary immunogenicity and protective efficacy of microencapsulated rPA. To assess the immunogenicity and protective efficacy of a microencapsulated formulation of rPA, groups of six female A/J mice were immunized parenterally with either microencapsulated (formulation 5 [Table 1]) or free rPA or the current United Kingdom anthrax vaccine licensed for use in humans (Centre for Applied Microbiology and Research, Wiltshire, United Kingdom). The mice received 0.4 mg of microspheres, which delivered a 10-µg dose of rPA, 10 µg of free rPA in 100 µl (total volume) of PBS (Oxoid, Basingstoke, United Kingdom), or 100 µl of human anthrax vaccine, which was equivalent to one-fifth of a human dose. All three formulations were injected i.m. by using a three-dose schedule that included boost doses of the microencapsulated and free rPA formulations given 28 and 63 days after the primary immunization and boost doses of the human anthrax vaccine given on days 28 and 42 after the primary immunization. Blood samples were taken on days 42 (prior to the boost immunization) and 84 and used for anti-PA immunoglobulin G (IgG) titer analysis performed with an enzyme-linked immunosorbent assay (ELISA), and the mice were challenged by the intraperitoneal (i.p.) route on day 105 after the primary immunization with 1 x 106 anthrax strain STI spores, as described below.
(iii) Screening of surface-modified microspheres for immunogenicity. In order to enhance the immunogenicity of microencapsulated rPA formulations and therefore reduce the number of doses required to induce a protective immune response, the microspheres were modified by attaching rPA to the sphere surface either by adsorption or lyophilization, as described above. Female BALB/c mice were immunized i.m. with formulations 1 to 6 (but not formulations 2a and 4a) (Table 1). Five mice were immunized per treatment group. Each mouse received 10 µg of rPA in the encapsulated formulation in 100 µl of PBS on days 1 and 21, and mice immunized with either formulation 1 or formulation 3 received an additional 10-µg i.m. dose on day 111 after the primary immunization. The immunizing dose for each animal was divided equally between sites on the hind legs. Blood samples were taken on days 28, 42, 85, and 120 after the primary immunization.
(iv) Protective efficacy of microencapsulated rPA. The two most immunogenic formulations, formulations 2 and 4 (see above), were used for experiments to assess the protection against challenge provided and to ascertain if the immunization route used increased or decreased the protective efficacy. In this and subsequent experiments, female A/J mice were immunized since these mice provide a consistent mouse model for anthrax infection (24). A/J mice were immunized in groups of 10 by either the i.m. route or the i.n. route or by a combination of the two (i.m. primary immunization followed by i.n. boost immunization or vice versa) with the two formulations. Immunization by the i.m. route was carried out as described above. For i.n. immunization, sufficient microspheres to deliver a 10-µg dose of rPA per animal were suspended in 50 µl of PBS and administered to a lightly anesthetized mouse as described above. The animals were primed on day 1 and boosted on day 21. Antibody titers were monitored by taking blood samples on day 28, and the serum was separated and used for analysis by ELISA. Mice were challenged with STI spores by the i.p. route on day 55 of the immunization regimen, as described below.
In a separate experiment, A/J mice (six mice per treatment group) were immunized by using an identical regimen and either the i.m. route, the i.n. route, or a combination of the two routes with second batches of formulations 2 and 4 (formulations 2a and 4a, respectively) that were produced with a greater load of rPA per sphere (Table 1). Each mouse was immunized on days 1 and 21 with sufficient spheres to deliver a 10-µg dose of rPA, and blood samples were taken on days 28 and 45 and used for serum analysis by ELISA. The mice were challenged by the aerosol route with STI spores on day 90 of the immunization regimen.
Injected challenge. For preparation of the challenge inoculum, STI spores were removed from a stock preparation, washed in sterile distilled water, and resuspended in PBS at a concentration of 7 x 108 spores per ml. Aliquots of the spore suspension were removed, and 100-µl portions were used to challenge mice i.p. with 7 x 107 spores per mouse (equivalent to 104 median lethal doses [MLDs] [1]). The spore suspension was diluted and used to challenge immunized mice with 7 x 106 spores per mouse (equivalent to 103 MLDs [1]). The animals were monitored for 14 days after challenge to determine their protected status. Humane end points were strictly observed so that any animal displaying a collection of clinical signs which together indicated that it had a lethal infection was culled.
Aerosol challenge. Aerosol exposure was carried out by using a Henderson-type apparatus (11) and Collison spray (15). Ten-milliliter aliquots of STI spores were suspended in sterile distilled water at a concentration of 109 CFU ml-1, and 3 drops of Antifoam 289 (Sigma) was added just before each preparation was placed in the Collison spray. Mice were placed in groups of up to 20, and only their heads were exposed for 10 min to an airstream containing an aerosol of B. anthracis STI spores generated by the Collison spray and conditioned by the Henderson-type apparatus. The concentration of STI spores in the aerosol was determined by taking samples from the exposure chamber with an All-glass impinger (AGI-30) (16) containing sterile distilled water. Diluted impinger samples were plated onto nutrient agar to determine the number of spores per liter of aerosol. The respiratory volume of the animals was calculated by the method of Guyton (9), and the actual dose inhaled and retained in the lungs was calculated by using the data of Harper and Morton (10). Animals were closely observed for 22 days after challenge to determine their protected status.
ELISA of serum samples to determine antibody titer to rPA. Microtiter plates (Immulon 2; Dynex Technologies) were coated overnight at 4°C with 5 µg of rPA (expressed from B. subtilis [19]) per ml in PBS, except for two rows per plate which were coated with 5 µg of goat anti-mouse antibody binding fragment (FAb) (Sigma) per ml. The plates were washed with PBS containing 1% (vol/vol) Tween 20 and blocked with 5% (wt/vol) skimmed milk powder in PBS (blotto) for 2 h at 37°C. Individual serum samples, double diluted in 1% blotto, were added to the rPA-coated wells and were assayed in duplicate alongside a murine IgG standard (Sigma) added to the anti-FAb-coated wells and incubated overnight at 4°C. After washing, horseradish peroxidase-conjugated goat anti-mouse IgG, IgG1, IgG2a, IgG2b, or IgG3 (Southern Biotechnology Associates Inc.) was added to all wells, diluted 1:2,000 in PBS, and incubated for 1 h at 37°C. The plates were washed again before addition of the substrate 2,2'-azinobis(3-ethylbenzthiazoline-sulfonic acid) (ABTS) (1.09 mM; Sigma). After 20 min of incubation at room temperature, the absorbance at 414 nm was determined for each well (Titertek Multiscan; ICN Flow). Standard curves were calculated by using Titersoft software, version 3.1c. Titers were expressed either in micrograms of IgG per milliliter of serum or as the reciprocal of the end point dilution which gave an absorbance that was 0.1 U greater than the background value. Group means ± standard errors of the means were calculated.
Statistical analysis. The significance of the differences in anti-rPA IgG concentrations for each administration route for formulations 2, 2a, 4, and 4a was determined by analysis of variance followed by a t test suitable for multiple comparisons (7).
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TABLE 2. Immune responses of A/J mice to three 10-µg i.m. doses of rPA given either free or in a microencapsulated formulation on days 1, 28, and 63 and immune responses of A/J mice given the human anthrax vaccine (one-fifth of a human dose) on days 1, 28, and 42a
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TABLE 3. Immune responses of BALB/c mice (n = 5) to either two (formulations 2, 4, 5, and 6) or three (formulations 1 and 3) 10-µg i.m. doses of rPA given as microencapsulated formulations on days 1 and 21 (two-dose regimen) and on days 1, 21, and 111 (three-dose regimen)
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FIG. 2. Anti-rPA IgG concentrations (means ± standard errors of the means; n = 5 for formulations 2 and 4; n = 6 for formulations 2a and 4a) for A/J mice immunized with sufficient formulation 2, 4, 2a, or 4a to deliver a 10-µg dose of rPA by either the i.m. route or the i.n. route on days 1 and 21 of the immunization regimen. Samples were taken 28 days after the primary immunization.
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TABLE 4. Survival of A/J mice immunized on two occasions (days 1 and 21) by the i.m. and i.n routes and challenged by the i.p. route on day 55 with either 103 or 104 MLDs of STI spores
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TABLE 5. Survival 22 days after aerosol challenge of A/J mice (six mice per group) immunized on days 1 and 21 by the i.m. and i.n. routes with sufficient spheres of either formulation 2a or formulation 4a to deliver a 10-µg dose of rPA
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Immunization studies with rPA incorporated into microspheres and gel formers have been described previously (M. Kende, C. Yan, J. Corbett, G. C. Atkins, and S. W. Shalaby, Proc. Int. Symp. Controlled Rel. Bioactivated Mater. 2000, abstr. 0223), and success with microencapsulation has previously been shown in mice with other antigens that protect, for example, against Yersinia pestis infection (3). In this study it was found that for two strains of mice, rPA can be encapsulated in polymeric microparticles without impairment of the immunogenicity and protective efficacy of the protein. In the preliminary trial of the microencapsulated rPA formulation, the circulating anti-rPA IgG concentrations in the formulation 5-immunized mice were approximately one-half those obtained for the mice immunized with free rPA (Table 2). These titers were greater than those in the human anthrax vaccine-immunized mice, which received only one-fifth of a human dose (approximately 0.5 µg of PA, assuming an average vaccine PA content of 2.5 µg per 0.5 ml [13]), 20 times less than the dose of microencapsulated rPA delivered in formulation 5. These data suggest that following i.m. injection, microencapsulated rPA is not processed and presented to the relevant elements in the immune system as effectively as free antigen. It is also feasible that exposure to sheer forces and/or organic solvents during the manufacture of this formulation may have damaged the critical antigenic epitopes of the rPA, reducing its immunogenicity. A number of studies have shown that there is no direct correlation between antibody titer to PA and protection against anthrax infection (12, 22, 25). Despite this, a certain threshold titer of antibody is most likely required for protection, and although microencapsulated rPA formulation 5 was not as immunogenic as free rPA when it was administered by the i.m. route, it induced the threshold titer necessary for protection and produced a level of protection comparable to that provided by the human anthrax vaccine.
Encapsulation and weak binding of antigen to biodegradable polymers can act as a continuous antigen release system, potentially reducing the number of immunizing doses required to elicit a protective immune response. This is important for patient compliance and also if there is a risk of exposure to the pathogen soon after immunization. The original encapsulated rPA formulation tested, formulation 5, was protective after three immunizing doses of rPA-containing microspheres. Compared to the number of doses recommended for the United Kingdom vaccine (four doses over a 6-month period, followed by yearly booster doses [human anthrax vaccine package insert]) or the United States vaccine (six doses over an 18-month period, followed by an annual booster dose [12]), this is a substantial improvement, but the objective was to reduce the number of doses more by further enhancing the presentation of rPA to the immune effector cells.
In addition to microspheres containing entrapped rPA, empty and rPA-containing particles with additional quantities of surface-associated rPA were prepared and tested for immunogenicity. It was anticipated that the immunogenicity of rPA might be improved by association with microparticles and that by using this method the potentially degradative elements that might be encountered during microencapsulation could be avoided. In the screening study, formulations 2 (rPA encapsulated and weakly surface bound) and 4 (rPA weakly surface bound to empty spheres) were found to be particularly promising. These formulations were used in an assessment of protective efficacy in the A/J mouse model and were found to induce protection following only two immunizing doses. In A/J mice there is a positive correlation between the immunizing dose of rPA administered and the protective antibody response stimulated, making this a suitable model for anthrax infection studies (23, 25). Due to the relatively small size of a mouse, the amount of spheres in a PBS suspension that can be administered is limited, and this also limits the immunizing dose of rPA delivered; however, with further modification of the microencapsulated formulations it may be possible to increase the deliverable rPA dose and therefore reduce the number of immunizing doses required to stimulate a protective immune response still further in order to produce a single-dose vaccine.
In this study, we also assessed how the administration route affected the immunogenicities and protective efficacies of formulations 2 and 4, which were selected based on the screening study, and the subsequently produced second batches of these formulations (formulations 2a and 4a). For all four formulations, i.m. priming followed by either i.m. or i.n. boosting resulted in the highest anti-rPA titers, and all immunization route combinations for formulations 2 and 4 protected against an injected challenge with 103 MLDs of anthrax strain STI. There was some breakthrough in protection of the mice immunized with formulation 2 (encapsulated and weakly surface-bound rPA) at the higher injected-challenge level (104 MLDs). Aerosol challenge of mice immunized with formulations 2a and 4a gave results similar to the injected-challenge results; the formulation 4a-immunized mice were fully protected against challenge with 30 MLDs of STI spores, but some breakthrough in protection was observed with the formulation 2a-immunized mice. Despite this, mice that were immunized with any of the four formulations by using a combined i.m.-i.n. schedule were fully protected at all challenge levels against both injected and aerosol challenges, which emphasized the importance of stimulating both the mucosal and systemic immune systems to obtain full protection against these types of challenges. It is perhaps noteworthy that with the exception of the i.n. primed groups, when formulations 4 and 4a were administered by using the same regimen, they did not induce the same magnitude of antibody response. It is unlikely that the performance of the different formulations could be attributed to their rPA contents, since formulation 2 contained more rPA than formulation 4 and indeed formulation 4a contained less rPA than formulation 2a. It is more likely that release of rPA and the accessibility of the rPA to the immune system are more critical criteria for effective induction of protective immunity in response to these formulations.
It has previously been demonstrated that immunization with rPA results in a Th2-directed immune response (26). This was also observed with rPA given as microspheric formulations, independent of the route of administration, showing that there is no qualitative difference in the antibody subclasses stimulated. This indicates that the protective immune mechanisms stimulated by the microsphere-associated rPA are identical to the mechanisms stimulated by the administration of rPA with other adjuvants, such as the alum used in the human anthrax vaccine, although the specific protective immune mechanism stimulated by PA immunization remains unknown.
This study demonstrated that association of rPA with biodegradable microparticles (either by entrapment or by surface association or both) is an effective approach for immunization against anthrax infection. Pharmaceutical modification of rPA in this way appears to facilitate effective delivery of the antigen to inductive sites in the mucosal immune system. We speculate that the immunogenicity of rPA may be further enhanced due to sustained release of the antigen from the polymeric carriers. It is known that microspheric material enters nasally associated lymphatic tissue, draining lymph nodes, and systemic immunological compartments following i.n. delivery. This may also contribute to the effectiveness of microsphere-associated or -entrapped rPA as a mucosal immunogen compared with the effectiveness of soluble rPA. In this study the utility of combined i.m. and i.n. immunization routes was particularly highlighted. This approach could be adapted for human use if an injected primary dose of microencapsulated rPA or rPA with alum as an adjuvant were followed by a nasal booster dose of microencapsulated antigen. This mixed-route regimen may be particularly appropriate because the respiratory tract epithelium is the initial site of infection following inhalation of anthrax spores, and it therefore seems logical to attempt to develop vaccination strategies that evoke appropriate localized responses to counteract the early events of pathogenesis. In this study we confirmed that robust protection against both injected and aerosol challenges with B. anthracis spores can be achieved by utilizing these dual immune mechanisms.
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