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Infection and Immunity, February 2004, p. 1184-1187, Vol. 72, No. 2
0019-9567/04/$08.00+0 DOI: 10.1128/IAI.72.2.1184-1187.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Department of Medical Microbiology, Dermatology and Infection, Lund University, Lund,1 Department of Medical Microbiology and Immunology, Göteborg University, Göteborg, Sweden2
Received 10 September 2003/ Returned for modification 9 October 2003/ Accepted 14 November 2003
| ABSTRACT |
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| INTRODUCTION |
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Some human and animal studies have focused on antibodies to GBS at the female genital mucosa (8-12, 24). Although, the role of these local antibodies in the pathogenesis of GBS infection is not clear, it seems reasonable to assume that they may to some extent protect against colonization with GBS (10). It has been reported that mucosal immunization with GBS polysaccharides or inactivated GBS bacteria induces systemic and local antibody responses in mice (8, 9, 12, 24). However, there is no previous report on mucosal immunization with purified GBS proteins.
Earlier studies have shown that parenterally administered cell surface proteins of GBS elicit a systemic IgG response and confer protection against experimental GBS infection (1, 6, 17, 18, 20). This made it of interest to examine if these proteins could also be used in a mucosal GBS vaccine. In the present study, Rib, a well-characterized GBS surface protein that is expressed by many strains causing invasive neonatal infection (17, 25, 26), was combined with recombinant cholera toxin B subunit (CTB) and administered intranasally (i.n.) to mice. The systemic and local IgG and IgA responses were examined. In addition, the protective capacity of this mucosal vaccination was evaluated by lethal intraperitoneal (i.p.) challenge with GBS.
| Preparation of conjugate vaccine. |
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| Immunizations and antibody responses. |
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The titers of IgG and IgA to protein Rib in serum and in genital extracts were determined by ELISA. The wells of microtiter plates (Nunc, Roskilde, Denmark) were coated by incubation overnight at room temperature with 100 µl of a solution of Rib in PBS (0.6 µg/ml). The plates were blocked with 0.1% bovine serum albumin-PBS by incubation for 30 min at 37°C and then washed once with PBS. Samples and controls were added in threefold serial dilutions. As a reference and a positive control, a serum pool from mice immunized with Rib-CTB, Rib+CTB i.n., and Rib s.c. was used. To detect specific antibodies, the plates were washed three times with PBS containing 0.05% Tween (PBST), and horseradish peroxidase-conjugated goat anti-mouse
chains (Jackson Immunoresearch Laboratories, Westgrove, Pa.) diluted 1:3,000 in 0.1% bovine serum albumin-PBST or goat anti-mouse IgA (Southern Biotechnology Inc., Birmingham, Ala.) diluted 1:1,000 in 0.1% bovine serum albumin-PBST was added to the wells. The plates were incubated for 90 min at room temperature. After three washes with PBST, the plates were developed using o-phenylenediamine (Sigma) and H2O2. ELISA titers are given as the reciprocal dilution giving an absorbance of 0.4 above the background level in a microplate reader (Labsystems Multiscan Plus, Helsinki, Finland) at 450 nm.
Intranasal immunization of mice with Rib-CTB or Rib+CTB elicited significant levels of serum IgG to protein Rib (Table 1). In contrast, the IgG response induced by i.n. immunization with Rib alone was approximately 100 times lower (Table 1). In agreement with previous studies (17, 18), s.c. immunization with protein Rib elicited a systemic Rib-specific IgG response (Table 1).
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| Protection against lethal GBS infection. |
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90% lethal dose of log-phase bacteria (BM110) diluted in 0.5 ml of Todd-Hewitt broth. Deaths were recorded daily for 7 days (17). Vaccine efficacy (or protective efficacy) was calculated by the following formula: (mortality in nonvaccinated - mortality in vaccinated)/(mortality in nonvaccinated). Statistical significance was estimated by Fisher's exact test and confidence intervals (CI). The confidence level was set at 0.95. A P value of less than 0.05 was considered statistically significant. Immunization with CTB-Rib or CTB+Rib provided protection against lethal infection with the GBS type III strain BM110 expressing the Rib protein (Fig. 1). Ten of fifteen mice vaccinated with Rib-CTB i.n. and 12 of 15 mice vaccinated with Rib+CTB survived a challenge with a lethal i.p. dose of GBS. The protective efficacy for Rib-CTB was 55% (CI, 37 to 73; P = 0.03) and 73% (CI, 57 to 89; P = 0.005) for Rib+CTB. In agreement with previous reports (17, 18), s.c. vaccination with the Rib protein protected against lethal GBS infection. We observed, however, that even though the amount of the Rib protein used for s.c. immunization was reduced and was given without adjuvant, it still induced sufficient immunity to confer complete protection against lethal GBS infection (P = 0.00002) (Fig. 1).
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| Conclusions. |
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We observed a wide range of antibody responses in some mouse groups (Tables 1 and 2). This variable antibody response was concordant with the individual response patterns for antibodies in both serum and genital tissue. However, since the number of mice in each group was small, it is difficult to draw general conclusions about the levels of antibody response to the different vaccines. The local antibody levels in the female genital tract vary with the stage of the estrous cycle, and it has been shown that pretreatment of mice with progesterone before mucosal immunizations increases the number of antibody-secreting cells in the genital tract not only in response to local vaginal immunization but also in response to i.n. immunization (13). Hence, the individual variation and the level of the antibody response might have been different in the present experiment had the mice been pretreated with hormones.
A relevant question is how the antibody response would be in humans. Although only vaccination studies with humans will give the full answer to this question, some encouraging observations have been published. In one study rhesus monkeys (Macacca mulatta) were immunized i.n. with a streptococcal protein antigen (AgI/II) either chemically conjugated to or mixed with CTB, which resulted in both systemic and local IgG and IgA responses to the vaccine antigens (23). Since these nonhuman primates are phylogenetically close to humans, it seems possible that humans would respond similarly to i.n. immunization with vaccines composed of bacterial protein and CTB. Further, i.n. immunization with CTB in humans has stimulated strong systemic as well as respiratory and vaginal mucosal antibody responses (3, 14, 22). Moreover, recent studies of naturally acquired antibodies to GBS cell surface proteins in different human populations have indicated that antibodies to GBS cell surface proteins are prevalent (10, 15), indicating that these protein antigens indeed are immunogenic also in humans.
The majority of clinically important GBS strains express either of the two proteins Rib or
(17, 25). Previously, we have shown that it is possible to include these two GBS cell surface proteins in a vaccine and elicit protective immunity in mice without any sign of immunogenic competition between the vaccine antigens (18). We conclude that i.n. immunization with a vaccine containing cell surface proteins from GBS strains that are prevalent among pregnant women may be an alternative strategy in the ongoing efforts to design an efficient vaccine against neonatal GBS disease.
| ACKNOWLEDGMENTS |
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We thank Margaretha Stålhammar-Carlemalm for her help and for purified protein Rib, and we thank Gun Wallerström for laboratory assistance.
| FOOTNOTES |
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