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Infection and Immunity, November 2006, p. 6348-6355, Vol. 74, No. 11
0019-9567/06/$08.00+0 doi:10.1128/IAI.01062-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
Centre for Molecular Microbiology and Infection, Department of Infectious Diseases, Flowers Building, Imperial College London, London SW7 2AZ, United Kingdom,1 Centre for Emergency Preparedness and Response, Health Protection Agency, Porton Down, Salisbury SP4 0JG, United Kingdom2
Received 6 July 2006/ Returned for modification 18 August 2006/ Accepted 29 August 2006
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Thirteen serogroups of the meningococci have been identified, based on the chemical and antigenic differences of their capsular polysaccharide (51). Five serogroups (A, C, B, W135, and Y) account for the overwhelming majority of human disease, and there are currently licensed vaccines available against four of these five serogroups (i.e., A, C, Y, and W135) which are directed at their capsular antigens (26). Unfortunately, there is still no universal vaccine against serogroup B strains, the most common cause of meningococcal disease in developed countries, although there has been success with outer membrane vesicle (OMV) vaccines to prevent infections with caused by a single strain (24). Strategies based on the serogroup B capsule, a polymer of
1-8-linked sialic acid, are hampered by its poor immunogenicity and relatedness to a modification of a human neural cell adhesion molecule, NCAM-1 (17, 18). Instead, approaches for developing vaccines against serogroup B infections have focused on surface-exposed, noncapsular antigens including lipopolysaccharide and outer membrane proteins, either individually or in complex preparations such as OMVs (37-41). Several OMV vaccines have undergone clinical trials but are limited by their restricted cross-reactivity against a range of meningococcal isolates and inconsistent immunogenicity among children under 4 years old, the most vulnerable group (7, 48).
The genetic and antigenic diversity of N. meningitidis is a further significant obstacle for the development of vaccines (13). For example, responses against OMVs are mainly directed at highly variable surface proteins and are usually effective against only a subset of closely related strains or those expressing the same variants of surface antigens as in the OMVs. A recent approach based on bacterial genome sequences, termed reverse vaccinology, has identified several promising candidates that elicit the bactericidal antibodies in mice (19). To date, these methods have not led to the production of an effective vaccine against serogroup B N. meningitidis. Therefore, alternative strategies are required for comprehensive vaccines that protect individuals against N. meningitidis disease.
Host defense against meningococcal disease is dependent on both humoral and cellular immune responses (8, 26). Most evidence indicates that the primary mechanism of protection against meningococcal disease is antibody- and complement-mediated bacteriolysis and/or opsonophagocytosis. Protective antibodies can be detected in vitro by measuring serum bactericidal activity (SBA) and using an opsonophagocytosis assay (OPA). Bacterial lysis in the presence of bactericidal antibodies follows the insertion of the membrane attack complex of the complement system into the bacterial outer membrane (21), while the OPA measures the uptake and/or intracellular destruction of N. meningitidis by phagocytic cells (31).
Mucosal colonization with a complex microbial ecosystem is often necessary for the development and maturation of natural immunity against infectious agents. The development of natural immunity against meningococcal disease occurs in all populations, with protection thought to be elicited by nasopharyngeal carriage of N. meningitidis or nonpathogenic Neisseria spp. (53) and other bacteria expressing cross-reactive antigens. Neisseria lactamica is a commensal of the human upper respiratory tract that is closely related to N. meningitidis (5, 47), and colonization with N. lactamica is proposed to promote immunity against the meningococcus (20). N. lactamica is often carried by infants and young children, but colonization rates then decline with age (20); this is the converse of age-specific carriage rates for N. meningitidis (10). However, levels of serum bactericidal antibodies against the meningococcus rise steadily during infancy despite low rates of N. meningitidis carriage. In a longitudinal study, individuals colonized with N. lactamica developed SBA against several serogroups of meningococcus, suggesting that strains of N. lactamica can induce protective immune responses against N. meningitidis (20, 44, 50). Furthermore, it has been shown recently that immunization of mice with OMVs derived from N. lactamica induces protective immunity in the absence of detectable SBA (22, 36).
In the present study, we provide further evidence that N. lactamica contributes to protective immunity against meningococcal infection. Using a murine challenge model, we demonstrate that systemic immunization with N. lactamica generates cross-protective immunity against meningococcal infection and detectable SBA against three important serogroups of N. meningitidis.
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siaD
rfaF) has been described previously (32). All bacteria were grown on brain heart infusion (BHI) plates with Levanthal's supplement in 5% CO2 at 37°C overnight. Immunization with live N. lactamica or N. meningitidis. Groups of 10 to 15 6-week old female BALB/c mice (Harlan) were immunized on days 1, 21, and 28 by intraperitoneal (i.p.) injection of N. lactamica or N. meningitidis. Bacteria were grown overnight on a solid medium and then harvested into phosphate-buffered saline (PBS). The number of CFU was estimated by measuring the absorbance at 260 nm of a lysate of the suspension in 1% sodium dodecyl sulfate (SDS)-0.1% NaOH, and the number of viable bacteria was confirmed by plating to solid media. Animals received 1 x 106 CFU of either N. lactamica or N. meningitidis in BHI medium containing 0.5% (vol/vol) iron dextran (Sigma, Poole, United Kingdom). Control groups consisted of mice given BHI medium with iron dextran alone. On day 43, the animals were challenged with 5 x 106 CFU of the serogroup B N. meningitidis strain MC58. Blood was collected from animals on day 0 by tail vein bleed or on day 35 by cardiac puncture under terminal anesthesia. All animal experiments were carried out under protocols reviewed and approved by the Home Office, United Kingdom. A one-tailed Student's t test was used to detect statistically significant differences in survival.
Whole-cell ELISAs. Whole-cell enzyme-linked immunosorbent assays (ELISAs) were performed to detect antibodies in serum binding to N. meningitidis by previously described protocols with minor modifications (32). Briefly, N. meningitidis and N. lactamica were grown on solid medium, resuspended in coating buffer (0.05 M carbonate-bicarbonate, pH 9.6 [catalog no. 3041; Sigma]), and then heat inactivated at 56°C for 60 min (50). Bacteria were added to the wells of microtiter plates and left overnight at 4°C. After washing with PBS-0.1% Tween 20 (PBS-T), dilutions of control or immune sera were added to the wells, which were incubated for 2 h, and the plate was washed with PBS-T. The binding of antibodies was detected with a horseradish peroxidase-conjugated goat anti-mouse polyclonal antibody (1:200; DAKO, Cambridgeshire, United Kingdom). After a final wash with PBS-T, o-phenylenediamine (Sigma, Poole, United Kingdom) was added for color development at room temperature and readings were taken at 492 nm. All assays were performed in duplicate, and readings for replicate samples analyzed on separate occasions were within 10% of each other. Results were considered positive when the optical density (OD) was more than three times above the maximum value from either wells with no antigen added or those with sera taken before immunization or following immunization with medium alone.
Preparation of bacterial lysates and Western blot analysis. Bacteria were grown overnight, collected, washed, and then adjusted to an OD at 600 nm (OD600) of 6 in PBS. The cells were boiled in the presence of loading buffer (1:1 [vol/vol], 50 mM Tris, pH 6.8, 2% sodium dodecyl sulfate [SDS], 0.1% bromophenol blue, 10% glycerol) for 10 min. The samples were resolved by polyacrylamide gel electrophoresis on 12% SDS-polyacrylamide gels and transferred to polyvinylidene difluoride membranes (Millipore, Stonehouse, United Kingdom) (12). After blocking in PBS-T containing 5% dry milk at 4°C overnight, membranes were incubated with control or immune sera for 2 h at room temperature. Membranes were briefly washed and incubated with a horseradish peroxidase-conjugated secondary antibody (1:200; DAKO, Cambridgeshire, United Kingdom) for another 2 h at room temperature. Following washing, reactivity was detected using the ECL enhanced chemiluminescence detection kit (Amersham Pharmacia Biotech).
FACS analysis. Strains were grown as described above, collected, fixed in 3% paraformaldehyde for 15 min at room temperature, and then washed three times with PBS. Next, 107 CFU were incubated with dilutions of control or immune sera in a total volume of 100 µl for 30 min at 37°C, washed twice, and then resuspended in PBS-T containing a fluorescein isothiocyanate (FITC)-conjugated donkey anti-mouse polyclonal antibody (1:200 dilution; Jackson ImmunoResearch Laboratories, Inc., Bath, United Kingdom) and incubated for 30 min on ice. After washing in PBS-T, fluorescence was measured using a FACSCalibur fluorescence-activated cell sorter (Becton Dickson), recording at least 104 events. Results are presented as the percentage of gated cells; the gate was set at around 5% of cells after incubation in preimmune serum.
Opsonophagocytosis assay. N. meningitidis was grown overnight, harvested, washed with PBS, and then killed by incubation in 3% paraformaldehyde overnight at 4°C. Bacteria were labeled by incubation in 0.25 mg/ml FITC (Fluka BioChemika, Poole, United Kingdom), washed thoroughly in PBS, resuspended in 10% glycerol in PBS, and kept at 80°C until use. HL-60 is a polymorphonuclear neutrophil leukocyte (PMN) cell line derived from a patient with acute promyelocytic leukemia (European Collection of Cell Culture) (9). Cells were differentiated by incubation for 5 days in Hanks' balanced salt solution medium (Gibco, Paisley, United Kingdom) with 0.2% (vol/vol) bovine serum albumin (BSA). For opsonophagocytosis, 20 µl of bacteria (concentration, 108 CFU/ml) was added to the same volume of control or immune serum diluted 1:20 in PBS in the wells of a microtiter plate. The plate was then incubated for 30 min at 37°C with gentle agitation, and then 10 µl of rabbit complement (Mast Diagnostics) was added to each well followed by another incubation for 15 min. Finally, 40 µl of a suspension of differentiated HL-60 cells (concentration, 2.5 x 106/ml) was added to the wells and incubated for 30 min. The reaction was stopped by the addition of 160 µl of ice-cold Hanks' balanced salt solution, and the contents of each well was transferred to an Eppendorf tube containing 400 µl of ice-cold Dulbecco's PBS with 0.02% (wt/vol) EDTA. Samples were kept on ice until analyzed by flow cytometry; at least 104 cells from each sample were evaluated with a horizontal fluorescence gate set to include 5% of the population of cells incubated in the absence of serum. The relative fluorescence index (FI) was calculated (FI = percentage of gated cells multiplied by the geometric mean fluorescence); significant differences were detected with a Student's t test. The FI ratio was calculated by taking the mean of FI of each serum and dividing it by the mean FI of the complement-only controls. Thus, background (complement-only) levels of phagocytosis have a value of 1. All opsonophagocytosis experiments were repeated on at least two occasions.
SBA. Serum bactericidal activity was measured according to internationally standardized methods (8, 25). Twofold dilutions of sera were prepared in sterile 96-well microtiter plates to which were added N. meningitidis strains with rabbit complement (Pel-freeze, Brown Deer, Wis.) and incubated for 1 h. The number of surviving bacteria was determined by plating aliquots of the suspension to solid medium. End point titers were calculated as the reciprocal of the dilution of serum yielding more than 50% bacterial killing; the lower limit of detection for SBA was 4. Each assay included sera from animals before immunization or those immunized with growth medium alone and sera from those vaccinated with a live attenuated N. meningitidis strain. Assays were performed at least in triplicate.
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FIG. 1. Immunization with N. lactamica strains L13 or L18 (shown as filled triangles and circles, respectively) protects against live meningococcal challenge. Groups of 15 animals were vaccinated with YH102 given i.p. on days 0, 21, and 28. Control animals (15 per group) were immunized with either N. meningitidis YH102 (given i.p. [filled diamonds]) or medium alone (given i.p. [open squares]). The survival of animals challenged with 5 x 106 CFU of MC58 on day 43 is shown.
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TABLE 1. Antibodies raised against live N. lactamica strains L13 and L18 recognize antigens on N. meningitidis of serogroups A, B, and Ca
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FIG. 2. Cross-reactivity of anti-N. lactamica mouse sera against whole-cell lysates of Neisseria spp. Proteins were separated by SDS-polyacrylamide gel electrophoresis in 12% acrylamide gels and then transferred to membranes. Each lane was loaded with 10 µl of a lysate of an N. meningitidis or N lactamica isolate (indicated above each lane), and blots were incubated with sera from animals immunized with N. lactamica L13 (A) or L18 (B). The sizes of molecular mass markers (in kDa) are shown.
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FIG. 3. Detection by flow cytometry of cross-reactive epitopes on the surface of N. meningitidis recognized by sera raised against N. lactamica. Isolates of N. meningitidis (A, MC58; B, FAM18; and C, Z2491) were incubated with sera from mice either prior to immunization or after immunization with N. lactamica L13 or L18 or with N. meningitidis YH102 (as indicated in each panel). Percentages of gated cells from three independent assays are shown in panel D. Error bars show the standard error of the mean.
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FIG. 4. Immunization with live N. lactamica elicits opsonophagocytic responses. Uptake of N. meningitidis MC58 by the PMN cell line HL-60 was enhanced in the presence of sera from mice immunized with live N. lactamica strains L13 (dotted line, A) and L18 (dark gray line, A) or a live attenuated N. meningitidis strain, YH102 (black line, A), compared with preimmune sera (light gray line, A). Percentages of gated cells are shown in panel B (performed in triplicate). Error bars show the standard error of the mean.
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TABLE 2. Immunization with live N. lactamica elicits SBAs against a range of meningococcal strainsa
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Although closely related to the meningococcus, N. lactamica does not express a polysaccharide capsule (29). This may be a significant advantage for the development of natural immunity, as the capsule is widely considered to be an unsuitable antigen for preventing serogroup B infections and expression of the capsule could impede the immunogenicity of other surface antigens. Furthermore, N. lactamica does not express PorA, a highly immunogenic and, therefore, highly variable protein on the surface of N. meningitidis (42, 43). Vaccine preparations that contain PorA (such as certain OMVs) tend to elicit responses which are largely directed at this protein and can thus be limited by their lack of coverage against strains expressing other PorA variants (39). Immunization with N. lactamica products therefore has several potential immunologic advantages over preparations of N. meningitidis and could be used to replicate and accelerate the development of natural immunity (23). The sporadic carriage with this commensal during early childhood may explain the susceptibility of some individuals to meningococcal disease; population-based vaccination programs could be used to ensure that coverage is comprehensive. However, there is a potential drawback to using N. lactamica products to prevent meningococcal disease. If the vaccine proved substantially more effective at preventing carriage with N. lactamica than N. meningitidis, the vaccine might afford only partial protection against meningococcal carriage and disease while entirely abolishing the beneficial effects of colonization with circulating N. lactamica.
The only validated immunologic correlate of protection against meningococcal disease is detectable SBA (3, 8, 21). Importantly for vaccine development, SBA is a ready marker of immunity for preclinical assessment of vaccines and provides a suitable end point in clinical trials. The importance of opsonophagocytic killing as a defense mechanism against the meningococcus has been demonstrated recently, with titers of opsonophagocytosis of beads coated with capsular antigen shown to be significantly correlated with SBA directed against capsular antigens (34). In the present study, we have shown that systemic immunization with two strains of N. lactamica (L13 and Y92-1009) elicits high-level bactericidal activity in mice against N. meningitidis strains, including the serogroup B strain, MC58. There are two important implications from this result. First, N. lactamica L18 failed to elicit bactericidal antibodies against any of three meningococcal strains even though the bacterium was given to animals by using precisely the same schedule as the other strains. This indicates that the profiles of antigens expressed by strains L13 and Y92-1009 are distinct from those produced by L18; therefore, N. lactamica strains differ in their immunogenic properties, and it is likely that not all strains can confer protection against N. meningitidis. The likely explanation for this is the considerable genetic diversity among N. lactamica as evidenced by both multilocus sequence typing and differences in gene content and antigen expression (2, 6). This is reflected in the meningococcal antigens recognized by immune sera raised against N. lactamica L13 and L18 (seen in Fig. 2). While immune sera against L13 and L18 reacted with multiple antigens by Western blot analysis, the profile of N. meningitidis proteins detected was distinct, and these differences may account for whether the N. lactamica strains elicit SBA or not. Therefore, knowledge of the antigenic profile of strains of N. lactamica is vital when deciding upon the choice of strain for N. lactamica-based vaccines against N. meningitidis. Of the N. lactamica strains we examined, L13 and Y92-1009 elicited functional responses against the three meningococcal strains. Second, we found that N. lactamica Y92-1009 elicited SBA when administered as a live organism, in contrast to when OMVs or killed cells from this bacterium were used to immunize animals. This could be explained by different routes of administration of the vaccine or different mouse genotypes used in this and a previous study (36). However, the most probable reason for this difference in the immune response is that the antigenic profile of the bacterium grown in vivo is distinct from that during growth in vitro when OMVs or killed whole cells were prepared. The coordinated control of gene expression is vital for microbial virulence (16), and the profile of antigens on the surface of pathogens varies at sites in the host and differs considerably during growth in the laboratory (46).
Although this study provides proof in principle that systemic immunization with live N. lactamica can induce SBA, this is not necessarily the optimal approach for preventing meningococcal infection with vaccines based on this commensal. Systemic immunization with a live organism can be reactogenic, and there have been reported cases of endocarditis and meningitis with N. lactamica (14, 30). Furthermore, there is clear evidence of horizontal DNA transfer between commensal and pathogenic species of Neisseria (15, 33), raising the concern that a vaccine strain could acquire virulence traits from pathogenic species. A more feasible approach might be the mucosal administration of N. lactamica; further studies are under way to determine the susceptibility of experimental animals to colonization with this commensal and its ability to generate systemic immune responses. N. lactamica is known to harbor genes related to those necessary for expression of type IV pili (1), which mediate host-specific adhesion of the meningococcus to human cells (35). Therefore colonization with N. lactamica may be inefficient unless the experimental host expresses an appropriate form of CD46 (27), the receptor proposed to be recognized by type IV pili (28).
Of much more potential value for vaccine design is that our findings demonstrate that strains of N. lactamica differ in their ability to produce functional immune responses against N. meningitidis. Understanding the basis for this observation should lead to the identification of those N. lactamica antigens that mediate cross-reactive protective immunity and the development of natural immunity. Additionally, defining the reason why live bacteria, but not OMVs or heat-killed bacteria, can elicit SBA in immunized animals may also help to pinpoint important antigens. These could then be incorporated into subunit vaccines for protecting of individuals against disseminated meningococcal infection.
This work was supported by the Meningitis Research Foundation.
Published ahead of print on 11 September 2006. ![]()
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