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Infection and Immunity, July 2007, p. 3683-3685, Vol. 75, No. 7
0019-9567/07/$08.00+0 doi:10.1128/IAI.01721-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.
PorA Variable Antigenic Regions VR1, VR2, and VR3 of Neisseria meningitidis Serogroups B and C Isolated in Brazil from 1999 to 2004
Ivano de Filippis,1,2*
Claudia Ferreira de Andrade,1
Luciete Silva,3
D. Rebecca Prevots,2 and
Ana Carolina P. Vicente4
National Institute for Quality Control of Health, Oswaldo Cruz Foundation, Rio de Janeiro 21045-900, Brazil,1
National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892,2
Leonidas and Maria Deane Research Center, Oswaldo Cruz Foundation, 69057-070 Manaus, Brazil,3
Genetics Department, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21045-900, Brazil4
Received 26 October 2006/
Returned for modification 24 January 2007/
Accepted 2 May 2007

ABSTRACT
The high genetic diversity found among the PorA regions VR1
and VR2 of 101
Neisseria meningitidis isolates from patients
with meningococcal disease and healthy carriers in Brazil contrasts
with the stability found in the PorA VR3 of these isolates.
The presence of VR3 epitope variant 35 or 36 on the surfaces
of 87% of the strains analyzed suggests that these antigens
should be considered for inclusion in new formulations of vaccines
against serogroup B meningococci in Brazil.

TEXT
Effective vaccines against the diverse group of heterologous
Neisseria meningitidis serogroup B strains remain under development.
Formulations using different outer membrane proteins (OMP),
including vaccines containing multiple PorA variants expressed
by genetically engineered meningococci, have been proposed previously
(
18). However, the interstrain variability of surface-exposed
proteins has restricted the protective efficacy of these vaccines
to a limited number of antigenically related strains. The inclusion
of several OMP, including variants of surface-exposed proteins,
in new vaccine formulations to induce a broader immune response
has been suggested previously (
23). The class 1 transmembrane
protein PorA has been one of the most commonly used targets
in vaccine trials with serogroup B meningococci derived from
locally prevalent epidemic strains in several countries (
2,
3,
4,
9,
12,
13,
17,
21). The PorA surface-exposed loops containing
variable regions 1 and 2, named VR1 (loop I) and VR2 (loop IV),
are used for the determination of meningococcal subtypes (
24).
According to the PorA sequence database (
http://neisseria.org/nm/),
the level of amino acid sequence variation among VR1 and VR2
is considerably high; these regions correspond to 11 and 18
sequence families, respectively, each with a large number of
genetic variants, for a total of 148 variants of VR1 and 389
of VR2 identified to date. Because of the high level of heterogeneity
found in these regions, the PorA vaccines show a narrow range
of specificity for
N. meningitidis strains. A third variable
region, designated VR3, is present on the top of loop V (
24).
The genetic variability of this region has also been studied
previously (
1,
6,
7,
10,
14,
19), and research has revealed
a lower level of genetic variability than that found within
VR1 and VR2. One potential explanation is that loop V, where
VR3 is located, is slightly shorter than loops I and IV, where
VR1 and VR2 are located. For this reason, the VR3 is less exposed
to the immune system and therefore subjected to less selection
pressure; however, the production of bactericidal antibodies
to loop V of PorA after immunization with synthetic peptides
has been described previously (
5,
15).
In this study, we considered the deduced amino acid sequences of VR1, VR2, and VR3 of 78 strains collected from patients with invasive disease reported through the Brazilian meningitis disease surveillance system and diagnosed in different geographic regions of the country from 1999 to 2004 and those of 23 strains isolated from a cluster of healthy carriers associated with a single index case of invasive disease in the Amazonas state in 2002. Among the strains included in this study, 86 belonged to serogroup B and 15 belonged to serogroup C (Table 1). All the strains isolated from carriers belonged to serogroup B. VR1 and VR2 of the same set of invasive strains described here were analyzed in a recent study (8). In the present study, we analyzed the VR3 of this set of invasive strains and VR1, VR2, and VR3 of the 23 carrier strains.
The amplification of the
porA gene was performed using a set
of primers described previously (
11,
14,
20). To assign variable
region sequences to families and variants, deduced amino acid
sequences of VR1 and VR2 were submitted to the
N. meningitidis PorA variable regions database (
http://neisseria.org/nm/typing/pora).
The VR3 variants were classified according to the sequences
described by Clarke et al. (
7).
Overall, 87.1% of the strains (88% of the invasive strains and 82% of the carrier strains) analyzed had one of two VR3 variants (Table 2). In contrast, 8 VR1 and 12 VR2 families corresponding to these strains had been identified. Of the seven VR3 families (designated 35 to 41) described to date, only four (35, 36, 37, and 38) were found among these Brazilian isolates. The most common VR3 family was 36, with 54 strains (53.4%) belonging to this family. The remaining strains were grouped into VR3 families 35 (34 strains; 36.6%), 37 (5 strains; 4.9%), and 38 (8 strains; 7.9%). The great majority of isolates (87.1%) belonged to VR3 family 35 or 36 (Table 1). The lower genetic diversity among VR3 than among VR1 and VR2 in strains from carriers as well as patients suggests that this epitope is actually under less selection pressure. This finding confirms the higher stability of VR3 than of VR1 and VR2, which can be explained in part by the possibly lower level of VR3 loop exposure to the extracellular environment, allowing VR3 to evade selection pressure from the host immune system.
Our finding also suggests the existence of two specific genosubtypes
each corresponding exclusively to invasive (P1.19,15,36) or
carrier (P1.12-5,1,35-1) strains. The population of carriers
from which these strains were isolated is not directly comparable
to the population from which the invasive disease strains were
collected, however, in that the invasive strains were isolated
in states throughout Brazil whereas the carriers were all contacts
associated with a single index case in the state of Amazonas.
For this reason, further studies with invasive disease patients
and carriers from the same outbreak will be needed.
Among the isolates, 32 potential antigenic profiles based on the combinations of VR1, VR2, and VR3 were found (Table 1). The three most common profiles were P1.19,15,36, P1.12-5,1,35-1, and P1.7-1,1,35-1 (Table 1). These three profiles represent 58.7% of the strains analyzed. Among the carrier strains, we found three new VR1 and two new VR2 variants. Finally, a number of strains (n = 7) would have appeared to be identical if VR3 typing had not been performed. The antigenic potential of these profiles has to be determined further.
Several OMP vaccines are used worldwide but show low levels of functional antibody cross-reactivity (22). The wide range of antigenic diversity within VR1 and VR2 has been demonstrated by the emergence of many variants of these two regions. Interestingly and in agreement with results of other studies, we found that among the 101 strains presenting previously described VR3 variants, there were 8 different VR1 families, 12 different VR2 families, and only 4 different VR3 families. Most of the strains with the Cuban vaccine-related genosubtype P1.19,15 presented VR3 family 36, but interestingly, two variants of this antigenic region in these strains were observed, which is probably a consequence of the exposition and selection of this epitope.
Finally, we believe that the inclusion of VR3 families 35 and 36 in new vaccines against serogroup B and C meningococcal strains isolated in Brazil would provide protection against more than of 80% of the genosubtypes found among carriers and invasive disease patients in Brazil. It has been indicated previously that VR1 and VR2 are immunodominant over other PorA loops, but they also show a higher level of genetic diversity, and thus, a vaccine containing a stable epitope such as VR3 may show a higher degree of efficacy against a wider number of strains. For this reason, it would be advisable to study new vaccine formulations using synthetic peptides 35 and 36 of VR3, since the potential of synthetic peptide immunogens to induce a protective immune response against serogroup B meningococci has already been established (5, 15, 16). Additionally, the present study shows the importance of maintaining a surveillance of the PorA variable regions to rapidly and accurately detect the emergence of genetic variations among circulating strains.
Nucleotide sequence accession numbers.
The GenBank accession numbers for porA sequences reported here are DQ094010 to DQ094082 and DQ177161 to DQ177183.

ACKNOWLEDGMENTS
We thank Rachel Urwin and Martin Maiden for their guidance with
porA genotyping carried out at the University of Oxford. This
study made use of the
N. meningitidis PorA typing website (
http://neisseria.org/nm/typing/)
hosted by the University of Oxford and developed by Keith Jolley
and Martin Maiden.
This work was funded by the Instituto Nacional de Controle de Qualidade em Saude (Manguinhos, Brazil) and the Wellcome Trust (United Kingdom).

FOOTNOTES
* Corresponding author. Mailing address: Fundacao Oswaldo Cruz, INCQS, Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21045-900, Brazil. Phone: 55-21-3865-5236. Fax: 55-21-2290-0915. E-mail:
ivano.defilippis{at}incqs.fiocruz.br 
Published ahead of print on 14 May 2007. 
Editor: V. J. DiRita

REFERENCES
1 - Arhin, F. F., F. Moreau, J. W. Coulton, and E. L. Mills. 1998. Sequencing of porA from clinical isolates of Neisseria meningitidis defines a subtyping scheme and its genetic regulation. Can. J. Microbiol. 44:56-63.[CrossRef][Medline]
2 - Bjune, G., E. A. Hoiby, J. K. Gronnesby, O. Arnesen, J. H. Fredriksen, A. Halstensen, E. Holten, A. K. Lindbak, H. Nokleby, E. Rosenqvist, et al. 1991. Effect of outer membrane vesicle vaccine against group B meningococcal disease in Norway. Lancet 338:1093-1096.[CrossRef][Medline]
3 - Boslego, J., J. Garcia, C. Cruz, W. Zollinger, B. Brandt, S. Ruiz, M. Martinez, J. Arthur, P. Underwood, W. Silva, E. Moran, W. Hankins, J. Gilly, J. Mays, and the Chilean National Committee for Meningococcal Disease. 1995. Efficacy, safety, and immunogenicity of a meningococcal group B (15:P1.3) outer membrane protein vaccine in Iquique, Chile. Vaccine 13:821-829.[CrossRef][Medline]
4 - Cartwright, K. A. V., R. Morris, H. Ruemke, A. Fox, R. Borrow, N. Begg, P. Richmond, and J. Poolman. 1999. Immunogenicity and reactogenicity in UK infants of a novel meningococcal vesicle vaccine containing multiple class 1 outer membrane proteins. Vaccine 17:2612-2619.[CrossRef][Medline]
5 - Christodoulides, M., B. T. McGuinness, and J. E. Heckels. 1993. Immunization with synthetic peptides containing epitopes of the class 1 outer-membrane protein of Neisseria meningitidis: production of bactericidal antibodies on immunization with a cyclic peptide. J. Gen. Microbiol. 139:1729-1738.[Abstract/Free Full Text]
6 - Clarke, S. C., M. A. Diggle, and G. F. Edwards. 2001. Semiautomation of multilocus sequence typing for the characterization of clinical isolates of Neisseria meningitidis. J. Clin. Microbiol. 39:3066-3071.[Abstract/Free Full Text]
7 - Clarke, S. C., M. A. Diggle, P. Molling, M. Unemo, and P. Olcen. 2003. Analysis of PorA variable region 3 in meningococci: implications for vaccine policy? Vaccine 21:2468-2473.[CrossRef][Medline]
8 - de Filippis, I., and A. C. Vicente. 2005. Multilocus sequence typing and repetitive element-based polymerase chain reaction analysis of Neisseria meningitidis isolates in Brazil reveal the emergence of 11 new sequence types genetically related to the ST-32 and ST-41/44 complexes and high prevalence of strains related to hypervirulent lineages. Diagn. Microbiol. Infect. Dis. 53:161-167.[CrossRef][Medline]
9 - de Moraes, C. J., B. A. Perkins, M. C. Camargo, N. T. Hidalgo, H. A. Barbosa, C. T. Sacchi, I. M. Landgraf, V. L. Gattas, and H. G. Vasconcelos. 1992. Protective efficacy of a serogroup B meningococcal vaccine in Sao Paulo, Brazil. Lancet 340:1074-1078.[CrossRef][Medline]
10 - Diggle, M. A., and S. C. Clarke. 2003. Detection and genotyping of meningococci using a nested PCR approach. J. Med. Microbiol. 52:51-57.[Abstract/Free Full Text]
11 - Feavers, I. M., and M. C. Maiden. 1998. A gonococcal porA pseudogene: implications for understanding the evolution and pathogenicity of Neisseria gonorrhoeae. Mol. Microbiol. 30:647-656.[CrossRef][Medline]
12 - Findlow, J., S. Taylor, A. Aase, R. Horton, R. Heyderman, J. Southern, N. Andrews, R. Barchha, E. Harrison, A. Lowe, E. Boxer, C. Heaton, P. Balmer, E. Kaczmarski, P. Oster, A. Gorringe, R. Borrow, and E. Miller. 2006. Comparison and correlation of Neisseria meningitidis serogroup B immunologic assay results and human antibody responses following three doses of the Norwegian meningococcal outer membrane vesicle vaccine MenBvac. Infect. Immun. 74:4557-4565.[Abstract/Free Full Text]
13 - Martin, S. L., R. Borrow, P. van der Ley, M. Dawson, A. J. Fox, and K. A. Cartwright. 2000. Effect of sequence variation in meningococcal PorA outer membrane protein on the effectiveness of a hexavalent PorA outer membrane vesicle vaccine. Vaccine 18:2476-2481.[CrossRef][Medline]
14 - Molling, P., M. Unemo, A. Backman, and P. Olcen. 2000. Genosubtyping by sequencing group A, B and C meningococci; a tool for epidemiological studies of epidemics, clusters and sporadic cases. APMIS 108:509-516.[CrossRef][Medline]
15 - Oomen, C. J., P. Hoogerhout, A. M. Bonvin, B. Kuipers, H. Brugghe, H. Timmermans, S. R. Haseley, L. van Alphen, and P. Gros.2003. Immunogenicity of peptide-vaccine candidates predicted by molecular dynamics simulations. J. Mol. Biol. 328:1083-1089.[CrossRef][Medline]
16 - Oomen, C. J., P. Hoogerhout, B. Kuipers, G. Vidarsson, L. van Alphen, and P. Gros. 2005. Crystal structure of an anti-meningococcal subtype P1.4 PorA antibody provides basis for peptide-vaccine design. J. Mol. Biol. 351:1070-1080.[CrossRef][Medline]
17 - Oster, P., D. Lennon, J. O'Hallahan, K. Mulholland, S. Reid, and D. Martin. 2005. MeNZB: a safe and highly immunogenic tailor-made vaccine against the New Zealand Neisseria meningitidis serogroup B disease epidemic strain. Vaccine 23:2191-2196.[CrossRef][Medline]
18 - Peeters, C. C., I. J. Claassen, M. Schuller, G. F. Kersten, E. M. van der Voort, and J. T. Poolman. 1999. Immunogenicity of various presentation forms of PorA outer membrane protein of Neisseria meningitidis in mice. Vaccine 17:2702-2712.[CrossRef][Medline]
19 - Riesbeck, K., P. Orvelid-Molling, H. Fredlund, and P. Olcen. 2000. Long-term persistence of a discotheque-associated invasive Neisseria meningitidis group C strain as proven by pulsed-field gel electrophoresis and porA gene sequencing. J. Clin. Microbiol. 38:1638-1640.[Abstract/Free Full Text]
20 - Russell, J. E., K. A. Jolley, I. M. Feavers, M. C. Maiden, and J. Suker. 2004. PorA variable regions of Neisseria meningitidis. Emerg. Infect. Dis. 10:674-678.[Medline]
21 - Sierra, G. V. G., H. C. Campa, N. W. Varcacel, I. L. Garcia, P. L. Izquierdo, P. F. Sotolongo, G. V. Casanueva, C. O. Rico, C. R. Rodriguez, and M. H. Terry. 1991. Vaccine against group B Neisseria meningitidis: protection trial and mass vaccination results in Cuba. NIPH Ann. 14:195-207.[Medline]
22 - Tappero, J. W., R. Lagos, A. M. Ballesteros, B. Plikaytis, D. Williams, J. Dykes, L. L. Gheesling, G. M. Carlone, E. A. Hoiby, J. Holst, H. Nokleby, E. Rosenqvist, G. Sierra, C. Campa, F. Sotolongo, J. Vega, J. Garcia, P. Herrera, J. T. Poolman, and B. A. Perkins. 1999. Immunogenicity of 2 serogroup B outer-membrane protein meningococcal vaccines: a randomized controlled trial in Chile. JAMA 281:1520-1527.[Abstract/Free Full Text]
23 - Urwin, R., J. E. Russell, E. A. Thompson, E. C. Holmes, I. M. Feavers, and M. C. Maiden. 2004. Distribution of surface protein variants among hyperinvasive meningococci: implications for vaccine design. Infect. Immun. 72:5955-5962.[Abstract/Free Full Text]
24 - van der Ley, P., J. E. Heckels, M. Virji, P. Hoogerhout, and J. T. Poolman. 1991. Topology of outer membrane porins in pathogenic Neisseria spp. Infect. Immun. 59:2963-2971.[Abstract/Free Full Text]
Infection and Immunity, July 2007, p. 3683-3685, Vol. 75, No. 7
0019-9567/07/$08.00+0 doi:10.1128/IAI.01721-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.