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Filamentous hemagglutinin (FHA) is an important adhesin of the whooping cough agent Bordetella pertussis and is contained in most acellular pertussis vaccines. Recently, FHA was proposed to exert an immunomodulatory activity through induction of tolerogenic IL-10 secretion from dendritic cells. We have re-evaluated the cytokine-inducing activity of FHA, placing specific emphasis on the role of the residual endotoxin contamination of FHA preparations. We show that endotoxin depletion did not affect the capacity of FHA to bind primary human monocyte-derived dendritic cells, while it abrogated the capacity of FHA to elicit TNF-α and IL-10 secretion and strongly reduced its capacity to trigger IL-6 production. The levels of cytokines induced by the different FHA preparations correlated with their residual contents of B. pertussis endotoxin. Moreover, FHA failed to trigger cytokine secretion in the presence of antibodies that block TLR2 and/or TLR4 signaling. The TLR2 signaling capacity appeared to be linked to the presence of endotoxin-associated components in FHA preparations and not to the FHA protein itself. These results show that the endotoxin-depleted FHA protein does not induce cytokine release from human dendritic cells. [ABSTRACT FROM AUTHOR]

Abstract: Bacterial polysaccharide–protein conjugate vaccines (Haemophilus influenzae type b [Hib], pneumococcal and meningococcal conjugates) have revolutionized pediatric vaccination strategies. The widely used carrier proteins are tetanus toxoid (TT), diphtheria toxoid (DT) and diphtheria toxoid variant CRM197 protein, DT conjugates being in general less immunogenic. Multivalent conjugates using TT were found to be at risk for reduced polysaccharide responses, whilst multivalent CRM197 conjugates are at lower risk for this, but may be at higher risk of inducing bystander interference, particularly affecting Hib and hepatitis B immune responses. Novel carriers avoiding these issues could enable the further development of pediatric schedules and combinations. [Copyright &y& Elsevier]

Abstract: Background: In contrast to the other vaccine serotypes, no protection could be demonstrated in the POET study against serotype 3 acute otitis media (AOM) following primary and booster vaccination with a multi-valent pneumococcal conjugate vaccine. Methods: AOM efficacy and immunogenicity data were reviewed. Pheno- and genotypic characteristics of different serotype 3 strains including efficacy study AOM isolates were evaluated. Results: Evaluation of vaccine efficacy before and after booster vaccination indicated that lack of efficacy against serotype 3 pneumococci might have been due to declined protection following the booster dose. However, although atypical immunogenicity was observed for serotype 3 in the second year of life, the capacity to respond to serotype 3 plain polysaccharide was not impaired. All but one of the serotype 3 strains examined had abundant polysaccharide capsules. Comparison of serotype 3 capsular polysaccharide biosynthesis gene sequences found no relevant differences between any of the serotype 3 strains, but mRNA transcript levels were lower for the less densely encapsulated strain. Conclusion: Lack of clinical efficacy against serotype 3 AOM following pneumococcal conjugate vaccination may be due to an impaired induction of immune memory. A possible alternative explanation may lie with the atypically abundant expression of capsular polysaccharide which could make serotype 3 strains less susceptible to anti-polysaccharide antibody defence mechanisms in the middle ear. The occurrence of acapsular forms during biofilm growth may also play a role. Clinical impact against otitis media, of vaccines containing pneumococcal serotype 3 components, remains unclear until further investigations have demonstrated the value. [Copyright &y& Elsevier]

The widespread use of whole-cell pertussis vaccines in the second half of the 20th century have reduced the incidence of the disease significantly. However, in some countries, concerns about the reactogenicity and potential neurological damage associated with whole-cell vaccines led to a decrease in vaccine acceptance and an increase in morbidity and mortality of pertussis in several countries. This prompted the development of less reactogenic acellular pertussis vaccines combined with diphtheria and tetanus toxoids, initially in Japan and later in other countries. In Europe, the improved diphtheria, tetanus and acellular pertussis (DTPa) vaccine was first introduced in March 1994.The pertussis component of this DTPa vaccine, developed by Glaxo SmithKline, consists of pertussis toxoid, filamentous haemagglutinin and pertactin. The vaccine is well tolerated, with a lower incidence of adverse reactions than after administration of whole-cell vaccines.The long-lasting efficacy and effectiveness of DTPa vaccines have been extensively documented and these are now the cornerstone of a large range of combined vaccines including DTPa–hepatitis B (HBV), DTPa–inactivated polio (IPV) and DTPa–HBV–IPV. A lyophilised Haemophilus influenzae type b (Hib) vaccine can be reconstituted with all of these liquid combinations. The introduction of well-tolerated and efficacious DTPa vaccines and their more polyvalent combinations has improved the acceptance and simplified the implementation of childhood immunisation. This paper is a review of the technical and scientific difficulties encountered and the lessons learned over the 10-year period that it took to develop and introduce six multivalent vaccines using the Glaxo SmithKline DTPa as a building block. [Copyright &y& Elsevier]

Invasive extraintestinal pathogenic Escherichia coli (ExPEC) disease (IED), characterised by sepsis and bacteraemia, is a major global healthcare concern worsened by emerging multidrug resistant (MDR) strains. The development of multivalent prophylactic vaccines targeting E. coli strains of IED-associated O-serotypes could address this. A better understanding of O-serotype distribution is required for this purpose. Here, we characterised O-serotype prevalence and drug resistance among ExPEC bacteraemia isolates in Japan. E. coli blood isolates from patients aged ≥60 years with bacteraemia were obtained from a retrospective surveillance study in Japan (2015–2017). O-serotyping was performed by agglutination; for isolates non-typeable by agglutination, O-genotyping was performed. Antimicrobial susceptibility was evaluated by broth microdilution using a 21-antibiotic panel. The frequency of drug resistant (DR) isolates was evaluated by antimicrobial susceptibility testing. Of 401 ExPEC bacteraemia isolates evaluated, the most prevalent O-serotype (≥1%) was O25 (28.7% [n = 115]), followed by O1 (14.2% [n = 57]), O2 (8.5% n = 34]), O6 (5.5% [n = 22]), O75, O18, O13, O16, O15, O4, O46/O134, O86, O8 and O83 (each <5% prevalence). These 14 O-serotypes accounted for 81.5% of isolates collected. In total, 19% (n = 77) of isolates were DR ≥ 3, of which 59.7% were O25. Fluoroquinolone-resistance among all and O25 isolates was most prevalent (35.7% and 84.3%, respectively). Almost all (98%) isolates identified as O25 were of subtype O25B. E. coli serotype O25B showed the highest prevalence and highest multidrug resistance among ExPEC bacteraemia isolates from patients ≥60 years in Japan. Our data may inform development of multivalent glycoconjugate vaccines to prevent IED. [ABSTRACT FROM AUTHOR]

Highlights: [•] Adult volunteers vaccinated with experimental Neisseria meningitidis serogroup B vaccines elicit cross-bactericidal antibodies. [•] Immuno-proteomics on a heterologous meningococcal strain identifies potential targets of these cross-bactericidal antisera. [•] Increases in bactericidal activity against the heterologous strain correlates with immune-proteome blot reactivity. [•] Well-known antigens such as Rmp, Opa, porB and FpbA are identified within the immune-proteome. [•] Important novel antigens e.g. putative cell binding factor, exoployphosphatase and glutamyltranspeptidase are also identified. [ABSTRACT FROM AUTHOR]

Abstract: Development of meningococcal serogroups A, C, W-135 and Y conjugate vaccines could expand coverage against devastating meningococcal diseases. The immunogenicity of one dose of each one of five MenACWY-TT formulations versus a licensed ACWY polysaccharide vaccine was evaluated in 175 healthy subjects of 15–25 years. Serum bactericidal titers (rSBA) were evaluated before and after vaccination. The percentage of rSBA responders to each serogroup A, C, W-135 and Y did not statistically differ from the control for each of the five formulations except for serogroup A that was lower after administration of one formulation. In the 3-year follow-up of the first study where the latter formulation was assessed, bactericidal antibody persistence was similar to the licensed ACWY polysaccharide vaccine for MenA and MenC and higher for MenW-135 and MenY. Our results present five investigational MenACWY-TT conjugate vaccine formulations which are well tolerated and highly immunogenic in adolescents. [Copyright &y& Elsevier]

• O-serotype prevalence in a tetravalent and decavalent ExPEC vaccine was studied. • By both agglutination and PCR, prevalence was higher for the decavalent vaccine. • Results also indicated protection against antibiotic-resistant ExPEC isolates. • An ExPEC vaccine may have potential for prophylaxis of post-procedure infections. There is an increasing incidence of infectious complications caused by extraintestinal pathogenic Escherichia coli (ExPEC) after transrectal ultrasound-guided prostate needle biopsy (TRUS-PNB), and a need for prophylaxis methods effective against associated antibiotic–resistant organisms. We aimed to identify the O-serotypes of ExPEC isolates collected in a sample of 60 patients with invasive ExPEC disease (IED) after TRUS-PNB, by serotype–specific agglutination and polymerase chain reaction (PCR) assays. The prevalence of O–serotypes included in a tetravalent ExPEC vaccine was 38.3% by agglutination and 46.7% by PCR, while the prevalence of O-serotypes included in a decavalent vaccine was 58.3% and 73.3%, respectively. Therefore, compared to the tetravalent vaccine, the decavalent vaccine would theoretically provide coverage for serotypes carried by a higher proportion of circulating ExPEC in patients undergoing TRUS-PNB, including a high proportion of antibiotic-resistant organisms. [ABSTRACT FROM AUTHOR]

Background: ExPEC4V (JNJ-63871860) is a bioconjugate vaccine, containing O-antigens from Escherichia coli serotypes O1A, O2, O6A, and O25B, developed for the prevention of invasive extra-intestinal pathogenic E coli (ExPEC) disease. We aimed to assess safety, reactogenicity, and immunogenicity of ExPEC4V in healthy adults.Methods: In this phase 2 randomised, double-blind placebo-controlled study, we recruited healthy adults (≥18 years with a body-mass index of 35 kg/m2 or less) between Nov 16, 2015, and Aug 8, 2017, and randomly assigned them to receive a single dose of ExPEC4V (antigen O1A:O2:O6A:O25B content 4:4:4:4 μg [group 1]; 4:4:4:8 μg [group 2], 8:8:8:8 μg [group 3], 8:8:8:16 μg [group 4], or 16:16:16:16 μg [group 5]) or placebo. The primary objectives were evaluation of the safety, tolerability, and immunogenicity of ExPEC4V and determination of its dose-dependent immunogenicity 15 days after vaccination by ELISA in individuals who had received at least one vaccination dose. Antibody titres and safety evaluation were used to select two ExPEC4V doses for assessment up to day 360. This trial is registered at ClinicalTrials.gov, number NCT02546960.Findings: Of 848 enrolled participants, 843 (99%) received the ExPEC4V vaccine (757) or placebo (86) and were included in the safety analysis. Of 757 participants vaccinated with ExPEC4V, 222 (29%) had a solicited local adverse event and 325 (43%) had any solicited systemic adverse event, compared with 11 (13%) and 30 (35%) of 86 participants in the control group. Symptoms were mild-to-moderate. The most frequently reported solicited local adverse event was pain or tenderness (205 [27·1%] of 757 in combined ExPEC4V groups) and the most frequently reported solicited systemic adverse event was fatigue (208 [27·6%] of 757). Only 13 (2%) of 843 had a grade 3 event. At day 15, 80% or more of all participants achieved a two times or greater increase in serotype-specific IgG antibodies (except O25B at the lowest dose, 103 [72%] of 144). At day 360, 66% (95% CI 56·47-74·33) of participants in group 2 and 71% (62·13-78·95) of participants in group 4 selected for long-term follow-up maintained a two times or greater increase in serotype-specific antibody compared with baseline.Interpretation: EXPEC4V seemed well tolerated and elicited robust and functional antibody responses across all serotypes, doses, and age groups. For the two dosages evaluated (4:4:4:8 μg and 8:8:8:16 μg), the immune response persisted for 1 year.Funding: Janssen Pharmaceuticals. [ABSTRACT FROM AUTHOR]

Highlights • Pertussis resurgence suggests low efficacy of existing vaccines. • New strategies to improve aP vaccines efficacy are urgently needed. • Pertactin-negative isolates have the potential to negatively impact aP efficacy. • Extra FIM2/3 reduces lung colonization and enhances aP efficacy in murine model. • Additional amounts of FIM2/3 do not change biomarkers of reactogenicity. Abstract Current acellular-pertussis (aP) vaccines appear inadequate for long-term pertussis control because of short-lived efficacy and the increasing prevalence of pertactin-negative isolates which may negatively impact vaccine efficacy. In this study, we added fimbriae (FIM)2 and FIM3 protein to licensed 2-, 3- or 5-component aP vaccines (Pentavac®, Boostrix®, Adacel®, respectively) to assess whether an aP vaccine with enhanced FIM content demonstrates enhanced efficacy. Vaccine-induced protection was assessed in an intranasal mouse challenge model. In addition, potential reactogenicity was measured by biomarkers in a human whole blood assay (WBA) in vitro and benchmarked the responses against licensed whole cell pertussis (wP) and aP vaccines including Easyfive®, Pentavac® and Pentacel®. The results show that commercial vaccines demonstrated reduced efficacy against pertactin-negative versus pertactin-positive strains. However, addition of higher amounts of FIM2/3 to aP vaccines reduced lung colonization and increased vaccine efficacy against a pertactin-negative strain in a dose-dependent manner. Improvements in efficacy were similar for FIM2 and FIM3-expressing strains. Increasing the amount of FIM2/3 proteins in aP formulations did not alter vaccine-induced biomarkers of potential reactogenicity including prostaglandin E 2 , cytokines and chemokines in human newborn cord and adult peripheral blood tested in vitro. These results suggest that increasing the quantity of FIM proteins in current pertussis vaccine formulations may further enhance vaccine efficacy against B. pertussis infection without increasing the reactogenicity of the vaccine. [ABSTRACT FROM AUTHOR]

Background Extra-intestinal pathogenic Escherichia coli (ExPEC) are major human pathogens; however, no protective vaccine is currently available. We assessed in animal models the immunogenicity and safety of a 4-valent E. coli conjugate vaccine (ExPEC-4V, serotypes O1, O2, O6 and O25 conjugated to Exotoxin A from Pseudomonas aeruginosa (EPA)) produced using a novel in vivo bioconjugation method. Methods Three doses of ExPEC-4V (with or without aluminum hydroxide) were administered to rabbits (2 μg or 20 μg per O-antigen, subcutaneously), mice (0.2 μg or 2 μg per O-antigen, subcutaneously) and rats (0.4 μg or 4 μg per O-antigen, intramuscularly). Antibody persistence and boostability were evaluated in rats using O6-EPA monovalent conjugate (0.4 μg O-antigen/dose, intramuscularly). Toxicity was assessed in rats (16 μg total polysaccharide, intramuscularly). Serum IgG and IgM antibodies were measured by ELISA. Results Robust antigen-specific IgG responses were observed in all animal models, with increased responses in rabbits when administered with adjuvant. O antigen-specific antibody responses persisted up to 168 days post-priming. Booster immunization induced a rapid recall response. Toxicity of ExPEC-4V when administered to rats was considered to be at the no observed adverse effect level. Conclusions ExPEC-4V conjugate vaccine showed good immunogenicity and tolerability in animal models supporting progression to clinical evaluation. [ABSTRACT FROM AUTHOR]

Background The protection elicited by polysaccharide pneumococcal vaccines against community-acquired pneumonia in older adults remains debatable. Alternative vaccine targets include well-conserved pneumococcal protein antigens, such as pneumococcal histidine triad protein D (PhtD). Objective To evaluate humoral and cellular immune responses and safety/reactogenicity following immunisation with PhtD vaccine with or without adjuvant (alum or AS02 V ) in older (≥65 years) and young (18–45 years) healthy adults. Methods Two phase I/II, single-blind, parallel-group studies were conducted in 150 older and 147 young adults. Participants were randomised to receive 2 doses (months 0 and 2) of PhtD 30 μg, PhtD 10 μg plus alum, PhtD 30 μg plus alum, PhtD 10 μg plus AS02 V or PhtD 30 μg plus AS02 V , or the 23-valent polysaccharide pneumococcal vaccine (23PPV) at month 0 with placebo (saline solution) at month 2. Safety/reactogenicity was assessed. PhtD-specific antibody, T cell and memory B cell responses were evaluated. Results Solicited adverse events were more common in young participants and with adjuvanted vaccines. No vaccine-related serious adverse events were reported. Although anti-PhtD geometric mean antibody concentrations (GMCs) were consistently lower in the older adult cohort than in young adults, GMCs in the older cohort following PhtD 30 μg plus AS02 V were comparable to those induced by plain PhtD or PhtD 30 μg plus alum in the young cohort. Compared with alum adjuvant, AS02 V adjuvant system was associated with an increased frequency of PhtD-specific CD4 cells in both cohorts and a significantly higher specific memory B cell response in the older cohort, similar to responses obtained in the young cohort. Conclusion The improved immune response to PhtD vaccine containing the AS02 V adjuvant system in comparison to alum suggests that the reduced immune response to vaccines in older adults can be partially restored to the response level observed in young adults. ClinicalTrials.gov identifiers: NCT00307528 / NCT01767402 . [ABSTRACT FROM AUTHOR]

Abstract: Neisseria meningitidis may be classified according to the lipooligosaccharide immunotype. We show that this classification can be achieved by PCR genotyping of the genes involved in the lipooligosaccharide inner-core biosynthesis, lpt3, lpt6, lgtG and lot3. Genotyping data correlated well (90–100%) with mass spectrometry data and was, therefore, applied to screen a random subset of recent N. meningitidis serogroup B isolates from Europe. Analysis of the proportion of the different lipooligosaccharide types highlighted the predominance of L3 strains. Surprisingly, high rates of L2 type strains were found in Spain (17%, versus 2.5% in Germany and 1.9% in the United Kingdom). Therefore, we also investigated further these Spanish L2 strains in an attempt to explain such prevalence despite the known sensitivity of L2 immunotype to complement. We explored the hypothesis that these strains express high amounts of factor H-binding protein (fHbp), but we found, on the contrary, that L2 strains express low or undetectable amounts of fHbp. Our findings suggest that, in addition to a genetic analysis, a multivalent approach may be necessary to estimate the effectiveness of a N. meningitidis serogroup B vaccine. [Copyright &y& Elsevier]

Abstract: Infections caused by Streptococcus pneumoniae are a major cause of mortality throughout the world. Protein-based pneumococcal vaccines are envisaged to replace or complement the current polysaccharide-based vaccines. In this context, detoxified pneumolysin (dPly) and pneumococcal histidine triad protein D (PhtD) are two potential candidates for incorporation into pneumococcal vaccines. In this study, the protective efficacy of a PhtD–dPly vaccine was evaluated in a rhesus macaque (Macaca mulatta) model of pneumonia. The animals were immunized twice with 10μg of PhtD and 10μg of dPly formulated in the Adjuvant System AS02 or with AS02 alone, before they were challenged with a 19F pneumococcal strain. The survival was significantly higher in the protein-vaccinated group and seemed to be linked to the capacity to greatly reduce bacterial load within the first week post-challenge. Vaccination elicited high concentrations of anti-PhtD and anti-Ply antibodies and a link was found between survival and antibody levels. In conclusion, AS02-adjuvanted PhtD–dPly vaccine protects against S. pneumoniae-induced pneumonia. It is probable that the protection is at least partially mediated by PhtD- and Ply-specific antibodies. [Copyright &y& Elsevier]

Abstract: Several vaccines are available against pertussis, differing by the number of Bordetella pertussis antigens that they contain as well as their formulation. The GlaxoSmithKline Biologicals (GSK Bio) tricomponent DTPa vaccine (DTPa3, Infanrix™), and the Sanofi-Pasteur (SP) five-component formulation (DTPa5, Pediacel™) were shown to have comparable short-term efficacy in clinical trials. However, potential differences in long-term protection were recently suggested, which might reflect the elicitation of different specific immune memory by the two vaccines. Therefore, the purpose of the present study was to investigate in mice the immune responses against B. pertussis, and particularly the establishment of specific B cell memory after immunization with DTPa3 and DTPa5 vaccines. Whereas intranasal challenge experiments showed similar protection with both vaccines, DTPa3 induced higher antibody levels to FHA and PRN than DTPa5. Further, the frequency of memory B cells was investigated by B cell ELISPOT. Higher frequencies of PT- and PRN-specific memory B cells were evidenced after vaccination with DTPa3, compared with DTPa5. Although the origin of such difference is unclear, the use of two different adjuvants (aluminum phosphate versus hydroxide) is proposed as a possible explanation. In conclusion, this study proposes that the induction of higher levels of B. pertussis antigen-specific memory B cells with DTPa3 participate to the suggested longer persistence of protection observed with this vaccine, as compared with DTPa5. [Copyright &y& Elsevier]

Abstract: The pneumococcal polysaccharide conjugate vaccine which includes a nonacylated protein D carrier from Haemophilus influenzae has been recently licensed for use in many countries. While this vaccine is protective against nontypeable Haemophilus influenzae (NTHI)-induced acute otitis media (OM), the mechanism underlying this protective efficacy is not yet fully understood. Protein D/glycerophosphodiester phosphodiesterase (PD/GlpQ) is an outer membrane lipoprotein expressed by NTHI that has been ascribed several functions, including host cell adherence and phosphorylcholine (PCho) acquisition. We found that a pd/glpQ NTHI mutant exhibited reduced adherence to airway epithelial cells, diminished phosphorylcholine (PCho) decoration of biofilms, and compromised fitness during experimental acute OM compared to the parent strain. We also found that exposure of NTHI to antibodies directed against the vaccine formulation recapitulated the PCho decoration and NTHI adherence phenotypes exhibited by PD/GlpQ-deficient NTHI, providing at least two likely mechanisms by which the pneumococcal polysaccharide-PD/GlpQ conjugate vaccine induces protection from NTHI-induced OM. [ABSTRACT FROM AUTHOR]

Abstract: Following primary and booster vaccination with an 11-valent pneumococcall protein D conjugate vaccine there was a 42.8% (95% CI: −16.7 to 71.9, ns) reduction in the carriage of Streptococcus pneumoniae vaccine serotypes and a 42.6% (95% CI: 1.3–66.6) reduction in the carriage of Haemophilus influenzae identified by standard microbiological techniques. When PCR and immunoblot assays were used to further improve specificity of non-typeable H. influenzae strain identification, carriage of H. influenzae was still reduced with 38.6% (95% CI: −6.3 to 64.6, ns). Reduction of acute otitis media (AOM) episodes preceded the impact on carriage. These data provide further support of the functional role of the protein D immunity. [Copyright &y& Elsevier]

Abstract: We assessed the development and role of serum anti-CbpA and -PhtD in early childhood in relation to pneumococcal exposure. Serum IgG concentrations to CbpA and PhtD were measured with enzyme immunoassay in serum samples collected at the ages of 6, 12, 18, and 24 months from 50 healthy children and from 50 adults. Furthermore, antibodies to CbpA, PhtD and the C-terminal fragment of PhtD (PhtD C) were measured in serum samples collected at 12 (N =286) and 18 months (N =259) to evaluate the risk of subsequent pneumococcal acute otitis media (AOM) in relation to antibody concentrations. The increase in anti-CbpA and -PhtD concentrations was related to prior pneumococcal exposure. At 12 and 18 months, in the risk model of pneumococcal AOM adjusted for prior pneumococcal AOM, higher concentrations of anti-CbpA, but not anti-PhtD, were associated with a lowered risk of subsequent pneumococcal AOM. In conclusion, pneumococcal exposure induces the development of serum anti-CbpA and -PhtD in early childhood. Anti-CbpA antibodies may play a role in the prevention of subsequent pneumococcal AOM during the second year of life. [Copyright &y& Elsevier]

Abstract: This study examined the vaccine potential of the autotransporter protein BrkA of Bordetella pertussis in the sublethal intranasal murine respiratory challenge model of infection. Five different acellular pertussis (Pa) vaccines, containing different pertussis-component antigens but all comprizing diphtheria (D) and tetanus (T) toxoids, were tested. A two-pertussis-component DTPa vaccine containing pertussis toxoid (PT) and filamentous hemagglutinin (FHA) induced only limited bacterial clearance. However, a three-pertussis-component DTPa vaccine containing PT, FHA and a recombinant BrkA protein (rBrkA) was found to be as efficacious in protecting mice against colonization by B. pertussis strains Tohama I and 18-323 as the commercial Infanrix™ vaccine that also includes PT and FHA but pertactin (PRN) instead of rBrkA. Vaccination of mice with rBrkA as the only B. pertussis antigen did not protect against colonization by B. pertussis. We also demonstrated that BrkA is ubiquitously expressed by highly prevalent clinical isolates of B. pertussis and suggest that new acellular pertussis vaccine formulations that include BrkA have equivalent efficacy as currently available DTPa vaccines against B. pertussis infections. [Copyright &y& Elsevier]

Abstract: Immunogenicity and safety of a novel combined Haemophilus influenzae type b-Neisseria meningitidis serogroups C and Y-tetanus-toxoid conjugate vaccine (Hib-MenCY-TT) candidate was evaluated when co-administered with DTPa-HBV-IPV(Pediarix™ 3 [3] Pediarix is the Trademark of the GlaxoSmithKline group of companies. )+PCV7(Prevnar™ 4 [4] Prevnar is the Trademark of Wyeth. ) at 2–4–6 months of age. Anti-PRP concentrations ≥1.0μg/mL were observed in 92.9–98.7%, rSBA-MenC/Y titres ≥1:8 in >98%, rSBA-MenC/Y titres ≥1:128 in >95.8 and >89.9% subjects. PRP and MenC responses were similar to respective controls (ActHIB™ 5 [5] ActHIB is the Trademark of Sanofi Pasteur. and Menjugate™ 6 [6] Menjugate is the Trademark of Novartis. ) including for antibody persistence. Response to co-administered vaccines was not impaired. Polysaccharide challenge (PRP, PSC, PSY at 11–14 months of age) evidenced immune memory was induced for Hib, MenC/Y conjugate components. The safety profile of Hib-MenCY-TT was similar to controls. Hib-MenCY-TT administered according to the current US Hib vaccine schedule has the potential to induce protective antibodies against Hib and meningococcal-CY disease in infants and toddlers. [Copyright &y& Elsevier]

Abstract: Immunological evaluation of the clinical impact of vaccines designed to protect against infection by Streptococcus pneumoniae requires measurement of serotype-specific functional antibodies. We describe the development and validation of a viable pneumococcal opsonophagocytosis assay (OPA) that can be used for routine serological analysis of paediatric immune responses after immunization. OPA seropositivity (%≥8 threshold) reflected well invasive pneumococcal disease (IPD) effectiveness. In contrast, the 22F inhibition ELISA seropositivity (%≥0.20μg/ml threshold) overestimated (19F) or underestimated (6B, 23F, 6A) IPD effectiveness for several serotypes. The seropositivity as estimated by a standardized and highly reproducible OPA was predictive for the serotype-specific IPD efficacy of pneumococcal conjugate vaccines. [Copyright &y& Elsevier]

Abstract: We explored the relationship between efficacy against acute otitis media (AOM) and both ELISA anti-polysaccharide IgG geometric mean concentrations (GMCs) and opsonophagocytic (OPA) geometric mean titres (GMTs) following primary and booster vaccination with pneumococcal protein D (Haemophilus influenzae-derived) conjugate vaccine. It was possible to distinguish between the OPA GMTs of low and high efficacy serotypes, however no such distinction was evident for ELISA GMCs. Also, there was a trend towards lower ELISA and OPA serotype-specific responses in subjects who developed AOM compared to controls. We conclude that serotype-specific OPA GMTs are an important endpoint to consider for evaluation of pneumococcal conjugate vaccines with respect to the protective efficacy against AOM (Study ID: 347414/NCT00119743). [Copyright &y& Elsevier]

Abstract: Primary vaccination with pneumococcal protein D conjugate vaccine in the first year of life induced clear ELISA and OPA responses, which varied considerably for the different serotypes. Antibody levels declined following primary vaccination but were restored (except for serotype 3) to above post-primary levels by booster vaccination in the second year of life. Antibody levels declined when measured in the fourth year of life, although remaining higher than in the non-immunized children. For some serotypes, antibody levels did not decline indicating exposure to pneumococci or cross-reacting bacteria. Development of natural immunity to several serotypes was evident from the increase in opsonophagocytic activity in the control group between booster and plain polysaccharide vaccination. Vigorous and rapid OPA and ELISA responses were elicited to all vaccine serotypes including serotype 3 following administration of plain polysaccharide vaccine in both the conjugate and control groups, being higher in the conjugate group (Study ID: 104083/NCT00169507). [Copyright &y& Elsevier]

Abstract: The meningococcal iron-limitation-inducible outer membrane protein FrpB (FetA) has been shown to induce bactericidal antibodies, and is, therefore, considered a vaccine candidate. However, these antibodies are strain specific and, consistently, epitope mapping showed that they are directed against a region, located in a surface-exposed loop, L5, that displays considerable sequence variability between strains. Here, we attempted to redirect the immune response to more conserved domains of the protein by deleting L5. Immunization with an FrpB protein lacking L5 resulted in a bactericidal antibody response, and epitope mapping showed that these antibodies were directed against loop L3, which also displays considerable sequence variability. To re-direct the immune response further, immunizations were performed with an FrpB protein lacking both L5 and L3. The antibodies obtained were not bactericidal. Furthermore, the bactericidal antibodies against L3 were only bactericidal in the absence of L5, and immunofluorescence microscopy experiments showed that L5 efficiently shields other immunogenic cell surface-exposed epitopes outside of this region on living cells. Whereas the ability of micro-organisms to vary surface-exposed domains that are targets for protective immunity has long been established, the current work shows that such domains can be remarkably efficient in shielding other, more conserved epitopes. [Copyright &y& Elsevier]

Abstract: Passive transfer of a pediatric human serum pool generated against polysaccharide-protein D conjugate vaccines conferred ∼34% protection against development of ascending NTHI-induced OM when used in a chinchilla viral–bacterial co-infection model. These data are in line with results obtained using a similar 11-valent-protein D conjugate vaccine in a pediatric clinical trial, wherein a vaccine efficacy of 35.6% was shown against acute OM episodes caused by NTHI. These observations strongly support the chinchilla passive transfer-superinfection model as one that could predict clinical trials outcomes for vaccines to prevent NTHI-induced OM. [Copyright &y& Elsevier]

Abstract: The vaccine potential of the Neisseria meningitidis lactoferrin-binding proteins LbpA and LbpB was evaluated. Sequencing and sequence alignments suggested that LbpA is relatively well conserved with variability largely restricted to two surface-exposed loops in a proposed topology model. Consistently, antisera raised against synthetic peptides corresponding to exposed loops generally recognized the LbpA proteins of many different strains. Hence, LbpA was considered an attractive vaccine candidate. LbpB shows a higher degree of sequence variability. For immunisation studies, LbpA was overproduced in N. meningitidis and a histidine-tagged LbpB protein was produced in Escherichia coli. Outer membrane vesicles carrying overproduced LbpA and purified LbpB were used to immunise laboratory animals. The bactericidal activity and cross-reactivity of the antibodies was evaluated using meningococcal strains of various clonal lineages. In addition, LbpB-specific monoclonal antibodies were analysed by Western blots and whole-cell enzyme-linked immunosorbent assays. Our results show that both proteins are immunogenic and able to induce bactericidal antibodies, but that the cross-reactivity of these antibodies is limited. [Copyright &y& Elsevier]

Abstract: A significant increase in the incidence of pertussis in adolescents and adults has been observed in vaccinated populations. Concomitantly, emergence of novel pertussis toxin and pertactin types in circulating Bordetella pertussis isolates was noticed. In this study, immunity induced by acellular vaccines against infection due to isolates expressing different pertactin types and fimbriae was monitored in a mouse model. In accordance with previous studies, the effect of a bicomponent DTPa vaccine on bacterial clearance was lower when compared with tri- or pentavalent DTPa vaccines. Whatever the isolates used to infect mice, the tri- or pentavalent DTPa vaccines were both efficacious in inducing immunity that resulted in clearance of infection. These findings suggest that re-emergence of pertussis might not be related to emergence of isolates escaping vaccine protection. The present study reduces potential concerns about acellular vaccine efficacy, but frequent monitoring of protection and surveillance of the evolution of the B. pertussis population remains of particular importance. [Copyright &y& Elsevier]

Abstract: In the past years, a significant rise in the proportion of childhood complicated pneumonia cases related to pneumococcal serotypes 1 and 3 has been observed. PhtD is a vaccine candidate protein antigen. By using a pneumococcal lethal intranasal challenge mouse model, a significant additive effect on protection was observed with the combination of vaccination-induced anti-PhtD and injected anti-polysaccharide antibodies specific for serotypes 1 and 3. [Copyright &y& Elsevier]