Wahid Rezwanul, Simon Raphael, Zafar Shah J, Levine Myron M, Sztein Marcelo B
Department of Pediatrics, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Clin Vaccine Immunol. 2012 Jun;19(6):825-34. doi: 10.1128/CVI.00058-12. Epub 2012 Apr 4.
Enteric fever caused by Salmonella enterica serovar Paratyphi A infection has emerged as an important public health problem. Recognizing that in randomized controlled field trials oral immunization with attenuated S. enterica serovar Typhi live vaccine Ty21a conferred significant cross-protection against S. Paratyphi B but not S. Paratyphi A disease, we undertook a clinical study to ascertain whether humoral immune responses could explain the field trial results. Ty21a immunization of adult residents of Maryland elicited predominantly IgA antibody-secreting cells (ASC) that recognize S. Typhi lipopolysaccharide (LPS). Cross-reactivity to S. Paratyphi A LPS was significantly lower than that to S. Paratyphi B LPS. ASC producing IgG and IgA that bind LPS from each of these Salmonella serovars expressed CD27 and integrin α4β7 (gut homing), with a significant proportion coexpressing CD62L (secondary lymphoid tissue homing). No significant differences were observed in serum antibody against LPS of the different serovars. Levels of IgA B memory (B(M)) cells to S. Typhi LPS were significantly higher than those against S. Paratyphi A or B LPS, with no differences observed between S. Paratyphi A and B. The response of IgA B(M) to outer membrane proteins (OMP) from S. Typhi was significantly stronger than that to OMP of S. Paratyphi A but similar to that to OMP of S. Paratyphi B. The percentages of IgG or IgA B(M) responders to LPS or OMP from these Salmonella strains were similar. Whereas cross-reactive humoral immune responses to S. Paratyphi A or B antigens are demonstrable following Ty21a immunization, they cannot explain the efficacy data gleaned from controlled field trials.
由甲型副伤寒沙门氏菌感染引起的肠热症已成为一个重要的公共卫生问题。认识到在随机对照现场试验中,口服减毒伤寒沙门氏菌活疫苗Ty21a可对副伤寒乙杆菌提供显著的交叉保护,但对甲型副伤寒沙门氏菌疾病无效,我们开展了一项临床研究,以确定体液免疫反应是否能解释现场试验结果。对马里兰州成年居民进行Ty21a免疫接种后,主要诱导出识别伤寒沙门氏菌脂多糖(LPS)的IgA抗体分泌细胞(ASC)。对甲型副伤寒沙门氏菌LPS的交叉反应性明显低于对副伤寒乙杆菌LPS的交叉反应性。产生结合这些沙门氏菌各血清型LPS的IgG和IgA的ASC表达CD27和整合素α4β7(归巢至肠道),其中很大一部分共表达CD62L(归巢至二级淋巴组织)。不同血清型LPS的血清抗体未观察到显著差异。针对伤寒沙门氏菌LPS的IgA B记忆(B(M))细胞水平显著高于针对甲型副伤寒沙门氏菌或副伤寒乙杆菌LPS的水平,甲型副伤寒沙门氏菌和副伤寒乙杆菌之间未观察到差异。IgA B(M)对伤寒沙门氏菌外膜蛋白(OMP)的反应明显强于对甲型副伤寒沙门氏菌OMP的反应,但与对副伤寒乙杆菌OMP的反应相似。这些沙门氏菌菌株LPS或OMP的IgG或IgA B(M)反应者百分比相似。虽然在Ty21a免疫接种后可证明对甲型副伤寒沙门氏菌或副伤寒乙杆菌抗原存在交叉反应性体液免疫反应,但它们无法解释从对照现场试验中收集到的疗效数据。