University of Gothenburg Vaccine Research Institute (GUVAX), Department of Microbiology and Immunology, University of Gothenburg, Box 435, 405 30 Gothenburg, Sweden.
Vaccine. 2013 May 7;31(20):2457-64. doi: 10.1016/j.vaccine.2013.03.027. Epub 2013 Mar 27.
A first-generation oral inactivated whole-cell enterotoxigenic Escherichia coli (ETEC) vaccine, comprising formalin-killed ETEC bacteria expressing different colonization factor (CF) antigens combined with cholera toxin B subunit (CTB), when tested in phase III studies did not significantly reduce overall (generally mild) ETEC diarrhea in travelers or children although it reduced more severe ETEC diarrhea in travelers by almost 80%. We have now developed a novel more immunogenic ETEC vaccine based on recombinant non-toxigenic E. coli strains engineered to express increased amounts of CF antigens, including CS6 as well as an ETEC-based B subunit protein (LCTBA), and the optional combination with a nontoxic double-mutant heat-labile toxin (LT) molecule (dmLT) as an adjuvant. Two test vaccines were prepared under GMP: (1) A prototype E. coli CFA/I-only formalin-killed whole-cell+LCTBA vaccine, and (2) A "complete" inactivated multivalent ETEC-CF (CFA/I, CS3, CS5 and CS6 antigens) whole-cell+LCTBA vaccine. These vaccines, when given intragastrically alone or together with dmLT in mice, were well tolerated and induced strong intestinal-mucosal IgA antibody responses as well as serum IgG and IgA responses to each of the vaccine CF antigens as well as to LT B subunit (LTB). Both mucosal and serum responses were further enhanced (adjuvanted) when the vaccines were co-administered with dmLT. We conclude that the new multivalent oral ETEC vaccine, both alone and especially in combination with the dmLT adjuvant, shows great promise for further testing in humans.
一种第一代口服灭活全细胞肠产毒性大肠杆菌(ETEC)疫苗,由表达不同定植因子(CF)抗原的福尔马林灭活 ETEC 细菌与霍乱毒素 B 亚单位(CTB)组成,在 III 期研究中进行测试时,虽然使旅行者中更严重的 ETEC 腹泻减少了近 80%,但并未显著减少旅行者和儿童的总体(通常为轻度)ETEC 腹泻。我们现在已经开发了一种新型的更具免疫原性的 ETEC 疫苗,基于重组非毒性大肠杆菌菌株,这些菌株经过工程改造后表达了更多的 CF 抗原,包括 CS6 以及一种基于 ETEC 的 B 亚单位蛋白(LCTBA),并可选地与一种无毒双突变不耐热毒素(LT)分子(dmLT)组合作为佐剂。两种测试疫苗均在 GMP 下制备:(1)原型大肠杆菌 CFA/I 仅福尔马林灭活全细胞+LCTBA 疫苗,和(2)“完整”灭活多价 ETEC-CF(CFA/I、CS3、CS5 和 CS6 抗原)全细胞+LCTBA 疫苗。这些疫苗单独或与 dmLT 一起经胃内给药,在小鼠中耐受性良好,并诱导强烈的肠黏膜 IgA 抗体应答以及针对疫苗 CF 抗原的血清 IgG 和 IgA 应答,以及 LT B 亚单位(LTB)。当疫苗与 dmLT 共同给药时,黏膜和血清应答进一步增强(佐剂)。我们得出结论,新型多价口服 ETEC 疫苗单独使用,特别是与 dmLT 佐剂联合使用,在人体中进一步测试具有很大的前景。