GSK + Novartis Vaccines and Diagnostics, Siena, Italy.
Femicare, Clinical Research for Women, Tienen, Belgium; Department of Obstetrics and Gynecology, Regional Hospital Heilig Hart, Tienen, Belgium; University Hospital Antwerpen, Antwerp, Belgium.
J Infect. 2018 May;76(5):449-456. doi: 10.1016/j.jinf.2018.01.006. Epub 2018 Jan 31.
The main aim of this exploratory study was to evaluate functional activity of antibodies elicited by a maternal Group B Streptococcus (GBS) investigational vaccine composed of capsular polysaccharides Ia, Ib, and III conjugated to genetically detoxified Diphtheria toxin CRM. The second objective was to investigate the relationship between serotype-specific IgG concentrations and functional activity in maternal and cord sera.
Maternal and cord sera collected at baseline and at delivery from vaccine and placebo recipients during a double-blind placebo-controlled Phase II study (www.clinicaltrials.gov, NCT01446289) were tested in an opsono-phagocytic bacterial killing assay. Cord sera from vaccine recipients were also passively transferred to newborn mice to investigate conferred protection against bacterial challenge.
Antibody-mediated GBS phagocytic killing was significantly increased in maternal serum at delivery and in cord sera from the investigational vaccine group as compared to the placebo group. Anti-capsular IgG concentrations above 1 µg/mL mediated in vitro killing against GBS strains belonging to all three serotypes and IgG levels correlated with functional titers. Passively administered cord sera elicited a dose-dependent protective response against all GBS serotypes in the in vivo model.
The maternal vaccine elicited functional antibodies that were placentally transferred. Anti-capsular IgG concentrations in maternal and cord sera were predictive of functional activity and in vivo protection in the mouse model.
本探索性研究的主要目的是评估由荚膜多糖 Ia、Ib 和 III 与基因解毒的白喉毒素 CRM 偶联而成的母体 B 型链球菌(GBS)研究性疫苗引起的抗体的功能活性。第二个目的是研究母体和脐带血清中血清型特异性 IgG 浓度与功能活性之间的关系。
在一项双盲安慰剂对照的 II 期研究(www.clinicaltrials.gov,NCT01446289)中,从疫苗和安慰剂接受者在基线和分娩时收集母体和脐带血清,并在吞噬细胞杀菌测定中进行测试。从疫苗接受者的脐带血清也被被动转移到新生小鼠中,以研究对细菌挑战的保护作用。
与安慰剂组相比,在分娩时的母体血清中和研究性疫苗组的脐带血清中,抗体介导的 GBS 吞噬杀菌作用显著增加。血清 IgG 浓度>1μg/ml 介导针对所有三种血清型的 GBS 菌株的体外杀伤作用,并且 IgG 水平与功能滴度相关。在体内模型中,被动给予的脐带血清在体内模型中针对所有 GBS 血清型引起了剂量依赖性的保护反应。
母体疫苗引发了具有胎盘转移功能的抗体。母体和脐带血清中的荚膜 IgG 浓度可预测功能活性和体内保护作用。