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实验性人体挑战定义了定植和未定植成人之间不同的肺炎球菌动力学特征和黏膜反应。

Experimental Human Challenge Defines Distinct Pneumococcal Kinetic Profiles and Mucosal Responses between Colonized and Non-Colonized Adults.

机构信息

Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom

Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands.

出版信息

mBio. 2021 Jan 12;12(1):e02020-20. doi: 10.1128/mBio.02020-20.

Abstract

Colonization of the upper respiratory tract with is the precursor of pneumococcal pneumonia and invasive disease. Following exposure, however, it is unclear which human immune mechanisms determine whether a pathogen will colonize. We used a human challenge model to investigate host-pathogen interactions in the first hours and days following intranasal exposure to Using a novel home sampling method, we measured early immune responses and bacterial density dynamics in the nose and saliva after volunteers were experimentally exposed to pneumococcus. Here, we show that nasal colonization can take up to 24 h to become established. Also, the following two distinct bacterial clearance profiles were associated with protection: nasal clearers with immediate clearance of bacteria in the nose by the activity of pre-existent mucosal neutrophils and saliva clearers with detectable pneumococcus in saliva at 1 h post challenge and delayed clearance mediated by an inflammatory response and increased neutrophil activity 24 h post bacterial encounter. This study describes, for the first time, how colonization with a bacterium is established in humans, signifying that the correlates of protection against pneumococcal colonization, which can be used to inform design and testing of novel vaccine candidates, could be valid for subsets of protected individuals. Occurrence of lower respiratory tract infections requires prior colonization of the upper respiratory tract with a pathogen. Most bacterial infection and colonization studies have been performed in murine and models due to the current invasive sampling methodology of the upper respiratory tract, both of which poorly reflect the complexity of host-pathogen interactions in the human nose. Self-collecting saliva and nasal lining fluid at home is a fast, low-cost, noninvasive, high-frequency sampling platform for continuous monitoring of bacterial encounter at defined time points relative to exposure. Our study demonstrates for the first time that, in humans, there are distinct profiles of pneumococcal colonization kinetics, distinguished by speed of appearance in saliva, local phagocytic function, and acute mucosal inflammatory responses, which may either recruit or activate neutrophils. These data are important for the design and testing of novel vaccine candidates.

摘要

定植于上呼吸道的 是肺炎球菌性肺炎和侵袭性疾病的前兆。然而,接触病原体后,尚不清楚哪些人体免疫机制决定了病原体是否会定植。我们使用人体挑战模型,在鼻内暴露于 后数小时至数天内,研究宿主-病原体相互作用。我们使用一种新的家庭采样方法,测量志愿者在实验性暴露于肺炎球菌后鼻腔和唾液中的早期免疫反应和细菌密度动态。在此,我们表明鼻腔定植可能需要长达 24 小时才能建立。此外,以下两种不同的细菌清除特征与保护相关:鼻腔清除者在鼻内通过预先存在的黏膜中性粒细胞的活性迅速清除细菌,以及唾液清除者在接触细菌后 1 小时内唾液中可检测到肺炎球菌,并且在细菌接触后 24 小时通过炎症反应和中性粒细胞活性增加介导的延迟清除。本研究首次描述了细菌在人体内定植的建立过程,表明针对肺炎球菌定植的保护相关因素,可用于指导新型候选疫苗的设计和测试,可能对某些受保护个体有效。下呼吸道感染的发生需要病原体在上呼吸道的定植。由于目前上呼吸道的侵袭性采样方法,大多数细菌感染和定植研究都在小鼠和 模型中进行,这些模型都不能很好地反映人体鼻腔中宿主-病原体相互作用的复杂性。在家中自行采集唾液和鼻腔衬里液是一种快速、低成本、非侵入性、高频采样平台,可用于在暴露时相对于暴露的特定时间点连续监测细菌接触。我们的研究首次表明,在人类中,肺炎球菌定植动力学有明显的特征,其特征在于在唾液中出现的速度、局部吞噬功能和急性黏膜炎症反应,这些特征可能招募或激活中性粒细胞。这些数据对于新型候选疫苗的设计和测试非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b76b/7844534/60720a6d61b0/mBio.02020-20-f0001.jpg

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