From the Instituto de Ciencias Básicas y Preclínicas "Victoria de Girón," Havana, Cuba.
Facultad de Ingenierías, Universidad Técnica "Luis Vargas Torres" de Esmeraldas, Esmeralda, Ecuador.
Pediatr Infect Dis J. 2021 Apr 1;40(4):375-381. doi: 10.1097/INF.0000000000003047.
Overall, there are over 30 different sexually transmitted infections with Neisseria gonorrhoeae being the third most frequent with a reported 78 million cases per year. Gonococcal infection causes genital inflammation, which can be a risk factor for others sexually transmitted infections, particularly human immunodeficiency virus. Gonorrhea is a treatable disease, but recently an increase in antibiotic resistance has been of concern. There are currently no vaccines available. However, parenteral vaccination with anti N. meningitidis serogroup B vaccine has been reported to decrease the incidence of gonococcal burden in New Zealand and in Cuba despite the fact that parenteral vaccination is not deemed to induce mucosal IgA. Here we explore possible mechanisms of protection against gonococcal infection through parenteral meningococcal B vaccination.
Ninety-two serum, saliva and oropharyngeal swabs samples of young adults (healthy and Neisseria carriers) of the internal higher school were obtained. They have been vaccinated with VA-MENGOC-BC (MBV) during their infancy and boosted with a third dose during this study. Serum and saliva samples were analyzed by ELISA and Western blot to measured IgG and IgA antibodies against N. meningitidis and N. gonorrhoeae antigens. N. meningitidis carriers were determined by standard microbiologic test. In addition, we reviewed epidemiologic data for N. meningitidis and N. gonorrhoeae infections in Cuba.
Epidemiologic data show the influence of MBV over gonorrhea incidence suggesting to be dependent of sexual arrival age of vaccines but not over syphilis. Laboratorial data permit the detection of 70 and 22 noncarriers and carriers of N. meningitidis, respectively. Serum anti-MBV antigens (PL) responses were boosted by a third dose and were independent of carriage stages, but saliva anti-PL IgA responses were only present and were significant induced in carriers subjects. Carriers boosted with a third dose of MBV induced similar antigonococcal and -PL saliva IgA and serum IgG responses; meanwhile, serum antigonococcal IgG was significantly lower. In saliva, at least 2 gonococcal antigens were identified by Western blot. Finally, gonococcal-specific mucosal IgA antibody responses, in addition to the serum IgG antibodies, might contributed to the reduction of the incidence of N. gonorrhoeae. We hypothesize that this might have contributed to the observed reductions of the incidence of N. gonorrhoeae.
These results suggest a mechanism for the influence of a Proteoliposome-based meningococcal BC vaccine on gonococcal incidence.
总体而言，有超过 30 种不同的性传播感染，淋病奈瑟菌是第三常见的病原体，每年报告的病例超过 7800 万例。淋病奈瑟菌感染引起生殖器炎症，这可能是其他性传播感染的危险因素，特别是人类免疫缺陷病毒。淋病是一种可治疗的疾病，但最近抗生素耐药性的增加引起了关注。目前尚无可用的疫苗。然而，已经有报道称，针对脑膜炎奈瑟菌 B 群的疫苗进行的皮内接种可以降低新西兰和古巴的淋病奈瑟菌负担发生率，尽管皮内接种被认为不会诱导黏膜 IgA。在这里，我们通过针对淋病奈瑟菌的皮内脑膜炎球菌 B 型疫苗接种来探索针对淋病奈瑟菌感染的可能保护机制。
从内部高等学校的 92 名年轻人（健康和淋病奈瑟菌携带者）的血清、唾液和咽拭子样本中获得。他们在婴儿期接种了 VA-MENGOC-BC（MBV）疫苗，并在本研究中加强了第三剂。通过 ELISA 和 Western blot 分析血清和唾液样本，以测量针对脑膜炎奈瑟菌和淋病奈瑟菌抗原的 IgG 和 IgA 抗体。通过标准微生物学测试确定脑膜炎奈瑟菌携带者。此外，我们还查阅了古巴脑膜炎奈瑟菌和淋病奈瑟菌感染的流行病学数据。
流行病学数据显示，MBV 对淋病发病率的影响表明，这取决于疫苗接种者的性成熟年龄，但与梅毒无关。实验室数据分别检测到 70 名和 22 名非携带者和脑膜炎奈瑟菌携带者。第三剂 MBV 加强了血清抗-MBV 抗原（PL）反应，且与携带阶段无关，但唾液抗-PL IgA 反应仅存在于且仅在携带者中显著诱导。接受 MBV 第三剂加强的携带者诱导了相似的抗淋病奈瑟菌和-PL 唾液 IgA 和血清 IgG 反应；同时，血清抗淋病奈瑟菌 IgG 显著降低。在唾液中，通过 Western blot 鉴定了至少 2 种淋病奈瑟菌抗原。最后，除了血清 IgG 抗体外，淋病奈瑟菌特异性黏膜 IgA 抗体反应可能有助于降低淋病奈瑟菌的发病率。我们假设这可能有助于解释淋病奈瑟菌发病率的降低。
这些结果表明，基于脂多糖体的脑膜炎球菌 B 群疫苗对淋病奈瑟菌发病率的影响存在一种机制。
