Vi-CRM 197 as a new conjugate vaccine against Salmonella Typhi.

An efficacious, low cost vaccine against typhoid fever, especially for young children, would make a major impact on disease burden in developing countries. The virulence capsular polysaccharide of Salmonella Typhi (Vi) coupled to recombinant mutant Pseudomonas aeruginosa exoprotein A (Vi-rEPA) has been shown to be highly efficacious. We investigated the use of carrier proteins included in infant vaccines, standardized the conjugation process and developed key assays required for routine lot release at production scale. Vi from a BSL1 organism, Citrobacter freundii, strain WR7011, was used as an alternative to Vi from S. Typhi. We showed that Vi conjugated to CRM(197), a non-toxic mutant of diphtheria toxin, widely used in commercial vaccines, was produced at high yield. Vi-CRM(197) proved immunogenic in animal studies, even without adjuvant. Thus, Vi-CRM(197) appears to be a suitable candidate for the development of a commercially viable, effective typhoid vaccine for developing countries.

Immunization experiments with recombinant Coxiella burnetii proteins in a murine infection model.

Previous attempts to develop Q fever vaccines were less successful in that the vaccines caused unacceptable side effects or failed to be protective. In this study, we tested the efficacy of a mixture of eight recombinant Coxiella burnetii (C. b.) proteins in sublethal challenge infections with mice. Eight potential C. b. virulence genes (Omp, Pmm, HspB, Fbp, Orf410, Crc, CbMip, and MucZ) were overexpressed in E. coli as his-tagged fusion proteins and partially purified. All recombinant proteins but rPmm proved to be antigenic in BALB/c mice when administered as protein mixtures. For efficacy testing, mice were immunized with an adjuvanted mixture of the eight recombinant proteins and subsequently challenged intraperitoneally with the C. b. isolate Nine Mile RSA493 (1.8 x 10(8) C. b.). Only animals vaccinated with the licensed Q fever vaccine Q-Vax (vaccination control) exhibited milder symptoms and minor gain of spleen and liver weights. In summary, clinical examinations and dissection of mice immunized with the eight recombinant C. b. proteins did not indicate a protective immune response after test infection.

Balb/c mouse model and real-time quantitative polymerase chain reaction for evaluation of the immunoprotectivity against Q fever.

The Balb/c mice were infected with Coxiella burnetii and samples of blood and major organs from the infected mice were collected on days 1 to 14 after infection. The DNAs extracted from the samples were detected by a developed real-time quantitative PCR specific for C. burnetii and high loads of C. burnetii were found in spleens, livers, and lungs, particularly in spleens. The Balb/c mice were immunized with whole cell antigen (WCA) of C. burnetii and coxiella loads in spleens of mice were assessed by the real-time quantitative PCR on day 7 after challenge with C. burnetii. The analysis suggested that phase I whole cells were excellent immunogen that elicited complete protection against coxiella infection by two-booster but not one-booster immunization. The results suggest that the combination of Balb/c model and the real-time quantitative PCR assay is a reliable and sensitive way to evaluate the efficiency of vaccines against Q fever.

Short- and long-term immune responses of CD-1 outbred mice to the scrub typhus DNA vaccine candidate: p47Kp.

Orientia tsutsugamushi is an obligate intracellular bacterium that is the causative agent of scrub typhus. To develop an effective vaccine to prevent or ameliorate scrub typhus, knowledge of the protective immune response to O. tsutsugamushi needs to be ascertained. Our laboratory has demonstrated that the DNA vaccine vector pVR1012 carrying the O. tsutsugamushi Karp strain 47-kDa protein gene (p47Kp) consistently provides outbred mice protection against homologous challenge.

Analysis of immunoprotectivity of the recombinant OmpA of Rickettsia heilongjiangensis.

A truncated gene ompA was amplified from Rickettsia heilongjiangensis isolated in China and a 56-kDa truncated OmpA protein was expressed in E. coli cells transformed with the ompA-recombined expression plasmid. High levels of serum antibodies to R. heilongjiangensis and proliferation of the splenic cells were found in mice immunized with the truncated OmpA. After challenge with R. heilongjiangensis or R. rickettsii, fever and pathological damages of the guinea pigs immunized with the truncated OmpA were significantly slighter as compared with those of nonimmunized guinea pigs. These results suggest that the truncated OmpA of R. heilongjiangii is immunogenic for effectively inducing humoral and cell-mediated immune responses against homologous and heterologous species in the spotted fever group.

[Immunization recommendations for travel in the Mediterranean area]. / Reisemedizinische Impfempfehlungen für den Mittelmeerraum.

The Mediterranean region is a popular destination for tourists during the summer. However, European tourists, who are travelers within their own continent, do not consider themselves exposed to possible, travel-associated infections, since problem awareness among tourists as well as doctors is rather weak. The objective of this consensus paper is to outline guidelines with regard to relevant travel immunizations for Mediterranean destinations. These recommendations are mainly based on risk calculations according to country-specific incidences and prevalences of vaccine-preventable diseases such as hepatitis A, hepatitis B, typhoid fever, meningococcal meningitis, rabies, and tick-borne encephalitis.

Vacunas contra rickettsias / Vaccines against rickettsias

Las rickettsias son transmitidas por la picadura de garrapatas y ácaros infectados o por la contaminación de la piel o membranas mucosas con heces de piojos o pulgas. La epidemiología se presenta en varias enfermedades: tifo epidémico, tifo murino, tifo escrofular, fiebre manchada de las montañas rocallosas y fiebre Q. En el aspecto histórico de las vacunas anti-rickettsiales, observando retrospectivamente, se concluye que el fracaso de esos intentos -iniciados antes de 1940- no es sorprendente dada la heterogeneidad antigénica de las cepas de esta especie. Los esfuerzos actuales para el desarrollo de las vacunas anti-rickettsiales están enfocados en la clonación de los genes que codifican para la proteína R. prowaseki; producirla mediante la tecnología del DNA recombinante y evaluar la proteína así expresada como probable vacuna. Aunque tales enfoque novedosos son prometedores, la prueba definitiva de eficiencia es la capacidad de la vacuna para proteger humanos expuestos a la infección con rickettsias

Development of local morphological changes after intradermal inoculation of Q-fever chemovaccine.

Development of morphological changes was studied in the site of intradermal inoculation of Q-fever chemovaccine. The chemovaccine was obtained by trichloroacetic acid extraction from Coxiella burnetii, strain Nine mile, phase I cells. The effect of two vaccine doses (0.2 mg and 1.0 mg) was compared in two groups of guinea pigs (each consisting of 21 animals). After inoculation of 1.0 mg vaccine abscesses formed in the dermis and in subcutaneous tissue along with dystrophic changes of skeletal muscles. Reparation of these lesions progressed sufficiently slowly and was not completed before 60 days after vaccine inoculation. The regeneration of skeletal muscles was of budding type. After inoculation of 0.2 mg of chemovaccine minimal lesions occurred in the subcutaneous tissue only. However, already within 48 hr this vaccine dose evoked a strong reparation response. Interesting was the finding of Kurloff cells in the haemorrhagic foci. The results suggest that the low-reactogenic chemovaccine dose of 0.2 mg might be sufficiently immunogenic after subcutaneous administration.

Q fever vaccination of sheep: challenge of immunity in ewes.

Adult ewes (17 months of age) were vaccinated against Coxiella burnetii, using a formalin-inactivated whole cell (WC) phase I Henzerling strain vaccine or a chloroform methanol residue (CMR) vaccine. Nineteen pregnant ewes were placed in 3 categories [(i) unvaccinated, (ii) WC vaccine, and (iii) CMR vaccine] and were challenge exposed at approximately the 100th day of gestation with 210,000 plaque-forming units of C burnetii inoculated subcutaneously. Shedding of rickettsiae was measurably reduced, but was not prevented in vaccinated groups, as shown by inoculating ewes' placental tissues, amniotic fluid, and colostrum into mice, as well as by histopathologic lesions of placental tissues. The rickettsiae were shed in the placenta, amniotic fluid, or colostrum in 6 nonvaccinated ewes. In comparison, rickettsiae were detected in placental inoculations from 2 of 6 ewes in the WC vaccine group and 1 of 6 in the CMR group. In contrast to those in the vaccinated ewes, placentitis, high concentrations of rickettsiae in microscopic preparations, and weak lambs were typical for the nonvaccinated ewes.

Reactogenicity, immunogenicity, and efficacy of a chick embryo cell-derived vaccine for Rocky Mountain spotted fever.

A new formalin-inactivated vaccine prepared by sucrose density gradient centrifugation of tissue culture-grown Rickettsia rickettsii was evaluated for safety and immunogenicity in a placebo-controlled, double-blind study. Most of the 52 seronegative adult vaccinees, 88% after the first and 66% after the second dose, experienced brief, mild (mostly local) reactions, but only 50% exhibited a systemic immune response to vaccination. Six unvaccinated volunteers (controls) and 16 of these vaccinees were challenged with R rickettsii one month after vaccination. Vaccine efficacy was 25%; all six controls and 12 of 16 vaccinees developed typical Rocky Mountain spotted fever. The incubation period was longer, the duration of constitutional symptoms shorter, and the height of fever lower in ill vaccinees than in controls. The vaccine provided only partial protection against Rocky Mountain spotted fever but ameliorated the illness.

Rocky Mountain spotted fever vaccine in an animal model.

Formalin-killed, purified Rickettsia rickettsii vaccine was evaluated in a guinea pig model of R. rickettsii infection. Vaccinated guinea pigs were partially protected by the vaccine when challenged with virulent, viable rickettsiae. Greater protection was observed when higher doses of vaccine were given and when frequent booster injections were administered. Stimulation of cell-mediated immunity to the vaccine antigens was variable and also appeared to be achieved more reproducibly with booster vaccinations. Serum antibody was elicited by high doses of vaccine and by booster vaccinations. The presence of serum antibody was useful in predicting immunity to challenge with R. rickettsii.

[Characteristics of the antitoxic immunity in persons inoculated with chemical typhus vaccine]. / Kharakteristika antitoksicheskogo immuniteta u privitykh khimicheskoi sypnotifoznoi vaktsinoi.

The determination of toxin-neutralizing antibodies in the sera of persons immunized with chemical typhus vaccine revealed that immunization made both in a single injection and in two injections resulted in the development of antitoxic immunity practically in all vaccinees. No toxin-neutralizing antibodies could be detected 6 months after immunization. The booster injection made at that period resulted in the development of antitoxic immunity which was as pronounced as that developing after primary immunization. In the blood sera of the vaccines the titers of toxin-neutralizing antibodies practically did not differ from those of complement-fixing antibodies.

Evaluation of a killed Rocky Mountain spotted fever vaccine in cynomolgus monkeys.

A nonhuman primate model of Rocky Mountain spotted fever infection was developed in cynomolgus monkeys (Macaca fascicularis) infected by the subcutaneous route or by aerosol. Clinical responses, hematology and serum chemistry values, and pathological findings were similar to those found in humans ill with Rocky Mountain spotted fever. The clinical model was then used to test the efficacy of a killed Rocky Mountain spotted fever vaccine grown in chicken embryo cells. Monkeys were immunized with varying dilutions of the vaccine with a two-dose schedule and then challenged at 2 months with virulent Rickettsia rickettsii by the subcutaneous route or by aerosol. The undiluted vaccine totally protected monkeys against both challenges, even at extremely high doses.

Gamma-irradiated scrub typhus immunogens: development and duration of immunity.

The development and duration of immunity to lethal scrub typhus infection was studied in BALB/c mice vaccinated with gamma-irradiated Rickettsia tsutsugamushi, strain Karp. One intraperitoneal injection containing approximately 10(8) 50% mouse lethal doses (MLD(50)) of irradiated organisms elicited an immune response protective against challenge with 10(5) MLD(50) of viable Karp. The same mass of immunogen given in three injections at 5-day intervals increased homologous (Karp strain) protection 25-fold and heterologous (Kato strain) protection 60-fold. Further temporal expansion of the immunization regimen did not increase protection. Subcutaneous vaccination provided significant, but lower, levels of protection than were achieved by intraperitoneal immunization, but the levels of cell-transferable immunity elicited by the two routes were approximately the same. Immunologically specific protection after intraperitoneal vaccination developed rapidly enough to provide resistance against simultaneous challenge with 200 MLD(50) of Karp. Homologous immunity was protective against a 10(6)-MLD(50) challenge 7 days after completion of the three-injection regimen, remained at that level for 3 months, dropped to 10(4) MLD(50) by 9 months, and was effective against a 50-MLD(50) Karp challenge at 12 months. Protection against heterologous challenge was first observed on day 17 and peaked on day 38, when the mice resisted a 10(5)-MLD(50) Kato challenge. Thereafter, heterologous protection waned rapidly and was not significant at 6 months.

Immunization against anaplasmosis and babesiosis: Part I. Evaluation of immunization using minimum infective doses under laboratory conditions.

A method of immunization against anaplasmosis and babesiosis using minimum infective doses was developed under laboratory conditions. Stabilates of Anaplasma marginale stored at -60 degrees C were found infective when diluted 10-fold to 10(-3). Stabilates of Babesia argentina and Babesia bigemina stored under the same conditions were infective when diluted 10-fold to 10(-1). Intact calves inoculated with the above dilutions of stabilates developed moderate parasitemias and recovered from infection without treatment. There was an immune response to vaccination with the formation of specific antibodies to A. marginale, B. bigemina and B. argentina as measured by the complement fixation (CF) test. All calves were found resistant to artificial challenge with lethal doses of the respective parasites.

Effect of vaccination schedule on immune response of Macaca mulatta to cell culture-grown Rocky Mountain spotted fever vaccine.

The effect of vaccination schedule on the immune response of Macaca mulatta to formalin-inactivated chicken embryo cell culture (CEC)-grown Rickettsia rickettsii vaccine was studied. Schedules consisted of inoculation on day 1 only, on days 1 and 15, on days 1 and 30, on days 1, 8, and 15, or on days 1, 15, and 45. Humoral antibody measured by microagglutination and indirect immunofluorescence and resistance to challenge with 10(4) plaque-forming units of yolk sac-grown R. rickettsii were assessed. Seroconversion was noted in all monkeys after the first dose of vaccine. A second dose administered 8 or 15 days after the primary infection, or a third given 7 or 30 days after the second, produced no long-term effect on antibody titer. Only monkeys given two doses of vaccine at a 30-day interval showed an increase in antibody titer during the period before challenge. Vaccination with one, two, or three doses of CEC vaccine prevented development of rash and rickettsemia after challenge. The two-dose schedules appeared to induce the highest degree of resistance to challenge, as indicated by unaltered hematological parameters and body temperature in monkeys. The one- and three-dose schedules were somewhat less effective, in that some challenged monkeys within each group displayed febrile and leukocyte responses associated with Rocky Mountain spotted fever infection. Our data suggest that administration of two doses of CEC vaccine at 15- or 30-day intervals is the immunization schedule of choice.

New assay of protective activity of Rocky Mountain spotted fever vaccines.

Areas under the fever curves of guinea pigs inoculated with Rocky Mountain spotted fever vaccine over a restricted dose range and infected with a standardized dose of Rickettsia rickettsii varied linearly with log10 dose of vaccine. A calculator was programmed to plot fever curves and calculate the vaccine dose that reduced the fever of infected animals by 50%.

Q fever (Coxiella burnetii) investigations in dairy cattle: persistence of antibodies after vaccination.

The immune response and persistence of antibodies were investigated in dairy cattle vaccinated with formalin-inactivated phase (ph) I Coxiella burnetii vaccine agglutinating antibody geometric mean titer (GMT) of 193.2 at 1 month after vaccination compared to a GMT of 2.0 for nonvaccinated calves. The agglutinating antibodies gradually decreased in vaccinated cattle, but the GMT remained approximately 4 times higher than that for the nonvaccinated group for at least 20 months. Results of serotests at 2 months after revaccination indicated a rapid increase in the GMT to 177.0 with agglutinating titers between 1:64 and 1:512.