Enhanced immunogenicity of the pre-S region of hepatitis B surface antigen

Quantitative analysis of pre-S1 and pre-S2 in relation to HBsAg expression

Sera from four patients with acute hepatitis B and 87 patients with chronic hepatitis B were examined quantitatively for pre-S1 and pre-S2 antigens by solid-phase enzyme immunoassays. Pre-S1 and pre-S2 antigens were detected in HBsAg-positive sera irrespective of the presence of viral replicative markers, and their titers correlated with those of HBsAg (r = 0.74, p less than 0.01; r = 0.74, p less than 0.01, respectively). Sera positive for HBeAg showed higher titers of pre-S1 (p less than 0.01) and pre-S2 (p less than 0.01) antigens than sera negative for HBeAg. The titers of pre-S1 and pre-S2 antigens also correlated with the levels of HBV-associated DNA polymerase activity (r = 0.51, p less than 0.01; r = 0.59, p less than 0.01, respectively) and HBV-DNA (r = 0.50, p less than 0.01; r = 0.46, p less than 0.01, respectively). However, the ratios between the titers of pre-S antigens and HBsAg had no significant relationships with those viral replicative markers. These findings suggest that the expression of pre-S antigens is intimately related to the expression of HBsAg and that they are not useful as markers of viral replication. The ratios between the titers of pre-S antigens and HBsAg tended to be high in patients with chronic active hepatitis and high aminotransferase levels. This finding may have been due to the hepatic release of pre-S antigens, over-production of which may have some relationship to liver injury.

Expression of pre-S2 region of hepatitis B surface antigen in Escherichia coli

We constructed a recombinant plasmid that can express the entire pre-S2 sequence of hepatitis B surface antigen (HBsAg) as a fusion protein in E. coli. The hybrid protein, which comprises the bacterial TrpLE protein and the pre-S2 sequence, was the prominent protein that was found in cell extracts. As determined by immune blot analysis, this protein reacted with human HBV convalescent sera, as well as with sera from animals immunized with either purified HBsAg or isolated polypeptides containing pre-S2. It bound specifically to 125I-polymerized human albumin cross-linked with glutaraldehyde but not to 125I-monomeric human albumin. A novel adjuvant formulation was used in place of Freund's adjuvant to immunize guinea pigs with the recombinant product. The antisera obtained from serial bleedings were found to react with HBsAg of both d and y subtypes. These antisera were also shown to react solely with HBsAg polypeptides which contain of HBsAg to solid-phase polymerized the binding of HBsAg to solid-phase polymerized human albumin.

Ultrastructural localization of Pre-S2 polypeptides in the liver tissues of patients with chronic hepatitis B virus infection

Pre-S2 polypeptides in the liver tissue were investigated by immunoperoxidase staining in 26 patients with chronic hepatitis B virus (HBV) infection positive for HBeAg. Pre-S2 polypeptides were detected in the liver of 25 patients, in 17 of whom Pre-S2 polypeptides were localized both on the hepatocyte membrane and in the cytoplasm, and in eight of whom only in the cytoplasm. The localization pattern of Pre-S2 polypeptides was not correlated with the histological findings but with the replicative status of HBV. In cases with a high level of DNA-polymerase in the serum or with both nuclear and cytoplasmic expression of HBcAg in the liver, Pre-S2 polypeptides were more frequently expressed both on the hepatocyte membrane and in the cytoplasm (P less than 0.05). Membranous expression of Pre-S2 polypeptides was speculated to be linked to active replication of HBV in the hepatocytes. Under immune electron microscopy, Pre-S2 polypeptides were observed on the plasma membrane, membranes and cisternae of endoplasmic reticulum (ER), or perinuclear space. Moreover, Pre-S2 polypeptides were detected on the tubular structures and the intracisternal particles about 40 nm in diameter considered to represent HBV. These findings suggest that the immunoreactions of Pre-S2 polypeptides in the liver tissue are similar to those of HBsAg, indicating that Pre-S2 polypeptides play an important role in the immunocharacteristics of HBsAg.

Vaccine engineering: enhancement of immunogenicity of synthetic peptide vaccines related to hepatitis in chemically defined models consisting of T- and B-cell epitopes

We report the development of two models for synthetic hepatitis B vaccines. The models were based on the multiple antigen peptide (MAP) system and contained the relevant B- and T-cell epitopes without any macromolecular carrier. Two peptides, representing the a determinant of the S region (S protein) of hepatitis B surface antigen, a dominant serotype of hepatitis B virus infection found in humans, and residues 12-26 of the pre-S(2) region of the middle protein were incorporated as either monoepitope or diepitope MAP models. Immunizations of outbred rabbits with the monoepitope MAP that contains the pre-S(2) antigen resulted in high-titered antibody response to the middle protein, but the other monoepitope, containing only the a-determinant peptide antigen, resulted in poor immune responses to either the peptide antigens or to the S protein. The diepitope MAPs containing both the a and the pre-S(2) determinants produced high-titer antibodies reactive to the a-synthetic peptide and the S protein, as well as to the middle proteins. Thus, our results show that the diepitope MAP models eliminate the need for a protein carrier and that the pre-S(2) peptide determinant serves as a T-helper cell epitope that enhances the immune response of the S region and overcomes the poor immunogenicity encountered with a single epitope of the S region.

Duck hepatitis B virus can tolerate insertion, deletion, and partial frameshift mutation in the distal pre-S region

In-frame and frameshift mutations were introduced into the pre-S region (1,212 base pairs) of duck hepatitis B virus. The in-frame mutants retained the inserted 12 nucleotides, while the frameshift mutants either reverted to wild type or exhibited a 10-nucleotide compensatory deletion downstream of the original mutation site. Thus, although duck hepatitis B virus has a compact and highly economical genome organization, it can replicate despite alterations of up to 9 amino acid codons in the pre-S and P open reading frames.

The preS1 antigen of hepatitis B virus is highly immunogenic at the T cell level in man

14 hepatitis B vaccine recipients who showed high titers of anti-hepatitis B surface antibodies in serum after booster immunization with a polyvalent hepatitis B surface antigen vaccine that contained trace amounts of hepatitis B virus (HBV) preS1 and preS2 envelope antigens were studied for their in vitro T cell response to these antigens. All 14 subjects displayed a significant proliferative T cell response to the S/p25 envelope region encoded polypeptide; 8 also responded to preS1, while only 1 showed a significant level of T cell proliferation to preS2. Limiting dilution analysis demonstrated that the frequency of preS-specific T cells in two of these vaccine recipients was higher than that of S/p25-specific T cells. T cell cloning was then performed and a total of 29 HBV envelope antigen-reactive CD4+ cloned lines were generated from two preS-responsive vaccines. 21 of these lines were S/p25 specific, 7 preS1 specific, and 1 preS2 specific. Taken together, all these results suggest that the preS1 antigen may function as a strong T cell immunogen in man.

Anti-pre-S(2) analysis after hepatitis B vaccination in haemodialysis patients

We investigated the development of anti-pre-S(2) antibodies by enzyme immunoassay and by Western blot analysis in a vaccination study in haemodialysis patients; both the Pasteur plasma vaccine retaining the pre-S(2) epitopes and the Merck, Sharp and Dohme (MSD) plasma vaccine containing only HBsAg were used. By enzyme immunoassay (EIA), one anti-pre-S(2) response at month 7 was registered in 23 patients after 5 injections with the 5 micrograms dose of Pasteur vaccine (PS group), whereas 6 responses were seen in 20 patients after 4 injections with the 10 micrograms dose (PD group). None of the 22 vaccines injected with MSD vaccine (40 micrograms) (4 injections, MD group) showed an anti-pre-S(2) response at month 7. In the Western blot an anti-pre-S(2) response was seen in 12 PS patients, in 8 PD patients and in none of the MD patients. Anti-pre-S(2) responses were predominantly observed in patients with a high anti-HBs response but exceptions occurred. Prevaccination anti-pre-S(2) positivity, in the absence of anti-HBc and anti-HBs, was detected in dialysis patients with EIA as well as Western blot, in 10.8 and 21.6%, respectively; similar findings were made in health care personnel. The possible nature of this phenomenon is discussed. In this study the Western blot technique has been shown to be a suitable test system for qualitative and semi-quantitative analysis of anti-pre-S(2) antibodies after hepatitis B vaccination with a higher sensitivity, but probably also a different specificity than the EIA.

Clearance of hepatitis B virus DNA and pre-S surface antigens in patients with markers of acute viral replication

To clarify the relationship between the pre-S antigens and other serological markers of hepatitis B virus (HBV) replication, we followed up 27 patients: 21 presented with symptoms of acute hepatitis (two progressed to chronicity) and six suffered from chronic hepatitis. Pre-S1, pre-S2, HBV DNA, IgM antihepatitis core antigen (HBc), hepatitis B e antigen (HBeAg), and anti-HBe were detected in about 200 sera serially collected at different times for at least 6-12 months from the onset of clinical observation. In the early symptomatic phase of acute hepatitis, the pre-S1 and pre-S2 antigens were present in 95% of the cases and correlated well with high levels of alanine-transferase (ALT) and IgM anti-HBc, while HBV DNA was present in the sera of only six (28.6%) patients (P less than 0.0001). This was the first marker to disappear (1 month after the initial stage). All of the HBV DNA-positive patients were also HBeAg positive, whereas no HBeAg-negative subjects were found with serum HBV DNA. In the six chronic patients, pre-S antigens were always present independently of the HBeAg/anti-HBe status; HBV DNA was detected in three of them, even if transiently, and in two of these it reappeared together with pre-S2 epitope. The follow-up data suggest that, in acute hepatitis, the clearance of pre-S antigens can be considered as a prognostic index of clinical resolution and that, in chronic hepatitis, the persistence of pre-S antigens seems to indicate progression of the disease. In particular, pre-S2, in patients in whom it is intermittent, can be considered as an index of reactivation.

Dissociated antibody responses to the S and pre-S2 regions of the hepatitis B virus after vaccination in hemophiliacs

The membranes of hepatocytes and the pre-S2 envelope protein of the hepatitis B virus (HBV) contain binding sites for polymerized human albumin, which is thought to act as a link between HBV and hepatocytes. Hence, anti-pre-S2 antibodies should prevent HBV uptake by the liver, and there is indeed preliminary evidence that they protect chimpanzees from HBV infection. To evaluate whether a plasma-derived vaccine containing the pre-S2 sequence induced an anti-pre-S2 response in 105 vaccinated hemophiliacs, anti-pre-S2 was measured in parallel with antibody to hepatitis B surface antigen (anti-HBs). Eighty-five percent of the hemophiliacs had both anti-pre-S2 and anti-HBs when vaccination was completed, 13% had anti-HBs alone, and 2% (two cases) had anti-pre-S2 alone. Eighty-seven percent of anti-pre-S2-positive hemophiliacs compared with only 50% of anti-pre-S2-negative hemophiliacs (P less than 0.001) developed high anti-HBs titers (greater than or equal to 1,000 mlU/ml). This study demonstrates, therefore, that the antibody responses to the S and pre-S2 regions of HBV may be dissociated after vaccination in hemophiliacs and that higher anti-HBs titers are attained in anti-pre-S2-positive hemophiliacs.

Expression of immunogenic epitopes of hepatitis B surface antigen with hybrid flagellin proteins by a vaccine strain of Salmonella

A nonvirulent Salmonella dublin flagellin-negative, aromatic-dependent live vaccine strain has been used to express hepatitis B virus surface antigen epitopes in an immunogenic form. The envelope proteins of the virion are encoded by the S gene, which contains the pre-S1, pre-S2, and S coding regions. Synthetic oligonucleotides corresponding to amino acid residues S-(122-137) and pre-S2-(120-145) were inserted in-frame into the hypervariable region of a cloned Salmonella flagellin gene, and the recombinant plasmids were introduced into a flagellin-negative aroA mutant live vaccine strain of S. dublin, SL5928. The flagellin gene was expressed in bacteria carrying the plasmids as detected by immunoblotting with anti-flagellin (H1-d) serum. Both the S and pre-S2 epitopes were detected in bacteria carrying the relevant plasmid by immunoblotting with anti-HBs (antibody to hepatitis B virus surface antigen) and anti-peptide antisera. Animals immunized intramuscularly or orally with the live recombinant bacteria developed antibodies specific to these hepatitis B virus epitopes as detected by ELISA.

Epitope mapping of neutralizing monoclonal antibodies against duck hepatitis B virus

In this article we report the first topological mapping of neutralizing epitopes of a hepadnavirus. Duck hepatitis B virus is the only hepadnavirus that can replicate and spread from cell to cell in tissue culture. As a result, it is possible to study hepadnaviral neutralization in vitro with this system. To accomplish this goal, we produced a library of monoclonal antibodies against duck hepatitis B virus and identified 12 neutralizing monoclonal antibodies by using an in vitro neutralization assay. The characteristics of six of the neutralizing monoclonal antibodies were further studied by epitope mapping. From the results of competitive binding studies, three distinct neutralizing epitopes were identified on the pre-S polypeptides and one was identified on the S polypeptide. Our findings suggest that antibodies to both the pre-S and S gene products of duck hepatitis B virus can neutralize viral infection in vitro. The pre-S gene product is at least as important as the S gene product in eliciting neutralizing antibodies.

HLA linked immune response to S and pre-S2 gene products in hepatitis B vaccination

In order to detect a possible HLA linked genetic control of human immune responses to hepatitis B virus, forty healthy adult persons of the same age typed for HLA-A, -B and -DR antigens, were vaccinated against virus hepatitis B and sequentially tested for anti-HBs and anti-pre-S2 antibodies. They received three injections of Hevac-B Pasteur vaccine, the second 1 month and the third 3 months after the first. Following the third immunization, 38 individuals (95%) had a protective level of anti-HBs antibodies and 17 (42.3%) had a positive level of anti-pre-S2 antibodies. HLA-A11 antigen was significantly more frequent (pc = 0.007) among anti-HBs high responders than low responders. In addition, anti-HBs high responders were more frequently HLA-DR1, and less frequently HLA-DR4 and DR7 positive; corrected values, however, were not significant. Anti-pre-S2 high responders showed an apparent increase of HLA-B7, B14 or DR3 antigens, when compared to low responders (pc not significant).

In vitro immune responses to hepatitis B surface antigen (Pre-S2 and S) following remote infection by hepatitis B virus in humans

In this report we evaluate the human immune response to hepatitis B surface antigen (HBsAg) following remote infection with hepatitis B virus (HBV). HBsAg-reactive lymphocytes can be readily demonstrated in the peripheral blood of individuals with established immunity following infection with HBV. In vitro stimulation with small doses of plasma-derived HBsAg, yeast-derived HBsAg (S region) or pre-S2 peptide will induce specific IgG to HBsAg (anti-HBs) in the absence of a polyclonal increase in total IgG. The pre-S2 peptide will stimulate, in a T cell-dependent fashion, the in vitro production of anti-HBs with specificity for the S domain. This anti-HBs production is mediated by pre-S2-stimulated soluble T-cell factors. Peripheral blood mononuclear cells from individuals with established immunity proliferate to the yeast-derived HBsAg but not to the plasma-derived HBsAg or pre-S2 peptide. The chronic HBsAg carriers do not produce anti-HBs following stimulation with HBsAg regardless of the source or component of antigen used. Different study protocols failed to demonstrate HBsAg-specific responses in the peripheral blood mononuclear cells of chronic carriers.

Production of hepatitis B virus surface antigen containing pre-S1 and pre-S2 domains by Chinese hamster ovary cells

We have established transformed Chinese hamster ovary cells, which secrete hepatitis B virus surface antigen containing both pre-S1 and pre-S2 domains into culture medium, by using the autologous S gene promoter.

Purification and characterization of pre-S-containing hepatitis B surface antigens produced in recombinant mammalian cell culture

Heterogeneous, pre-S-rich HBsAg particles were expressed in recombinant mammalian cell culture and purified to near homogeneity. The purification process comprises: concentration of cell culture medium, protein precipitation by poly(ethylene glycol), gel filtration column chromatography, isopycnic ultracentrifugation by KBr and sucrose density gradient ultracentrifugation. The resulting HBsAg product was greater than 98% pure, and contained much of pre-S1 and pre-S2 components. Scanning densitometry analysis of the silver-stained HBsAg product showed approximately 70-80% S protein, approximately 10-20% pre-S2 protein, and approximately 5-15% pre-S1 protein. It was estimated that the amount of HBV-specific DNA present the final product was less than 7 pg mg-1 HBsAg. Further biochemical analysis has demonstrated that the HBsAg particles are very heterogeneous in charge and density. Charge heterogeneity was quite random among the particles, but density heterogeneity could be related to the different amounts of pre-S2 component in the particles.

Expression of hepatitis B virus surface antigen containing the pre-S region in mammalian cell culture system

The surface antigen of hepatitis B virus (HBV) has been expressed in a mouse cell line using metallothionein-bovine papilloma virus vectors. Four different recombinant plasmids were used and it was found that the expression level varies significantly from one plasmid to another. Removing the HBV polyadenylation signal from the plasmid drastically reduced the expression level. Providing even a heterologous polyadenylation signal improved the expression level from the reduced one by at least tenfold. The steady-state level of cytoplasmic HBV-specific RNA was much higher when the polyadenylation signal was present. One of the constructs gave a very high expression level and has been characterized further. It was possible to detect any plasmid in the episomal form in the producing clones and all the HBV DNA was found to be integrated in the mouse chromosome at more than one site. The copy number of the plasmid varied greatly between different clones and in the best one it is approximately 150 copies per haploid genome. Cells can be grown continuously in the presence of cadmium chloride without splitting for more than two months and the excreted surface antigen can be harvested during this period. Western blot analysis showed that the antigen contains the pre-S region.

Serum titers of pre-S(2) antigen in patients with acute and chronic type B hepatitis: relation to serum aminotransferase activity and other hepatitis B virus markers

The peptide which is encoded by the pre-S(2) region of hepatitis B virus DNA, the pre-S(2) antigen, was determined quantitatively by an enzyme immunoassay system employing monoclonal antibodies. The prevalence and titer of pre-S(2)Ag were 91.9% (91/99) and 10,356 +/- 19,053 units (mean +/- S.D., arbitrary units) for hepatitis B e antigen (HBeAg)-positive patients with acute and chronic HBV infection and 86.0% (74/86) and 952 +/- 1,565 units for HBeAg-negative subjects. In four patients with acute hepatitis B, pre-S(2)Ag titers changed in parallel with HBV DNA levels, and the disappearance of pre-S(2)Ag from serum was associated with a rapid fall of ALT levels into the normal range, whereas the fluctuation of pre-S(2)Ag titer correlated with persistence of ALT elevations. In all of the 19 episodes of acute exacerbation of hepatitis which occurred in nine patients with chronic active hepatitis B, a significant elevation of pre-S(2)Ag titer was observed, closely overlapping an increase or appearance of HBV DNA, and its peak preceded peaks of ALT by 1 to 11 weeks (mean +/- S.D. = 4.26 +/- 2.57 weeks). These observations suggest that quantitative measurement of pre-S(2)Ag would be useful for estimation of the magnitude of HBV replication and would help predict the prognosis of acute hepatitis B and of acute exacerbation in chronic hepatitis B.

Vaccines against tumor antigens

Effective vaccines against tumor antigens have not yet been produced. However, immunomodulators hold much promise in cancer therapy. Such treatments will probably involve using combinations of various immunomodulators together with activated killer cells. Development of vaccines against tumor-causing viruses seems to be a rational approach to preventing the onset of virus-induced cancers. It seems that efficient vaccines have already been developed for hepatitis B virus; such vaccines have the potential to decrease the incidence of its associated hepatoma. However, successful vaccines against RNA-containing tumor viruses have yet to be developed, although they hold much promise.

Molecular and genetic aspects of the immune responses to hepatitis B viral antigens

In the absence of an inbred animal model of hepatitis B virus (HBV) infection, several laboratories have chosen to study the murine immune response to HBV-encoded proteins as immunogens as opposed to an infectious agent. This article reviews the immunogenicity, the fine specificity of T and B cell recognition of HBV antigens, and the genetic influences that regulate these responses. It is anticipated that this approach will increase our understanding of immune-mediated viral clearance mechanisms during HBV infection, and may provide the framework for the design of second and third generation HBV vaccines.

Anti-pre-S antibodies in different groups of patients with hepatitis B virus infection

The anti-pre-S antibody in the samples of sera from normal healthy persons and patients with different clinical types of liver diseases due to hepatitis B virus (HBV) infection was detected by a newly established enzyme-linked immunosorbent assay technique. This test is a blocking assay where anti-pre-S antibody in the patient's serum blocks subsequent addition of horse radish peroxidase-labelled polymerized human serum albumin (pHSA) to the pHSA-receptor site of HBsAg molecules fixed on a solid surface. Anti-pre-S activity was not detected in any from 95 healthy persons who were negative for all HBV-markers or from 105 healthy HBV carriers. In 12 sera from HBV vaccine recipients, anti-pre-S activity was noted in higher proportions compared with anti-HBs, after both the second and third doses of vaccine. Anti-pre-S activity was detected in small proportions of HBsAg positive sera from acute viral hepatitis (4.2%) and chronic active hepatitis (10%). In subacute viral hepatitis patients, the anti-pre-S antibody was totally absent. However, anti-pre-S activity was recorded in high proportions of HBsAg-positive sera from patients with cirrhosis of liver (57.2%) and fulminant hepatitis (41.6%). The anti-pre-S antibodies were assumed to be implicated in the clearance of HBV particles from circulation without causing tissue damage.

Purity, antigenicity and immunogenicity of the hepatitis B surface antigen purified by five different methods

Five published methods for the purification of HBsAg from plasma were compared for specific activity (SA), degree of purification, and yield. The SA value was determined by dividing the reciprocal of the end point dilution per milliliter as determined using a commercial radioimmunoassay (AUSRIA II; Abbott Laboratories, North Chicago, IL) by the protein concentration quantitated by the Lowry method. HBsAg purified by two consecutive isopycnic ultracentrifugation separations in KBr and one rate-zonal separation in sucrose using a zonal rotor (Ti-14, Beckman, Palo Alto, CA) yielded a preparation which gave the highest SA value, degree of purification and yield as compared to four other methods. Each purified preparation was adsorbed to alum adjuvant and injected into mice to determine the immunogenic dose at which 50% of the animals elicited an anti-HBs response (ID50). The zonal rotor method resulted in the lowest ID50 value (365 ng/ml) supporting the highest SA value. Furthermore, SDS polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot analysis revealed that this preparation had the greatest number of HBsAg-specific polypeptides (N = 7) and the fewest contaminating polypeptides (N = 5). The contaminating proteins were identified as alpha-2-macroglobulin, heavy chains of IgG and IgM, immunoglobulin kappa chain, and albumin.

Non-responsiveness to hepatitis-B vaccination: revaccination and immunogenetic typing

The variation in immune responses to standard inoculation of the hepatitis-B virus vaccine suggest that host factors influence response in ways that are not presently understood. We studied 25 low/nonresponding health care workers (anti-HBs titer less than 50 IU/l) after the third inoculation of an experimental hepatitis-B vaccine to determine their immune status (through lymphocyte phenotypes) and HLA type. After application of a fourth inoculation, the seroconverting subjects showed only low anti-HBs levels; three male subjects remained anti-HBs negative. Twelve months after the fourth inoculation only 9 of 25 subjects (36%) maintained anti-HBs titer greater than 10 IU/l. Almost all subjects had normal B-cell and CD-4 and CD-8 counts and ratios. Relative to other European populations HLA-A-10 (P less than 0.05), B-12 (P less than 0.025), CW-5 (P less than 0.05), DR-3 (P less than 0.025), and DR-5 (P less than 0.025) were increased, whereas DR-2 (P less than 0.05) was decreased. However, after correction of the P-values for the number of HLA antigens determined, these differences were no longer significant. Furthermore, these HLA types were not the same as those reported in other studies (except for DR-3). We suggest that larger sample sizes or even not yet available immunogenetic markers will be required to prove an "immunogenetic background" in low/nonresponders, if it exists.

Cellular immune response to hepatitis B virus antigens. An overview

It has been suggested that the cellular immune response to HBV antigens is responsible for hepatocellular injury in acute and chronic hepatitis B. However, definitive immunological studies have so far been hampered by the lack of appropriate model systems to study HBV antigen-specific T cells. The availability of highly purified and recombinant HBV antigens and of experimental techniques to maintain in continuous growth antigen-specific T cells derived not only from the peripheral blood but also from the liver should allow a better understanding of the fine immunopathogenetical mechanisms involved in viral clearance and liver damage. Whether some important biological characteristics of HBV antigens described in the mouse system, such as the high immunogenicity of the pre-S antigens and the capacity of the nucleocapsid of HBV to be a T cell-dependent and -independent antigen, are relevant to the immunopathogenesis of liver damage during natural HBV infection in man remains to be evaluated.

Anti-pre-S2 antibodies in natural hepatitis B virus infection and after immunization

Anti-pre-S2 antibodies were detected by enzyme-linked immuno-absorbant assay using a synthetic peptide analogue of pre-S2 protein, in different groups of hepatitis-B-infected subjects, including patients presenting with cirrhosis and liver cancer, and also in infants immunized with hepatitis B vaccine. Anti-pre-S2 antibodies were not detected in hepatitis B surface antigen (HBsAg) chronic carriers, including patients with cirrhosis or primary liver cancer. Anti-pre-S2 antibodies were not detected in HBsAg-positive sera during the early phase of acute hepatitis. They were only noted upon recovery, when anti-HBs antibodies are detectable at the same time as HBsAg. After recovery, anti-pre-S2 antibodies were noted in 57% of test sera and were still detectable in 16% of anti-HBs-positive sera obtained years after HBV infection. Anti-pre-S2 antibodies were detected in 70% of infants immunized with 2 or 5 micrograms doses of Hevac B Pasteur vaccine, confirming that this vaccine contains pre-S2 antigen. Anti-pre-S2 detection was correlated with the anti-HBs antibody titre.

Characterization of purified hepatitis B surface antigen containing pre-S(2) epitopes expressed in Saccharomyces cerevisiae

The cloning and expression of the hepatitis B middle-protein surface antigen gene in the yeast Saccharomyces cerevisiae is described. A generalized expression vector carrying the yeast glyceraldehyde-3-phosphate dehydrogenase gene promoter was used. Expressed material, in the form of supramolecular particles, was purified and characterized. Severe proteolysis within the pre-S(2) region was observed for material expressed in a wild-type yeast host. This proteolysis was substantially reduced by utilization of a protease-deficient host. Immunoblotting of sodium dodecyl sulfate-polyacrylamide gels with several antibodies of differing specificity was performed to characterize the various protein species present. All species were analyzed by N-terminal sequencing after electroelution from gels. Carbohydrate staining of gels and glycosidase treatments of the purified antigen material indicated that full-length antigen was present in both glycosylated and unglycosylated forms. Glycosylation appeared to be of both asparagine-linked and threonine/serine-linked types. Site-directed mutagenesis was used to convert two arginine residues in the pre-S(2) region of the antigen to glutamine residues. The changes abolished reactivity with one polyclonal and two monoclonal antibodies specific for epitopes within the pre-S(2) region.

Translational selection in the expression of the hepatitis B virus envelope proteins

The region of the hepatitis B virus (HBV) genome coding for the viral envelope proteins contains three inphase ATGs that are conserved among viral subtypes. Each of these ATGs can be used as mRNA initiation codons. The three translated proteins share a carboxy-terminal region (the S protein) and extend amino-terminally to include the pre-S2 region in the middle (M) protein, and the pre-S1 and pre-S2 regions in the large (L) protein. We have inserted the HBV DNA coding for the M protein into a baculovirus expression vector. Infected insect cells transcribe a mRNA that is initiated solely within a baculovirus promoter, and that contains the initiator codons for both M and S proteins. Although these cells primarily secrete the M protein, the major translational product is the S protein, which is not secreted. This preferential translation, the result of the use of an internal initiator codon, demonstrates that the regulation of HBV envelope protein production can occur at the translational level.

Persistence of specific antibodies after hepatitis B vaccination

Antibody levels to hepatitis B surface antigen (anti-HBs) in healthy adults vaccinated with three doses of plasma-derived hepatitis B vaccine, containing 20, 10 or 5 micrograms of antigen, were followed for 4-6 years. After vaccination, 1034 of 1076 individuals had developed anti-HBs and 1016 had antibody concentrations above 10 IU/l. 681 of all initial responders could be tested after 1 year, 520 after 2, 380 after 3 and 213 after 4 years. 72 and 39 individuals, respectively, of the 185 earliest vaccinated volunteers were available for retesting after 5 and 6 years. Four years after the first vaccination, anti-HBs levels in 34% had dropped below 10 IU/l. The persistence of anti-HBs above this value depended on the peak antibody response after the third vaccination. Whereas all vaccinees tested with peak anti-HBs levels above 10,000 IU/l still had levels above 10 IU/l after 6 years, no-one with initial values between 10 and 100 IU/l maintained antibody concentrations above 10 IU/l for longer than 4 years. The rate of decrease in anti-HBs was independent of the peak anti-HBs value, the vaccine dose, and the age and sex of the vaccinees.

Methods for the study of pre-S proteins of hepatitis B virus and their antibodies: pathogenetic and clinical implications

The envelope gene of hepatitis B virus (HBV) consists of a large open reading frame which codes 3 different polypeptides by the variable use of 3 contiguous regions: the pre-S1, pre-S2 and S regions. The protein coded by the entire sequence (L protein) is identified by its unique pre-S1 epitopes and has a role in virus assembly and secretion. Pre-S1 antigens are expressed preferentially on virions and are less abundant, but present, on subviral particles. The pre-S2 sequence contains a species-specific receptor for polyalbumin, which has been implicated in virus binding to hepatocytes. Methods have been recently developed to measure pre-S1 and pre-S2 levels in serum and available data indicate that these assays may be useful in prognostic assessment of acute hepatitis B and to measure virus replication in chronic infection, although further studies are certainly needed to define specificity and sensitivity compared to conventional HBV markers. Both pre-S1 and pre-S2 are highly immunogenic and elicit anti-pre-S antibodies. Methods for detection of anti-pre-S in human sera have proved difficult to be developed due to unspecific reaction of serum components with pre-S sequences and epitope variability of the immune response in humans. Anti-pre-S2 seems a marker of recovery from acute infection, while evidence of its involvement in liver damage is weak. Both anti-pre-S2 and anti-pre-S1, but we have limited information on the latter, may be involved in virus neutralization. These issues are particularly relevant for future HB vaccine development, as it is proposed that inclusion of strategic pre-S sequences could increase efficacy.

Receptors for polymerized human serum albumin in plasma derived hepatitis B vaccines

The presence of polymerized human serum albumin receptors (pHSA-R) in two hepatitis B virus (HBV) plasma derived vaccines (HB-Vax, Merck Sharp and Dohme; Hevac-B, Pasteur) was detected by three methods, using pHSA polystyrene coated beads and 125I-anti-HBs (method 1) and polyclonal (method 2) or monoclonal (method 3) peroxidase conjugated anti-HBs. Only a very weak reaction was found for pHSA-R in HB-Vax vaccine when the tests were performed in undiluted vaccine. No reactivity in 1/100 dilution (normally used to test pHSA-R in serum samples) was observed. In contrast, Hevac-B vaccine contained pHSA-R activity in 1/100 dilution as tested by any of the three methods. Furthermore, the level of pHSA-R detected in Hevac-B vaccine is similar to that observed in asymptomatic HBsAg carriers with the same HBsAg concentration. In summary, Hevac-B vaccine contains pHSA-R, whilst HB-Vax shows only weakly reacting pHSA-R, probably insufficient to develop anti-pHSA-R antibodies.

Expression of hepatitis B virus middle and large surface antigen genes in Saccharomyces cerevisiae

The hepatitis B virus genome carries the surface antigen (SAg) gene and an open reading frame that encodes two SAg-related polypeptides: SAg with a 55-amino-acid N-terminal extension polypeptide and SAg with a 174-amino-acid N-terminal extension polypeptide. These are termed middle S and large S, respectively. These polypeptides or their glycosylated derivatives have been detected in Dane particles, but their chemical and biological properties have remained largely unknown because of their limited availability. We attempted to produce these proteins in Saccharomyces cerevisiae by placing the coding regions under the control of the promoter of the yeast glyceraldehyde-3-phosphate dehydrogenase (GAPDH) gene. Yeast cells carrying middle S and large S coding sequences produced 33,000- and 42,000-dalton products, respectively, each of which reacted with anti-S antibody and bound to polymerized human serum albumin, in accordance with the known properties of pre-S proteins from particles in human sera (K. H. Heermann, U. Goldmann, W. Schwartz, T. Seyffarth, H. Baumgarten, and W. H. Gerlich, J. Virol. 52:396-402, 1984; A. Machida, S. Kishimoto, H. Ohnuma, K. Baba, Y. Ito, H. Miyamoto, G. Funatsu, K. Oda, S. Usuda, S. Togami, T. Nakamura, Y. Miyakawa, and M. Mayumi, Gastroenterology 86:910-918, 1984). The middle S polypeptide is glycosylated and can be assembled into particles whose size and density are similar to those of SAg. However, this polypeptide was highly susceptible to proteolytic degradation into 29,000- and 26,000-dalton polypeptides, of which only the former retained the binding activity to polymerized albumin. The large S polypeptides are nonglycosylated, relatively stable, and do not seem to assemble into particles by themselves.

Antibody production to the nucleocapsid and envelope of the hepatitis B virus primed by a single synthetic T cell site

The nucleocapsid (HBcAg) of the hepatitis B virus (HBV) can induce antibody responses via both a T-cell dependent and a T-cell independent pathway and is highly immunogenic during infection. We have examined the T-cell determinants of the antigen and find that HBcAg-specific helper T cells (TH) can help B cells produce antibody against envelope (HBsAg) antigens as well as HBcAg, even though these antigens are found on separate molecules. We have also been able to prime helper T cells with synthetic T-cell epitopes of HBcAg; helper cells primed with a single synthetic epitope can induce B cells to produce antibody that reacts with multiple HBsAg epitopes. One problem with the development of an HBV vaccine is that some vaccinees and patients do not respond to HBsAg directly; our results indicate that this problem can be circumvented using the response to HBcAg.

Detection of antibodies to pre-S2 encoded epitopes of hepatitis B virus by monoclonal antibody-enzyme immunoassay

An inhibition enzyme immunoassay (IEIA) for the detection of anti-pre-S2 antibody has been developed and used to evaluate anti-pre-S2 responses in the sera of patients recovering from acute type B hepatitis and in the sera of healthy recipients of HBV vaccine. In the assay, we used two monoclonal antibodies recognizing the nonoverlapping epitopes (pre-S2a and pre-S2b) of the pre-S2 protein of HBV envelope which compete with human anti-pre-S2 for the limited antibody-binding sites on recombinant HBsAg particles (pre-S and S gene product). Two variants of the method were assayed employing the reference pre-S2 antigen on the solid (IEIA-sp) or in the liquid phase (IEIA-lp). Two McAbs were used to detect antibodies reacting specifically with pre-S2a and pre-S2b epitopes of the pre-S2 sequence. Both variants gave similar results and were successfully used for the determination of anti-pre-s2 in sera. We demonstrated that during HBV infection as well as after vaccination against HBV both pre-S2 epitopes generate specific immune responses. Anti-pre-S2 were detected in 45.3% patients recovering from HBV infection and in 43.7% of healthy recipients of the HBV vaccine licensed in France. Anti-pre-S2a and anti-pre-S2b were detected in sera in dilutions up to 10(-5). IEIA may provide a specific and highly sensitive screening test for monitoring serum anti-pre-S2 levels during HBV infection and after immunization with HBV vaccine.

Biochemical and immunological characterization of the duck hepatitis B virus envelope proteins

To examine the envelope proteins of duck hepatitis B virus (DHBV), which are encoded by the pre-S/S open reading frame of the viral genome, an antiserum was raised in rabbits against a fusion protein comprising most of the pre-S coding segment. By using this antiserum, viral particles could be precipitated from serum, and two pre-S proteins with molecular sizes of approximately 35 and 37 kilodaltons were detected in the sera and livers of DHBV-infected ducks after Western blotting and after biosynthetic labeling of a primary duck liver cell culture. In serum, the pre-S proteins were shown to exist predominantly in DHBV-DNA-free particles associated with a 17-kilodalton protein which, by N-terminal amino acid sequence analysis, was shown to represent the viral S protein which is encoded by the 3' proximal segment of the DHBV pre-S/S open reading frame. To compare the immunogenic potential of the S and pre-S proteins, serum particles and gel-purified S protein were used to immunize rabbits. In neither case was a significant immune response against the DHBV S protein observed. However, a good antibody titer against DHBV pre-S was obtained even after immunization with small amounts of the pre-S antigen.

Immunological cross-reactivity between preS2 sequences of the hepatitis B virus envelope proteins corresponding to serological subtypes adw2 and ayw

An immune response to epitopes localized on the preS region of the hepatitis B virus (HBV) envelope (env) is elicited during recovery from HBV infection and appears to play a role in virus clearance. Anti-preS antibodies (Ab) are expected to be protective against HBV infection as indicated by the virus-neutralizing capacity of Ab to a preS2-specific synthetic peptide preS(120-145). However, there is considerable amino acid variability between preS regions corresponding to distinct serological subtypes of HBV, raising the question whether the preS sequences are sufficiently related immunologically to have the potential of inducing cross-protective immunity. To answer this question concerning the preS2 region, antisera to synthetic peptides preS(120-153) and preS(128-153) corresponding to subtypes adw2 and ayw, as well as to the native env [ayw] protein were raised. Using the resulting polyclonal Ab, an immunological relatedness between preS2 sequences of subtypes adw2 and ayw was demonstrated. On the other hand, Ab selected by affinity chromatography or by cloning hybridoma cells may recognize with strong preference subtype-specific determinants within the preS2 region when the compared antigens are in solution rather than on the solid phase. These findings have implication for the design of: (1) preS2-specific immunogens and (2) immunoassays for quantitation of preS2 sequences in HBV env proteins.

A synthetic peptide coded for by the pre-S2 region of hepatitis B virus for adding immunogenicity to small spherical particles made of the product of the S gene

Small spherical particles produced in the non-permissive phase of hepatitis B virus infection, when the viral genome is integrated into the chromosome of hosts, are rich in the product of the S gene, but poor in the product of the pre-S2 region. For the purpose of adding immunogenicity to spherical particles deficient in the pre-S2 region product, they were conjugated with a synthetic peptide of 19 amino acid residues. The peptide reproduced a hydrophilic area of the pre-S2 region product encoded by viral genomes of subtypes adr, ayw and ayr. The spherical particles supplemented with the pre-S2 peptide raised antibody to the pre-S2 region product in mice, in addition to antibody to the product of the S gene. Antibody to pre-S2 region product, prepared from sera of immunized mice by absorption with the S gene product, bound to spherical particles bearing pre-S2 region product, irrespective of adr, adw, ayw or ayr subtype, and agglutinated hepatitis B virions in immune electron microscopy. Based on the results obtained, the synthetic peptide may prove useful in adding protective efficacy to small spherical particles poor in pre-S2 region product.

The preS1 protein of hepatitis B virus is acylated at its amino terminus with myristic acid

The preS/S coding region of hepatitis B virus encodes two polypeptides (preS1 and preS2) that are larger in size but less abundant than the major viral surface antigen (S) protein. Unlike the preS2 and S proteins, the preS1 protein is preferentially localized on circulating virus particles but is not efficiently secreted from mammalian cells in culture. To search for differences in protein processing that might relate to these properties, we determined whether any of the hepatitis B virus surface proteins are acylated with long-chain fatty acids. Transfected COS cells expressing all three proteins were incubated with 3H-palmitate or 3H-myristate, and the cell extracts were examined by immunoprecipitation. While none of these proteins was labeled with 3H-palmitate, the preS1 protein but not the preS2 or S protein incorporated 3H-myristate via a hydroxylamine-resistant amide linkage. Comparison of the N-terminal amino acid sequences of hepadnaviral preS1 proteins with those of known myristylated proteins suggests that this unusual modification may be a common feature of all hepadnaviral preS1 proteins.

Selective synthesis and secretion of particles composed of the hepatitis B virus middle surface protein directed by a recombinant vaccinia virus: induction of antibodies to pre-S and S epitopes

Selective synthesis in mammalian cells of the hepatitis B virus middle surface (MS) protein, which is 55 amino acids longer than the major surface (S) protein, was achieved by using a recombinant vaccinia virus. The 33-kilodalton MS polypeptide was glycosylated and secreted as particles that resembled human hepatitis B surface antigen as well as particles composed solely of S protein with regard to antigenicity, buoyant density, size, and electron micrographic appearance. The MS particles differed from S particles, however, by binding to polymerized human albumin and inducing antibodies that reacted with a pre-S peptide and inhibited the binding of human plasma-derived hepatitis B surface antigen to polymerized human albumin.

Regulation of secretion of the hepatitis B virus major surface antigen by the preS-1 protein

P24, P30, and P39, the three major surface antigens of the envelope of hepatitis B virus, are co-carboxy-terminal proteins with different amino-terminal extensions. We prompted expression of these proteins in Chinese hamster ovary (CHO) cells by placing the appropriate coding sequence(s) under the control of the simian virus 40 early promoter. P24 and P30 formed 22-nm particles which were efficiently secreted. In contrast, P39 accumulated in a perinuclear structure, presumably the Golgi complex, and was not secreted. Coexpressing P39 and P24 resulted in the localization of both in the perinuclear region and restricted the secretion of P24. We found that P39 must be expressed at a relatively low level to allow efficient secretion of P24 in typical spherical particles. We hypothesize that P39, by inhibiting the formation of spherical particles, helps to induce formation of filamentous particles and mature Hepatitis B virus.

A monoclonal antibody enzyme immunoassay for the detection of epitopes encoded by the pre-S2 region of the hepatitis B virus genome

Pre-S2-coded sequences of the hepatitis B virus (HBV) represent important serological markers of HBV infection and elicit the antibodies essential for recovery from type B hepatitis. Monoclonal antibodies (McAbs) directed against two non-overlapping epitopes (pre-S2a and pre-S2b) of the pre-S2 protein of HBV were used to develop an enzyme immunosorbent assay (EIA). The assay was based on the solid-phase sandwich principle in which two different epitope-specific antibodies were used as immunadsorbents and as enzyme-labelled probes. The assay sensitivity was in the pg range and permitted precise quantitation of the pre-S2 sequences in sera. Using the 'site-specific' monoclonal assay we demonstrated that pre-S2a and pre-S2b epitopes are expressed on HBsAg particles of both ay and ad subtypes. The assay is the most sensitive currently available method for the detection of pre-S2 epitopes and may be used for routine immunodiagnosis of hepatitis B.