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Gavilán AM, Perán-Ramos P, Sanz JC, García-Comas L, Pérez-Abeledo M, Castellanos AM, Berciano JM, López-Perea N, Masa-Calles J, Echevarría JE, Fernández-García A. Investigating Local Patterns of Mumps Virus Circulation, Using a Combination of Molecular Tools. Viruses 2023; 15:2420. [PMID: 38140661 PMCID: PMC10747990 DOI: 10.3390/v15122420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Mumps is a vaccine-preventable disease caused by the mumps virus (MuV). However, MuV has re-emerged in many countries with high vaccine coverage. The World Health Organization (WHO) recommends molecular surveillance based on sequencing of the small hydrophobic (SH) gene. Additionally, the combined use of SH and non-coding regions (NCR) has been described in different studies, proving to be a useful complement marker to discriminate general patterns of circulation at national and international levels. The aim of this work is to test local-level usefulness of the combination of SH and MF-NCR sequencing in tracing hidden transmission clusters and chains during the last epidemic wave (2015-2020) in Spain. A database with 903 cases from the Autonomous Community of Madrid was generated by the integration of microbiological and epidemiological data. Of these, 453 representative cases were genotyped. Eight different SH variants and thirty-four SH haplotypes were detected. Local MuV circulation showed the same temporal pattern previously described at a national level. Only two of the thirteen previously identified outbreaks were caused by more than one variant/haplotype. Geographical representation of SH variants allowed the identification of several previously undetected clusters, which were analysed phylogenetically by the combination of SH and MF-NCR, in a total of 90 cases. MF-NCR was not able to improve the discrimination of geographical clusters based on SH sequencing, showing limited resolution for outbreak investigations.
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Affiliation(s)
- Ana M. Gavilán
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
| | - Paula Perán-Ramos
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
| | - Juan Carlos Sanz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, 28055 Madrid, Spain;
| | - Luis García-Comas
- Servicio de Epidemiología, Consejería de Sanidad de la Comunidad de Madrid, 28009 Madrid, Spain;
| | - Marta Pérez-Abeledo
- Laboratorio Regional de Salud Pública de la Comunidad de Madrid, 28055 Madrid, Spain;
| | - Ana M. Castellanos
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
| | - José M. Berciano
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
| | - Noemí López-Perea
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid/IdiPAZ, 28049 Madrid, Spain
| | - Josefa Masa-Calles
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Juan E. Echevarría
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
| | - Aurora Fernández-García
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.G.); (J.M.B.)
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (J.C.S.); (N.L.-P.); (J.M.-C.)
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2
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Vaidya SR. Immuno-Colorimetric Neutralization Test: A Surrogate for Widely Used Plaque Reduction Neutralization Tests in Public Health Virology. Viruses 2023; 15:v15040939. [PMID: 37112919 PMCID: PMC10143445 DOI: 10.3390/v15040939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/23/2023] [Accepted: 03/30/2023] [Indexed: 04/29/2023] Open
Abstract
Since their first documentation in 1952, plaque reduction neutralization tests (PRNTs) have become the choice of test for the measurement of neutralizing antibodies against a particular virus. However, PRNTs can be performed only against viruses that cause cytopathic effects (CPE). PRNTs also require skilled personnel and can be time-consuming depending on the time required for the virus to cause CPE. Hence, their application limits large-scale studies or epidemiological and laboratory investigations. Since 1978, many surrogate PRNTs or immunocolorimetric assay (ICA)-based focus reduction neutralization tests (FRNT) have been developed. In this article, ICAs and their utility in FRNTs for the characterization of neutralizing antibodies, homologous or heterologous cross-neutralization, and laboratory diagnosis of viruses of public health importance have been discussed. Additionally, possible advancements and automations have been described that may help in the development and validation of novel surrogate tests for emerging viruses.
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Affiliation(s)
- Sunil R Vaidya
- Virus Registry and Virus Repository, ICMR-National Institute of Virology, 20-A Dr. Ambedkar Road, Pune 411001, India
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3
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Foley DJ, Connell AR, Gonzalez G, Connell J, Leahy TR, De Gascun C, Hassan J. Mumps-specific IgG, IgG subclasses and neutralization titres to the vaccine and outbreak mumps strains differ in vaccinated healthy controls, breakthrough mumps infection cases and naturally infected individuals. J Clin Virol 2022; 157:105296. [PMID: 36209622 DOI: 10.1016/j.jcv.2022.105296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/22/2022] [Accepted: 09/19/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Despite widespread use of the mumps vaccine resulting in significant reduction in the incidence of symptomatic mumps infection, large outbreaks continue to occur in highly vaccinated populations. OBJECTIVES We examined the mumps-specific IgG, IgG subclasses and neutralization titres to the outbreak Genotype G5 and Jeryl Lynn vaccine (Genotype A) mumps strains. STUDY DESIGN Sera from 207 individuals were classified into five distinct cohorts: healthy controls and mumps cases of 5-17 years and 18-25 years, and naturally infected individuals of 50+ years. Mumps specific IgG and IgG subclass levels were measured using modified ELISA assays with lysates and nucleoprotein antigens from both the mumps vaccine and circulating Genotype G5 strains. All sera were investigated for in vitro neutralizing antibody titres (GMT) using focus reduction neutralization assays. Data was analysed using the Kruskal-Wallis test and pairwise Wilcoxon tests. RESULTS Mumps cases had higher mumps IgG levels compared to controls, to both the vaccine and outbreak strains, however levels decreased with age. Mumps IgG3 levels were significantly raised in mumps cases (p < 0.001). Neutralization titres were lower to the outbreak strain in all cohorts with titres markedly lower in the mumps cohorts compared to healthy controls. Mean GMT to the vaccine strain increased with age. The naturally infected group displayed the highest GMT to the JL vaccine and the lowest GMT to the outbreak strain. CONCLUSIONS Antigenic differences between mumps vaccine strain and circulating mumps viruses decrease the cross-neutralization capacity of vaccine-induced antibodies which may play a role in breakthrough infection.
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Affiliation(s)
- Deirdre Jane Foley
- Department of Paediatric Immunology and Infectious Diseases, Children's Health Ireland at Crumlin, Dublin 12, Ireland
| | - Anna Rose Connell
- National Children's Research Centre, Children's Health Ireland at Crumlin, Dublin 12, Ireland
| | - Gabriel Gonzalez
- National Virus Reference Laboratory, University College Dublin, Dublin 4, Belfield, Ireland; International Collaboration Unit, Research Center for Zoonosis Control, Hokkaido University, N20 W10 Kita-ku, Sapporo, 001-0020, Japan
| | - Jeff Connell
- National Virus Reference Laboratory, University College Dublin, Dublin 4, Belfield, Ireland
| | - Timothy Ronan Leahy
- Department of Paediatric Immunology and Infectious Diseases, Children's Health Ireland at Crumlin, Dublin 12, Ireland; Department of Paediatrics, University of Dublin, Trinity College, Dublin 2, Ireland
| | - Cillian De Gascun
- National Virus Reference Laboratory, University College Dublin, Dublin 4, Belfield, Ireland
| | - Jaythoon Hassan
- National Children's Research Centre, Children's Health Ireland at Crumlin, Dublin 12, Ireland; National Virus Reference Laboratory, University College Dublin, Dublin 4, Belfield, Ireland.
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Abstract
The resurgence of mumps in vaccinated adult populations has raised concerns about possible waning vaccine immunity or a potential lack of protection to the circulating strain. A number of individual studies have investigated if there are amino acid variations between the circulating wild-type strains and vaccine strains. In these studies, the HN and F mumps surface glycoproteins have been of interest, because of their role in viral infection, and because the HN protein is the target of neutralizing antibodies. Here, we summarize the single nucleotide variants and their potential effect that have been identified between mumps genotypes in the HN and F proteins.
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Affiliation(s)
- Jasmine Rae Frost
- Department of Medical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (J.R.F.); (S.S.)
| | - Saba Shaikh
- Department of Medical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (J.R.F.); (S.S.)
| | - Alberto Severini
- Department of Medical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (J.R.F.); (S.S.)
- JC Wilt Infectious Diseases Research Centre, NMLB, Public Health Agency of Canada, Winnipeg, MB R3E 3R2, Canada
- Correspondence: ; Tel.: +1-204-789-6022; Fax: +1-204-318-2222
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5
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Bianchi FP, Stefanizzi P, Trerotoli P, Tafuri S. Sex and age as determinants of the seroprevalence of anti-measles IgG among European healthcare workers: A systematic review and meta-analysis. Vaccine 2022; 40:3127-3141. [PMID: 35491343 DOI: 10.1016/j.vaccine.2022.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/14/2022] [Accepted: 04/04/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The international literature shows good evidence of a significant rate of measles susceptibility among healthcare workers (HCWs). As such, they are an important public health issue. METHODS We conducted a systematic review and meta-analysis to estimate the prevalence of susceptible HCWs in EU/EEA countries and in the UK and to explore the characteristics (sex and age differences) and management of those found to be susceptible. RESULTS Nineteen studies were included in the meta-analysis. The prevalence of measles-susceptible HCWs was 13.3% (95 %CI: 10.0-17.0%). In a comparison of serosusceptible female vs. male HCWs, the RR was 0.92 (95 %CI = 0.83-1.03), and in a comparison of age classes (born after vs. before 1980) the RR was 2.78 (95 %CI = 2.20-3.50). The most recent studies proposed the mandatory vaccination of HCWs. DISCUSSION According to our meta-analysis, the prevalence of serosusceptible European HCWs is 13%; HCWs born in the post-vaccination era seem to be at higher risk. Healthcare professionals susceptible to measles are a serious epidemiological concern. Greater efforts should therefore be made to identify those who have yet to be vaccinated and actively encourage their vaccination.
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Affiliation(s)
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - Paolo Trerotoli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Italy.
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Kaaijk P, Emmelot ME, Kerkhof J, van Els CACM, Meiring HD, de Wit J, Bodewes R. Genetic Analysis Reveals Differences in CD8 + T Cell Epitope Regions That May Impact Cross-Reactivity of Vaccine-Induced T Cells against Wild-Type Mumps Viruses. Vaccines (Basel) 2021; 9:699. [PMID: 34202193 DOI: 10.3390/vaccines9070699] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 11/20/2022] Open
Abstract
Nowadays, mumps is re-emerging in highly vaccinated populations. Waning of vaccine-induced immunity plays a role, but antigenic differences between vaccine and mumps outbreak strains could also contribute to reduced vaccine effectiveness. CD8+ T cells play a critical role in immunity to viruses. However, limited data are available about sequence variability in CD8+ T cell epitope regions of mumps virus (MuV) proteins. Recently, the first set of naturally presented human leukocyte antigen Class I (HLA-I) epitopes of MuV was identified by us. In the present study, sequences of 40 CD8+ T cell epitope candidates, including previously and newly identified, obtained from Jeryl–Lynn mumps vaccine strains were compared with genomes from 462 circulating MuV strains. In 31 epitope candidates (78%) amino acid differences were detected, and in 17 (43%) of the epitope candidates the corresponding sequences in wild-type strains had reduced predicted HLA-I-binding compared to the vaccine strains. These findings suggest that vaccinated persons may have reduced T cell immunity to circulating mumps viruses due to antigenic differences.
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Abstract
INTRODUCTION Measles, mumps, and rubella incidence decreased drastically following vaccination programs' implementation. However, measles and mumps' resurgence was recently reported, outbreaks still occur, and challenges remain to control these diseases. AREAS COVERED This qualitative narrative review provides an objective appraisal of the literature regarding current challenges in controlling measles, mumps, rubella infections, and interventions to address them. EXPERT OPINION While vaccines against measles, mumps, and rubella (including trivalent vaccines) are widely used and effective, challenges to control these diseases are mainly related to insufficient immunization coverage and changing vaccination needs owing to new global environment (e.g. traveling, migration, population density). By understanding disease transmission peculiarities by setting, initiatives are needed to optimize vaccination policies and increase vaccination coverage, which was further negatively impacted by COVID-19 pandemic. Also, awareness of the potential severity of infections and the role of vaccines should increase. Reminder systems, vaccination of disadvantaged, high-risk and difficult-to-reach populations, accessibility of vaccination, healthcare infrastructure, and vaccination services management should improve. Outbreak preparedness should be strengthened, including implementation of high-quality surveillance systems to monitor epidemiology. While the main focus should be on these public health initiatives to increase vaccination coverage, slightly more benefits could come from evolution of current vaccines.
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Affiliation(s)
| | - Catherine Heffernan
- NHS England (London Region), 1st Floor, Wellington House, 133-155 Waterloo Road, London, SE16UG, UK
| | - François Meurice
- GSK, Avenue Fleming 20, 1300 Wavre, Belgium.,Biomedical Sciences Department, Faculty of Medicine, University of Namur (UNamur), Rue de Bruxelles 61, 5000 Namur, Belgium
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8
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Kaaijk P, Wijmenga-Monsuur AJ, van Houten MA, Veldhuijzen IK, Ten Hulscher HI, Kerkhof J, van der Klis FR, van Binnendijk RS. A Third Dose of Measles-Mumps-Rubella Vaccine to Improve Immunity Against Mumps in Young Adults. J Infect Dis 2020; 221:902-909. [PMID: 31112277 DOI: 10.1093/infdis/jiz188] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 04/18/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Waning of vaccine-induced immunity is considered to play a central role in the reemergence of mumps among vaccinated young adults. The aim of the present study was to investigate antibody responses and safety of a third dose of measles-mumps-rubella vaccine (MMR-3) in 150 young adults. Antibody levels were related to a surrogate of protection based on preoutbreak serum antibody levels in 31 persons with and 715 without serological evidence of mumps. METHODS Mumps virus-specific immunoglobulin G (IgG) antibody responses and mumps virus-neutralizing antibody responses (based on the focus-reduction neutralizing test) against both the Jeryl Lynn mumps virus vaccine strain (hereafter, the "vaccine strain") and the MuVi/Utrecht.NLD/40.10 outbreak strain (hereafter, the "outbreak strain") were determined, and vaccine safety was evaluated. RESULTS Four weeks following MMR-3 receipt, levels of IgG, anti-vaccine strain, and anti-outbreak strain antibodies increased by a factor of 1.65, 1.34, and 1.35, respectively. Although antibody levels decreased 1 year later, they were still above the baseline level by a factor of 1.37, 1.15, and 1.27, respectively. Based on the surrogate protective antibody cutoff, significantly more participants were protected against mumps virus infection up to 1 year after vaccination (ie, they had antibody levels above the presumed threshold for herd immunity). CONCLUSIONS MMR-3 receipt increased antibody levels that may protect against mumps virus infection for longer than previously assumed and is expected to be a good and safe intervention for controlling a mumps outbreak. CLINICAL TRIALS REGISTRATION 2016-001104-36; NTR5911.
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Affiliation(s)
- Patricia Kaaijk
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
| | - Alienke J Wijmenga-Monsuur
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
| | | | - Irene K Veldhuijzen
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
| | - Hinke I Ten Hulscher
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
| | - Jeroen Kerkhof
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
| | - Fiona R van der Klis
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
| | - Rob S van Binnendijk
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven
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Abreu TC, Boshuizen H, Mollema L, Berbers GAM, Korthals Altes H. Association between season of vaccination and antibody levels against infectious diseases. Epidemiol Infect 2020; 148:e276. [PMID: 33148351 PMCID: PMC7770373 DOI: 10.1017/s0950268820002691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 10/02/2020] [Accepted: 10/15/2020] [Indexed: 11/19/2022] Open
Abstract
Vaccination has reduced the disease burden of vaccine-preventable diseases. However, the extent to which seasonal cycles of immunity could influence vaccine-induced immunity is not well understood. A national cross-sectional serosurveillance study performed in the Netherlands (Pienter-2) yielded data to investigate whether season of vaccination was associated with antibody responses induced by DT-IPV (diphtheria, tetanus and poliomyelitis), MMR (measles, mumps and rubella) and meningococcus C (MenC) vaccines in children. In total, 434 children met the inclusion criteria to study DT-IPV immunity, 811 for MMR and 311 for MenC. Differences in log(antibody levels) by season of vaccination were investigated with linear multivariable regression analyses. Seroconversion rates varied according to season of vaccination for rubella (90% of autumn-vaccinated children vs. 99% of winter-vaccinated had concentrations above cut-off levels). Summer-vaccinated boys showed a slower decline of tetanus antibodies (6% per month), in comparison with winter-vaccinated boys. In conclusion, season of vaccination showed little association with immunological protection. However, a number of associations were seen with a P-value of about 0.03; and adding data from a just-completed nationwide serological study might add more power to the current study. Further immunological and longitudinal investigations could help understand the mechanisms of seasonal influence in vaccine-induced responses.
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Affiliation(s)
- T. C. Abreu
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - H. Boshuizen
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - L. Mollema
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - G. A. M. Berbers
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - H. Korthals Altes
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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van de Ven K, de Heij F, van Dijken H, Ferreira JA, de Jonge J. Systemic and respiratory T-cells induced by seasonal H1N1 influenza protect against pandemic H2N2 in ferrets. Commun Biol 2020; 3:564. [PMID: 33037319 PMCID: PMC7547016 DOI: 10.1038/s42003-020-01278-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 09/04/2020] [Indexed: 12/16/2022] Open
Abstract
Traditional influenza vaccines primarily induce a narrow antibody response that offers no protection against heterosubtypic infections. Murine studies have shown that T cells can protect against a broad range of influenza strains. However, ferrets are a more potent model for studying immune correlates of protection in influenza infection. We therefore set out to investigate the role of systemic and respiratory T cells in the protection against heterosubtypic influenza A infections in ferrets. H1N1-priming induced systemic and respiratory T cells that responded against pandemic H2N2 and correlated with reduced viral replication and disease. CD8-positive T cell responses in the upper and lower respiratory tract were exceptionally high. We additionally confirmed that H2N2-responsive T cells are present in healthy human blood donors. These findings underline the importance of the T cell response in influenza immunity and show that T cells are a potent target for future universal influenza vaccines.
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Affiliation(s)
- Koen van de Ven
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Femke de Heij
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Harry van Dijken
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - José A Ferreira
- Department of Statistics, Informatics and Modelling, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Jørgen de Jonge
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
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11
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de Wit J, Emmelot ME, Meiring H, van Gaans-van den Brink JAM, van Els CACM, Kaaijk P. Identification of Naturally Processed Mumps Virus Epitopes by Mass Spectrometry: Confirmation of Multiple CD8+ T-Cell Responses in Mumps Patients. J Infect Dis 2020; 221:474-482. [PMID: 31560392 DOI: 10.1093/infdis/jiz480] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 09/19/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The re-emergence of mumps among vaccinated young adults has become a global issue. Besides waning of antibody responses, suboptimal induction of T-cell responses may reduce protection. In a recent study, we observed a dominant polyfunctional CD8+ T-cell response after natural mumps virus (MuV) infection that was not present after vaccination. Unraveling the MuV epitope repertoire can provide insight in the specificity, functionality, and breadth of the T-cell response against MuV. METHODS Peptides were eluted from human leukocyte antigen (HLA) class I molecules of MuV-infected cells and characterized by advanced mass spectrometry. Selected identified MuV peptides were tested for in vitro and ex vivo immunogenicity. RESULTS In this study, we identified a broad landscape of 83 CD8+ T-cell epitopes of MuV, 41 of which were confirmed based on synthetic peptide standards. For 6 epitopes, we showed induction of an HLA-A*02-restriced CD8+ T-cell response. Moreover, robust T-cell responses against 5 selected MuV epitopes could be detected in all tested mumps patients using peptide/HLA-A*02:01 dextramers. CONCLUSIONS The identified CD8+ T-cell epitopes will help to further characterize MuV-specific T-cell immunity after natural MuV infection or vaccination. These MuV epitopes may provide clues for a better understanding of, and possibly for preventing, mumps vaccine failure.We identified for the first time 41 mumps virus (MuV)-specific HLA-A*02 epitopes. For 6 epitopes, CD8+ T-cell responses were confirmed in T cells derived from several mumps cases, and MuV-specific CD8+ T cells could be identified by peptide/dextramer staining.
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Affiliation(s)
- Jelle de Wit
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Maarten E Emmelot
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Hugo Meiring
- Intravacc (Institute for Translational Vaccinology), Bilthoven, The Netherlands
| | | | - Cécile A C M van Els
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Patricia Kaaijk
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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12
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Connell AR, Connell J, Leahy TR, Hassan J. Mumps Outbreaks in Vaccinated Populations-Is It Time to Re-assess the Clinical Efficacy of Vaccines? Front Immunol 2020; 11:2089. [PMID: 33072071 PMCID: PMC7531022 DOI: 10.3389/fimmu.2020.02089] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/31/2020] [Indexed: 01/05/2023] Open
Abstract
History illustrates the remarkable public health impact of mass vaccination, by dramatically improving life expectancy and reducing the burden of infectious diseases and co-morbidities worldwide. It has been perceived that if an individual adhered to the MMR vaccine schedule that immunity to mumps virus (MuV) would be lifelong. Recent mumps outbreaks in individuals who had received two doses of the Measles Mumps Rubella (MMR) vaccine has challenged the efficacy of the MMR vaccine. However, clinical symptoms, complications, viral shedding and transmission associated with mumps infection has been shown to be reduced in vaccinated individuals, demonstrating a benefit of this vaccine. Therefore, the question of what constitutes a good mumps vaccine and how its impact is assessed in this modern era remains to be addressed. Epidemiology of the individuals most affected by the outbreaks (predominantly young adults) and variance in the circulating MuV genotype have been well-described alluding to a collection of influences such as vaccine hesitancy, heterogeneous vaccine uptake, primary, and/or secondary vaccine failures. This review aims to discuss in detail the interplay of factors thought to be contributing to the current mumps outbreaks seen in highly vaccinated populations. In addition, how mumps diagnoses has progressed and impacted the understanding of mumps infection since a mumps vaccine was first developed, the limitations of current laboratory tests in confirming protection in vaccinated individuals and how vaccine effectiveness is quantified are also considered. By highlighting knowledge gaps within this area, this state-of-the-art review proposes a change of perspective regarding the impact of a vaccine in a highly vaccinated population from a clinical, diagnostic and public perspective, highlighting a need for a paradigm shift on what is considered vaccine immunity.
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Affiliation(s)
- Anna R Connell
- National Children's Research Centre, Children's Health Ireland, Dublin, Ireland
| | - Jeff Connell
- National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
| | - T Ronan Leahy
- Children's Health Ireland, Dublin, Ireland.,Department of Pediatrics, University of Dublin, Trinity College, Dublin, Ireland
| | - Jaythoon Hassan
- National Children's Research Centre, Children's Health Ireland, Dublin, Ireland.,National Virus Reference Laboratory, University College Dublin, Dublin, Ireland
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Ravault S, Friel D, Di Paolo E, Caplanusi A, Gillard P, Povey M, Carryn S. Assessment of Mumps Virus-Specific Antibodies: Comparison of Plaque Reduction Neutralization Test and Enzyme-Linked Immunosorbent Assay Estimates. J Infect Dis 2020; 220:1462-1468. [PMID: 31299077 PMCID: PMC6761965 DOI: 10.1093/infdis/jiz345] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 07/10/2019] [Indexed: 02/03/2023] Open
Abstract
Background The plaque reduction neutralization test (PRNT), which measures a subset of immunoglobulin antibodies (functional neutralizing antibodies), and the enzyme-linked immunosorbent assay (ELISA), which measures total immunoglobulin (neutralizing and nonneutralizing antibodies), characterize different aspects of the anti–mumps virus antibody response after vaccination. Methods Data from a recent phase 3 clinical trial (NCT01681992) of 2 measles-mumps-rubella vaccines were used to compare anti-mumps antibody responses measured using an unenhanced PRNT (GSK; seropositivity cutoff and threshold, 2.5 and 4 times the 50% end-point dilution, respectively) with those estimated using an ELISA (thresholds, 5 and 10 ELISA units/mL, respectively). Results Of 3990 initially seronegative samples, 3284 (82.3%) were seropositive after vaccination for anti-mumps antibodies in both assays. The Pearson correlation coefficient for double-positive samples was 0.57, indicative of a moderate correlation. Receiver operating characteristic curve analysis showed that an ELISA threshold of 51.7 ELISA units/mL best corresponded to the PRNT seroresponse threshold. There was no obvious vaccine brand effect on the correlation between assays. Conclusions The moderate correlation between the anti-mumps antibody measurements obtained with PRNT and ELISA reflects different aspects of the serological response. In the absence of a well-defined protective serological threshold, PRNT provides complementary information on the antibody response, whereas ELISA remains a critically useful measurement of vaccine immunogenicity.
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Pacenti M, Maione N, Lavezzo E, Franchin E, Dal Bello F, Gottardello L, Barzon L. Measles Virus Infection and Immunity in a Suboptimal Vaccination Coverage Setting. Vaccines (Basel) 2019; 7:vaccines7040199. [PMID: 31795157 PMCID: PMC6963570 DOI: 10.3390/vaccines7040199] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 11/23/2019] [Accepted: 11/26/2019] [Indexed: 11/24/2022] Open
Abstract
Despite efforts to improve surveillance and vaccination coverage, measles virus (MeV) continues to cause outbreaks also in high-income countries. As the reference laboratory of the Veneto Region, Italy, we analyzed changes in population immunity, described measles outbreaks, investigated MeV genetic diversity, and evaluated cross-protection of measles vaccination against MeV epidemic strains. Like most European areas, the Veneto Region has suboptimal measles vaccination coverage and is facing a growing public mistrust of vaccination. A progressive decline of measles vaccine uptake was observed during the last decade in the Veneto Region, leading to immunity gaps in children and young adults. Measles outbreaks were caused by the same MeV genotype B3, D4, and D8 strains that were circulating in other European countries. Eleven cases of measles were observed in immunized subjects. These cases were not associated with particular MeV genotypes nor with mutations in epitopes recognized by neutralizing antibodies. Accordingly, sera from fully vaccinated subjects cross-neutralized epidemic MeV strains, including the genotypes B3, D4, and D8, with the same high efficiency demonstrated against the vaccine strain. In fully vaccinated subjects, high MeV IgG antibody titers persisted up to 30 years following vaccination. These results support the use of the current measles-containing vaccines and strategies to strengthen vaccination.
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Affiliation(s)
- Monia Pacenti
- Microbiology and Virology Unit, Padova University Hospital, 35128 Padova, Italy; (M.P.); (E.F.); (F.D.B.)
| | - Nataskya Maione
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (N.M.); (E.L.)
| | - Enrico Lavezzo
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (N.M.); (E.L.)
| | - Elisa Franchin
- Microbiology and Virology Unit, Padova University Hospital, 35128 Padova, Italy; (M.P.); (E.F.); (F.D.B.)
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (N.M.); (E.L.)
| | - Federico Dal Bello
- Microbiology and Virology Unit, Padova University Hospital, 35128 Padova, Italy; (M.P.); (E.F.); (F.D.B.)
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (N.M.); (E.L.)
| | - Lorena Gottardello
- Department of Hygiene and Public Health, Azienda ULSS 6 Euganea, 35131 Padova, Italy;
| | - Luisa Barzon
- Microbiology and Virology Unit, Padova University Hospital, 35128 Padova, Italy; (M.P.); (E.F.); (F.D.B.)
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (N.M.); (E.L.)
- Correspondence: ; Tel.: +39-049-821-8946
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Abstract
Medical Center Occupational Health (MCOH) programs must protect health care personnel (HCP) against the occupational risk of vaccine-preventable diseases. This thematic review outlines the rationale for the use of recommended vaccines in HCP; summarizes the available evidence regarding vaccine effectiveness, administration, and assessment of immunity; and provides guidance for MCOH programs navigating challenging situations.
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Affiliation(s)
- Melanie D Swift
- Division of Preventive Occupational and Aerospace Medicine, Mayo Clinic, Rochester, MN.
| | - Amy J Behrman
- Department of Emergency Medicine, Perelman School of Medicine, Philadelphia, PA
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Rasheed MAU, Hickman CJ, McGrew M, Sowers SB, Mercader S, Hopkins A, Grimes V, Yu T, Wrammert J, Mulligan MJ, Bellini WJ, Rota PA, Orenstein WA, Ahmed R, Edupuganti S. Decreased humoral immunity to mumps in young adults immunized with MMR vaccine in childhood. Proc Natl Acad Sci U S A 2019; 116:19071-6. [PMID: 31481612 DOI: 10.1073/pnas.1905570116] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In the past decade, multiple mumps outbreaks have occurred in the United States, primarily in close-contact, high-density settings such as colleges, with a high attack rate among young adults, many of whom had the recommended 2 doses of mumps-measles-rubella (MMR) vaccine. Waning humoral immunity and the circulation of divergent wild-type mumps strains have been proposed as contributing factors to mumps resurgence. Blood samples from 71 healthy 18- to 23-year-old college students living in a non-outbreak area were assayed for antibodies and memory B cells (MBCs) to mumps, measles, and rubella. Seroprevalence rates of mumps, measles, and rubella determined by IgG enzyme-linked immunosorbent assay (ELISA) were 93, 93, and 100%, respectively. The index standard ratio indicated that the concentration of IgG was significantly lower for mumps than rubella. High IgG avidity to mumps Enders strain was detected in sera of 59/71 participants who had sufficient IgG levels. The frequency of circulating mumps-specific MBCs was 5 to 10 times lower than measles and rubella, and 10% of the participants had no detectable MBCs to mumps. Geometric mean neutralizing antibody titers (GMTs) by plaque reduction neutralization to the predominant circulating wild-type mumps strain (genotype G) were 6-fold lower than the GMTs against the Jeryl Lynn vaccine strain (genotype A). The majority of the participants (80%) received their second MMR vaccine ≥10 years prior to study participation. Additional efforts are needed to fully characterize B and T cell immune responses to mumps vaccine and to develop strategies to improve the quality and durability of vaccine-induced immunity.
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Vermeire T, Barbezange C, Francart A, Hamouda A, Litzroth A, Hutse V, Martens L, Vandermarliere E, Van Gucht S. Sera from different age cohorts in Belgium show limited cross-neutralization between the mumps vaccine and outbreak strains. Clin Microbiol Infect 2019; 25:907.e1-907.e6. [DOI: 10.1016/j.cmi.2018.11.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/05/2018] [Accepted: 11/10/2018] [Indexed: 11/30/2022]
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Nakayama T, Eda M, Hirano M, Goto W. Immunogenicity and safety of the new MMR vaccine containing measles AIK-C, rubella Takahashi, and mumps RIT4385 strains in Japanese children: a randomized phase I/II clinical trial. Hum Vaccin Immunother 2019; 15:1139-1144. [PMID: 30724658 PMCID: PMC6605871 DOI: 10.1080/21645515.2019.1578591] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Domestic measles, mumps, and rubella combined (MMR) vaccines were discontinued in 1993 in Japan because of the unexpected high incidence of aseptic meningitis. The introduction of an effective MMR vaccine with lower reactogenicity has been expected. A new MMR vaccine (JVC-001) was developed, using mumps RIT4385 strain in combination with Japanese measles AIK-C strain and rubella Takahashi strain (MR) vaccine. An open-label, randomized, phase I/II clinical study was conducted in 100 healthy Japanese children equally randomized to a JVC-001 group and an MR with monovalent mumps vaccine (Hoshino strain) group. Immunogenicity was assessed using a neutralization test (NT) for measles, hemagglutination inhibition (HI) test for rubella, and NT and enzyme-linked immune-sorbent assay (ELISA) for mumps strain with different genotypes (genotype A, B, D and G) on Day 0 and Day 42–56. Solicited and unsolicited adverse events (AEs) were recorded. Seroconversion rates of measles and rubella were both 100%. JVC-001 induced higher immunogenicity against mumps virus genotype G with seroconversion rate of 77.1% (95% confidence interval [CI]: 62.7–88.0%) compared to 65.3% (95% CI: 50.4–78.3%) in the control group. Geometric mean titer (GMT) was 12.5 (95% CI: 8.6–18.3) in the JVC-001 group and 7.1 (95% CI: 5.0–10.1) in the control group. JVC-001 also induced good immunogenicity against other genotypes (A, B and D). There was no apparent difference in the incidence of AEs between JVC-001 and the control groups. JVC-001 is safe and induces effective immunogenicity against measles, mumps, and rubella compared with the currently marketed vaccines in Japan.
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Affiliation(s)
- Tetsuo Nakayama
- a Kitasato Institute for Life Sciences, Laboratory of Viral Infection , Tokyo , Japan
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de Wit J, Emmelot ME, Poelen MCM, Lanfermeijer J, Han WGH, van Els CACM, Kaaijk P. The Human CD4 + T Cell Response against Mumps Virus Targets a Broadly Recognized Nucleoprotein Epitope. J Virol 2019; 93:e01883-18. [PMID: 30626672 DOI: 10.1128/JVI.01883-18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 12/15/2018] [Indexed: 11/22/2022] Open
Abstract
Recent outbreaks of mumps among vaccinated young adults have been reported worldwide. Humoral responses against mumps virus (MuV) are well characterized, although no correlate of protection has been elucidated, stressing the need to better understand cellular MuV-specific immunity. In this study, we identified the first MuV T cell epitope, which is derived from the viral nucleoprotein (MuV-N) and was recognized by a cytotoxic/Th1 CD4+ T cell clone that was isolated from a mumps case. Moreover, the epitope was predicted to bind a broad variety of common HLA-DRB1 alleles, which was confirmed by the epitope-specific cytotoxic/Th1 CD4+ T cell responses observed in multiple mumps cases with various HLA-DRB1 genotypes. The identified epitope is completely conserved among various mumps strains. These findings qualify this promiscuous MuV T cell epitope as a useful tool for further in-depth exploration of MuV-specific T cell immunity after natural mumps virus infection or induced by vaccination. Mumps outbreaks among vaccinated young adults stress the need for a better understanding of mumps virus (MuV)-induced immunity. Antibody responses to MuV are well characterized, but studies on T cell responses are limited. We recently isolated a MuV-specific CD4+ T cell clone by stimulating peripheral blood mononuclear cells (PBMCs) from a mumps case with the viral nucleoprotein (MuV-N). In this study, we further explored the identity and relevance of the epitope recognized by the CD4+ T cell clone and ex vivo by T cells in a cohort of mumps cases. Using a two-dimensional matrix peptide pool of 15-mer peptides covering the complete MuV-N, we identified the epitope recognized by the T cell clone as MuV-N110–124 GTYRLIPNARANLTA, present in a well-conserved region of the viral protein. Upon peptide-specific stimulation, the T cell clone expressed the activation marker CD137 and produced gamma interferon, tumor necrosis factor, and interleukin-10 in a HLA-DR4-restricted manner. Moreover, the CD4+ T cells exerted a cytotoxic phenotype and specifically killed cells presenting MuV-N110–124. Furthermore, the identified peptide is widely applicable to the general population since it is predicted to bind various common HLA-DR molecules, and epitope-specific CD4+ T cells displaying cytotoxic/Th1-type properties were found in all tested mumps cases expressing different HLA-DR alleles. This first broadly recognized human MuV-specific CD4+ T cell epitope could provide a useful tool to detect and evaluate virus-specific T cell responses upon MuV infection or following vaccination. IMPORTANCE Recent outbreaks of mumps among vaccinated young adults have been reported worldwide. Humoral responses against mumps virus (MuV) are well characterized, although no correlate of protection has been elucidated, stressing the need to better understand cellular MuV-specific immunity. In this study, we identified the first MuV T cell epitope, which is derived from the viral nucleoprotein (MuV-N) and was recognized by a cytotoxic/Th1 CD4+ T cell clone that was isolated from a mumps case. Moreover, the epitope was predicted to bind a broad variety of common HLA-DRB1 alleles, which was confirmed by the epitope-specific cytotoxic/Th1 CD4+ T cell responses observed in multiple mumps cases with various HLA-DRB1 genotypes. The identified epitope is completely conserved among various mumps strains. These findings qualify this promiscuous MuV T cell epitope as a useful tool for further in-depth exploration of MuV-specific T cell immunity after natural mumps virus infection or induced by vaccination.
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Dilcher M, Barratt K, Douglas J, Strathdee A, Anderson T, Werno A. Monitoring Viral Genetic Variation as a Tool To Improve Molecular Diagnostics for Mumps Virus. J Clin Microbiol 2018; 56:e00405-18. [PMID: 30021826 DOI: 10.1128/JCM.00405-18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 07/11/2018] [Indexed: 11/20/2022] Open
Abstract
Here, we report how the analysis of viral genetic variation using next-generation sequencing (NGS) can be used as a tool to improve mumps virus diagnostics. Analysis of NGS data from recently circulating mumps virus isolates allowed optimization of the current mumps virus real-time reverse transcription-PCR (RT-PCR) by primer and probe modifications due to nucleotide variations. The modified assay showed a higher efficiency and sensitivity than the previously used CDC protocol for the detection of currently circulating mumps virus strains and could therefore offer better support for outbreak control. The NGS sequence data were also used to make predictions of changes in the hemagglutinin-neuraminidase protein structure that could explain possible immune escape mechanisms.
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Gouma S, Vermeire T, Van Gucht S, Martens L, Hutse V, Cremer J, Rota PA, Leroux-Roels G, Koopmans M, van Binnendijk R, Vandermarliere E. Differences in antigenic sites and other functional regions between genotype A and G mumps virus surface proteins. Sci Rep 2018; 8:13337. [PMID: 30190529 DOI: 10.1038/s41598-018-31630-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 08/22/2018] [Indexed: 11/08/2022] Open
Abstract
The surface proteins of the mumps virus, the fusion protein (F) and haemagglutinin-neuraminidase (HN), are key factors in mumps pathogenesis and are important targets for the immune response during mumps virus infection. We compared the predicted amino acid sequences of the F and HN genes from Dutch mumps virus samples from the pre-vaccine era (1957-1982) with mumps virus genotype G strains (from 2004 onwards). Genotype G is the most frequently detected mumps genotype in recent outbreaks in vaccinated communities, especially in Western Europe, the USA and Japan. Amino acid differences between the Jeryl Lynn vaccine strains (genotype A) and genotype G strains were predominantly located in known B-cell epitopes and in N-linked glycosylation sites on the HN protein. There were eight variable amino acid positions specific to genotype A or genotype G sequences in five known B-cell epitopes of the HN protein. These differences may account for the reported antigenic differences between Jeryl Lynn and genotype G strains. We also found amino acid differences in and near sites on the HN protein that have been reported to play a role in mumps virus pathogenesis. These differences may contribute to the occurrence of genotype G outbreaks in vaccinated communities.
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Cui A, Zhu Z, Mao N, Si Y, Ma Y, Hu Y, Deng X, Wang L, Zeng L, Zhang Y, Xu W. Assessment of one-dose mumps-containing vaccine effectiveness on wild-type genotype F mumps viruses circulating in mainland China. Vaccine 2018; 36:5725-31. [DOI: 10.1016/j.vaccine.2018.08.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/03/2018] [Accepted: 08/04/2018] [Indexed: 11/20/2022]
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Immunogenicity and safety of measles-mumps-rubella vaccine at two different potency levels administered to healthy children aged 12–15 months: A phase III, randomized, non-inferiority trial. Vaccine 2018; 36:5781-8. [DOI: 10.1016/j.vaccine.2018.07.076] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 07/23/2018] [Accepted: 07/30/2018] [Indexed: 10/28/2022]
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Affiliation(s)
- Stanley A Plotkin
- Emeritus Professor of Pediatrics, University of Pennsylvania, Vaxconsult, Doylestown, Pennsylvania
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Nunn A, Masud S, Krajden M, Naus M, Jassem AN. Diagnostic Yield of Laboratory Methods and Value of Viral Genotyping during an Outbreak of Mumps in a Partially Vaccinated Population in British Columbia, Canada. J Clin Microbiol 2018; 56:e01954-17. [PMID: 29491021 PMCID: PMC5925731 DOI: 10.1128/jcm.01954-17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 02/26/2018] [Indexed: 11/20/2022] Open
Abstract
Mumps remains endemic in North America despite routine use of the measles, mumps, and rubella (MMR) vaccine. In 2016, an outbreak of mumps in British Columbia, Canada, provided an opportunity to determine the diagnostic utility of laboratory testing methods. Specimens from patients with clinical mumps were tested for infection using a commercial enzyme-linked immunosorbent assay (ELISA) for antibody detection and an in-house reverse transcriptase PCR (RT-PCR) targeting viral fusion and small hydrophobic (SH) genes. Viral genotyping was performed by SH gene sequencing. Laboratory data was linked with epidemiologic case data. Of the 139 confirmed cases, 94 (68%) had reported or documented history of MMR vaccination. Specimens were typically collected 1 day (for buccal and IgM tests) or 2 days (for urine tests) after symptom onset. Most confirmed cases (69%) were confirmed by buccal swab RT-PCR. Among cases tested by multiple methods, the percent positivity for buccal swab RT-PCR was 90% (96/107) compared to 43% (30/69) for both IgM ELISA and urine RT-PCR. Mumps IgM detection was higher in confirmed cases with no history of vaccination than in those with history (64% versus 34%, P = 0.02). The outbreak strain was identified as genotype G related to MuVi/Sheffield.GBR/1.05 but with conserved variations in five nucleotides within the SH gene that allowed linkage of geographically distinct cases. In conclusion, RT-PCR of buccal specimens had the highest diagnostic yield during a mumps outbreak in a partially vaccinated population. To optimize mumps diagnostic potential, clinicians should collect specimens depending on when the patient presents for care and their immunization history.
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Affiliation(s)
- Alexandra Nunn
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Shazia Masud
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mel Krajden
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Monika Naus
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Agatha N Jassem
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Principi N, Esposito S. Mumps outbreaks: A problem in need of solutions. J Infect 2018; 76:503-6. [PMID: 29678496 DOI: 10.1016/j.jinf.2018.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 03/18/2018] [Accepted: 03/24/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To discuss what is presently known about recent mumps outbreaks and what solutions can be suggested to ensure more complete protection against mumps. METHODS PubMed was used to search for all of the studies published over the last 15 years using the key words "mumps" or "mumps virus" or "mumps vaccine". More than 1500 articles were found, but only those published in English or providing evidence-based data were included in the evaluation. RESULTS Prevention of mumps remains an unsolved problem. Available vaccines are effective but the protection they evoke declines over time. The use of booster doses can control outbreaks but it is not precisely defined whether they can prevent them. The rapid decline of antibody levels could limit the impact of the introduction of a third dose in the recommended immunization schedule. Furthermore, in most of the areas, mumps viral strains that are genetically different from those included in the vaccines are emerging and this might favour vaccine escape. However, also for this problem, its real relevance in favouring outbreak development is not precisely defined. CONCLUSIONS The true reasons for the development of mumps outbreaks in people with very high vaccination coverage are not clearly understood. The use of a booster dose or the preparation of vaccines containing the emerging serotypes are possible solutions, but both have some limitations. Further studies mainly devoted to improve our knowledge of the immune response to mumps vaccines are needed before long-term effective mumps vaccines can be prepared and outbreaks can be avoided.
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Liu Y, Liu Z, Deng X, Hu Y, Wang Z, Lu P, Guo H, Sun X, Xu Y, Tang F, Zhu FC. Waning immunity of one-dose measles-mumps-rubella vaccine to mumps in children from kindergarten to early school age: a prospective study. Expert Rev Vaccines 2018; 17:445-452. [PMID: 29478347 DOI: 10.1080/14760584.2018.1445529] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND In China, one dose measles-mumps-rubella vaccine (MMR) was administered to children aged 18-24 months. The mumps incidence was still high. Data on the waning immunity to mumps after MMR vaccination are limited. This study aimed to describe the waning immunity to mumps in kindergarten and primary school children to provide a scientific basis for confirming an optimal age for a second dose. METHODS An observational, prospective study on one-dose MMR in children in kindergarten and primary school was conducted from 2015 to 2016. Waning immunity to mumps in terms of seropositivity and geometric antibody concentration (GMC) with time was analyzed. RESULTS In total, 7436 eligible subjects in kindergarten (3435) and primary school (4001) were included in 2015. The overall GMC (201.7 U/ml) and seropositivity (75.4%) to mumps antibodies in 2016 were significantly lower compared to those in 2015 (218.7 U/ml, 78.4%). Asymptomatic infection occurred within one year in 8.8% of children who received one-dose MMR. CONCLUSIONS Children who received one-dose MMR in kindergarten and primary school were at high risk of mumps infection, and waning immunity occurred with time. Determining the optimal age for the second dose of MMR in children should be prioritized to prevent mumps epidemics.
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Affiliation(s)
- Yuanbao Liu
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Zhihao Liu
- b Department of Health education , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Xiuying Deng
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Ying Hu
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Zhiguo Wang
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Peishan Lu
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Hongxiong Guo
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Xiang Sun
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Yan Xu
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Fenyang Tang
- a Department of Expanded Programme on Immunization , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
| | - Feng-Cai Zhu
- c Department of Vaccine Clinical Evaluation , Jiangsu Provincial Center for Disease Control and Prevention , Nanjing , China
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May M, Rieder CA, Rowe RJ. Emergent lineages of mumps virus suggest the need for a polyvalent vaccine. Int J Infect Dis 2017; 66:1-4. [PMID: 28987391 DOI: 10.1016/j.ijid.2017.09.024] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/23/2017] [Accepted: 09/26/2017] [Indexed: 12/01/2022] Open
Abstract
Mumps outbreaks among vaccinated patients have become increasingly common in recent years. While there are multiple conditions driving this re-emergence, convention has suggested that these outbreaks are associated with waning immunity rather than vaccine escape. Molecular evidence from both the ongoing American and Dutch outbreaks in conjunction with recent structural biology studies challenge this convention, and suggest that emergent lineages of mumps virus exhibit key differences in antigenic epitopes from the vaccine strain employed: Jeryl-Lynn 5. The American and Dutch 2016-2017 outbreak lineages were examined using computational biology through the lens of diversity in immunogenic epitopes. Findings are discussed and the laboratory evidence indicating neutralization of heterologous mumps strains by serum from vaccinated individuals is reviewed. Taken together, it is concluded that the number of heterologous epitopes occurring in mumps virus in conjunction with waning immunity is facilitating small outbreaks in vaccinated patients, and that consideration of a polyvalent mumps vaccine is warranted.
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Affiliation(s)
- Meghan May
- University of New England, Biddeford, ME, USA.
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