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Morrison AL, Sarfas C, Sibley L, Williams J, Mabbutt A, Dennis MJ, Lawrence S, White AD, Bodman-Smith M, Sharpe SA. IV BCG Vaccination and Aerosol BCG Revaccination Induce Mycobacteria-Responsive γδ T Cells Associated with Protective Efficacy against M. tb Challenge. Vaccines (Basel) 2023; 11:1604. [PMID: 37897006 PMCID: PMC10611416 DOI: 10.3390/vaccines11101604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Intravenously (IV) delivered BCG provides superior tuberculosis (TB) protection compared with the intradermal (ID) route in non-human primates (NHPs). We examined how γδ T cell responses changed in vivo after IV BCG vaccination of NHPs, and whether these correlated with protection against aerosol M. tuberculosis challenge. In the circulation, Vδ2 T cell populations expanded after IV BCG vaccination, from a median of 1.5% (range: 0.8-2.3) of the CD3+ population at baseline, to 5.3% (range: 1.4-29.5) 4 weeks after M. tb, and were associated with TB protection. This protection was related to effector and central memory profiles; homing markers; and production of IFN-γ, TNF-α and granulysin. In comparison, Vδ2 cells did not expand after ID BCG, but underwent phenotypic and functional changes. When Vδ2 responses in bronchoalveolar lavage (BAL) samples were compared between routes, IV BCG vaccination resulted in highly functional mucosal Vδ2 cells, whereas ID BCG did not. We sought to explore whether an aerosol BCG boost following ID BCG vaccination could induce a γδ profile comparable to that induced with IV BCG. We found evidence that the aerosol BCG boost induced significant changes in the Vδ2 phenotype and function in cells isolated from the BAL. These results indicate that Vδ2 population frequency, activation and function are characteristic features of responses induced with IV BCG, and the translation of responses from the circulation to the site of infection could be a limiting factor in the response induced following ID BCG. An aerosol boost was able to localise activated Vδ2 populations at the mucosal surfaces of the lung. This vaccine strategy warrants further investigation to boost the waning human ID BCG response.
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Affiliation(s)
- Alexandra L. Morrison
- Vaccine Development and Evaluation Centre, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Charlotte Sarfas
- Vaccine Development and Evaluation Centre, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Laura Sibley
- Vaccine Development and Evaluation Centre, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Jessica Williams
- Vaccine Development and Evaluation Centre, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Adam Mabbutt
- Vaccine Development and Evaluation Centre, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Mike J. Dennis
- Vaccine Development and Evaluation Centre, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Steve Lawrence
- Vaccine Development and Evaluation Centre, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Andrew D. White
- Vaccine Development and Evaluation Centre, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
| | - Mark Bodman-Smith
- Infection and Immunity Research Institute, St. George’s University of London, London SW17 0BD, UK
| | - Sally A. Sharpe
- Vaccine Development and Evaluation Centre, UK Health Security Agency, Porton Down, Salisbury SP4 0JG, UK
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2
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White AD, Tran AC, Sibley L, Sarfas C, Morrison AL, Lawrence S, Dennis M, Clark S, Zadi S, Lanni F, Rayner E, Copland A, Hart P, Diogo GR, Paul MJ, Kim M, Gleeson F, Salguero FJ, Singh M, Stehr M, Cutting SM, Basile JI, Rottenberg ME, Williams A, Sharpe SA, Reljic R. Spore-FP1 tuberculosis mucosal vaccine candidate is highly protective in guinea pigs but fails to improve on BCG-conferred protection in non-human primates. Front Immunol 2023; 14:1246826. [PMID: 37881438 PMCID: PMC10594996 DOI: 10.3389/fimmu.2023.1246826] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 09/19/2023] [Indexed: 10/27/2023] Open
Abstract
Tuberculosis remains a major health threat globally and a more effective vaccine than the current Bacillus Calmette Guerin (BCG) is required, either to replace or boost it. The Spore-FP1 mucosal vaccine candidate is based on the fusion protein of Ag85B-Acr-HBHA/heparin-binding domain, adsorbed on the surface of inactivated Bacillus subtilis spores. The candidate conferred significant protection against Mycobacterium. tuberculosis challenge in naïve guinea pigs and markedly improved protection in the lungs and spleens of animals primed with BCG. We then immunized rhesus macaques with BCG intradermally, and subsequently boosted with one intradermal and one aerosol dose of Spore-FP1, prior to challenge with low dose aerosolized M. tuberculosis Erdman strain. Following vaccination, animals did not show any adverse reactions and displayed higher antigen specific cellular and antibody immune responses compared to BCG alone but this did not translate into significant improvement in disease pathology or bacterial burden in the organs.
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Affiliation(s)
- Andrew D. White
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Andy C. Tran
- Institute for Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Laura Sibley
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Charlotte Sarfas
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Alexandra L. Morrison
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Steve Lawrence
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Mike Dennis
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Simon Clark
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Sirine Zadi
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Faye Lanni
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Emma Rayner
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Alastair Copland
- Institute for Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Peter Hart
- Institute for Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Gil Reynolds Diogo
- Institute for Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Matthew J. Paul
- Institute for Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Miyoung Kim
- Institute for Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Fergus Gleeson
- Department of Oncology, The Churchill Hospital, Oxford, United Kingdom
| | - Francisco J. Salguero
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | | | | | - Simon M. Cutting
- School of Biological Sciences, Royal Holloway University of London, Surrey, United Kingdom
- Sporegen Ltd , London Bioscience Innovation Centre, London, United Kingdom
| | - Juan I. Basile
- Department of Microbiology, Tumour and Cell Biology and Centre for Tuberculosis Research, Karolinska Institute, Stockholm, Sweden
| | - Martin E. Rottenberg
- Department of Microbiology, Tumour and Cell Biology and Centre for Tuberculosis Research, Karolinska Institute, Stockholm, Sweden
| | - Ann Williams
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Sally A. Sharpe
- United Kingdom Health Security Agency (UKHSA), Porton Down, Salisbury, United Kingdom
| | - Rajko Reljic
- Institute for Infection and Immunity, St George’s University of London, London, United Kingdom
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3
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Kim H, Choi HG, Shin SJ. Bridging the gaps to overcome major hurdles in the development of next-generation tuberculosis vaccines. Front Immunol 2023; 14:1193058. [PMID: 37638056 PMCID: PMC10451085 DOI: 10.3389/fimmu.2023.1193058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
Although tuberculosis (TB) remains one of the leading causes of death from an infectious disease worldwide, the development of vaccines more effective than bacille Calmette-Guérin (BCG), the only licensed TB vaccine, has progressed slowly even in the context of the tremendous global impact of TB. Most vaccine candidates have been developed to strongly induce interferon-γ (IFN-γ)-producing T-helper type 1 (Th1) cell responses; however, accumulating evidence has suggested that other immune factors are required for optimal protection against Mycobacterium tuberculosis (Mtb) infection. In this review, we briefly describe the five hurdles that must be overcome to develop more effective TB vaccines, including those with various purposes and tested in recent promising clinical trials. In addition, we discuss the current knowledge gaps between preclinical experiments and clinical studies regarding peripheral versus tissue-specific immune responses, different underlying conditions of individuals, and newly emerging immune correlates of protection. Moreover, we propose how recently discovered TB risk or susceptibility factors can be better utilized as novel biomarkers for the evaluation of vaccine-induced protection to suggest more practical ways to develop advanced TB vaccines. Vaccines are the most effective tools for reducing mortality and morbidity from infectious diseases, and more advanced technologies and a greater understanding of host-pathogen interactions will provide feasibility and rationale for novel vaccine design and development.
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Affiliation(s)
- Hongmin Kim
- Department of Microbiology, Institute for Immunology and Immunological Diseases, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Han-Gyu Choi
- Department of Microbiology and Medical Science, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Sung Jae Shin
- Department of Microbiology, Institute for Immunology and Immunological Diseases, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, Republic of Korea
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4
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Surveillance of Daughter Micronodule Formation Is a Key Factor for Vaccine Evaluation Using Experimental Infection Models of Tuberculosis in Macaques. Pathogens 2023; 12:pathogens12020236. [PMID: 36839508 PMCID: PMC9961649 DOI: 10.3390/pathogens12020236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/29/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Tuberculosis (TB) is still a major worldwide health problem and models using non-human primates (NHP) provide the most relevant approach for vaccine testing. In this study, we analysed CT images collected from cynomolgus and rhesus macaques following exposure to ultra-low dose Mycobacterium tuberculosis (Mtb) aerosols, and monitored them for 16 weeks to evaluate the impact of prior intradermal or inhaled BCG vaccination on the progression of lung disease. All lesions found (2553) were classified according to their size and we subclassified small micronodules (<4.4 mm) as 'isolated', or as 'daughter', when they were in contact with consolidation (described as lesions ≥ 4.5 mm). Our data link the higher capacity to contain Mtb infection in cynomolgus with the reduced incidence of daughter micronodules, thus avoiding the development of consolidated lesions and their consequent enlargement and evolution to cavitation. In the case of rhesus, intradermal vaccination has a higher capacity to reduce the formation of daughter micronodules. This study supports the 'Bubble Model' defined with the C3HBe/FeJ mice and proposes a new method to evaluate outcomes in experimental models of TB in NHP based on CT images, which would fit a future machine learning approach to evaluate new vaccines.
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Determination of the Pharmacokinetics and Pharmacodynamics of Isoniazid, Rifampicin, Pyrazinamide and Ethambutol in a Cross-Over Cynomolgus Macaque Model of Mycobacterium tuberculosis Infection. Pharmaceutics 2022; 14:pharmaceutics14122666. [PMID: 36559163 PMCID: PMC9780811 DOI: 10.3390/pharmaceutics14122666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
Innovative cross-over study designs were explored in non-human primate (NHP) studies to determine the value of this approach for the evaluation of drug efficacy against tuberculosis (TB). Firstly, the pharmacokinetics (PK) of each of the drugs Isoniazid (H), Rifampicin (R), Pyrazinamide (Z) and Ethambutol (E), that are standardly used for the treatment of tuberculosis, was established in the blood of macaques after oral dosing as a monotherapy or in combination. Two studies were conducted to evaluate the pharmacokinetics and pharmacodynamics of different drug combinations using cross-over designs. The first employed a balanced, three-period Pigeon design with an extra period; this ensured that treatment by period interactions and carry-over could be detected comparing the treatments HR, HZ and HRZ using H37Rv as the challenge strain of Mycobacterium tuberculosis (M. tb). Although the design accounted for considerable variability between animals, the three regimens evaluated could not be distinguished using any of the alternative endpoints assessed. However, the degree of pathology achieved using H37Rv in the model during this study was less than expected. Based on these findings, a second experiment using a classical AB/BA design comparing HE with HRZ was conducted using the M. tb Erdman strain. More extensive pathology was observed, and differences in computerized tomography (CT) scores and bacteriology counts in the lungs were detected, although due to the small group sizes, clearer differences were not distinguished. Type 1 T helper (Th1) cell response profiles were characterized using the IFN-γ ELISPOT assay and revealed differences between drug treatments that corresponded to decreases in disease burden. Therefore, the studies performed support the utility of the NHP model for the determination of PK/PD of TB drugs, although further work is required to optimize the use of cross-over study designs.
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Choy RKM, Bourgeois AL, Ockenhouse CF, Walker RI, Sheets RL, Flores J. Controlled Human Infection Models To Accelerate Vaccine Development. Clin Microbiol Rev 2022; 35:e0000821. [PMID: 35862754 PMCID: PMC9491212 DOI: 10.1128/cmr.00008-21] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The timelines for developing vaccines against infectious diseases are lengthy, and often vaccines that reach the stage of large phase 3 field trials fail to provide the desired level of protective efficacy. The application of controlled human challenge models of infection and disease at the appropriate stages of development could accelerate development of candidate vaccines and, in fact, has done so successfully in some limited cases. Human challenge models could potentially be used to gather critical information on pathogenesis, inform strain selection for vaccines, explore cross-protective immunity, identify immune correlates of protection and mechanisms of protection induced by infection or evoked by candidate vaccines, guide decisions on appropriate trial endpoints, and evaluate vaccine efficacy. We prepared this report to motivate fellow scientists to exploit the potential capacity of controlled human challenge experiments to advance vaccine development. In this review, we considered available challenge models for 17 infectious diseases in the context of the public health importance of each disease, the diversity and pathogenesis of the causative organisms, the vaccine candidates under development, and each model's capacity to evaluate them and identify correlates of protective immunity. Our broad assessment indicated that human challenge models have not yet reached their full potential to support the development of vaccines against infectious diseases. On the basis of our review, however, we believe that describing an ideal challenge model is possible, as is further developing existing and future challenge models.
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Affiliation(s)
- Robert K. M. Choy
- PATH, Center for Vaccine Innovation and Access, Seattle, Washington, USA
| | - A. Louis Bourgeois
- PATH, Center for Vaccine Innovation and Access, Seattle, Washington, USA
| | | | - Richard I. Walker
- PATH, Center for Vaccine Innovation and Access, Seattle, Washington, USA
| | | | - Jorge Flores
- PATH, Center for Vaccine Innovation and Access, Seattle, Washington, USA
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7
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Sultana N, Pervin M, Sultana S, Islam M, Mostaree M, Khan MAHNA. Pathological study and molecular detection of zoonotic diseases in small ruminants at slaughter houses in Mymensingh, Bangladesh. Vet World 2022; 15:2119-2130. [PMID: 36341049 PMCID: PMC9631356 DOI: 10.14202/vetworld.2022.2119-2130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 08/02/2022] [Indexed: 12/03/2022] Open
Abstract
Background and Aim: Slaughterhouses act as a significant public health hotspot in developing countries like Bangladesh. The study aimed to investigate small ruminants at slaughterhouses for pathological study and molecular detection of important zoonotic diseases. Materials and Methods: A total of 75 goats and 14 sheep were investigated from June 2019 to January 2020 at different slaughterhouses in Mymensingh division, Bangladesh. The targeted diseases were tuberculosis (TB), listeriosis, Q fever, brucellosis, anthrax, toxoplasmosis, hydatidosis, and linguatulosis. The tentative diagnosis was made based on gross and histopathological lesions. Polymerase chain reaction (PCR) was performed to confirm the causal agents of zoonotic diseases using disease-specific primers. Results: Grossly, caseous nodule formation in the visceral organs; enlarged and calcifications of mesenteric lymph nodes (MLNs); hydatid cyst formation in the liver were the predominant lesions observed. Histopathologically, granuloma, caseous necrosis, and calcifications admixed with acid-fast bacteria in the MLNs, liver, spleen, and kidney were seen as suggestive of infectivity due to TB. Septic lymphadenitis mixed with rod-shaped bacteria, doughnut granuloma, fibroplasia accompanied by eosinophils and lymphocytic infiltration in MLNs, and portal granuloma were observed in listeriosis, Q fever, linguatulosis, and toxoplasmosis suspected cases, respectively. The PCR amplified Mycobacterium tuberculosis complex (372 bp), Mycobacterium bovis (600 bp), Listeria monocytogenes (517 bp), Toxoplasma gondii (512 bp), and Coxiella burnetii (687 bp) species-specific amplicons. In addition, linguatulosis and hydatidosis were identified in six and three goats, respectively. Brucellosis and anthrax were not detected in any cases. The slaughterhouse samples were also found to harbor the coexistence of different zoonotic pathogens. Conclusion: Deadly infectious zoonotic diseases in goats and sheep at slaughterhouses may cause widespread public health risks. As a result, more intensive monitoring and epidemiological surveys are required to successfully prevent and control zoonotic diseases.
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Affiliation(s)
- Nazneen Sultana
- Department of Pathology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Munmun Pervin
- Department of Pathology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Sajeda Sultana
- Department of Pathology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Mahmuda Islam
- Department of Pathology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Moutuza Mostaree
- Department of Pathology, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh, Bangladesh
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8
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Fenn J, Ridgley LA, White A, Sarfas C, Dennis M, Dalgleish A, Reljic R, Sharpe S, Bodman-Smith M. Bacillus Calmette-Guerin (BCG) induces superior anti-tumour responses by Vδ2+ T cells compared with the aminobisphosphonate drug zoledronic acid. Clin Exp Immunol 2022; 208:301-315. [PMID: 35404420 PMCID: PMC9226146 DOI: 10.1093/cei/uxac032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/07/2022] [Accepted: 04/08/2022] [Indexed: 11/14/2022] Open
Abstract
Vδ2+ T cells can recognize malignantly transformed cells as well as those infected with mycobacteria. This cross-reactivity supports the idea of using mycobacteria to manipulate Vδ2+ T cells in cancer immunotherapy. To date, therapeutic interventions using Vδ2+ T cells in cancer have involved expanding these cells in or ex vivo using zoledronic acid (ZA). Here, we show that the mycobacterium Bacillus Calmette–Guérin (BCG) also causes Vδ2+ T-cell expansion in vitro and that resulting Vδ2+ cell populations are cytotoxic toward tumour cell lines. We show that both ZA and BCG-expanded Vδ2+ cells effectively killed both Daudi and THP-1 cells. THP-1 cell killing by both ZA and BCG-expanded Vδ2+ cells was enhanced by treatment of targets cells with ZA. Although no difference in cytotoxic activity between ZA- and BCG-expanded Vδ2+ cells was observed, BCG-expanded cells degranulated more and produced a more diverse range of cytokines upon tumour cell recognition compared to ZA-expanded cells. ZA-expanded Vδ2+ cells were shown to upregulate exhaustion marker CD57 to a greater extent than BCG-expanded Vδ2+ cells. Furthermore, ZA expansion was associated with upregulation of inhibitory markers PD-1 and TIM3 in a dose-dependent manner whereas PD-1 expression was not increased following expansion using BCG. Intradermal BCG vaccination of rhesus macaques caused in vivo expansion of Vδ2+ cells. In combination with the aforementioned in vitro data, this finding suggests that BCG treatment could induce expansion of Vδ2+ T cells with enhanced anti-tumour potential compared to ZA treatment and that either ZA or BCG could be used intratumourally as a means to potentiate stronger anti-tumour Vδ2+ T-cell responses.
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Affiliation(s)
- J Fenn
- Institute for Infection and Immunity, St. George's, University of London, London, UK.,NIHR Health Protection Research Unit in Respiratory Infections, National Heart and Lung Institute, Imperial College London, London, UK
| | - L A Ridgley
- Institute for Infection and Immunity, St. George's, University of London, London, UK
| | - A White
- UK Health Security Agency, Porton Down, UK
| | - C Sarfas
- UK Health Security Agency, Porton Down, UK
| | - M Dennis
- UK Health Security Agency, Porton Down, UK
| | - A Dalgleish
- Institute for Infection and Immunity, St. George's, University of London, London, UK
| | - R Reljic
- Institute for Infection and Immunity, St. George's, University of London, London, UK
| | - S Sharpe
- UK Health Security Agency, Porton Down, UK
| | - M Bodman-Smith
- Institute for Infection and Immunity, St. George's, University of London, London, UK
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9
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Hunter L, Hingley-Wilson S, Stewart GR, Sharpe SA, Salguero FJ. Dynamics of Macrophage, T and B Cell Infiltration Within Pulmonary Granulomas Induced by Mycobacterium tuberculosis in Two Non-Human Primate Models of Aerosol Infection. Front Immunol 2022; 12:776913. [PMID: 35069548 PMCID: PMC8770544 DOI: 10.3389/fimmu.2021.776913] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/14/2021] [Indexed: 12/25/2022] Open
Abstract
Non-human primate models of Tuberculosis (TB) are one of the most commonly used within the experimental TB field because they closely mimic the whole spectrum of disease progression of human TB. However, the early cellular interactions of the pulmonary granuloma are still not well understood. The use of this model allows investigation into the early interactions of cells within pulmonary granulomas which cannot be undertaken in human samples. Pulmonary granulomas from rhesus and cynomolgus macaques from two timepoints post infection were categorised into categories 1 – 6 (early to late stage granulomas) and immunohistochemistry was used to identify CD68+ macrophages, CD3+ T cells and CD20+ B cells. Multinucleated giant cells and acid-fast bacilli were also quantified. At week four post infection, cynomolgus macaques were found to have more CD68+ cells than rhesus in all but category 1 granulomas. Cynomolgus also had a significantly higher percentage of CD20+ B cells in category 1 granulomas. At week twelve post infection, CD68+ cells were most abundant in category 4 and 5 granulomas in both species; however, there were no significant differences between them. CD3+ T cells and CD20+ B cells were significantly higher in the majority of granuloma categories in cynomolgus compared to rhesus. Multinucleated giant cells and acid-fast bacilli were most abundant in categories 5 and 6 at week 12 post challenge in both species. This study has identified the basic cellular composition and spatial distribution of immune cells within pulmonary granulomas in both rhesus and cynomolgus macaques over time. The data from this study will add to the knowledge already gained in this field and may inform future research on vaccines and therapeutics for TB.
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Affiliation(s)
- Laura Hunter
- Research and Evaluation, UK Health Security Agency (UKHSA), Salisbury, United Kingdom.,School of Biosciences and Medicine, University of Surrey, Guildford, United Kingdom
| | - Suzie Hingley-Wilson
- School of Biosciences and Medicine, University of Surrey, Guildford, United Kingdom
| | - Graham R Stewart
- School of Biosciences and Medicine, University of Surrey, Guildford, United Kingdom
| | - Sally A Sharpe
- Research and Evaluation, UK Health Security Agency (UKHSA), Salisbury, United Kingdom
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10
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Bitencourt J, Peralta-Álvarez MP, Wilkie M, Jacobs A, Wright D, Salman Almujri S, Li S, Harris SA, Smith SG, Elias SC, White AD, Satti I, Sharpe SS, O’Shea MK, McShane H, Tanner R. Induction of Functional Specific Antibodies, IgG-Secreting Plasmablasts and Memory B Cells Following BCG Vaccination. Front Immunol 2022; 12:798207. [PMID: 35069580 PMCID: PMC8767055 DOI: 10.3389/fimmu.2021.798207] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/13/2021] [Indexed: 12/19/2022] Open
Abstract
Tuberculosis (TB) is a major global health problem and the only currently-licensed vaccine, BCG, is inadequate. Many TB vaccine candidates are designed to be given as a boost to BCG; an understanding of the BCG-induced immune response is therefore critical, and the opportunity to relate this to circumstances where BCG does confer protection may direct the design of more efficacious vaccines. While the T cell response to BCG vaccination has been well-characterized, there is a paucity of literature on the humoral response. We demonstrate BCG vaccine-mediated induction of specific antibodies in different human populations and macaque species which represent important preclinical models for TB vaccine development. We observe a strong correlation between antibody titers in serum versus plasma with modestly higher titers in serum. We also report for the first time the rapid and transient induction of antibody-secreting plasmablasts following BCG vaccination, together with a robust and durable memory B cell response in humans. Finally, we demonstrate a functional role for BCG vaccine-induced specific antibodies in opsonizing mycobacteria and enhancing macrophage phagocytosis in vitro, which may contribute to the BCG vaccine-mediated control of mycobacterial growth observed. Taken together, our findings indicate that the humoral immune response in the context of BCG vaccination merits further attention to determine whether TB vaccine candidates could benefit from the induction of humoral as well as cellular immunity.
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Affiliation(s)
- Julia Bitencourt
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz (IGM/Fiocruz), Salvador, Brazil
| | | | - Morven Wilkie
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Ashley Jacobs
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Department of Medicine, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Daniel Wright
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Salem Salman Almujri
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Shuailin Li
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Stephanie A. Harris
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Steven G. Smith
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Division of Biosciences, Brunel University, London, United Kingdom
| | - Sean C. Elias
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Andrew D. White
- United Kingdom Health Security Agency, Porton Down, Salisbury, United Kingdom
| | - Iman Satti
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Sally S. Sharpe
- United Kingdom Health Security Agency, Porton Down, Salisbury, United Kingdom
| | - Matthew K. O’Shea
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Helen McShane
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Rachel Tanner
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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11
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Joshi H, Kandari D, Bhatnagar R. Insights into the molecular determinants involved in Mycobacterium tuberculosis persistence and their therapeutic implications. Virulence 2021; 12:2721-2749. [PMID: 34637683 PMCID: PMC8565819 DOI: 10.1080/21505594.2021.1990660] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/17/2021] [Accepted: 10/05/2021] [Indexed: 01/08/2023] Open
Abstract
The establishment of persistent infections and the reactivation of persistent bacteria to active bacilli are the two hurdles in effective tuberculosis treatment. Mycobacterium tuberculosis, an etiologic tuberculosis agent, adapts to numerous antibiotics and resists the host immune system causing a disease of public health concern. Extensive research has been employed to combat this disease due to its sheer ability to persist in the host system, undetected, waiting for the opportunity to declare itself. Persisters are a bacterial subpopulation that possesses transient tolerance to high doses of antibiotics. There are certain inherent mechanisms that facilitate the persister cell formation in Mycobacterium tuberculosis, some of those had been characterized in the past namely, stringent response, transcriptional regulators, energy production pathways, lipid metabolism, cell wall remodeling enzymes, phosphate metabolism, and proteasome protein degradation. This article reviews the recent advancements made in various in vitro persistence models that assist to unravel the mechanisms involved in the persister cell formation and to hunt for the possible preventive or treatment measures. To tackle the persister population the immunodominant proteins that express specifically at the latent phase of infection can be used for diagnosis to distinguish between the active and latent tuberculosis, as well as to select potential drug or vaccine candidates. In addition, we discuss the genes engaged in the persistence to get more insights into resuscitation and persister cell formation. The in-depth understanding of persistent cells of mycobacteria can certainly unravel novel ways to target the pathogen and tackle its persistence.
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Affiliation(s)
- Hemant Joshi
- Molecular Biology and Genetic Engineering Laboratory, School of Biotechnology, Jawaharlal Nehru University, New Delhi, India
| | - Divya Kandari
- Molecular Biology and Genetic Engineering Laboratory, School of Biotechnology, Jawaharlal Nehru University, New Delhi, India
| | - Rakesh Bhatnagar
- Molecular Biology and Genetic Engineering Laboratory, School of Biotechnology, Jawaharlal Nehru University, New Delhi, India
- Amity University of Rajasthan, Jaipur, Rajasthan, India
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12
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White AD, Sibley L, Gullick J, Sarfas C, Clark S, Fagrouch Z, Verschoor E, Salguero FJ, Dennis M, Sharpe S. TB and SIV Coinfection; a Model for Evaluating Vaccine Strategies against TB Reactivation in Asian Origin Cynomolgus Macaques: A Pilot Study Using BCG Vaccination. Vaccines (Basel) 2021; 9:945. [PMID: 34579182 PMCID: PMC8473354 DOI: 10.3390/vaccines9090945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/12/2021] [Accepted: 08/16/2021] [Indexed: 11/17/2022] Open
Abstract
This pilot study aimed to determine the utility of a cynomolgus macaque model of coinfection with simian immunodeficiency virus (SIV) for the assessment of vaccines designed to prevent reactivation of TB. Following infection caused by aerosol exposure to an ultralow dose of Mycobacterium tuberculosis (M. tb), data trends indicated that subsequent coinfection with SIVmac32H perturbed control of M. tb infection as evidenced by the increased occurrence of progressive disease in this group, higher levels of pathology and increased frequency of progressive tuberculous granulomas in the lung. BCG vaccination led to improved control of TB-induced disease and lower viral load in comparison to unvaccinated coinfected animals. The M. tb-specific IFNγ response after exposure to M. tb, previously shown to be associated with bacterial burden, was lower in the BCG-vaccinated group than in the unvaccinated groups. Levels of CD4+ and CD8+ T cells decreased in coinfected animals, with counts recovering more quickly in the BCG-vaccinated group. This pilot study provides proof of concept to support the use of the model for evaluation of interventions against reactivated/exacerbated TB caused by human immunodeficiency virus (HIV) infection.
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Affiliation(s)
- Andrew D. White
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
| | - Laura Sibley
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
| | - Jennie Gullick
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
| | - Charlotte Sarfas
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
| | - Simon Clark
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
| | - Zahra Fagrouch
- Department of Virology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (Z.F.); (E.V.)
| | - Ernst Verschoor
- Department of Virology, Biomedical Primate Research Centre, Lange Kleiweg 161, 2288 GJ Rijswijk, The Netherlands; (Z.F.); (E.V.)
| | - Francisco J. Salguero
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
| | - Mike Dennis
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
| | - Sally Sharpe
- Public Health England, National Infections Service, Porton Down, Salisbury SP4 0JG, UK; (A.D.W.); (J.G.); (C.S.); (S.C.); (F.J.S.); (M.D.); (S.S.)
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13
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High-dose Mycobacterium tuberculosis aerosol challenge cannot overcome BCG-induced protection in Chinese origin cynomolgus macaques; implications of natural resistance for vaccine evaluation. Sci Rep 2021; 11:12274. [PMID: 34112845 PMCID: PMC8192909 DOI: 10.1038/s41598-021-90913-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/19/2021] [Indexed: 12/01/2022] Open
Abstract
This study describes the use of cynomolgus macaques of Chinese origin (CCM) to evaluate the efficacy and immunogenicity of the BCG vaccine against high dose aerosol Mycobacterium tuberculosis challenge. Progressive disease developed in three of the unvaccinated animals within 10 weeks of challenge, whereas all six vaccinated animals controlled disease for 26 weeks. Three unvaccinated animals limited disease progression, highlighting the intrinsic ability of this macaque species to control disease in comparison to macaques of other species and genotypes. Low levels of IFNγ were induced by BCG vaccination in CCM suggesting that IFNγ alone does not provide a sufficiently sensitive biomarker of vaccination in this model. An early response after challenge, together with the natural bias towards terminal effector memory T-cell populations and the contribution of monocytes appears to enhance the ability of CCM to naturally control infection. The high dose aerosol challenge model of CCM has value for examination of the host immune system to characterise control of infection which would influence future vaccine design. Although it may not be the preferred platform for the assessment of prophylactic vaccine candidates, the model could be well suited for testing post-exposure vaccination strategies and drug evaluation studies.
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14
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Sibley L, Daykin-Pont O, Sarfas C, Pascoe J, White AD, Sharpe S. Differences in host immune populations between rhesus macaques and cynomolgus macaque subspecies in relation to susceptibility to Mycobacterium tuberculosis infection. Sci Rep 2021; 11:8810. [PMID: 33893359 PMCID: PMC8065127 DOI: 10.1038/s41598-021-87872-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/01/2021] [Indexed: 12/22/2022] Open
Abstract
Rhesus (Macaca mulatta) and cynomolgus (Macaca fasicularis) macaques of distinct genetic origin are understood to vary in susceptibility to Mycobacterium tuberculosis, and therefore differences in their immune systems may account for the differences in disease control. Monocyte:lymphocyte (M:L) ratio has been identified as a risk factor for M. tuberculosis infection and is known to vary between macaque species. We aimed to characterise the constituent monocyte and lymphocyte populations between macaque species, and profile other major immune cell subsets including: CD4+ and CD8+ T-cells, NK-cells, B-cells, monocyte subsets and myeloid dendritic cells. We found immune cell subsets to vary significantly between macaque species. Frequencies of CD4+ and CD8+ T-cells and the CD4:CD8 ratio showed significant separation between species, while myeloid dendritic cells best associated macaque populations by M. tuberculosis susceptibility. A more comprehensive understanding of the immune parameters between macaque species may contribute to the identification of new biomarkers and correlates of protection.
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Affiliation(s)
- Laura Sibley
- Public Health England - Porton, National Infections Service, Porton Down, Salisbury, Wiltshire, SP4 0JG, UK.
| | - Owen Daykin-Pont
- Public Health England - Porton, National Infections Service, Porton Down, Salisbury, Wiltshire, SP4 0JG, UK
| | - Charlotte Sarfas
- Public Health England - Porton, National Infections Service, Porton Down, Salisbury, Wiltshire, SP4 0JG, UK
| | - Jordan Pascoe
- Public Health England - Porton, National Infections Service, Porton Down, Salisbury, Wiltshire, SP4 0JG, UK
| | - Andrew D White
- Public Health England - Porton, National Infections Service, Porton Down, Salisbury, Wiltshire, SP4 0JG, UK
| | - Sally Sharpe
- Public Health England - Porton, National Infections Service, Porton Down, Salisbury, Wiltshire, SP4 0JG, UK
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15
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Tanner R, Hoogkamer E, Bitencourt J, White A, Boot C, Sombroek CC, Harris SA, O'Shea MK, Wright D, Wittenberg R, Sarfas C, Satti I, Verreck FA, Sharpe SA, Fletcher HA, McShane H. The in vitro direct mycobacterial growth inhibition assay (MGIA) for the early evaluation of TB vaccine candidates and assessment of protective immunity: a protocol for non-human primate cells. F1000Res 2021; 10:257. [PMID: 33976866 PMCID: PMC8097740 DOI: 10.12688/f1000research.51640.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2021] [Indexed: 04/04/2024] Open
Abstract
The only currently available approach to early efficacy testing of tuberculosis (TB) vaccine candidates is in vivo preclinical challenge models. These typically include mice, guinea pigs and non-human primates (NHPs), which must be exposed to virulent M.tb in a 'challenge' experiment following vaccination in order to evaluate protective efficacy. This procedure results in disease development and is classified as 'Moderate' in severity under EU legislation and UK ASPA licensure. Furthermore, experiments are relatively long and animals must be maintained in high containment level facilities, making them relatively costly. We describe an in vitro protocol for the direct mycobacterial growth inhibition assay (MGIA) for use in the macaque model of TB vaccine development with the aim of overcoming some of these limitations. Importantly, using an in vitro assay in place of in vivo M.tb challenge represents a significant refinement to the existing procedure for early vaccine efficacy testing. Peripheral blood mononuclear cell and autologous serum samples collected from vaccinated and unvaccinated control animals are co-cultured with mycobacteria in a 48-well plate format for 96 hours. Adherent monocytes are then lysed to release intracellular mycobacteria which is quantified using the BACTEC MGIT system and colony-forming units determined relative to an inoculum control and stock standard curve. We discuss related optimisation and characterisation experiments, and review evidence that the direct NHP MGIA provides a biologically relevant model of vaccine-induced protection. The potential end-users of the NHP MGIA are academic and industry organisations that conduct the assessment of TB vaccine candidates and associated protective immunity using the NHP model. This approach aims to provide a method for high-throughput down-selection of vaccine candidates going forward to in vivo efficacy testing, thus expediting the development of a more efficacious TB vaccine and offering potential refinement and reduction to the use of NHPs for this purpose.
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Affiliation(s)
- Rachel Tanner
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
| | - Emily Hoogkamer
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
- Public Health England, Salisbury, SP4 0JG, UK
| | - Julia Bitencourt
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
- Gonҫalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, 40296-710, Brazil
| | | | - Charelle Boot
- Department of Parasitology, Biomedical Primate Research Centre, Rijswijk, 2288 GJ, The Netherlands
| | - Claudia C. Sombroek
- Department of Parasitology, Biomedical Primate Research Centre, Rijswijk, 2288 GJ, The Netherlands
| | | | - Matthew K. O'Shea
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
- Institute of Immunology and Immunotherapy, University of Birmingham, UK, Birmingham, B15 2TH, UK
| | - Daniel Wright
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
| | - Rachel Wittenberg
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
| | | | - Iman Satti
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
| | - Frank A.W. Verreck
- Department of Parasitology, Biomedical Primate Research Centre, Rijswijk, 2288 GJ, The Netherlands
| | | | - Helen A. Fletcher
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
- London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Helen McShane
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
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16
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Tanner R, Hoogkamer E, Bitencourt J, White A, Boot C, Sombroek CC, Harris SA, O'Shea MK, Wright D, Wittenberg R, Sarfas C, Satti I, Verreck FAW, Sharpe SA, Fletcher HA, McShane H. The in vitro direct mycobacterial growth inhibition assay (MGIA) for the early evaluation of TB vaccine candidates and assessment of protective immunity: a protocol for non-human primate cells. F1000Res 2021; 10:257. [PMID: 33976866 PMCID: PMC8097740.2 DOI: 10.12688/f1000research.51640.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/15/2021] [Indexed: 11/29/2022] Open
Abstract
The only currently available approach to early efficacy testing of tuberculosis (TB) vaccine candidates is in vivo preclinical challenge models. These typically include mice, guinea pigs and non-human primates (NHPs), which must be exposed to virulent M.tb in a 'challenge' experiment following vaccination in order to evaluate protective efficacy. This procedure results in disease development and is classified as 'Moderate' in severity under EU legislation and UK ASPA licensure. Furthermore, experiments are relatively long and animals must be maintained in high containment level facilities, making them relatively costly. We describe an in vitro protocol for the direct mycobacterial growth inhibition assay (MGIA) for use in the macaque model of TB vaccine development with the aim of overcoming some of these limitations. Importantly, using an in vitro assay in place of in vivo M.tb challenge represents a significant refinement to the existing procedure for early vaccine efficacy testing. Peripheral blood mononuclear cell and autologous serum samples collected from vaccinated and unvaccinated control animals are co-cultured with mycobacteria in a 48-well plate format for 96 hours. Adherent monocytes are then lysed to release intracellular mycobacteria which is quantified using the BACTEC MGIT system and colony-forming units determined relative to an inoculum control and stock standard curve. We discuss related optimisation and characterisation experiments, and review evidence that the direct NHP MGIA provides a biologically relevant model of vaccine-induced protection. The potential end-users of the NHP MGIA are academic and industry organisations that conduct the assessment of TB vaccine candidates and associated protective immunity using the NHP model. This approach aims to provide a method for high-throughput down-selection of vaccine candidates going forward to in vivo efficacy testing, thus expediting the development of a more efficacious TB vaccine and offering potential refinement and reduction to the use of NHPs for this purpose.
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Affiliation(s)
- Rachel Tanner
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
| | - Emily Hoogkamer
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
- Public Health England, Salisbury, SP4 0JG, UK
| | - Julia Bitencourt
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
- Gonҫalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, 40296-710, Brazil
| | | | - Charelle Boot
- Department of Parasitology, Biomedical Primate Research Centre, Rijswijk, 2288 GJ, The Netherlands
| | - Claudia C Sombroek
- Department of Parasitology, Biomedical Primate Research Centre, Rijswijk, 2288 GJ, The Netherlands
| | - Stephanie A Harris
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
| | - Matthew K O'Shea
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
- Institute of Immunology and Immunotherapy, University of Birmingham, UK, Birmingham, B15 2TH, UK
| | - Daniel Wright
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
| | - Rachel Wittenberg
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
| | | | - Iman Satti
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
| | - Frank A W Verreck
- Department of Parasitology, Biomedical Primate Research Centre, Rijswijk, 2288 GJ, The Netherlands
| | | | - Helen A Fletcher
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
- London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Helen McShane
- Nuffield Department of Medicine, The Jenner Institute, Oxford, OX3 7DQ, UK
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17
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MTBVAC vaccination protects rhesus macaques against aerosol challenge with M. tuberculosis and induces immune signatures analogous to those observed in clinical studies. NPJ Vaccines 2021; 6:4. [PMID: 33397991 PMCID: PMC7782851 DOI: 10.1038/s41541-020-00262-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/13/2020] [Indexed: 01/15/2023] Open
Abstract
A single intradermal vaccination with MTBVAC given to adult rhesus macaques was well tolerated and conferred a significant improvement in outcome following aerosol exposure to M. tuberculosis compared to that provided by a single BCG vaccination. Vaccination with MTBVAC resulted in a significant reduction in M. tuberculosis infection-induced disease pathology measured using in vivo medical imaging, in gross pathology lesion counts and pathology scores recorded at necropsy, the frequency and severity of pulmonary granulomas and the frequency of recovery of viable M. tuberculosis from extrapulmonary tissues following challenge. The immune profiles induced following immunisation with MTBVAC reflect those identified in human clinical trials of MTBVAC. Evaluation of MTBVAC- and TB peptide-pool-specific T-cell cytokine production revealed a predominantly Th1 response from poly- (IFN-γ+TNF-α+IL2+) and multi-(IFN-γ+TNF-α+) functional CD4 T cells, while only low levels of Th22, Th17 and cytokine-producing CD8 T-cell populations were detected together with low-level, but significant, increases in CFP10-specific IFN-γ secreting cells. In this report, we describe concordance between immune profiles measured in clinical trials and a macaque pre-clinical study demonstrating significantly improved outcome after M. tuberculosis challenge as evidence to support the continued development of MTBVAC as an effective prophylactic vaccine for TB vaccination campaigns.
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18
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A non-human primate in vitro functional assay for the early evaluation of TB vaccine candidates. NPJ Vaccines 2021; 6:3. [PMID: 33397986 PMCID: PMC7782578 DOI: 10.1038/s41541-020-00263-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/23/2020] [Indexed: 01/29/2023] Open
Abstract
We present a non-human primate mycobacterial growth inhibition assay (MGIA) using in vitro blood or cell co-culture with the aim of refining and expediting early tuberculosis vaccine testing. We have taken steps to optimise the assay using cryopreserved peripheral blood mononuclear cells, transfer it to end-user institutes, and assess technical and biological validity. Increasing cell concentration or mycobacterial input and co-culturing in static 48-well plates compared with rotating tubes improved intra-assay repeatability and sensitivity. Standardisation and harmonisation efforts resulted in high consistency agreements, with repeatability and intermediate precision <10% coefficient of variation (CV) and inter-site reproducibility <20% CV; although some systematic differences were observed. As proof-of-concept, we demonstrated ability to detect a BCG vaccine-induced improvement in growth inhibition in macaque samples, and a correlation between MGIA outcome and measures of protection from in vivo disease development following challenge with either intradermal BCG or aerosol/endobronchial Mycobacterium tuberculosis (M.tb) at a group and individual animal level.
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19
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White AD, Sarfas C, Sibley LS, Gullick J, Clark S, Rayner E, Gleeson F, Català M, Nogueira I, Cardona PJ, Vilaplana C, Dennis MJ, Williams A, Sharpe SA. Protective Efficacy of Inhaled BCG Vaccination Against Ultra-Low Dose Aerosol M. tuberculosis Challenge in Rhesus Macaques. Pharmaceutics 2020; 12:pharmaceutics12050394. [PMID: 32344890 PMCID: PMC7284565 DOI: 10.3390/pharmaceutics12050394] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 11/23/2022] Open
Abstract
Ten million cases of tuberculosis (TB) were reported in 2018 with a further 1.5 million deaths attributed to the disease. Improved vaccination strategies are urgently required to tackle the ongoing global TB epidemic. In the absence of a validated correlate of protection, highly characterised pre-clinical models are required to assess the protective efficacy of new vaccination strategies. In this study, we demonstrate the application of a rhesus macaque ultra-low dose (ULD) aerosol M. tuberculosis challenge model for the evaluation of TB vaccination strategies by directly comparing the immunogenicity and efficacy of intradermal (ID) and aerosol BCG vaccination delivered using a portable vibrating mesh nebulizer (VMN). Aerosol- and ID-delivered Bacille Calmette-Guérin (BCG) induced comparable frequencies of IFN-γ spot forming units (SFU) measured in peripheral blood mononuclear cells (PBMCs) by ELISpot, although the induction of IFN-γ SFU was significantly delayed following aerosol immunisation. This delayed response was also apparent in an array of secreted pro-inflammatory and chemokine markers, as well as in the frequency of antigen-specific cytokine producing CD4 and CD8 T-cells measured by multi-parameter flow cytometry. Interrogation of antigen-specific memory T-cell phenotypes revealed that vaccination-induced CD4 and CD8 T-cell populations primarily occupied the central memory (TCM) and transitional effector memory (TransEM) phenotype, and that the frequency of CD8 TCM and TransEM populations was significantly higher in aerosol BCG-vaccinated animals in the week prior to M. tuberculosis infection. The total and lung pathology measured following M. tuberculosis challenge was significantly lower in vaccinated animals relative to the unvaccinated control group and pathology measured in extra-pulmonary tissues was significantly reduced in aerosol BCG-vaccinated animals, relative to the ID-immunised group. Similarly, significantly fewer viable M. tuberculosis CFU were recovered from the extra-pulmonary tissues of aerosol BCG-vaccinated macaques relative to unvaccinated animals. In this study, a rhesus macaque ULD M. tuberculosis aerosol challenge model was applied as a refined and sensitive system for the evaluation of TB vaccine efficacy and to confirm that aerosol BCG vaccination delivered by portable VMN can confer a significant level of protection that is equivalent, and by some measures superior, to intradermal BCG vaccination.
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Affiliation(s)
- Andrew D. White
- Public Health England, National Infection Service, Porton Down, Salisbury SP4 0JG, UK; (C.S.); (L.S.S.); (J.G.); (S.C.); (E.R.); (M.J.D.); (A.W.); (S.A.S.)
- Correspondence: ; Tel.: +44-198-061-2100
| | - Charlotte Sarfas
- Public Health England, National Infection Service, Porton Down, Salisbury SP4 0JG, UK; (C.S.); (L.S.S.); (J.G.); (S.C.); (E.R.); (M.J.D.); (A.W.); (S.A.S.)
| | - Laura S. Sibley
- Public Health England, National Infection Service, Porton Down, Salisbury SP4 0JG, UK; (C.S.); (L.S.S.); (J.G.); (S.C.); (E.R.); (M.J.D.); (A.W.); (S.A.S.)
| | - Jennie Gullick
- Public Health England, National Infection Service, Porton Down, Salisbury SP4 0JG, UK; (C.S.); (L.S.S.); (J.G.); (S.C.); (E.R.); (M.J.D.); (A.W.); (S.A.S.)
| | - Simon Clark
- Public Health England, National Infection Service, Porton Down, Salisbury SP4 0JG, UK; (C.S.); (L.S.S.); (J.G.); (S.C.); (E.R.); (M.J.D.); (A.W.); (S.A.S.)
| | - Emma Rayner
- Public Health England, National Infection Service, Porton Down, Salisbury SP4 0JG, UK; (C.S.); (L.S.S.); (J.G.); (S.C.); (E.R.); (M.J.D.); (A.W.); (S.A.S.)
| | | | - Martí Català
- Comparative Medicine and Bioimage Centre of Catalonia (CMCiB), Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, 08916 Catalonia, Spain;
| | - Isabel Nogueira
- Servei de Radiodiagnòstic, Hospital Universitari Germans Trias i Pujol, Badalona, 08916 Catalonia, Spain;
| | - Pere-Joan Cardona
- Unitat de Tuberculosi Experimental, Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, CIBERES, 28029 Madrid, Spain; (P.-J.C.); (C.V.)
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES). Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0. 28029 Madrid, Spain
| | - Cristina Vilaplana
- Unitat de Tuberculosi Experimental, Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, CIBERES, 28029 Madrid, Spain; (P.-J.C.); (C.V.)
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES). Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0. 28029 Madrid, Spain
| | - Mike J. Dennis
- Public Health England, National Infection Service, Porton Down, Salisbury SP4 0JG, UK; (C.S.); (L.S.S.); (J.G.); (S.C.); (E.R.); (M.J.D.); (A.W.); (S.A.S.)
| | - Ann Williams
- Public Health England, National Infection Service, Porton Down, Salisbury SP4 0JG, UK; (C.S.); (L.S.S.); (J.G.); (S.C.); (E.R.); (M.J.D.); (A.W.); (S.A.S.)
| | - Sally A. Sharpe
- Public Health England, National Infection Service, Porton Down, Salisbury SP4 0JG, UK; (C.S.); (L.S.S.); (J.G.); (S.C.); (E.R.); (M.J.D.); (A.W.); (S.A.S.)
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20
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Bucsan AN, Mehra S, Khader SA, Kaushal D. The current state of animal models and genomic approaches towards identifying and validating molecular determinants of Mycobacterium tuberculosis infection and tuberculosis disease. Pathog Dis 2020; 77:5543892. [PMID: 31381766 PMCID: PMC6687098 DOI: 10.1093/femspd/ftz037] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 07/25/2019] [Indexed: 12/31/2022] Open
Abstract
Animal models are important in understanding both the pathogenesis of and immunity to tuberculosis (TB). Unfortunately, we are beginning to understand that no animal model perfectly recapitulates the human TB syndrome, which encompasses numerous different stages. Furthermore, Mycobacterium tuberculosis infection is a very heterogeneous event at both the levels of pathogenesis and immunity. This review seeks to establish the current understanding of TB pathogenesis and immunity, as validated in the animal models of TB in active use today. We especially focus on the use of modern genomic approaches in these models to determine the mechanism and the role of specific molecular pathways. Animal models have significantly enhanced our understanding of TB. Incorporation of contemporary technologies such as single cell transcriptomics, high-parameter flow cytometric immune profiling, proteomics, proteomic flow cytometry and immunocytometry into the animal models in use will further enhance our understanding of TB and facilitate the development of treatment and vaccination strategies.
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Affiliation(s)
- Allison N Bucsan
- Tulane Center for Tuberculosis Research, Covington, LA, USA.,Tulane National Primate Research Center, Covington, LA, USA
| | - Smriti Mehra
- Tulane National Primate Research Center, Covington, LA, USA
| | | | - Deepak Kaushal
- Tulane Center for Tuberculosis Research, Covington, LA, USA.,Tulane National Primate Research Center, Covington, LA, USA.,Southwest National Primate Research Center, San Antonio, TX, USA.,Texas Biomedical Research Institute, San Antonio, TX, USA
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21
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Bencivenga MA, Bowling PA, Fiallos JO, Gehling AM, Stafford RG, Long SY, Fetterer DP, Bocan TM, Hofer CC. Investigation of Various Intramuscular Volumes Delivered to the Semimembranosus Muscle of Cavia porcellus. JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE 2020; 59:310-321. [PMID: 32156326 DOI: 10.30802/aalas-jaalas-19-000101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The goal of this study is to provide quantitative data on the ideal volume for intramuscular (IM) injections into the semimembranosus muscle of guinea pigs weighing between 320 to 410 grams. This evaluation comprised 2 experiments. The first was to assess dispersion leakage of intramuscularly injected iohexol, a radiocontrast agent commonly used in Computed Tomography (CT), based on analysis of in vivo imaging. The second used varying volumes of intramuscularly injected sodium chloride (0.9% NaCl) to assess pain and pathology associated with IM injection. Hartley guinea pigs were injected IM with varying volumes of either iohexol or sodium chloride (150, 300, 500, 1000 and 1500 μL). In the iohexol experiment, results suggest IM volumes of 150 and 300 μL remain within the target muscle. In the experiment using sodium chloride, pain and pathology did not increase as IM volume increased. The pathology noted was related to needle tract through the musculature rather than the volume size of the injectate. The results did not reveal a correlation between volume of IM 0.9% NaCl and pain levels. We conclude that volume size correlates more with precision and accuracy of delivery into the intended muscle tissue. Regarding tissue distribution, our findings also suggest that the optimal capacity for IM injection in the semimembranosus muscle should be less than 500 μL.
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Affiliation(s)
- Michael A Bencivenga
- Comparative Medicine Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland;,
| | - Philip A Bowling
- Comparative Medicine Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland
| | - Jimmy O Fiallos
- Comparative Medicine Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland
| | - Alicia M Gehling
- Comparative Medicine Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland
| | - Robert G Stafford
- In Vivo Imaging, Translational Sciences, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland
| | - Simon Y Long
- Pathology Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland
| | - David P Fetterer
- Statistics Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland
| | - Thomas M Bocan
- In Vivo Imaging, Translational Sciences, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland
| | - Christian C Hofer
- Comparative Medicine Division, United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland
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22
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Abstract
Tuberculosis (TB) is the leading killer among all infectious diseases worldwide despite extensive use of the Mycobacterium bovis bacille Calmette-Guérin (BCG) vaccine. A safer and more effective vaccine than BCG is urgently required. More than a dozen TB vaccine candidates are under active evaluation in clinical trials aimed to prevent infection, disease, and recurrence. After decades of extensive research, renewed promise of an effective vaccine against this ancient airborne disease has recently emerged. In two innovative phase 2b vaccine clinical trials, one for the prevention of Mycobacterium tuberculosis infection in healthy adolescents and another for the prevention of TB disease in M. tuberculosis-infected adults, efficacy signals were observed. These breakthroughs, based on the greatly expanded knowledge of the M. tuberculosis infection spectrum, immunology of TB, and vaccine platforms, have reinvigorated the TB vaccine field. Here, we review our current understanding of natural immunity to TB, limitations in BCG immunity that are guiding vaccinologists to design novel TB vaccine candidates and concepts, and the desired attributes of a modern TB vaccine. We provide an overview of the progress of TB vaccine candidates in clinical evaluation, perspectives on the challenges faced by current vaccine concepts, and potential avenues to build on recent successes and accelerate the TB vaccine research-and-development trajectory.
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23
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Roy A, Tomé I, Romero B, Lorente-Leal V, Infantes-Lorenzo JA, Domínguez M, Martín C, Aguiló N, Puentes E, Rodríguez E, de Juan L, Risalde MA, Gortázar C, Domínguez L, Bezos J. Evaluation of the immunogenicity and efficacy of BCG and MTBVAC vaccines using a natural transmission model of tuberculosis. Vet Res 2019; 50:82. [PMID: 31615555 PMCID: PMC6792192 DOI: 10.1186/s13567-019-0702-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 09/25/2019] [Indexed: 12/13/2022] Open
Abstract
Effective vaccines against tuberculosis (TB) are needed in order to prevent TB transmission in human and animal populations. Evaluation of TB vaccines may be facilitated by using reliable animal models that mimic host pathophysiology and natural transmission of the disease as closely as possible. In this study, we evaluated the immunogenicity and efficacy of two attenuated vaccines, BCG and MTBVAC, after each was given to 17 goats (2 months old) and then exposed for 9 months to goats infected with M. caprae. In general, MTBVAC-vaccinated goats showed higher interferon-gamma release than BCG vaccinated goats in response to bovine protein purified derivative and ESAT-6/CFP-10 antigens and the response was significantly higher than that observed in the control group until challenge. All animals showed lesions consistent with TB at the end of the study. Goats that received either vaccine showed significantly lower scores for pulmonary lymph nodes and total lesions than unvaccinated controls. Both MTBVAC and BCG vaccines proved to be immunogenic and effective in reducing severity of TB pathology caused by M. caprae. Our model system of natural TB transmission may be useful for evaluating and optimizing vaccines.
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Affiliation(s)
- Alvaro Roy
- BIOFABRI S.L., Porriño, Pontevedra, Spain.,VISAVET Health Surveillance Centre, Universidad Complutense de Madrid, Madrid, Spain
| | - Irene Tomé
- VISAVET Health Surveillance Centre, Universidad Complutense de Madrid, Madrid, Spain
| | - Beatriz Romero
- VISAVET Health Surveillance Centre, Universidad Complutense de Madrid, Madrid, Spain
| | - Víctor Lorente-Leal
- VISAVET Health Surveillance Centre, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Mercedes Domínguez
- Servicio de Inmunología Microbiana, Centro Nacional de Microbiología, Instituto de Investigación Carlos III, Majadahonda, Madrid, Spain
| | - Carlos Martín
- Grupo de Genética de Micobacterias, Departamento de Microbiología y Medicina Preventiva, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain.,CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.,Servicio de Microbiología, Hospital Universitario Miguel Servet, IIS Aragón, Zaragoza, Spain
| | - Nacho Aguiló
- Grupo de Genética de Micobacterias, Departamento de Microbiología y Medicina Preventiva, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain.,CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Lucía de Juan
- VISAVET Health Surveillance Centre, Universidad Complutense de Madrid, Madrid, Spain.,Dpto. de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - María A Risalde
- Dpto. de Anatomía y Anatomía Patológica Comparadas, Universidad de Córdoba, Córdoba, Spain.,Infectious Diseases Unit, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía de Córdoba, Universidad de Córdoba, Córdoba, Spain
| | - Christian Gortázar
- SaBio (Health and Biotechnology), Instituto de Investigación en Recursos Cinegéticos IREC (CSIC-UCLM), Ciudad Real, Spain
| | - Lucas Domínguez
- VISAVET Health Surveillance Centre, Universidad Complutense de Madrid, Madrid, Spain.,Dpto. de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - Javier Bezos
- VISAVET Health Surveillance Centre, Universidad Complutense de Madrid, Madrid, Spain. .,Dpto. de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain.
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24
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Abebe F. Synergy between Th1 and Th2 responses during Mycobacterium tuberculosis infection: A review of current understanding. Int Rev Immunol 2019; 38:172-179. [PMID: 31244354 DOI: 10.1080/08830185.2019.1632842] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Induction of Th1 (cell-mediated) immunity and associated production of IFN-γ by CD4+ T cells has been widely used as a marker of protective immunity against tuberculosis (TB). This is based on two assumptions. The first is the widely accepted view that Mycobacterium tuberculosis (Mtb), the causative agent of TB is an obligate intracellular pathogen, and the second is based on the Th1/Th2 paradigm, which posits that polarization of CD4+ T cells into type1 (cell-mediated) and type 2 (humoral) is central for proper induction of protective immunity against pathogens. However, almost all licensed vaccines currently in use are primarily anti-body based whether intracellular or extra-cellular. In addition, converging data from both animal models and humans indicate that the production of IFN-γ alone is not sufficient to confer protection against TB. In addition, a substantial body of the literature suggests that, in addition to Th1 cells, antibody classes and sub-classes are protective against TB. In a recent study, we have shown that there is a synergy between IFN-γ (cell-mediated) and IgA (humoral) in human population in an endemic setting. In this review, current data from both animal and human studies that support mixed Th1 and Th2 responses that are protective against Mtb and other pathogens are presented.
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Affiliation(s)
- Fekadu Abebe
- University of Oslo, Faculty of Medicine, Institute of Health and Society , Oslo , Norway
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25
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Tanner R, Villarreal-Ramos B, Vordermeier HM, McShane H. The Humoral Immune Response to BCG Vaccination. Front Immunol 2019; 10:1317. [PMID: 31244856 PMCID: PMC6579862 DOI: 10.3389/fimmu.2019.01317] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 05/23/2019] [Indexed: 01/19/2023] Open
Abstract
Bacillus Calmette Guérin (BCG) is the only currently available vaccine against tuberculosis (TB), but it confers incomplete and variable protection against pulmonary TB in humans and bovine TB (bTB) in cattle. Insights into the immune response induced by BCG offer an underexploited opportunity to gain knowledge that may inform the design of a more efficacious vaccine, which is urgently needed to control these major global epidemics. Humoral immunity in TB and bTB has been neglected, but recent studies supporting a role for antibodies in protection against TB has driven a growing interest in determining their relevance to vaccine development. In this manuscript we review what is known about the humoral immune response to BCG vaccination and re-vaccination across species, including evidence for the induction of specific B cells and antibodies; and how these may relate to protection from TB or bTB. We discuss potential explanations for often conflicting findings and consider how factors such as BCG strain, manufacturing methodology and route of administration influence the humoral response. As novel vaccination strategies include BCG prime-boost regimens, the literature regarding off-target immunomodulatory effects of BCG vaccination on non-specific humoral immunity is also reviewed. Overall, reported outcomes to date are inconsistent, but indicate that humoral responses are heterogeneous and may play different roles in different species, populations, or individual hosts. Further study is warranted to determine whether a new TB vaccine could benefit from the targeting of humoral as well as cell-mediated immunity.
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Affiliation(s)
- Rachel Tanner
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Bernardo Villarreal-Ramos
- Department of Bacteriology, Animal and Plant Health Agency, Addlestone, United Kingdom
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - H. Martin Vordermeier
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Department of Bacteriology, Animal and Plant Health Agency, Addlestone, United Kingdom
- Institute of Biological, Environmental and Rural Sciences, Aberystwyth University, Aberystwyth, United Kingdom
| | - Helen McShane
- The Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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26
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Lyadova I, Nikitina I. Cell Differentiation Degree as a Factor Determining the Role for Different T-Helper Populations in Tuberculosis Protection. Front Immunol 2019; 10:972. [PMID: 31134070 PMCID: PMC6517507 DOI: 10.3389/fimmu.2019.00972] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 04/16/2019] [Indexed: 12/15/2022] Open
Abstract
Efficient tuberculosis (TB) control depends on early TB prediction and prevention. Solution to these tasks requires knowledge of TB protection correlates (TB CoPs), i.e., laboratory markers that are mechanistically involved in the protection and which allow to determine how well an individual is protected against TB or how efficient the candidate TB vaccine is. The search for TB CoPs has been largely focused on different T-helper populations, however, the data are controversial, and no reliable CoPs are still known. Here we discuss the role of different T-helper populations in TB protection focusing predominantly on Th17, “non-classical” Th1 (Th1*) and “classical” Th1 (cTh1) populations. We analyze how these populations differ besides their effector activity and suggest the hypothesis that: (i) links the protective potential of Th17, Th1*, and cTh1 to their differentiation degree and plasticity; (ii) implies different roles of these populations in response to vaccination, latent TB infection (LTBI), and active TB. One of the clinically relevant outcomes of this hypothesis is that over-stimulating T cells during vaccination and biasing T cell response toward the preferential generation of Th1 are not beneficial. The review sheds new light on the problem of TB CoPs and will help develop better strategies for TB control.
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Affiliation(s)
- Irina Lyadova
- Laboratory of Cellular and Molecular Mechanisms of Histogenesis, Koltsov Institute of Developmental Biology, Moscow, Russia.,Laboratory of Biotechnology, Department of Immunology, Central Tuberculosis Research Institute, Moscow, Russia
| | - Irina Nikitina
- Laboratory of Cellular and Molecular Mechanisms of Histogenesis, Koltsov Institute of Developmental Biology, Moscow, Russia.,Laboratory of Biotechnology, Department of Immunology, Central Tuberculosis Research Institute, Moscow, Russia
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27
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Foreman TW, Mehra S, Lackner AA, Kaushal D. Translational Research in the Nonhuman Primate Model of Tuberculosis. ILAR J 2018; 58:151-159. [PMID: 28575319 DOI: 10.1093/ilar/ilx015] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 04/10/2017] [Indexed: 11/14/2022] Open
Abstract
Infection with Mycobacterium tuberculosis predominantly establishes subclinical latent infection over the lifetime of an individual, with a fraction of infected individuals rapidly progressing to active disease. The immune control in latent infection can be perturbed by comorbidities such as diabetes mellitus, obesity, smoking, and coinfection with helminthes or HIV. Modeling the varying aspects of natural infection remains incomplete when using zebrafish and mice. However, the nonhuman primate model of tuberculosis offers a unique and accurate model to investigate host responses to infection, test novel therapeutics, and thoroughly assess preclinical vaccine candidates. Rhesus macaques and cynomolgus macaques manifest the full gamut of clinical and pathological findings in human Mycobacterium tuberculosis infection, including the ability to co-infect macaques with Simian Immunodeficiency Virus to model HIV co-infection. Here we discuss advanced techniques to assay various clinical outcomes of the natural progression of infection as well as therapeutics in development and novel preclinical vaccines. Finally, we survey the translational aspects of nonhuman primate research and argue the urgent need to thoroughly examine preclinical therapeutics and vaccines using this model prior to clinical implementation.
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Affiliation(s)
- Taylor W Foreman
- Tulane National Primate Research Center, Covington, Louisiana.,Tulane University School of Medicine, New Orleans, Louisiana
| | - Smriti Mehra
- Louisiana State University School, Veterinary Medicine, Baton Rouge, Louisiana.,Tulane National Primate Research Center in Covington, Louisiana
| | - Andrew A Lackner
- Tulane National Primate Research Center, Covington, Louisiana.,Immunology and Pathology at Tulane University School of Medicine in New Orleans, Louisiana
| | - Deepak Kaushal
- Tulane National Primate Research Center, Covington, Louisiana.,Immunology at Tulane University School of Medicine, New Orleans, Louisiana.,Department of Medicine, Tulane University School of Medicine in New Orleans, Louisiana
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28
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Marimani M, Ahmad A, Duse A. The role of epigenetics, bacterial and host factors in progression of Mycobacterium tuberculosis infection. Tuberculosis (Edinb) 2018; 113:200-214. [PMID: 30514504 DOI: 10.1016/j.tube.2018.10.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/21/2018] [Accepted: 10/23/2018] [Indexed: 12/29/2022]
Abstract
Tuberculosis (TB) infection caused by Mycobacterium tuberculosis (Mtb) is still a persistent global health problem, particularly in developing countries. The World Health Organization (WHO) reported a mortality rate of about 1.8 million worldwide due to TB complications in 2015. The Bacillus Calmette-Guérin (BCG) vaccine was introduced in 1921 and is still widely used to prevent TB development. This vaccine offers up to 80% protection against various forms of TB; however its efficacy against lung infection varies among different geographical settings. Devastatingly, the development of various forms of drug-resistant TB strains has significantly impaired the discovery of effective and safe anti-bacterial agents. Consequently, this necessitated discovery of new drug targets and novel anti-TB therapeutics to counter infection caused by various Mtb strains. Importantly, various factors that contribute to TB development have been identified and include bacterial resuscitation factors, host factors, environmental factors and genetics. Furthermore, Mtb-induced epigenetic changes also play a crucial role in evading the host immune response and leads to bacterial persistence and dissemination. Recently, the application of GeneXpert MTB/RIF® to rapidly diagnose and identify drug-resistant strains and discovery of different molecular markers that distinguish between latent and active TB infection has motivated and energised TB research. Therefore, this review article will briefly discuss the current TB state, highlight various mechanisms employed by Mtb to evade the host immune response as well as to discuss some modern molecular techniques that may potentially target and inhibit Mtb replication.
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Affiliation(s)
- Musa Marimani
- Clinical Microbiology and Infectious Diseases, School of Pathology, Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Aijaz Ahmad
- Clinical Microbiology and Infectious Diseases, School of Pathology, Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Infection Control, Charlotte Maxeke Johannesburg Academic Hospital, National Health Laboratory Service, South Africa.
| | - Adriano Duse
- Clinical Microbiology and Infectious Diseases, School of Pathology, Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Infection Control, Charlotte Maxeke Johannesburg Academic Hospital, National Health Laboratory Service, South Africa
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29
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Gordaliza PM, Muñoz-Barrutia A, Abella M, Desco M, Sharpe S, Vaquero JJ. Unsupervised CT Lung Image Segmentation of a Mycobacterium Tuberculosis Infection Model. Sci Rep 2018; 8:9802. [PMID: 29955159 PMCID: PMC6023884 DOI: 10.1038/s41598-018-28100-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 06/12/2018] [Indexed: 02/06/2023] Open
Abstract
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis that produces pulmonary damage. Radiological imaging is the preferred technique for the assessment of TB longitudinal course. Computer-assisted identification of biomarkers eases the work of the radiologist by providing a quantitative assessment of disease. Lung segmentation is the step before biomarker extraction. In this study, we present an automatic procedure that enables robust segmentation of damaged lungs that have lesions attached to the parenchyma and are affected by respiratory movement artifacts in a Mycobacterium Tuberculosis infection model. Its main steps are the extraction of the healthy lung tissue and the airway tree followed by elimination of the fuzzy boundaries. Its performance was compared with respect to a segmentation obtained using: (1) a semi-automatic tool and (2) an approach based on fuzzy connectedness. A consensus segmentation resulting from the majority voting of three experts' annotations was considered our ground truth. The proposed approach improves the overlap indicators (Dice similarity coefficient, 94% ± 4%) and the surface similarity coefficients (Hausdorff distance, 8.64 mm ± 7.36 mm) in the majority of the most difficult-to-segment slices. Results indicate that the refined lung segmentations generated could facilitate the extraction of meaningful quantitative data on disease burden.
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Affiliation(s)
- Pedro M Gordaliza
- Universidad Carlos III de Madrid, Departamento de Bioingeniería e Ingeniería Aeroespacial, Leganés, ES28911, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, ES28007, Spain
| | - Arrate Muñoz-Barrutia
- Universidad Carlos III de Madrid, Departamento de Bioingeniería e Ingeniería Aeroespacial, Leganés, ES28911, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, ES28007, Spain
| | - Mónica Abella
- Universidad Carlos III de Madrid, Departamento de Bioingeniería e Ingeniería Aeroespacial, Leganés, ES28911, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, ES28007, Spain
- Centro de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
| | - Manuel Desco
- Universidad Carlos III de Madrid, Departamento de Bioingeniería e Ingeniería Aeroespacial, Leganés, ES28911, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, ES28007, Spain
- Centro de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, ES28029, Spain
| | - Sally Sharpe
- Public Health England, Microbiology Services Division, Porton Down, SP4 0JG, England
| | - Juan José Vaquero
- Universidad Carlos III de Madrid, Departamento de Bioingeniería e Ingeniería Aeroespacial, Leganés, ES28911, Spain.
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, ES28007, Spain.
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30
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Dynamics of Immune Responses during Experimental Mycobacterium kansasii Infection of Cynomolgus Monkeys (Macaca fascicularis). Mediators Inflamm 2018; 2018:8354902. [PMID: 29967568 PMCID: PMC6008762 DOI: 10.1155/2018/8354902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/26/2018] [Accepted: 05/03/2018] [Indexed: 11/18/2022] Open
Abstract
To profile the dynamic changes of immune responses for M. kansasii infection, 3 cynomolgus monkeys were experimentally infected with M. kansasii by intratracheal inhalation of 1 × 106 CFU bacteria per monkey. Every 2 to 4 weeks, tuberculin skin testings (TSTs) were performed and blood samples were collected for immunoassay. Multiple cytokines in a single sample were measured by Luminex xMAP technologies. IgM and IgA were detected by double-antibody sandwich ELISA. IgG against PPD and 11 M. tuberculosis proteins were detected by using of indirect ELISA. At week 16, all animals were euthanized for necropsy and histological analysis. Positivities of TSTs emerged from week 2 to 6 postinfection. Leukocyte counts and T lymphocyte subsets experienced moderate increases. Among 44 kinds of cytokines, 36 kinds of them showed increases of different dynamic types and 8 kinds of them showed no specific changes. Total IgM and IgA showed a transient increase at an early infection stage. Positivities of M. tuberculosis specific IgM and IgA emerged as early as week 2 postinfection. All animals showed positive IgG against PPD and negative IgG responses to 38 kDa, MPT64L, TB16.3, 16 kDa, U1, and MTB81 antigens during the infection period. IgG against ESAT-6, CFP10, CFP10-ESAT-6, Ag85b, and 14 kDa antigens reached positive levels. The IgG avidities of PPD, ESAT-6, CFP10-ESAT-6, and Ag85b were all above 50 percent. In conclusion, the data indicate that M. kansasii infection in monkeys can induce positivities of TSTs, increases of multiple cytokines, and cross-reactive antibody responses to M. tuberculosis antigens.
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31
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Zhang J, Guo M, Rao Y, Wang Y, Xian Q, Yu Q, Huang Z, Wang X, Bao R, Yue J, Tang Z, Zhuang K, Zhou L, Li Z. Mycobacterium tuberculosis Erdman infection of cynomolgus macaques of Chinese origin. J Thorac Dis 2018; 10:3609-3621. [PMID: 30069358 DOI: 10.21037/jtd.2018.05.189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Nearly one-third of the population worldwide is estimated to have latent tuberculosis infection (LTBI), which represents a vast reservoir for a constant source of tuberculosis (TB) transmission. It has been suggested that cynomolgus macaques are less susceptible to Mycobacterium tuberculosis (M.tb) infection than rhesus macaques, we examined M.tb infection of Chinese cynomolgus macaques. Methods Eight Chinese cynomolgus macaques were infected with M.tb Erdman strain with a small [25 colony forming unit (CFU)] or large dose (500 CFU) via bronchoscopy. The infected animals were monitored for symptoms and examined by chest X-ray, computed tomography (CT), tuberculin skin test (TST), and enzyme-linked immunospot (ELISPOT). Results Based on TST conversion and the specific immune responses to M.tb antigens, all animals were successfully infected. Half of the animals developed active infection and died within 15 months postinfection. The other four animals were grouped with latent M.tb infection because of positive TST but few clinical signs and pathological changes of TB during the course of this study. Interestingly, a challenge with a large dose of M.tb also induced latent infection. Similar to the changes that occur with human TB patients, the animals with active infection exhibited weight loss, cough and typical TB pathological changes, including caseous granulomas, cavities, consolidation, lipid pneumonia, pleural effusion, lymphadenopathy and bacterial burden in lungs and other organs. Conclusions The low dose of M.tb was sufficient to cause both active and latent M.tb infection in cynomolgus macaques of Chinese origin.
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Affiliation(s)
- Jing Zhang
- Department of Immunology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Animal Biosafety Level III Laboratory at the Center for Animal Experiment, Wuhan University School of Medicine, Wuhan 430072, China
| | - Ming Guo
- Animal Biosafety Level III Laboratory at the Center for Animal Experiment, Wuhan University School of Medicine, Wuhan 430072, China
| | - Yan Rao
- Animal Biosafety Level III Laboratory at the Center for Animal Experiment, Wuhan University School of Medicine, Wuhan 430072, China
| | - Yong Wang
- Animal Biosafety Level III Laboratory at the Center for Animal Experiment, Wuhan University School of Medicine, Wuhan 430072, China
| | - Qiaoyang Xian
- Animal Biosafety Level III Laboratory at the Center for Animal Experiment, Wuhan University School of Medicine, Wuhan 430072, China
| | - Qian Yu
- Animal Biosafety Level III Laboratory at the Center for Animal Experiment, Wuhan University School of Medicine, Wuhan 430072, China
| | - Zhixiang Huang
- Animal Biosafety Level III Laboratory at the Center for Animal Experiment, Wuhan University School of Medicine, Wuhan 430072, China
| | - Xin Wang
- Animal Biosafety Level III Laboratory at the Center for Animal Experiment, Wuhan University School of Medicine, Wuhan 430072, China
| | - Rong Bao
- Animal Biosafety Level III Laboratory at the Center for Animal Experiment, Wuhan University School of Medicine, Wuhan 430072, China
| | - Junqiu Yue
- Department of Pathology, Hubei Cancer Hospital, Wuhan 430070, China
| | - Zhijiao Tang
- Animal Biosafety Level III Laboratory at the Center for Animal Experiment, Wuhan University School of Medicine, Wuhan 430072, China
| | - Ke Zhuang
- Animal Biosafety Level III Laboratory at the Center for Animal Experiment, Wuhan University School of Medicine, Wuhan 430072, China
| | - Li Zhou
- Animal Biosafety Level III Laboratory at the Center for Animal Experiment, Wuhan University School of Medicine, Wuhan 430072, China
| | - Zhuoya Li
- Department of Immunology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Sharpe SA, Smyth D, McIntyre A, Gleeson F, Dennis MJ. Refinement and reduction through application of a quantitative score system for estimation of TB-induced disease burden using computed tomography. Lab Anim 2018; 52:599-610. [PMID: 29482429 DOI: 10.1177/0023677218757815] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Until validated correlates of protection are identified, animal models remain the only way to test the efficacy of the new vaccines and drugs urgently needed to fight the global epidemic caused by infection with Mycobacterium tuberculosis. Non-human primates (NHP) offer the most relevant models of human tuberculosis (TB) and are central to the development process for new interventions. Efficacy evaluations are dependent on the capability of the test model to discriminate improved outcomes between treated groups after experimental exposure to M. tuberculosis and therefore the ability to measure TB-induced disease burden is central to the process. We have developed a score system that allows us to quantify the disease burden induced in macaques by infection with M. tuberculosis, based on the extent and features of disease visible on computed tomography (CT) images. The CT determined disease burden was then verified against that obtained using an established pathology-based approach. Trials of the system as a tool to measure disease burden have shown the approach capable of revealing differences between treatment groups in order to: (a) characterise outcome of infection and enable model refinement; (b) demonstrate the efficacy of drug treatment regimens by showing differences in outcome between test groups. Initial trials suggest that the imaging-based score system provides a valuable additional tool for the measurement of TB-induced disease burden that offers the opportunity to apply both refinement and reduction within studies.
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Affiliation(s)
- Sally A Sharpe
- 1 National Infection Service, Public Health England, Porton Down, Salisbury, UK
| | - Donna Smyth
- 1 National Infection Service, Public Health England, Porton Down, Salisbury, UK
| | | | | | - Mike J Dennis
- 1 National Infection Service, Public Health England, Porton Down, Salisbury, UK
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Collymore C, Kent L, Ahn SK, Xu W, Li M, Liu J, Turner PV, Banks EK. Humane Endpoints for Guinea Pigs Used for Mycobacterium tuberculosis Vaccine Research. Comp Med 2018; 68:41-47. [PMID: 29460720 PMCID: PMC5824138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 07/11/2017] [Accepted: 10/02/2017] [Indexed: 06/08/2023]
Abstract
Guinea pigs are a commonly used model for tuberculosis vaccine research. Loss of body weight is the most frequently described humane endpoint for animals used in these studies. During a chronic study, we noted labored breathing in some tuberculosis-infected guinea pigs. To develop consistent humane endpoints for these guinea pigs, we performed an observational study using multiple clinical signs. A combination of body weight loss, labored breathing, and activity level during handling estimated the time to euthanasia within approximately 7 d. Histologic severity scores of lesions in the cranial or caudal lung lobe (or both) supported clinical endpoints. This study presents humane endpoints for the refinement of studies using guinea pigs in tuberculosis research.
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Affiliation(s)
- Chereen Collymore
- Division of Comparative Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;,
| | - Laura Kent
- Division of Comparative Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sang Kyun Ahn
- Departments of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Wenxi Xu
- Princess Margaret Cancer Center, Immune Therapy Program, University Health Network, Toronto, Ontario, Canada
| | - Ming Li
- Departments of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Jun Liu
- Departments of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Patricia V Turner
- Department of Pathobiology, University of Guelph, Guelph, Ontario, Canada
| | - E Kate Banks
- Division of Comparative Medicine, Faculty of Medicine, Departments of Physiology, University of Toronto, Toronto, Ontario, Canada
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Harris SA, White A, Stockdale L, Tanner R, Sibley L, Sarfas C, Meyer J, Peter J, O'Shea MK, Manjaly Thomas ZR, Hamidi A, Satti I, Dennis MJ, McShane H, Sharpe S. Development of a non-human primate BCG infection model for the evaluation of candidate tuberculosis vaccines. Tuberculosis (Edinb) 2018; 108:99-105. [PMID: 29523335 PMCID: PMC5854371 DOI: 10.1016/j.tube.2017.11.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 11/09/2017] [Accepted: 11/14/2017] [Indexed: 12/18/2022]
Abstract
The lack of validated immunological correlates of protection makes tuberculosis vaccine development difficult and expensive. Using intradermal bacille Calmette-Guréin (BCG) as a surrogate for aerosol Mycobacterium tuberculosis (M.tb) in a controlled human infection model could facilitate vaccine development, but such a model requires preclinical validation. Non-human primates (NHPs) may provide the best model in which to do this. Cynomolgus and rhesus macaques were infected with BCG by intradermal injection. BCG was quantified from a skin biopsy of the infection site and from draining axillary lymph nodes, by culture on solid agar and quantitative polymerase chain reaction. BCG was detected up to 28 days post-infection, with higher amounts of BCG detected in lymph nodes after high dose compared to standard dose infection. Quantifying BCG from lymph nodes of cynomolgus macaques 14 days post-high dose infection showed a significant reduction in the amount of BCG detected in the BCG-vaccinated compared to BCG-naïve animals. Demonstrating a detectable vaccine effect in the lymph nodes of cynomolgus macaques, which is similar in magnitude to that seen in an aerosol M.tb infection model, provides support for proof-of-concept of an intradermal BCG infection model and evidence to support the further evaluation of a human BCG infection model.
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Affiliation(s)
- Stephanie A. Harris
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7DQ, UK
| | | | - Lisa Stockdale
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7DQ, UK
| | - Rachel Tanner
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7DQ, UK
| | | | | | - Joel Meyer
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7DQ, UK
| | - Jonathan Peter
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7DQ, UK
| | - Matthew K. O'Shea
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7DQ, UK
| | | | - Ali Hamidi
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7DQ, UK
| | - Iman Satti
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7DQ, UK
| | | | - Helen McShane
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7DQ, UK
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Williams A, Sharpe S, Verreck F, Vordermeier M, Hewinson G. Response to: Systematic review: animal studies of TB vaccines. Int J Epidemiol 2017; 45:583-4. [PMID: 27174838 DOI: 10.1093/ije/dyw059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2015] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ann Williams
- Public Health England, National Infections Service, Manor Farm Road, Porton, Salisbury, SP4 0JG
| | - Sally Sharpe
- Public Health England, National Infections Service, Manor Farm Road, Porton, Salisbury, SP4 0JG
| | - Frank Verreck
- Biomedical Primate Research Centre, Department of Parasitology, Rijswijk, The Netherlands and
| | - Martin Vordermeier
- Animal and Plant Health Agency, Department of Bacteriology, Weybridge, UK
| | - Glyn Hewinson
- Animal and Plant Health Agency, Department of Bacteriology, Weybridge, UK
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Abstract
Tuberculosis infects millions of people worldwide and remains a leading global killer despite widespread neonatal administration of the tuberculosis vaccine, bacillus Calmette-Guérin (BCG). BCG has clear and sustained efficacy, but after 10 years, its efficacy appears to wane, at least in some populations. Fortunately, there are many new tuberculosis vaccines in development today, some in advanced stages of clinical trial testing. Here we review the epidemiological need for tuberculosis vaccination, including evolving standards for administration to at risk individuals in developing countries. We also examine proven sources of immune protection from tuberculosis, which to date have exclusively involved natural or vaccine exposure to whole cell mycobacteria. After summarizing evidence for the use and efficacy of BCG, we detail the most promising new candidate vaccines against tuberculosis. The global need for a new tuberculosis vaccine is acute and huge, but clinical trials to be completed in the coming few years are likely either to identify a new tuberculosis vaccine or to substantially reframe how we understand immune protection from this historical scourge.
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Abstract
Immunity against Mycobacterium tuberculosis requires a balance between adaptive immune responses to constrain bacterial replication and the prevention of potentially damaging immune activation. Regulatory T (Treg) cells express the transcription factor Foxp3+ and constitute an essential counterbalance of inflammatory Th1 responses and are required to maintain immune homeostasis. The first reports describing the presence of Foxp3-expressing CD4+ Treg cells in tuberculosis (TB) emerged in 2006. Different Treg cell subsets, most likely specialized for different tissues and microenvironments, have been shown to expand in both human TB and animal models of TB. Recently, additional functional roles for Treg cells have been demonstrated during different stages and spectrums of TB disease. Foxp3+ regulatory cells can quickly expand during early infection and impede the onset of cellular immunity and persist during chronic TB infection. Increased frequencies of Treg cells have been associated with a detrimental outcome of active TB, and may be dependent on the M. tuberculosis strain, animal model, local environment, and the stage of infection. Some investigations also suggest that Treg cells are required together with effector T cell responses to obtain reduced pathology and sterilizing immunity. In this review, we will first provide an overview of the regulatory cells and mechanisms that control immune homeostasis. Then, we will review what is known about the phenotype and function of Treg cells from studies in human TB and experimental animal models of TB. We will discuss the potential role of Treg cells in the progression of TB disease and the relevance of this knowledge for future efforts to prevent, modulate, and treat TB.
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Abstract
Among the animal models of tuberculosis (TB), the non-human primates, particularly rhesus macaques (Macaca fascicularis) and cynomolgus macaques (Macaca mulatta), share the greatest anatomical and physiological similarities with humans. Macaques are highly susceptible to Mycobacterium tuberculosis infection and manifest the complete spectrum of clinical and pathological manifestations of TB as seen in humans. Therefore, the macaque models have been used extensively for investigating the pathogenesis of M. tuberculosis infection and for preclinical testing of drugs and vaccines against TB. This review focuses on published major studies that exemplify how the rhesus and cynomolgus macaques have enhanced and may continue to advance global efforts in TB research.
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Chancellor A, White A, Tocheva AS, Fenn JR, Dennis M, Tezera L, Singhania A, Elliott T, Tebruegge M, Elkington P, Gadola S, Sharpe S, Mansour S. Quantitative and qualitative iNKT repertoire associations with disease susceptibility and outcome in macaque tuberculosis infection. Tuberculosis (Edinb) 2017; 105:86-95. [PMID: 28610792 PMCID: PMC6168056 DOI: 10.1016/j.tube.2017.04.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 04/11/2017] [Accepted: 04/19/2017] [Indexed: 12/11/2022]
Abstract
Correlates of immune protection that reliably predict vaccine efficacy against Mycobacterium tuberculosis (Mtb) infection are urgently needed. Invariant NKT cells (iNKTs) are CD1d-dependent innate T cells that augment host antimicrobial immunity through production of cytokines, including interferon (IFN)-γ and tumour necrosis factor (TNF)-α. We determined peripheral blood iNKT numbers, their proliferative responses and iNKT subset proportions after in vitro antigen expansion by α-galactosylceramide (αGC) in a large cohort of mycobacteria-naïve non-human primates, and macaques from Bacillus Calmette-Guerin (BCG) vaccine and Mtb challenge studies. Animals studied included four genetically distinct groups of macaques within cynomolgus and rhesus species that differ in their susceptibility to Mtb infection. We demonstrate significant differences in ex vivo iNKT frequency between groups, which trends towards an association with susceptibility to Mtb, but no significant difference in overall iNKT proliferative responses. Susceptible animals exhibited a skewed CD4+/CD8+ iNKT subset ratio in comparison to more Mtb-resistant groups. Correlation of iNKT subsets post BCG vaccination with clinical disease manifestations following Mtb challenge in the Chinese cynomolgus and Indian rhesus macaques identified a consistent trend linking increased CD8+ iNKTs with favourable disease outcome. Finally, a similar iNKT profile was conferred by BCG vaccination in rhesus macaques. Our study provides the first detailed characterisation of iNKT cells in macaque tuberculosis infection, suggesting that iNKT repertoire differences may impact on disease outcome, which warrants further investigation.
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Affiliation(s)
- Andrew Chancellor
- Academic Unit of Clinical and Experimental Sciences, University of Southampton, Faculty of Medicine and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Andrew White
- Public Health England, National Infections Service, Porton Down, Salisbury, United Kingdom
| | - Anna S Tocheva
- Academic Unit of Clinical and Experimental Sciences, University of Southampton, Faculty of Medicine and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Joe R Fenn
- Academic Unit of Clinical and Experimental Sciences, University of Southampton, Faculty of Medicine and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Mike Dennis
- Public Health England, National Infections Service, Porton Down, Salisbury, United Kingdom
| | - Liku Tezera
- Academic Unit of Clinical and Experimental Sciences, University of Southampton, Faculty of Medicine and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Akul Singhania
- Academic Unit of Clinical and Experimental Sciences, University of Southampton, Faculty of Medicine and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Tim Elliott
- Institute for Life Sciences, University of Southampton, Southampton, United Kingdom; Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Marc Tebruegge
- Academic Unit of Clinical and Experimental Sciences, University of Southampton, Faculty of Medicine and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; Institute for Life Sciences, University of Southampton, Southampton, United Kingdom; Global Health Research Institute, University of Southampton, Southampton, United Kingdom; NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Paul Elkington
- Academic Unit of Clinical and Experimental Sciences, University of Southampton, Faculty of Medicine and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; Institute for Life Sciences, University of Southampton, Southampton, United Kingdom; Global Health Research Institute, University of Southampton, Southampton, United Kingdom; NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Stephan Gadola
- Academic Unit of Clinical and Experimental Sciences, University of Southampton, Faculty of Medicine and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; Institute for Life Sciences, University of Southampton, Southampton, United Kingdom; F.Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Sally Sharpe
- Public Health England, National Infections Service, Porton Down, Salisbury, United Kingdom
| | - Salah Mansour
- Academic Unit of Clinical and Experimental Sciences, University of Southampton, Faculty of Medicine and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; Institute for Life Sciences, University of Southampton, Southampton, United Kingdom.
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Coutinho LN, Brito M, Imbeloni AA, Lacreta A, Rech F, Souto MP, Ataíde I. Radiographic evaluation of cardiac silhouette using vertebral heart size method in squirrel monkey (Saimiri sciureus). J Med Primatol 2017; 46:228-231. [PMID: 28523853 DOI: 10.1111/jmp.12274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Saimiri sciureus represents a valuable resource for biomedical research, due to its large number on primate centers and similarity to human anatomy and physiology. The aim of this study was to apply the method proposed by Buchanan & Bücheler in healthy squirrel monkeys (S. sciureus) and determine by radiographic examination, the average value of the vertebral heart size (VHS) for the specie. METHOD Laterolateral left (LLL), laterolateral right (LLR), ventrodorsal (VD), and dorsoventral (DV) projections were used for radiographic examinations to evaluate the heart silhouette of S. sciureus. RESULTS There was no statistical difference between the projections LLL and LLR, or VD and DV, and between males and females, so measurements in the four radiographic projections were not performed. CONCLUSION The values obtained in VHS of S. sciureus showed up species specific.
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Affiliation(s)
- L N Coutinho
- Federal Rural University of Amazônia (Universidade Federal Rural da Amazônia - UFRA), Institute for Animal Health and Production (Instituto da Saúde e Produção Animal - ISPA), Belém, PA, Brazil
| | - Mbs Brito
- State University of São Paulo "Júlio de Mesquita Filho" (Universidade Estadual Paulista - UNESP), School of Agriculture and Veterinary Sciences (Faculdade de Ciências Agrárias e Veterinárias - FCAV), Jaboticabal, SP, Brazil
| | - A A Imbeloni
- National Primate Center (Centro Nacional de Primatas - CENP), Health Surveillance Office (Secretaria de Vigilância em Saúde - SVS), Ministry of Health (Ministério da Saúde - MS), Ananindeua, PA, Brazil
| | - Acc Lacreta
- Federal University of Lavras (Universidade Federal de Lavras- UFLA), Veterinary Medicine Departament (Departamento de Medicina Veterinária), Lavras, MG, Brazil
| | - F Rech
- Federal Rural University of Amazônia (Universidade Federal Rural da Amazônia - UFRA), Institute for Animal Health and Production (Instituto da Saúde e Produção Animal - ISPA), Belém, PA, Brazil
| | - M P Souto
- Federal Rural University of Amazônia (Universidade Federal Rural da Amazônia - UFRA), Institute for Animal Health and Production (Instituto da Saúde e Produção Animal - ISPA), Belém, PA, Brazil
| | - Ira Ataíde
- Federal Rural University of Amazônia (Universidade Federal Rural da Amazônia - UFRA), Institute for Animal Health and Production (Instituto da Saúde e Produção Animal - ISPA), Belém, PA, Brazil
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Marinova D, Gonzalo-Asensio J, Aguilo N, Martin C. MTBVAC from discovery to clinical trials in tuberculosis-endemic countries. Expert Rev Vaccines 2017; 16:565-576. [PMID: 28447476 DOI: 10.1080/14760584.2017.1324303] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION BCG remains the only vaccine against tuberculosis (TB) in use today and despite its impressive global coverage, the nature of BCG protection against the pulmonary forms of TB remains subject to ongoing debate. Because of the limitations of BCG, novel TB vaccine candidates have been developed and several have reached the clinical pipeline. One of these candidates is MTBVAC, the first and only TB vaccine in the clinical pipeline to date based on live-attenuated Mycobacterium tuberculosis that has successfully entered clinical evaluation, a historic milestone in human vaccinology. Areas covered: This review describes development of MTBVAC from discovery to clinical development in high burden TB-endemic countries. The preclinical experiments where MTBVAC has shown to confer improved safety and efficacy over BCG are presented and the clinical development plans for MTBVAC are revealed. The search of all supportive literature in this manuscript was carried out via Pubmed. Expert commentary: Small experimental medicine trials in humans and preclinical efficacy studies with a strong immunological component mimicking clinical trial design are considered essential by the scientific community to help identify reliable vaccine-specific correlates of protection in order to support and accelerate community-wide efficacy trials of new TB vaccines.
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Affiliation(s)
- Dessislava Marinova
- a Grupo de Genética de Micobacterias, Dpto. Microbiología, Medicina Preventiva y Salud Pública , Universidad de Zaragoza , Zaragoza , Spain.,b CIBER Enfermedades Respiratorias , Instituto de Salud Carlos III , Madrid , Spain
| | - Jesus Gonzalo-Asensio
- a Grupo de Genética de Micobacterias, Dpto. Microbiología, Medicina Preventiva y Salud Pública , Universidad de Zaragoza , Zaragoza , Spain.,b CIBER Enfermedades Respiratorias , Instituto de Salud Carlos III , Madrid , Spain.,c Servicio de Microbiología , Hospital Universitario Miguel Servet, ISS Aragón , Zaragoza , Spain
| | - Nacho Aguilo
- a Grupo de Genética de Micobacterias, Dpto. Microbiología, Medicina Preventiva y Salud Pública , Universidad de Zaragoza , Zaragoza , Spain.,b CIBER Enfermedades Respiratorias , Instituto de Salud Carlos III , Madrid , Spain
| | - Carlos Martin
- a Grupo de Genética de Micobacterias, Dpto. Microbiología, Medicina Preventiva y Salud Pública , Universidad de Zaragoza , Zaragoza , Spain.,b CIBER Enfermedades Respiratorias , Instituto de Salud Carlos III , Madrid , Spain.,c Servicio de Microbiología , Hospital Universitario Miguel Servet, ISS Aragón , Zaragoza , Spain
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Sharpe SA, White AD, Sibley L, Gleeson F, Hall GA, Basaraba RJ, McIntyre A, Clark SO, Gooch K, Marsh PD, Williams A, Dennis MJ. An aerosol challenge model of tuberculosis in Mauritian cynomolgus macaques. PLoS One 2017; 12:e0171906. [PMID: 28273087 PMCID: PMC5342172 DOI: 10.1371/journal.pone.0171906] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/27/2017] [Indexed: 11/21/2022] Open
Abstract
Background New interventions for tuberculosis are urgently needed. Non-human primate (NHP) models provide the most relevant pre-clinical models of human disease and play a critical role in vaccine development. Models utilising Asian cynomolgus macaque populations are well established but the restricted genetic diversity of the Mauritian cynomolgus macaques may be of added value. Methods Mauritian cynomolgus macaques were exposed to a range of doses of M. tuberculosis delivered by aerosol, and the outcome was assessed using clinical, imaging and pathology-based measures. Results All macaques developed characteristic clinical signs and disease features of tuberculosis (TB). Disease burden and the ability to control disease were dependent on exposure dose. Mauritian cynomolgus macaques showed less variation in pulmonary disease burden and total gross pathology scores within exposure dose groups than either Indian rhesus macaques or Chinese cynomolgus macaques Conclusions The genetic homogeneity of Mauritian cynomolgus macaques makes them a potentially useful model of human tuberculosis.
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Affiliation(s)
- S. A. Sharpe
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
- * E-mail:
| | - A. D. White
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - L. Sibley
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - F. Gleeson
- The Churchill Hospital, Headington, Oxford, United Kingdom
| | - G. A. Hall
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - R. J. Basaraba
- Department of Microbiology Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, United States of America
| | - A. McIntyre
- The Churchill Hospital, Headington, Oxford, United Kingdom
| | - S. O. Clark
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - K. Gooch
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - P. D. Marsh
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - A. Williams
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - M. J. Dennis
- Public Health England, National Infection Service, Porton Down, Salisbury, SP4 0JG, United Kingdom
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Using Data from Macaques To Predict Gamma Interferon Responses after Mycobacterium bovis BCG Vaccination in Humans: a Proof-of-Concept Study of Immunostimulation/Immunodynamic Modeling Methods. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2017; 24:CVI.00525-16. [PMID: 28077441 PMCID: PMC5339646 DOI: 10.1128/cvi.00525-16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 01/04/2017] [Indexed: 12/13/2022]
Abstract
Macaques play a central role in the development of human tuberculosis (TB) vaccines. Immune and challenge responses differ across macaque and human subpopulations. We used novel immunostimulation/immunodynamic modeling methods in a proof-of-concept study to determine which macaque subpopulations best predicted immune responses in different human subpopulations. Data on gamma interferon (IFN-γ)-secreting CD4+ T cells over time after recent Mycobacterium bovis BCG vaccination were available for 55 humans and 81 macaques. Human population covariates were baseline BCG vaccination status, time since BCG vaccination, gender, and the monocyte/lymphocyte cell count ratio. The macaque population covariate was the colony of origin. A two-compartment mathematical model describing the dynamics of the IFN-γ T cell response after BCG vaccination was calibrated to these data using nonlinear mixed-effects methods. The model was calibrated to macaque and human data separately. The association between subpopulations and the BCG immune response in each species was assessed. The macaque subpopulations that best predicted immune responses in different human subpopulations were identified using Bayesian information criteria. We found that the macaque colony and the human baseline BCG status were significantly (P < 0.05) associated with the BCG-induced immune response. For humans who were BCG naïve at baseline, Indonesian cynomolgus macaques and Indian rhesus macaques best predicted the immune response. For humans who had already been BCG vaccinated at baseline, Mauritian cynomolgus macaques best predicted the immune response. This work suggests that the immune responses of different human populations may be best modeled by different macaque colonies, and it demonstrates the potential utility of immunostimulation/immunodynamic modeling to accelerate TB vaccine development.
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Verreck FAW, Tchilian EZ, Vervenne RAW, Sombroek CC, Kondova I, Eissen OA, Sommandas V, van der Werff NM, Verschoor E, Braskamp G, Bakker J, Langermans JAM, Heidt PJ, Ottenhoff THM, van Kralingen KW, Thomas AW, Beverley PCL, Kocken CHM. Variable BCG efficacy in rhesus populations: Pulmonary BCG provides protection where standard intra-dermal vaccination fails. Tuberculosis (Edinb) 2017; 104:46-57. [PMID: 28454649 DOI: 10.1016/j.tube.2017.02.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 02/13/2017] [Accepted: 02/15/2017] [Indexed: 01/22/2023]
Abstract
M.bovis BCG vaccination against tuberculosis (TB) notoriously displays variable protective efficacy in different human populations. In non-human primate studies using rhesus macaques, despite efforts to standardise the model, we have also observed variable efficacy of BCG upon subsequent experimental M. tuberculosis challenge. In the present head-to-head study, we establish that the protective efficacy of standard parenteral BCG immunisation varies among different rhesus cohorts. This provides different dynamic ranges for evaluation of investigational vaccines, opportunities for identifying possible correlates of protective immunity and for determining why parenteral BCG immunisation sometimes fails. We also show that pulmonary mucosal BCG vaccination confers reduced local pathology and improves haematological and immunological parameters post-infection in animals that are not responsive to induction of protection by standard intra-dermal BCG. These results have important implications for pulmonary TB vaccination strategies in the future.
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Affiliation(s)
- Frank A W Verreck
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands.
| | - Elma Z Tchilian
- The Peter Medawar Building for Pathogen Research, University of Oxford, South Parks Road, Oxford, UK.
| | - Richard A W Vervenne
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Claudia C Sombroek
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Ivanela Kondova
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Okke A Eissen
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Vinod Sommandas
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Nicole M van der Werff
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Ernst Verschoor
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Gerco Braskamp
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Jaco Bakker
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Jan A M Langermans
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Peter J Heidt
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Tom H M Ottenhoff
- Department of Infectious Diseases, Leiden University Medical Centre (LUMC), Albinusdreef 2, 2333-ZA, Leiden, The Netherlands
| | - Klaas W van Kralingen
- Department of Pulmonology, Leiden University Medical Centre (LUMC), Albinusdreef 2, 2333-ZA, Leiden, The Netherlands
| | - Alan W Thomas
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
| | - Peter C L Beverley
- The Peter Medawar Building for Pathogen Research, University of Oxford, South Parks Road, Oxford, UK.
| | - Clemens H M Kocken
- Biomedical Primate Research Centre (BPRC), Lange Kleiweg 161, 2288-GJ, Rijswijk, The Netherlands
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Sharpe S, White A, Sarfas C, Sibley L, Gleeson F, McIntyre A, Basaraba R, Clark S, Hall G, Rayner E, Williams A, Marsh PD, Dennis M. Alternative BCG delivery strategies improve protection against Mycobacterium tuberculosis in non-human primates: Protection associated with mycobacterial antigen-specific CD4 effector memory T-cell populations. Tuberculosis (Edinb) 2016; 101:174-190. [PMID: 27865390 PMCID: PMC5120991 DOI: 10.1016/j.tube.2016.09.004] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 09/11/2016] [Indexed: 12/01/2022]
Abstract
Intradermal (ID) BCG injection provides incomplete protection against TB in humans and experimental models. Alternative BCG vaccination strategies may improve protection in model species, including rhesus macaques. This study compares the immunogenicity and efficacy of BCG administered by ID and intravenous (IV) injection, or as an intratracheal mucosal boost (ID + IT), against aerosol challenge with Mycobacterium tuberculosis Erdman strain. Disease pathology was significantly reduced, and survival improved, by each BCG vaccination strategy, relative to unvaccinated animals. However, IV induced protection surpassed that achieved by all other routes, providing an opportunity to explore protective immunological mechanisms using antigen-specific IFN-γ ELISpot and polychromatic flow cytometry assays. IFN-γ spot forming units and multifunctional CD4 T-cell frequencies increased significantly following each vaccination regimen and were greatest following IV immunisation. Vaccine-induced multifunctional CD4 T-cells producing IFN-γ and TNF-α were associated with reduced disease pathology following subsequent M.tb challenge; however, high frequencies of this population following M.tb infection correlated with increased pathology. Cytokine producing T-cells primarily occupied the CD4 transitional effector memory phenotype, implicating this population as central to the mycobacterial response, potentially contributing to the stringent control observed in IV vaccinated animals. This study demonstrates the protective efficacy of IV BCG vaccination in rhesus macaques, offering a valuable tool for the interrogation of immunological mechanisms and potential correlates of protection.
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Affiliation(s)
- S Sharpe
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK.
| | - A White
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - C Sarfas
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - L Sibley
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - F Gleeson
- Churchill Hospital, Headington, Oxford, UK
| | - A McIntyre
- Churchill Hospital, Headington, Oxford, UK
| | - R Basaraba
- Colorado State University, Fort Collins, CO, USA
| | - S Clark
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - G Hall
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - E Rayner
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - A Williams
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - P D Marsh
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
| | - M Dennis
- Public Health England, Porton Down, Wiltshire, SP4 0JG, UK
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46
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Kashangura R, Sena ES, Young T, Garner P. Effects of MVA85A vaccine on tuberculosis challenge in animals: systematic review. Int J Epidemiol 2016; 44:1970-81. [PMID: 26351306 PMCID: PMC4689998 DOI: 10.1093/ije/dyv142] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The existing Bacillus Calmette–Guérin (BCG) vaccination provides partial protection against tuberculosis (TB). The modified vaccinia ankara virus-expressing antigen 85A (MVA85A) aims to boost BCG immunity. We evaluated the animal evidence supporting the testing of MVA85A in humans. Methods: Our protocol included in vivo preclinical studies of the MVA85A booster with BCG compared with BCG alone, followed by a TB challenge. We used standard methods for systematic review of animal studies, and summarized mortality, measures of pathology and lung bacterial load. The comprehensive literature search was to September 2014. Two independent investigators assessed eligibility and performed data extraction. We assessed study quality and pooled bacteria load using random effect meta-analysis. Findings: We included eight studies in 192 animals. Three experiments were in mice, two in guinea pigs, two in macaques and one in calves. Overall, study quality was low with no randomization, baseline comparability not described and blinding not reported. For animal death (including euthanasia due to severe morbidity), studies were underpowered, and overall no benefit demonstrated. No difference was shown for lung pathology measured on an ordinal scale or bacterial load. The largest mortality trial carried out in macaques had more deaths in the MVA85A vaccine group, and was published after a trial in South Africa had started recruiting children. Conclusions: This independent assessment of the animal data does not provide evidence to support efficacy of MVA85A as a BCG booster. More rigorous conduct and reporting of preclinical research are warranted, and we believe the results of studies should be publicly available before embarking on trials in humans, irrespective of the findings.
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Affiliation(s)
- Rufaro Kashangura
- Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
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47
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Testing the H56 Vaccine Delivered in 4 Different Adjuvants as a BCG-Booster in a Non-Human Primate Model of Tuberculosis. PLoS One 2016; 11:e0161217. [PMID: 27525651 PMCID: PMC4985151 DOI: 10.1371/journal.pone.0161217] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 08/02/2016] [Indexed: 11/19/2022] Open
Abstract
The search for new and improved tuberculosis (TB) vaccines has focused on IFN-γ both for selecting antigens and for evaluating vaccine delivery strategies. The essential role of IFN-γ in endogenous host protection is well established, but it is still uncertain whether this also holds true for vaccine protection. Here we evaluate the H56 fusion protein vaccine as a BCG booster in a non-human primate (NHP) model of TB that closely recapitulates human TB pathogenesis. To date, only a handful of novel adjuvants have been tested in the NHP model of TB, and therefore we administered H56 in 3 novel cationic liposome adjuvants of increasing immunogenicity (CAF01, CAF04, CAF05) and compared them to H56 in the IC31® adjuvant previously reported to promote protection in this model. The individual clinical parameters monitored during infection (weight, ESR, X-ray) all correlated with survival, and boosting BCG with H56 in all adjuvants resulted in better survival rates compared to BCG alone. The adjuvants promoted IFN-γ-responses of increasing intensity as measured by ELISPOT in the peripheral blood, but the level of vaccine-specific IFN-γ production did not correlate with or predict disease outcome. This study’s main outcome underscores the importance of the choice of adjuvant for TB subunit vaccines, and secondly it highlights the need for better correlates of protection in preclinical models of TB.
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48
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Javed S, Marsay L, Wareham A, Lewandowski KS, Williams A, Dennis MJ, Sharpe S, Vipond R, Silman N, Ball G, Kempsell KE. Temporal Expression of Peripheral Blood Leukocyte Biomarkers in a Macaca fascicularis Infection Model of Tuberculosis; Comparison with Human Datasets and Analysis with Parametric/Non-parametric Tools for Improved Diagnostic Biomarker Identification. PLoS One 2016; 11:e0154320. [PMID: 27228113 PMCID: PMC4882019 DOI: 10.1371/journal.pone.0154320] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 04/12/2016] [Indexed: 12/19/2022] Open
Abstract
A temporal study of gene expression in peripheral blood leukocytes (PBLs) from a Mycobacterium tuberculosis primary, pulmonary challenge model Macaca fascicularis has been conducted. PBL samples were taken prior to challenge and at one, two, four and six weeks post-challenge and labelled, purified RNAs hybridised to Operon Human Genome AROS V4.0 slides. Data analyses revealed a large number of differentially regulated gene entities, which exhibited temporal profiles of expression across the time course study. Further data refinements identified groups of key markers showing group-specific expression patterns, with a substantial reprogramming event evident at the four to six week interval. Selected statistically-significant gene entities from this study and other immune and apoptotic markers were validated using qPCR, which confirmed many of the results obtained using microarray hybridisation. These showed evidence of a step-change in gene expression from an ‘early’ FOS-associated response, to a ‘late’ predominantly type I interferon-driven response, with coincident reduction of expression of other markers. Loss of T-cell-associate marker expression was observed in responsive animals, with concordant elevation of markers which may be associated with a myeloid suppressor cell phenotype e.g. CD163. The animals in the study were of different lineages and these Chinese and Mauritian cynomolgous macaque lines showed clear evidence of differing susceptibilities to Tuberculosis challenge. We determined a number of key differences in response profiles between the groups, particularly in expression of T-cell and apoptotic makers, amongst others. These have provided interesting insights into innate susceptibility related to different host `phenotypes. Using a combination of parametric and non-parametric artificial neural network analyses we have identified key genes and regulatory pathways which may be important in early and adaptive responses to TB. Using comparisons between data outputs of each analytical pipeline and comparisons with previously published Human TB datasets, we have delineated a subset of gene entities which may be of use for biomarker diagnostic test development.
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Affiliation(s)
- Sajid Javed
- Public Health England, Infection Services, Health Protection Agency Porton, Porton Down, Salisbury, Wiltshire, United Kingdom
| | - Leanne Marsay
- Public Health England, Infection Services, Health Protection Agency Porton, Porton Down, Salisbury, Wiltshire, United Kingdom
| | - Alice Wareham
- Public Health England, Infection Services, Health Protection Agency Porton, Porton Down, Salisbury, Wiltshire, United Kingdom
| | - Kuiama S. Lewandowski
- Public Health England, Infection Services, Health Protection Agency Porton, Porton Down, Salisbury, Wiltshire, United Kingdom
| | - Ann Williams
- Public Health England, Infection Services, Health Protection Agency Porton, Porton Down, Salisbury, Wiltshire, United Kingdom
| | - Michael J. Dennis
- Public Health England, Infection Services, Health Protection Agency Porton, Porton Down, Salisbury, Wiltshire, United Kingdom
| | - Sally Sharpe
- Public Health England, Infection Services, Health Protection Agency Porton, Porton Down, Salisbury, Wiltshire, United Kingdom
| | - Richard Vipond
- Public Health England, Infection Services, Health Protection Agency Porton, Porton Down, Salisbury, Wiltshire, United Kingdom
| | - Nigel Silman
- Public Health England, Infection Services, Health Protection Agency Porton, Porton Down, Salisbury, Wiltshire, United Kingdom
| | - Graham Ball
- School of Science and Technology, Nottingham Trent University, Clifton Lane, Nottingham, United Kingdom
| | - Karen E. Kempsell
- Public Health England, Infection Services, Health Protection Agency Porton, Porton Down, Salisbury, Wiltshire, United Kingdom
- * E-mail:
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49
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Beverley PCL. Selective presentation of MVA85A tuberculosis booster vaccine preclinical animal data. Int J Epidemiol 2016; 45:581-2. [DOI: 10.1093/ije/dyw082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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50
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Sena E, Young T, Kashangura R, Garner P. Authors’ Response to: Letters re MVA85A. Int J Epidemiol 2016; 45:584-5. [DOI: 10.1093/ije/dyw083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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