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Ávila-Nieto C, Pedreño-López N, Mitjà O, Clotet B, Blanco J, Carrillo J. Syphilis vaccine: challenges, controversies and opportunities. Front Immunol 2023; 14:1126170. [PMID: 37090699 PMCID: PMC10118025 DOI: 10.3389/fimmu.2023.1126170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/27/2023] [Indexed: 04/25/2023] Open
Abstract
Syphilis is a sexually or vertically (mother to fetus) transmitted disease caused by the infection of Treponema pallidum subspecie pallidum (TPA). The incidence of syphilis has increased over the past years despite the fact that this bacterium is an obligate human pathogen, the infection route is well known, and the disease can be successfully treated with penicillin. As complementary measures to preventive campaigns and early treatment of infected individuals, development of a syphilis vaccine may be crucial for controlling disease spread and/or severity, particularly in countries where the effectiveness of the aforementioned measures is limited. In the last century, several vaccine prototypes have been tested in preclinical studies, mainly in rabbits. While none of them provided protection against infection, some prototypes prevented bacteria from disseminating to distal organs, attenuated lesion development, and accelerated their healing. In spite of these promising results, there is still some controversy regarding the identification of vaccine candidates and the characteristics of a syphilis-protective immune response. In this review, we describe what is known about TPA immune response, and the main mechanisms used by this pathogen to evade it. Moreover, we emphasize the importance of integrating this knowledge, in conjunction with the characterization of outer membrane proteins (OMPs), to expedite the development of a syphilis vaccine that can protect against TPA infection.
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Affiliation(s)
- Carlos Ávila-Nieto
- IrsiCaixa AIDS Research Institute, Badalona, Spain
- Autonomous University of Barcelona, Cerdanyola del Vallès, Catalonia, Spain
| | | | - Oriol Mitjà
- Skin Neglected Tropical Diseases and Sexually Transmitted Infections Department, Germans Trias i Pujol Hospital, Badalona, Spain
- Fight Infections Foundation, Germans Trias i Pujol Hospital, Badalona, Catalonia, Spain
- Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic – Central University of Catalonia (UVic – UCC), Vic, Catalonia, Spain
| | - Bonaventura Clotet
- IrsiCaixa AIDS Research Institute, Badalona, Spain
- Fight Infections Foundation, Germans Trias i Pujol Hospital, Badalona, Catalonia, Spain
- Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic – Central University of Catalonia (UVic – UCC), Vic, Catalonia, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- CIBERINFEC, Instituto de Salut Carlos III (ISCIII), Madrid, Spain
| | - Julià Blanco
- IrsiCaixa AIDS Research Institute, Badalona, Spain
- Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic – Central University of Catalonia (UVic – UCC), Vic, Catalonia, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- CIBERINFEC, Instituto de Salut Carlos III (ISCIII), Madrid, Spain
| | - Jorge Carrillo
- IrsiCaixa AIDS Research Institute, Badalona, Spain
- Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- CIBERINFEC, Instituto de Salut Carlos III (ISCIII), Madrid, Spain
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Aihara KI, Azuma H, Akaike M, Ikeda Y, Sata M, Takamori N, Yagi S, Iwase T, Sumitomo Y, Kawano H, Yamada T, Fukuda T, Matsumoto T, Sekine K, Sato T, Nakamichi Y, Yamamoto Y, Yoshimura K, Watanabe T, Nakamura T, Oomizu A, Tsukada M, Hayashi H, Sudo T, Kato S, Matsumoto T. Strain-dependent embryonic lethality and exaggerated vascular remodeling in heparin cofactor II-deficient mice. J Clin Invest 2007; 117:1514-26. [PMID: 17549254 PMCID: PMC1878511 DOI: 10.1172/jci27095] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2005] [Accepted: 03/27/2007] [Indexed: 01/04/2023] Open
Abstract
Heparin cofactor II (HCII) specifically inhibits thrombin action at sites of injured arterial wall, and patients with HCII deficiency exhibit advanced atherosclerosis. However, the in vivo effects and the molecular mechanism underlying the action of HCII during vascular remodeling remain elusive. To clarify the role of HCII in vascular remodeling, we generated HCII-deficient mice by gene targeting. In contrast to a previous report, HCII(-/-) mice were embryonically lethal. In HCII(+/-) mice, prominent intimal hyperplasia with increased cellular proliferation was observed after tube cuff and wire vascular injury. The number of protease-activated receptor-1-positive (PAR-1-positive) cells was increased in the thickened vascular wall of HCII(+/-) mice, suggesting enhanced thrombin action in this region. Cuff injury also increased the expression levels of inflammatory cytokines and chemokines in the vascular wall of HCII(+/-) mice. The intimal hyperplasia in HCII(+/-) mice with vascular injury was abrogated by human HCII supplementation. Furthermore, HCII deficiency caused acceleration of aortic plaque formation with increased PAR-1 expression and oxidative stress in apoE-KO mice. These results demonstrate that HCII protects against thrombin-induced remodeling of an injured vascular wall by inhibiting thrombin action and suggest that HCII is potentially therapeutic against atherosclerosis without causing coagulatory disturbance.
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Affiliation(s)
- Ken-ichi Aihara
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Hiroyuki Azuma
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Masashi Akaike
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Yasumasa Ikeda
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Masataka Sata
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Nobuyuki Takamori
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Shusuke Yagi
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Takashi Iwase
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Yuka Sumitomo
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Hirotaka Kawano
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Takashi Yamada
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Toru Fukuda
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Takahiro Matsumoto
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Keisuke Sekine
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Takashi Sato
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Yuko Nakamichi
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Yoko Yamamoto
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Kimihiro Yoshimura
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Tomoyuki Watanabe
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Takashi Nakamura
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Akimasa Oomizu
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Minoru Tsukada
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Hideki Hayashi
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Toshiki Sudo
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Shigeaki Kato
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
| | - Toshio Matsumoto
- Department of Medicine and Bioregulatory Sciences and
21st Century Center of Excellence Program, The University of Tokushima Graduate School of Health Biosciences, Tokushima, Japan.
Institute of Molecular and Cellular Biosciences and
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
ERATO, Japan Science and Technology Agency, Saitama, Japan.
Benesis Corp., Osaka, Japan.
First Institute of New Drug Discovery, Otsuka Pharmaceutical Co., Tokushima, Japan
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