Meningococcal vaccines: a progress report

Peptide-displaying phage technology in glycobiology

Phage display technology is an emerging drug discovery tool. Using that approach, short peptides that mimic part of a carbohydrate's conformation are selected by screening a peptide-displaying phage library with anti-carbohydrate antibodies. Chemically synthesized peptides with an identified sequence have been used as an alternative ligand to carbohydrate-binding proteins. These peptides represent research tools useful to assay the activities of glycosyltransferases and/or sulfotransferases or to inhibit the carbohydrate-dependent binding of proteins in vitro and in vivo. Peptides can also serve as immunogens to raise anti-carbohydrate antibodies in vivo in animals. Phage display has also been used in single-chain antibody technology by inserting an immunoglobulin's variable region sequence into the phage. A single-chain antibody library can then be screened with a carbohydrate antigen as the target, resulting in a recombinant anti-carbohydrate antibody with high affinity to the antigen. This review provides examples of successful applications of peptide-displaying phage technology to glycobiology. Such an approach should benefit translational research by supplying carbohydrate-mimetic peptides and carbohydrate-binding polypeptides.

Meningococcal meningitis in critical care: an overview, new treatments/preventions, and a case study

Meningococcal meningitis (MM) is a disease process that can become insidious and deadly in a short amount of time if not properly diagnosed. New and effectively known treatments and preventions are the key to improve recovery. The Neisseria meningitidis (NM) bacteria is the culprit in the MM discussed in this article. The pathophysiology, symptoms, and assessment are important to review, as well as typical antibiotic therapy and other treatments. Morbidity and mortality is affected by the improvement of these therapies. Critical care nurses must correctly and prudently assess their patients quickly for rapid response to treatment. The vaccine for the NM bacteria associated with the serotype B is not available at this time. College freshmen are the most vulnerable population in contracting the disease because of small living spaces and lifestyle habits that increase their association with the disease. The issue of prophylactically giving the vaccine is controversial but may become necessary because of the increase in incidence in the last 5 years on college campuses. Chemoprophylaxis efficacy may also be of help to those healthcare workers exposed as well as to those individuals at high risk for contracting the disease after an exposure. Public health concerns with community and college campus participation and education can be key to a sense of well-being among those possible individuals who may be exposed. Steroid, coagulapathy, and immunotherapy, as well as other new treatments, are worth investigating and pursuing in these times of increased risk to certain vulnerable populations of people.

Rates of Neisseria meningitidis increasing in young adults

The burden of meningococcal disease has remained unchanged in the United States for the past 4 decades. The currently available meningococcal vaccine is safe and effective, however, due to immunogenic limitations inherent to polysaccharide vaccines, it has been available only for high-risk populations older than 2. Incorporation of a more immunogenic and effective conjugated vaccine into the routine immunization schedule offers an opportunity to substantially affect the incidence of meningococcal disease. The routine use of a meningococcal conjugate vaccine in the United States will save lives and prevent significant morbidity in children and young adults.

Direct isolation of recombinant human antibodies against group B Neisseria meningitidis from scFv expression libraries

The successful generation of human antibodies from large nai;ve antibody libraries requires iterative selection steps. Here, we describe a new and fast method for the isolation of high affinity antibodies directly from human single chain Fv antibody (scFv) expression libraries. Escherichia coli scFv expression libraries were made from peripheral blood lymphocytes from four individuals vaccinated with group B Neisseria meningitidis outer membrane vesicle (OMV) vaccine. Forty thousand clones were directly screened for antibodies binding N. meningitidis strain 44/76 (B:15:P1.7,16). Of 430 specific clones detected, 225 candidates were isolated and re-screened against the N. meningitidis strains NZ-98/254 (B:4:P1.7b,4) giving 4% cross-reactive clones. Antibodies were further characterized by DNA sequencing, ELISA and surface plasmon resonance (SPR) analysis, showing broad V-gene diversity and nanomolar scFv affinities. Antibodies derived by this method may assist in the discovery and development of new vaccine antigens as well as therapeutic antibody agents for the treatment of meningococcal diseases.