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Happe M, Samuvel DJ, Ohtola JA, Korte JE, Westerink MAJ. Race-related differences in functional antibody response to pneumococcal vaccination in HIV-infected individuals. Vaccine 2019; 37:1622-1629. [PMID: 30797636 PMCID: PMC6428581 DOI: 10.1016/j.vaccine.2019.01.084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 01/11/2019] [Accepted: 01/28/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Both HIV positivity and African American (AA) ethnicity are associated with increased incidence of invasive pneumococcal disease (IPD). Poor immune response to pneumococcal polysaccharide-based vaccines may contribute to the race related increased frequency of IPD in African American HIV positive individuals. METHODS Caucasian and AA HIV-infected (HIV+) individuals 40-65 years old with CD4+ T cells/µl (CD4) >200 on antiretroviral therapy (ART) received either the 13-valent pneumococcal conjugate vaccine (PCV) followed by the 23-valent pneumococcal polysaccharide vaccine (PPV) or PPV only. Serum IgG, IgM and opsonophagocytic antibody responses to serotypes 14 and 23F as well as serum IgG and opsonophagocytic antibody responses to serotype 19A were measured pre- and post-vaccination. We measured serum markers of inflammation in all participants and performed single cell gene expression profiling at the baseline by HD Biomark in Caucasians and African Americans. RESULTS There were no significant differences in pre-immunization inflammatory markers or post-vaccination IgG and IgM concentrations between Caucasian and African American participants. However, we found significantly lower opsonophagocytic activity in response to serotypes 14 and 19A in the AA group compared to the Caucasian group. There was no association between inflammatory markers and immune response to vaccination, however we found extensive biomodal variation in gene expression levels in single IgM+ memory B cells. Differentially expressed genes may be related to differences in the immune response between ethnic groups. CONCLUSIONS Distinct racial differences were found in the functional immune response following either PPV and/or PCV/PPV immunization in HIV-positive adults, although these differences were serotype dependent. Decreased ability to respond to vaccination may in part explain racial disparities in pneumococcal disease epidemiology. ClinicalTrials.gov ID: NCT03039491.
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Affiliation(s)
- Myroslawa Happe
- Department of Immunology and Microbiology, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 927, Charleston, SC 29425, United States.
| | - Devadoss J Samuvel
- Department of Medicine, Division of Infectious Diseases, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 927, Charleston, SC 29425, United States.
| | - Jennifer A Ohtola
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, 3000 Arlington Ave, Toledo, OH 43614, United States.
| | - Jeff E Korte
- Department of Public Health Sciences, 135 Cannon St, Charleston, SC 29425, United States.
| | - M A Julie Westerink
- Department of Medicine, Division of Infectious Diseases, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 927, Charleston, SC 29425, United States; Department of Medicine, Ralhp H. Johnson Veterans Administration Medical Center, 109 Bee Street, Charleston, SC 29401, United States.
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The Role of Serotype-Specific Immunological Memory in Pneumococcal Vaccination: Current Knowledge and Future Prospects. Vaccines (Basel) 2019; 7:vaccines7010013. [PMID: 30700048 PMCID: PMC6466264 DOI: 10.3390/vaccines7010013] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 12/30/2018] [Accepted: 01/28/2019] [Indexed: 12/19/2022] Open
Abstract
Streptococcus pneumoniae (S. pneumoniae, pneumococcus) is a major cause of morbidity and mortality worldwide. Achieving long-term immunity against S. pneumoniae through immunization is an important public health priority. Long-term protection after immunization is thought to rely both on protective serum antibody levels and immunological memory in the form of antigen-specific memory B cells (MBCs). Although the ability to achieve protective antibody levels shortly after pneumococcal vaccination has been well documented for the various infant immunization schedules currently in use worldwide, the examination of immunological memory in the form of antigen-specific MBCs has been much more limited. Such responses are critical for long-term protection against pneumococcal colonization and disease. This review summarizes the published literature on the MBC response to primary or booster immunization with either pneumococcal polysaccharide vaccine (PPV23) or pneumococcal conjugate vaccines (PCVs), aiming to elucidate the immunological mechanisms that determine the magnitude and longevity of vaccine protection against pneumococcus. There is evidence that PCVs induce the production of antigen-specific MBCs, whereas immunization with PPV23 does not result in the formation of MBCs. Increased understanding of the immunological factors that facilitate the induction, maintenance and recall of MBCs in response to pneumococcal vaccination could enable the use of MBC enumeration as novel correlates of protection against S. pneumoniae. Ongoing studies that examine MBC response to pneumococcal vaccination in high burden settings will be extremely important in our understanding of long-term protection induced by pneumococcal conjugate vaccines.
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Ohtola JA, Saul-McBeth JL, Iyer AS, Leggat DJ, Khuder SA, Khaskhely NM, Westerink MJ. Quantitative and Functional Antibody Responses to the 13-Valent Conjugate and/or 23-Valent Purified Polysaccharide Vaccine in Aging HIV-Infected Adults. ACTA ACUST UNITED AC 2016; 7. [PMID: 27158552 DOI: 10.4172/2155-6113.1000556] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The number of aging human immunodeficiency virus-infected (HIV+) individuals living in the United States has substantially grown over the past two decades. Advanced age and HIV infection both increase susceptibility to Streptococcus pneumoniae infection due to B cell dysfunction. The combined impact of these factors on pneumococcal vaccine responses remains unknown. METHODS We assessed serum immunoglobulin (Ig) G and IgM levels and opsonophagocytic killing assay (OPA) titers to pneumococcal serotypes 14 and 23F in HIV+ subjects and HIV-uninfected (HIV-) controls 50-65 years old. HIV+ individuals with CD4+ T cells/μl (CD4) >200 and ≥1 year of antiretroviral therapy (ART) received either a dose of the 13-valent pneumococcal conjugate vaccine followed by the 23-valent pneumococcal polysaccharide vaccine 8 weeks later (PCV/PPV) as currently recommended (n=15) or a single dose of PPV only (n=22). HIV- controls received PCV/PPV (n=14). RESULTS HIV+ PCV/PPV and PPV groups exhibited similar increases in IgG levels and OPA titers for both serotypes after immunization. Postvaccination IgM levels for serotype 23F, but not 14, were significantly higher in HIV+ PCV/PPV compared to PPV groups. IgG and IgM levels for serotype 14 and OPA titers to serotype 23F were significantly reduced in HIV+ compared to HIV- PCV/PPV groups. Serotype-specific IgG levels correlated with OPA titers for all groups. CONCLUSIONS Our data suggest that the recommended PCV/PPV regimen may not significantly improve quantitative or functional antibody responses compared to PPV only in aging HIV+ subjects. Continued efforts aimed at improving vaccine responses in this high risk population are warranted.
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Affiliation(s)
- Jennifer A Ohtola
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio
| | - Jessica L Saul-McBeth
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio
| | - Anita S Iyer
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio
| | - David J Leggat
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio
| | - Sadik A Khuder
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio; Department of Public Health and Preventative Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio
| | - Noor M Khaskhely
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio
| | - Ma Julie Westerink
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio; Department of Pathology, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio; Department of Medical Microbiology and Immunology, University of Toledo College of Medicine & Life Sciences, Toledo, Ohio
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Iyer AS, Khaskhely NM, Leggat DJ, Ohtola JA, Saul-McBeth JL, Khuder SA, Westerink MAJ. Inflammatory Markers and Immune Response to Pneumococcal Vaccination in HIV-Positive and -Negative Adults. PLoS One 2016; 11:e0150261. [PMID: 26930208 PMCID: PMC4773189 DOI: 10.1371/journal.pone.0150261] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 02/01/2016] [Indexed: 11/30/2022] Open
Abstract
Background Members of the Tumor Necrosis Factor (TNF)-superfamily have speculated roles in the response against T-independent type II antigens (TI-II) including pneumococcal polysaccharides (PPS). Dysregulation in their expression is associated with an enhanced risk for pneumococcal disease in neonates but their expression in other high-risk populations including HIV-positive individuals remains to be elucidated. Objective To investigate signals that contribute towards PPS-response and identify potential anomalies that may account for diminished serological response in HIV-positive individuals post Pneumovax (PPV23) immunization. Methods Markers of inflammation, C-reactive protein (CRP), IL-6, sCD27 and sCD30, were assessed in HIV-positive and -negative individuals as potential predictors of PPV23 response. Serum levels of B cell activating factor (BAFF), transmembrane activator and calcium-modulator and cytophilin ligand interactor (TACI), B cell maturation antigen (BCMA) and B cell expression of BAFF-R, TACI, BCMA, CD40 and CD21 were assessed in total (unselected) and PPS23F (antigen)-specific B cells of PPV23 immunized HIV-positive and -negative individuals. Results CRP, sCD27, sCD30 and BAFF were significantly elevated in the serum of HIV-positive individuals but did not adversely affect PPV23 response. Assessment of PPS-specific B cells revealed enhanced TACI and reduced BAFF-R expression compared to unselected B cells in HIV-positive and -negative individuals. Surface TACI was similar but soluble TACI was significantly lower in HIV-positive compared to HIV-negative individuals. Conclusion Current studies highlight a potential role for TACI in PPV23 response based on its enhanced expression on PPS-specific B cells. Although surface levels of TACI were similar, diminished soluble TACI (sTACI) in HIV-positive compared to HIV-negative individuals could potentially decrease BAFF responsiveness and Ig response. A better understanding of the role of TNF receptors could contribute to the design of improved pneumococcal vaccines. Trial Registration ClinicalTrials.gov NCT02515240
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Affiliation(s)
- Anita S Iyer
- Department of Medicine, University of Toledo, 3000 Arlington Avenue, Toledo, Ohio 43614, United States of America
| | - Noor M Khaskhely
- Department of Medicine, University of Toledo, 3000 Arlington Avenue, Toledo, Ohio 43614, United States of America
| | - David J Leggat
- Department of Medicine, University of Toledo, 3000 Arlington Avenue, Toledo, Ohio 43614, United States of America
| | - Jennifer A Ohtola
- Department of Medicine, University of Toledo, 3000 Arlington Avenue, Toledo, Ohio 43614, United States of America
| | - Jessica L Saul-McBeth
- Department of Medicine, University of Toledo, 3000 Arlington Avenue, Toledo, Ohio 43614, United States of America
| | - Sadik A Khuder
- Department of Public Health, University of Toledo, 3000 Arlington Avenue, Toledo, Ohio 43614, United States of America
| | - M A Julie Westerink
- Department of Medicine; Department of Infectious Diseases and Department of Microbiology and Immunology, 135 Rutledge Avenue, Charleston, South Carolina 29425, United States of America
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Ohtola JA, Khaskhely NM, Saul-Mcbeth JL, Iyer AS, Leggat DJ, Khuder SA, Westerink MAJ. Alterations in serotype-specific B cell responses to the 13-valent pneumococcal conjugate vaccine in aging HIV-infected adults. Vaccine 2015; 34:451-457. [PMID: 26707220 DOI: 10.1016/j.vaccine.2015.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 11/18/2015] [Accepted: 12/07/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND Advanced age and human immunodeficiency virus (HIV) infection are associated with increased pneumococcal disease risk. The impact of these factors on cellular responses to vaccination is unknown. METHODS HIV-infected (HIV+) individuals 50-65 years old with CD4(+) Tcells/μl (CD4) >200 on antiretroviral therapy (ART) ≥1 year received either the 13-valent pneumococcal conjugate vaccine followed by the 23-valent pneumococcal polysaccharide vaccine (PCV/PPV) or PPV only. HIV-uninfected (HIV-) controls received PCV/PPV. Phenotype distribution and surface expression of complement receptor CD21 and tumor necrosis factor superfamily receptors (TNFRs) were compared on serotype-specific B cells postvaccination. RESULTS Postvaccination serotype-specific B cell percentages were significantly lower in HIV+ PCV/PPV compared to PPV groups, but similar between HIV+ or HIV- PCV/PPV groups. Transmembrane activator and calcium-modulating cyclophilin ligand interactor (TACI)(+) serotype-specific B cell percentages were significantly decreased in HIV+ PCV/PPV compared to PPV groups. CD21(+) serotype-specific B cells were significantly higher in HIV- compared to HIV+ PCV/PPV groups. CONCLUSIONS An initial dose of PCV reduced the frequency, but not phenotype distribution, of serotype-specific B cells and also lowered TACI expression in aging HIV+ subjects postvaccination with PPV. These findings suggest that PCV does not enhance cellular responses to revaccination with PPV.
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Affiliation(s)
- Jennifer A Ohtola
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, United States
| | - Noor M Khaskhely
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, United States
| | - Jessica L Saul-Mcbeth
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, United States
| | - Anita S Iyer
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, United States
| | - David J Leggat
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, United States
| | - Sadik A Khuder
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, United States; Department of Public Health and Preventative Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, United States
| | - M A Julie Westerink
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, Toledo, OH, United States; Department of Pathology, University of Toledo College of Medicine & Life Sciences, Toledo, OH, United States; Department of Medical Microbiology and Immunology, University of Toledo College of Medicine & Life Sciences, Toledo, OH, United States.
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Pogliaghi M, Ripa M, Pensieroso S, Tolazzi M, Chiappetta S, Nozza S, Lazzarin A, Tambussi G, Scarlatti G. Beneficial Effects of cART Initiated during Primary and Chronic HIV-1 Infection on Immunoglobulin-Expression of Memory B-Cell Subsets. PLoS One 2015; 10:e0140435. [PMID: 26474181 PMCID: PMC4608708 DOI: 10.1371/journal.pone.0140435] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 09/25/2015] [Indexed: 01/08/2023] Open
Abstract
Introduction During HIV-1 infection the B-cell compartment undergoes profound changes towards terminal differentiation, which are only partially restored by antiretroviral therapy (cART). Materials and Methods To investigate the impact of infection as early as during primary HIV-1 infection (PHI) we assessed distribution of B-cell subsets in 19 PHI and 25 chronic HIV-1-infected (CHI) individuals before and during 48 weeks of cART as compared to healthy controls (n = 23). We also analysed Immunoglobulin-expression of memory B-cell subsets to identify alterations in Immunoglobulin-maturation. Results Determination of B-cell subsets at baseline showed that total and Naive B-cells were decreased whereas Activated Memory (AM), Tissue-like Memory (TLM) B-cells and Plasma cells were increased in both PHI and CHI patients. After 4 weeks of cART total B-cells increased, while AM, TLM B-cells and Plasma cells decreased, although without reaching normal levels in either group of individuals. This trend was maintained until week 48, though only total B-cells normalized in both PHI and CHI. Resting Memory (RM) B-cells were preserved since baseline. This subset remained stable in CHI, while was expanded by an early initiation of cART during PHI. Untreated CHI patients showed IgM-overexpression at the expenses of switched (IgM-IgD-) phenotypes of the memory subsets. Interestingly, in PHI patients a significant alteration of Immunoglobulin-expression was evident at BL in TLM cells, and after 4 weeks, despite treatment, in AM and RM subsets. After 48 weeks of therapy, Immunoglobulin-expression of AM and RM almost normalized, but remained perturbed in TLM cells in both groups. Conclusions In conclusion, aberrant activated and exhausted B-cell phenotypes rose already during PHI, while most of the alterations in Ig-expression seen in CHI appeared later, despite 4 weeks of effective cART. After 48 weeks of cART B-cell subsets distribution improved although without full normalization, while Immunoglobulin-expression normalized among AM and RM, remaining perturbed in TLM B-cells of PHI and CHI.
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Affiliation(s)
- Manuela Pogliaghi
- Università Vita-Salute San Raffaele, Milan, Italy
- Department of Infectious and Tropical Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Marco Ripa
- Università Vita-Salute San Raffaele, Milan, Italy
- Department of Infectious and Tropical Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Simone Pensieroso
- Viral Evolution and Transmission Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Monica Tolazzi
- Viral Evolution and Transmission Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Stefania Chiappetta
- Università Vita-Salute San Raffaele, Milan, Italy
- Department of Infectious and Tropical Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Silvia Nozza
- Department of Infectious and Tropical Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Adriano Lazzarin
- Università Vita-Salute San Raffaele, Milan, Italy
- Department of Infectious and Tropical Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Giuseppe Tambussi
- Department of Infectious and Tropical Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Gabriella Scarlatti
- Viral Evolution and Transmission Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
- * E-mail:
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Leggat DJ, Iyer AS, Westerink MAJ. No Benefit to Delaying Pneumococcal Polysaccharide Vaccination in HIV-Positive Adults. J Infect Dis 2015; 212:1851-2. [PMID: 26109676 DOI: 10.1093/infdis/jiv349] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 06/15/2015] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Anita S Iyer
- Department of Medicine, University of Toledo, Ohio
| | - M A Julie Westerink
- Department of Medicine, University of Toledo, Ohio Department of Medical Microbiology and Immunology, University of Toledo, Ohio Department of Pathology, University of Toledo, Ohio
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