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Talaat KR, Porter CK, Bourgeois AL, Lee TK, Duplessis CA, Maciel M, Gutierrez RL, DeNearing B, Adjoodani B, Adkinson R, Testa KJ, Feijoo B, Alcala AN, Brubaker J, Beselman A, Chakraborty S, Sack D, Halpern J, Trop S, Wu H, Jiao J, Sullivan E, Riddle MS, Joseph SS, Poole ST, Prouty MG. Oral delivery of Hyperimmune bovine serum antibodies against CS6-expressing enterotoxigenic Escherichia coli as a prophylactic against diarrhea. Gut Microbes 2020; 12:1732852. [PMID: 32167011 PMCID: PMC7524165 DOI: 10.1080/19490976.2020.1732852] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND . Oral administration of bovine antibodies active against enterotoxigenic Escherichia coli (ETEC) have demonstrated safety and efficacy against diarrhea in human challenge trials. The efficacy of bovine serum immunoglobulins (BSIgG) against recombinant colonization factor CS6 or whole cell ETEC strain B7A was assessed against challenge with the CS6-expressing B7A. METHODS . This was a randomized, double-blind, placebo-controlled trial in which healthy adults received oral hyperimmune BSIgG anti-CS6, anti-B7A whole cell killed or non-hyperimmune BSIgG (placebo) in a 1:1:1 ratio then challenged with ETEC B7A. Two days pre-challenge, volunteers began a thrice daily, seven day course of immunoprophylaxis. On day 3, subjects received 1 × 1010 CFUs of B7A. Subjects were observed for safety and the primary endpoint of moderate-severe diarrhea (MSD). RESULTS . A total of 59 volunteers received product and underwent ETEC challenge. The BSIgG products were well-tolerated across all subjects. Upon challenge, 14/20 (70%) placebo recipients developed MSD, compared to 12/19 (63%; p = .74) receiving anti-CS6 BSIgG and 7/20 (35%; p = .06) receiving anti-B7A BSIgG. Immune responses to the ETEC infection were modest across all groups. CONCLUSIONS . Bovine-derived serum antibodies appear safe and well tolerated. Antibodies derived from cattle immunized with whole cell B7A provided 50% protection against MSD following B7A challenge; however, no protection was observed in subjects receiving serum antibodies targeting CS6. The lack of observed efficacy in this group may be due to low CS6 surface expression on B7A, the high dose challenge inoculum and/or the use of serum derived antibodies versus colostrum-derived antibodies.
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Affiliation(s)
- KR Talaat
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - CK Porter
- Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, USA,CONTACT CK Porter Naval Medical Research Center, Silver Spring, MD, USA
| | - AL Bourgeois
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - TK Lee
- Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, USA
| | - CA Duplessis
- Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, USA
| | - M Maciel
- The Henry M. Jackson Foundation, Bethesda, MD, USA
| | - RL Gutierrez
- Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, USA
| | - B DeNearing
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - B Adjoodani
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - R Adkinson
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - KJ Testa
- The Henry M. Jackson Foundation, Bethesda, MD, USA
| | - B Feijoo
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - AN Alcala
- The Henry M. Jackson Foundation, Bethesda, MD, USA
| | - J Brubaker
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - A Beselman
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - S Chakraborty
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - D Sack
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - J Halpern
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - S Trop
- The Henry M. Jackson Foundation, Bethesda, MD, USA
| | - H Wu
- SAB Biotherapeutics Inc, Sioux Falls, SD, USA
| | - J Jiao
- SAB Biotherapeutics Inc, Sioux Falls, SD, USA
| | - E Sullivan
- SAB Biotherapeutics Inc, Sioux Falls, SD, USA
| | - MS Riddle
- Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, USA
| | - SS Joseph
- The Henry M. Jackson Foundation, Bethesda, MD, USA
| | - ST Poole
- The Henry M. Jackson Foundation, Bethesda, MD, USA
| | - MG Prouty
- Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, USA
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