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Clinical and Diagnostic Laboratory Immunology, September 2002, p. 1021-1024, Vol. 9, No. 5
1071-412X/02/$04.00+0 DOI: 10.1128/CDLI.9.5.1021-1024.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
BioSante Pharmaceuticals, Inc., Smyrna, Georgia 30082
Received 28 January 2002/ Returned for modification 15 March 2002/ Accepted 6 May 2002
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Mucosal vaccine delivery is a promising strategy. Mucosal vaccines administered in one part of the body can elicit an antibody response in mucosal tissues remote from the site of initial antigen exposure. This effect occurs because of the common mucosal immune system (13). A major obstacle to developing a mucosal vaccine in humans is finding a safe and effective adjuvant. Experimental mucosal adjuvants include cholera toxin, heat-labile enterotoxin, mutant toxins (LTK63 and LTR72), CpG oligodeoxynucleotide, polymerized liposomes, microparticles, and interleukins or immune modulators. None of these adjuvants is approved for use in humans (3, 12, 18).
Biodegradable calcium phosphate particles have been investigated as an alternative to aluminum adjuvants for parenteral vaccines. Clinical studies conducted in France described the use of a calcium phosphate adjuvant for secondary or booster immunizations against diphtheria and tetanus (8). Calcium phosphate has also been used for allergen desensitization (6, 16). Early studies indicated that calcium phosphate particles produce strong adjuvant effects, induced less immunoglobulin E (IgE) than aluminum adjuvants, and elicited only minimal local irritation in animal experiments and human clinical trials (6, 8, 11, 17).
Here, we describe a unique formulation of calcium phosphate nanoparticles (CAP) which is distinct from the formulations of calcium phosphate described by European scientists (16) and demonstrate its use as an effective mucosal adjuvant. Our results indicate that following viral challenge, mice immunized with CAP-based formulations of herpes simplex virus type 2 (HSV-2) glycoprotein exhibited significantly increased survival rates and less severe clinical infection than controls. These findings demonstrate that CAP delivered as a mucosal adjuvant confers protective antiviral immunity.
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Animals. Female BALB/c mice, 6 to 8 weeks old and weighing 25 g, were obtained from Charles River Laboratories. The mice were maintained in standard housing with a normal diet of Purina rodent chow 5001.
Immunization and sample collection. Eight groups of five female BALB/c mice were inoculated intravaginally or intranasally with HSV-2+CAP (20 µg of viral protein plus 100 µg of CAP per dose per mouse), HSV-2 alone (20 µg per dose per mouse), or CAP alone (100 µg per dose per mouse) in a total volume of 50 µl (intravaginally) or 10 µl (intranasally).
The mice received two inoculations, on days 0 and 7. Samples were collected 7, 14, and 38 days after the last immunization. Blood was obtained from the orbital sinus, and the serum samples were stored at -20°C. Mucosal samples were collected 14 days after the last immunization by vaginal lavage with 100 µl of PBS. The sediments were removed by centrifugation, and samples were pooled and stored at -20°C.
ELISA. HSV-specific antibodies were detected by an end-point dilution enzyme-linked immunosorbent assay (ELISA) as described previously (3). Titers for IgG in plasma samples were expressed as group mean ± standard error of the mean of values for individual animals. Titers for IgA and IgG in mucosal samples were expressed as the mean of triplicate assays from pooled mucosal samples.
HSV-2 challenge experiment. Using methods reported previously (7), mice were injected subcutaneously with DepoProvera (Upjohn, Kalamazoo, Mich.) at a concentration of 2 mg/mouse in 50 µl of distilled water on the 45th day following primary immunization. Five days later, the mice were challenged intravaginally with 106 PFU of HSV-2. Mice were examined daily for genital pathology, and the clinical scoring was performed by an investigator blinded to the animal's immunization status. Clinical pathology was scored on a 5-point scale: 0, no apparent infection; 1, slight redness of external vagina; 2, severe redness and swelling of external vagina; 3, genital ulceration with severe redness, swelling, and hair loss of genital and surrounding tissue; 4, severe ulceration of genital and surrounding tissue and paralysis; and 5, death.
Neutralization assay. As reported previously (7), Vero cells were propagated in culture plates. Pooled mouse serum samples from day 38 after the last immunization were incubated with HSV-2 and assessed for the presence of HSV-2-specific neutralizing antibodies by plaque assay. The titer is the reciprocal of the serum dilution required to inhibit the cytolysis of a confluent monolayer of Vero cells by 50%.
Statistical analysis. Pathological data were analyzed by analysis of variance to determine the difference between groups.
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FIG. 1. Groups of five female BALB/c mice were immunized on days 0 and 7 by intranasal or intravaginal delivery of PBS (vertically striped bars), CAP alone (open bars), HSV-2 alone (horizontally striped bars), or HSV-2+CAP (solid bars). The antigen concentration and vaginal lavage fluid dilution used in the ELISA were 100 µg/ml and 1:1, respectively.
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FIG. 2. The antigen concentration and antibody dilution used in the IgG ELISA were 6 µg/ml and 1:200, respectively. The antigen concentration and antibody dilution used in the IgG2a ELISA were 100 µg/ml and 1:50, respectively. Each bar represents the group mean antibody level for mice immunized intranasally or intravaginally with PBS (vertically striped bars), CAP alone (open bars), HSV-2 alone (horizontally striped bars), or HSV-2+CAP (solid bars).
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Resistance to HSV-2 infection was evaluated by monitoring clinical pathology. On days 6, 8, and 10, the reduced clinical severity in mice intravaginally immunized with HSV-2+CAP achieved statistical significance (P < 0.05) compared to mice immunized with PBS, CAP alone, or HSV-2 alone (Fig. 3, right panel). One of five mice intravaginally inoculated with HSV-2+CAP died from HSV-2 infection, whereas all of the mice intravaginally vaccinated with PBS, HSV-2 alone, and CAP alone developed severe disease and died by day 8 or 10. Similarly, the mice vaccinated intranasally with HSV-2+CAP showed reduced clinical severity compared with mice immunized with PBS, CAP alone, or HSV-2 alone at days 8 and 10 (Fig. 3, left panel). Two of five mice intranasally vaccinated with CAP+HSV-2 died, compared with the controls (i.e., recipients of PBS, CAP alone, and HSV-2 only), all of which died eventually. All surviving mice were kept for 2 more weeks and recovered gradually.
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FIG. 3. Five BALB/c mice per group were immunized intranasally or intravaginally with PBS (vertically striped bars), CAP alone (open bars), HSV-2 alone (horizontally striped bars), or HSV-2+CAP (solid bars) and challenged intravaginally with 106 PFU of HSV-2 at 43 days after the last immunization. Clinical pathology was scored as described in the text. The stars indicate P values of <0.05 for HSV-2+CAP versus PBS, CAP alone, and HSV-2 alone.
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We have reported previously that CAP delivered intraperitoneally with HSV-2 and Epstein-Barr virus proteins induced high titers of IgG2a antibody and neutralizing antibody and facilitated a high degree of protection against viral infection in a murine model (7). In this study, using HSV-2 protein as a model antigen, we evaluated the immunity and efficacy of an HSV-2+CAP experimental vaccine. Our results indicated that mice vaccinated either intravaginally or intranasally with HSV-2+CAP had high antibody levels at mucosal surfaces and effective neutralizing antibody titers and were protected against virus infection. We assumed that the neutralizing antibody prevented the attachment of pathogens to the epithelial surfaces and conferred protection against subsequent viral infection. Our findings also confirmed the previous studies (4, 15) showing that antibodies can efficiently neutralize virus in mucosal areas.
The immune system within the female lower genital tract is the initial defense against sexually transmitted diseases. Our study suggested that intravaginal immunization induced relatively higher levels of mucosal IgG and IgA than intranasal immunization, providing optimal protection against HSV-2 infection. This observation supports the findings of others (1, 9, 10) and suggests that genital local immunity and Th1 response in association with other protecting factors, such as local production of antibodies and viral clearance from the vaginal mucosa, play a major role in HSV-2 infection in mice. Our next step is to prove that CD4+ T cells secreting gamma interferon and B cells or natural antibodies are critical for immune protection against lethal genital HSV-2 reinfection.
The exact mechanism of the adjuvant action of CAP is not fully understood. M cells in the mucosal tissues are known to reside exclusively in the epithelium and deliver foreign material by transepithelial transport from the lumen to the underlying mucosa-associated lymphoid tissue. Particulate antigens are desirable because they permit M cells to translocate across the tight epithelial barrier to mucosal dendritic cells. Therefore, the particulate mucosal vaccine created from the combination of soluble antigens formulated within CAP provides the desirable size and functional attributes to induce effective mucosal immunity.
Recent comparative studies have indicated that microparticles are potent adjuvants for mucosal delivery (18). However, microparticles are not an ideal size for inducing cellular immunity because they tend to be too large, and it is believed that M cells, dendritic cells, macrophages, and local lymph nodes are more effective at taking up smaller particles. Advantageously, CAP are generally in the preferred size range (i.e., less than 1.2 µm, versus 1 µm-sized polymers) and also stimulate cellular immunity and cytotoxic T lymphocyte responses (unpublished data). Based on these results, we conclude that (i) the CAP-based HSV-2 subunit vaccine appears to concurrently induce both systemic and mucosal immunity and (ii) CAP shows great potential as a safe and effective mucosal vaccine adjuvant for humans, given its relative absence of side effects and lack of IgE antibody induction.
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