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Clinical and Vaccine Immunology, September 2006, p. 981-990, Vol. 13, No. 9
1071-412X/06/$08.00+0 doi:10.1128/CVI.00156-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
Department of Infectious Disease, St. Jude Children's Research Hospital, Memphis, Tennessee 38105,1 Department of Immunology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105,2 Department of Physiology, The University of Tennessee Health Science Center, Memphis, Tennessee 38163,3 Department of Veterinary Medicine, University of Maryland, College Park, Maryland 207424
Received 26 April 2006/ Returned for modification 20 June 2006/ Accepted 5 July 2006
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Typical assays used to measure vaccine responses against influenza antigens include hemagglutination inhibition (HI) and microneutralization assays. These standardized tests are easy to perform and provide a quantitative measure of antibodies based on their ability to neutralize viral particles (57). Use of these assays has shown that high levels of antibody are required to see effective neutralization in vivo (54). While neutralizing titers immediately following vaccination may be high enough to meet this threshold, antibody titers wane over time. In many cases, it may be difficult for the host to maintain a neutralizing antibody titer sufficient to prevent infection during an entire influenza season and into subsequent seasons.
In addition to their neutralizing properties, antibodies can mediate host effector functions and facilitate the removal of a pathogen from a host. Specifically, the Fc portion of immunoglobulin G2a (IgG2a) antibodies interacts with complement components (51) and activatory Fc receptors (21, 25, 69) with a high affinity. This interaction can efficiently activate Fc receptor-mediated effector functions, which include the stimulation of antibody-dependent cell-mediated cytotoxicity (36) and opsonophagocytosis by macrophages (64), the latter of which has been shown to contribute to the clearance of influenza virus from infected hosts (31). The Fc portion of IgG1 antibodies mediates a lower-affinity interaction with activatory Fc receptors and does not stimulate Fc receptor-mediated immune responses as effectively (52, 53). Interestingly, protective anti-influenza immunity in the absence of measurable neutralizing antibodies has been described to occur in influenza vaccine trials with both animals (38, 39) and humans (4, 9), but the explanation for this observation has yet to be determined.
BALB/c mice typically respond to inactivated influenza vaccines and subunit vaccines with a Th2-type immune response (2, 5, 27, 48), which is associated with the stimulation of IgG1 antibodies (60). However, the major antibody isotype present in the sera of mice that survive viral infections is IgG2a (10, 11), which is stimulated during Th1-type immune responses (60). Stimulation of IgG2a antibodies has been associated with increased efficacy of influenza vaccination (1, 30, 31, 48). Additionally, monoclonal antibodies of the IgG2a isotype are more efficient at clearing influenza (20, 50), Ebola (71), and yellow fever (58) virus infections than monoclonal antibodies of the IgG1 isotype displaying similar antigenic specificities.
In the present study, we specifically stimulated immunity against the hemagglutinin (HA) surface glycoprotein of influenza virus without complementary immunity from other external (neuraminidase) and internal (nucleoprotein [NP] and acid polymerase [PA]) components of the virus that are known to play a role in immunity against influenza viruses (13, 33-35). While focusing on the HA alone does not induce optimal protection against influenza challenge, it allowed us to dissect the distinct contributions of different elements of the immune response. We delivered influenza HA expressed in plasmid DNA via the gene gun, a route of vaccination that is known to induce a predominantly IgG1 response in BALB/c mice (16, 41, 76). We then vaccinated mice with replication-deficient viral replicon particles (VRP) from Venezuelan equine encephalitis (VEE) virus, which express the influenza HA in a manner known to enhance IgG2a antibody levels in mice (23, 75, 76). Our results support a role for IgG1 antibodies in the neutralization of viral particles both in vitro and in vivo. In contrast, the specific induction of IgG2a antibodies was not associated with neutralization of influenza virus but appears to assist in the clearance of influenza virus from the infected host. The data are discussed with emphasis on the different roles of antibody isotypes in antiviral immunity.
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Coupling plasmid DNA to gold particles. HA from the A/Hong Kong/1/68 (H3N2) (HK68) (GenBank accession no. AF348176) strain of influenza virus was cloned into pHW2000 plasmid DNA as described previously (29). The HA cloned in these studies differed from the GenBank sequence at N153I (A458T).
Spermidine (0.1 M) (Sigma, St. Louis, MO), 2.5 M CaCl2 (Fisher, Fair Lawn, NJ), and 2.5 µg plasmid DNA per 1 mg gold (1-µm particle size) (Bio-Rad Laboratories, Hercules, CA) were incubated at room temperature. Ethanol-washed gold beads were suspended in ethanol containing 0.2 mg ml1 polyvinylpyrrolidone (molecular weight, 360,000) and dried onto Tefzel tubing (Saint-Gobain Performance Plastics, Mickleton, NJ).
VRP creation. VEE VRP expressing an identical HA sequence were produced as described previously (46, 55) using constructs provided by Alphavax (Alphavax, Inc., Research Triangle Park, NC). Briefly, RNA from a single construct expressing both VEE nonstructural proteins and HK68 HA in place of VEE structural proteins was transfected into baby hamster kidney (BHK) cells by electroporation. Concurrently, RNA from two helper constructs that expressed VEE structural proteins but lacked packaging signals was transfected into BHK cells. Coelectroporation of these three RNA constructs results in the production of VRP that express the nonstructural proteins of VEE and the influenza HA. Supernatants from transfected BHK cells containing VRP were purified and concentrated prior to inoculation. VRP encoding green fluorescent protein (GFP) in place of influenza HA were used as a heterologous antigen control (46).
HK/Syd reassortant influenza virus. Individual influenza genes were cloned into pHW2000 plasmid vectors as described previously (29). The HA component of the virus was derived from the HK68 HA plasmid described above. The neuraminidase component used for creation of these viruses was from the A/Sydney/5/97 (H3N2) strain of influenza virus. The remaining genes used to create influenza virus were from A/Puerto Rico/8/34 (Erich Hoffmann, St. Jude Children's Research Hospital). Influenza virus (HK/Syd) was created using the reverse genetics technique described previously (28), and the rescued virus was propagated in 10-day-old embryonated chicken eggs for 72 h at 37°C.
HK/Syd virus created using reverse genetics had an egg 50% infective dose (ID50) of 107.50 and a Madin-Darby canine kidney (MDCK) 50% tissue culture infective dose (TCID50) of 107.375, measured using techniques described previously (74). With BALB/c mice (Jackson Laboratories, Bar Harbor, ME), the ID50 was 1 TCID50, while the 50% lethal dose was 105.5 TCID50. Following administration of lethal doses of influenza (either 3 or 10 50% minimum lethal doses [MLD50]), mice were monitored for signs of morbidity (weight loss) and mortality (survival). Mice that lost more than 33% of their initial body weight were euthanized and recorded as dying on the following day. Either 3 or 6 days after sublethal challenge (100 50% median infective doses [MID50]), mice were euthanized, lungs were removed, rinsed in sterile phosphate-buffered saline (PBS), and homogenized, and TCID50 values for dilutions of these homogenates were determined. ID50 and 50% lethal dose values were calculated using the method of Reed and Muench (56).
Vaccination. For DNA vaccination, 2.5 µg of either HA- or vector control DNA-coated gold particles (1 mg) was delivered at two nonoverlapping sites on the abdomen, using a Helios (Bio-Rad) gene gun, at 21-day intervals. Mice that were boosted with VRP received 1 x 106 infectious units expressing either HA or GFP (vector control) delivered subcutaneously in a 10-µl volume in the right rear footpad (46) at 28-day intervals. For an additional control group, mice were inoculated in the right rear footpad with PBS. When DNA was delivered without subsequent VRP administration, mice received three DNA inoculations (primary, secondary, and tertiary exposures). For groups that received DNA and VRP, mice were inoculated with two doses of DNA (primary and secondary) followed by two vaccinations with either VRP or PBS in the footpad (tertiary and quaternary). For all experiments, when DNA was administered, serum was collected 14 days after each vaccination, and when VRP or PBS was inoculated into the footpad, serum was collected at day 21 postinoculation. Serum was obtained from blood collected via the orbital plexus of isoflurane-anesthetized mice. Vaccination and serum collection time points were optimized through prior preparatory experiments conducted in our lab with these immunogens.
ELISA.
Egg-grown HK/Syd virus was concentrated, purified over a sucrose gradient as described previously (42), and inactivated with 0.025% formalin treatment for 3 days at 4°C (68). HA content of this virus preparation was quantitated after resolution through 10% sodium dodecyl sulfate-polyacrylamide gel electrophoresis (Bio-Rad) using bovine serum albumin (BSA) (Pierce, Rockford, IL) as a standard. Enzyme-linked immunosorbent assay (ELISA) plates (Becton Dickinson and Company, Franklin Lakes, NJ) were coated with 1 µg HA ml1 in PBS. Plates were washed with PBS containing 0.05% (vol/vol) Tween 20 (Sigma) (PBST) and blocked with 10% fetal bovine serum (HyClone, Logan, UT) in PBST (FBS-PBST). Receptor-destroying-enzyme-treated (Accurate Chemical & Scientific Corp., Westbury, NY), heat-inactivated sera were diluted in FBS-PBST. Alkaline phosphatase-conjugated goat anti-mouse IgA, IgM, IgG1, IgG2a, IgG2b, IgG3, or IgG (
heavy chain specific) (Southern Biotechnology Associates, Birmingham, AL), diluted 1:1,000 in FBS-PBST, was used as the detection antibody, with p-nitrophenylphosphate as a substrate (Sigma). The optical density (OD) was read at 405 nm using a Multiskan Ascent plate reader (Labsystems, Helsinki, Finland) 1 h after substrate addition. Reciprocal serum antibody titers were calculated at 50% maximal binding on the titration curve. Samples with OD values of less than 0.5 at the starting dilution (1:50) were reported as having a titer of less than 50.
Microneutralization. HK/Syd (2 x 103 TCID50 ml1) was incubated for 2 h with serum diluted in infection media as described previously (57). Virus-serum mixtures were then added to PBS-washed MDCK cell monolayers in 96-well Falcon plates (Becton Dickinson) and incubated for 2 h. Inoculum was removed, and cells were incubated with media containing 2 µg ml1 TPCK-trypsin for 18 to 22 h. Influenza virus was detected using mouse monoclonal antibody specific for influenza A virus nucleoprotein (kindly provided by Robert G. Webster, St. Jude Children's Research Hospital) diluted 1:2,000 in 1% BSA (Invitrogen, Grand Island, NY) in PBS containing 0.1% (vol/vol) Tween 20 (Sigma), as described previously (57). Horseradish peroxidase-conjugated goat anti-mouse IgG (Fc specific) (Sigma), diluted 1:2,000 in 1% BSA in PBS containing 0.1% (vol/vol) Tween 20, was used as the detection antibody, with o-phenylenediamine dihydrochloride as the substrate (Sigma). Upon addition of 1 N H2SO4, the OD at 492 nm was measured using a Multiskan Ascent plate reader. The microneutralization titer is reported as the reciprocal of the final serum dilution that exhibits an OD value less than one-half of that measured in virus control wells.
Flow cytometry. Mice were euthanized, the axillary artery was cut, and cells were recovered from the bronchoalveolar lavage (BAL) fluid by three 1-ml washes with Hanks balanced salt solution. The inferior vena cava was cut, and the liver was perfused via the hepatic portal vein. The gallbladder was excised during the liver's removal. Livers were minced and plunged through fine-mesh filters. The cell suspension was washed twice in cold PBS with 2% fetal bovine serum and 0.02% sodium azide and spun through 33.8% Percoll (Amersham Biosciences, Sweden) for 12 min at 693 x g to isolate lymphocytes as previously described (24). Isolated cells were incubated for 20 min on ice with phycoerythrin-conjugated anti-CD8 (BD Pharmingen) and an unconjugated rat anti-mouse CD16/32 antibody (BD Pharmingen) to block nonspecific Fc receptor-mediated binding. Cell populations were analyzed using a FACSCalibur system and CellQuest software (BD Biosciences, San Jose, CA).
Statistical analysis. Comparison of survival between groups of mice was done with a log rank chi-square test of the Kaplan-Meier survival data. Comparison between antibody titers was done using repeated-measures analysis of variance (ANOVA) by the Holm-Sidak method. SigmaStat for Windows (v3.11; SysStat Software, Inc.) was utilized for all statistical analyses. A P value of <0.05 was considered significant for these comparisons. Because of small group sizes, the analysis lacked the power to distinguish statistically between lung titer values.
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FIG. 1. Response of BALB/c mice to HA-DNA gene gun vaccination and influenza challenge. (A) IgG1 and IgG2a antibody levels were measured by ELISA 14 days after primary, secondary, and tertiary exposures to vector control or influenza HA delivered by DNA vaccine at 3-week intervals. Data are reported for six vector control-inoculated mice, with the exception of IgG2a readings at day 14 of the tertiary response (five mice). Data are shown for six HA-inoculated mice for the primary response and five HA-inoculated mice for the secondary and tertiary responses for both isotypes. An asterisk indicates a significant difference in titer compared to that for mice inoculated with vector DNA (P < 0.01 by ANOVA). A double asterisk indicates a significant difference in titer compared to those for all other groups (P < 0.01 by ANOVA). (B) Mice were challenged with 3 MLD50 HK/Syd on day 21 of the tertiary response to the vaccine. Mean levels of weight loss ± standard deviations are pictured for seven randomly selected mice per group. Survival data are reported for 10 vector control mice and 17 HA-vaccinated mice. An asterisk indicates a significant difference in survival compared to that of controls (P < 0.01 by log rank test of the Kaplan-Meier survival data).
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FIG. 2. Serum neutralizing antibody response of BALB/c mice to DNA prime followed by VRP boost. Microneutralization titers against HK/Syd (2,000 TCID50 ml1) at day 21 of the quaternary response to the vaccine are reported. Data are reported for the following numbers of mice in the various groups: for vector DNA plus PBS, n = 8; for vector DNA plus GFP-VRP, n = 15; for vector DNA plus HA-VRP, n = 15; for HA-DNA plus PBS, n = 10; for HA-DNA plus GFP-VRP, n = 17; and for HA-DNA plus HA-VRP, n = 18. An asterisk indicates a significant difference in titer compared to those for groups inoculated with vector DNA (P < 0.01 by ANOVA).
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FIG. 3. Virus-specific serum antibody response of BALB/c mice to DNA prime followed by VRP boost. IgG antibody titers against HK/Syd (1 µg HA ml1) were measured by ELISA and are shown at day 21 of the quaternary response to the vaccine. Data are reported for the following numbers of mice in the various groups: for vector DNA plus PBS, n = 8; for vector DNA plus GFP-VRP, n = 15; for vector DNA plus HA-VRP, n = 15; for HA-DNA plus PBS, n = 10; for HA-DNA plus GFP-VRP, n = 17; and for HA-DNA plus HA-VRP, n = 18. An asterisk indicates a significant difference in titer for mice vaccinated with HA-DNA plus PBS and mice vaccinated with HA-DNA plus GFP-VRP compared to those for mice in groups inoculated with vector DNA plus PBS and vector DNA plus GFP-VRP (P < 0.01 by ANOVA). A double asterisk indicates a significant difference in titer for mice vaccinated with HA-DNA plus HA-VRP compared to those for all three groups of vector DNA-vaccinated mice (P < 0.01 by ANOVA).
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FIG. 4. Virus-specific serum antibody response of BALB/c mice to DNA prime followed by VRP boost. IgG1 and IgG2a antibody isotype titers against HK/Syd (1 µg HA ml1) were measured by ELISA and are shown after primary (day 14), secondary (day 14), tertiary (day 21), and quaternary (day 21) responses to the vaccine. For all days and isotypes measured, the following numbers of mice were included in the various groups: for vector DNA plus PBS, n = 8; for vector DNA plus GFP-VRP, n = 15; for vector DNA plus HA-VRP, n = 15; for HA-DNA plus PBS, n = 10; for HA-DNA plus GFP-VRP, n = 17; and for HA-DNA plus HA-VRP, n = 18. An asterisk indicates a significant difference in titer for HA-DNA-vaccinated mice compared to that for vector DNA-vaccinated mice (P < 0.01 by ANOVA). A double asterisk indicates a significant difference in titer for mice vaccinated with HA-DNA plus HA-VRP compared to those for all other groups (P < 0.01 by ANOVA).
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In vivo neutralization and protective immunity against influenza are optimized when both HA-DNA and HA-VRP are delivered. To assess the role of vaccine-induced antibodies in protection against influenza, mice were first challenged with a sublethal dose (100 MID50) of influenza virus. At both 3 and 6 days after challenge, mice that were primed with HA-DNA exhibited lower viral titers than those that were primed with vector DNA (Fig. 5). The most effective in vivo neutralization was seen with mice that received a prime with HA-DNA and a boost with HA-VRP. On day 6 after viral challenge, two mice in the group inoculated with HA-DNA plus HA-VRP had undetectable levels of virus in their lungs, and the third mouse in that group had a lung viral titer of 2 x 103 TCID50 ml1.
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FIG. 5. Lung viral titers of BALB/c mice after HK/Syd challenge. After the quaternary exposure to the vaccine, mice were infected with 100 MID50 HK/Syd, and lung viral titers at days 3 and 6 after inoculation were determined. Data are reported for the following numbers of mice in the various groups: for vector DNA plus GFP-VRP, n = 3; for vector DNA plus HA-VRP, n = 3; for HA-DNA plus GFP-VRP, n = 4; and for HA-DNA plus HA-VRP, n = 4. On day 6 after viral challenge, all four groups contained three mice each.
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FIG. 6. Survival of BALB/c mice after HK/Syd challenge. After the quaternary exposure to the vaccine, mice were infected with 10 MLD50 HK/Syd and monitored for morbidity (percent weight loss) (top) and mortality (percent survival) (bottom). Data are reported for the following numbers of mice in the various groups: for vector DNA plus PBS, n = 8; for vector DNA plus GFP-VRP, n = 9; for vector DNA plus HA-VRP, n = 9; for HA-DNA plus PBS, n = 10; for HA-DNA plus GFP-VRP, n = 10; and for HA-DNA plus HA-VRP, n = 11. An asterisk indicates a significant difference in results compared to those for vector DNA-plus-PBS and vector DNA-plus-GFP-VRP groups (P < 0.05 by log rank test of the Kaplan-Meier survival data).
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FIG. 7. Effector CD8+ T-cell populations in the BAL fluid and livers of BALB/c mice after HK/Syd challenge. After the quaternary response to the vaccine, mice were infected with 100 MID50 HK/Syd. BAL fluid and liver cells were isolated and analyzed for CD8+ T-cell populations on day 6 after challenge. All groups consisted of three mice.
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When mice were exposed to both HA-DNA and HA-VRP, antibody levels reached their highest as measured by both microneutralization and ELISA. These elevated antibody levels correlated with protection against a more stringent challenge dose of influenza virus (10 MLD50). While it was expected that mice inoculated with both HA-DNA and HA-VRP would achieve optimal survival in this experiment, it was surprising that the mice that received HA-VRP alone, a group which had low levels of viral neutralization and IgG1 expression, achieved equivalent survival rates. Analysis of antibody expression by ELISA revealed IgG antibody levels that were comparable to those seen with HA-DNA-vaccinated mice, but the major IgG isotype expressed within these animals was IgG2a, not IgG1. The inability of the observed protection to be explained by vaccine-induced memory effector T cells within these mice implicates influenza-specific antibodies in both the neutralization and the clearance of this virus. It has been reported that antigen delivery using a VRP vehicle can result in enhanced antigen-specific serum IgA expression (76), but we were unable to detect this isotype after HA-DNA and HA-VRP vaccination. The low levels of IgG2b and IgG3 observed after gene gun and VRP vaccination are similar to what has been reported previously (16, 23). Taken together, the analyses of different serum antibody isotypes after vaccination with this regimen strengthen the argument that vaccine-induced IgG1 and IgG2a antibodies contribute to the protective responses observed.
Of specific interest is the observation with this model that mice were protected from influenza infection even when serum neutralizing activity was not detectable by standard assays. Protective immunity in the absence of strong neutralizing antibody titers has been observed previously with influenza vaccine studies (4, 38, 39, 44). Here we show that antibody levels are measured more efficiently by an ELISA method, allowing for the quantitation of vaccine-induced antibodies that remain undetected when traditional neutralization assays are employed. Furthermore, by using the ELISA technique, not only were we able to detect vaccine-induced antibodies within these mice but we were able to analyze the individual isotypes stimulated and the differential contributions of these isotypes to immunity against influenza. Specifically, we describe contributions of both neutralizing and host effector response-activating antibody isotypes that together result in strong immunity against influenza. Since the induction of these isotypes could be detected and differentiated only by ELISA, our findings argue for the incorporation of this technique in studies designed to assess correlates of immunity after influenza vaccination, in particular, when neutralizing antibody levels are either low or undetectable.
In support of the hypothesis that antibody isotypes play different roles in antiviral immunity, experiments conducted with monoclonal antibodies against Ebola envelope antigens showed that IgG2a antibodies were more effective at clearing infections than antibodies of the IgG1 isotype, even when each was specific for the same epitope (71). Protection against Ebola was achieved with lower concentrations of IgG2a antibodies, making it possible that, in addition to neutralizing viral particles, antibodies of the IgG2a isotype can stimulate host effector mechanisms that aid in the clearance of viral infections (71). Host effector mechanisms that are stimulated by IgG2a antibodies include complement fixation (51) and Fc receptor activation (52, 53). Since high levels of antibody (approximately 70 antibody molecules) are required to neutralize a single influenza virion (65), the presence of antibodies that are more active inducers of host clearance mechanisms and that are effective at lower concentrations (71) may aid in the resolution of the infection when levels of neutralizing antibodies begin to wane.
A contribution of the complement system in stimulating anti-influenza T-cell immunity has been described previously (40), but its role in the clearance of influenza virus is still unclear (17, 50). Alternatively, a role for Fc receptor-mediated clearance of influenza from vaccinated hosts has been described previously (31) through the use of mice deficient in expression of activating Fc receptors that signal through the common
chain (64), a group that now includes the recently described Fc
RIV (52). Furthermore, antibodies of the IgG2a isotype exhibit the best Fc receptor activatory-to-inhibitory ratio of all IgG isotypes (53), making it the isotype predicted to have the greatest ability to activate Fc receptor-mediated host effector responses.
Vaccination against the HA component of influenza by use of either HA-DNA or HA-VRP does not appear to induce strong T-cell-mediated immunity, as enriched memory populations of CD8 T cells were not detected in the local (BAL fluid) or systemic (liver) populations after challenge of these mice with influenza virus. While the absence of these cells implies that antibodies are the main contributors to the protection seen within this model, the important role of T cells in the eventual resolution of the virus infection cannot be excluded. T cells are important in viral clearance due to their ability to lyse infected cells (45, 73) and stimulate cytokine expression, which activates cells, like macrophages, that are involved in the clearance of pathogens (18, 37, 49). Since the vaccine itself does not specifically enrich T cells but the antibodies present can significantly reduce the amount of virus to which the host is exposed, it is possible that the stimulation of T cells is delayed past day 6 after challenge and that these cells do not reach their maximal capacity until later in the infection process, during the resolution phase. For this study, we deliberately used a vaccine strategy that would not be predicted to induce T-cell immunity. A vaccine of similar design, utilizing a protein that stimulates cellular immunity, such as NP, would be predicted to be more efficacious in terms of improved overall survival.
The vaccine design described in this study stimulates IgG1 and IgG2a antibodies in a way that makes it possible to study the contribution of these isotypes both individually and in concert. This study reveals that even in the absence of neutralizing antibodies a vaccinated host may have protective immunity against influenza. These findings have implications in the development of vaccines for pandemic preparedness, as subunit and recombinant vaccines against H5 antigens have shown low immunogenicity in humans, as measured by HI titers, microneutralization, single radial hemolysis, and ELISA for total IgG (61, 62). In order to increase the immunogenicity of a vaccine against the H5N3 virus A/Duck/Singapore/97, the adjuvant MF59, which has been licensed for use in Europe (59), was included in the vaccine (62). MF59 increases influenza-specific antibody responses in humans (14, 47), with evidence of modest IgG2a antibody induction after vaccination of BALB/c mice (26).
Additionally, H5 HA-expressing DNA delivered via the gene gun to either mice or chickens induces protection against homologous and heterologous virus challenge, even in the absence of high HI titers (38, 39). Our results suggest that reduced expression of neutralizing antibodies in response to H5 antigens does not necessarily indicate an ineffective vaccine and that characterization of the immune response induced using more-sensitive, isotype-specific assays may better predict vaccine efficacy. Pursuit of a vaccine strategy to induce complement-fixing and Fc receptor-activating antibodies in addition to neutralizing antibodies might improve vaccine efficacy.
DNA vaccines provide an advantage over conventional influenza vaccines in their ability to be mass-produced safely in a short period of time and their ability to be quickly altered to deal with the rapidly changing antigens of influenza viruses that circulate within the human population (19). Unfortunately, the applicability of DNA vaccines to humans has been limited by low efficacy (15, 19). One proposed way to increase the immunogenicity of DNA vaccines is to deliver them in a prime-boost manner using viral vectors as the boosting vehicle (6, 15, 22). This vaccination regimen has been shown by other groups to be beneficial over repeated exposures to the antigen delivered by either the DNA or the viral vector alone (8, 43). Our data support this concept and demonstrate that the increased immunity seen after delivery of both the DNA and the viral vector is not simply due to increases in total antibody responses. Instead, the prime-boost regimens may be more effective due to their ability to stimulate both neutralizing and host effector response-activating antibodies, thus better equipping the host to deal with infection.
We have no conflicting financial interests.
This work was supported by the American Lebanese Syrian Associated Charities (ALSAC).
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