Advertisement

Bacterial Mucosal Vaccines: Vibrio cholerae as a Live Attenuated Vaccine/Vector Paradigm

  • K. Killeen
  • D. Spriggs
  • J. Mekalanos
Chapter
Part of the Current Topics in Microbiology and Immunology book series (CT MICROBIOLOGY, volume 236)

Abstract

Immunization is the most effective public health tool used to control infectious disease. Moreover, immunization is extremely cost effective given that disease treatment is far more expensive than prevention of disease. The cost of vaccines and their administration from birth to age 16 is estimated by the Centers for Disease Control (CDC) to be US $500. Each US $1 spent on vaccinations saves US $16 in avoiding costly drug therapies and hospitalizations (Fettner 1994) ultimately saving approximately US $7500 per vaccinated individual. Furthermore, phenomena such as herd immunity can provide protection to a community, even when only a minority of the total population has been vaccinated. Ideally, vaccination leads to the total eradication of an infectious agent that has no alternative hosts or environmental reservoirs, e.g., smallpox and, in the near future, polio.

Keywords

Vaccine Strain Cholera Vaccine Inactivate Poliovirus Vaccine Bacterial Vector Attenuate Vaccine Strain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Albert MJ, Bhuiyan NA, Talukder KA, Faruque ASG, Nahar S, Faruque SM, Ansaruzzaman M, Rahman M (1997) Phenotypic and genotypic changes in Vibrio cholerae O139 Bengal. J Clin Microbiol 35:2588–2592PubMedGoogle Scholar
  2. Anderson RJ, Pasetti MF, Sztein MB, Levine MM, Noriega FR (1997) Immune response induced by a Shigella vaccine strain harboring a eukaryotic expression vector. ASM 97th General Meeting, Miami Beach, FL, May 4–8Google Scholar
  3. Barzu S, Fontaine A, Sansonetti P, Phalipon A (1996) Induction of a local anti-IpaC antibody response in mice by use of a Shigella flexneri 2a vaccine candidate: implications for use of IpaC as a protein carrier. Infect Immum 64:1190–1196Google Scholar
  4. Brennan MJ, Burns DL, Meade BD, Shahin RD, Manclark CR (1992) Recent development in the development of pertussis vaccines. In: Ellis RW (ed) Vaccines: new approaches to immunological problems. Butterworth-Heinemann, Boston, pp 23–52Google Scholar
  5. Butterton JR, Beattie DT, Gardel CL, Carroll PA, Hyman T, Killeen KP, Mekalanos JJ, Calderwood SB (1995) Heterologous antigen expression in Vibrio cholerae vector strains. Infect Immun 63:2689–2696PubMedGoogle Scholar
  6. Centers for Disease Control (1997) Poliomyelitis prevention in the United States: introduction of a sequential schedule of inactivated poliovirus vaccine followed by oral poliovirus vaccine. 46:RR-3Google Scholar
  7. Cholera Working Group (1993) Large epidemic of cholera-like disease in Bangladesh caused by Vibrio cholerae O139 synonym Bengal. Lancet 342:387–390CrossRefGoogle Scholar
  8. Colwell RC (1996) Global climate and infectious disease: the cholera paradigm. Science 274:2025–2031PubMedCrossRefGoogle Scholar
  9. Coster TS, Killeen KP, Waldor MK, Beattie DT, Spriggs DR, Kenner JR, Trofa A, Sadoff JC, Mekalanos JJ, Taylor DN (1995) Safety, immunogenicity, and efficacy of live attenuated Vibrio cholerae 0139 vaccine prototype. Lancet 345:959–952CrossRefGoogle Scholar
  10. Cryz SJ, Kaper J, Tacket C, Nataro J, Levine MM (1995) Vibrio cholerae CVD103-HgR live oral attenuated vaccine: construction, safety, immunogenicity, excretion, and non-target effects. Dev Biol Stand 84:237–244PubMedGoogle Scholar
  11. DiRita VJ, Neely M, Taylor RK, Bruss PM (1996) Differential expression of the ToxR regulon in classical and El Tor biotypes of Vibrio cholerae is due to biotype-specific control over toxT expression. Proc Natl Acad Sci USA 93:7991–7995PubMedCrossRefGoogle Scholar
  12. Edwards MF, Stocker BAD (1984) Construction of ΔaroA his ΔpurA strains of Salmonella typhi. J Bacteriol 170:3991–3995Google Scholar
  13. Faruque SM, Ahmed KM, Abdul Alim ARM, Qadri F, Siddique AK, Albert J (1997) Emergence of a new clone of toxigenic Vibrio cholerae O1 biotype E1 Tor displacing V. cholerae Ol39 Bengal in Bangladesh. J Clin Microbiol 35:624–630PubMedGoogle Scholar
  14. Faruque SM, Ahmed SM, Siddique AK, Zaman K, Abdul Amin ARM, Albert J (1997) Molecular analysis of toxigenic Vibrio cholerae Ol39 Bengal strains isolated in Bangladesh between 1993 and 1996: evidence for emergence of a new clone of the Bengal vibrios. J Clin Microbiol 35:2299–2306PubMedGoogle Scholar
  15. Fettner A (1994) A Crack in the shield - our unvaccinated children. A report on the colloquium. Cold Spring Harbor Laboratory, December 11–14Google Scholar
  16. Fontaine A, Arondel J, Sansonetti PJ (1990) Construction and evaluation of live attenuated vaccine strains of Shigella flexneri and Shigella dysenteriae 1. Res Microbiol 141:907–912PubMedCrossRefGoogle Scholar
  17. Gentschev K, Hess J, Goebel W (1990) Change in the cellular localization of alkaline phosphatase by alteration of its carboxy-terminal sequence. Mol Gen Genet 222:211–216PubMedCrossRefGoogle Scholar
  18. Gonzalez C, Hone D, Noriega F, et al. (1994) S. typhi vaccine strain CVD 908 expressing circumspor- ozoite protein of Plasmodium falciparum: strain construction and safety and immunogenicity in humans. J Infect Dis 169:927–931PubMedCrossRefGoogle Scholar
  19. Haider K, Metcalfe KA, Beattie DT, Killeen KP (1995) Vibrio-vectored Shigella sonnei O-antigen bio- synthetic genes. 95th General Meeting of the American Society of MicriobiologyGoogle Scholar
  20. Herrington DA, Hall RH, Losonsky G, Mekalanos JJ, Taylor RK, Levine MM (1988) Toxin, toxin- coregulated pili, and the toxR regulon are essential for Vibrio cholerae pathogenesis in humans. J Exp Med 168:1487–1492PubMedCrossRefGoogle Scholar
  21. Hess J, Gentschev I, Miko D, Welzel M, Ladel C, Goebel W, Kaufmann SHE (1996) Superior efficacy of secreted over somatic antigen display in recombinant Salmonella vaccine induced protection against Listeriosis. Proc Natl Acad Sci USA 93:1458–1463PubMedCrossRefGoogle Scholar
  22. Hess J, Dietrich G, Gentschev I, Miko D, Goebel W, Kaufmann SHE (1997) Protection against murine Listeriosis by an attenuated recombinant Salmonella typhimurium vaccine strain that secretes the naturally somatic antigen superoxide dismutase. Infect Immun 65:1286–1292PubMedGoogle Scholar
  23. Hohmann EL, Oletta CA, Miller SI (1996) Evaluation of a phoP/phoQ-deleted, aroA-deleted Live Oral S. typhi vaccine strain in human volunteers. Vaccine 14:19–24PubMedCrossRefGoogle Scholar
  24. Hohmann EL, Oletta CA, Killeen KP, Miller SI (1996) phoP/phoQ-deleted S. typhi.(Ty800) is a safe and immunogenic single-dose typhoid fever vaccine in volunteers. J Infect Dis 173:1408–1414PubMedCrossRefGoogle Scholar
  25. Hone DM, Attridge SR, Forrest B, Morona R, Daniels D, LaBrooy JT, Bartholomeusz RZ, Shearman DJ, Hackett J (1988) A galE via (Vi antigen-negative) mutant of S. typhi Ty2 retains virulence in humans. Infect Immun 56:1326–1333PubMedGoogle Scholar
  26. Jordan Report (1996) Accelerated Development of Vaccines. Division of Microbiology and Infectious Diseases. National Institute of Allergy and Infectious Disease. National Institutes of HealthGoogle Scholar
  27. Kaper JB, Lockman H, Balini M, Levine MM (1984) Recombinant nontoxinogenic Vibrio cholerae strains as attenuated cholera vaccine candidates. Nature 308:655–658PubMedCrossRefGoogle Scholar
  28. Käppeli O, Auberson L (1997) The science and intricacy of environmental safety evaluations. Tibtech 15:342–349Google Scholar
  29. Karolis DKR, Lan R, Reeves PR (1995) The sixth and seventh cholera pandemics are due to independent clones separately derived from environmental, nontoxigenic, non-O1 Vibrio cholerae. J Bacteriol 177:3191–3198Google Scholar
  30. Kaufmann SHE (1996) Concepts in vaccine development, de Gruyter, BerlinGoogle Scholar
  31. Kenner JR, Coster TS, Taylor DN, Trofa AF, Barrera-Oro M, Hyman T, Adams JM, Beattie DT, Killeen KP, Spriggs DR, Mekalanos JJ, Sadoff JC (1995) Peru-15, an improved live attenuated oral vaccine candidate for Vibrio cholerae 01. J Infect Dis 172:1126–1129PubMedCrossRefGoogle Scholar
  32. Levine MM, Ferreccio C, Black RE, Germanier R (1987) Large-scale field trial of Ty21a live oral typhoid vaccine in enteric-coated capsule formulation. Lancet 1:1049–1052PubMedCrossRefGoogle Scholar
  33. Levine MM, Herrington D, Murphy JR, et al. (1987) Safety, infectivity, immunogenicity and in vivo stability of two attenuated auxotrophic mutant strains of S. typhi 541Ty and 543Ty, as live oral vaccines in man. J Clin Invest 79:888–902PubMedCrossRefGoogle Scholar
  34. Levine MM, Kaper JB, Herrington D, Losonsky G, Morris JG, Clements M, Black RE, Tall B, Hall R (1988) Volunteer studies of deletion mutants of Vibrio cholerae 01 prepared by recombinant techniques. Infect Immun 56:161–167PubMedGoogle Scholar
  35. Levine MM, Kaper JB, Herrington D, Ketley J, Losonsky G, Tacket CO, Tall B, Cryz R (1988) Safety, immunogenicity, and efficacy of recombinant live oral cholera vaccines, CVD 103 and CVD 103-HgR. Lancet ii:467–470CrossRefGoogle Scholar
  36. Li A, Tibor P, Forsum U, Lindberg AA (1992) Safety and immunogenicity of live oral auxotrophic Shigella flexneri SFK24 in volunteers. Vaccine 10:395–404PubMedCrossRefGoogle Scholar
  37. Lorenz MG, Wackernagel W (1994) Bacterial gene transfer by natural genetic transformation in the environment. Microbiol Rev 58:563–602PubMedGoogle Scholar
  38. Manning PA, Stroeher UH, Moron a R (1994) Molecular basis for O-antigen biosynthesis in Vibrio cholerae Ol: Ogawa-Inaba switching. In: Wacksmuth IK, Blake PA, Olsvik O (eds) Vibrio cholerae and cholera. ASM Press, Washington, DC, pp 77–94Google Scholar
  39. Mekalanos J J, Swartz DJ, Pearson GD, Harford N, Groyne F, deWilde M (1983) Cholera toxin genes: nucleotide sequence, deletion analysis and vaccine development. Nature 306:551–557PubMedCrossRefGoogle Scholar
  40. Mekalanos JJ, Waldor MK, Gardel CL, Coster TR, Kenner J, Killeen KP, Beattie DT, Trofa A, Taylor DN, Sadoff JC (1995) Live cholera vaccines: perspectives on their construction and safety. Bull Inst Pasteur 93:255–262CrossRefGoogle Scholar
  41. Mekalanos JJ (1994) Live bacterial vaccines: environmental aspects. Curr Opin Biotech 5:312–319PubMedCrossRefGoogle Scholar
  42. Mooi RF, Bik EM (1997) The evolution of epidemic Vibrio cholerae strains. Trends Microbiol 5:161–165PubMedCrossRefGoogle Scholar
  43. Nakayama K, Kelly SM, Curtiss III R (1988) Construction of an ASD+ expression-cloning vector: stable maintenance and high level expression of cloned genes in a Salmonella vaccine strain. Biotechnology 6:693–697CrossRefGoogle Scholar
  44. Parsot C, Taxman E, Mekalanos J J (1991) ToxT regulated the production of lipoproteins and the expression of serum resistance in Vibrio cholerae. Proc Natl Acad Sci USA, 88:1641–1645PubMedCrossRefGoogle Scholar
  45. Pearson GDN, Woods A, Chaing S Mekalanos JJ (1993) CTX genetic element encodes a site-specific recombination system and an intestinal colonization factor. Proc Natl Acad Sci USA 90:3750–3754PubMedCrossRefGoogle Scholar
  46. Ryan ET, Butterton JR, Zhang T, Baker MA, Stanley, Jr. SL, Calderwood SB (1997) Oral immunization with attenuated vaccine strains of Vibrio cholerae expressing a dodecapeptide repeat of the serine-rich entamoeba histolytica protein fused to the cholera toxin B subunit induces systemic and mucosal antiamebic and anti-V. cholerae antibody responses in mice. Infect Immun 65:3118–3125PubMedGoogle Scholar
  47. Ryan ET, Butterton JR, Smith RN, Carroll PA, Crean TI, Calderwood SB (1997) Protective immunity against Clostridium difficile toxin A induced by oral immunization with a live, attenuated Vibrio cholerae vector strain. Infect Immun 65:2941–2949PubMedGoogle Scholar
  48. Sack DA, Sack RB, Shimko J, Gomes G, O’Sullivan D, Metcalfe K, and Spriggs D (1997a) Evaluation of Peru-15, a new live oral vaccine for cholera, in volunteers. J Infect Dis 176:201–205PubMedCrossRefGoogle Scholar
  49. Sack DA, Shimko J, Sack RB, Gomes G, MacLeod K, O’Sullivan D, Spriggs D (1997b) Comparison of alternative buffers for use with a new live oral cholera vaccine, Peru-15, in outpatient volunteers. Infect Immun 65:2107–2111PubMedGoogle Scholar
  50. Sharma C, Balakrish Nair N, Mukhopadhyay AK, Bhattacharya SK, Ghosh RK, Ghosh A (1997) Molecular characterization of Vibrio cholerae O1 biotype E1 Tor strains isolated between 1992 and 1995 in Calcutta, India: evidence for the emergence of a new clone of the E1 Tor biotype. J Infect Dis 175:1134–1141PubMedCrossRefGoogle Scholar
  51. Sizemore, DR, Branstrom, AA, Sadoff, JC (1997) Attenuated bacteria as a DNA delivery vehicle for DNA-mediated immunization. Vaccine 15:804–807PubMedCrossRefGoogle Scholar
  52. Stover CK (1994) Recombinant vaccine delivery systems and encoded vaccines. Curr Opin Immunol 6:568–571PubMedCrossRefGoogle Scholar
  53. Stroeher UH, Jedani KE, Dredge BK, Morona R, Brown MH, Karageorgos LE, Albert MJ, Manning PA (1995) Genetic rearrangements in the rfb regions of Vibrio cholerae O1 and O1 39. Proc Natl Acad Sci USA 92:10374–10378PubMedCrossRefGoogle Scholar
  54. Suharyono C, Simanjuntak N, Witham N, Punjabi K, Heppner G, Losonsky G, Totsusdirjo H, Rifai A, Clemens J, Lim Y, Burr D, Wasserman S, Kaper J, Sorenson S, Cryz S, Levine M (1992) Safety and immunogenicity of single-dose live oral cholera vaccine CVD 103-HgR in 5–9 year-old Indonesian children. Lancet 340:689–694PubMedCrossRefGoogle Scholar
  55. Sztein MB, Wasserman SS, Tacket CO, et al. (1994) Cytokine production patterns and lymphoprolif- erative responses in volunteers orally immunized with attenuated vaccine strains of Salmonella typhi. J Infect Dis 170:1508–1517PubMedCrossRefGoogle Scholar
  56. Tacket CO, Hone DM, Losonsky GA, Guers L, Edelman R, Levine MM (1992) Clinical acceptability and immunogenicity of CVD 908 S. typhi vaccine strain. Vaccine 10:443–446PubMedCrossRefGoogle Scholar
  57. Tacket CO, Hone DM, Curtiss R, III, et al. (1992) Comparison of the safety and immunogenicity ΔaroC ΔaroD and ΔcyaΔcrp S. typhi strains in adult volunteers. Infect Immun 60:536–541PubMedGoogle Scholar
  58. Tacket CO, Kelly SA, Schodel F, Losonsky G, Nataro JP, Edelman R, Levine MM, Curtiss III,R. (1997) Safety and immunogenicity in humans of an attenuated S. typhi vaccine vector strain expressing plasmid-encoded hepatitis B antigens stabilized by the Asd-balanced lethal vector system. Infect Immun 65:33881–33885Google Scholar
  59. Tacket CO, Sztein MB, Losonsky GA, et al. (1997) Safety and immune response in humans of live oral S. typhi vaccine strains deleted in htrA and aroC, aroD. Infect Immun 65:452–456PubMedGoogle Scholar
  60. Tacket CO, Kelly SM, Schodel F, et al. (1997) Safety and immunogenicity in humans of an attenuated S. typhi vaccine vector strain expressing plasmid-encoded hepatitis B antigens stabilized by the ASD balanced lethal system. Infect Immun 65:3381–3385PubMedGoogle Scholar
  61. Tzschaschel BD, Klee SR, de Lorenzo V, Timmis KN, Guzmán CA (1996) Towards a vaccine candidate against Shigella dysenteriae 1: expression of the Shiga toxin B-subunit in an attenuated Shigella flexneri aroD carrier strain. Micro Path 21:277–288CrossRefGoogle Scholar
  62. Veal DA, Stokes HW, Daggard G (1992) Genetic exchange in natural microbial communities. Adv Microb Ecol 12:383–430Google Scholar
  63. Wahdan MH, Serie C, Cerisier Y, Sallam S, Germanier R (1982) A controlled field trial of live S. typhi strain Ty21 a oral vaccine against typhoid: three year results. J Infect Dis 145:292–296PubMedCrossRefGoogle Scholar
  64. Waldor MK, Mekalanos J J (1996a) Vibrio cholerae: molecular pathogenesis, immune response, and vaccine development. In: Paradise LJ (ed) Enteric infections and immunity. Plenum, New York, pp 37–56Google Scholar
  65. Waldor MK, Mekalanos JJ (1996b) Lysogenic conversion by a filamentous phage encoding cholera toxin. Science 272:1910–1914PubMedCrossRefGoogle Scholar
  66. Waldor MK, Tschäpe H, Mekalanos J J (1996) A new type of conjugative transposon encodes resistance to sulfamethoxazole, trimethoprim, and streptomycin in Vibrio cholerae O139. J Bacteriol 178: 4157– 4165PubMedGoogle Scholar
  67. Wilson M, Lindow SE (1993) Release of recombinant microorganisms. Annu Rev Microbiol 47:913–944PubMedCrossRefGoogle Scholar
  68. World Health Organization (1996) Report of the meeting on new strategies of accelerating Shigella vaccine development. 25–26 November, GenevaGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1999

Authors and Affiliations

  • K. Killeen
    • 1
  • D. Spriggs
    • 1
  • J. Mekalanos
    • 2
  1. 1.Virus Research InstituteCambridgeUSA
  2. 2.Department of Microbiology and Molecular GeneticsHarvard Medical School and the Shipley Institute of MedicineBostonUSA

Personalised recommendations