Streptococcus pneumoniae kills more people in the U.S. than all other vaccine-preventable diseases combined and is estimated to cause over 1.6 million deaths/year worldwide. The native pneumococcal vaccine currently used in adults consists of capsular polysaccharides (PPS) derived from 23 different serotypes and therefore provides broad coverage against invasive disease. Nonetheless, protection eventually wanes as antibody titers diminish, typically by 10 years post-immunization. Unfortunately, PPS boosting does not induce recall responses. This is typical of most polysaccharide (Ps) antigens. This is a significant concern given the potential for diminished protection against pneumococcal infections. PPS-protein conjugate vaccines do not effectively boost or yield superior titers to native PPS in adults, in contrast to what is observed in young children. This, along with the high cost and limited serotype coverage of conjugate vaccines, suggests that alternative strategies are needed to enhance PPS vaccine efficacy. To improve native Ps vaccines, it is imperative to develop a mechanistic understanding of the factors preventing Ps-specific antibody recall responses. Our data supports that memory B cells are generated in response to Ps antigens but that they are largely unresponsive when antigen is re-encountered following infection or revaccination. Our data also suggest that select adjuvant combinations may overcome this defect and enable successful boosting. In this proposal, we will test the hypothesis that active mechanisms of immune suppression limit Ps-specific memory B cell generation and functional responsiveness to secondary antigen encounter. In addition, we will test the hypothesis that "danger" signals supplied through toll-like (TLR) and C-type lectin receptors (CLR) can overcome this suppression.
In Aim 1, we will specifically examine the B cell-intrinsic and -extrinsic roles for B7:CD28 superfamily inhibitory receptors and ligands in suppressing Ps-specific memory B cell formation and effector function.
In Aim 2, we will examine the extent to which TLR4/RP105 and Mincle agonists synergize to promote Ps-specific memory B cell generation and functional responsiveness during boosting. We will examine the mechanisms by which this is achieved, including the extent to which these agonists overcome the inhibitory effects of B7:CD28 superfamily receptors. Completion of these studies is expected to provide us with critical knowledge regarding the mechanisms responsible for suppressed secondary antibody responses to native Ps as well as the feasibility of using TLR and CLR-based adjuvant combinations to overcome this barrier to effective vaccination. Our results are expected to have a significant impact on the use of prime-boost strategies employing native Ps, as well as the future design of more affordable and efficacious Ps-based vaccines with the highest possible serotype coverage.

Public Health Relevance

The goal of the research proposed in the current application is to understand how the immune system is regulated to respond to polysaccharide vaccines important for protection against against Streptococcus pneumoniae. The knowledge gained from these studies may lead to improved vaccines that provide enhanced protection against pneumococcal infections currently threatening global public health.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
High Priority, Short Term Project Award (R56)
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Immunity and Host Defense Study Section (IHD)
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Ferguson, Stacy E
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Wake Forest University Health Sciences
Schools of Medicine
United States
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