Enterovirus 71 (EV71) is an emerging picornavirus that has become endemic in Asia-Pacific regions. EV71 infection commonly manifests in childhood as an exanthem known as hand, foot, and mouth disease (HFMD), but in children under the age of 5, severe complications may occur, such as brainstem and/or cerebellar encephalitis, aseptic meningitis, and acute flaccid paralysis. The most devastating complication of EV71 neurologic disease is neurogenic cardiac failure with pulmonary edema. This syndrome can be fatal within hours of onset. There are no specific anti-viral drugs or vaccines approved for EV71 disease. But, in endemic areas, intravenous immunoglobulins (IVIG) are a standard component of supportive care, as IVIG in those regions have significant EV71 IgG titers. Should EV71 spread to non-endemic areas, such as the United States, IVIG will not be useful due to low EV71 IgG titers. Essentially nothing is known about the human antibody response to EV71 at the level of individual antibodies. The objective of the research is to characterize the human neutralizing IgG response to EV71 in subjects who have survived endemic EV71 infection in Taiwan. Two innovative techniques will be used for studying the human antibody response to EV71. A proteomics approach will identify the specific EV71-reactive IgG clonotypes found in sera of naturally infected EV71 patients. This method is an innovative combination of protein mass spectrometry and a NextGen sequencing method that preserves natural HC:LC pairing. Concurrently, a novel hybridoma method of human antibody cloning will functionally screen human mAbs from the same patients in order to identify those with EV71 neutralizing activity. Correlation of these combined datasets will allow an assignment of functions to the exact antibodies present in the serum repertoire. This unprecedented level of detail about the human anti- EV71 antibody repertoire will enable studies to understand the function of antibodies in protection from EV71, including structural studies and animal modeling. The research will seek to identify pairs of non-cross-resistant mAbs with broad-spectrum neutralization activity that will establish proof-of-concept for an EV71 therapeutic intended for use in the USA.

Public Health Relevance

Enterovirus 71 (EV71) is an emerging epidemic virus that causes hand foot and mouth disease (HFMD), but can have catastrophic consequences, especially in children. Antibody immunity is essential for survival from EV71 infection, but littleis known about the human antibody response during acute EV71 infection. This project will use novel proteomics and antibody cloning methods to functionally and precisely define the protective antibodies that arise in response to EV71 infection in order to enable creation of antibody therapeutics for EV71 treatment.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21AI119368-02
Application #
9260768
Study Section
Immunity and Host Defense (IHD)
Program Officer
Park, Eun-Chung
Project Start
2016-04-13
Project End
2018-03-31
Budget Start
2017-04-01
Budget End
2018-03-31
Support Year
2
Fiscal Year
2017
Total Cost
$200,209
Indirect Cost
$41,984
Name
Lankenau Institute for Medical Research
Department
Type
Research Institutes
DUNS #
125797084
City
Wynnewood
State
PA
Country
United States
Zip Code
19096
Liu, Yanling; McDaniel, Jonathan R; Khan, Srijit et al. (2018) Antibodies Encoded by FCRL4-Bearing Memory B Cells Preferentially Recognize Commensal Microbial Antigens. J Immunol 200:3962-3969