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- Svennerholm, A M, et al.
(author)
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Mucosal antitoxic and antibacterial immunity after cholera disease and after immunization with a combined B subunit-whole cell vaccine.
- 1984
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In: Journal of Infectious Diseases. - 0022-1899 .- 1537-6613. ; 149:6, s. 884-93
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Journal article (peer-reviewed)abstract
- Mucosal and systemic immune responses to a new oral cholera vaccine, consisting of the B subunit plus killed vibrios, were studied in Bangladeshi volunteers and compared with those to clinical cholera. A single peroral dose of vaccine induced a local IgA antitoxin response in intestinal-lavage fluid of seven of eight vaccinees; the response closely mimicked that of patients convalescing from cholera, and evidence of the induction of local immunologic memory was found as well. Two peroral doses were needed for stimulation of an intestinal IgA immune response to the lipopolysaccharide of Vibrio cholerae that was comparable to the response obtained after clinical cholera. This response to peroral immunization was considerably stronger than that to parenteral vaccination, although the intramuscular route gave rise to the strongest IgG antitoxin and antilipolysaccharide responses in serum. The results suggest that B subunit-whole cell vaccine, when given in at least two oral doses, may be a good candidate for use in cholera prophylaxis.
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| 2. |
- Holmgren, J, et al.
(author)
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Enterotoxigenic Escherichia coli diarrhea in an endemic area prepares the intestine for an anamnestic immunoglobulin A antitoxin response to oral cholera B subunit vaccination.
- 1988
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In: Infection and Immunity. - 0019-9567 .- 1098-5522. ; 56:1, s. 230-3
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Journal article (peer-reviewed)abstract
- We examined whether infection with enterotoxigenic Escherichia coli (ETEC) producing the heat-labile enterotoxin (LT) can prime the gut immune system to respond more efficiently to the immunologically related cholera B subunit component of a recently developed oral B subunit-whole-cell cholera vaccine (B-WCV). Nine Bangladeshi adults who had been hospitalized for watery diarrhea caused by LT-producing ETEC were given a single oral immunization with B-WCV on day 28 after hospital admission. The vaccine preparation used was adjusted to contain a lower-than-usual dose of B subunit, which had been found in previous studies to elicit a significant gut mucosal immunoglobulin A antitoxin response mainly in individuals with previous toxin-specific priming of their gut immune system. For comparison, nine patients convalescing from severe cholera disease and eight healthy subjects with no recent history of either cholera or ETEC infection were given the same oral vaccination with B-WCV. Vaccination in the ETEC convalescents induced an immunoglobulin A antitoxin response in intestinal lavage fluid which was comparable with that in the vaccinated cholera convalescents and superior to that in the vaccinated, previously uninfected controls. By contrast, only the cholera patients responded with anamnestic-type anti-cholera lipopolysaccharide antibody titer rises in the intestine after vaccination. These data support the specificity of the anamnestic anti-cholera toxin response in the ETEC patients after vaccination with cholera B-WCV.
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| 3. |
- Svennerholm, A M, et al.
(author)
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Current status of an oral B subunit whole cell cholera vaccine.
- 1983
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In: Developments in biological standardization. - 0301-5149. ; 53, s. 73-9
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Journal article (peer-reviewed)abstract
- Purified B subunit of cholera toxin retains membrane-binding capacity and protective immunogenicity and yet has no toxic activity as tested in animals. These properties suggest that B subunit might be a promising immunogen, particularly as an oral vaccine, for stimulating protective antitoxic immunity against cholera in man. A method has been elaborated which allows preparation of +/- 10 grams of pure B subunit per fermentor culture cycle. As tested in both Swedish and Bangladeshi volunteers purified B subunit alone or in combination with conventional whole cell vaccine gives no side-effects at all when given orally and only very mild local reactions after parenteral administration. A single peroral or intramuscular immunization with B subunit has given significant intestinal IgA antitoxin antibody formation in 75-85% of Bangladeshi women tested; however, the duration of the response was longer after the oral route. The preliminary results of a recent study (Svennerholm, A.M., Jertborn, M., Gothefors, L., Karim, A., Sack, D. and Holmgren, J., to be published) have further shown that two peroral immunizations of Bangladeshi volunteers with a combined B subunit--whole cell cholera vaccine give rise to mucosal IgA antitoxin as well as anti-lipopolysaccharide antibody formation which closely resemble these antibody responses in cholera convalescents. The combined vaccine also evoked a local immunologic memory comparable to that induced by clinical disease.
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