OpenUCT :: Browsing by Author "Hanekom, Willem A"

Browsing by Author "Hanekom, Willem A"

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Open Access
Association between BCG-induced immunity and risk of TB disease
(2011) Kagina, Benjamin Mugo; Hanekom, Willem A; Abel, Brian
We tested the hypothesis that a lower frequency and profile of specific T cells induced by BCG vaccination at birth is associated with subsequent risk of developing tuberculosis.
Open Access
Association of human TLR1 and TLR6 deficiency with altered immune responses to BCG vaccination in South African infants
(Public Library of Science, 2011) Randhawa, April Kaur; Shey, Muki S; Keyser, Alana; Peixoto, Blas; Wells, Richard D; de Kock, Marwou; Lerumo, Lesedi; Hughes, Jane; Hussey, Gregory; Hawkridge, Anthony; Kaplan, Gilla; Hanekom, Willem A; Hawn, Thomas R
The development of effective immunoprophylaxis against tuberculosis (TB) remains a global priority, but is hampered by a partially protective Bacillus Calmette-Guérin (BCG) vaccine and an incomplete understanding of the mechanisms of immunity to Mycobacterium tuberculosis. Although host genetic factors may be a primary reason for BCG's variable and inadequate efficacy, this possibility has not been intensively examined. We hypothesized that Toll-like receptor (TLR) variation is associated with altered in vivo immune responses to BCG. We examined whether functionally defined TLR pathway polymorphisms were associated with T cell cytokine responses in whole blood stimulated ex vivo with BCG 10 weeks after newborn BCG vaccination of South African infants. In the primary analysis, polymorphism TLR6_C745T (P249S) was associated with increased BCG-induced IFN-γ in both discovery (n = 240) and validation (n = 240) cohorts. In secondary analyses of the combined cohort, TLR1_T1805G (I602S) and TLR6_G1083C (synonymous) were associated with increased IFN-γ, TLR6_G1083C and TLR6_C745T were associated with increased IL-2, and TLR1_A1188T was associated with increased IFN-γ and IL-2. For each of these polymorphisms, the hypo-responsive allele, as defined by innate immunity signaling assays, was associated with increased production of TH1-type T cell cytokines (IFN-γ or IL-2). After stimulation with TLR1/6 lipopeptide ligands, PBMCs from TLR1/6-deficient individuals (stratified by TLR1_T1805G and TLR6_C745T hyporesponsive genotypes) secreted lower amounts of IL-6 and IL-10 compared to those with responsive TLR1/6 genotypes. In contrast, no IL-12p70 was secreted by PBMCs or monocytes. These data support a mechanism where TLR1/6 polymorphisms modulate TH1 T-cell polarization through genetic regulation of monocyte IL-10 secretion in the absence of IL-12. These studies provide evidence that functionally defined innate immune gene variants are associated with the development of adaptive immune responses after in vivo vaccination against a bacterial pathogen in humans. These findings could potentially guide novel adjuvant vaccine strategies as well as have implications for IFN-γ-based diagnostic testing for TB.
Open Access
BCG-specific T cell proliferation and cytotoxic capacity in infants as risk of tuberculosis disease, following newborn BCG vaccination
(2014) Keyser, Alana; Hanekom, Willem A; Scriba, Thomas
BCG is the only vaccine against tuberculosis and has been used for over 90 years. BCG efficacy is variable, especially in countries with high TB prevalence, where over a million deaths due to tuberculosis, are still reported annually. New TB vaccines are under development to either replace or boost the BCG vaccine. However, our understanding of the immune response required for protection against TB disease, remains inadequate. Identification of a protective immune response is only possible in a clinical trial of an efficacious vaccine, allowing comparison of vaccine-induced immune responses in protected and unprotected individuals. In the absence of such a vaccine, as is the case with TB, we can only explore biomarkers of risk of disease. The most commonly measured outcomes of anti-mycobacterial immunity in clinical trials, specific Th1 cells, are typically thought to be protective in TB. However, to date, human mycobacteria-specific Th1 responses have not correlated with risk of TB disease. New approaches are urgently required to identify other factors at play in conferring protection against TB. In this thesis, we explored BCG-specific cytotoxic T cells as candidate correlates of risk of TB disease in BCG-vaccinated infants. We hypothesized that reduced production of cytotoxic molecules by T cells in response to BCG are associated with risk of developing TB disease. We designed a case/control study nested within a large trial of newborn BCG-vaccination.Blood was collected at 10 weeks and infants, were followed up for two years.We compared outcomes in infants ultimately diagnosed with TB (at risk of TB disease) and two groups of healthy infants (not at risk of TB disease), the first group had household contact with TB cases, the second group were randomly selected from the community, which is endemic for TB. Amongst these groups, we designated a training and a test cohort to allow validation of candidate correlates of risk of TB.
Open Access
The candidate TB vaccine, MVA85A, induces highly durable Th1 responses
(Public Library of Science, 2014) Tameris, Michele; Geldenhuys, Hennie; Luabeya, Angelique KanyKany; Smit, Erica; Hughes, Jane E; Vermaak, Samantha; Hanekom, Willem A; Hatherill, Mark; Mahomed, Hassan; McShane, Helen; Scriba,Thomas J
BACKGROUND: Vaccination against tuberculosis (TB) should provide long-term protective immunity against Mycobacterium tuberculosis ( M.tb ). The current TB vaccine, Bacille Calmette-Guerin (BCG), protects against disseminated childhood TB, but protection against lung TB in adolescents and adults is variable and mostly poor. One potential reason for the limited durability of protection may be waning of immunity through gradual attrition of BCG-induced T cells. We determined if a MVA85A viral-vector boost could enhance the durability of mycobacteria-specific T cell responses above those induced by BCG alone. METHODS: We describe a long-term follow-up study of persons previously vaccinated with MVA85A. We performed a medical history and clinical examination, a tuberculin skin test and measured vaccine-specific T cell responses in persons previously enrolled as adults, adolescents, children or infants into three different Phase II trials, between 2005 and 2011. RESULTS: Of 252 potential participants, 183 (72.6%) consented and completed the study visit. Vaccine-induced Ag85A-specific CD4+ T cell responses were remarkably persistent in healthy, HIV-uninfected adults, adolescents, children and infants, up to 6 years after MVA85A vaccination. Specific CD4+ T cells expressed surface markers consistent with either CD45RA−CCR7+ central memory or CD45RA−CCR7− effector memory T cells. Similarly durable Ag85A-specific CD4+ T cell responses were detected in HIV-infected persons who were on successful antiretroviral therapy when MVA85A was administered. By contrast, Ag85A-specific CD4+ T cell frequencies in untreated MVA85A-vaccinated HIV-infected persons were mostly undetectable 3-5 years after vaccination. CONCLUSION: MVA85A induces remarkably durable T cell responses in immunocompetent persons. However, results from a recent phase IIb trial of MVA85A, conducted in infants from the same geographic area and study population, showed no vaccine efficacy, suggesting that these durable T cell responses do not enhance BCG-induced protection against TB in infants.
Open Access
CD8+ T-cell interleukin-7 receptor alpha expression as a potential indicator of disease status in HIV-infected children
(Public Library of Science, 2008) Sharma, Tanvi S; Hughes, Jane; Murillo, Amarylis; Riley, Joanne; Soares, Andreia; Little, Francesca; Mitchell, Charles D; Hanekom, Willem A
BACKGROUND: Initiation and modification of antiretroviral therapy in HIV-infected children depend on viral load and CD4+ T-cell count. However, these surrogates have limitations, and complementary immunological markers to assess therapeutic response are needed. Our aim was to evaluate CD8+ T-cell expression of CD127 as a marker of disease status in HIV-infected children, based on adult data suggesting its usefulness. We hypothesized that CD127 expression on CD8+ T-cells is lower in children with more advanced disease. METHODS: In a cross-sectional evaluation, we used flow cytometry to measure CD127+ expression on CD8+ T-cells in whole blood from HIV-infected children with varying disease status. This was compared with expression of CD38 on this subset, currently used in clinical practice as a marker of disease status. RESULTS: 51 HIV-infected children were enrolled. There was a strong positive correlation between CD127 expression on CD8+ T-cells and CD4+ T-cell count, and height and weight z-scores, and a strong negative correlation between CD127 expression and viral load. In contrast, we found no association between CD38 expression and these disease status markers. CONCLUSIONS: CD8+ T-cell CD127 expression is significantly higher in children with better HIV disease control, and may have a role as an immunologic indicator of disease status. Longitudinal studies are needed to determine the utility of this marker as a potential indicator of HIV disease progression.
Open Access
Changes in the BCG-Induced T cell response over the first year of life
(2011) Soares, Andreia; Hanekom, Willem A
Bacille Calmette-Guerin (BCG), the only currently available tuberculosis vaccine, is the most widely administered vaccine in the Expanded Programme on Immunisation (EPI). Despite this, many gaps in our knowledge of BCG-induced T cell responses exist. The primary objective of this study was to comprehensively delineate T cell immunity induced by BCG vaccination of newborns and to longitudinally assess BCG-specific T cell responses over the first year of life.
Open Access
Characterisation of the T cell responses induced by BCG in infants over the first year of life
(2011) Kwong Chung, Cheong Kwet Choy; Hanekom, Willem A
Mycobacterium bovis Bacille Calmette Guerin (BCG) is the only licensed tuberculosis (TB) vaccine. Despite the immunisation of 3 billion individuals with this vaccine, TB remains a major cause of mortality worldwide. Therefore, there is an urgent need for more effective TB vaccines. BCG is likely to remain central to future TB prevention strategies, which could include a BCG prime at birth, followed by boosts with novel TB vaccines within the first year of life, or at later ages. Therefore, a comprehensive understanding of BCG induced immunity is required for the successful design and implementation of novel TB vaccination strategies. This was addressed in the following two studies.The aim of the first study was to characterise specific T cell immunity following BCG vaccination. These data are critical to determine when to optimally boost BCG induced immunity in infants. We enrolled infants routinely vaccinated with BCG at birth, and determined the frequency of T cells induced by immunisation, at various time points over the first year of life. The T cells were identified by binding of cell surface markers and characterised by cell-specific cytokine production, following 12 hr incubation of infant whole blood with BCG. Multiparameter flow cytometry was used for the analysis. We found that the peak vaccine induced CD4+ T cell response occurred at 10 weeks, followed by a contraction phase. BCG specific CD4+ T cells became more poly functional, and acquired the profile of long-lived T cells (measured by Bcl-2 expression), over the first year of life.
Open Access
Characterization of CD8 T cell responses in Mycobacterium Tuberculosis infection
(2011) Moshi, Noell Dominika; Day, Cheryl; Hanekom, Willem A
The aim of this project was to compare the breadth and magnitude of CFP10 and ESAT6-specific CD8 T cell responses in individuals with latent Mycobacterium tuberculosis (MTB) infection (LTBI) and active TB disease, and further define MTB-specific CD8 T cell phenotypes associated with latent infection and active disease. Ex vivo IFN? Elispots and proliferation assays were used to identify immunodominant ESAT6 and CFP10 15mer peptides targeted by CD8 T cells in LTBI and TB donors. A multiparameter flow cytometry panel was designed and optimized to assess turnover, susceptibility to apoptosis and terminal differentiation/senescence in CD8 T cells from TB and LTBI donors. Bcl-2, Ki67,CD95, CD57, CD127 and IFNγ were thus measured in each group.
Open Access
A comparative analysis of polyfunctional T cells and secreted cytokines induced by Bacille Calmette-Guerin immunisation in children and adults
(Public Library of Science, 2012) Ritz, Nicole; Strach, Madeleine; Yau, Carmen; Dutta, Binita; Tebruegge, Marc; Connell, Tom G; Hanekom, Willem A; Britton, Warwick J; Robins-Browne, Roy; Curtis, Nigel
BCG vaccine is one of the most commonly-administered vaccines worldwide. Studies suggest the protective efficacy of BCG against TB is better for children than for adults. One potential explanation is that BCG induces a better protective immune response in children. Twenty six children and adults were immunised with BCG. The proportion of Th1-cytokine-producing mycobacterial-specific T cells, and the concentrations of secreted cytokines, were measured before and 10 weeks after BCG immunisation. A significant increase in the proportion of mycobacterial-specific cytokine-producing T cells was observed in both age groups. After BCG immunisation, children and adults had comparable proportions of mycobacterial-specific polyfunctional CD4 T cells when measured relative to the total number of CD4 T cells. However, relative to the subset of Th-1-cytokine-producing CD4 T cells, the proportion of polyfunctional cells was greater in children. Concentrations of secreted cytokines were comparable in children and adults. These findings suggest that the mycobacterial-specific cell-mediated immune response induced by BCG immunisation in children and adults is similar. The implication of a shift to a more polyfunctional immune response within the Th1-cytokine-producing CD4 T cells in children is uncertain as this aspect of the immune response has not been assessed as a potential correlate of protection against TB.
Open Access
Comparison of immune responses induced by Bacillus calmette-Guerin when given at birth or at 6 weeks of age in Ugandan Infants
(2014) Lutwama, Fredrick; Hanekom, Willem A; Kagina, Benjamin Mugo; Day, Cheryl; Mayanja-Kizza, Harriet
In Uganda, infants delivered at a health care facility receive the tuberculosis vaccine Bacillus Calmette-Guerin (BCG) on the first day of life. Infants delivered at home receive BCG at their first health care facility visit at 6 weeks of age. Our aim was to determine the effect of this delay in BCG administration on the induced immune response. Our hypothesis was that infants who received BCG at 6 weeks of age would show an enhanced BCG-induced T cell immunity compared to infants vaccinated at birth. We optimised several polychromatic flow cytometry reagent panels to compare BCG-specific immunity in 9 months-old infants who had received the vaccine either at birth or at 6 weeks of age. We used a 12-hour whole blood intracellular cytokine/cytotoxic marker assay to measure T cell-associated cytokine expression and memory phenotypes. We also compared the capacity of BCGspecific T cells to proliferate and produce cytokines upon antigenic stimulation with a 6-day proliferation assay. Finally, we measured plasma soluble cytokines levels in the two groups of infant using multiplex assay. We enrolled 92 infants: 50 had received BCG at birth and 42 at 6 weeks of age. BCG induced predominantly CD4⁺ T cell responses, and lesser CD8⁺ T cell responses, in both groups. Birth vaccination was associated with greater induction of CD4⁺ and CD8⁺ T cells expressing either IFN-γ alone, or IFN-γ together with perforin, compared with delayed vaccination. Further, birth vaccination induced proliferating cells that had greater capacity to produce IFN-γ, TNF-α and IL-2 together, compared with delayed vaccination. In conclusion, distinct patterns of T cell induction occurred when BCG was given at birth and at 6 weeks of age. We propose that this diversity might impact protection against tuberculosis. Our results differ from those of delayed BCG vaccination studies in South Africa and the Gambia, suggesting geographical and population heterogeneity may affect BCG-induced T cell response.
Open Access
Correlates of risk of TB disease in infants with differential response to BCG vaccination
(2014) Njikan, Samuel Ayaba; Hanekom, Willem A; Nemes, Elisa; Scriba, Thomas J
Studying prospective immune correlates of risk of TB disease following BCG vaccination is an important first step towards determining correlates of protection against TB, which can be identified only in a placebo-controlled randomized controlled trial (RCT) of an effective vaccine. To study correlates of risk of TB disease, we collected and stored blood from healthy 10-week old infants vaccinated with BCG at birth. During two years of follow up, infants who developed lung TB were defined as cases, while those who did not develop TB disease were defined as controls. We measured Th1/Th17 cytokine production by BCG-specific T cells, release of pro- and anti-inflammatory mediators, cytotoxic T cell potential and proliferation in response to BCG as potential correlates of risk of TB disease but none of these outcomes were different between cases and controls. However, transcriptional profiling of PBMC revealed two clusters of infants and interestingly, the gene expression profiles from cases and controls in the two clusters were in opposite directions. Based on this, we hypothesised that analysing the two clusters of infants separately will allow discovery of correlates of risk of TB, which were absent when clustering was not taken into account.
Open Access
Determinants of innate immune responses to mycobacteria
(2012) Shey, Muki Shehu; Hanekom, Willem A; Scriba, Thomas J
Innate cells such as macrophages, monocytes, myeloid dendritic cells and granulocytes recognise mycobacteria and initiate immune responses such as phagocytosis, cytokine production and expression of maturation markers. The type and magnitude of innate responses to mycobacteria may determine the subsequent adaptive responses generated. Our aims were to determine maturational changes in innate immune responses to mycobacteria over the first 9 months of life, and to assess effects of genetic variations in toll-like receptors on host responses to mycobacteria. This knowledge is important for designing rational strategies for vaccination against tuberculosis.
Open Access
Development of novel T cell assays and assessment of immune recognition to latency associated M.tuberculosis-specific antigens Rv2660 and Rv2659
(2010) Govender, Lerisa; Hanekom, Willem A; Abel, Brian
Nearly 130 years have elapsed since the discovery of Mycobacterium tuberculosis (M.tb), the causative agent of tuberculosis, yet today it is estimated that 1 in every 3 of the worldʼs population is infected with this pathogen. In South Africa alone there were approximately 1000 new TB cases per 100 000 population in 2007, ranking the country second in incidence rate, globally. Hence research into new vaccine strategies to control the epidemic is vital. Current vaccines under development are prophylactic and designed to boost pre-existing immunity induced by the only licensed TB vaccine, BCG. A new approach is the development of a post-infection vaccine aimed at inducing an immune response that prevents progression to TB disease when administered to individuals latently infected with M.tb. This vaccine would have a dramatic impact on the worldwide TB burden. Our objective was to address 2 areas in TB vaccinology, firstly a novel postinfection TB vaccine strategy, and secondly, optimal measurement of vaccineinduced responses using a new immunological assay. The aim of the first study was to investigate human T cell responses to antigens that have been associated with M.tb latency. Rv2660 and Rv2659 were investigated, as these antigens are candidate antigens for a postinfection vaccine based on findings from in vitro models of M.tb suggesting preferential expression during latency in vivo. No information exists on the immune response to these antigens in M.tb infected or TB diseased individuals. Hence, we investigated the immune recognition of Rv2660 and Rv2659 in these 2 groups, and further characterised the nature of these antigen-specific T cell responses. We observed that (i) these antigens are significantly more likely to be recognised during M.tb infection compared with TB disease as shown by measurement of soluble IFN-γ in response to the specific antigens, (ii) M.tb infected persons had greater Rv2660- and Rv2659- specific CD4+ T cell proliferation and associated cytokine expression compared, with TB diseased persons. We propose that Rv2660 and Rv2659 may be candidates for incorporation into a post-infection vaccine.
Open Access
The effect of birth weight and gestational age on BCG-induced immune responses in infants following BCG vaccination
(2010) Dube, Frederick; Hanekom, Willem A
Bacillus Calmette?Gu?rin (BCG), the only currently licensed tuberculosis (TB) vaccine, provides variable efficacy. Despite the use of BCG, TB remains a global health problem. BCG is administered at birth; however, more than 15% of infants are born preterm [PT (<37 weeks gestation)], or have low birth weights [LBW (<2,500g)], with >90% of these born in developing countries, where the majority of TB cases are found. It is not known how birth weight at the time of vaccination may affect the BCG-induced immune response and subsequent protection against TB. We hypothesised that BCG-vaccinated PT and LBW infants would have a qualitatively and quantitatevely less optimal immune response, compared to term or normal birth weight (NBW) infants.
Open Access
Evaluation of Xpert® MTB/RIF assay in induced sputum and gastric lavage samples from young children with suspected tuberculosis from the MVA85A TB vaccine trial
(Public Library of Science, 2015) Bunyasi, Erick Wekesa; Tameris, Michele; Geldenhuys, Hennie; Schmidt, Bey-Marrie; Luabeya, Angelique Kany Kany; Mulenga, Humphrey; Scriba, Thomas J; Hanekom, Willem A; Mahomed, Hassan; McShane, Helen
Objective Diagnosis of childhood tuberculosis is limited by the paucibacillary respiratory samples obtained from young children with pulmonary disease. We aimed to compare accuracy of the Xpert ® MTB/RIF assay, an automated nucleic acid amplification test, between induced sputum and gastric lavage samples from young children in a tuberculosis endemic setting. METHODS: We analyzed standardized diagnostic data from HIV negative children younger than four years of age who were investigated for tuberculosis disease near Cape Town, South Africa [2009-2012]. Two paired, consecutive induced sputa and early morning gastric lavage samples were obtained from children with suspected tuberculosis. Samples underwent Mycobacterial Growth Indicator Tube [MGIT] culture and Xpert MTB/RIF assay. We compared diagnostic yield across samples using the two-sample test of proportions and McNemar's χ 2 test; and Wilson's score method to calculate sensitivity and specificity. RESULTS: 1,020 children were evaluated for tuberculosis during 1,214 admission episodes. Not all children had 4 samples collected. 57 of 4,463[1.3%] and 26 of 4,606[0.6%] samples tested positive for Mycobacterium tuberculosis on MGIT culture and Xpert MTB/RIF assay respectively. 27 of 2,198[1.2%] and 40 of 2,183[1.8%] samples tested positive [on either Xpert MTB/RIF assay or MGIT culture] on induced sputum and gastric lavage samples, respectively. 19/1,028[1.8%] and 33/1,017[3.2%] admission episodes yielded a positive MGIT culture or Xpert MTB/RIF assay from induced sputum and gastric lavage, respectively. Sensitivity of Xpert MTB/RIF assay was 8/30[26.7%; 95% CI: 14.2-44.4] for two induced sputum samples and 7/31[22.6%; 11.4-39.8] [p = 0.711] for two gastric lavage samples. Corresponding specificity was 893/893[100%;99.6-100] and 885/890[99.4%;98.7-99.8] respectively [p = 0.025]. CONCLUSION: Sensitivity of Xpert MTB/RIF assay was low, compared to MGIT culture, but diagnostic performance of Xpert MTB/RIF did not differ sufficiently between induced sputum and gastric lavage to justify selection of one sampling method over the other, in young children with suspected pulmonary TB. Trial Registration ClinicalTrials.gov NCT00953927
Open Access
Genetic variation in TLR genes in Ugandan and South African populations and comparison with HapMap data
(Public Library of Science, 2012) Baker, Allison R; Qiu, Feiyou; Randhawa, April Kaur; Horne, David J; Adams, Mark D; Shey, Muki; Barnholtz-Sloan, Jill; Mayanja-Kizza, Harriet; Kaplan, Gilla; Hanekom, Willem A; Boom, W Henry; Hawn, Thomas R; Stein, Catherine M
Genetic epidemiological studies of complex diseases often rely on data from the International HapMap Consortium for identification of single nucleotide polymorphisms (SNPs), particularly those that tag haplotypes. However, little is known about the relevance of the African populations used to collect HapMap data for study populations conducted elsewhere in Africa. Toll-like receptor (TLR) genes play a key role in susceptibility to various infectious diseases, including tuberculosis. We conducted full-exon sequencing in samples obtained from Uganda (n = 48) and South Africa (n = 48), in four genes in the TLR pathway: TLR2, TLR4, TLR6, and TIRAP. We identified one novel TIRAP SNP (with minor allele frequency [MAF] 3.2%) and a novel TLR6 SNP (MAF 8%) in the Ugandan population, and a TLR6 SNP that is unique to the South African population (MAF 14%). These SNPs were also not present in the 1000 Genomes data. Genotype and haplotype frequencies and linkage disequilibrium patterns in Uganda and South Africa were similar to African populations in the HapMap datasets. Multidimensional scaling analysis of polymorphisms in all four genes suggested broad overlap of all of the examined African populations. Based on these data, we propose that there is enough similarity among African populations represented in the HapMap database to justify initial SNP selection for genetic epidemiological studies in Uganda and South Africa. We also discovered three novel polymorphisms that appear to be population-specific and would only be detected by sequencing efforts.
Open Access
Human newborn bacille Calmette–Guérin vaccination and risk of tuberculosis disease: a case-control study
(2016) Fletcher, Helen A; Filali-Mouhim, Ali; Nemes, Elisa; Hawkridge, Anthony; Keyser, Alana; Njikan, Samuel; Hatherill, Mark; Scriba, Thomas J; Abel, Brian; Kagina, Benjamin M; Veldsman, Ashley; Agudelo, Nancy Marín; Kaplan, Gilla; Hussey, Gregory D; Sekaly, Rafick-Pierre; Hanekom, Willem A
: An incomplete understanding of the immunological mechanisms underlying protection against tuberculosis (TB) hampers the development of new vaccines against TB. We aimed to define host correlates of prospective risk of TB disease following bacille Calmette-Guérin (BCG) vaccination. : In this study, 5,726 infants vaccinated with BCG at birth were enrolled. Host responses in blood collected at 10 weeks of age were compared between infants who developed pulmonary TB disease during 2 years of follow-up (cases) and those who remained healthy (controls). : Comprehensive gene expression and cellular and soluble marker analysis failed to identify a correlate of risk. We showed that distinct host responses after BCG vaccination may be the reason: two major clusters of gene expression, with different myeloid and lymphoid activation and inflammatory patterns, were evident when all infants were examined together. Cases from each cluster demonstrated distinct patterns of gene expression, which were confirmed by cellular assays. : Distinct patterns of host responses to Mycobacterium bovis BCG suggest that novel TB vaccines may also elicit distinct patterns of host responses. This diversity should be considered in future TB vaccine development.
Open Access
Inflammatory and myeloid-associated gene expression before and one day after infant vaccination with MVA85A correlates with induction of a T cell response
(2014-06-09) Matsumiya, Magali; Harris, Stephanie A; Satti, Iman; Stockdale, Lisa; Tanner, Rachel; O’Shea, Matthew K; Tameris, Michelle; Mahomed, Hassan; Hatherill, Mark; Scriba, Thomas J; Hanekom, Willem A; McShane, Helen; Fletcher, Helen A
Abstract Background Tuberculosis (TB) remains a global health problem, with vaccination likely to be a necessary part of a successful control strategy. Results of the first Phase 2b efficacy trial of a candidate vaccine, MVA85A, evaluated in BCG-vaccinated infants were published last year. Although no improvement in efficacy above BCG alone was seen, cryopreserved samples from this trial provide an opportunity to study the immune response to vaccination in this population. Methods We investigated blood samples taken before vaccination (baseline) and one and 28 days post-vaccination with MVA85A or placebo (Candin). The IFN-γ ELISpot assay was performed at baseline and on day 28 to quantify the adaptive response to Ag85A peptides. Gene expression analysis was performed at all three timepoints to identify early gene signatures predictive of the magnitude of the subsequent adaptive T cell response using the significance analysis of microarrays (SAM) statistical package and gene set enrichment analysis. Results One day post-MVA85A, there is an induction of inflammatory pathways compared to placebo samples. Modules associated with myeloid cells and inflammation pre- and one day post-MVA85A correlate with a higher IFN-γ ELISpot response post-vaccination. By contrast, previous work done in UK adults shows early inflammation in this population is not associated with a strong T cell response but that induction of regulatory pathways inversely correlates with the magnitude of the T cell response. This may be indicative of important mechanistic differences in how T cell responses develop in these two populations following vaccination with MVA85A. Conclusion The results suggest the capacity of MVA85A to induce a strong innate response is key to the initiation of an adaptive immune response in South African infants but induction of regulatory pathways may be more important in UK adults. Understanding differences in immune response to vaccination between populations is likely to be an important aspect of developing successful vaccines and vaccination strategies. Trial registration ClinicalTrials.gov number NCT00953927
Open Access
Mycobacterium tuberculosis peptides presented by HLA-E molecules are targets for human CD8 T-cells with cytotoxic as well as regulatory activity
(Public Library of Science, 2010) Joosten, Simone A; van Meijgaarden, Krista E; van Weeren, Pascale C; Kazi, Fatima; Geluk, Annemieke; Savage, Nigel D L; Drijfhout, Jan W; Flower, Darren R; Hanekom, Willem A; Klein, Michèl R
Tuberculosis (TB) is an escalating global health problem and improved vaccines against TB are urgently needed. HLA-E restricted responses may be of interest for vaccine development since HLA-E displays very limited polymorphism (only 2 coding variants exist), and is not down-regulated by HIV-infection. The peptides from Mycobacterium tuberculosis (Mtb) potentially presented by HLA-E molecules, however, are unknown. Here we describe human T-cell responses to Mtb-derived peptides containing predicted HLA-E binding motifs and binding-affinity for HLA-E. We observed CD8+ T-cell proliferation to the majority of the 69 peptides tested in Mtb responsive adults as well as in BCG-vaccinated infants. CD8+ T-cells were cytotoxic against target-cells transfected with HLA-E only in the presence of specific peptide. These T cells were also able to lyse M. bovis BCG infected, but not control monocytes, suggesting recognition of antigens during mycobacterial infection. In addition, peptide induced CD8+ T-cells also displayed regulatory activity, since they inhibited T-cell proliferation. This regulatory activity was cell contact-dependent, and at least partly dependent on membrane-bound TGF-β. Our results significantly increase our understanding of the human immune response to Mtb by identification of CD8+ T-cell responses to novel HLA-E binding peptides of Mtb, which have cytotoxic as well as immunoregulatory activity.
Open Access
Patients with tuberculosis disease have Mycobacterium tuberculosis-specific CD8 T cells with a pro-apoptotic phenotype and impaired proliferative capacity, which is not restored following treatment
(Public Library of Science, 2014) Day, Cheryl L; Moshi, Noella D; Abrahams, Deborah A; Van Rooyen, Michele; O'rie, Terrence; De Kock, Marwou; Hanekom, Willem A
CD8 T cells play a critical role in control of chronic viral infections; however, the role of these cells in containing persistent bacterial infections, such as those caused by Mycobacterium tuberculosis (Mtb), is less clear. We assessed the phenotype and functional capacity of CD8 T cells specific for the immunodominant Mtb antigens CFP-10 and ESAT-6, in patients with pulmonary tuberculosis (TB) disease, before and after treatment, and in healthy persons with latent Mtb infection (LTBI). In patients with TB disease, CFP-10/ESAT-6-specific IFN-γ + CD8 T cells had an activated, pro-apoptotic phenotype, with lower Bcl-2 and CD127 expression, and higher Ki67, CD57, and CD95 expression, than in LTBI. When CFP-10/ESAT-6-specific IFN-γ + CD8 T cells were detectable, expression of distinct combinations of these markers was highly sensitive and specific for differentiating TB disease from LTBI. Successful treatment of disease resulted in changes of these markers, but not in restoration of CFP-10/ESAT-6-specific CD8 or CD4 memory T cell proliferative capacity. These data suggest that high mycobacterial load in active TB disease is associated with activated, short-lived CFP-10/ESAT-6-specific CD8 T cells with impaired functional capacity that is not restored following treatment. By contrast, LTBI is associated with preservation of long-lived CFP-10/ESAT-6-specific memory CD8 T cells that maintain high Bcl-2 expression and which may readily proliferate.