Abstract
The Bacille Calmette Guérin (BCG) vaccine is the only routine vaccination at birth that effectively induces neonatal T-helper 1 (Th1)-polarized immune responses. The primary cytokine that drives CD4+ T-cell Th1 differentiation is interleukin (IL)-12 p70, a heterodimeric cytokine composed of the IL-12 p35 and IL-12 p40 subunits. We therefore examined the mechanisms involved in BCG vaccine stimulation of IL-12 p35 and p40 production from human umbilical cord (neonatal) cells. We found that BCG bacilli did not upregulate IL-12 p35 mRNA production, but upregulated IL-12 p40 mRNA production in a Toll-like receptor (TLR)2-dependent manner, in human neonatal monocyte-derived dendritic cells (mdDCs). The combination of TLR2 signaling, Type I interferon (IFN), and Type II IFN induced maximal levels of IL-12 p35 and p40 mRNA production in human neonatal mdDCs. The cell-free supernatants of reconstituted BCG vaccine vials contained extracellular mycobacterial (BCG) DNA which could induce IFN-α (Type I IFN) production in human neonatal plasmacytoid dendritic cells (pDCs). BCG bacilli also stimulated human neonatal CD16lo natural killer (NK) cells to produce IFN-γ (Type II IFN) in a TLR2-dependent manner. We have therefore proposed a model where BCG vaccine could stimulate the combination of neonatal conventional DCs (cDCs), pDCs, and CD16lo NK cells to produce optimal neonatal IL-12 p35 and p40 (IL-12 p70) production and subsequent CD4+ T-cell Th1 polarization. An adjuvant that emulates the mechanism by which the BCG vaccine stimulates neonatal IL-12 p35 and p40 production could improve vaccine strategies at birth for protection against intracellular pathogens and toxins.
Highlights
The Bacille Calmette Guérin (BCG) vaccine is given to neonates in most countries to prevent infantile tuberculous meningitis and miliary disease
We found that BCG bacilli did not upregulate IL-12 p35 mRNA production, but upregulated IL-12 p40 mRNA production in a Toll-like receptor (TLR)2-dependent manner, in human neonatal monocyte-derived dendritic cells
We found that BCG stimulation did not upregulate IL-12 p35 mRNA production in human neonatal monocyte-derived dendritic cells (mdDCs) (Fig 1A)
Summary
The Bacille Calmette Guérin (BCG) vaccine is given to neonates in most countries to prevent infantile tuberculous meningitis and miliary disease. It is one of the most widely used vaccines worldwide. The all-cause mortality benefit of neonatal BCG vaccination may be partially related to its ability to induce heterologous Th1-polarizing immune responses during the neonatal period [9,10,11,12]. Neonates and infants generally have reduced IL-12 p70 production and CD4+ T-cell Th1 responses to intracellular pathogens and toxins [15,16,17,18]. Enhanced neonatal Th1-polarized immune responses would be beneficial for combating infections with intracellular pathogens and toxin-producing organisms
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