Abstract

Enterovirus A71 (EV-A71), the pathogen responsible for the seasonal hand-foot-and-mouth epidemics, can cause significant mortality in infants and young children. The vaccine against EV-A71 could potentially prevent virus-induced neurological complications and mortalities occurring due to the high risk of poliomyelitis-like paralysis and fatal encephalitis. It is known that polysaccharide purified from Ganoderma lucidum (PS-G) can effectively modulate immune function. Here, we used PS-G as an adjuvant with the EV-A71 mucosal vaccine and studied its effects. Our data showed that PS-G-adjuvanted EV-A71 generated significantly better IgA and IgG in the serum, saliva, nasal wash, bronchoalveolar lavage fluid (BALF), and feces. More importantly, these antibodies could neutralize the infectivity of EV-A71 (C2 genotype) and cross-neutralize the B4, B5, and C4 genotypes of EV-A71. In addition, more EV-A71-specific IgA- and IgG- secreting cells were observed with the used of a combination of EV-A71 and PS-G. Furthermore, T-cell proliferative responses and IFN-γ and IL-17 secretions levels were notably increased in splenocytes when the EV-A71 vaccine contained PS-G. We also found that levels of IFN-γ and IL-17 released in Peyer’s patch cells were significantly increased in EV-A71, after it was combined with PS-G. We further demonstrated that both CD4+ and CD8+ T cells were able to generate IFN-γ and IL-17 in the spleen. An easy-accessed model of hybrid hSCARB2+/+/stat-1–/– mice was used for EV-A71 infection and pathogenesis. We infected the mouse model with EV−A71, which was premixed with mouse sera immunized with the EV-A71 vaccine with or without PS-G. Indeed, in the EV-A71 + PS-G group, the levels of VP1-specific RNA sequences in the brain, spinal cord, and muscle decreased significantly. Finally, hSCARB2-Tg mice immunized via the intranasal route with the PS-G-adjuvanted EV-A71 vaccine resisted a subsequent lethal oral EV-A71 challenge. Taken together, these results demonstrated that PS-G could potentially be used as an adjuvant for the EV-A71 mucosal vaccine.

Highlights

  • Enterovirus type A71 (EV-A71) has become the main cause of epidemics such as hand-foot-and-mouth disease (HFMD), acute flaccid paralysis, brainstem encephalitis, and aseptic meningitis, and is associated with severe fatal neurological disorders in infants and children [1,2,3,4]

  • The neutralizing-antibody titer of mice vaccinated with the PSG adjuvant EV-A71 was significantly higher than those of mice immunized with EV-A71 (p < 0.05)

  • We found that the neutralizing-antibody titer in saliva of mice immunized with PSG adjuvant EV-A71 (Figure 2B) was significantly higher than that of mice immunized with RD lysate (p < 0.01) and EV-A71 (p < 0.05)

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Summary

Introduction

Enterovirus type A71 (EV-A71) has become the main cause of epidemics such as hand-foot-and-mouth disease (HFMD), acute flaccid paralysis, brainstem encephalitis, and aseptic meningitis, and is associated with severe fatal neurological disorders in infants and children (under 5 years of age) [1,2,3,4]. EV-A71-associated HFMD outbreaks have been reported worldwide, and hundreds of children have died from serious encephalomyelitis-related complications [2, 4, 7, 8]. It was the first large-scale HFMD outbreak in the AsiaPacific region that caused 1.5 million infections; in 1998, a total of 405 severe cases (including 78 deaths) were reported during the epidemic of HFMD in Taiwan [9]. The precaution measures for the EV-A71 epidemics can only depend on public surveillance

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