Adjuvant AS01 induces monocyte activation that favors T cell expansion and diversification in primary human cells

Abstract

Abstract Vaccines are less effective in older adults, and efforts to improve vaccine efficacy generally show limited clinical improvement. However, the vaccine Shingrix, developed by GlaxoSmithKline, is FDA approved and recommended for adults over the age of 50 for the prevention of shingles. Shingrix contains the novel adjuvant AS01 and shows remarkably high (>90%) effectiveness at both preventing shingles and reducing the development of postherpetic neuralgia, even in adults over 80. We seek to examine AS01-induced activation of myeloid cells and determine their impacts on T cell memory differentiation and function in an effort to understand how this vaccine’s high clinical efficacy is produced. We use peripheral blood samples to examine AS01-induced innate immune cell activation, including interactions with T cells once activated. We find that AS01 induces costimulatory marker upregulation and cytokine production in myeloid dendritic cells and monocytes in a synergistic manner, with the most upregulation seen in monocytes. Naïve and memory CD4 T cells incubated with AS01-treated monocytes have increased frequencies of TH17 (CCR6+ CXCR3−) cells and decreased frequencies of TH1 cells compared to controls. Naïve CD4 T cells proliferate more when incubated with AS01-treated monocytes than with controls. AS01-treated monocytes additionally induce 2x less IFN-γ and IL-5 in response to mitogen (SEB) from CD4 T cells, suggesting a modulation of response. We propose that AS01 influences monocytes to diversify the existing memory T cell repertoire and skews naïve T cells towards more cytotoxic phenotypes such as TH17, contributing to greater clinical efficacy in preventing shingles in vivo. Supported by VA Merit grant (CX002060)