Abstract

Elderly people are at high risk for influenza-related morbidity and mortality due to progressive immunosenescence. While toll-like receptor (TLR) agonist containing adjuvants, and other adjuvants, have been shown to enhance influenza vaccine-induced protective responses, the mechanisms underlying how these adjuvanted vaccines could benefit the elderly remain elusive. Here, we show that a split H1N1 influenza vaccine (sH1N1) combined with a TLR4 agonist, glucopyranosyl lipid adjuvant formulated in a stable oil-in-water emulsion (GLA-SE), boosts IgG2c:IgG1 ratios, enhances hemagglutination inhibition (HAI) titers, and increases protection in aged mice. We find that all adjuvanted sH1N1 vaccines tested were able to protect both young and aged mice from lethal A/H1N1/California/4/2009 virus challenge after two immunizations compared to vaccine alone. We show that GLA-SE combined with sH1N1, however, also provides enhanced protection from morbidity in aged mice given one immunization (based on change in weight percentage). While the GLA-SE-adjuvanted sH1N1 vaccine promotes the generation of cytokine-producing T helper 1 cells, germinal center B cells, and long-lived bone marrow plasma cells in young mice, these responses were muted in aged mice. Differential in vitro responses, dependent on age, were also observed from mouse-derived bone marrow-derived dendritic cells and lung homogenates following stimulation with adjuvants, including GLA-SE. Besides enhanced HAI titers, additional protective factors elicited with sH1N1 + GLA-SE in young mice were observed, including (a) rapid reduction of viral titers in the lung, (b) prevention of excessive lung inflammation, and (c) homeostatic maintenance of alveolar macrophages (AMs) following H1N1 infection. Collectively, our results provide insight into mechanisms of adjuvant-mediated immune protection in the young and elderly.

Highlights

  • Influenza and influenza-related complications are leading causes of death in elderly populations

  • C57BL/6 mice were originally selected as the mouse strain for these studies; our data showed no evidence of HA (A/H1N1/California/4/2009) CD4 T cell epitopes in C57BL/6 mice, whereas CB6F1 mice have a confirmed CD4 T cell epitope

  • We found that young mice that received MF59-like or GLA-SE adjuvanted split H1N1 influenza vaccine (sH1N1) vaccines generated a significant number of antigen-specific Bone Marrow Plasma Cells (BMPCs) (Figure 3E)

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Summary

Introduction

Influenza and influenza-related complications are leading causes of death in elderly populations. Older people exhibit increased morbidity and mortality in response to influenza infection due to uncontrolled respiratory inflammation, severe pneumonia, or multi-organ inflammation and failure [1]. Adjuvanted H1N1 Vaccine Improves Immunity individuals older than 65 years of age who have received influenza vaccines in consecutive years are still at high risk of influenza infection [2]. Immunosenescence causes the attenuation of both innate and adaptive immune systems including reduced levels and function of TLRs in macrophages and plasmacytoid dendritic cells [4, 5], decreased output of naïve B cell numbers [6], severe reduction of thymopoiesis [7], and insufficient immune synapse generation [8]. Defective antigen presentation and reduced T cell and B cell repertoires in aged individuals results in poor cellular, humoral, and vaccineinduced responses

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