Intranasal immunization with an acellular pertussis vaccine containing a Th1/17 skewing adjuvant, BcfA, improves B. pertussis clearance from the mouse respiratory tract.

Abstract

Abstract Bordetella pertussis is the causative agent of whooping cough, a resurging vaccine-preventable disease. This highly contagious disease is most severe in infants and young children. Current alum-adjuvanted acellular pertussis vaccines (aPV) prevent severe disease but do not prevent nasal carriage and subsequent person-to-person pathogen transmission. The Th1/2 skewed immune response induced by aPV is one potential explanation for this failure. We are testing the hypothesis that modification of current aPV by the addition of an adjuvant, BcfA, that skews immune responses towards the more protective Th1/17 phenotype will improve protection. We also hypothesize that changing the delivery route from intramuscular (i.m) to intranasal (i.n) administration will generate mucosal immunity and further improve protection. In the established mouse model of B. pertussis infection, we found that i.m. immunization of mice with an experimental aPV containing BcfA and alum as the adjuvants significantly reduced bacterial numbers in the lungs compared to an alum-adjuvanted vaccine alone. Further, i.n administration of the BcfA+alum containing vaccine provided better protection against colonization of the trachea and lungs than i.m. immunization. Alum-induced Th2 cytokine responses were reduced by addition of BcfA, and were further reduced by i.n. vaccine delivery. Thus, a revised aPV that includes BcfA, administered i.n, may improve protection against B. pertussis infection compared with current formulations and delivery method.