Abstract

In spite of several decades of research, an effective vaccine against schistosomiasis remains elusive. The radiation-attenuated (RA) cercarial vaccine is still the best model eliciting high protection levels, although the immune mechanisms have not yet been fully characterized. In order to identify genes and pathways underlying protection we investigated patterns of gene expression in PBMC and skin draining Lymph Nodes (LN) from mice using two exposure comparisons: vaccination with 500 attenuated cercariae versus infection with 500 normal cercariae; one versus three doses. Vaccinated mice were challenged with 120 normal parasites. Integration of PBMC and LN data from the infected group revealed early up-regulation of pathways associated with Th2 skewing and polarization of IgG antibody profiles. Additionally, hemostasis pathways were downregulated in infected mice, correlating with platelet reduction, potentially a mechanism to assist parasite migration through capillary beds. Conversely, up regulation of such mechanisms after vaccination may explain parasite blockade in the lungs. In contrast, a single exposure to attenuated parasites revealed early establishment of a Th1 bias (signaling of IL-1, IFN-γ; and Leishmania infection). Genes encoding chemokines and their receptors were more prominent in vaccinated mice, indicating an enhanced capacity for inflammation, potentially augmenting the inhibition of intravascular migration. Increasing the vaccinations from one to three did not dramatically elevate protection, but there was a clear shift towards antibody-mediated effectors. However, elements of the Th1 bias were still evident. Notable features after three vaccinations were markers of cytotoxicity (including IL-6 and NK cells) together with growth factors and their receptors (FGFR/VEGF/EGF) and the apoptosis pathway. Indeed, there is evidence for the development of anergy after three vaccinations, borne out by the limited responses detected in samples after challenge. We infer that persistence of a Th1 response puts a limit on expression of antibody-mediated mechanisms. This feature may explain the failure of multiple doses to drive protection towards sterile immunity. We suggest that the secretions of lung stage parasites would make a novel cohort of antigens for testing in protection experiments.

Highlights

  • Schistosomiasis is a debilitating disease caused by flatworms of the genus Schistosoma

  • The results showed the ability of systems biology approach to predict the immunogenicity of these vaccines and revealed new molecular mechanisms involved in immunity

  • Our aim was to seek answers to two key questions concerning the modus operandi of the RA vaccine at the level of host immune gene expression about why: 1) attenuated larvae elicit a protective response while normal larvae do not; 2) multiple exposures to the RA vaccine change the balance from a Th1 to a Th1-Th2 profile but fail to drive protection towards sterile immunity

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Summary

Introduction

Schistosomiasis is a debilitating disease caused by flatworms of the genus Schistosoma It represents a serious public health problem for which various control measures are available but fail to prevent re-infection in endemic areas [1]. In order for schistosomes to establish in the mammalian host, cercariae must penetrate the skin, transform into schistosomula, and migrate in the bloodstream to the hepatic portal venules of the liver. Diagnostics for schistosomiasis are not very sensitive and cannot detect lowlevel infections [2] In this context, an effective vaccine with longterm protective effects via the activation of the immune system would be the ideal tool to prevent this disease [3]. Since the parasite does not replicate in its definitive host, it is evident that even a partial reduction in parasite burden would have an impact on disease morbidity, control and eradication [4]

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