Production Of IgG Antibodies Research Articles

Adequate Use of the 4T´s Score As a Primary Screening Tool for Heparin Induced Thrombocytopenia

Introduction:Thrombocytopenia is a common problem in hospitalized patients, which has a diverse etiology. One of the infrequent causes is heparin-induced thrombocytopenia (HIT), a complex immune disorder in which heparin leads to the production of IgG antibodies, targeting platelet factor 4 (PF4). HIT diagnosis is based on a decrease in the platelet count of more than 50% beginning 5 to 10 days after starting heparin, in association with platelet-activating HIT antibodies (screening test), positive functional tests (confirmatory tests), in patients with no alternative causes for thrombocytopenia, necrosis or thrombosis (Figure 1).Most patients admitted to our institution receive unfractionated or low molecular weight heparin for venous thromboembolism prophylaxis. The risk of HIT depends on the type of heparin the patient receives. Even though HIT is rare, we tend to have a high suspicion and low threshold to order laboratory workup for this condition, occasionally without using the 4T«s score (Table 1). The 4T«s score is a validated system with a very high negative predictive value (NPV) of up to 99%, when the score is ²3. The aim of this study is to determine if the 4T«s score has been used appropriately in our institution. It is a very useful tool with a high negative likelihood ratio and using it systematically may decrease unnecessary laboratory testing, consequently decreasing costs and potentially length of stay.Methods:This is a retrospective descriptive study from a single teaching community hospital. Between January and December of 2015, 57 HIT screening tests (PF4 ELISA) were ordered in our institution. We reviewed all of the patient charts to determine their 4T«s score. The patients were divided into low, moderate and high pretest probability based on their score (low probability if ²3, intermediate 4-5, and high if ³6). The data analysis was completed with SPSS software.Results:57 tests were ordered, 5 patient charts did not have enough information to calculate 4T«s score and were excluded. 52 charts were reviewed, 28 patients were male and 24 were female (53 and 46% respectively), and they were between 25 and 89 years of age. 7 (13.4%) did not receive heparin (during current hospitalization or within 100 days), 11 (21.1%) received therapeutic doses of unfractionated heparin, 11 (21.1%) received prophylactic doses of unfractionated heparin, and 23 (44.2%) received prophylactic low molecular weight heparin (enoxaparin). The 4T«s score was calculated for each patient; 40 were low risk, 10 intermediate risk and 2 high risk (76.9, 19.2, 3.8% respectively). All the patients had HIT screening antibodies ordered; only 10 (19.2%) were positive and from those only 1 (1.9%) was confirmed by the serotonin release assay. This confirmed patient had a 4T«s score of 6. Of the 7 tested patients who did not receive heparin, none had a positive screening test (all had 4T«s score of 1 or 2). 35 of the screening tests were ordered by internal medicine residents, 5 by surgical residents, 12 by attending physicians (67.3, 9.6 and 23% respectively).Previous studies validated that a 4T«s score of ²3 can predict negative results for the confirmatory tests. By using theMcNemar«stest for matched pairs, we attempted to determine a cut off for the 4T«s score that would predict a negativeHIT screeningtest. We found that a 4T«s score ²2 predicted a negativeHIT screeningtest, with aNPVof 75% (p=0.0018). Since our study included a small patient cohort and due to the possibility of laboratory work up not being ordered in patients with a low 4T«s score, we suspect theNPVis actually lower than our current finding. A prospective study with a larger cohort of patients would be necessary to confirm these findings.Conclusions:Only 12% of the patients had a 4T«s score ³4 that would warrant laboratory work up, therefore we concluded that PF4 ELISA screening tests have been over utilized in our institution, increasing false positive results, length of stay and cost of hospitalization in patients without a significant risk for HIT. This could be avoided by calculating the 4T«s score before obtaining any further laboratory tests. The 4T«s scoring system has been validated by multiple studies with large cohorts in the past. We will continue to work with our staff, especially the residents, to improve education on HIT and adequate diagnosis, based on current guidelines. [Display omitted] [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Autoimmune Thrombocytopenia in Mice Immunized with Allogeneic Platelets: A Model for Post-Transfusion Purpura (PTP)?

PTP is characterized by profound thrombocytopenia (TP) associated with a strong allo-response against a transfused human platelet antigen (HPA), usually HPA-1a. It is unclear why individuals with PTP develop TP, since their alloantibodies are non-reactive with autologous platelets. We recently studied a patient with PTP in whom, using autologous platelets obtained after recovery, convincing evidence was obtained that TP was caused by GPIIb/IIIa-reactive autoantibodies produced concomitantly with potent alloantibodies specific for platelet antigens HPA-1a and HPA-2a (Am J Hematol 91;848-51, 2016). Sporadic reports by others suggest that production of an autoantibody by an individual mounting an allo-response against a blood cell alloantigen is not rare. We undertook studies to determine whether this phenomenon can be recapitulated in a mouse model that will lend itself to the study of underlying mechanisms.The two most immunogenic platelet glycoproteins (GP), αIIb/β3 integrin (GPIIb/IIIa) and GPIb/IX are closely homologous in various mouse strains. We used available data bases to select strains C57BL/6J, 129S1 and SPRET in which the composition of these glycoproteins (GP) differed maximally between strains. Mice were immunized weekly for 5 weeks with autologous or allogeneic platelets. After 2-3 weeks, 93% of 28 animals produced IgG antibodies (abs) specific for platelets of the donor strain. At 3-4 weeks, 36% also produced abs specific for autologous platelets as shown by an increase in platelet-associated IgG and a significant drop in platelet levels; 70% of these mice had detectable plasma abs that bound to platelets from the recipient strain. Immunoprecipitation studies showed that all abs detected were specific for GPIIb/IIIa despite disparities of only 2-6 amino acids in these GPs between strains. No abs were produced following immunization with autologous platelets. To enhance the observed immune responses, C57BL/6 PKCd KO mice that are defective in development of B cell tolerance were studied. Each of two KO mice immunized with 129S1 platelets produced both allo- and autoantibodies at 3 weeks and became profoundly thrombocytopenic (~10% of normal).These findings show that mice mounting an allo-response against GPIIb/IIIa commonly produce autoantibodies against the same protein, leading to thrombocytopenia, as in PTP experienced by transfused humans. An alloimmune response is usually triggered by a single amino acid disparity between donor and recipient. We propose that in this process, random somatic hypermutation occasionally modifies one or more amino acids in the antigen-combining site of a B cell receptor (BCR) in such a way that recognition of the amino acid that governs allo-antigenicity is lost and specificity for a corresponding autoepitope is gained (Figure 1). Sequencing of allo- and autoantibodies produced following murine cross-species platelet immunization will enable this hypothesis to be formally tested.Molecular characterization of epitopes recognized by alloantibodies in this model are expected to define for the first time in an animal, platelet-specific alloantigen systems comparable to human HPA that can be used to study pathogenesis of PTP and the alloimmune disorder neonatal alloimmune thrombocytopenia (NAIT) under "natural" conditions. [Display omitted] DisclosuresAster:Bloodcenter of Wisconsin: Patents & Royalties: A patent application has been filed on a Method of detecting platelet activating antibodies that cause heparin-induced thrombocytopenia/thrombosis; PCT/US14/62591.

Pneumococcal Polysaccharide Vaccination Elicits IgG Anti-A/B Blood Group Antibodies in Healthy Individuals and Patients with Type I Diabetes Mellitus.

Blood group antibodies are natural antibodies that develop early in life in response to cross-reactive environmental antigens in the absence of antigen encounter. Even later in life structural similarities in saccharide composition between environmental antigens such as bacterial polysaccharides and blood group A/B antigens could lead to changes in serum levels, IgM/IgG isotype, and affinity maturation of blood group anti-A/B antibodies. We addressed the question whether immunization with pneumococcal polysaccharide (PnP) vaccine Pneumo 23 Vaccine "Pasteur Merieux" (Pn23) could have such an effect in patients with type I diabetes mellitus (DM I), an autoimmune disease where an aberrant immune response to microbial antigens likely plays a role. Anti-PnP IgM and IgG responses were determined by ELISA, and the DiaMed-ID Micro Typing System was used to screen anti-A/B antibody titer before and after Pn23 immunization in 28 healthy individuals and 16 patients with DM I. In addition, surface plasmon resonance (SPR) technology using the Biacore® device and a synthetic blood group A/B trisaccharide as the antigen was applied to investigate IgM and IgG anti-A/B antibodies and to measure antibody binding dynamics. All healthy individuals and DM I patients responded with anti-PnP IgM and IgG antibody production 4-6 weeks after Pn23 immunization, while no increase in blood group anti-A/B antibody titer was observed when measured by the DiaMed-ID Micro Typing System. Interestingly, isotype-specific testing by SPR technology revealed an increase in blood group anti-A/B IgG, but not IgM, following Pn23 immunization in both patients and controls. No change in binding characteristics of blood group anti-A/B antibodies could be detected following Pn23 vaccination, supporting the assumption of an increase in IgG antibody titer with no or very little affinity maturation. The study provides evidence for epitope sharing between pneumococcal polysaccharides and blood group ABO antigens, which leads to a booster of blood group anti-A/B antibodies of the IgG isotype after Pn23 immunization in healthy individuals. Manifest autoimmunity such as present in DM I patients has no additional effect on the cross-reactive antibody response against pneumococcal polysaccharides and blood group antigens.

IL-6 promotes the differentiation of a subset of naive CD8+ T cells into IL-21-producing B helper CD8+ T cells.

IL-6 is known to contribute to the differentiation of CD4+ T cells into different subsets of effector T helper cells. Less is known about the potential of IL-6 in regulating CD8+ T cell effector function. Here, we identify IL-6 as a master regulator of IL-21 in effector CD8+ T cells. IL-6 promotes the differentiation of a subset of naive CD8+ T cells that express IL-6R into a unique population of effector CD8+ T cells characterized by the production of high levels of IL-21 and low levels of IFN-γ. Similar to CD4+ T follicular helper (Tfh) cells, IL-21-producing CD8+ T cells generated in the presence of IL-6 directly provide help to B cells to induce isotype switching. CD8+ T cell-derived IL-21 contributes to the production of protective virus-specific IgG antibodies during influenza virus infection. Thus, this study reveals the presence of a new mechanism by which IL-6 regulates antibody production during viral infection, and a novel function of effector CD8+ T cells in the protection against viruses.

The soluble pattern recognition receptor PTX3 links humoral innate and adaptive immune responses by helping marginal zone B cells.

Pentraxin 3 (PTX3) is a fluid-phase pattern recognition receptor of the humoral innate immune system with ancestral antibody-like properties but unknown antibody-inducing function. In this study, we found binding of PTX3 to splenic marginal zone (MZ) B cells, an innate-like subset of antibody-producing lymphocytes strategically positioned at the interface between the circulation and the adaptive immune system. PTX3 was released by a subset of neutrophils that surrounded the splenic MZ and expressed an immune activation-related gene signature distinct from that of circulating neutrophils. Binding of PTX3 promoted homeostatic production of IgM and class-switched IgG antibodies to microbial capsular polysaccharides, which decreased in PTX3-deficient mice and humans. In addition, PTX3 increased IgM and IgG production after infection with blood-borne encapsulated bacteria or immunization with bacterial carbohydrates. This immunogenic effect stemmed from the activation of MZ B cells through a neutrophil-regulated pathway that elicited class switching and plasmablast expansion via a combination of T cell-independent and T cell-dependent signals. Thus, PTX3 may bridge the humoral arms of the innate and adaptive immune systems by serving as an endogenous adjuvant for MZ B cells. This property could be harnessed to develop more effective vaccines against encapsulated pathogens.

ApoA1 and ApoA1-specific self-antibodies in cardiovascular disease

Apolipoprotein A1 (ApoA1) is a main protein moiety in high-density lipoprotein (HDL) particles. Generally, ApoA1 and HDL are considered as atheroprotective. In prooxidant and inflammatory microenvironment in the vicinity to the atherosclerotic lesion, ApoA1/HDL are subjected to modification. The chemical modifications such as oxidation, nitration, etc result in altering native architecture of ApoA1 toward dysfunctionality and abnormality. Neutrophil myeloperoxidase has a prominent role in this mechanism. Neo-epitopes could be formed and then exposed that makes them immunogenic. Indeed, these epitopes may be recognized by immune cells and induce production of proatherogenic ApoA1-specific IgG antibodies. These antibodies are biologically relevant because they are able to react with Toll-like receptor (TLR)-2 and TLR4 in target cells and induce a variety of pro-inflammatory responses. Epidemiological and functional studies underline a prognostic value of ApoA1 self-antibodies for several cardiovascular diseases, including myocardial infarction, acute coronary syndrome, and severe carotid stenosis.

Heterologous Pseudomonas aeruginosa O-antigen delivery using a Salmonella enterica serovar Typhimurium wecA mutant strain

There is a broad interest in adapting live vaccine strains (LVS) for use as recombinant vaccines that can deliver heterologous antigens. The Salmonella enterica serovar Typhimurium SL1344 ΔwecA LVS contains a mutation in wecA that abrogates production of Enterobacterial common antigen. This ΔwecA strain is attenuated in vivo, persistently colonizes the host, and protects against both wild type and cross-Salmonella serovar lethal challenge in a murine model of salmonellosis. Given these characteristics, we hypothesized that the SL1344 ΔwecA strain could be used as a carrier for heterologous antigen expression. To test this hypothesis, SL1344 ΔwecA was engineered to express the Pseudomonas aeruginosa O11 O-antigen gene cluster. Intraperitoneal (IP) but not oral immunization of BALB/c mice with the heterologous expression strain protected against lethal P. aeruginosa intranasal (IN) challenge. Furthermore, IP immunization resulted in P. aeruginosa O11-specific Ig and IgG antibody production. Functional analysis of sera collected from the IP immunized mice showed antibody-mediated agglutination and opsonophagocytic activity against P. aeruginosa. En masse, these results indicate that the S. Typhimurium SL1344 ΔwecA strain expressing the P. aeruginosa O11 O-antigen gene cluster is able to induce a humoral immune response and to protect against lethal P. aeruginosa challenge. As such, the S. Typhimurium SL1344 ΔwecA LVS can likely serve as a vehicle for expression of a wide variety of heterologous antigens as a means to create recombinant vaccines.

IgG4 but no IgG1 antibody production after intralymphatic immunotherapy with recombinant MAT-Feld1 in human.

Allergy immunotherapy (AIT) mediates protection against allergen exposure in part due to allergen-specific antibodies. While immunization typically stimulated IgG1 and IgG2, AIT is often associated with production of IgG4. Here, twenty cat dander-sensitized patients were randomized to receive three injections of intralymphatic immunotherapy (ILIT) with MAT-Feld1 adsorbed to aluminum hydroxide or just aluminum hydroxide (placebo) in a double-blind setting (ClinicalTrials.gov NCT00718679). Whereas the clinical data, showing benefit of Mat-Feld1 ILIT was published in 2012 (Senti et al., J Allergy Clin Immunol, vol 129(5):1290-1296), the current study investigated the cat allergen-specific antibody responses. Blood was drawn prior to ILIT, as well as 1, 3, and 12 months after first ILIT. The sera were analyzed to characterize all IgG subclasses and IgE antibody responses. ILIT with MAT-Feld1 elicited high levels of total IgG that were maintained for at least 12 months. Interestingly, a strong increase in IgG4 and some increase in IgG2 were observed throughout the study, while production of cat-specific IgG1 and IgG3 was not stimulated by MAT-Feld1 ILIT. The IgE levels remained constant.

Specific delivery of an immunosuppressive drug to splenic B cells by antigen-modified liposomes and its antiallergic effect

Background: Use of the reverse targeting drug delivery system (RT-DDS) is a new targeting strategy based on the specific delivery of drugs to immune cells in antigen-sensitized animals by using antigen-modified liposomes, and it is expected to be a curative treatment for allergic diseases.Purpose: Herein, we prepared ovalbumin (OVA)-modified liposomes encapsulating the immunosuppressive drug FK506 (OVA-LipFK) and aimed to demonstrate the delivery selectivity of the liposomes to splenic B cells, and its antiallergic effect in an OVA-sensitized allergic model mouse.Methods: Fluorescently labeled OVA-LipFK was intravenously injected into OVA-sensitized mice, and the intrasplenic localization of liposomes was observed. The antiallergic effect of OVA-LipFK in OVA-sensitized mice was examined by measuring the blood levels of OVA-specific IgE and IgG antibodies.Results and discussion: OVA-LipFK was co-localized to not only B cells but also germinal centers, in the spleen of OVA-sensitized mice. However, there was no accumulation of unmodified liposomes encapsulating FK506 (LipFK) in the splenic B-cell area. In a therapeutic study, OVA-LipFK significantly suppressed the production of both OVA-specific IgE and IgG antibodies in OVA-sensitized mice after the animals had been boosted with OVA, whereas LipFK showed little antiallergic effect.Conclusions: The present study suggested that the introduction of RT-DDS for use with immunosuppressive drugs could be useful for the treatment of allergic diseases.

Coupling Peptide Antigens to Virus-Like Particles or to Protein Carriers Influences the Th1/Th2 Polarity of the Resulting Immune Response.

We have conjugated the S9 peptide, a mimic of the group B streptococcal type III capsular polysaccharide, to different carriers in an effort to elicit an optimal immune response. As carriers, we utilized the soluble protein keyhole limpet hemocyanin and virus-like particles (VLPs) from two plant viruses, Cowpea Chlorotic Mottle Virus and Cowpea Mosaic Virus. We have found that coupling the peptide to the soluble protein elicits a Th2 immune response, as evidenced by the production of the peptide-specific IgG1 antibody and IL-4/IL-10 production in response to antigen stimulation, whereas the peptide conjugated to VLPs elicited a Th1 response (IgG2a, IFN-γ). Because the VLPs used as carriers package RNA during the assembly process, we hypothesize that this effect may result from the presence of nucleic acid in the immunogen, which affects the Th1/Th2 polarity of the response.

Hyaluronic Acid-Modified Cationic Lipid-PLGA Hybrid Nanoparticles as a Nanovaccine Induce Robust Humoral and Cellular Immune Responses.

Here, we investigated the use of hyaluronic acid (HA)-decorated cationic lipid-poly(lactide-co-glycolide) acid (PLGA) hybrid nanoparticles (HA-DOTAP-PLGA NPs) as vaccine delivery vehicles, which were originally developed for the cytosolic delivery of genes. Our results demonstrated that after the NPs uptake by dendritic cells (DCs), some of the antigens that were encapsulated in HA-DOTAP-PLGA NPs escaped to the cytosolic compartment, and whereas some of the antigens remained in the endosomal/lysosomal compartment, where both MHC-I and MHC-II antigen presentation occurred. Moreover, HA-DOTAP-PLGA NPs led to the up-regulation of MHC, costimulatory molecules, and cytokines. In vivo experiments further revealed that more powerful immune responses were induced from mice immunized with HA-DOTAP-PLGA NPs when compared with cationic lipid-PLGA nanoparticles and free ovalbumin (OVA); the responses included antigen-specific CD4(+) and CD8(+) T-cell responses, the production of antigen-specific IgG antibodies and the generation of memory CD4(+) and CD8(+) T cells. Overall, these data demonstrate the high potential of HA-DOTAP-PLGA NPs for use as vaccine delivery vehicles to elevate cellular and humoral immune responses.

Chimeric virus-like particles containing a conserved region of the G protein in combination with a single peptide of the M2 protein confer protection against respiratory syncytial virus infection

To investigate the feasibility and efficacy of a virus-like particle (VLP) vaccine composed of the conserved antigenic epitopes of respiratory syncytial virus (RSV), the chimeric RSV VLPs HBcΔ-tG and HBcΔ-tG/M282-90 were generated based on the truncated hepatitis B virus core protein (HBcΔ). HBcΔ-tG consisted of HBcΔ, the conserved region (aa 144–204) of the RSV G protein. HBcΔ-tG was combined with a single peptide (aa 82–90) of the M2 protein to generate HBcΔ-tG/M282-90. Immunization of mice with the HBcΔ-tG or HBcΔ-tG/M282-90 VLPs elicited RSV-specific IgG and neutralizing antibody production and conferred protection against RSV infection. Compared with HBcΔ-tG, HBcΔ-tG/M282-90 induced decreased Th2 cytokine production (IL-4 and IL-5), increased Th1 cytokine response (IFN-γ, TNF-α, and IL-2), and increased ratios of IgG2a/IgG1 antibodies, thereby relieving pulmonary pathology upon subsequent RSV infection. Our results demonstrated that chimeric HBcΔ-tG/M282-90 VLPs represented an effective RSV subunit vaccine candidate.

Participation of plasmacytoid dendritic cells and NKT cells in the mouse model of lupus induced by non-bilayer phospholipid arrangements

Abstract Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease where animal models are used to study its pathogenesis. We have developed a mouse model of an autoimmune disease that resembles human lupus by the injection of liposomes bearing non-bilayer phospholipid arrangements (NPA). We detected the presence of IgG antibodies against NPA in the serum of mice with lupus and patients with SLE. In this work, we determined by citofluorometry the presence of plasmacytoid dendritic cells (pDC) the main producer of type I interferons, and of NKT cells in the secondary lymphoid organs of mice 30 and 60 days after the injection of liposomes with or without NPA induced with 8 mM promazine. In both groups of mice injected with liposomes bearing NPA a significant increase of pDC cells (5-fold) was found which correlates with the high concentration of type I interferon previously detected in this mouse model of lupus and in patients with SLE. A significant increase of NKT (3-fold) was detected at 30 days, specifically in the NKT subpopulation CD4+ that is known to cooperate with B cells in response of lipid antigens; this increase suggests its probable involvement in adaptive immune responses, which lead to the production of anti-NPA IgG antibodies. The increase of pDC and NKT cells found by cytometry in secondary lymphoid organs in this work, suggests their involvement in the formation of anti-NPA IgG antibodies and the development of the disease resembling human lupus.

284. Long-Term Therapeutic Immune Reconstitution in XSCID Canine Model via In Vivo Foamy Virus Delivery of Common Gamma Chain

X-linked combined immunodeficiency disease (XSCID) is caused by mutation in the common gamma chain, γC (interleukin-2 receptor subunit gamma, IL2RG) in both humans and canines. It is characterized by the inability of T-cell development leading to absence of T-cells in peripheral blood, lack of T-cell mediated immune response, low IgA and IgG levels, and early infant mortality. In the 1990s, human XSCID clinical trials utilizing gamma-retroviral vectors to deliver the IL2RG gene caused leukemia in 5 out of 20 patients due to vector integration in or near proto-oncogenes. Recent studies showed Foamy virus based vectors as an excellent alternative for in vivo gene-therapy because it is non-pathogenic in humans while exhibiting increased serum stability and favorable integration pattern. Previously, we have demonstrated CD3+ T-cell reconstitution in the canine model via intravenous injection of foamy virus expressing human elongation factor-1 alpha promoter (Ef1α)-yC. Unfortunately, the treated animals contained a low number of gene corrected progenitors at a sub-therapeutic level. Here, we achieved long-term therapeutic immune-reconstitution by intravenous delivery of a human phosphoglycerate kinase promoter (Pgk)-mediated γC foamy viral vector into XSCID neonatal canines. Long-term (2 years) post-injection follow-up demonstrated therapeutic levels of CD3+ T-cell expansion. Within the T-cell population, gene correction with Pgk-γC stabilized at ~80%. We validated T-cell functionality by using spectratyping analysis, which exhibited a diverse repertoire of receptor gene rearrangement. Retroviral integration site analysis (RIS) indicated polyclonal contribution to the reconstituted T-cells. Immunoglobulin ELISA assays showed that IgA and IgG levels in peripheral blood are comparable to normal healthy controls. We immunized the gene-corrected canine recipients with bacteriophage ϕx174 and confirmed production of specific IgG antibodies, showing the ability for isotype switching in B-lymphocytes. Currently, the gene-corrected canines exhibit comparable health and physical attributes to normal controls. Furthermore, semen from the gene-corrected male canine was used via artificial insemination to produce a litter of viable offsprings. In summary, our data demonstrate that Pgk-γC foamy viral vector delivered long-term therapeutic gene correction in a large-animal model for XSCID gene therapy. Most importantly, these results indicate that in vivo Pgk-γC foamy vector administration is a viable option for long-term immune reconstitution in future XSCID human clinical trials.

B cells respond via germinal centers to produce anti-lipid IgG antibodies in a murine model of lupus

Abstract Anti-lipid IgG antibodies are produced in some mycobacterial infections and autoimmune diseases (lupus, anti-phospholipid syndrome). However, few studies have addressed the mechanisms that lead to the production of these immunoglobulins. Anti-lipid IgG antibodies are consistently found in a mouse model of lupus induced by chlorpromazine-stabilized non-bilayer phospholipid arrangements (NPA). NPA are transitory lipid associations found in the membrane of most cells; when NPA are stabilized they can become immunogenic and induce specific IgG antibodies, which are involved in the development of the disease. We used this model of lupus to investigate the in vivo mechanisms that lead to the production of anti-lipid IgG antibodies. B cells are activated, in response to most protein antigens, via germinal centers or extrafollicular reactions. In germinal centers, a T cell-dependent response leads to isotype switch, somatic hypermutation, affinity maturation and memory generation, whereas these events do not usually occur in extrafollicular reactions. In this mouse model of lupus induced by chlorpromazine-stabilized NPA, we found plasma cells producing NPA-specific IgGs in the inguinal lymph nodes, the spleen, and bone marrow of mice. We also found a significant number of germinal center B cells specific for NPA in the inguinal lymph nodes and the spleen, and we demonstrated the presence of NPA in these same germinal centers. In contrast, we found very few extrafollicular reaction B cells specific for NPA. Altogether, our data suggest that, in this murine model of lupus, B cells produce anti-NPA IgG antibodies mainly via germinal centers.

696. TLR9 Signaling Mediates Transgene Antibody Formation

Recent success in gene therapy clinical trials have shown great promise towards developing efficacious treatments, however antibody formation to the therapeutic protein resulting in treatment attenuation still remains a concern. Driven by the immunologic stimuli of vector administration, transgene expression can elicit a humoral response against “non-self” protein, as these antigens were not presented during the process of central tolerance induction. Previously, we have shown that TLR9 signaling is necessary to mount a CD8+ T cell response that reduces expression of non-secreted transgene product. Here, we show that TLR9 signaling is also involved in driving the activation of B cells to secrete transgene-specific neutralizing antibody. Delivery of the viral vector and the effect of TRL9, route of administration, and promoter on the immune response to transgene expression was studied using the human IDUA gene, which is mutated in the lysosomal storage disorder, mucopolysaccharidosis type I (MPS I). IV administration of C57Bl/6 mice with AAV9.hIDUA under the control of a universal CMV promoter resulted in the production of neutralizing IgG antibodies and loss of transgene activity measured in serum. Surprisingly, when administered to TLR9 knockout mice, antibody formation was very modest to not detectable and IDUA activity maintained at a steady state. Next, we administered AAV9 vectors with expression driven by different promoters, including the universal promoters, CMV and CB7, and the liver-restricted promoter, TBG. Mice that received vectors containing universal promoters demonstrated elevated IgG to hIDUA, while those with liver-specific expression did not. Co-administration of the TBG- and CMV-containing vectors did not inhibit IgG formation, demonstrating that expression in non-liver tissue drives the immune system to a humoral response, and overcomes the potential tolerogenic effect of liver-specific expression. In ongoing experiments, hIDUA constructs containing CpG motifs that are known to bind efficiently to TLR9 will be used to assess the impact of TLR9 signaling on transgene-specific neutralizing antibody production. Overall, our results suggest that TLR9 signaling is important for the development of anti-transgene antibodies.

Amorphous nanosilica particles block induction of oral tolerance in mice

The mucosal immune system is exposed to non-self antigens in food and the gut microbiota. Therefore, the recognition of orally ingested non-self antigens is suppressed in healthy individuals to avoid excessive immune responses in a process called “oral tolerance”. The breakdown of oral tolerance has been cited as a possible cause of food allergy, and amorphous silica nanoparticles (nSP) have been implicated in this breakdown. As nSP are widely used in foodstuffs and other products, exposure to them is increasing; thus, investigations of any effects of nSP on oral tolerance are urgent. This study evaluated the effects of nSP30 (particle diameter = 39 nm) on immunological unresponsiveness induced in mice with oral ovalbumin (OVA). Specifically, production of OVA-specific antibodies, splenocyte proliferation in response to OVA, and effects on T-helper (TH)-1, TH2, and TH17 responses (in terms of cytokine and IgG/IgE subclass expression) were evaluated. nSP30 increased the levels of OVA-specific IgG in OVA-tolerized mice and induced the proliferation of OVA-immunized splenocytes in response to OVA in a dose-related manner. nSP30 also increased the expression of OVA-specific IgG1, IgE, and IgG2a, indicating stimulation of the TH1 and TH2 responses. The expression of interferon (IFN)-γ (TH1), interleukin (IL)-4 and IL-5 (TH2), and IL-17 (TH17) was also stimulated in a dose-related manner by nSP30 in splenocytes stimulated ex vivo with OVA. The induction of tolerance by OVA, the production of anti-OVA IgG antibodies, and proliferation of splenocytes in response to OVA was inhibited by nSP30 in conjunction with OVA and was dose-related. The nSP30 enhanced TH1 and TH2 responses that might prevent the induction of oral tolerance. Overall, this study showed that the abrogation of OVA-induced oral tolerance in mice by exposure to nSP30 was dose-related and that nSP30 stimulated TH1, TH2, and TH17 responses.

Toxoplasma gondii: Protective immunity induced by a DNA vaccine expressing GRA1 and MIC3 against toxoplasmosis in BALB/c mice

The intracellular parasite Toxoplasma gondii is a major cause of abortion and neonatal loss in livestock, and can cause severe illness to human with weakened immune system. The heavy incidence and severe consequence indicate the development of vaccines against T. gondii is required. In this study, DNA vaccines encoding GRA1 and MIC3 antigens were developed. The parasite-specific immune responses and protection efficiency against toxoplasmosis by these DNA vaccines were evaluated in BALB/c mice. The results demonstrated that the IgG antibody production was significantly increased in multi-antigenic vaccine encoding GRA1 and MIC3 immunized group, as well as the IFN-γ level, when compared with single-gene vaccines and controls groups (p < 0.05). Two weeks after the final vaccination, the mice were challenged with either 1 × 104 or 1 × 102 RH strain tachyzoites, and the mortality and parasite reduction were observed. The multi-antigenic vaccine encoding GRA1 and MIC3 lead to the longest survival time as well as the less parasite-loads in brain and liver of immunized mice (p < 0.01). The present study indicates that the GRA1 and MIC3 showed the potential as target for vaccine investigation against toxoplasmosis. And the immune efficacy induced by multi-antigenic vaccine encoding GRA1 and MIC3 was better than that induced by single-antigenic vaccines alone.

Chronic HIV-1 Infection Induces B-Cell Dysfunction That Is Incompletely Resolved by Long-Term Antiretroviral Therapy.

To determine the effect of long-term antiretroviral therapy (ART) on HIV-1-induced B-cell dysfunction. Comparative study of ART-naive and ART-treated HIV-infected patients with non-HIV controls. B-cell dysfunction was examined in patients with HIV-1 infection (n = 30) who had received ART for a median time of 9.25 years (range: 1.3-21.7) by assessing proportions of CD21 B cells (a marker of B-cell exhaustion) and proportions of tumor necrosis factor-related apoptosis-inducing ligand or B and T lymphocyte attenuator B cells, and serum levels of immunoglobulin free light chains (markers of B-cell hyperactivation). The association of these markers with serum levels of IgG1 and IgG2, and production of IgG antibodies after vaccination with pneumococcal polysaccharides were also examined. ART-naive patients with HIV (n = 20) and controls (n = 20) were also assessed for comparison. ART-treated patients had increased proportions of CD21 and tumor necrosis factor-related apoptosis-inducing ligand B cells and, furthermore, although proportions of B and T lymphocyte attenuator B cells were not significantly different from controls, they correlated negatively with CD21 B cells. Proportions of CD21 B cells also correlated negatively with current CD4 T-cell counts. In ART-naive patients with HIV, free light chains correlated with CD21 B cells and IgG1, but not IgG2. Serum IgG2:IgG1 ratios were substantially lower than normal in patients with HIV and did not resolve on ART. In ART-treated patients, IgG antibody responses to pneumococcal polysaccharides after vaccination were not associated with markers of B-cell dysfunction. B-cell dysfunction persists in patients with HIV receiving long-term ART. The causes and consequences of this require further investigation.

The natural history of acute Q fever: a prospective Australian cohort.

A detailed description of the natural history of acute Q fever, caused by infection with Coxiella burnetii, AIM: : To significantly increase understanding of the illness. Subjects with provisional acute Q fever (n = 115) were recruited from primary care in rural Australia, and followed prospectively by interview and blood collection including for serological confirmation. A nested series of subjects with prolonged illness (cases), and those without (controls), were investigated in detail. Total phase I and phase II anti-C. burnetii antibodies were detected by complement fixation test; and IgG, IgM and IgA phase I and phase II titres by immunofluorescence. Flow cytometric analysis was conducted to enumerate circulating T cells subsets, B cells, monocytes and natural killer cells. Serological testing confirmed acute Q fever in 73 subjects (63%). The acute illness featured fever, headache, sweats, fatigue and anorexia; and varied widely in severity, causing an average of 8 days in bed and 15 days out of work or other role in the first month of illness. The illness course varied from 2 days to greater than a year. No cases of chronic, localized Q fever infection, such as endocarditis, were identified. Neither severe nor prolonged illness were associated with persistence of C. burnetii DNA, altered patterns of C. burnetii-specific IgG, IgM or IgA antibody production, or altered leucocyte subsets. The severity of acute Q fever alone predicted prolonged duration. Further studies are warranted to better understand the pathophysiology of prolonged illness after acute Q fever.