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. 2013 Mar 15;31(12):1576-81.
doi: 10.1016/j.vaccine.2013.01.019. Epub 2013 Jan 31.

Potential coverage of a multivalent M protein-based group A streptococcal vaccine

James B Dale  1 , Thomas A Penfound, Boubou Tamboura, Samba O Sow, James P Nataro, Milagritos Tapia, Karen L Kotloff
Affiliations

Potential coverage of a multivalent M protein-based group A streptococcal vaccine

James B Dale et al. Vaccine. .

Abstract

Background: The greatest burden of group A streptococcal (GAS) disease worldwide is due to acute rheumatic fever (ARF) and rheumatic heart disease (RHD). Safe, effective and affordable vaccines designed to prevent GAS infections that trigger ARF could reduce the overall global morbidity and mortality from RHD. The current study evaluated the potential coverage of a new 30-valent M protein-based vaccine using GAS isolates from school children in Bamako, Mali, a population at high risk for the development of RHD.

Methods: The bactericidal activity of rabbit antisera against the 30-valent vaccine was assessed using a collection of GAS isolates recovered during a study of the epidemiology of pharyngitis in Bamako.

Results: Single isolates representing 42 of 67 emm-types, accounting for 85% of the GAS infections during the study, were evaluated. All (14/14) of the vaccine emm-types in the collection were opsonized (bactericidal killing >50%) and 26/28 non-vaccine types were opsonized. Bactericidal activity was observed against 60% of the total emm-types recovered in Bamako, which accounted for 81% of all infections.

Conclusions: Multivalent vaccines comprised of N-terminal M peptides elicit bactericidal antibodies against a broad range of GAS serotypes, indicating that their efficacy may extend beyond the emm-types included in the vaccine.

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Figures

Figure 1
Figure 1
Indirect bactericidal activity of 30-valent GAS vaccine rabbit antiserum against selected isolates of GAS recovered from symptomatic school children in Bamako, Mali. Indirect bactericidal tests were performed using non-immune human blood mixed with the test isolate and either pre-immune serum or 30-valent vaccine antiserum. Bactericidal killing was calculated as described in the text.
Figure 2
Figure 2
Summary of GAS emm-types that showed >50% bactericidal killing in the presence of 30-valent vaccine antisera. Non-vaccine emm-types that were cross-opsonized by the rabbit antisera (solid bars) accounted for 47% of the total GAS in the collection. Together with vaccine emm-types in the collection (open bars), potential coverage of the vaccine could reach 84% of the total GAS recovered (solid circles).
See this image and copyright information in PMC

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