Vaccines for Pseudomonas aeruginosa: a long and winding road

Abstract

Despite the recognition of Pseudomonas aeruginosa as an opportunistic pathogen, no vaccine against this bacteria has come to market. This review describes the current state-of-the-art in vaccinology for this bacterium. This includes a discussion of those at risk for infection, the types of vaccines and the approaches for empirical and targeted antigen selection under development, as well as a perspective on where the field should go. In addition, the challenges in developing a vaccine for those individuals at risk are discussed.

Fig. 1

Key immune mechanisms of selected vaccines for Pseudomonas aeruginosa. Important antibody functions include enhancement of opsonophagocytosis (opsonic antibody, shown to be important for LPS O antigen, alginate, Psl, flagella, and OprI), disruption of the type III secretion system (anti-toxin antibody, shown to be important for PcrV), and interference with binding of OprF to IFN-γ (anti-virulence antibody). T cell mechanisms of protection include IFN-γ secretion (OprF), IL-17 secretion (PopB and live-attenuated vaccines), and GM-CSF secretion (live-attenuated vaccines), which will act in concert with opsonophagocytic antibodies to enhance bacterial clearance.