Generalized urticaria induced by the Na-ASP-2 hookworm vaccine: implications for the development of vaccines against helminths

Albert B. Sabin Vaccine Institute. Washington, DC, USA/George Washington University. Department of Microbiology, Immunology and Tropical Medicine. Washington, DC, USA/ Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, Brazil
Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, Brazil
Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, Brazil
Albert B. Sabin Vaccine Institute. Washington, DC, USA
George Washington University. Department of Microbiology, Immunology and Tropical Medicine. Washington, DC, USA/Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, Brazil
Johns Hopkins University School of Medicine. Baltimore, MD, USA
Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, Brazil
James Cook University. Queensland Tropical Health Alliance. Cairns, Australia
James Cook University. Queensland Tropical Health Alliance. Cairns, Australia
James Cook University. Queensland Tropical Health Alliance. Cairns, Australia/Queensland Institute of Medical Research. Brisbane, Australia
Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, Brazil
Albert B. Sabin Vaccine Institute. Washington, DC, USA/ Baylor College of Medicine. Departments of Pediatrics and Molecular Virology and Microbiology. Houston, TX, USA
George Washington University. Department of Microbiology, Immunology and Tropical Medicine. Washington, DC, USA/Fundação Oswaldo Cruz. Centro de Pesquisas René Rachou. Belo Horizonte, MG, Brazil

Abstract

Objective: To assess the safety and immunogenicity of recombinant Na-ASP-2 adjuvanted with Alhydrogel in healthy Brazilian adults previously infected with N americanus. Methods: Participants were randomized to receive Na-ASP-2 or hepatitis B vaccine. Major IgG and IgE epitopes of the Na-ASP-2 molecule were mapped by using sera from these same subjects. Seroepidemiologic studies in adults and children residing in hookworm-endemic areas were conducted to assess the prevalence of IgE responses to Na-ASP-2. Results; Vaccination with a single dose of Na-ASP-2 resulted in generalized urticarial reactions in several volunteers. These reactions were associated with pre-existing Na-ASP-2–specific IgE likely induced by previous hookworm infection. Surveys revealed that a significant proportion of the population in hookworm-endemic areas had increased levels of IgE to Na-ASP-2. Epitope mapping demonstrated sites on the Na-ASP-2 molecule that are uniquely or jointly recognized by IgG and IgE antibodies. Conclusion: Infection with N americanus induces increased levels of total and specific IgE to Na-ASP-2 that result in generalized urticaria on vaccination with recombinant Na-ASP-2. These data advance knowledge of vaccine development for helminths given their propensity to induce strong TH2 responses. Study data highlight the important differences between the immune responses to natural helminth infection and to vaccination with a recombinant helminth antigen.

Keywords

Hookworm
Necator americanus
urticaria
vaccine
Na-ASP-2
IgE

Publisher

American Academy of Allergy

Citation

DIEMERT, David J. et al. Generalized urticaria induced by the Na-ASP-2 hookworm vaccine: implications for the development of vaccines against helminths. Journal of Allergy and Clinical Immunology, v. 130, n.1, p. 169-176, 2012

ISSN

0091-6749
10.1016/j.jaci.2012.04.027

Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/11413

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