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

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Diemert, David J. Pinto, Antonio G. Freire, Janaina Jariwala, Amar Santiago, Helton Hamilton, Robert G. Periago, Maria Victoria Loukas, Alex Tribolet, Leon Mulvenna, Jason Correa-Oliveira, Rodrigo Hotez, Peter J. Bethony, Jeffrey M.
Spatial Coverage	Brazil
Description	Country affiliation: United States Author Affiliation: Diemert DJ ( Albert B. Sabin Vaccine Institute, Washington, DC 20037, USA. david.diemert@sabin.org)
Abstract	BACKGROUND: Necator americanus Ancylostoma-secreted protein 2 (Na-ASP-2) is secreted by infective hookworm larvae on entry into human hosts. Vaccination of laboratory animals with recombinant Na-ASP-2 provides significant protection against challenge infections. In endemic areas antibodies to Na-ASP-2 are associated with reduced risk of heavy N americanus infections. 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 T(H)2 responses. Study data highlight the important differences between the immune responses to natural helminth infection and to vaccination with a recombinant helminth antigen.
File Format	HTM / HTML
ISSN	00916749
e-ISSN	10976825
Journal	Journal of Allergy and Clinical Immunology
Issue Number	1
Volume Number	130
Language	English
Publisher	Elsevier
Publisher Date	2012-07-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Immunology Antigens, Helminth Adverse Effects Helminth Proteins Necator Americanus Immunology Necatoriasis Prevention & Control Urticaria Epidemiology Vaccines, Synthetic Adolescent Animals Administration & Dosage Epitope Mapping Immunoglobulin E Blood Immunoglobulin G Seroepidemiologic Studies Etiology Vaccination Clinical Trial, Phase I Randomized Controlled Trial Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Immunology and Allergy Immunology

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

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