A Class I Haemophilus ducreyi Strain Containing a Class II hgbA Allele Is Partially Attenuated in Humans: Implications for HgbA Vaccine Efficacy Trials

Infect Immun. 2019 Jun 20;87(7):e00112-19. doi: 10.1128/IAI.00112-19. Print 2019 Jul.

Abstract

Haemophilus ducreyi causes chancroid and is a major cause of cutaneous ulcers in children. Due to environmental reservoirs, both class I and class II H. ducreyi strains persist in cutaneous ulcer regions of endemicity following mass drug administration of azithromycin, suggesting the need for a vaccine. The hemoglobin receptor (HgbA) is a leading vaccine candidate, but its efficacy in animal models is class specific. Controlled human infection models can be used to evaluate vaccines, but only a class I strain (35000HP) has been characterized in this model. As a prelude to evaluating HgbA vaccines in the human model, we tested here whether a derivative of 35000HP containing a class II hgbA allele (FX548) is as virulent as 35000HP in humans. In eight volunteers infected at three sites with each strain, the papule formation rate was 95.8% for 35000HP versus 62.5% for FX548 (P = 0.021). Excluding doses of FX548 that were ≥2-fold higher than those of 35000HP, the pustule formation rate was 25% for 35000HP versus 11.7% for FX548 (P = 0.0053). By Western blot analysis, FX548 and 35000HP expressed equivalent amounts of HgbA in whole-cell lysates and outer membranes. The growth of FX548 and 35000HP was similar in media containing hemoglobin or hemin. By whole-genome sequencing and single-nucleotide polymorphism analysis, FX548 contained no mutations in open reading frames other than hgbA We conclude that by an unknown mechanism, FX548 is partially attenuated in humans and is not a suitable strain for HgbA vaccine efficacy trials in the model.

Keywords: Haemophilus ducreyi; hemoglobin; vaccines.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Alleles
  • Bacterial Proteins / administration & dosage
  • Bacterial Proteins / genetics*
  • Bacterial Proteins / immunology*
  • Carrier Proteins / administration & dosage
  • Carrier Proteins / genetics*
  • Carrier Proteins / immunology*
  • Chancroid / immunology
  • Chancroid / microbiology
  • Chancroid / prevention & control*
  • Female
  • Haemophilus Vaccines / administration & dosage
  • Haemophilus Vaccines / genetics
  • Haemophilus Vaccines / immunology*
  • Haemophilus ducreyi / genetics
  • Haemophilus ducreyi / immunology*
  • Humans
  • Male
  • Middle Aged
  • Young Adult

Substances

  • Bacterial Proteins
  • Carrier Proteins
  • Haemophilus Vaccines
  • hemoglobin-binding protein, bacteria