A feasibility study of controlled human infection with Streptococcus pneumoniae in Malawi



Morton, Ben ORCID: 0000-0002-6164-2854, Burr, Sarah, Chikaonda, Tarsizio, Nsomba, Edna, Manda-Taylor, Lucinda, Henrion, Marc YR, Banda, Ndaziona Peter, Rylance, Jamie, Ferreira, Daniela M, Jambo, Kondwani ORCID: 0000-0002-3195-2210
et al (show 2 more authors) (2021) A feasibility study of controlled human infection with Streptococcus pneumoniae in Malawi. EBIOMEDICINE, 72. 103579-.

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Abstract

<h4>Background</h4>Persistent carriage of pneumococcal vaccine serotypes has occurred after introduction of PCV13 vaccination in Africa but the mechanisms are unclear. We tested the feasibility of using a human pneumococcal challenge model in Malawi to understand immune correlates of protection against carriage and to trial alternative vaccine candidates. We aimed to identify a dose of Streptococcus pneumoniae serotype 6B sufficient to establish nasopharyngeal carriage in 40% of those nasally inoculated and evaluate nasal mucosal immunity before and after experimental inoculation.<h4>Methods</h4>Healthy student volunteers were recruited and inoculated with saline, 20,000 CFU/naris or 80,000 CFU/naris of Streptococcus pneumoniae serotype 6B Post inoculation carriage was determined by nasal sampling for bacterial culture and lytA PCR. Immunological responses were measured in serum and nasal mucosal biopsies before and after bacterial inoculation.<h4>Findings</h4>Twenty-four subjects completed the feasibility protocol with minimal side effects. pneumococcal carriage was established in 0/6, 3/9 and 4/9 subjects in the saline, 20,000 CFU/naris and 80,000 CFU/naris groups, respectively. Incidental (natural) serotype carriage was common (7/24 participants carried non-6B strains, 29.2%. Experimentally induced type 6B pneumococcal carriage was associated with pro-inflammatory nasal mucosal responses prior to inoculation and altered mucosal recruitment of immune cells post bacterial challenge. There was no association with serum anti-capsular antibody.<h4>Interpretation</h4>The serotype 6B experimental human pneumococcal carriage model is feasible in Malawi and can now be used to determine the immunological correlates of protection against carriage and vaccine efficacy in this population.<h4>Funding</h4>None.

Item Type: Article
Uncontrolled Keywords: Human infection model, Mucosal inflammation, Nasal, Streptococcus pneumoniae
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences
Depositing User: Symplectic Admin
Date Deposited: 19 May 2022 07:27
Last Modified: 18 Jan 2023 21:01
DOI: 10.1016/j.ebiom.2021.103579
Open Access URL: https://doi.org/10.1016/j.ebiom.2021.103579
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3155092