title: Vaccination against shigellosis with attenuated Shigella flexneri 2a strain SC602.
abstract: The Shigella flexneri 2a SC602 vaccine candidate carries deletions of the plasmid-borne virulence gene icsA (mediating intra- and intercellular spread) and the chromosomal locus iuc (encoding aerobactin) (S. Barzu, A. Fontaine, P. J. Sansonetti, and A. Phalipon, Infect. Immun. 64:1190-1196, 1996). Dose selection studies showed that SC602 causes shigellosis in a majority of volunteers when 3 x 10(8) or 2 x 10(6) CFU are ingested. In contrast, a dose of 10(4) CFU was associated with transient fever or mild diarrhea in 2 of 15 volunteers. All volunteers receiving single doses of >/=10(4) CFU excreted S. flexneri 2a, and this colonization induced significant antibody-secreting cell and enzyme-linked immunosorbent assay responses against S. flexneri 2a lipopolysaccharide in two-thirds of the vaccinees. Seven volunteers who had been vaccinated 8 weeks earlier with a single dose of 10(4) CFU and 7 control subjects were challenged with 2 x 10(3) CFU of virulent S. flexneri 2a organisms. Six of the control volunteers developed shigellosis with fever and severe diarrhea or dysentery, while none of the vaccinees had fever, dysentery, or severe symptoms (P = 0. 005). Three vaccinees experienced mild diarrhea, and these subjects had lower antibody titers than did the fully protected volunteers. Although the apparent window of safety is narrow, SC602 is the first example of an attenuated S. flexneri 2a candidate vaccine that provides protection against shigellosis in a stringent, human challenge model.
authors.affiliation: Medical Division, United States Army Medical Research Institute for Infectious Diseases, Fort Detrick, Maryland 21702, USA.
authors.forename: T S
authors.initials: TS
authors.lastname: Coster
authors.forename: C W
authors.initials: CW
authors.lastname: Hoge
authors.forename: L L
authors.initials: LL
authors.lastname: VanDeVerg
authors.forename: A B
authors.initials: AB
authors.lastname: Hartman
authors.forename: E V
authors.initials: EV
authors.lastname: Oaks
authors.forename: M M
authors.initials: MM
authors.lastname: Venkatesan
authors.forename: D
authors.initials: D
authors.lastname: Cohen
authors.forename: G
authors.initials: G
authors.lastname: Robin
authors.forename: A
authors.initials: A
authors.lastname: Fontaine-Thompson
authors.forename: P J
authors.initials: PJ
authors.lastname: Sansonetti
authors.forename: T L
authors.initials: TL
authors.lastname: Hale
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics / Q000276:immunology*; D001428:Bacterial Vaccines / Q000008:administration & dosage / Q000276:immunology*; D004268:DNA-Binding Proteins / Q000235:genetics; D004405:Dysentery, Bacillary / Q000276:immunology* / Q000517:prevention & control; D005798:Genes, Bacterial; D006801:Humans; D016297:Mutagenesis, Site-Directed; D010957:Plasmids; D012763:Shigella flexneri / Q000235:genetics / Q000276:immunology*; D014157:Transcription Factors / Q000235:genetics; D014611:Vaccination
chemical_list: D001426:Bacterial Proteins; D001428:Bacterial Vaccines; D004268:DNA-Binding Proteins; D014157:Transcription Factors; C058483:virG protein, Shigella flexneri