title: Antigen-specific memory B-cell responses in Bangladeshi adults after one- or two-dose oral killed cholera vaccination and comparison with responses in patients with naturally acquired cholera.
abstract: The mediators of protective immunity against cholera are currently unknown, but memory B-cell responses may play a central role in facilitating long-term and anamnestic responses against Vibrio cholerae, the cause of cholera. We compared memory B-cell responses in adults with natural cholera in Bangladesh (n = 70) to responses in Bangladeshi adults after one-dose (n = 30) or two-dose (n = 30) administration of an oral killed cholera vaccine, WC-rBS (Dukoral; Crucell), assessing the responses at the acute stage of disease or prevaccination and then on days 3, 30, 90, 180, 270, and 360. Individuals with natural cholera developed prominent vibriocidal and plasma anti-cholera toxin B subunit (CtxB) and lipopolysaccharide (LPS) IgG and IgA responses, but these responses returned to baseline by 1 year of follow-up. Vaccinees developed plasma anti-CtxB and anti-LPS IgG and IgA responses that were generally comparable to those in individuals recovering from natural disease, but vibriocidal responses were lower in vaccinees than in infected patients. Individuals recovering from natural disease developed memory B-cell IgG and IgA anti-CtxB and anti-LPS responses by day 30, and these responses were detectable through at least days 180 to 360. In contrast, we detected no IgA or IgG memory B-cell responses to LPS in vaccinees; anti-CtxB IgA responses were only detectable on day 30, and anti-CtxB IgG responses were detectable until days 90 to 180, compared to days 270 to 360 in patients. These findings may explain in part the relatively short-term protection afforded by oral cholera vaccination compared to natural disease.
authors.affiliation: Immunology Unit, Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Mohakali, Dhaka 1212, Bangladesh.
authors.forename: Mohammad Murshid
authors.initials: MM
authors.lastname: Alam
authors.forename: M Asrafuzzaman
authors.initials: MA
authors.lastname: Riyadh
authors.forename: Kaniz
authors.initials: K
authors.lastname: Fatema
authors.forename: Mohammad Arif
authors.initials: MA
authors.lastname: Rahman
authors.forename: Nayeema
authors.initials: N
authors.lastname: Akhtar
authors.forename: Tanvir
authors.initials: T
authors.lastname: Ahmed
authors.forename: Mohiul Islam
authors.initials: MI
authors.lastname: Chowdhury
authors.forename: Fahima
authors.initials: F
authors.lastname: Chowdhury
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Calderwood
authors.forename: Jason B
authors.initials: JB
authors.lastname: Harris
authors.forename: Edward T
authors.initials: ET
authors.lastname: Ryan
authors.forename: Firdausi
authors.initials: F
authors.lastname: Qadri
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial / Q000276:immunology; D000992:Antitoxins / Q000097:blood; D001402:B-Lymphocytes / Q000276:immunology*; D001459:Bangladesh; D001770:Blood Bactericidal Activity; D002771:Cholera / Q000276:immunology*; D022121:Cholera Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007156:Immunologic Memory; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014611:Vaccination / Q000379:methods; D015164:Vaccines, Inactivated / Q000008:administration & dosage / Q000276:immunology; D014734:Vibrio cholerae / Q000276:immunology*; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D000992:Antitoxins; D022121:Cholera Vaccines; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D015164:Vaccines, Inactivated