Abstract
Cholera is endemic to many countries. Recent major outbreaks of cholera have prompted World Health Organization to recommend oral cholera vaccination as a public-health strategy. Variation in percentage of seroconversion upon cholera vaccination has been recorded across populations. Vaccine-induced responses are influenced by host genetic differences. We have investigated association between single-nucleotide polymorphic (SNP) loci in and around 296 immunologically relevant genes and total anti-lipopolysaccharide (LPS) antibody response to a killed whole-cell vaccine, comprising LPS from multiple strains of Vibrio cholerae. Titers derived from standard vibriocidal assays were also analyzed to gain further insights on validated SNP associations. Vaccination was administered to 1000 individuals drawn from India. Data on two independent random subsets, each comprising ∼500 vaccinees, were used for discovery of genomic associations and validation, respectively. Significant associations of four SNPs and haplotypes in three genes (MARCO, TNFAIP3 and CXCL12) with AR were discovered and validated, of which two in TNFAIP3 and CXCL12 were also significantly associated with immunity (fourfold increase in vibriocidal titers). CXCL12 is a neutrophil and lymphocyte chemoattractant that is upregulated in response to V. cholerae infection. LPS in the vaccine possibly provides signals that mimic those of the live bacterium. TNFAIP3 promotes intestinal epithelial barrier integrity and provides tight junction protein regulation; possible requirements for adequate response to the vaccine. LPS is a potent activator of innate immune responses and a ligand of MARCO. Variants in this gene have been found to be associated with LPS response, but not with high vibriocidal titer level.
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References
World Health Organization: Cholera: global surveillance summary, 2008. Weekly Epid Rec 2009; 84: 309–324.
World Health Organization: Meeting of the Strategic Advisory Group of Experts on immunization October 2009–conclusions and recommendations. Weekly Epid Rec 2009; 50: 526–528.
Date KA, Vicari A, Hyde TB et al: Considerations for oral cholera vaccine use during outbreak after earthquake in Haiti 2010-2011. Emerg Infect Dis 2011; 17: 2105–2112.
Tappero JW, Tauxe-Emer RV : Lessons learned during public health response to cholera epidemic in haiti and the dominican republic. Emerg Infect Dis 2011; 17: 2087–2093.
Institute of Medicine: New Vaccine Development Establishing Priorities Volume II Diseases of Importance in Developing Countries. Washington DC: National Academy Press, 1986.
World Health Organization:: Cholera, 2010. Weekly Epid Rec 2011; 86: 325–340.
Ryan ET : The cholera pandemic still with us after half a century Time to rethink. PLoS Negl Trop Dis 2011; 5: e1003.
Nandy RK, Sengupta TK, Mukhopadhyay S, Ghosh AC : A comparative study of the properties of Vibrio cholera 0139 01 and other non-01 strains. J Med Microbiol 1995; 42: 251–257.
Levine MM, Black RE, Clements ML, Cisneros L, Nalin DR, Young CR : Duration of infection-derived immunity to cholera. J Infect Dis 1981; 143: 818–820.
World Health Organization: Global Task Force on Cholera Control. Cholera Vaccines A new public health tool? Report of a WHO meeting 10–11 December 2002 Geneva Switzerland World Health Organization 2002, pp 14.
Sinclair D, Abba K, Zaman K, Qadri F, Graves PM : Oral vaccines for preventing cholera. Cochrane Database Syst Rev 2011; (Issue 3): Art No CD008603.
Provenzano D, Kovác P, Wade WF : The ABCs (Antibody B cells and Carbohydrate epitopes) of cholera immunity considerations for an improved vaccine. Microbiol Immunol 2006; 50: 899–927.
Clemens JD, Sack DA, Harris JR et al: ABO blood groups and cholera new observations on specificity of risk and modification of vaccine efficacy. J Infect Dis 1989; 159: 770–773.
Glass RI, Holmgren J, Haley CE et al: Predisposition for cholera of individuals with O blood groupPossible evolutionary significance. Am J Epidemiol 1985; 121: 791–796.
Harris JB, Khan AI, LaRocque RC et al: Blood group immunity and risk of infection with Vibrio cholerae in an area of endemicity. Infect Immun 2005; 73: 7422–7427.
Lagos R, Avendaño A, Prado V et al: Attenuated live cholera vaccine strain CVD 103-HgR elicits significantly higher serum vibriocidal antibody titres in persons of blood group O. Infect Immun 1995; 63: 707–709.
Ramamurthy T, Wagener D, Chowdhury G, Majumder PP : A large study on immunological response to a whole-cell killed oral cholera vaccine reveals that there are significant geographical differences in response and that O blood group individuals do not elicit a higher response. Clin Vaccine Immunol 2010; 17: 1232–1237.
Poland GA : Variability in immune response to pathogens using measles vaccine to probe immunogenetic determinants of response. Am J Hum Genet 1998; 62: 215–220.
Poland GA, Jacobson RM, Colbourne SA et al: Measles antibody seroprevalence rates among immunized Inuit Innu and Caucasian subjects. Vaccine 1999; 17: 1525–1531.
Milich DR, Leroux-Roels GG : Immunogenetics of the response to HBsAg vaccination. Autoimmun Rev 2003; 2: 248–257.
Zuckerman JN : Nonresponse to hepatitis B vaccines and the kinetics of anti-HBs production. J Med Virol 1996; 50: 283–288.
Gupta D, Faridi MM, Aggarwal A, Kaur I : Seroprevalence of anti-Vi antibodies and immunogenicity of Typhim Vi vaccine in children. Hum Vaccine 2008; 4: 305–308.
Sur D, Ochiai RL, Bhattacharya SK et al: A cluster-randomized effectiveness trial of Vi typhoid vaccine in India. N Engl J Med 2009; 361: 403–405.
Kimman TG, Vandebriel RJ, Hoebee B : Genetic variation in the response to vaccination. Community Genet 2007; 10: 201–217.
Kruskall MS, Alper CA, Awdeh Z, Yunis EJ, Marcus-Bagley D : The immune response to hepatitis B vaccine in humans inheritance patterns in families. J Exp Med 1992; 175: 495–502.
Gelder CM, Lambkin R, Hart KW et al: Associations between human leukocyte antigens and nonresponsiveness to influenza vaccine. J Infect Dis 2002; 185: 114–117.
Poland GA, Ovsyannikova IG, Jacobson RM : Immunogenetics of seasonal influenza vaccine response. Vaccine 2008; 26: D35–D40.
Poland GA, Ovsyannikova IG, Jacobson RM : Vaccine immunogenetics bedside to bench to population. Vaccine 2008; 26: 6183–6188.
van Eden W, de Bries RRP, Stanford JL, Rook GAW : HLADR3 associated genetic control of response to multiple skin tests with new tuberculins. Clin Exp Immunol 1983; 52: 287–292.
Wang C, Tang J, Song W, Lobashevsky E, Wilson CM, Kaslow RA : HLA and cytokine gene polymorphisms are independently associated with responses to hepatitis B vaccination. Hepatology 2004; 39: 978–988.
Anh DD, Canh do G, Lopez AL et al: Safety and immunogenicity of a reformulated Vietnamese bivalent killed whole-cell oral cholera vaccine in adults. Vaccine 2007; 25: 1149–1155.
Pulendran B, Kumar P, Cutler CW, Mohamadzadeh M, Van Dyke T, Banchereau J : Lipopolysaccharides from distinct pathogens induce different classes of immune responses in vivo. J Immunol 2001; 167: 5067–5076.
Jin P, Wang E : Polymorphism in clinical immunology—from HLA typing to immunogenetic profiling. J Transl Med 2003; 1: 8.
Majumder PP, Staats HF, Sarkar-Roy N et al: Genetic determinants of immune-response to a polysaccharide vaccine for typhoid. HUGO J 2009; 3: 17–30.
Ovsyannikova IG, Haralambieva IH, Vierkant RA, Pankratz VS, Jacobson RM, Poland GA : The role of polymorphisms in Toll-like receptors and their associated intracellular signaling genes in measles vaccine immunity. Hum Genet 2011; 130: 547–561.
Benenson AS, Saad A, Mosley WH : Serological studies in cholera 2 The vibriocidal antibody response of cholera patients determined by a microtechnique. Bull World Health Organ 1968; 38: 277–285.
Sarkar-Roy N, Mondal D, Bhattacharya P, Majumder P : A novel statistical algorithm for enhancing the utility of HapMap data to design genomic association studies in non-HapMap populations. Int J Data Mining Bioinf 2011; 5: 706–716.
Price AL, Patterson NJ, Plenge RM, Weinblatt ME, Shadick NA, Reich D : Principal components analysis corrects for stratification in genome-wide association studies. Nat Genet 2006; 38: 904–909.
Benjamini Y, Hochberg Y : Controlling the false discovery rate a practical and powerful approach to multiple testing. J Roy Statist Soc Ser B Methodological 1995; 57: 289–300.
Conneely KN, Boehnke M : So many correlated tests so little time! Rapid adjustment of P values for multiple correlated tests. Am J Hum Genet 2007; 81: 1158–1168.
Han B, Kang HM, Eskin E : Rapid and accurate multiple testing correction and power estimation for millions of correlated markers. PLoS Genet 2009; 5: e1000456.
Stephens M, Smith N, Donnelly P : A new statistical method for haplotype reconstruction from population data. Am J Hum Genet 2001; 68: 978–989.
Eko FO, Schukovskaya T, Lotzmanova EY et al: Evaluation of the protective efficacy of Vibrio cholerae ghost VCG; candidate vaccines in rabbits. Vaccine 2003; 21: 3663–3674.
Tarique AA, Kalsy A, Arifuzzaman M et al: Transcutaneous immunization with a Vibrio cholerae O1 Ogawa synthetic hexasaccharide conjugate following oral whole-cell cholera vaccination boosts vibriocidal responses and induces protective immunity in mice. Clin Vaccine Immunol 2012; 19: 594–602.
Sack DA, Sack RB, Nair GB, Siddique AK : Cholera. Lancet 2004; 363: 223–233.
Kaper JB, Morris JG, Levine MM : Cholera. Clin Microbiol Rev 1995; 8: 48–86.
Clemens JD, van Loon F, Sack DA et al: Field trial of oral cholera vaccines in Bangladesh serum vibriocidal and antitoxic antibodies as markers of the risk of cholera. J Infect Dis 1991; 163: 1235–1242.
Saha D, LaRocque RC, Khan AI et al: Incomplete correlation of serum vibriocidal antibody titer with protection from Vibrio cholerae infection in urban Bangladesh. J Infect Dis 2004; 189: 2318–2322.
Losonsky GA, Yunyongying J, Lim V et al: Factors influencing secondary vibriocidal immune responses Relevance for understanding immunity to cholera. Infect Immun 1996; 64: 10–15.
Alam MM, Riyadh MA, Fatema K et al: 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. Clin Vaccine Immunol 2011; 18: 844–850.
Leung DT, Rahman MA, Mohasin M et al: Memory B Cell and Other Immune Responses in Children Receiving Two Doses of an Oral Killed Cholera Vaccine Compared to Responses following Natural Cholera Infection in Bangladesh. Clin Vaccine Immunol 2012; 19: 690–698.
Levine MM : Immunogenicity and efficacy of oral vaccines in developing countries lessons from a live cholera vaccine. BMC Biol 2010; 8: 129.
Serazin AC, Shackelton LA, Wilson C, Bhan MK : Improving the performance of enteric vaccines in the developing world. Nat Immunol 2010; 11: 769–773.
LaRocque RC, Sabeti P, Duggal P et al: A variant in long palate lung and nasal epithelium clone 1 is associated with cholera in a Bangladeshi population. Genes Immun 2009; 10: 267–272.
Shin OS, Uddin T, Citorik R et al: LPLUNC1 modulates innate immune responses to Vibrio cholera. J Infect Dis 2011; 204: 1349–1357.
Agle KA, Vongsa RA, Dwinell MB : Chemokine stimulation promotes enterocyte migration through laminin-specific integrins. Am J Physiol Gastrointest Liver Physiol 2011; 301: G968–G980.
Ou G, Rompikuntal PK, Bitar A et al: Vibrio cholerae cytolysin causes an inflammatory response in human intestinal epithelial cells that is modulated by the prtv protease. PLoS ONE 2009; 4: e7806.
Poggi A, Carosio R, Fenoglio D et al: Migration of Vδ1 and Vδ2T cells in response to CXCR3 and CXCR4 ligands in healthy donors and HIV-1–infected patients competition by HIV-1 Tat. Blood 2003; 103: 2205–2213.
Jennner RG, Young RA : Insights into host responses against pathogens from transcriptional profiling. Nat Rev Microbiol 2005; 3: 281–294.
Kolodziej LE, Lodolce JP, Chang JE et al: TNFAIP2 maintains intestinal barrier function and supports epithelial cell tight junctions. PLoS One 2011; 6: e26352.
Fung EY, Smyth DJ, Howson JM et al: Analysis of 17 autoimmune disease-associated variants in type 1 diabetes identifies 6q23/TNFAIP3 as a susceptibility locus. Genes Immunity 2009; 10: 188–191.
Kraal G, van der Laan LJW, Elomaa O, Tryggvason K : The macrophage receptor MARCO. Microbes Infect 2000; 2: 313–316.
Van der Laan LJW, Dopp EA, Haworth R et al: Regulation and functional involvement of macrophage scavenger receptor MARCO in clearance of bacteria in vivo. J Immunol 1999; 162: 939–947.
Sankala M, Brännström A, Schulthess T et al: Characterization of Recombinant Soluble Macrophage Scavenger Receptor MARCO. J Biol Chem 2002; 277: 33378–33385.
Alam MM, Riyadh MA, Fatema K et al: 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. Clin Vac Immuol 2011; 18: 844–850.
Acknowledgements
Financial support for this work was provided by U.S. National Institute of Allergy and Infectious Diseases, National Institutes of Health Contract HHSN200400067C. The vaccine was used in this study with approval of the Drug Controller General of India, and the entire study was approved by the Health Ministry Monitoring Committee, Government of India; we are grateful to them for the approvals. We are grateful to members of CpG and TCGA for their expert help in the conduct of this project.
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Majumder, P., Sarkar-Roy, N., Staats, H. et al. Genomic correlates of variability in immune response to an oral cholera vaccine. Eur J Hum Genet 21, 1000–1006 (2013). https://doi.org/10.1038/ejhg.2012.278
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DOI: https://doi.org/10.1038/ejhg.2012.278


