The human immune response to a new recombinant plague vaccine, comprising recombinant F1 (rF1) and rV antigens, has been assessed during a phase 1 safety and immunogenicity trial in healthy volunteers. All the subjects produced specific immunoglobulin G (IgG) in serum after the priming dose, which peaked in value after the booster dose (day 21), with the exception of one individual in the lowest dose level group, who responded to rF1 only. Three subjects, found to have an anti-rV titer at screening, were excluded from the overall analysis. Human antibody functionality has been assessed by quantification of antibody competing for binding to rV in vitro and also by the transfer of protective immunity in human serum into the naïve mouse. Human and macaque IgG competed for binding to rV in vitro with a mouse monoclonal antibody, previously shown to protect mice against challenge with plague, suggesting that this protective B-cell epitope on rV is conserved between these three species. Total IgG to rV in individuals and the titer of IgG competing for binding to rV correlated significantly at days 21 (r ‫؍‬ 0.72; P < 0.001) and 28 (r ‫؍‬ 0.82; P < 0.001). Passive transfer of protective immunity into mice also correlated significantly with total IgG titer to rF1 plus rV at days 21 (r 2 ‫؍‬ 98.6%; P < 0.001) and 28 (r 2 ‫؍‬ 76.8%; P < 0.03). However, no significant vaccination-related change in activation of peripheral blood mononuclear cells was detected at any time. Potential serological immune correlates of protection have been investigated, but no trends specific to vaccination could be detected in cellular markers.

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It was demonstrated that nitrate concentration fluctuates dramatically in both urine and saliva throughout the study period and hence single time point ('spot') samples of either fluid give a poor measure of previous nitrate exposure. In contrast, the nitrate recovery in complete 24 h urine collections showed a strong positive correlation with previous nitrate exposure which was independent of the nature of the food matrix in which the nitrate was ingested. Regression analysis of the data showed that the apparent urinary recovery of 70% appears to consist of 55% arising from the original challenge and a background of approximately 0.22 mmol/day which is independent of the challenge and which may reflect endogenous mammalian synthesis of nitrate. It is therefore important that in future epidemiological studies, in which dietary nitrate exposures are to be determined, that analyses are conducted only on 24 h urine collections. A large inter-individual variation was found in the conversion of salivary nitrate to nitrite presumably mediated by the oral flora. The resulting differences in nitrite formation may be one of the factors determining the level of endogenous N-nitroso compound formation in an individual.

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