Heparin-binding haemagglutinin (HBHA)-specific immune responses have been linked to protection against tuberculosis (TB).We investigated the hypothesis that BCG vaccination of human infants primes an HBHA-specific response, using multiplex to measure secreted cytokines and chemokines following HBHA and Mycobacterium tuberculosis purified protein derivative (PPD) stimulation of diluted whole blood samples from BCG-vaccinated or -unvaccinated infants. Of 42 analytes measured, 24 and 32 significant, BCG-associated increases were detected in response to HBHA and PPD, respectively. Both response profiles included Th-1, Th-2, Th-17 and inflammatory cytokines and chemokines (e.g. IFN-γ, TNF-α, IL-5, IL-10, IL-13, IL-17, MIP-1α and MIP-1β). We also found that six of the seven responses most closely correlated with IFN-γ were common to both HBHA and PPD. Notably, all HBHA-specific secretion of cytokines and chemokines from infant samples was dependant on previous BCG vaccination. Also, long-term persistence of HBHA-specific responses was found in adolescents with evidence of infant BCG vaccination. This study demonstrates for the first time BCG priming of an HBHA-specific immune response in infants that is characterised by a broad cytokine and chemokine signature. It also suggests a number of BCG vaccination associated, HBHA-induced responses that should be useful for future studies of biomarkers of protection against TB.Keywords: BCG vaccination r Chemokines r Cytokines r Heparin-binding haemagglutinin (HBHA) r tuberculosis Supporting Information available online
IntroductionThe current global burden of tuberculosis (TB) disease is one of the greatest challenges to public health. That the problem is focussed in tropical countries is in part due to the lack of protective efficacy Correspondence: Dr. Steven G. Smith e-mail: steven.smith@lshtm.ac.uk of the BCG vaccine against adult pulmonary disease at lower latitudes [1]. Efforts towards the development of a more efficacious vaccine for TB should ensure that the resultant immune response is an improvement upon that induced by BCG in the regions where it is least effective.Infant BCG vaccination is a consistently efficacious and cost-effective preventative measure against childhood forms of TB [2,3]. There is also evidence that BCG not only affords 2512 Steven G. Smith et al. Eur. J. Immunol. 2012. 42: 2511-2522 protection to infants in more equatorial regions but that this protection is against all forms of TB and persists for 15-20 years [4]. The efficacy of infant BCG vaccination must therefore be considered when new TB vaccines designed to improve protection against adult pulmonary TB are developed and tested. Although homologous boosting of the BCG vaccine has proven ineffective [5], the immunity induced by prior BCG vaccination may be effectively boosted with selected antigens. Such a heterologous approach has seen the induction of strong, polyfunctional CD4 + T-cell responses in humans, specific for the mycobacterial antigen 85A, which was delivered via the modifi...