Randomised, double-blind, safety and efficacy of a killed oral vaccine for enterotoxigenic E. Coli diarrhoea of travellers to Guatemala and Mexico

Sack, David A.; Shimko, Janet; Torres, Olga; Bourgeois, A. Louis; Francia, Domingo Sanchez; Gustafsson, Björn; Kärnell, Anders; Nyquist, Iréne; Svennerholm, Ann Mari

doi:10.1016/j.vaccine.2007.03.034

Cited by 106 publications

(76 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…21,22 Our finding indicates that LT, either alone or in combination with ST, was expressed in less than half of ETEC isolates. Thus, for effective vaccination coverage using an LT immunogen, multiple CFs or other VFs will be required to provide protection against ST-only ETEC strains.…”

Section: Discussionmentioning

confidence: 69%

“…31 A study of a killed oral vaccine combining Vibrio cholerae-binding toxin plus ETEC CFs, carried out in Mexico and Guatemala, was of limited value because it did not contain CS6 found in prevalent ETEC strains encountered in the study. 22 The lead scientific group working with this vaccine is now adding CS6 to the vaccine. 32 In looking at the ST-only strains in this study, CS21 expression was seen in 106/164 (65%) of ST-ETEC strain while CS6 expression was seen in 31/164 (19%) of the ST-ETEC strains.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Colonization Factors in Enterotoxigenic Escherichia coli Strains in Travelers to Mexico, Guatemala, and India Compared with Children in Houston, Texas

Kharat¹,

Ahmed²,

Jiang³

et al. 2016

Am J Trop Med Hyg

View full text Add to dashboard Cite

Abstract. Enterotoxigenic Escherichia coli (ETEC) can be attributed to around 200 million diarrheal episodes and 380,000 deaths in the developing regions. Travelers' diarrhea occurs in 15-40% of travelers to developing regions with ETEC being the most important etiologic agent. This study aims to describe the distribution of enterotoxins and colonization factor (CF) profiles of ETEC isolates from stool samples of adult travelers acquiring diarrhea in Mexico, Guatemala, and India and a group of children with acute diarrhea in Houston, TX, between 2007 and 2012. The heat-labile/heat-stable (LT/ST) enterotoxins and CFs from 252 patients were determined using polymerase chain reaction assay. Among the 252 ETEC isolates, 15% were LT-only, 58% were ST-only, and 28% produced both LT and ST. The distribution of LT-only (12-15%) and ST-only (55-56%) isolates was similar between Latin American and Indian sites. The most prevalent CF was CS21, expressed in 65% of the isolates followed by CS6 (25%) and CS3 (17%). Among the international travelers, 64% of the ETEC isolates expressed CS21. CS21 was expressed in 46% of isolates from Latin America compared with 96% of isolates from India (P < 0.0001). CS21 was expressed in 85% isolates from Houston children. CS21 was increasingly found in ST-only (P = 0.003) and ST/LT (P = 0.026) ETEC compared with LT-only ETEC. High frequency of finding CS21 among recent isolates of ETEC over a wide geographic distribution warrants additional studies on this CF. Highly conserved CS21 is an important target for potential multivalent ETEC vaccines.

show abstract

Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Colonization Factors in Enterotoxigenic Escherichia coli Strains in Travelers to Mexico, Guatemala, and India Compared with Children in Houston, Texas

Kharat¹,

Ahmed²,

Jiang³

et al. 2016

Am J Trop Med Hyg

View full text Add to dashboard Cite

show abstract

“…1 and 3). ETEC is an important cause of acute infantile diarrhea and travelers' diarrhea (9-11), and LT-ETEC is found in approximately two thirds of cases of ETEC-associated diarrhea (12)(13)(14). Our results suggest that MucoRice-CTB could therefore be used to control a large proportion of ETEC-induced diarrhea.…”

Section: Discussionmentioning

confidence: 77%

“…ETEC produces heat-stable enterotoxin (ST) and/ or heat-labile enterotoxin (LT) (2). LT is found in approximately two thirds of cases of ETEC-induced diarrhea (12)(13)(14). In addition, previous studies have shown that anti-LT immunity protects against ETEC-induced diarrhea in human (15)(16)(17).…”

mentioning

confidence: 97%

Secretory IgA-mediated protection againstV. choleraeand heat-labile enterotoxin-producing enterotoxigenicEscherichia coliby rice-based vaccine

Tokuhara

Yuki

Nochi

et al. 2010

Proc. Natl. Acad. Sci. U.S.A.

107

110

View full text Add to dashboard Cite

Cholera and enterotoxigenic Escherichia coli (ETEC) are among the most common causes of acute infantile gastroenteritis globally. We previously developed a rice-based vaccine that expressed cholera toxin B subunit (MucoRice-CTB) and had the advantages of being cold chain-free and providing protection against cholera toxin (CT)-induced diarrhea. To advance the development of MucoRice-CTB for human clinical application, we investigated whether the CTB-specific secretory IgA (SIgA) induced by MucoRice-CTB gives longstanding protection against diarrhea induced by Vibrio cholerae and heatlabile enterotoxin (LT)-producing ETEC (LT-ETEC) in mice. Oral immunization with MucoRice-CTB stored at room temperature for more than 3 y provided effective SIgA-mediated protection against CTor LT-induced diarrhea, but the protection was impaired in polymeric Ig receptor-deficient mice lacking SIgA. The vaccine gave longstanding protection against CT-or LT-induced diarrhea (for ≥6 months after primary immunization), and a single booster immunization extended the duration of protective immunity by at least 4 months. Furthermore, MucoRice-CTB vaccination prevented diarrhea in the event of V. cholerae and LT-ETEC challenges. Thus, MucoRice-CTB is an effective long-term cold chain-free oral vaccine that induces CTBspecific SIgA-mediated longstanding protection against V. choleraeor LT-ETEC-induced diarrhea. cholera toxin B subunit | mucosal vaccine | oral vaccine | plant-made vaccine | MucoRice

show abstract

“…95 However, further evaluation of efficacy in 1,357 volunteers from the USA traveling to Mexico or Guatemala, 2 vaccine doses prior to travel marginally reduced the overall number of diarrhea cases attributed to ETEC strains carrying homologous CFs and LT (24%, not significant protective efficacy). 96 Importantly, a significant reduction in the number of moderate diarrhea episodes (77%, 95% CI: -6-95%) and episodes affecting normal activities (85%, 95% CI: -20-98%) was reported. Higher efficacy rates are expected if expression levels of CFs are increased, a theory that is currently being tested, as development of new formulations continues.…”

Section: Ace257mentioning

confidence: 91%

Vaccines for viral and bacterial pathogens causing acute gastroenteritis: Part II: Vaccines forShigella,Salmonella,enterotoxigenicE. coli(ETEC) enterohemorragicE. coli(EHEC) andCampylobacter jejuni

O’Ryan

Vidal

Canto

et al. 2015

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

Randomised, double-blind, safety and efficacy of a killed oral vaccine for enterotoxigenic E. Coli diarrhoea of travellers to Guatemala and Mexico

Cited by 106 publications

References 27 publications

Colonization Factors in Enterotoxigenic Escherichia coli Strains in Travelers to Mexico, Guatemala, and India Compared with Children in Houston, Texas

Colonization Factors in Enterotoxigenic Escherichia coli Strains in Travelers to Mexico, Guatemala, and India Compared with Children in Houston, Texas

Secretory IgA-mediated protection againstV. choleraeand heat-labile enterotoxin-producing enterotoxigenicEscherichia coliby rice-based vaccine

Vaccines for viral and bacterial pathogens causing acute gastroenteritis: Part II: Vaccines forShigella,Salmonella,enterotoxigenicE. coli(ETEC) enterohemorragicE. coli(EHEC) andCampylobacter jejuni

Contact Info

Product

Resources

About