This
electron micrograph shows the flower-like structure of polymorphic
membrane protein D (PmpD) after it was purified from the surface of the C. trachomatis bacterium. Scientists are hoping to develop PmpD into a vaccine candidate to prevent chlamydial infection. Credit: NIAID
NIAID Researchers Developing Vaccine for Chlamydia
The bacterium Chlamydia trachomatis is among the oldest and
most prevalent causes of infectious disease on earth. The World Health
Organization (WHO) estimates that between 80 and 140 million people are
infected with C. trachomatis, mostly women and children in developing countries, making chlamydia the most common bacterial disease in the world.
In the United States, chlamydia is perceived primarily as a “silent”
disease that, despite showing no symptoms in more than half of the
infected population, can damage reproductive organs and cause
infertility. Chlamydia is the most reported sexually transmitted disease
in the United States, and, in 2006, U.S. cases for the first time
topped 1 million, according to the Centers for Disease Control and
Prevention (CDC).
But in more than 50 developing countries, C. trachomatis is
known for causing blindness. WHO estimates that untreated cases of the
disease trachoma have left about 6 million people blind in Africa, the
Middle East, Central and Southeast Asia, and Latin America. Trachoma
causes eyelids to fold inward, so that the eyelashes rub the eyeball and
scar the cornea, which can result in impaired vision and blindness.
In 1997, WHO coordinated a multinational program to eliminate
blinding trachoma by 2020, called Global Elimination of Trachoma
(GET2020). Because chlamydia is easily treated and cured with medical
care, GET2020 has highlighted four areas for eliminating trachoma:
eyelid surgery, facial cleanliness, environmental changes, and
antibiotics.
Another focus of the WHO effort is to develop a vaccine to prevent
chlamydial infection. One of the greatest challenges to fighting
chlamydial infection is that people do not develop a sustained
protective immune response to the infection. Understanding how C. trachomatis evades host immunity is central to developing a vaccine. That’s where NIAID scientists hope to contribute.
A Promising Re-Start
In 1975, Harlan Caldwell, Ph.D., now chief of NIAID’s Laboratory of
Intracellular Parasites, was a graduate student at the University of
Washington. He observed that blood samples from people who suffered
different chlamydial diseases all appeared to have antibodies against
the same protein antigen from C. trachomatis. He suspected that
the antigen played a key role in the spread of disease, but at that
time there was no equipment to further study the hypothesis.
The materials went into the freezer until, some 30 years later, while conferring with a colleague about C. trachomatis surface
proteins, Dr. Caldwell recalled the earlier work. He had an idea of how
to use new technology to study its potential to prevent C. trachomatis from spreading.
Now, based on successful initial laboratory test results, NIAID has
sought patent protection on the concept, and Dr. Caldwell’s research
group has begun to study animal models. But much work remains to be done
to understand how C. trachomatis spreads and evades human immunity.
Deconstructing PmpD
Dr. Caldwell’s group is trying to confirm that the protein antigen he
identified, known as polymorphic membrane protein D, or PmpD, has an
active role in suppressing an immune response. That information could
become the basis for a multivalent vaccine, or a vaccine that prevents
infection from all 15 varieties of C. trachomatis. If PmpD
indeed suppresses host immunity, then a vaccine that neutralizes PmpD
could prevent infection and allow protective immunity to develop.
In its latest work, published online November 10, 2008, in Infection and Immunity,
the group observed structural details of PmpD, showing that it exists
in two forms that could each promote infection. Though they do not know
the precise mechanisms involved, the scientists hypothesize that one
form, found on the cell surface, is a flower-like structure that could
help the bacteria attach to host cells and invade them. The other form
is soluble; the scientists suggest its fragments could be released into
the environment around a cell, where they act on and suppress cells
involved in the immune response.
Understanding how these forms of PmpD function is critical to the
design of a vaccine. Ultimately, as their work advances, Dr. Caldwell’s
group will be trying to learn whether a PmpD-based vaccine can generate
multi-functional, neutralizing antibodies that can block C. trachomatis infection.