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    Impact of CD4+ T Cell Responses on Clinical Outcome following Oral Administration of Wild-Type Enterotoxigenic Escherichia coli in Humans

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    Author
    McArthur, M.A.
    Chen, W.H.
    Magder, L.
    Date
    2017
    Journal
    PLoS Neglected Tropical Diseases
    Publisher
    Public Library of Science
    Type
    Article
    
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    Show full item record
    See at
    https://doi.org/10.1371/journal.pntd.0005291
    Abstract
    Enterotoxigenic Escherichia coli (ETEC) is a non-invasive enteric pathogen of considerable public health importance, being one of the most common attributable causes of diarrheal illness in infants and young children in developing countries and the most common cause of traveler’s diarrhea. To enhance study-to-study consistency of our experimental challenge model of ETEC in volunteers, and to allow concomitant multi-site trials to evaluate anti-ETEC immunoprophylactic products, hundreds of vials, each containing a standardized inoculum of virulent wild-type (wt) ETEC strain H10407 (serotype O78:H11 expressing colonization factor antigen I and heat-labile and heat-stable enterotoxins), were prepared under current Good Manufacturing Practices (cGMP) and frozen. Following thawing, the contents of each vial can be used (diluted as necessary) to prepare consistent challenge inoculum, even at different study sites. A preliminary human experimental challenge study using this cGMP inoculum was conducted on a research isolation ward and the clinical and cell-mediated immune responses evaluated. Of the 6 healthy adult volunteers challenged 83% (5/6) developed diarrhea and 50% developed moderate-to-severe diarrhea (MSD). Moderate and severe diarrhea were defined as passage of ≥ 1 liter or ≥ 3 liters of diarrheal stool respectively. We compared the CD4+ T cell responses of volunteers who developed MSD against those who did not and identified significant differences in ETEC-specific cytokine production and gut homing potential. We furthermore demonstrated that increased expression of the gut-homing molecule integrin α4β7 by peripheral T follicular helper cells (pTfh) correlated with decreased stool volume and increased ETEC-specific IgA B memory cell (BM) development. Collectively, despite small numbers of volunteers, our results indicate a potential role for CD4+ T cells, in particular pTfh, in modulating disease outcome following exposure to wt ETEC in a volunteer experimental challenge model. Copyright 2017 McArthur et al.
    Sponsors
    This work was funded by the Department of Defense, Defense Advanced Research Projects (DARPA, W91INF-13-0346) to WHC and MML and the National Institute of Allergy and Infectious Diseases U19-AI082655 (Cooperative Center for Human Immunology [CCHI]) to MAM and MBS.
    Keyword
    CD4-Positive T-Lymphocytes--immunology
    Enterotoxigenic Escherichia coli--physiology
    Escherichia coli Infections--immunology
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85012893217&doi=10.1371%2fjournal.pntd.0005291&partnerID=40&md5=40811e741756e5edbad190a91c7f3591; http://hdl.handle.net/10713/11309
    ae974a485f413a2113503eed53cd6c53
    10.1371/journal.pntd.0005291
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