Original Paper J Biomed Sci 1999;6:357–363 Received: February 5, 1999 Accepted: March 30, 1999 A Nontoxic Pseudomonas Exotoxin A Induces Active Immunity and Passive Protective Antibody against Pseudomonas Exotoxin A Intoxication Tzong-Yueh Chen a, b Chia Po Lin c, d Chien-Chang Loa d Tso-Ling Chen c Huey-Fang Shang e Jaulang Hwang b Cho-Fat Hui a, f a Institute of Genetics, School of Life Science, National Yang-Ming University, b Institute of Molecular Biology, Academia Sinica, c Division of Drug Biology, National Laboratories of Foods and Drugs, Department of Health, Executive Yuan, d Graduate School of Microbiology, Soochow University, e Department of Medicine, Taipei Medical College, and f Institute of Zoology, Academia Sinica, Taipei, Taiwan, ROC Key Words Pseudomonas exotoxin A W Vaccination Abstract Pseudomonas exotoxin A (PE) is one of the most potent cytotoxic agents produced by Pseudomonas aeruginosa. In this study, we examined the possibility of using PE with a deletion of 38 carboxyl-terminal amino acid residues, designated PE(¢576–613), for active immunization against PE-mediated disease. We first examined the toxic effects of PE and PE(¢576–613) on 5- and 9-weekold ICR mice. The results show that the subcutaneous administration of PE(¢576–613) at a dose of 250 Ìg was still nontoxic to 5- and 9-week-old ICR mice, while native PE was lethal at a dose of 0.5 and 1 Ìg, respectively. PE(¢576–613) was then used to immunize ICR mice. The minimum dose of PE(¢576–613) that could effectively induce anti-PE antibodies in 5- and 9-week-old ICR mice was found to be 250 ng. However, immunization with 250 ng PE(¢576–613) failed to protect the immunized mice from a lethal dose of PE. The effective immunization dose of PE(¢576–613) that could protect mice ABC Fax + 41 61 306 12 34 E-Mail [email protected] www.karger.com © 1999 National Science Council, ROC S. Karger AG, Basel 1021–7770/99/0065–0357$17.50/0 Accessible online at: http://BioMedNet.com/karger against a 2 Ìg PE challenge was found to be 15 Ìg. In addition, sera obtained from PE(¢576–613)-immunized ICR mice were able to neutralize PE intoxication and effectively protect mice from PE. Thus, PE(¢576–613) may be used as an alternative route to new PE vaccine development. Introduction Pseudomonas aeruginosa are gram-negative bacilli and are among the most problematic opportunistic pathogens [31]. They are widely distributed in nature and seldom infect healthy people. Yet, these bacteria always infect immunodeficient individuals, such as patients suffering from burns, cystic fibrosis, or patients who take immunosuppressive drugs [3, 7, 26, 27]. In addition, treatment of these infections is greatly impaired by the acquired resistance of P. aeruginosa to antibiotics [8, 22, 37]. Therefore, immunization against Pseudomonas infection may offer a promising approach to circumvent this difficulty. In the past decade, approaches to prevent P. aeruginosa infec- Dr. Jaulang Hwang Institute of Molecular Biology Academia Sinica, Nankang, Taipei 115, Taiwan (ROC) Tel. +886 2 2789 9217, Fax +886 2 2782 6085 E-Mail [email protected] tion have used the outer membrane components or detoxified secretory toxins such as lipopolysaccharides [9, 24, 32], common endotoxin proteins [39], toxoids [10, 25], cross-reacting mutant toxins or nontoxic materials [20], flagella [2, 19, 29], pili [40], high-molecular-weight polysaccharides [7, 33–35], and outer membrane proteins [16, 30] as antigens for vaccination. However, among all identified pathogenic factors released from P. aeruginosa, Pseudomonas exotoxin A (PE) is the most toxic component and is considered to be the most important virulent factor [6]. Thus, development of a vaccine against PE may be an alternative route to P. aeruginosa vaccination. The intoxication process is thought to proceed first by the binding of PE to its specific receptor on the surface of toxin-sensitive cells. The PE-receptor complex then enters the cell through receptor-mediated endocytosis. Finally, PE is translocated to the cytosol where it catalyzes the transfer of the ADP-ribose moiety of NAD+ to elongation factor 2 (EF-2). This renders EF-2 inactive in protein synthesis and leads to the death of PE-affected cells [15, 28]. Thus PE should contain at least three functional domains in order to be toxic, namely binding to the receptor on the cell membrane, translocation across the membrane, and ADP ribosylation activities. Recent studies have correlated the structural domains of PE with specific biological functions [1, 4, 14, 18, 21]. Based on information obtained from the three-dimensional structure [1] and the study of PE using recombinant DNA methods [14, 18, 21], binding, translocation and ADP ribosylation domains have been identified to reside in domain Ia (residues 1–252), domain II (residues 253–364), and domain III (residues 405–613), respectively. Recently, our studies indicated that PE with a deletion of the carboxyl 38 amino acid residues, designed PE(¢576–613), completely loses its ADP ribosylation activity and, correspondingly, loses its cytotoxicity. Furthermore, PE(¢576–613) is able to block PE cytotoxic activity when it is assayed in NIH 3T3 cells [5]. Therefore, PE(¢576–613) might be a safer and more useful antigen for PE vaccination. The purpose of the present study was to assess the immunogenic properties of PE(¢576–613), and the possibility of using PE(¢576–613) for vaccine development. Materials and Methods Animals The ICR strain mice used in this study were obtained from the Animal Center, College of Medicine, National Taiwan University and were bred in the animal facilities of the National Laboratories of 358 J Biomed Sci 1999;6:357–363 Foods and Drugs. The animals were housed in standard cages and supplied with rodent laboratory chow (Purina Mills, Inc.) and water ad libitum. These animals did not show any detectable antibody responses to PE before experiments. Materials and Bacterial Strains Pseudomonas exotoxin A was purchased from ICN Biomedicals. Plasmid pJJ3, which encoded Pseudomonas exotoxin A with a deletion of 38 carboxyl-terminal amino acid residues, was obtained as described previously [5]. BL21(DE3), which had been lysogenized with a phage (DE3) carrying the T7 RNA polymerase gene under the control of a lac UV5 promoter [38], was a gift from Dr. F. W. Studies, Biology Department, Brookhaven National Laboratory, and used as a host to express PE(¢576–613). Nutrients for bacterial broth were purchased from Difco Laboratories. Reagents for sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and enzyme-linked immunosorbent assay (ELISA), and standard molecular weight markers were purchased from Bio-Rad Laboratories. All other reagents were of analytical grade. Expression and Purification of PE(¢576–613) PE(¢576–613) was prepared from BL21(DE3) transfected with plasmid pJJ3 [5]. BL21(DE3) containing pJJ3 was cultured in LB broth with 50 Ìg/ml ampicillin at 37 ° C. When absorbance at 650 nm reached 0.3, 1-isopropyl-ß-D-1-thiogalacto-pyranoside (IPTG) was added to a final concentration of 0.5 ÌM. Cells were harvested 90 min later and were resuspended into 20-cell-pellet volumes of lysis buffer (1.5 mg/ml lysozyme, 1 mM EDTA, 50 mM Tris, pH 8.0). DNase I, MgCl2, and MnCl2 were then added to a final concentration of 50 Ìg, 10 mM, and 1 mM per ml, respectively. The incubation was performed at room temperature for 15 min. In order to lyse the cells completely, 50 mM EDTA and 1% Triton X-100 were added and the incubation was prolonged for 2 additional minutes. The lysates were then centrifuged at 13,000 g for 10 min to pellet the inclusion bodies. The pellets were washed several times with a large volume of wash buffer (1% Triton X-100, 5 mM EDTA, 10 mM Tris, pH 8.0) in order to remove residual cell debris. Finally, the pellets were extracted with a 10-pellet volume of 8 M urea. The purity of PE(¢576–613) in the 8 M urea extracts reached approximately 70% purity. The purification of PE(¢576–613) was performed as follows. First, the 8 M urea extracts were dialyzed at 4 ° C against 500 vol of buffer containing 1 mM EDTA, and 10 mM Tris, pH 8.0. After 5 changes of dialysis buffer, samples were loaded onto a DEAE-Sephacel column, which was pre-equilibrated with 1 mM EDTA, 10 mM Tris, pH 8.1, and eluted with a NaCl gradient up to 1 M NaCl. PE(¢576–613) was eluted at 0.4 M NaCl. The fractions containing PE(¢576–613) were then collected and examined by SDS-PAGE. SDS-Polyacrylamide Gel Electrophoresis Samples containing PE(¢576–613) were dissolved in Laemmli buffer and boiled for 5 min prior to application to a 0.1% SDS, 12.5% acrylamide slab gel. Gels were stained by Coomassie Blue after electrophoresis as described by Laemmli [33]. A total of 20 Ìg protein sample was loaded per lane for visualization. All reagents used for gel staining and destaining were freshly prepared. Marker proteins used were: phosphorylase b, MW 97,400; bovine serum albumin, MW 66,200; ovalbumin, MW 42,700; carbonic anhydrase, MW 31,000; soybean trypsin inhibitor, MW 21,500; and lysozyme, MW 14,400. Chen/Lin/Loa/Chen/Shang/Hwang/Hui Animal Toxicity To test the toxicity of native PE and PE(¢576–613) in animals, various doses of PE and PE(¢576–613) were subcutaneously injected into ICR strain mice. Groups of twelve mice aged 5 weeks (18–20 g body weight) or 9 weeks (28–30 g body weight) were used for this study. The days of spontaneous death were recorded. Mortality rates were then compiled for 7 days after injection for estimating the 50% lethal dose (LD50) as described by Reed and Muench [36]. Immune Response Studies Five-week-old mice weighing from 18 to 20 g were immunized with PE(¢576–613) which was well suspended in 0.18% AlPO4 solution prior to immunization. Four groups of ICR mice were then inoculated subcutaneously with various doses of PE(¢576–613) on days 0, 7, and 14 to measure the minimum effective dose of PE(¢576– 613) for inducing anti-PE(¢576–613) antibodies. After the minimum effective immunizing dose was obtained, three groups of ICR mice of the same age were used to examine different immunization protocols. The PE(¢576–613) was administered subcutaneously on day 0 (group a), days 0 and 14 (group b), or days 0, 7, and 14 (group c). Venous blood samples from these immunized mice were then taken on days 0, 7, 14, 21, 28, and 42 for quantitation of the response of anti-PE antibody. Usually, sera were kept frozen at –20 ° C until assayed. Enzyme-Linked Immunosorbent Assay To quantitate the magnitude of anti-PE antisera induced by PE(¢576–613), sera from immunized animals were examined by ELISA [11]. Native PE was used to coat the polyvinylchoride flatbottom, 96-well microtiter plates (Falcon) at a concentration of 3 Ìg/ ml. 100 Ìl serial diluted mouse serum was added to a well precoated with PE and incubated at 37 ° C for 1 h. Peroxidase-conjugated goat antimouse immunoglobulin (Zymed) was used as the secondary antibody. The substrate solution contained 0.54 mg/ml of 2,2)-azainobis(3-ethylbenzthiazoline-6-sulfonic acid) and 0.03% H2O2 in 0.1 M citric acid. Results Expression and Purification of PE(¢576–613) As shown in figure 1, PE(¢576–613) was expressed in BL21(DE3)/pJJ3 and could be directly visualized as a major band at the expected molecular weight after Coomassie blue staining (fig. 1, lane 1). Since PE(¢576–613) existed as a form of inclusion body, it was extracted with 8 M urea from the inclusion body fraction (fig. 1, lane 2), followed by dialysis to renature it. By this approach, PE(¢576–613) was purified to about 70% purity (fig. 1, lane 3). The renatured PE(¢576–613) was then further purified through a DEAE-Sephacel column to obtain over 95% purity (fig. 1, lane 4). Fig. 1. SDS-PAGE of isolated PE(¢576–613). SDS-PAGE was per- formed on a 12.5% polyacrylamide gel 12 ! 14 cm and electrophoresed with 8 mA of constant current for 16 h at room temperature. After electrophoresis, gels were stained with Coomassie blue: lane 1, PE(¢576–613) in whole cell lysates; lane 2, PE(¢576–613) in 8 M urea extract; lane 3, PE(¢576–613) after dialysis; and lane 4, PE(¢576–613) after DEAE-Sephacel column chromatography. Table 1. Toxicity of PE and PE(¢576–613) in 5-week- and 9-weekold ICR micea 5-week-old mice 9-week-old mice PE, Ìg 2 1 0.5 0.25 0.125 0.0625 – 12/12 12/12 7/12 0/12 0/12 12/12b 12/12 9/12 1/12 0/12 – PE(¢576–613), Ìg 250 50 15 5 0 0/12 0/12 0/12 0/12 0/12 0/12 0/12 0/12 0/12 0/12 a The toxicity of PE and PE(¢576–613) was determined by subcutaneous injection of toxin into 5-week-old (weighing 18–20 g) or 9week-old (weighing 28–30 g) female ICR mice. The LD50 of PE was estimated according to a method described previously [36]. b All values given are number of mice which died/number of mice injected. Animal Toxicity of PE and PE(¢576–613) The toxicity of native PE and PE(¢576–613) in ICR mice of different ages was examined as shown in table 1. Vaccination against Pseudomonas Exotoxin A J Biomed Sci 1999;6:357–363 359 Since immunization in the experiments took 4 weeks, the toxicity of PE and PE(¢576–613) was examined in 5- and 9-week-old ICR mice. Various doses of PE or PE(¢576– 613) were administered subcutaneously. Five-week-old ICR mice were found to be more sensitive to PE toxicity than 9-week-old ICR mice. For 5-week-old ICR mice, 7 out of 12 receiving 0.25 Ìg of native PE, and all mice receiving 0.5 Ìg PE or more died. Among 9-week-old ICR mice, 1 of 12 mice receiving 0.25 Ìg PE, 9 of 12 mice receiving 0.5 Ìg PE, and all mice receiving 1 Ìg PE or more died. According to the method of Reed and Muench [36], the LD50 of ICR mice aged 5 and 9 weeks for PE was 0.23 and 0.38 Ìg/mouse, respectively. On the other hand, the subcutaneous administration of PE(¢576–613) to ICR mice at doses as high as 250 Ìg, which is equivalent to 650 times the LD50 dose of native PE, was found to be nontoxic in 5- and 9-week old ICR mice. These results are consistent with previous observations that PE(¢576–613) lacks its ADP ribosylation activity and consequently loses its cytotoxicity [5]. Therefore, PE(¢576–613) may be a useful antigen for vaccination against PE-mediated diseases. Fig. 2. Effects of various doses of PE(¢576–613) and different immunization protocols on the induction of anti-PE(¢576–613) antibody in ICR mice. a Immune response induced by subcutaneous injection. Groups of twelve 5-week-old female ICR mice were used in the experiment. Mice were given several doses of PE(¢576–613) well suspended in 0.18% AlPO4 (0.4 mg Al +3/ml) solution subcutaneously on days 0, 7, and 14. Blood samples from 2 mice in each experimental group were taken on days 0, 7, 14, 21, 28, and 42, and the response of anti-PE(¢576–613) antibody was evaluated at a 1:50 dilution as described in Materials and Methods. Each data point of absorbance at 410 nm by ELISA was the average of two replicate readings of 2 mice: [ = 0 Ìg; P = 0.05 Ìg; o = 0.25 Ìg; d = 1.5 Ìg. b Immune responses induced by various immunization time schedules. Twelve 5-week-old female mice per group received 0.25 Ìg of PE(¢576–613) subcutaneously in 0.5 ml of 0.18% AlPO4 on day 0 (d); days 0 and 14 (o), or days 0, 7, and 14 (P); [ = control AlPO4-immunized group. The response of anti-PE(¢576–613) antibody was evaluated at a 1:50 dilution of the collected sera as described in Materials and Methods. Data are expressed as the means of absorbance at 410 nm by ELISA from 12 mice. 360 J Biomed Sci 1999;6:357–363 Immunogenic Properties of PE(¢576–613) To examine the immunogenic properties of PE(¢576– 613), we first measured the minimum dose and time course of PE(¢576–613) administration which could result in an ideal induction of anti-PE(¢576–613) antibody in ICR mice. PE(¢576–613) was used at a dose-range of 0.05 Ìg–1.5 Ìg and was well suspended in a 0.18% AlPO4 solution before injection. As shown in figure 2a, no antiPE(¢576–613) antibody could be detected during the whole course of immunization with 0.05 Ìg PE(¢576– 613). However, detectable anti-PE(¢576–613) antibody was observed on day 21 of immunization with 0.25 Ìg PE(¢576–613) and a higher anti-PE(¢576–613) antibody response was found in mice immunized with 1.5 Ìg PE(¢576–613) after day 28. We then examined the efficiency of immunization by 0.25 Ìg PE(¢576–613) under three different immunization protocols. The induction of an anti-PE immune response was measured on days 0, 7, 14, and 21 for all three immunization protocols, and the results are summarized in figure 2b. The immunization protocols of groups a and b failed to give a detectable antiPE immune response, while the ICR mice immunized three times on days 0, 7 and 14 had an increase in anti-PE immune response (fig. 2b). We, therefore, chose protocol c for the active immunization against PE intoxication. Chen/Lin/Loa/Chen/Shang/Hwang/Hui Active Immunization against PE Intoxication Groups of six 5-week-old ICR mice weighing between 18 and 20 g were used for active immunization against PE intoxication. Each mouse was injected subcutaneously with different doses of PE(¢576–613) ranging from 0.15 to 15 Ìg on days 0, 7, and 14. On day 28, mice were challenged with 2 Ìg of PE, equivalent to about 6 times the LD50 of PE in 9-week-old ICR mice. Mortality was recorded for 7 days post-challenge. As shown in table 2, only the group receiving higher immunizing doses, i.e. 15 Ìg of PE(¢576–613), survived after PE challenge. However, 3 of 6 mice immunized with 2.5 Ìg PE(¢576– 613), 5 of 6 mice immunized with 1.5 Ìg PE(¢576–613), and all mice immunized with less than 0.25 Ìg PE(¢576– 613) died. These results indicate that immunization with 15 Ìg of PE(¢576–613) could evoke a protective immune response against PE. In order to distinguish whether the protection induced by 15 Ìg of PE(¢576–613) came from the production of anti-PE(¢576–613) antibodies instead of the competition between PE(¢576–613) and native PE, we also injected 6 5-week-old ICR mice with 2 Ìg of native PE which was mixed with 15 Ìg of PE(¢576–613). All mice died in this control experiment. In addition, we also quantitated the level of PE(¢576–613) antibodies obtained from the surviving mice of the 1.5 Ìg immunizing group by ELISA. All the survivors exhibited significantly higher levels of PE(¢576–613) antibodies (data not shown). Blocking of PE Intoxication with Anti-PE(¢576–613) Antibody in ICR Mice The neutralization experiments were carried out to clarify that the protective effects of PE(¢576–613) in mice immunized against PE were due to the neutralization of PE by anti-PE(¢576–613) which was raised during the period of PE(¢576–613) immunization. Animals were immunized with 15 Ìg of PE(¢576–613) on days 0, 7, and 14 and then challenged with 2 Ìg of native PE on day 28. On day 35, sera collected from surviving mice were diluted 10-, 50-, or 250-fold with PBS buffer and then mixed thoroughly with 2 Ìg native PE, which was equivalent to about 8-fold the LD50 of PE for 5-week-old ICR mice. As shown in table 3, all mice survived after 7 days of subcutaneous administration of the mixture of 2 Ìg PE with 10-fold diluted sera from ICR mice immunized with 15 Ìg PE(¢576–613). In addition, we also demonstrated that the antisera induced by PE(¢576–613) could block both 35S-PE binding ability on NIH 3T3 cells and ADP ribosylation activity (data not shown). Vaccination against Pseudomonas Exotoxin A Table 2. Active immunization against PE intoxication in ICR mice preimmunized with different doses of PE(¢576–613)a Immune dose Death after PE challenge/mice injectedb PE(¢576–613), Ìg 0.15 0.25 1.5 2.5 15 6/6 6/6 5/6 3/6 0/6 a Five-week-old female ICR mice were given 10 ! graded PE(¢576–613), which was well suspended in 0.18% AlPO4 (0.4 mg Al +3/ml), subcutaneously on days 0, 7, and 14, and then challenged with 2 Ìg PE on day 28. b Number of dead mice was recorded over a 7-day period. Table 3. Neutralization of PE by sera from the survivors among the PE(¢576–613) immunized mice followed by native PE toxin challengea Serum dilutionb Deathc 1:10 1:50 1:250 0/3 1/3 3/3 a Five-week-old female ICR mice were used in the experiment. ICR mice were immunized subcutaneously on days 0, 7, and 14 by PE(¢576–613) and challenged with 2 Ìg native PE on day 28. Sera from mice surviving 7 days after challenge were diluted 10-, 50-, or 250-fold with PBS and then mixed thoroughly with 2 Ìg native PE. 0.5 ml of each mixture was injected subcutaneously into ICR mice. c Mortality rates were compiled for 7 days after injection of native PE. Values given are number of dead mice/number of mice injected. b Discussion The potential role of PE in the pathogenesis of Pseudomonas infection in humans has been well documented [41]. As reported by Cross et al. [6], there are distinct differences in the titers of anti-PE antibody in sera obtained from dead and surviving patients after P. aeruginosa infection [6]. These observations thus indicate that antiPE antibody might be one of the most effective factors in protecting humans from life-threatening P. aeruginosa infection. Thus, to avoid the pathogenesis of Pseudomonas infection, development of a vaccine against PE intoxication might be an appropriate approach. This study was J Biomed Sci 1999;6:357–363 361 thus conducted in an effort to examine the possibility of using a nontoxic PE fragment, PE(¢576–613), for active immunization against PE intoxication. From a vaccination viewpoint, an ideal antigen would be highly antigenic and nontoxic. Hwang et al. [21] demonstrated that the ADP ribosylation domain is located in domain III of PE. Therefore, deletion of the carboxyl-terminal portion of PE would destroy ADP ribosylation activity, but retain the majority of epitopes for PE antigenicity [21]. Based on this concept, our recent study [5] showed that PE with a deletion of 38 amino acid residues from the carboxyl terminus completely loses ADP ribosylation activity and, consequently, loses cytotoxicity. Such experiments further demonstrate that PE(¢576–613) is a nontoxic component and can completely block PE intoxication in NIH 3T3 cells. In the present study, PE(¢576–613) as an active immunogen for the prevention of PE intoxication was evaluated in ICR mice. Our results indicate that using PE(¢576–613) as an antigen for the prevention of native PE intoxication is valid. Previously, components of the outer membrane of P. aeruginosa, such as lipopolysaccharides [7, 8, 24], protein F [17, 26] and conjugate vaccine [8, 11, 24], have been used as antigens against P. aeruginosa infection. Their abilities to induce protective immune responses in certain experimental animals and even in human beings have also been demonstrated [31]. In addition, vaccinations with lipopolysaccharides [7], high-molecular-weight polysaccharide [14], and several other components [2, 16, 40] have also been shown to be effective against challenge by PE [7, 11–13, 24, 35]. However, such preparations require pooled surface antigens from viable cells of several different P. aeruginosa serotypes. Furthermore, because of the high possibility of endotoxin contamination in LPS products, there is an inherent limitation in using lipopolysaccharide products for vaccination. Thus, the development of outer membrane components as vaccines against Pseudomonas infection is impaired. In this study, we have reported the simplicity of an engineered PE derivative, PE(¢576–613), which can be used in active immunization against PE intoxication. The advantages of using PE(¢576–613) for vaccination against PE intoxication can be summarized as follows: (1) PE(¢576–613) is a recombinant protein expressed in BL21(DE3)/pJJ3. The purification procedure to obtain high-purity PE(¢576– 613) is simple. Thus, it is easy to obtain a large quantity of PE(¢576–613) at low cost. (2) The application of PE(¢576–613) in dosage form for vaccination is easier as compared with the reported protective immunogens found against P. aeruginosa infection so far. (3) PE(¢576– 613) after purification lacks any inherent endotoxicity. Finally, like other available reported immunogenic materials, PE(¢576–613) is effective in the treatment of Pseudomonas infection. Our results showed that vaccination of ICR strain mice with PE(¢576–613) can protect them against PE. Antibodies raised by PE(¢576–613) also successfully protect mice against PE, and the protection against PE intoxication in PE(¢576–613)-immunized mice resulted from the neutralizing activity of antiPE(¢576–613) antibody. Thus, this study concludes that the use of PE(¢576–613) as an antigen is a valuable alternative in PE vaccine development. Acknowledgments This work was supported by a grant from the National Science Council (NSC87-2312-B-001-007) and Academia Sinica, Taiwan, ROC. References 1 Allured VS, Collier RJ, Carroll SF, McKay DB. Structure of exotoxin A of Pseudomonas aeruginosa at 3.0 ångstrom resolution. Proc Natl Acad Sci USA 83:1320–1324;1986. 2 Anderson TR, Montie TC. Opsonophagocytosis of Pseudomonas aeruginosa treated with anti-flagellar serum. Infect Immun 55:3204– 3206;1987. 3 Bodey GP, Bolivar R, Fainstein V, Jadeja L. Infections caused by Pseudomonas aeruginosa. Rev Infect Dis 5:279–313;1983. 4 Chen ST, Jordan EM, Wilson RB, Draper RK, Clowes RC. Transcription and expression of the exotoxin A gene of Pseudomonas aeruginosa. J Gen Microbiol 133:3081–3091;1987. 362 5 Chow JT, Chen MS, Wu HCP, Hwang J. Identification of the carboxyl-terminal amino acids important for the ADP-ribosylation activity of Pseudomonas aeruginosa A. J Biol Chem 264: 18818–18823;1989. 6 Cross AS, Sadoff JC, Iglewski BH, Sokol PA. Evidence for the role of toxin A in the pathogenesis of infection with Pseudomonas aeruginosa in humans. J Infect Dis 142:538–546; 1980. 7 Cryz SJ, Fürer E, Germanier R. Protection against fatal Pseudomonas aeruginosa burn wound sepsis by immunization with lipopolysaccharide and high-molecular-weight polysaccharide. Infect Immun 43:795–799;1984. J Biomed Sci 1999;6:357–363 8 Cryz SJ, Lang AB, Sadoff JC, Germanier R, Fürer E. Vaccine potential of Pseudomonas aeruginosa O-polysaccharide-toxin A conjugates. Infect Immun 55:1547–1551;1987. 9 Cryz SJ, Fürer E, Sadoff JC, Germanier R. Pseudomonas aeruginosa immunotype 5 polysaccharide-toxin A conjugate vaccine. Infect Immun 52:161–165;1986. 10 Cryz SJ, Iglewski BH. Toxoids of Pseudomonas aeruginosa exotoxin A: Production by chemical and genetic means. Rev Infect Dis 5(suppl): S992–997;1983. Chen/Lin/Loa/Chen/Shang/Hwang/Hui 11 Cryz SJ, Sadoff JC, Ohman D, Fürer E. Characterization of the human immune response to a Pseudomonas aeruginosa O-polysaccharidetoxin A conjugate vaccine. J Lab Clin Med 111: 701–707;1988. 12 Cryz SJ, Fürer E, Cross AS, Wegmann A, Germanier R, Sadoff JC. Safety and immunogenicity of a Pseudomonas aeruginosa O-polysaccharide-toxin A conjugate vaccine in humans. J Clin Invest 80:51–56;1987. 13 Doring G. Host response to Pseudomonas aeruginosa. Acta Paediatr Scand 363(suppl):37–40; 1989. 14 Douglas CM, Collier RJ. Exotoxin A of Pseudomonas aeruginosa: Substitution of glutamic acid 553 with aspartic acid drastically reduces toxicity and enzymatic activity. J Bacteriol 169:4967–4971;1987. 15 Eidels L, Proia RL, Hart DA. Membrane receptors for bacterial toxins. Microbiol Rev 47: 596–620;1983. 16 Gilleland HE Jr, Parker MG, Mattews JM, Berg RD. Use of a purified outer membrane protein F (porin) preparation of Pseudomonas aeruginosa as a protective vaccine in mice. Infect Immun 44:49–54;1984. 17 Gilleland HE Jr, Gilleland LB, MatthewsGreer JM. Outer membrane protein F preparation of Pseudomonas aeruginosa as a vaccine against chronic pulmonary infection with heterologous immunotype strains in a rat model. Infect Immun 56:1017–1022;1988. 18 Gray GL, Smith DH, Baldridge JS, Harkins RN, Vasil ML, Chen EY, Heyneker HL. Cloning, nucleotide sequence, and expression in Escherichia coli of the exotoxin A structural gene of Pseudomonas aeruginosa. Proc Natl Acad Sci USA 81:2645–2649;1984. 19 Holder IA, Wheeler A, Monite TC. Flagellar preparations from Pseudomonas aeruginosa: Animal protection studies. Infect Immun 35: 276–280;1982. 20 Hooke AM, Sordelli DO, Cerquetti MC, Bellanti JA. Differential growth characteristics and immunogenicity of tight and coasting temperature sensitive mutants of Pseudomonas aeruginosa. Infect Immun 55:99–103;1987. Vaccination against Pseudomonas Exotoxin A 21 Hwang J, Fitzgerald DJ, Adhya S, Pastan I. Functional domains of Pseudomonas exotoxin identified by deletion analysis of the gene expressed in E. coli. Cell 48:129–136;1987. 22 King A, Shannon K, Eykyn S, Philips I. Reduced sensitivity to ß-lactam antibiotics arising during ceftazidine treatment of Pseudomonas aeruginosa infections. J Antimicrob Chemother 12:363–370;1983. 23 Laemmli UK. Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature 227:680–685;1970. 24 MacIntyre S, Lucken R, Owen P. Smooth lipopolysaccharide is the major protective antigen for mice in the surface extract from IATS serotype 6 contributing to the polyvalent Pseudomonas aeruginosa vaccine PEV. Infect Immun 52:76–84;1986. 25 Marburg S, Tolman RL, Callahan LT. Pseudomonas exotoxin A: Toxoid preparation by photoaffinity inactivation. Proc Natl Acad Sci USA 80:2870–2873;1983. 26 Mathews-Greer JM, Gilleland HE Jr. Outer membrane protein F (Porin) preparation of Pseudomonas aeruginosa as a protective vaccine against heterologous immunotype strains in a burned mouse model. J Infect Dis 155: 1282–1291;1987. 27 McManus AT, Mason AD Jr, McManus WF, Pruitt BA Jr. Twenty-five-year review of Pseudomonas aeruginosa bacteremia in a burn center. Eur J Clin Microbiol 4:219–223;1985. 28 Middlebrook JL, Dorland RB. Bacteria toxins: Cellular mechanisms of action. Microbiol Rev 48:199–221;1984. 29 Montie TC, Doyle-Huntzinger D, Craven RC, Holder IA. Loss of virulence associated with absence of flagellum in an isogenic mutant of Pseudomonas aeruginosa in the burned mouse model. Infect Immun 38:1296–1298;1982. 30 Mutharia LM, Hancock REW. Surface localization of Pseudomonas aeruginosa outer membrane porin protein F by using monoclonal antibodies. Infect Immun 42:1027–1033; 1983. 31 Pennington JE. Pseudomonas aeruginosa. Vaccines and immunotherapy. Infect Dis Clin North Am 4:259–270;1990. 32 Pennington JE. Preliminary investigations of Pseudomonas aeruginosa vaccine in patients with leukemia and cystic fibrosis. J Infect Dis 130: S159–162;1974. 33 Pier GB, Cohen M, Jennings H. Further purification and characterization of high molecular weight polysaccharide from Pseudomonas aeruginosa. Infect Immun 42:936–941;1983. 34 Pier GB, Pollack M, Cohen M, Thomas DM. Immunochemical characterization of high-molecular-weight polysaccharide from Fisher immunotype 3 Pseudomonas aeruginosa. Infect Immun 45:309–313;1984. 35 Pollack M, Pier GB, Prescott RK. Immunization with Pseudomonas aeruginosa high molecular weight polysaccharides prevents death from Pseudomonas burn infections in mice. Infect Immun 43:759–760;1984. 36 Reed LJ, Muench H. A simple method of estimating fifty percent endpoints. Am J Hyg 27: 493–497;1938. 37 Sanders CC, Sanders WE Jr. Microbial resistance to newer generation ß-lactam antibiotics: Clinical and laboratory implications. J Infect Dis 151:399–406;1985. 38 Studier FW, Moffatt BA. Use of bacteriophage T7 RNA polymerase to direct selective high level expression of cloned genes. J Mol Biol 189:113–130;1986. 39 Tsay GC, Collins MS. Preparation and characterization of a nontoxic polysaccharide-protein conjugate that induces active immunity and passively protective antibody against Pseudomonas aeruginosa immunotype 1 in mice. Infect Immun 45:217–221;1984. 40 Woods DE, Straus DC, Johanson WG Jr, Berry VK, Bass JA. Role of pili in adherence of Pseudomonas aeruginosa to mammalian buccal epithelial cells. Infect Immun 29:1146–1151; 1980. 41 Woods DE, Iglewski BH. Toxins of Pseudomonas aeruginosa: New perspectives. J Infect Dis 5:S715–722;1983. J Biomed Sci 1999;6:357–363 363
© Copyright 2026 Paperzz