A long-standing challenge in developing vaccines against enterotoxigenic Escherichia coli (ETEC), the most common bacteria causing diarrhea in children of developing countries and travelers to these countries, is to protect against heat-stable toxin type Ib (STa or hSTa). STa and heat-labile toxin (LT) are virulence determinants in ETEC diarrhea. LT antigens are often used in vaccine development, but STa has not been included because of its poor immunogenicity and potent toxicity. Toxic STa is not safe for vaccines, but only STa possessing toxicity is believed to be able to induce neutralizing antibodies. However, recent studies demonstrated that nontoxic STa derivatives (toxoids), after being fused to an LT protein, induced neutralizing antibodies and suggested that different STa toxoids fused to an LT protein might exhibit different STa antigenic propensity. In this study, we selected 14 STa toxoids from a mini-STa toxoid library based on toxicity reduction and reactivity to anti-native STa antibodies, and genetically fused each toxoid to a monomeric double mutant LT (dmLT) peptide for 14 STa -toxoid -dmLT toxoid fusions. These toxoid fusions were used to immunize mice and were characterized for induction of anti-STa antibody response. The results showed that different STa toxoids (in fusions) varied greatly in anti-STa antigenicity. Among them, STa N12S , STa N12T , and STa A14H were the top toxoids in inducing anti-STa antibodies. In vitro neutralization assays indicated that antibodies induced by the 3؋STa N12S -dmLT fusion antigen exhibited the greatest neutralizing activity against STa toxin. These results suggested 3؋STa N12S -dmLT is a preferred fusion antigen to induce an anti-STa antibody response and provided long-awaited information for effective ETEC vaccine development.
Diarrhea remains a leading cause of death in children younger than 5 years who live in developing countries (1). Enterotoxigenic Escherichia coli (ETEC) strains (i.e., E. coli strains producing enterotoxins) are the most common bacteria causing diarrhea, particularly in children younger than 1 year from developing countries (2). ETEC diarrhea is responsible for an estimated annual death rate of 300,000 to 500,000, with the vast majority being children younger than 5 years (3, 4). ETEC strains are also the leading cause of diarrhea in children and adults who travel from developed countries to countries or regions where ETEC is endemic and in military personnel deployed in these areas and is also a threat to immunocompromised patients (3, 5-7). The virulence determinants of ETEC in diarrhea are bacterial adhesins and enterotoxins. Adhesins mediate initial ETEC bacteria attachment to host epithelial cells and subsequent colonization at host small intestines. Attachment and colonization bring ETEC bacteria in close proximity, which allows ETEC to deliver enterotoxins to host epithelial cells. Enterotoxins, mainly heat-labile toxin (LT) and heat-stable toxin type Ib (human-type STa or hSTa, which differs from type Ia STa or pSTa associa...