The capacity of licensed vaccines to protect the ocular surface against
infection is limited. Common ocular pathogens such as herpes simplex virus type
1 (HSV-1) are increasingly recognized as major contributors to visual morbidity
worldwide. Humoral immunity is an essential correlate of protection against
HSV-1 pathogenesis and ocular pathology, yet the ability of antibody to protect
against HSV-1 is deemed limited due to the slow IgG diffusion rate in the
healthy cornea. We show that a live-attenuated HSV-1 vaccine elicits humoral
immune responses that are unparalleled by a glycoprotein subunit vaccine
vis-à-vis antibody persistence and host protection. The live-attenuated
vaccine was utilized to assess the impact of immunization route on vaccine
efficacy. The hierarchical rankings of primary immunization route with respect
to efficacy were: subcutaneous ≥ mucosal > intramuscular. Prime-boost
vaccination via sequential subcutaneous and intramuscular administration yielded
greater efficacy than any other primary immunization route alone. Moreover, our
data also support a role of complement in prophylactic protection as evidenced
by intracellular deposition of C3d in the corneal epithelium of vaccinated
animals following challenge and delayed viral clearance in C3-deficient mice. We
also identify that the neonatal Fc receptor (FcRn) is upregulated in the cornea
following infection or injury concomitant with increased antibody perfusion.
Lastly, selective siRNA-mediated knockdown of FcRn in the cornea impeded
protection against ocular HSV-1 challenge in vaccinated mice. Collectively,
these findings establish a novel mechanism of humoral protection in the eye
involving FcRn and may facilitate vaccine and therapeutic development for other
ocular surface diseases.