Neisserial surface protein A (NspA) is a highly conserved outer membrane protein previously investigated as a meningococcal vaccine candidate. Despite eliciting serum bactericidal activity in mice, a recombinant NspA vaccine failed to elicit serum bactericidal antibodies in a phase 1 clinical trial in humans. The discordant results may be explained by the recent discovery that NspA is a human-specific ligand of the complement inhibitor factor H (FH). Therefore, in humans but not mice, NspA would be expected to form a complex with FH, which could impair human anti-NspA protective antibody responses. To investigate this question, we immunized human FH transgenic BALB/c mice with three doses of recombinant NspA expressed in Escherichia coli microvesicles, with each dose being separated by 3 weeks. Three of 12 (25%) transgenic mice and 13 of 14 wild-type mice responded with bactericidal titers of >1:10 in postimmunization sera (P ؍ 0.0008, Fisher's exact test). In contrast, human FH transgenic and wild-type mice immunized with a control meningococcal native outer membrane vesicle vaccine had similar serum bactericidal antibody responses directed at PorA, which is not known to bind human FH, and a mutant factor H binding protein ( T he 1990s witnessed the discovery of two promising recombinant protein meningococcal vaccine candidates capable of eliciting broad serum bactericidal antibody responses in mice: neisserial surface protein A (NspA) (1-3) and transferrin-binding protein (TbpB) (4-6). However, in phase 1 clinical trials, both recombinant protein vaccines failed to elicit serum bactericidal antibody responses in humans (7,8). NspA was subsequently shown to bind specifically to human complement factor H (FH) (9), and transferrin-binding protein was known to bind specifically to human and not mouse transferrin (10). The impaired serum bactericidal antibody responses to these vaccines in humans may have resulted in part from binding of the host proteins to the vaccine antigens. For example, human FH transgenic mice immunized with meningococcal factor H binding protein (FHbp) vaccines that bound human FH had lower serum anti-FHbp bactericidal antibody responses than wild-type mice whose mouse FH did not bind to FHbp (11,12). Rhesus macaques with FH that bound with a high avidity to FHbp also had lower serum antiFHbp bactericidal antibody responses than macaques with FH containing a polymorphism associated with low-avidity binding to FHbp (13). Pigs immunized with a mutant Haemophilus parasuis TbpB vaccine with decreased binding to porcine transferrin elicited higher T-and B-cell responses than pigs immunized with a native TbpB that bound porcine transferrin (12).NspA is highly conserved in Neisseria meningitidis (1) and, therefore, would be of interest for use as a component of a serogroup B vaccine if the antigen were capable of eliciting protective antibodies in humans. In the present study, we immunized wildtype and human FH transgenic BALB/c mice with a prototype recombinant NspA vaccine expressed in Esche...