The neglected role of antibody in protection against bacteremia caused by nontyphoidal strains of Salmonella in African children
Calman A. MacLennan, … , Malcolm E. Molyneux, Mark T. Drayson
Calman A. MacLennan, … , Malcolm E. Molyneux, Mark T. Drayson
Published March 20, 2008
Citation Information: J Clin Invest. 2008;118(4):1553-1562. https://doi.org/10.1172/JCI33998.
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Research Article Immunology

The neglected role of antibody in protection against bacteremia caused by nontyphoidal strains of Salmonella in African children

Abstract

Nontyphoidal strains of Salmonella (NTS) are a common cause of bacteremia among African children. Cell-mediated immune responses control intracellular infection, but they do not protect against extracellular growth of NTS in the blood. We investigated whether antibody protects against NTS bacteremia in Malawian children, because we found this condition mainly occurs before 2 years of age, with relative sparing of infants younger than 4 months old. Sera from all healthy Malawian children tested aged more than 16 months contained anti-Salmonella antibody and successfully killed NTS. Killing was mediated by complement membrane attack complex and not augmented in the presence of blood leukocytes. Sera from most healthy children less than 16 months old lacked NTS-specific antibody, and sera lacking antibody did not kill NTS despite normal complement function. Addition of Salmonella-specific antibody, but not mannose-binding lectin, enabled NTS killing. All NTS strains tested had long-chain lipopolysaccharide and the rck gene, features that resist direct complement-mediated killing. Disruption of lipopolysaccharide biosynthesis enabled killing of NTS by serum lacking Salmonella-specific antibody. We conclude that Salmonella-specific antibody that overcomes the complement resistance of NTS develops by 2 years of life in Malawian children. This finding and the age-incidence of NTS bacteremia suggest that antibody protects against NTS bacteremia and support the development of vaccines against NTS that induce protective antibody.

Authors

Calman A. MacLennan, Esther N. Gondwe, Chisomo L. Msefula, Robert A. Kingsley, Nicholas R. Thomson, Sarah A. White, Margaret Goodall, Derek J. Pickard, Stephen M. Graham, Gordon Dougan, C. Anthony Hart, Malcolm E. Molyneux, Mark T. Drayson

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Figure 7

P22 bacteriophage sensitivity and lipopolysaccharide profiles of invasive NTS isolates from Malawi.

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Age-based comparison of healthy Malawian children with cases of NTS bact...
(A) P22 bacteriophage sensitivity of 8 Malawian clinical isolates of S. Typhimurium from bacteremic children (lanes 1–8) compared with smooth S. Typhimurium strain SL1344 (lane 9), E. coli strain C600 (lane 10), and rough S. Typhimurium strain BA85 (lane 11). P22 was streaked across LB agar between the arrows and allowed to dry before the bacterial strains were cross-streaked. The plate was left overnight at 37°C before photographing. (B) Comparison of lipopolysaccharide profiles of 8 Malawian clinical S. Typhimurium isolates from bacteremic children (lanes 1–8) with laboratory smooth (SL1344; lane 9) and rough (BA85; lane 10) strains of S. Typhimurium. Lipopolysaccharide was prepared from S. Typhimurium and separated by SDS-PAGE prior to silver staining.