Background: There is a clear and pressing need for a vaccine against Streptococcus pyogenes. Induction of functional antibodies is essential for immune protection and functional immunoassays are central to vaccine development. Functional immunoassays for S. pyogenes are labour-intensive, low throughput and difficult to scale.
Methods: We have developed scalable antibody dependent cellular phagocytosis (ADCP) and neutrophil phagocytosis (ADNP) assays for S. pyogenes candidate vaccine antigens: GAC, SLO, SpyAD, and SpyCEP. Monocytes (THP-1) were used in ADCP assays and neutrophils (DMF-differentiated HL-60 cells) in ADNP assays. Plasma samples from healthy adults pre- and 1-month post-challenge, in the CHIVAS-M75 pharyngitis study, were incubated with fluorescent microspheres conjugated to antigens, and phagocytosis was measured by flow cytometry and confirmed by microscopy.
Results: ADCP and ADNP responses for all antigens were highly variable before and after challenge. Participants who did not develop pharyngitis had higher baseline antibody activity compared to those who did, especially for the SLO ADCP assay (p = 0.05). Increased functional antibodies were observed in participants with pharyngitis, most significantly in the SpyCEP ADCP (p < 0.0001). Functional antibodies in ADCP and ADNP were highly correlated with SpyAD IgG titres (r > 0.7) and moderately for SLO (r > 0.3) and SpyCEP (r > 0.5). IgG titres and GAC antibody-mediated phagocytosis correlated poorly (r < 0.2).
Conclusion: Adults have a diverse repertoire of functional antibodies against S. pyogenes, influenced by infection. This can be measured in these reproducible, sample sparing, high-throughput, antigen-specific assays.