Background:
Understanding the functional capacity of antibodies to conserved Streptococcus pyogenes vaccine antigens is critical for vaccine development. We studied performance of functional immunoassays in a setting with high disease burden.
Methods:
Sera (n=114) from two cross sectional cohorts in The Gambia spanning infancy to adulthood were randomly selected from strata of binding IgG titres to SLO, SpyAD and SpyCEP. Functional immunoassays measured inhibition of SLO-mediated hemolysis, SpyCEP-mediated IL-8 cleavage, and opsonophagocytosis of SpyAD- and GAC-coated beads as well as FITC-labelled whole M1 bacteria into THP-1 cells1,2,3.
Results:
Stronger correlations were observed between IgG binding levels to SLO and inhibition of haemolysis (Spearman’s coefficient=0.78) than between IgG to SpyCEP and inhibition of IL-8 cleavage (coefficient=0.59). Opsonophagocytosis of antigen-coated beads correlated strongly with binding IgG for GAC (coefficient=0.73) and SpyAD (coefficient=0.81). A higher proportion of samples with IgG levels above previously identified 50% protective thresholds demonstrated opsonophagocytosis of M1 bacteria compared to those below the threshold for SLO (74% vs 34%, p=0.00078), SpyAD (93% vs 35%, p<0.0001), and SpyCEP (70% vs 36%, p=0.011).
Discussion:
We observed substantial heterogeneity, with broad correlation between binding IgG and functionality. SpyCEP-mediated Il-8 cleavage inhibition demonstrated a less clear correlation with anti-SpyCEP IgG, suggesting binding of antibodies to non-functional regions of SpyCEP. Given IgG to M1 was low, observed opsonophagocytosis is assumed to have occurred mediated by antibodies directed at targets other than the M1 hypervariable region. Further assessment in clinical vaccine trials and human challenge models will further clarify the utility of these assays.