Human cytomegalovirus (HCMV) is a β-herpesvirus that establishes a life-long presence in the infected host. The adaptive immune response is indispensable in controlling HCMV infection. Consequently, healthy individuals show no or mild symptoms following primary infection. In contrast, immunocompromised individuals who develop primary infection or recrudescence of HCMV can experience severe morbidity, and sometimes mortality. HCMV-specific T cell populations undergo changes in the architecture of their T cell receptor (TCR) repertoire following each episode of viral reactivation. A diverse TCR repertoire is thought to be required to provide the most efficient protection against virus infection. Perturbation to this repertoire, as can occur in immunocompromised individuals following transplantation, can lead to an increase risk of developing virus-associated clinical disease. Therefore, the study of factors influencing TCR selection is critically important in both healthy and immunocompromised individuals. To further understand the factors governing TCR selection in a persistent virus infection, the current thesis examined this process in different settings. CD8+ T cell responses to persistent viral infections are characterised by the accumulation of T cells exhibiting an oligoclonal T cell repertoire, with a parallel reduction in the naïve T cell pool. However, the precise mechanism for this phenomenon remains elusive. Here, we showed that HCMV-specific CD8+ T cells recognising distinct epitopes from the pp65 protein and restricted through an identical HLA class I allele (HLA B*3508) exhibited either a highly conserved public T cell repertoire, or a private, diverse T cell response, which was uniquely altered in each donor following in vitro antigen exposure. Selection of a public TCR was co-incident with an atypical peptide-MHC (pMHC) structure, whereby the epitope adopted a helical conformation that bulged from the peptide-binding groove, whilst a diverse TCR profile was observed in response to the epitope that formed a flatter, more ‘featureless’ landscape. Clonotypes with biased TCR usage demonstrated more efficient recognition of virus-infected cells, a greater CD8 dependency, and were more terminally differentiated in their phenotype when compared to the T cells expressing diverse TCR. These findings provide new insights into our understanding of how the biology of antigen presentation, in addition to the structural features of the pMHC, might shape the T cell phenotype and its corresponding repertoire architecture. Next, the role of HCMV in shaping the global and antigen-specific TCR repertoire in healthy donors was examined. First, exposure to HCMV led to an inflation of terminally differentiated CD57-expressing T cells. This effect was not seen in HCMV seronegative individuals who showed evidence of exposure to another persistent herpesvirus, Epstein-Barr virus (EBV). More importantly, these terminally differentiated CD8+ T cells in HCMV-exposed individuals displayed a highly skewed architecture of their peripheral blood T cell repertoire, with large monoclonal/oligoclonal expansions. However, ex vivo analyses of HCMV-specific T cells revealed a heterogeneous pattern of CD57 expression that showed no correlation to the antigenic source of its cognate epitope. Based on these observations, we proposed that exposure to HCMV drives the differentiation of not only the global T cell population, but select HCMV-specific T cell populations as well, and that expression of CD57 by these cells was co-incident with an oligoclonal T cell repertoire. Finally, the TCR repertoire was examined in a cohort of solid organ transplant (SOT) recipients, where primary infection or recrudescence of latent virus infection can be manifested either as asymptomatic or symptomatic disease. We examined 18 SOT recipients, and observed that symptomatic HCMV or EBV infection or recrudescence following solid organ transplantation was co-incident with a dramatic skewing of the TCR repertoire, with expansions of monoclonal/oligoclonal clonotypes. As the clinical symptoms resolved, the peripheral blood repertoire reverted to a more diverse distribution. In contrast, SOT recipients with asymptomatic or no HCMV/EBV infection or recrudescence showed minimal or no skewing of the TCR repertoire, and maintained TCR repertoire diversity. Interestingly, this disparate repertoire showed no correlation with levels of viral load in the peripheral blood. More importantly, we showed that large monoclonal/oligoclonal repertoire expansions was linked to the loss of antigen-specific T cell function observed in SOT patients undergoing symptomatic viral infection or recrudescence, while SOT recipients who maintained peripheral blood TCR repertoire diversity and functional antigen-specific T cell responses could resist clinical symptomatic disease in spite of high levels of viral load. Therefore, the work presented in this thesis provides additional evidence on the factors governing TCR selection in HCMV-exposed healthy individuals, as well as the consequences that perturbation to the TCR repertoire has on the functionality of the T cell compartment in immunocompromised individuals.

Made available in DSpace on 2014-06-11T19:27:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-12-10Bitstream added on 2014-06-13T20:56:15Z : No. of bitstreams: 1 herter_drc_me_sjrp.pdf: 754038 bytes, checksum: 1546a0d9c3ae0583356f9052fe2fb9e8 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / O presente estudo avaliou a relação entre a resposta de anticorpos contra AMA-1 das variantes de P. vivax (VK210, VK247 e P. vivax-like) e os polimorfismos do gene HLA-DRB1 em populações endêmicas da Amazônia brasileira, para melhor entendimento dos mecanismos que modulam a resposta imune contra a malária. A resposta sorológica foi analisada em indivíduos maláricos e não-maláricos por testes de ELISA para AMA-1. Um subgrupo de amostras foi utilizado para genotipagem do gene HLA-DRB1 por PCR-SSP. Foram detectados 13 alelos diferentes do gene HLA- DRB1, sendo o alelo HLA-DRB1*04 o prevalente na população estudada. Foi detectada uma alta freqüência de respondedores para o antígeno AMA-1, com níveis crescentes de acordo com exposição prévia a malária. Nenhuma associação significativa foi observada entre as variantes da CSP do P.vivax e a resposta a AMA- 1, bem como aos polimorfismos do HLA-DRB1. O HLA-DRB1 apresenta uma distribuição heterogênea na população estudada, evidenciando uma contribuição característica de descendência ameríndia. A resposta de anticorpos contra o antígeno AMA-1 parece não influenciar na epidemiologia das variantes da CSP de P. vivax. Os polimorfismos do gene HLA-DRB1 não influenciam no desenvolvimento de reposta de anticorpos contra o AMA-1 na malária vivax na Amazônia brasileira / To better understand the mechanisms of the immune response modulation against malaria, this study evaluated the relationship among the antibody response to AMA-1 and variants of the circumsporozoite protein (CSP) of the P. vivax (VK210, VK247 and P. vivax-like) and the polymorphisms of HLA-DRB1 gene in populations endemic from the Brazilian Amazon. The antibody response was analyzed in malarial and non-malarial individuals by AMA-1ELISA test. A subset of samples was genotyping of HLA-DRB1 by PCR-SSP. We detected 13 different alleles of HLA-DRB gene, where the HLA-DRB1*04 was the commonest allele. A high frequency of responders to the antigen AMA-1 was detected, with increasing levels according to previous malaria experience. No significant association was observed among the response to P. vivax AMA-1 and, the variants of the CSP and the polymorphisms of HLA-DRB gene. The HLA-DRB1 has a heterogeneous distribution in the population studied, showing an effective contribution of Amerindian groups. The antibody response against the antigen AMA-1 does not influence the epidemiology of variants of the CSP of P. vivax. The polymorphisms of HLA-DRB1 gene do not influence the development of antibody response against AMA-1 in vivax malaria around the Brazilian Amazon region

Orientador: Ricardo Luiz Dantas Machado / Banca: Paula Rahal / Banca: Carlos Eugênio Cavasini / Resumo: O presente estudo avaliou a relação entre a resposta de anticorpos contra AMA-1 das variantes de P. vivax (VK210, VK247 e P. vivax-like) e os polimorfismos do gene HLA-DRB1 em populações endêmicas da Amazônia brasileira, para melhor entendimento dos mecanismos que modulam a resposta imune contra a malária. A resposta sorológica foi analisada em indivíduos maláricos e não-maláricos por testes de ELISA para AMA-1. Um subgrupo de amostras foi utilizado para genotipagem do gene HLA-DRB1 por PCR-SSP. Foram detectados 13 alelos diferentes do gene HLA- DRB1, sendo o alelo HLA-DRB1*04 o prevalente na população estudada. Foi detectada uma alta freqüência de respondedores para o antígeno AMA-1, com níveis crescentes de acordo com exposição prévia a malária. Nenhuma associação significativa foi observada entre as variantes da CSP do P.vivax e a resposta a AMA- 1, bem como aos polimorfismos do HLA-DRB1. O HLA-DRB1 apresenta uma distribuição heterogênea na população estudada, evidenciando uma contribuição característica de descendência ameríndia. A resposta de anticorpos contra o antígeno AMA-1 parece não influenciar na epidemiologia das variantes da CSP de P. vivax. Os polimorfismos do gene HLA-DRB1 não influenciam no desenvolvimento de reposta de anticorpos contra o AMA-1 na malária vivax na Amazônia brasileira / Abstract: To better understand the mechanisms of the immune response modulation against malaria, this study evaluated the relationship among the antibody response to AMA-1 and variants of the circumsporozoite protein (CSP) of the P. vivax (VK210, VK247 and P. vivax-like) and the polymorphisms of HLA-DRB1 gene in populations endemic from the Brazilian Amazon. The antibody response was analyzed in malarial and non-malarial individuals by AMA-1ELISA test. A subset of samples was genotyping of HLA-DRB1 by PCR-SSP. We detected 13 different alleles of HLA-DRB gene, where the HLA-DRB1*04 was the commonest allele. A high frequency of responders to the antigen AMA-1 was detected, with increasing levels according to previous malaria experience. No significant association was observed among the response to P. vivax AMA-1 and, the variants of the CSP and the polymorphisms of HLA-DRB gene. The HLA-DRB1 has a heterogeneous distribution in the population studied, showing an effective contribution of Amerindian groups. The antibody response against the antigen AMA-1 does not influence the epidemiology of variants of the CSP of P. vivax. The polymorphisms of HLA-DRB1 gene do not influence the development of antibody response against AMA-1 in vivax malaria around the Brazilian Amazon region / Mestre

<p>Southern Africa is facing one of the most serious HIV epidemics. This project contributes to the HIVNET, Network for Prevention Trials cohort for vaccine development. HIV’s biology and rapid mutation rate have made vaccine design difficult. We examined HIV-1 subtype C diversity and how it relates to CTL epitope location along viral gag sequences. We found a negative correlation between codon sites under positive selection and epitope regions / suggesting epitope regions are evolutionarily conserved. It is possible that epitopes exist in non-conserved regions, yet fail to be detected due to the reference strain diverging from the circulating viral population. To test if CTL clustering is an artifact of the reference strain, we calculated differences between the gag codons and the reference strain. We found a weak negative correlation, suggesting epitopes in less conserved regions maybe evading detection. Locating conserved and optimal epitopes that can be recognized by CTLs is essential for the design of vaccine reagents.</p>

O antígeno leucocitário humano (HLA)-G corresponde a uma molécula não clássica de classe I do complexo principal de histocompatibilidade. Segundo a literatura, tal molécula pode ser expressa em ambos os contextos patológico e fisiológico. Diversos autores têm apresentado evidências acerca do papel do HLA-G na tolerância imune do feto durante a gestação, bem como para o sucesso de alotransplantes. No entanto, até o momento, há poucas informações publicadas a respeito da expressão fisiológica dessa molécula nos diferentes órgãos humanos. Em acréscimo a isso, a participação do HLA-G em eventos fisiológicos é ainda um assunto controverso entre cientistas. Tendo em vista o exposto, o objetivo desse estudo foi investigar a expressão da proteína HLA-G em órgãos fetais durante o progredir da gestação, bem como em órgãos adultos. Trata-se de um estudo descritivo, comparativo, transversal e retrospectivo realizado com base na revisão de prontuários e análise de necropsias/biópsias de diferentes órgãos de fetos e adultos através do método de imunohistoquímica. Os resultados demonstraram a existência de diferença estatística significativa na imunomarcação da proteína HLA-G em glândulas adrenais (p= 0,0003), baço (p= 0,0276), coração (p= 0,0474), fígado (p= 0,0052), pulmões (p = 0,0367), rins (p = 0,0377) e timo (p= 0,0336) na comparação entre o primeiro e segundo trimestre gestacional; em glândulas adrenais (p= 0,0329), baço (p= 0,0095), pâncreas (p= 0,0009) e placenta (p= 0,0285) na comparação entre o segundo e terceiro trimestre gestacional; e no coração (p= 0,0304), fígado (p= 0,0055), pulmões (p= 0,0150) e rins (p= 0,0312) na comparação entre o terceiro trimestre gestacional e a fase adulta. Foi verificado um aumento na expressão do HLA-G fetal a partir do segundo trimestre gestacional em órgãos como glândulas adrenais, coração, fígado, rins, timo e pulmões. Entretanto, isso não foi uma constante, pois em outros, a exemplo do baço, pâncreas e placenta, não observouse essa tendência durante o mesmo período. Durante o terceiro trimestre gestacional e a fase adulta evidenciou-se valores mais elevados para a expressão do HLA-G nos rins, e valores bastante inferiores no fígado. A expressão fisiológica do HLA-G embora positiva em todos os órgãos avaliados, nos três trimestres gestacionais e/ou na fase adulta, apresentou diferenças na intensidade e localização nos diferentes órgãos e períodos. Os achados a partir dessa pesquisa certamente representam uma importante contribuição para um melhor entendimento do mecanismo gestacional, assim como da fisiologia do HLA-G em adultos, sobretudo no que concerne o estabelecimento da tolerância imunológica em transplante de órgãos / Human leukocyte antigen (HLA)-G is a nonclassical class I major histocompatibility complex molecule. According to the literature, this molecule can be expressed in both pathological and physiological contexts. Several authors have presented evidence about the role of HLA-G in the immune tolerance of the fetus during pregnancy, as well as for the success of allotransplants. However, until now, there are very few published data regarding the physiological expression of this molecule in different human organs. Moreover, the role of HLA-G in physiological events is still a controversial subject among scientists. In view of the above, the objective of this study was to investigate the expression of HLA-G protein in fetal organs during the progression of gestation, as well as in adult organs. This was a descriptive, comparative, cross-sectional and retrospective study based on the review of medical records and immunohistochemical analysis of different organs of fetuses and adult people. The results showed a statistically significant difference in the immunostaining of HLA-G protein in adrenal glands (p = 0.0003), spleen (p = 0.0276), heart (p = 0.0474), liver (p = 0.0367), kidneys (p = 0.0377) and thymus (p = 0.0336) in the comparison between the first and second gestational trimesters; in adrenal glands (p = 0.0329), spleen (p = 0.0095), pancreas (p = 0.0009) and placenta (p = 0.0285) in the comparison between the second and third gestational trimesters; and in the heart (p = 0.0304), liver (p = 0.0055), lungs (p = 0.0150) and kidneys (p = 0.0312) in the comparison between the third gestational trimester and the adult phase. An increase of fetal HLA-G expression was observed from the second gestational trimester in organs such as adrenal glands, heart, liver, kidneys, thymus and lungs. However, this was not a constant finding, since in other organs including spleen, pancreas and placenta, this trend was not observed during the same period. During the third gestational trimester and the adult phase, higher values for HLA-G expression in the kidneys and much lower values in the liver were observed. Although the physiological expression of HLA-G has been positive in all evaluated organs (in the three gestational trimesters and/or in adulthood), it showed differences in its intensity and location in the different organs and periods. The findings from this research certainly represent an important contribution to a better understanding of the gestational mechanism, as well as on the physiology of HLA-G in adults, especially regarding the establishment of immunological tolerance in organ transplantation

Base teórica: A sepse é uma síndrome heterogênea, definida como disfunção orgânica que ameaça à vida, causada por uma resposta desregulada do hospedeiro à infecção. É um problema de saúde mundial, graças à sua alta prevalência, morbimortalidade associada, além de custos para seu tratamento. As células Natural Killer (NK) fazem parte do sistema imune inato reconhecendo moléculas de HLA de classe I em células alvo, através de seus receptores de membrana killer cell immunoglobulin-like receptors (KIR). A intensidade da resposta à infecção pode variar entre indivíduos, logo pode-se considerar que esta seja determinada por bases genéticas, e estas influenciem na ocorrência de sepse e variabilidade nos desfechos. Objetivos: Avaliar a associação entre os genes KIR e os ligantes HLA em pacientes críticos, comparando pacientes com sepse e controles não sépticos internados na mesma UTI. Métodos: Foi examinado o polimorfismo de 16 genes KIR e seus ligantes HLA em 271 pacientes críticos, caucasóides, sendo 211 pacientes com sepse e 60 controles, pela técnica de PCR-SSO e PCR-SSP, respectivamente. Resultados: Os genes ativadores KIR2DS1 e KIR3DS1 foram mais frequentes nos controles que nos pacientes com sepse (41,23% versus 55,00%, e 36,49% versus 51,67%; p = 0.041 e 0,025, respectivamente). Estes resultados fornecem informação inicial sobre o papel de polimorfismos de KIR na sepse, sugerindo que este possa ser um potencial marcador diagnóstico ou prognóstico da doença. / Background: Sepsis is a heterogeneous syndrome, defined a life-threatening organic dysfunction caused by a dysregulated host response to infection. Sepsis is a global health problem, due to its high prevalence, associated morbidity and mortality, and costs for its treatment. Cells Natural Killer (NK) cells are part of the innate immune system that recognize HLA class I molecules on target cells via membrane receptors called killer cell immunoglobulin-like receptors (KIR). The intensity of the response to an infection may vary among individuals and might be influenced genetic features affecting sepsis occurrence and variability in outcomes. Objectives: To evaluate the association between KIR genes and HLA ligands in critically ill patients, comparing patients with sepsis and without sepsis admitted to the same ICU. Methods: We examined the polymorphism of 16 KIR genes and their HLA ligands in 271 critically ill patients, Caucasians, and 211 patients with sepsis and 60 controls by PCR-SSO and PCR-SSP, respectively. Results: Activating KIR2DS1 and KIR3DS1 genes were more common in controls than in patients with sepsis (41.23% versus 55.00% and 36.49% versus 51.67%, p = 0.041 and 0.025, respectively). These results provide initial information on the role of polymorphism of KIR in sepsis, suggesting that this may be a potential diagnostic or prognostic marker of the disease.

Cancer immunotherapy seeks to boost the host’s immune system to respond to tumor antigens. The adaptive immune system comprises of two arms, one that elicits a cellular immune response and one that elicits a humoral immune response. Cytotoxic T lymphocytes (CTL) recognize short antigenic peptides presented to them in the context of class I major histocompatibility complex (MHC) molecules and are capable of killing tumor cells. CTL are educated to discriminate between foreign and self-antigen. Tumors frequently express self-antigen which usually makes them poorly immunogenic. Because tumors are genetically unstable, they may present excess self peptides and/or peptides in a reading frame different from wild type self proteins. These frameshift (FS) peptides, are caused by an insertion or deletion of nucleotides that disrupt translation of the normal reading frame and alters the protein produced such that it is non-self. Binding affinity, dissociation rate and the overall stability of the peptide/MHC/β₂-microglobulin complex are important considerations in determining the immunogenicity of a given peptide. Interaction between the anchor residues in a peptide and binding pockets in MHC are essential, but this interaction is not always strong enough to stimulate T cell responses. This indicates that not all amino acids of the peptide ligand bound to MHC are equally important for the functional outcome of the receptor engagement and that other amino acid residues in the sequence are important for binding. Optimized peptide ligands (OPL) are analogues derived from natural wild type antigenic peptides that contain amino acid substitutions at anchor and auxiliary residues. OPL can be rationally designed to generate a more robust immune response compared to that of the wild-type peptide. Active immunotherapy using OPL of tumor antigen epitopes are designed to elicit tumor-specific CTL that can overcome tolerance and either re-awaken or elicit new T-cell responses to an antigen. The work and principles presented here using brain tumor-derived peptides demonstrates that HLA-A*0201-restricted CTL generated against wild type, frameshift and OPL peptides elicit CTL that were able to recognize and respond to wild type, tumorderived peptides. The response was donor dependent in that not all individuals responded more strongly to OPL; a minority responded better to wild type peptide. This data further suggests that the rational design and testing of multiple peptides for the same epitope should elicit a broader response among different individuals than single peptide immunization.

<p>Southern Africa is facing one of the most serious HIV epidemics. This project contributes to the HIVNET, Network for Prevention Trials cohort for vaccine development. HIV’s biology and rapid mutation rate have made vaccine design difficult. We examined HIV-1 subtype C diversity and how it relates to CTL epitope location along viral gag sequences. We found a negative correlation between codon sites under positive selection and epitope regions / suggesting epitope regions are evolutionarily conserved. It is possible that epitopes exist in non-conserved regions, yet fail to be detected due to the reference strain diverging from the circulating viral population. To test if CTL clustering is an artifact of the reference strain, we calculated differences between the gag codons and the reference strain. We found a weak negative correlation, suggesting epitopes in less conserved regions maybe evading detection. Locating conserved and optimal epitopes that can be recognized by CTLs is essential for the design of vaccine reagents.</p>

Base teórica: A sepse é uma síndrome heterogênea, definida como disfunção orgânica que ameaça à vida, causada por uma resposta desregulada do hospedeiro à infecção. É um problema de saúde mundial, graças à sua alta prevalência, morbimortalidade associada, além de custos para seu tratamento. As células Natural Killer (NK) fazem parte do sistema imune inato reconhecendo moléculas de HLA de classe I em células alvo, através de seus receptores de membrana killer cell immunoglobulin-like receptors (KIR). A intensidade da resposta à infecção pode variar entre indivíduos, logo pode-se considerar que esta seja determinada por bases genéticas, e estas influenciem na ocorrência de sepse e variabilidade nos desfechos. Objetivos: Avaliar a associação entre os genes KIR e os ligantes HLA em pacientes críticos, comparando pacientes com sepse e controles não sépticos internados na mesma UTI. Métodos: Foi examinado o polimorfismo de 16 genes KIR e seus ligantes HLA em 271 pacientes críticos, caucasóides, sendo 211 pacientes com sepse e 60 controles, pela técnica de PCR-SSO e PCR-SSP, respectivamente. Resultados: Os genes ativadores KIR2DS1 e KIR3DS1 foram mais frequentes nos controles que nos pacientes com sepse (41,23% versus 55,00%, e 36,49% versus 51,67%; p = 0.041 e 0,025, respectivamente). Estes resultados fornecem informação inicial sobre o papel de polimorfismos de KIR na sepse, sugerindo que este possa ser um potencial marcador diagnóstico ou prognóstico da doença. / Background: Sepsis is a heterogeneous syndrome, defined a life-threatening organic dysfunction caused by a dysregulated host response to infection. Sepsis is a global health problem, due to its high prevalence, associated morbidity and mortality, and costs for its treatment. Cells Natural Killer (NK) cells are part of the innate immune system that recognize HLA class I molecules on target cells via membrane receptors called killer cell immunoglobulin-like receptors (KIR). The intensity of the response to an infection may vary among individuals and might be influenced genetic features affecting sepsis occurrence and variability in outcomes. Objectives: To evaluate the association between KIR genes and HLA ligands in critically ill patients, comparing patients with sepsis and without sepsis admitted to the same ICU. Methods: We examined the polymorphism of 16 KIR genes and their HLA ligands in 271 critically ill patients, Caucasians, and 211 patients with sepsis and 60 controls by PCR-SSO and PCR-SSP, respectively. Results: Activating KIR2DS1 and KIR3DS1 genes were more common in controls than in patients with sepsis (41.23% versus 55.00% and 36.49% versus 51.67%, p = 0.041 and 0.025, respectively). These results provide initial information on the role of polymorphism of KIR in sepsis, suggesting that this may be a potential diagnostic or prognostic marker of the disease.

Despite the success of vaccines in routine use worldwide, there are substantial challenges hampering our ability to develop vaccines against extant diseases including malaria and tuberculosis. Novel approaches are urgently required to help us understand immunological correlates of protection against disease and facilitate our understanding of the impact of human genetic variation on the success of diverse vaccines. To identify host genetic factors responsible for variation in antibody responses against vaccine antigens delivered routinely to infants worldwide I performed a genome-wide association study (GWAS) involving 2,499 infants recruited from three diverse sites across Africa. I identified strong genetic associations between variants in the class II major histocompatibility complex (MHC) locus and responses against five antigens: pertussis toxin (PT), filamentous haemagglutinin (FHA) and pertactin; diphtheria toxin (DT); and hepatitis B surface antigen. To characterise these associations at the gene and allelic level I developed a large, high-resolution (6-digit 'G') population-specific human leukocyte antigen (HLA) imputation reference panel including 697 individuals from the vaccine GWAS typed at 11 genes, highlighting the diversity of HLA across the African continent. Using this panel I imputed HLA into the remaining GWAS dataset to fine-map the associations to specific HLA alleles, amino acid and single nucleotide polymorphism sites; some of which were found to be African specific. I then used these HLA association findings observed with PT response to correlate, through genetics, this trait with susceptibility to whooping cough in an independently recruited and analysed set of cohorts from the UK. I further used these genetic correlations to demonstrate the relevance of levels of PT-specific circulating follicular helper T-cells and TRBV29-1 T-cell receptor gene expression levels in the development of this protective immune response against PT. By using HLA-peptide binding studies I also demonstrate the diversity of mechanisms that are involved in HLA-disease association, showing that the breadth and affinity of DT-peptide binding are increased with HLA-DRB1 alleles associated with increased DT antibody responses. Taken together, these data represent the first comprehensive genetic association study of multiple vaccine responses undertaken in African infants. These results highlight the importance of human genetics in modulating protective responses against vaccine antigens and demonstrate how such associations can be harnessed to understand biological mechanisms of protective efficacy in greater detail that may in turn facilitate future vaccine development.