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Investigations of enterotoxigenic E. Coli (ETEC) intestinal colonization in neonatal mice and human shedding of panchol, a new live attenuated oral cholera vaccine

BACKGROUND: Vibrio cholerae and Enterotoxigenic E. Coli (ETEC) are enteropathogens that are global causes of cholera and traveler’s diarrhea which are responsible for millions of diarrhea cases every year. ETEC and cholera are primarily found in Sub-Saharan Africa and Asia, particularly in nations with inadequate sanitation systems or little access to clean water. Infants and children are most vulnerable to these diseases, as severe infections can lead to stunting and death. The incidence of cholera and ETEC diarrhea have increased, due in part to changing weather patterns. At present, robust animal models for studies of ETEC colonization are lacking to study colonization and bottlenecks. The only licensed vaccines against cholera in endemic countries are killed whole cells, however, new live attenuated oral cholera vaccines (OCV) are in development and offer significant advantages. PanChol is a live attenuated OCV entering phase I trials.
SPECIFIC AIMS: To propel studies of ETEC pathogenesis, I attempted to create a suckling mouse model of this globally important pathogen. To accomplish this goal, I constructed barcoded ETEC libraries that enabled me to determine founding population sizes along with intestinal ETEC burdens. To better understand PanChol, a new live attenuated OCV, I studied the shedding of the vaccine in the first 3 human volunteers to ingest this novel agent.
METHODS: Triparental mating of donor strains MFDλpir pJMP1039 and MFDλpir pSM1 with recipient ETEC strains enabled construction of barcoded libraries. Neonatal CD-1 and C57BL/6 mice were infected with 104-107 CFU of wild-type ETEC to develop an infant mouse model. Founding population sizes of ETEC strains were compared via sequencing and STAMPR analysis while CFU burdens were determined via plating. Shedding of PanChol was done through enumeration of serial dilutions of fecal samples. Serotyping of shed PanChol was carried out using anti-Ogawa and anti-Inaba antisera.
RESULTS: There were marked differences in ETEC small intestinal colonization in different mouse strains. Outbred CD-1 suckling mice only colonized with a 107 dose. In contrast, colonization of ETEC was approximately 106 CFU/small intestine at inocula sizes of 105 or greater in C57BL/6 mice. Laboratory studies using simulated bottlenecks made by serial dilutions established that the barcoded libraries accurately reflect founding population sizes up to 105 CFU. There was no difference in founding population sizes at the same inoculum size between WT ETEC and a hypervesiculation ∆mlaE mutant, though the founding population size increased with increasing input. PanChol retained the Hikojima serotype and shedding occurred in all volunteers with maximum colonization occurring 3 days post administration of 106 CFU.
CONCLUSIONS: C57BL/6 P5 mice can serve as a new model to study ETEC intestinal colonization. Hypervesiculating ETEC did not produce a difference in founding population or colonization at the same input as WT ETEC strains. PanChol shows great promise as a viable OCV with shedding at 106 input and no serotype reversion.

Identiferoai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/48403
Date14 March 2024
CreatorsWang, Bryan
ContributorsWetzler, Lee, Waldor, Matthew K.
Source SetsBoston University
Languageen_US
Detected LanguageEnglish
TypeThesis/Dissertation
RightsAttribution-NonCommercial-ShareAlike 4.0 International, http://creativecommons.org/licenses/by-nc-sa/4.0/

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