S Antohi’s research while affiliated with Icahn School of Medicine at Mount Sinai and other places

While vaccines are effective in adults, they are less successful in newborns and infants. Neonatal unresponsiveness to vaccines could be owing to immaturity of lymphocytes and/or to inhibition by maternal antibodies. Unresponsiveness of newborn to vaccines can be overcame by genetic immunization. In the present study we investigated the effect of maternal antibodies on the anti-influenza virus protective response in progeny born to dams immunized with plasmid containing the hemagglutinin gene or UV-inactivated virus. The effect of maternal antibodies was studied in plasmid immunized F1 mice born to BALB/c dams, previously immunized with virus or plasmid and crossed with C57BL/6 males, as well as in offspring born to BALB/c dams immunized with plasmid and then immunized with UV-inactivated WSN virus. We have found that the inhibition period of the anti-HA antibody response in offspring born to dams immunized with DNA is shorter than that of offspring born to dams immunized with virus. Furthermore, there is a persistent inhibitory effect on B cells from offspring born to dams immunized with virus or injected with antiviral monoclonal antibodies (MoAb), after the decline of maternal antibody titers. The analysis of the haemagglutinin-specific clonotype reactivity pattern of offspring born to dams immunized with inactivated influenza virus or with a plasmid showed that clonotypes producing antibodies specific for the immunizing virus strain were predominant in offspring born to dams immunized with DNA compared to those born to dams immunized with virus. Maternal antibodies do not affect cell-mediated immunity. These findings might be used to design efficient vaccination schedules for newborns and infants.

Autoantibodies to fibrillin-1 (Fbn-1) have been found in systemic sclerosis (SSc), calcinosis, Raynaud's esophagael dysmotility, sclerodectyly, and telaengectasia (CREST) and mixed connective tissue disease (MCTD) diseases. The purpose of this study was to determine whether patients with primary pulmonary hypertension (PPH) and appetite-suppressant-associated PPH have anti-Fbn-1 autoantibodies. In addition we assessed the human leucocyte antigen (HLA) class II alleles (DRB1, 3, 4, 5 and DQB1) in these patients in order to determine whether the response is genetically restricted. The frequency of anti-Fbn-1 autoantibodies in patient groups was compared with that of a control group of 88 healthy patients, and HLA was correlated similarly with a group of 51 healthy subjects. Anti-Fbn-1 autoantibodies were found at high frequency in PPH: in 70 of 75 adults with PPH (93%), in 28 of 33 children with PPH (84.8) and in 12 of 18 (67%) patients with appetite-suppressant-associated PPH. Utilization of two Fbn-1 fusion proteins allowed us to determine the dominant determinant region, recognized by anti-Fbn-1 autoantibodies, which may be located on the N-terminal fragment of the Fbn-1 protein. No significant immunogenetic correlations were found when the PPH patient groups were compared with normal controls. This novel category of autoantibodies is found in diseases characterized by endothelial and extracellular matrix protein alterations and fibrosis.

Using a highly sensitive Radioimmunoassay (RIA), the kinetics of synthesis of anti-fibrillin (Fbn-1) autoantibodies were studied in 17 patients with mixed connective tissue disease (MCTD) and two with CREST syndrome calcinosis, Raynaud's oesophageal dismotility, sclerodectyly and teleangiectasis who were found to be positive for this autoimmune response. IgG autoantibodies specific for recombinant Fbn-1 (rFbn-1) (aa 369-425) were found in all patients excepting one with MCTD, multiple sclerosis, and dermatomyositis. IgM were found in fewer cases. Several kinetics patterns of anti-Fbn-1 autoantibodies were observed: a) long lasting persistence of IgG and IgM autoantibodies up to 14 years; b) fluctuation of antibodies during various periods up to 16 years; c) disappearance of antibody response after several years, and d) patients producing IgG but not IgM autoantibodies. No differences in the synthesis of autoantibodies were observed between MCTD patients with a stable disease, and those developing during the course features of systemic sclerosis (SSc), Sjogren's syndrome, or rheumatoid-like arthritis. In one patient displaying a lupus-like syndrome for 3 years, the appearance of anti-Fbn-1 autoantibodies coincided with the occurrence of MCTD and scleroderma. While the detection of anti-Fbn-1 autoantibodies may be clinically useful in differential diagnosis or eventual prognosis of patients with connective tissue diseases, their role in the pathogenesis of scleroderma syndromes requires further investigation.

To investigate the adhesion characteristics of corneal myofibroblasts in a cell culture model. Immunocytochemistry, immunoprecipitation, western blot analysis, and attachment assays were used to evaluate matrix adhesion characteristics of myofibroblasts. Myofibroblasts, defined by their expression of the smooth muscle isoform of alpha-actin, were evaluated and compared with fibroblasts. Myofibroblasts had larger vinculin-containing focal adhesions and expressed more of the classic fibronectin receptor (FNR) alpha5beta1 per cell. However, myofibroblasts had less surface expression of the higher molecular weight alpha4 subunit of another FNR, alpha4beta1, than did fibroblasts. Myofibroblasts adhered more avidly in an integrin-dependent manner to fibronectin than did fibroblasts. The attachment to fibronectin was actin-dependent for both phenotypes, but the myofibroblasts' adhesion was more resistant to disruption by cytochalasin than were fibroblasts'. In addition to the previously described expression of a 135-kDa classic cadherin, myofibroblasts also expressed a 115-kDa mesenchymal cadherin, cadherin-11. Differentiation of corneal fibroblasts into myofibroblasts is associated with characteristics that would indicate that the latter have a special role in wound closure. The increase in focal and cell adhesion molecules that accompanies smooth muscle-specific actin expression provides the basis for the myofibroblasts' enhanced cell-fibronectin and cell-cell adhesion.

Virus-based influenza vaccines induce less protection in old compared to young subjects due, in part, to age-associated alterations in the immune response. This study shows that old mice produce a less diverse HI antibody response after immunization than adult mice. However, immunization of old and young mice with plasmids expressing the HA gene induced comparable clearance of influenza virus from the lungs and the same level of protection from a lethal challenge with live WSN influenza virus. Thus, genetic immunization may offer advantages for the elderly over virus-base vaccines.

In contrast to adult mice immunized with influenza A virus strain WSN and plasmid expressing WSN hemagglutinin (HA) gene which developed primary and secondary anti-HA antibody responses, mice immunized as neonates with virus failed to produce anti-HA antibodies while those immunized with plasmid developed weak primary but strong secondary responses. Analysis of the frequency of HA-specific B clonotypes as well as their reactivity pattern (RP) showed that viral or genetic immunization of adults increased the frequency of clonotypes which exhibit broad RP. The most striking observation of our study is that immunization of neonates with plasmid leads to increased synthesis of anti-HA antibodies as well as to an increased frequency of clonotypes exhibiting an adult-like RP. In contrast, neonatal immunization with virus caused a long-lasting unresponsiveness and the few clonotypes stimulated in vitro exhibited only a monoreactive pattern. Isotype patterns of mAb are also diversified in the case of mice immunized with plasmid as neonates. Rapid replacement of neonatal with adult clonotypes may explain the significant survival of the mice immunized with plasmid and challenged 1 or 3 months later with lethal doses of virus.

In contrast to adult mice immunized with influenza A virus strain WSN and plasmid expressing WSN hemagglutinin (HA) gene which developed primary and secondary anti-HA antibody responses, mice immunized as neonates with virus failed to produce anti-HA antibodies while those immunized with plasmid developed weak primary but strong secondary responses. Analysis of the frequency of HA-specific B clonotypes as well as their reactivity pattern (RP) showed that viral or genetic immunization of adults increased the frequency of clonotypes which exhibit broad RP. The most striking observation of our study is that immunization of neonates with plasmid leads to increased synthesis of anti-HA antibodies as well as to an increased frequency of clonotypes exhibiting an adult-like RP. In contrast, neonatal immunization with virus caused a longlasting unresponsiveness and the few clonotypes stimulated in vitro exhibited only a monoreactive pattern. Isotype patterns of mAb are also diversified in the case of mice immunized with plasmid as neonates. Rapid replacement of neonatal with adult clonotypes may explain the significant survival of the mice immunized with plasmid and challenged 1 or 3 months later with lethal doses of virus.

Neonates and infants display an intrinsic disability to mount protective immune responses to influenza viruses or conventional influenza vaccines. We investigated the ability of naked DNA to prime protective immune responses by inoculating newborn and adult mice with a plasmid (pHA) expressing hemagglutinin (HA) from the neurovirulent strain A/WSN/33 of influenza virus. Continuous exposure to small doses of antigen subsequent to neonatal DNA immunization led to effective priming of specific B and Th cells, rather than tolerance induction. The pHA immunization of adult mice primed a strongly biased Th1 response, whereas in neonates it induced a mixed Th1/Th2 response. In contrast to the effect of live-virus immunization, DNA immunization of neonates was followed by enhanced cytotoxic T lymphocyte responses subsequent to challenge with A/WSN/33 influenza virus. Mice immunized as neonates or adults with pHA plasmid exhibited significant increases in survival and decreases in virus lung titers following lethal challenge with the A/WSN/33 virus or the A/PR8/34 drift variant. Our results demonstrate that DNA vaccination is an efficient and safe means to generate broad humoral and cellular immune responses to influenza viruses, during the earliest stages of postnatal life.

Neonates display lower immune responsiveness and higher susceptibility for high-dose tolerance. Quantitative as well as functional differences between the neonatal and adult lymphocytes or antigen presenting cells (APC) respectively, explain the particular immune responsiveness during the early stages of the postnatal development. Reduced numbers of lymphocytes and APCs as well as a modified responsiveness of T cells in neonates, are the main factors that account for the low threshold of tolerance in newborns. Taking into account these particularities, the design of effective vaccines for neonates poses significant difficulties. We hypothesized that a continuous exposure to low doses of antigens may avoid high-zone tolerance and may lead instead, to effective expansion of effector and memory cells. Indeed, inoculation of newborn mice with plasmids encoding nucleoprotein (NP) or hemagglutinin (HA) of influenza virus, led to the priming of specific cytotoxic (CTL), helper (Th) and B cells, rather than induction of unresponsiveness. Mice immunized as neonates with naked DNA and challenged later with lethal doses of influenza virus, displayed significant protection. Thus, DNA immunization may be a promising strategy for vaccination against serious infectious diseases of infants and children.

We had previously shown that a genetically engineered Ig expressing an immunodominant CD4+ T epitope corresponding to the 110-120 amino acids of influenza virus hemagglutinin (HA), activated T cells more efficiently than the synthetic peptide. Taking advantage of a T cell hybridoma specific for HA 110-120 and transfected with a reporter gene under the IL-2 promoter, we studied the kinetics of generation and persistence on surface MHC-II of the HA 110-120 peptide derived from various carriers. Our results show that the generation rate of immunogenic MHC II-peptide complex is dependent on the nature of the carrier. Abs specific for HA 110-120 peptide or for other epitopes on HA affect through various mechanisms the presentation of HA 110-120 peptide to T cells. The persistence of immunogenic MHC II-peptide complex on the surface of APC is not dependent on the nature of the carrier and correlates with the half-life of class II molecules, suggesting an irreversible binding of peptides to MHC-II molecules in 2PK3 murine B lymphoma cells.