@article {12024, title = {Generalized urticaria induced by the Na-ASP-2 hookworm vaccine: implications for the development of vaccines against helminths}, journal = {The Journal of Allergy and Clinical Immunology}, volume = {130}, number = {1}, year = {2012}, note = {Diemert, David J
Pinto, Antonio G
Freire, Janaina
Jariwala, Amar
Santiago, Helton
Hamilton, Robert G
Periago, Maria Victoria
Loukas, Alex
Tribolet, Leon
Mulvenna, Jason
Correa-Oliveira, Rodrigo
Hotez, Peter J
Bethony, Jeffrey M
eng
Clinical Trial, Phase I
Randomized Controlled Trial
Research Support, Non-U.S. Gov{\textquoteright}t
2012/05/29 06:00
J Allergy Clin Immunol. 2012 Jul;130(1):169-76.e6. doi: 10.1016/j.jaci.2012.04.027. Epub 2012 May 26.}, month = {Jul}, pages = {169-76 e6}, abstract = {

BACKGROUND: Necator americanus Ancylostoma-secreted protein 2 (Na-ASP-2) is secreted by infective hookworm larvae on entry into human hosts. Vaccination of laboratory animals with recombinant Na-ASP-2 provides significant protection against challenge infections. In endemic areas antibodies to Na-ASP-2 are associated with reduced risk of heavy N americanus infections. OBJECTIVE: To assess the safety and immunogenicity of recombinant Na-ASP-2 adjuvanted with Alhydrogel in healthy Brazilian adults previously infected with N americanus. METHODS: Participants were randomized to receive Na-ASP-2 or hepatitis B vaccine. Major IgG and IgE epitopes of the Na-ASP-2 molecule were mapped by using sera from these same subjects. Seroepidemiologic studies in adults and children residing in hookworm-endemic areas were conducted to assess the prevalence of IgE responses to Na-ASP-2. RESULTS: Vaccination with a single dose of Na-ASP-2 resulted in generalized urticarial reactions in several volunteers. These reactions were associated with pre-existing Na-ASP-2-specific IgE likely induced by previous hookworm infection. Surveys revealed that a significant proportion of the population in hookworm-endemic areas had increased levels of IgE to Na-ASP-2. Epitope mapping demonstrated sites on the Na-ASP-2 molecule that are uniquely or jointly recognized by IgG and IgE antibodies. CONCLUSION: Infection with N americanus induces increased levels of total and specific IgE to Na-ASP-2 that result in generalized urticaria on vaccination with recombinant Na-ASP-2. These data advance knowledge of vaccine development for helminths given their propensity to induce strong T(H)2 responses. Study data highlight the important differences between the immune responses to natural helminth infection and to vaccination with a recombinant helminth antigen.

}, keywords = {Adolescent, Adult, Animals, Antigens, Helminth/administration \& dosage/*adverse effects/immunology, Brazil/epidemiology, Epitope Mapping, Female, Helminth Proteins/administration \& dosage/*adverse effects/immunology, Humans, Immunoglobulin E/blood, Immunoglobulin G/blood, Male, Middle Aged, Necator americanus/*immunology, Necatoriasis/epidemiology/immunology/*prevention \& control, Seroepidemiologic Studies, Treatment Outcome, Urticaria/*epidemiology/etiology, Vaccination/adverse effects, Vaccines, Synthetic/administration \& dosage/*adverse effects/immunology, Young Adult}, isbn = {1097-6825 (Electronic)
0091-6749 (Linking)}, author = {Diemert, D. J. and Pinto, A. G. and Freire, J. and Jariwala, A. and Santiago, H. and Hamilton, R. G. and Periago, M. V. and Loukas, A. and Tribolet, L. and Mulvenna, J. and Correa-Oliveira, R. and Hotez, P. J. and Bethony, J. M.} }