Vaccine and compositions for the prevention and treatment of neisserial infections

BACKGROUND OF THE INVENTION

[0003]

Neisseria gonorrhoeae
is the causative agent of the disease gonorrhea. Approximately 300,000 women a year contract gonorrhea in the U.S. Worldwide, the number of women with this infection is in the millions. It is a major cause of infertility and pelvic inflammatory disease. It is also a major co-factor in the spread of HIV1.

[0004] In men, gonococcal infection develops as an acute urethritis that is typically characterized by a purulent discharge that results as a consequence of the concurrent inflammatory response to infection. In women, gonococcal infection can develop as an ascending infection of the genital tract that can lead to an acute pelvic inflammatory disease, infertility, or ectopic pregnancy. High proportions of women, however, initially develop asymptomatic gonococcal infections, in contrast to N. gonorrhoeae infection in men.

[0005] The mechanisms by which the gonococcus infects and invades the female genital tract are only beginning to be understood. Research has shown that gonococci are capable of invading primary human epithelial cells derived from both the endo- and the ectocervix. These studies implied that the mechanism(s) used by the gonococcus to breech the cervical epithelium are distinct from those mechanisms used to invade the urethral epithelium of men and that several endocytic mechanisms appear to play a role in gonococcal invasion of the female genital tract.

[0006] Currently there is no vaccine for the prevention of gonorrhea in men or women. Therefore, there is a need for an effective means to prevent or ameliorate neisserial infections in women.

SUMMARY OF THE INVENTION

[0007] The present invention provides a polypeptide, polynucleotide, vaccine, and methods of vaccination effective to immunize a susceptible female patient against Neisseria gonorrhoeae. Such immunization can prevent, ameliorate or reduce the incidence of gonorrhea in women. The vaccine contains an immunogenic amount of polypeptide comprising polypeptide p177, p88, p64, p55 or p46 from N. gonorrhoeae, in combination with a physiologically-acceptable, non-toxic vehicle. An example of p177 is amino acid sequence SEQ ID NO:1; an example of p88 is SEQ ID NO:2; an example of p64 is SEQ ID NO:3; an example of p55 is SEQ ID NO:4; and an example of p46 is SEQ ID NO:5. The polynucleotides of the present invention include nucleic acid sequences encoding polypeptide p177, p88, p64, p55 or p46 from N. gonorrhoeae. Polypeptide p177 may be encoded by SEQ ID NO:6; p88 may be encoded by SEQ ID NO:7; p64 may be encoded by SEQ ID NO:8; p55 may be encoded by SEQ ID NO:9; and p46 may be encoded by SEQ ID NO:10. The vaccine may further comprise an effective amount of an immunological adjuvant.

[0008] Also provided are methods of preventing infection or colonization of Neisseria gonorrhoeae in a female patient by administering to the patient a compound that inhibits CR3. The compound may be an antibody (monoclonal, polyclonal, or humanized) specific for CR3. Alternatively, the compound may be chemical or synthetic inhibitors e.g. peptides, carbohydrates, glycoproteins, glycolipids, or divalent cation chelators.

[0009] As used herein, the term “neisserial protein” includes variants or biologically active or inactive fragments of p177, p88, p64, p55 or p46 from N. gonorrhoeae. A “variant” of the polypeptide is a neisserial protein that is not completely identical to a native neisserial protein. A variant neisserial protein can be obtained by altering the amino acid sequence by insertion, deletion or substitution of one or more amino acid. The amino acid sequence of the protein is modified, for example by substitution, to create a polypeptide having substantially the same or improved qualities as compared to the native polypeptide. The substitution may be a conserved substitution. A “conserved substitution” is a substitution of an amino acid with another amino acid having a similar side chain. A conserved substitution would be a substitution with an amino acid that makes the smallest change possible in the charge of the amino acid or size of the side chain of the amino acid (alternatively, in the size, charge or kind of chemical group within the side chain) such that the overall peptide retains its spacial conformation but has altered biological activity. For example, common conserved changes might be Asp to Glu, Asn or Gln; His to Lys, Arg or Phe; Asn to Gln, Asp or Glu and Ser to Cys, Thr or Gly. Alanine is commonly used to substitute for other amino acids. The 20 essential amino acids can be grouped as follows: alanine, valine, leucine, isoleucine, proline, phenylalanine, tryptophan and methionine having nonpolar side chains; glycine, serine, threonine, cystine, tyrosine, asparagine and glutamine having uncharged polar side chains; aspartate and glutamate having acidic side chains; and lysine, arginine, and histidine having basic side chains. Stryer, L. Biochemistry (2d edition) W. H. Freeman and Co. San Francisco (1981), p. 14-15; Lehninger, A. Biochemistry (2d ed., 1975), p. 73-75.

[0010] It is known that variant polypeptides can be obtained based on substituting certain amino acids for other amino acids in the polypeptide structure in order to modify or improve biological activity. For example, through substitution of alternative amino acids, small conformational changes may be conferred upon a polypeptide that result in increased bioactivity. Alternatively, amino acid substitutions in certain polypeptides may be used to provide residues that may then be linked to other molecules to provide peptide-molecule conjugates that retain sufficient properties of the starting polypeptide to be useful for other purposes.

[0011] One can use the hydropathic index of amino acids in conferring interactive biological function on a polypeptide, wherein it is found that certain amino acids may be substituted for other amino acids having similar hydropathic indices and still retain a similar biological activity. Alternatively, substitution of like amino acids may be made on the basis of hydrophilicity, particularly where the biological function desired in the polypeptide to be generated in intended for use in immunological embodiments. The greatest local average hydrophilicity of a protein, as governed by the hydrophilicity of its adjacent amino acids, correlates with its immunogenicity. U.S. Pat. No. 4,554,101. Accordingly, it is noted that substitutions can be made based on the hydrophilicity assigned to each amino acid. In using either the hydrophilicity index or hydropathic index, which assigns values to each amino acid, it is preferred to conduct substitutions of amino acids where these values are ±2, with ±1 being particularly preferred, and those with in ±0.5 being the most preferred substitutions.

[0012] The variant neisserial protein comprises at least seven amino acid residues, preferably about 20 to about 2000 residues, and more preferably about 50 to about 1000 residues, and even more preferably about 80 to about 200 residues, wherein the variant neisserial protein has at least 50%, preferably at least about 80%, and more preferably at least about 90% but less than 100%, contiguous amino acid sequence homology or identity to the amino acid sequence of a corresponding native neisserial protein.

[0013] The amino acid sequence of the variant neisserial protein corresponds essentially to the native neisserial protein amino acid sequence. As used herein “correspond essentially to” refers to a polypeptide sequence that will elicit a protective immunological response substantially the same as the response generated by native neisserial protein. Such a response may be at least 60% of the level generated by native neisserial protein, and may even be at least 80% of the level generated by native neisserial protein. An immunological response to a composition or vaccine is the development in the host of a cellular and/or antibody-mediated immune response to the polypeptide or vaccine of interest. Usually, such a response consists of the subject producing antibodies, B cell, helper T cells, suppressor T cells, and/or cytotoxic T cells directed specifically to an antigen or antigens included in the composition or vaccine of interest.

[0014] A variant of the invention may include amino acid residues not present in the corresponding native neisserial protein, or may include deletions relative to the corresponding native neisserial protein. A variant may also be a truncated “fragment” as compared to the corresponding native neisserial protein, i.e., only a portion of a full-length protein. Neisserial protein variants also include peptides having at least one D-amino acid.

[0015] The neisserial protein of the present invention may be expressed from an isolated nucleic acid (DNA or RNA) sequence encoding the neisserial protein. Amino acid changes from the native to the variant neisserial protein may be achieved by changing the codons of the corresponding nucleic acid sequence. “Recombinant” is defined as a peptide or nucleic acid produced by the processes of genetic engineering. It should be noted that it is well-known in the art that, due to the redundancy in the genetic code, individual nucleotides can be readily exchanged in a codon, and still result in an identical amino acid sequence. The terms “protein,” “peptide” and “polypeptide” are used interchangeably herein.

[0016] The neisserial protein as described above may be operably linked to an amino acid sequence for a therapeutic agent. An amino acid or nucleic acid is “operably linked” when it is placed into a functional relationship with another amino acid or nucleic acid sequence. For example, DNA a pre-sequence or secretory leader is operably linked to DNA for a polypeptide if it is expressed as a pre-protein that participates in the secretion of the polypeptide; a promoter or enhancer is operably linked to a coding sequence if it affects the transcription of the sequence; or a ribosome binding site is operably linked to a coding sequence if it is positioned so as to facilitate translation. Generally, “operably linked” means that the amino acid or nucleic acid sequences being linked are contiguous, and, in the case of a secretory leader in DNA, contiguous and in reading phase. However, enhancers do not have to be contiguous. Linking is accomplished by ligation at convenient restriction sites. If such sites do not exist, the synthetic oligonucleotide adaptors or linkers are used in accordance with conventional practice.

[0017] As used herein, the term “therapeutic agent” refers to any agent or material that has a beneficial effect on the mammalian recipient. Thus, “therapeutic agent” embraces both therapeutic and prophylactic molecules having nucleic acid or protein components.

BRIEF DESCRIPTION OF THE FIGURES

[0018] The patent or application file contains at least one drawing executed in color. Copies of this patent or patent application publication with color drawing(s) will be provided by the Office upon request and payment of the necessary fee.

[0019]
FIG. 1. Anti-CR3 antibodies inhibit gonococcal attachment and invasion of CR3-transfected CHO cells. CHO-CR3 cell monolayers were pretreated with antibodies to the CR3 alpha subunit CD11b (H5A4, Bear1) or CD18 (anti-CD18, IB4) or anti-CD18 antibody and an anti-CD18 blocking peptide as outlined in the text. Antibody-treated cell monolayers were challenged for two hours with gonococci prior to gentimicin addition, cervical cell lysis, and plating of serial dilutions to determine colony-forming units. Gentamicin treatment was omitted from attachment assays. Percent inhibition was determined as a normalized function of the ability of gonococci to adhere to or invade CHO-CR3 cells in the absence of antibody. Values given are the mean values of at least three trials. A Kruskal-Wallis analysis of variance was used to determine the statistical significance of the invasion assays. ρ-values were less than 0.05 for all of the antibodies tested alone.

[0020]
FIG. 2. Anti-CR3 antibodies inhibit gonococcal invasion of primary cervical cells. Invasion of primary, human, ecto- and endocervical cell monolayers by gonococci was performed as outlined in the text. Antibodies H5A4 and Bear1 recognize the CR3 alpha subunit, CD11b. Anti-CD18 and IB4 are specific for the CR3 beta subunit, CD18. Inhibition of invasion was determined as a normalized function of the ability of gonococci to invade primary ecto- and endocervical cells in the absence of antibody. Values given are the mean values of at least three trials. A Kruskal-Wallis analysis of variance was used to determine the statistical significance of the invasion assays. ρ-values were less than 0.05 for all of the antibodies tested.

[0021]
FIG. 3. The effect of Clostridium C3 neurotoxin on the invasion of primary cervical cells by N. gonorrhoeae. The ability of gonococci to invade primary ecto- and endocervical cells was determined as outlined in the text. Invasion was determined as a proportion of the original infection inoculum. Values given are the mean values of three trials. A Kruskal-Wallis analysis of variance was used to determine the statistical significance of percent invasion with C3 toxin in comparison to percent invasion without C3 toxin treatment. ρ-values were 0.05 for each assay.

[0022]
FIG. 4. Laser scanning confocal microscopy (LSCM) demonstrates that the characteristic cytokeratin staining pattern of the tissue biopsies has been retained in the respective primary cervical epithelial cell cultures. Sectioned tissue biopsies and primary cervical epithelial cell monolayers were incubated with a FITC-conjugated antibody to the noted specific cytokeratin. Ethidium bromide was used to counter-stain the tissue sections. Endocervical cells labeled intensely with antibody 8.12, which is specific for type I cytokeratins 13, 15, and 16 panel A). The labeling of endocervical cells with an antibody specific for type II cytokeratin 4 (panel C) was considerably less intense, and it was not uniformly distributed. Ectocervical cells labeled positive with an antibody specific for cytokeratins 13, 15, and 16 (panel B) and cytokeratin 4 (panel D).

[0023]
FIG. 5. Scanning electron microscopy (SEM) analysis shows the predominant changes that occur in the cervical cell membrane over the course of a three hour infection as the result of cervical epithelial cell-gonococcal interactions. At early (0 to 60 minutes) phases of infection N. gonorrhoeae could be found on the surface of endocervical cells either associated with microvilli (A) or undergoing an endocytic process (B). As the infection process continued, microvilli appeared to acquire directionality. Filopodia/lamellipodia became evident after thirty minutes post infection (C). Bacteria appeared to be in the process of internalization (D). Loss of microvilli with a smoothing of the cervical cell membrane around the periphery of some sites of gonococcal infection also became evident at approximately thirty minutes post infection (E). Membrane ruffles (F, endocervical; G, ectocervical) appeared at sixty minutes, and they became prevalent at ninety minutes post infection. Ruffles could be induced to occur at approximately thirty minutes post infection with use of a primed infection inoculum (see Example 1) (G). A visible smoothing of the cervical cell membrane encircling membrane ruffles can be seen (H). By three hours post infection large ruffles could readily be observed.

[0024]
FIG. 6. Bright-field light microscopy (BFLM) and immuno-transmission electron microscopy (TEM) studies demonstrate ruffling of the cervical surface and invasion of the primary cervical epithelial cells at ninety minutes and three hours post infection. For TEM analysis, bacteria were labeled with an antibody specific to the gonococcal surface protein, H.8; cervical cells were labeled with a polyclonal antibody to actin. 30 nm and 10 nm gold bead antibody-conjugates were used to label the bacteria- and host-specific primary antibodies, respectively. Membrane protrusions can be seen that are labeled with actin and that are encompassing gonococci at ninety minutes after the onset of infection (A). Bacteria can also be seen entering the cervical cell as individual entities in actin-lined, spacious vacuoles (B). Large membrane ruffles can be seen associating with gonococci at three hours post infection (C and D). For BFLM (D) thick (1 m) paraffin sections of endocervical cells were stained with hematoxylin and eosin. Arrows denote bacteria. Bar=2 μm.

[0025]
FIG. 7. This figure shows TEM studies of cervical biopsies from women with gonococcal cervicitis. Panels A and B demonstrate cytoskeletal changes and membrane ruffling occur during naturally acquired gonococcal infection. Panel A and panel B show large and small membrane protrusions associated with gonococci (designated by arrows) that are similar to those seen in FIG. 6.

[0026]
FIG. 8. Differential interference contrast (DIC) and LSCM analysis demonstrate co-localization of N. gonorrhoeae 1291-green with a concentrated accumulation of the actin-associated protein, vinculin. In panel A, vinculin was immunolabeled with a TRITC-conjugated antibody and in a colored version of this figure was visible as a red fluorescence (A); in panel B, bacteria were transformed with green fluorescent protein (GFP) and in a colored version of this figure were visible as a green fluorescence. (C) In a merged image of panels A and B, arrows denote co-localization of bacteria with vinculin, which was visualized in a colored version of this figure as a yellow-orange because of the combined signal of the individual fluorophores. (D) Merged LSCM and DIC image (of the ectocervical cells). Similar results were seen with endocervical cells and for the actin-associated proteins ezrin and myosin, but the focal accumulation of a-actinin and talin was less pronounced. No accumulation of actin-associated proteins was observed in uninfected (control) cervical epithelial cells. Magnification, X20.

[0027]
FIG. 9. Neisseria gonorrhoeae co-localizes with CR3 in vivo. Cryosections of a clinical biopsy derived from a women with documented gonococcal cervicitis were immunolabeled with anti-CD18 (visible as a green fluorescence) and 2C3 (specific for gonococcal H.8 outer membrane protein, visible as a red fluorescence) antibodies. Co-localization of CR3 with gonococci occurs as a yellow fluorescence because of the combined signal of the two fluorophores. A) 63× oil B) 5× zoom image of the area designated by the white box in A. Co-localization is confirmed as a profile plot of the area designated by the red line where the individual fluorescence of each fluorophore is recorded and plotted, individually, by the viewing system. C) Areas of confirmed co-localization are observed where the peaks of the lines of the graph overlap.

[0028]
FIG. 10. Bacterial products that are released with gonococcal infection.

[0029]
FIG. 11. Proteomic analysis of gonococcal products released with cervical cell infection.

DETAILED DESCRIPTION OF THE INVENTION

[0030] Definitions

[0031] The term “nucleic acid” refers to deoxyribonucleotides or ribonucleotides and polymers thereof in either single- or double-stranded form, composed of monomers (nucleotides) containing a sugar, phosphate and a base which is either a purine or pyrimidine. Unless specifically limited, the term encompasses nucleic acids containing known analogs of natural nucleotides which have similar binding properties as the reference nucleic acid and are metabolized in a manner similar to naturally occurring nucleotides. Unless otherwise indicated, a particular nucleic acid sequence also implicitly encompasses conservatively modified variants thereof (e.g., degenerate codon substitutions) and complementary sequences as well as the sequence explicitly indicated. Specifically, degenerate codon substitutions may be achieved by generating sequences in which the third position of one or more selected (or all) codons is substituted with mixed-base and/or deoxyinosine residues (Batzer et al., Nucl. Acids Res., 19:508 (1991); Ohtsuka et al., JBC, 260:2605 (1985); Rossolini et al., Mol. Cell. Probes, 8:91 (1994). A “nucleic acid fragment” is a fraction of a given nucleic acid molecule. Deoxyribonucleic acid (DNA) in the majority of organisms is the genetic material while ribonucleic acid (RNA) is involved in the transfer of information contained within DNA into proteins. The term “nucleotide sequence” refers to a polymer of DNA or RNA which can be single- or double-stranded, optionally containing synthetic, non-natural or altered nucleotide bases capable of incorporation into DNA or RNA polymers. The terms “nucleic acid”, “nucleic acid molecule”, “nucleic acid fragment”, “nucleic acid sequence or segment”, or “polynucleotide” may also be used interchangeably with gene, cDNA, DNA and RNA encoded by a gene.

[0032] The invention encompasses isolated or substantially purified nucleic acid or protein compositions. In the context of the present invention, an “isolated” or “purified” DNA molecule or an “isolated” or “purified” polypeptide is a DNA molecule or polypeptide that exists apart from its native environment and is therefore not a product of nature. An isolated DNA molecule or polypeptide may exist in a purified form or may exist in a non-native environment such as, for example, a transgenic host cell. For example, an “isolated” or “purified” nucleic acid molecule or protein, or biologically active portion thereof, is substantially free of other cellular material, or culture medium when produced by recombinant techniques, or substantially free of chemical precursors or other chemicals when chemically synthesized. In one embodiment, an “isolated” nucleic acid is free of sequences that naturally flank the nucleic acid (i.e., sequences located at the 5′ and 3′ ends of the nucleic acid) in the genomic DNA of the organism from which the nucleic acid is derived. For example, in various embodiments, the isolated nucleic acid molecule can contain less than about 5 kb, 4 kb, 3 kb, 2 kb, 1 kb, 0.5 kb, or 0.1 kb of nucleotide sequences that naturally flank the nucleic acid molecule in genomic DNA of the cell from which the nucleic acid is derived. A protein that is substantially free of cellular material includes preparations of protein or polypeptide having less than about 30%, 20%, 10%, 5%, (by dry weight) of contaminating protein. When the protein of the invention, or biologically active portion thereof, is recombinantly produced, preferably culture medium represents less than about 30%, 20%, 10%, or 5% (by dry weight) of chemical precursors or non-protein-of-interest chemicals. Fragments and variants of the disclosed nucleotide sequences and proteins or partial-length proteins encoded thereby are also encompassed by the present invention. By “fragment” or “portion” is meant a full length or less than full length of the nucleotide sequence encoding, or the amino acid sequence of, a polypeptide or protein.

[0033] The term “gene” is used broadly to refer to any segment of nucleic acid associated with a biological function. Thus, genes include coding sequences and/or the regulatory sequences required for their expression. For example, gene refers to a nucleic acid fragment that expresses mRNA, functional RNA, or specific protein, including regulatory sequences. Genes also include nonexpressed DNA segments that, for example, form recognition sequences for other proteins. Genes can be obtained from a variety of sources, including cloning from a source of interest or synthesizing from known or predicted sequence information, and may include sequences designed to have desired parameters.

[0034] “Naturally occurring” is used to describe an object that can be found in nature as distinct from being artificially produced. For example, a protein or nucleotide sequence present in an organism (including a virus), which can be isolated from a source in nature and which has not been intentionally modified by man in the laboratory, is naturally occurring.

[0035] The term “chimeric” refers to any gene or DNA that contains 1) DNA sequences, including regulatory and coding sequences, that are not found together in nature, or 2) sequences encoding parts of proteins not naturally adjoined, or 3) parts of promoters that are not naturally adjoined. Accordingly, a chimeric gene may comprise regulatory sequences and coding sequences that are derived from different sources, or comprise regulatory sequences and coding sequences derived from the same source, but arranged in a manner different from that found in nature.

[0036] A “transgene” refers to a gene that has been introduced into the genome by transformation and is stably maintained. Transgenes may include, for example, DNA that is either heterologous or homologous to the DNA of a particular cell to be transformed. Additionally, transgenes may comprise native genes inserted into a non-native organism, or chimeric genes. The term “endogenous gene” refers to a native gene in its natural location in the genome of an organism. A “foreign” gene refers to a gene not normally found in the host organism but that is introduced by gene transfer.

[0037] The terms “protein,” “peptide” and “polypeptide” are used interchangeably herein.

[0038] A “variant” of a molecule is a sequence that is substantially similar to the sequence of the native molecule. For nucleotide sequences, variants include those sequences that, because of the degeneracy of the genetic code, encode the identical amino acid sequence of the native protein. Naturally occurring allelic variants such as these can be identified with the use of well-known molecular biology techniques, as, for example, with polymerase chain reaction (PCR) and hybridization techniques. Variant nucleotide sequences also include synthetically derived nucleotide sequences, such as those generated, for example, by using site-directed mutagenesis which encode the native protein, as well as those that encode a polypeptide having amino acid substitutions. Generally, nucleotide sequence variants of the invention will have at least 40, 50, 60, to 70%, e.g., preferably 71%, 72%, 73%, 74%, 75%, 76%, 77%, 78%, to 79%, generally at least 80%, e.g., 81%-84%, at least 85%, e.g., 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, to 98%, sequence identity to the native (endogenous) nucleotide sequence.

[0039] “Conservatively modified variations” of a particular nucleic acid sequence refers to those nucleic acid sequences that encode identical or essentially identical amino acid sequences, or where the nucleic acid sequence does not encode an amino acid sequence, to essentially identical sequences. Because of the degeneracy of the genetic code, a large number of functionally identical nucleic acids encode any given polypeptide. For instance the codons CGT, CGC, CGA, CGG, AGA, and AGG all encode the amino acid arginine. Thus, at every position where an arginine is specified by a codon, the codon can be altered to any of the corresponding codons described without altering the encoded protein. Such nucleic acid variations are “silent variations” which are one species of “conservatively modified variations.”

[0040] Every nucleic acid sequence described herein which encodes a polypeptide also describes every possible silent variation, except where otherwise noted. One of skill will recognize that each codon in a nucleic acid (except ATG, which is ordinarily the only codon for methionine) can be modified to yield a functionally identical molecule by standard techniques. Accordingly, each “silent variation” of a nucleic acid which encodes a polypeptide is implicit in each described sequence.

[0041] “Recombinant DNA molecule” is a combination of DNA sequences that are joined together using recombinant DNA technology and procedures used to join together DNA sequences as described, for example, in Sambrook et al., Cold Spring Harbor, N.Y.: Cold Spring Harbor Laboratory Press (1989).

[0042] The terms “heterologous DNA sequence,” “exogenous DNA segment” or “heterologous nucleic acid,” each refer to a sequence that originates from a source foreign to the particular host cell or, if from the same source, is modified from its original form. Thus, a heterologous gene in a host cell includes a gene that is endogenous to the particular host cell but has been modified. The terms also include non-naturally occurring multiple copies of a naturally occurring DNA sequence. Thus, the terms refer to a DNA segment that is foreign or heterologous to the cell, or homologous to the cell but in a position within the host cell nucleic acid in which the element is not ordinarily found. Exogenous DNA segments are expressed to yield exogenous polypeptides.

[0043] A “homologous” DNA sequence is a DNA sequence that is naturally associated with a host cell into which it is introduced.

[0044] “Wild-type” refers to the normal gene, or organism found in nature without any known mutation.

[0045] “Genome” refers to the complete genetic material of an organism.

[0046] A “vector” is defined to include, inter alia, any plasmid, cosmid, phage or binary vector in double or single stranded linear or circular form which may or may not be self transmissible or mobilizable, and which can transform prokaryotic or eukaryotic host either by integration into the cellular genome or exist extrachromosomally (e.g., autonomous replicating plasmid with an origin of replication).

[0047] “Cloning vectors” typically contain one or a small number of restriction endonuclease recognition sites at which foreign DNA sequences can be inserted in a determinable fashion without loss of essential biological function of the vector, as well as a marker gene that is suitable for use in the identification and selection of cells transformed with the cloning vector. Marker genes typically include genes that provide tetracycline resistance, hygromycin resistance or ampicillin resistance.

[0048] “Expression cassette” as used herein means a DNA sequence capable of directing expression of a particular nucleotide sequence in an appropriate host cell, comprising a promoter operably linked to the nucleotide sequence of interest which is operably linked to termination signals. It also typically comprises sequences required for proper translation of the nucleotide sequence. The coding region usually codes for a protein of interest but may also code for a functional RNA of interest, for example antisense RNA or a nontranslated RNA, in the sense or antisense direction. The expression cassette comprising the nucleotide sequence of interest may be chimeric, meaning that at least one of its components is heterologous with respect to at least one of its other components. The expression cassette may also be one which is naturally occurring but has been obtained in a recombinant form useful for heterologous expression. The expression of the nucleotide sequence in the expression cassette may be under the control of a constitutive promoter or of an inducible promoter which initiates transcription only when the host cell is exposed to some particular external stimulus. In the case of a multicellular organism, the promoter can also be specific to a particular tissue or organ or stage of development.

[0049] Such expression cassettes will comprise the transcriptional initiation region of the invention linked to a nucleotide sequence of interest. Such an expression cassette is provided with a plurality of restriction sites for insertion of the gene of interest to be under the transcriptional regulation of the regulatory regions. The expression cassette may additionally contain selectable marker genes.

[0050] “Coding sequence” refers to a DNA or RNA sequence that codes for a specific amino acid sequence and excludes the non-coding sequences. It may constitute an “uninterrupted coding sequence”, i.e., lacking an intron, such as in a cDNA or it may include one or more introns bounded by appropriate splice junctions. An “intron” is a sequence of RNA which is contained in the primary transcript but which is removed through cleavage and re-ligation of the RNA within the cell to create the mature mRNA that can be translated into a protein.

[0051] The terms “open reading frame” and “ORF” refer to the amino acid sequence encoded between translation initiation and termination codons of a coding sequence. The terms “initiation codon” and “termination codon” refer to a unit of three adjacent nucleotides (‘codon’) in a coding sequence that specifies initiation and chain termination, respectively, of protein synthesis (mRNA translation).

[0052] A “functional RNA” refers to an antisense RNA, ribozyme, or other RNA that is not translated.

[0053] The term “RNA transcript” refers to the product resulting from RNA polymerase catalyzed transcription of a DNA sequence. When the RNA transcript is a perfect complementary copy of the DNA sequence, it is referred to as the primary transcript or it may be a RNA sequence derived from posttranscriptional processing of the primary transcript and is referred to as the mature RNA. “Messenger RNA” (mRNA) refers to the RNA that is without introns and that can be translated into protein by the cell. “cDNA” refers to a single- or a double-stranded DNA that is complementary to and derived from mRNA.

[0054] “Regulatory sequences” and “suitable regulatory sequences” each refer to nucleotide sequences located upstream (5′ non-coding sequences), within, or downstream (3′ non-coding sequences) of a coding sequence, and which influence the transcription, RNA processing or stability, or translation of the associated coding sequence. Regulatory sequences include enhancers, promoters, translation leader sequences, introns, and polyadenylation signal sequences. They include natural and synthetic sequences as well as sequences which may be a combination of synthetic and natural sequences. As is noted above, the term “suitable regulatory sequences” is not limited to promoters. However, some suitable regulatory sequences useful in the present invention will include, but are not limited to constitutive promoters, tissue-specific promoters, development-specific promoters, inducible promoters and viral promoters.

[0055] “5′ non-coding sequence” refers to a nucleotide sequence located 5′ (upstream) to the coding sequence. It is present in the fully processed mRNA upstream of the initiation codon and may affect processing of the primary transcript to mRNA, mRNA stability or translation efficiency (Turner et al., Mol. Biotech., 3:225 (1995).

[0056] “3′ non-coding sequence” refers to nucleotide sequences located 3′ (downstream) to a coding sequence and include polyadenylation signal sequences and other sequences encoding regulatory signals capable of affecting mRNA processing or gene expression. The polyadenylation signal is usually characterized by affecting the addition of polyadenylic acid tracts to the 3′ end of the mRNA precursor.

[0057] The term “translation leader sequence” refers to that DNA sequence portion of a gene between the promoter and coding sequence that is transcribed into RNA and is present in the fully processed mRNA upstream (5′) of the translation start codon. The translation leader sequence may affect processing of the primary transcript to mRNA, mRNA stability or translation efficiency.

[0058] The term “mature” protein refers to a post-translationally processed polypeptide without its signal peptide. “Precursor” protein refers to the primary product of translation of an mRNA. “Signal peptide” refers to the amino terminal extension of a polypeptide, which is translated in conjunction with the polypeptide forming a precursor peptide and which is required for its entrance into the secretory pathway. The term “signal sequence” refers to a nucleotide sequence that encodes the signal peptide.

[0059] “Promoter” refers to a nucleotide sequence, usually upstream (5′) to its coding sequence, which controls the expression of the coding sequence by providing the recognition for RNA polymerase and other factors required for proper transcription. “Promoter” includes a minimal promoter that is a short DNA sequence comprised of a TATA-box and other sequences that serve to specify the site of transcription initiation, to which regulatory elements are added for control of expression. “Promoter” also refers to a nucleotide sequence that includes a minimal promoter plus regulatory elements that is capable of controlling the expression of a coding sequence or functional RNA. This type of promoter sequence consists of proximal and more distal upstream elements, the latter elements often referred to as enhancers. Accordingly, an “enhancer” is a DNA sequence which can stimulate promoter activity and may be an innate element of the promoter or a heterologous element inserted to enhance the level or tissue specificity of a promoter. It is capable of operating in both orientations (normal or flipped), and is capable of functioning even when moved either upstream or downstream from the promoter. Both enhancers and other upstream promoter elements bind sequence-specific DNA-binding proteins that mediate their effects. Promoters may be derived in their entirety from a native gene, or be composed of different elements derived from different promoters found in nature, or even be comprised of synthetic DNA segments. A promoter may also contain DNA sequences that are involved in the binding of protein factors which control the effectiveness of transcription initiation in response to physiological or developmental conditions.

[0060] The “initiation site” is the position surrounding the first nucleotide that is part of the transcribed sequence, which is also defined as position +1. With respect to this site all other sequences of the gene and its controlling regions are numbered. Downstream sequences (i.e. further protein encoding sequences in the 3′ direction) are denominated positive, while upstream sequences (mostly of the controlling regions in the 5′ direction) are denominated negative.

[0061] Promoter elements, particularly a TATA element, that are inactive or that have greatly reduced promoter activity in the absence of upstream activation are referred to as “minimal or core promoters.” In the presence of a suitable transcription factor, the minimal promoter functions to permit transcription. A “minimal or core promoter” thus consists only of all basal elements needed for transcription initiation, e.g., a TATA box and/or an initiator.

[0062] “Constitutive expression” refers to expression using a constitutive or regulated promoter. “Conditional” and “regulated expression” refer to expression controlled by a regulated promoter.

[0063] “Operably-linked” refers to the association of nucleic acid sequences on single nucleic acid fragment so that the function of one is affected by the other. For example, a regulatory DNA sequence is said to be “operably linked to” or “associated with” a DNA sequence that codes for an RNA or a polypeptide if the two sequences are situated such that the regulatory DNA sequence affects expression of the coding DNA sequence (i.e., that the coding sequence or functional RNA is under the transcriptional control of the promoter). Coding sequences can be operably-linked to regulatory sequences in sense or antisense orientation.

[0064] “Expression” refers to the transcription and/or translation of an endogenous gene or a transgene in cells. For example, in the case of antisense constructs, expression may refer to the transcription of the antisense DNA only. In addition, expression refers to the transcription and stable accumulation of sense (mRNA) or functional RNA. Expression may also refer to the production of protein.

[0065] “Transcription stop fragment” refers to nucleotide sequences that contain one or more regulatory signals, such as polyadenylation signal sequences, capable of terminating transcription. Examples include the 3′ non-regulatory regions of genes encoding nopaline synthase and the small subunit of ribulose bisphosphate carboxylase.

[0066] “Translation stop fragment” refers to nucleotide sequences that contain one or more regulatory signals, such as one or more termination codons in all three frames, capable of terminating translation. Insertion of a translation stop fragment adjacent to or near the initiation codon at the 5′ end of the coding sequence will result in no translation or improper translation. Excision of the translation stop fragment by site-specific recombination will leave a site-specific sequence in the coding sequence that does not interfere with proper translation using the initiation codon.

[0067] The terms “cis-acting sequence” and “cis-acting element” refer to DNA or RNA sequences whose functions require them to be on the same molecule.

[0068] The terms “trans-acting sequence” and “trans-acting element” refer to DNA or RNA sequences whose function does not require them to be on the same molecule.

[0069] “Chromosomally-integrated” refers to the integration of a foreign gene or DNA construct into the host DNA by covalent bonds. Where genes are not “chromosomally integrated” they may be “transiently expressed.” Transient expression of a gene refers to the expression of a gene that is not integrated into the host chromosome but functions independently, either as part of an autonomously replicating plasmid or expression cassette, for example, or as part of another biological system such as a virus.

[0070] The following terms are used to describe the sequence relationships between two or more nucleic acids or polynucleotides: (a) “reference sequence”, (b) “comparison window”, (c) “sequence identity”, (d) “percentage of sequence identity”, and (e) “substantial identity”.

[0071] (a) As used herein, “reference sequence” is a defined sequence used as a basis for sequence comparison. A reference sequence may be a subset or the entirety of a specified sequence; for example, as a segment of a full length cDNA or gene sequence, or the complete cDNA or gene sequence.

[0072] (b) As used herein, “comparison window” makes reference to a contiguous and specified segment of a polynucleotide sequence, wherein the polynucleotide sequence in the comparison window may comprise additions or deletions (i.e., gaps) compared to the reference sequence (which does not comprise additions or deletions) for optimal alignment of the two sequences. Generally, the comparison window is at least 20 contiguous nucleotides in length, and optionally can be 30, 40, 50, 100, or longer. Those of skill in the art understand that to avoid a high similarity to a reference sequence due to inclusion of gaps in the polynucleotide sequence a gap penalty is typically introduced and is subtracted from the number of matches.

[0073] Methods of alignment of sequences for comparison are well known in the art. Thus, the determination of percent identity between any two sequences can be accomplished using a mathematical algorithm. Preferred, non-limiting examples of such mathematical algorithms are the algorithm of Myers and Miller, CABIOS, 4:11 (1988); the local homology algorithm of Smith et al., Adv. Appl. Math., 2:482 (1981); the homology alignment algorithm of Needleman and Wunsch, JMB, 48:443 (1970); the search-for-similarity-method of Pearson and Lipman, Proc. Natl. Acad. Sci. USA, 85:2444 (1988); the algorithm of Karlin and Altschul, Proc. Natl. Acad. Sci. USA, 87:2264 (1990), modified as in Karlin and Altschul, Proc. Natl. Acad. Sci. USA, 90:5873 (1993).

[0074] Computer implementations of these mathematical algorithms can be utilized for comparison of sequences to determine sequence identity. Such implementations include, but are not limited to: CLUSTAL in the PC/Gene program (available from Intelligenetics, Mountain View, Calif.); the ALIGN program (Version 2.0) and GAP, BESTFIT, BLAST, FASTA, and TFASTA in the Wisconsin Genetics Software Package, Version 8 (available from Genetics Computer Group (GCG), 575 Science Drive, Madison, Wis., USA). Alignments using these programs can be performed using the default parameters. The CLUSTAL program is well described by Higgins et al., Gene, 73:237 (1988); Higgins et al., CABIOS, 5:151 (1989); Corpet et al., Nucl. Acids Res., 16:10881 (1988); Huang et al., CABIOS, 8:155 (1992); and Pearson et al., Meth. Mol. Biol., 24:307 (1994). The ALIGN program is based on the algorithm of Myers and Miller, supra. The BLAST programs of Altschul et al., JMB, 215:403 (1990); Nucl. Acids Res., 25:3389 (1990), are based on the algorithm of Karlin and Altschul supra.

[0075] Software for performing BLAST analyses is publicly available through the National Center for Biotechnology Information (http://www.ncbi.nlm.nih.gov/). This algorithm involves first identifying high scoring sequence pairs (HSPs) by identifying short words of length W in the query sequence, which either match or satisfy some positive-valued threshold score T when aligned with a word of the same length in a database sequence. T is referred to as the neighborhood word score threshold. These initial neighborhood word hits act as seeds for initiating searches to find longer HSPs containing them. The word hits are then extended in both directions along each sequence for as far as the cumulative alignment score can be increased. Cumulative scores are calculated using, for nucleotide sequences, the parameters M (reward score for a pair of matching residues; always >0) and N (penalty score for mismatching residues; always <0). For amino acid sequences, a scoring matrix is used to calculate the cumulative score. Extension of the word hits in each direction are halted when the cumulative alignment score falls off by the quantity X from its maximum achieved value, the cumulative score goes to zero or below due to the accumulation of one or more negative-scoring residue alignments, or the end of either sequence is reached.

[0076] In addition to calculating percent sequence identity, the BLAST algorithm also performs a statistical analysis of the similarity between two sequences. One measure of similarity provided by the BLAST algorithm is the smallest sum probability (P(N)), which provides an indication of the probability by which a match between two nucleotide or amino acid sequences would occur by chance. For example, a test nucleic acid sequence is considered similar to a reference sequence if the smallest sum probability in a comparison of the test nucleic acid sequence to the reference nucleic acid sequence is less than about 0.1, more preferably less than about 0.01, and most preferably less than about 0.001.

[0077] To obtain gapped alignments for comparison purposes, Gapped BLAST (in BLAST 2.0) can be utilized as described in Altschul et al., Nucleic Acids Res. 25:3389 (1997). Alternatively, PSI-BLAST (in BLAST 2.0) can be used to perform an iterated search that detects distant relationships between molecules. See Altschul et al., supra. When utilizing BLAST, Gapped BLAST, PSI-BLAST, the default parameters of the respective programs (e.g. BLASTN for nucleotide sequences, BLASTX for proteins) can be used. The BLASTN program (for nucleotide sequences) uses as defaults a wordlength (W) of 11, an expectation (E) of 10, a cutoff of 100, M=5, N=−4, and a comparison of both strands. For amino acid sequences, the BLASTP program uses as defaults a wordlength (W) of 3, an expectation (E) of 10, and the BLOSUM62 scoring matrix. See http://www.ncbi.nlm.nih.gov. Alignment may also be performed manually by inspection.

[0078] For purposes of the present invention, comparison of nucleotide sequences for determination of percent sequence identity to the promoter sequences disclosed herein is preferably made using the BlastN program (version 1.4.7 or later) with its default parameters or any equivalent program. By “equivalent program” is intended any sequence comparison program that, for any two sequences in question, generates an alignment having identical nucleotide or amino acid residue matches and an identical percent sequence identity when compared to the corresponding alignment generated by the preferred program.

[0079] (c) As used herein, “sequence identity” or “identity” in the context of two nucleic acid or polypeptide sequences makes reference to a specified percentage of residues in the two sequences that are the same when aligned for maximum correspondence over a specified comparison window, as measured by sequence comparison algorithms or by visual inspection. When percentage of sequence identity is used in reference to proteins it is recognized that residue positions which are not identical often differ by conservative amino acid substitutions, where amino acid residues are substituted for other amino acid residues with similar chemical properties (e.g., charge or hydrophobicity) and therefore do not change the functional properties of the molecule. When sequences differ in conservative substitutions, the percent sequence identity may be adjusted upwards to correct for the conservative nature of the substitution. Sequences that differ by such conservative substitutions are said to have “sequence similarity” or “similarity.”Means for making this adjustment are well known to those of skill in the art. Typically this involves scoring a conservative substitution as a partial rather than a full mismatch, thereby increasing the percentage sequence identity. Thus, for example, where an identical amino acid is given a score of 1 and a non-conservative substitution is given a score of zero, a conservative substitution is given a score between zero and 1. The scoring of conservative substitutions is calculated, e.g., as implemented in the program PC/GENE (Intelligenetics, Mountain View, Calif.).

[0080] (d) As used herein, “percentage of sequence identity” means the value determined by comparing two optimally aligned sequences over a comparison window, wherein the portion of the polynucleotide sequence in the comparison window may comprise additions or deletions (i.e., gaps) as compared to the reference sequence (which does not comprise additions or deletions) for optimal alignment of the two sequences. The percentage is calculated by determining the number of positions at which the identical nucleic acid base or amino acid residue occurs in both sequences to yield the number of matched positions, dividing the number of matched positions by the total number of positions in the window of comparison, and multiplying the result by 100 to yield the percentage of sequence identity.

[0081] (e)(i) The term “substantial identity” of polynucleotide sequences means that a polynucleotide comprises a sequence that has at least 70%, 71%, 72%, 73%, 74%, 75%, 76%, 77%, 78%, or 79%, preferably at least 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, or 89%, more preferably at least 90%, 91%, 92%, 93%, or 94%, and most preferably at least 95%, 96%, 97%, 98%, or 99% sequence identity, compared to a reference sequence using one of the alignment programs described using standard parameters. One of skill in the art will recognize that these values can be appropriately adjusted to determine corresponding identity of proteins encoded by two nucleotide sequences by taking into account codon degeneracy, amino acid similarity, reading frame positioning, and the like. Substantial identity of amino acid sequences for these purposes normally means sequence identity of at least 70%, more preferably at least 80%, 90%, and most preferably at least 95%.

[0082] Another indication that nucleotide sequences are substantially identical is if two molecules hybridize to each other under stringent conditions (see below). Generally, stringent conditions are selected to be about 5° C. lower than the thermal melting point (Tm) for the specific sequence at a defined ionic strength and pH. However, stringent conditions encompass temperatures in the range of about 1° C. to about 20° C., depending upon the desired degree of stringency as otherwise qualified herein. Nucleic acids that do not hybridize to each other under stringent conditions are still substantially identical if the polypeptides they encode are substantially identical. This may occur, e.g., when a copy of a nucleic acid is created using the maximum codon degeneracy permitted by the genetic code. One indication that two nucleic acid sequences are substantially identical is when the polypeptide encoded by the first nucleic acid is immunologically cross reactive with the polypeptide encoded by the second nucleic acid.

[0083] (e)(ii) The term “substantial identity” in the context of a peptide indicates that a peptide comprises a sequence with at least 70%, 71%, 72%, 73%, 74%, 75%, 76%, 77%, 78%, or 79%, preferably 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, or 89%, more preferably at least 90%, 91%, 92%, 93%, or 94%, or even more preferably, 95%, 96%, 97%, 98% or 99%, sequence identity to the reference sequence over a specified comparison window. Preferably, optimal alignment is conducted using the homology alignment algorithm of Needleman and Wunsch, J. Mol. Biol. 48:443 (1970). An indication that two peptide sequences are substantially identical is that one peptide is immunologically reactive with antibodies raised against the second peptide. Thus, a peptide is substantially identical to a second peptide, for example, where the two peptides differ only by a conservative substitution.

[0084] For sequence comparison, typically one sequence acts as a reference sequence to which test sequences are compared. When using a sequence comparison algorithm, test and reference sequences are input into a computer, subsequence coordinates are designated if necessary, and sequence algorithm program parameters are designated. The sequence comparison algorithm then calculates the percent sequence identity for the test sequence(s) relative to the reference sequence, based on the designated program parameters.

[0085] As noted above, another indication that two nucleic acid sequences are substantially identical is that the two molecules hybridize to each other under stringent conditions. The phrase “hybridizing specifically to” refers to the binding, duplexing, or hybridizing of a molecule only to a particular nucleotide sequence under stringent conditions when that sequence is present in a complex mixture (e.g., total cellular) DNA or RNA. “Bind(s) substantially” refers to complementary hybridization between a probe nucleic acid and a target nucleic acid and embraces minor mismatches that can be accommodated by reducing the stringency of the hybridization media to achieve the desired detection of the target nucleic acid sequence.

[0086] “Stringent hybridization conditions” and “stringent hybridization wash conditions” in the context of nucleic acid hybridization experiments such as Southern and Northern hybridizations are sequence dependent, and are different under different environmental parameters. Longer sequences hybridize specifically at higher temperatures. The thermal melting point (Tm) is the temperature (under defined ionic strength and pH) at which 50% of the target sequence hybridizes to a perfectly matched probe. Specificity is typically the function of post-hybridization washes, the critical factors being the ionic strength and temperature of the final wash solution. For DNA-DNA hybrids, the Tm can be approximated from the equation of Meinkoth and Wahl, Anal. Biochem., 138:267 (1984); Tm 81.5° C.+16.6 (log M)+0.41 (% GC)−0.61 (% form)−500/L; where M is the molarity of monovalent cations, % GC is the percentage of guanosine and cytosine nucleotides in the DNA, % form is the percentage of formamide in the hybridization solution, and L is the length of the hybrid in base pairs. Tm is reduced by about 1° C. for each 1% of mismatching; thus, Tm, hybridization, and/or wash conditions can be adjusted to hybridize to sequences of the desired identity. For example, if sequences with >90% identity are sought, the Tm can be decreased 10° C. Generally, stringent conditions are selected to be about 5° C. lower than the Tm for the specific sequence and its complement at a defined ionic strength and pH. However, severely stringent conditions can utilize a hybridization and/or wash at 1, 2, 3, or 4° C. lower than the Tm; moderately stringent conditions can utilize a hybridization and/or wash at 6, 7, 8, 9, or 10° C. lower than the Tm; low stringency conditions can utilize a hybridization and/or wash at 11, 12, 13, 14, 15, or 20° C. lower than the Tm. Using the equation, hybridization and wash compositions, and desired temperature, those of ordinary skill will understand that variations in the stringency of hybridization and/or wash solutions are inherently described. If the desired degree of mismatching results in a temperature of less than 45° C. (aqueous solution) or 32° C. (formamide solution), it is preferred to increase the SSC concentration so that a higher temperature can be used. An extensive guide to the hybridization of nucleic acids is found in Tijssen, Laboratory Techniques in Biochemistry and Molecular Biology Hybridization with Nucleic Acid Probes, part I chapter 2 “Overview of principles of hybridization and the strategy of nucleic acid probe assays” Elsevier, New York (1993). Generally, highly stringent hybridization and wash conditions are selected to be about 5° C. lower than the Tm for the specific sequence at a defined ionic strength and pH.

[0087] An example of highly stringent wash conditions is 0.15 M NaCl at 72° C. for about 15 minutes. An example of stringent wash conditions is a 0.2×SSC wash at 65° C. for 15 minutes (see, Sambrook, infra, for a description of SSC buffer). Often, a high stringency wash is preceded by a low stringency wash to remove background probe signal. An example medium stringency wash for a duplex of, e.g., more than 100 nucleotides, is 1×SSC at 45° C. for 15 minutes. An example low stringency wash for a duplex of, e.g., more than 100 nucleotides, is 4-6×SSC at 40° C. for 15 minutes. For short probes (e.g., about 10 to 50 nucleotides), stringent conditions typically involve salt concentrations of less than about 1.5 M, more preferably about 0.01 to 1.0 M, Na ion concentration (or other salts) at pH 7.0 to 8.3, and the temperature is typically at least about 30° C. and at least about 60° C. for long probes (e.g., >50 nucleotides). Stringent conditions may also be achieved with the addition of destabilizing agents such as formamide. In general, a signal to noise ratio of 2×(or higher) than that observed for an unrelated probe in the particular hybridization assay indicates detection of a specific hybridization. Nucleic acids that do not hybridize to each other under stringent conditions are still substantially identical if the proteins that they encode are substantially identical. This occurs, e.g., when a copy of a nucleic acid is created using the maximum codon degeneracy permitted by the genetic code.

[0088] Very stringent conditions are selected to be equal to the Tm for a particular probe. An example of stringent conditions for hybridization of complementary nucleic acids which have more than 100 complementary residues on a filter in a Southern or Northern blot is 50% formamide, e.g., hybridization in 50% formamide, 1 M NaCl, 1% SDS at 37° C., and a wash in 0.1×SSC at 60 to 65° C. Exemplary low stringency conditions include hybridization with a buffer solution of 30 to 35% formamide, 1M NaCl, 1% SDS (sodium dodecyl sulphate) at 37° C., and a wash in 1×to 2×SSC (20×SSC=3.0 M NaCl/0.3 M trisodium citrate) at 50 to 55° C. Exemplary moderate stringency conditions include hybridization in 40 to 45% formamide, 1.0 M NaCl, 1% SDS at 37° C., and a wash in 0.5×to 1×SSC at 55 to 60° C.

[0089] By “variant” polypeptide is intended a polypeptide derived from the native protein by deletion (so-called truncation) or addition of one or more amino acids to the N-terminal and/or C-terminal end of the native protein; deletion or addition of one or more amino acids at one or more sites in the native protein; or substitution of one or more amino acids at one or more sites in the native protein. Such variants may results form, for example, genetic polymorphism or from human manipulation. Methods for such manipulations are generally known in the art.

[0090] Thus, the polypeptides of the invention may be altered in various ways including amino acid substitutions, deletions, truncations, and insertions. Methods for such manipulations are generally known in the art. For example, amino acid sequence variants of the polypeptides can be prepared by mutations in the DNA. Methods for mutagenesis and nucleotide sequence alterations are well known in the art. See, for example, Kunkel, Proc. Natl. Acad. Sci. USA, 82:488 (1985); Kunkel et al., Meth. Enzymol., 154:367 (1987); U.S. Pat. No. 4,873,192; Walker and Gaastra, Techniques in Mol. Biol. (MacMillan Publishing Co. (1983), and the references cited therein. Guidance as to appropriate amino acid substitutions that do not affect biological activity of the protein of interest may be found in the model of Dayhoff et al., Atlas of Protein Sequence and Structure (Natl. Biomed. Res. Found. 1978). Conservative substitutions, such as exchanging one amino acid with another having similar properties, are preferred.

[0091] Thus, the genes and nucleotide sequences of the invention include both the naturally occurring sequences as well as mutant forms. Likewise, the polypeptides of the invention encompass both naturally occurring proteins as well as variations and modified forms thereof. Such variants will continue to possess the desired activity. The deletions, insertions, and substitutions of the polypeptide sequence encompassed herein are not expected to produce radical changes in the characteristics of the polypeptide. However, when it is difficult to predict the exact effect of the substitution, deletion, or insertion in advance of doing so, one skilled in the art will appreciate that the effect will be evaluated by routine screening assays.

[0092] Individual substitutions deletions or additions that alter, add or delete a single amino acid or a small percentage of amino acids (typically less than 5%, more typically less than 1%) in an encoded sequence are “conservatively modified variations,” where the alterations result in the substitution of an amino acid with a chemically similar amino acid. Conservative substitution tables providing functionally similar amino acids are well known in the art. The following five groups each contain amino acids that are conservative substitutions for one another: Aliphatic: Glycine (G), Alanine (A), Valine (V), Leucine (L), Isoleucine (I); Aromatic: Phenylalanine (F), Tyrosine (Y), Tryptophan (W); Sulfur-containing: Methionine (M), Cysteine (C); Basic: Arginine (R), Lysine (K), Histidine (H); Acidic: Aspartic acid (D), Glutamic acid (E), Asparagine (N), Glutamine (O). In addition, individual substitutions, deletions or additions which alter, add or delete a single amino acid or a small percentage of amino acids in an encoded sequence are also “conservatively modified variations.”

[0093] The term “transformation” refers to the transfer of a nucleic acid fragment into the genome of a host cell, resulting in genetically stable inheritance. Host cells containing the transformed nucleic acid fragments are referred to as “transgenic” cells, and organisms comprising transgenic cells are referred to as “transgenic organisms”.

[0094] “Transformed,” “transgenic,” and “recombinant” refer to a host cell or organism into which a heterologous nucleic acid molecule has been introduced. The nucleic acid molecule can be stably integrated into the genome generally known in the art and are disclosed in Sambrook et al., Molecular Cloning: A Laboratory Manual (2d ed., Cold Spring Harbor Laboratory Press, Plainview, N.Y.) (1989). See also Innis et al., PCR Protocols, Academic Press (1995); and Gelfand, PCR Strategies, Academic Press (1995); and Innis and Gelfand, PCR Methods Manual, Academic Press (1999). Known methods of PCR include, but are not limited to, methods using paired primers, nested primers, single specific primers, degenerate primers, gene-specific primers, vector-specific primers, partially mismatched primers, and the like. For example, “transformed,” “transformant,” and “transgenic” cells have been through the transformation process and contain a foreign gene integrated into their chromosome. The term “untransformed” refers to normal cells that have not been through the transformation process.

[0095] A “transgenic” organism is an organism having one or more cells that contain an expression vector.

[0096] By “portion” or “fragment”, as it relates to a nucleic acid molecule, sequence or segment of the invention, when it is linked to other sequences for expression, is meant a sequence having at least 80 nucleotides, more preferably at least 150 nucleotides, and still more preferably at least 400 nucleotides. If not employed for expressing, a “portion” or “fragment” means at least 9, preferably 12, more preferably 15, even more preferably at least 20, consecutive nucleotides, e.g., probes and primers (oligonucleotides), corresponding to the nucleotide sequence of the nucleic acid molecules of the invention.

[0097] Direct Association of CR3 with Pathogenic Neisseria

[0098] Phagocytosis that is mediated by complement receptor type 3 (CR3) occurs independently of a proinflammatory response in immune cells (Caron et al. 1998). CR3 exists as an integrin heterodimer composed of an alpha (αM or CD11b) and a beta (β2 or CD18) subunit. The distribution of CR3 is thought to be limited to professional phagocytes; however, Hussain et al. (1995) demonstrated the expression of CR3 in rectal epithelia. Additionally, Hussain et al. (1995) were able to detect the presence of CD11b in a small subpopulation of cervicovaginal epithelia, although they were unable to detect the presence of CD18.

[0099] Up-regulation of CD11b in neutrophils has been documented in response to Neisseria meningiditis infection (Kragsbjerg et al. 2000). The direct association of CR3 with pathogenic Neisseria, however, has not been demonstrated. The present inventors herein describe the occurrence of CR3 expression in primary human cervical epithelial cells and its co-localization with N. gonorrhoeae upon infection of these primary epithelial cells. They also describe the distribution of CR3 in immortalized tissue culture cell lines and within tissue biopsies derived from the male and female urogenital tracts. Monoclonal antibodies directed against CR3 inhibit gonococcal invasion of primary cervical cells and of CR3-transfected CHO cells suggesting that CR3 serves as a receptor for N. gonorrhoeae during infection. In addition, these studies help to explain why the inflammatory response initiated by gonococcal infection of the lower female genital tract differs from that observed with gonococcal infection of the male urogenital genital tract.

[0100] The distribution of CR3 in tissue biopsies derived from defined sites within the human male and female genital tracts and in primary, immortalized, and malignant epithelial cells derived from these sites is described in Example 2 below. Laser scanning confocal microscopy (LSCM) demonstrated CR3 was not present in tissues and cell derived from the male urogenital tract and from tissue derived from the female urethra; however, CR3 was present on tissues and cells derived from the female genital tract. CR3 expression was greatest within the ectocervix tissue. Surface levels of CR3 appeared to decrease progressively from the ectocervix to the upper female genital tract in these tissues. A low level of CR3-associated immunofluorescence was observed in fallopian tube tissue. Consistent with results obtained with LSCM analysis of tissue biopsies, primary endo- and ectocervical cells possessed both CR3 subunits, and CR3 expression appeared to be greater on primary ectocervical cells in comparison to primary endocervical cells.

[0101] In contrast to results obtained with analysis of tissue biopsies and primary cervical cells, CR3 expression was negligible on immortalized and malignant cell lines (i.e., HCK, End1, ME180, Hec1B). Infection studies using N. gonorrhoeae strains 1291, 1291-green, MS11-green, or FA1090-green did not significantly influence the level of CR3 surface expression on these immortalized or malignant cell lines. However, N. gonorrhoeae did appear in induce up-regulation of CR3 surface expression on primary endo- and ectocervical cells. Gonococci were observed to co-localize with CR3 on primary cervical cells, and co-localization became increasingly prominent with extended infection. Immunoprecipitation studies confirmed the presence of CD11b and CD18 in primary cervical cells and CR3 co-localization with the gonococcus. Gonococci bound CR3-transfected K562 and CHO cells, and binding could be inhibited by the presence of anti-CD11b or -CD18 antibodies (FIG. 1). Similarly, invasion of primary cervical cells and CHO-CR3 cells could be inhibited by the addition of anti-CR3 antibodies to gentimicin-survival assays (FIGS. 1 and 2). Gonococcal invasion of primary endo- and ectocervical cells was also inhibited by the addition of Clostridium C3 neurotoxin to invasion assays (FIG. 3), which is consistent with CR3-mediated phagocytosis (Caron et al. 1998).

[0102] Extensive membrane ruffling could be induced to occur in the absence of gonococci in primary endo- and ectocervical cells and in CHO-CR3 cells by the addition of anti-CD11b or -CD18 antibodies to infection assays. This suggests that engagement of CR3 elicits membrane ruffling, which occurs in response to N gonorrhoeae infection of the cervical epithelium.

[0103] The role of complement (C′) in innate immunity is multifactorial; however, C′ predominately serves to eliminate foreign antigens and to regulate the inflammatory response directed towards these exogenous particles. C′ protein C3 of the C′ alternative pathway (AP) plays a paramount role in AP C′ regulation in that it serves to amplify the complement-mediated response by a positive feedback regulatory loop, which converts a relatively inefficient response to a highly efficient defense mechanism. Activation of the AP occurs constitutively at a low rate, which is tightly regulated by C′ regulatory proteins, e.g., factors H (fH) and I (fI). Deposition of C3 on an exogenous surface (e.g. a bacterium) results in spontaneous C3 hydrolysis to produce C3b. C3b can bind factor B (fB) to generate C3 convertase activity leading to the formation of the membrane attack complex. Alternatively, C3b can bind fH leading to C′ inactivation via cleavage of C3b by fI to produce iC3b, a ligand for CR3.

[0104] CR3 distribution has generally been considered to be limited to immune cells (e.g., monocytes, neutrophils, and macrophages); however, CR3 has also been found on renal glomerular (Sandilands et al. 1985) and rectal (Hussain et al. 1995) epithelial cells. By in situ hybridization Hussain et al. (1995) detected CD11b in a sub-population of endocervical tissue specimens, but they were unable to detect CD18. The inability to detect CD18 was attributed to a level of CR3 expression that was below the sensitivity of the antibody and detection method used (Hussain et al. 1995). LSCM of surgical biopsies and of primary endo- and ectocervical cell monolayers (using two, well defined, antibodies to each CR3 subunit) demonstrated CR3 within the ectocervical, endocervical, endometrial, and fallopian tube epithelia; however, CR3 expression appeared to progressively decrease from the ectocervix to the fallopian tubes. Although CR3 is structurally and functionally related to the very late antigen (VLA) sub-family of integrins, which are present within the female genital tract (Sülz et al. 1998), these two distinct groups of proteins are not immunologically cross-reactive (Hynes, R. O. 1987). Additionally, isotype control antibodies failed to label primary cell monolayers or tissue cryosections.

[0105] The present inventors' immunohistochemical data provide evidence for the presence of CR3 within the female genital tract. Furthermore, immunoprecipitation of primary cervical cell lysates confirmed the presence of CR3 within the endo- and ectocervix by the presence of the appropriate 95 kDa (CD18) and 170 kDa (CD11b) bands with subsequent western blotting. These data suggest that the distribution of CR3 should now be extended to include the endo- and ectocervix and, possibly, the epithelia of the endometrium and fallopian tubes. The female reproductive tract and seminal fluid have been hypothesized to exhibit anomalous C′ regulatory characteristics that exist to ensure successful reproduction by hindering an amplified immune response to seminal plasma (Vanderpuye et al. 1992). Seminal plasma has been demonstrated to contain unidentified C1 and C3 C′ component inhibitors, trace amounts of fH and fI, and a soluble form of the C3 regulatory protein, CD46 (Hussain et al. 1995), but fB has not been detected (Vanderpuye et al. 1992).

[0106] Full AP complement activity has been reported in cervical mucous (Price et al. 1979; Vanderpuye et al. 1992); however, C4 of the complement classical pathway (CP) was only detected in a small sub-population of luteal-phase cervical secretions (Vanderpuye et al. 1992). Additionally, AP, but not CP, components are produced by the vaginal epithelium (Price et al. 1979), and there are some data to suggest that C′ components are synthesized by the endometrium (Vanderpuye et al. 1992). Collectively these data suggest that CR3 present within the female genital tract would function to eliminate exogenous antigens (with the absence of neutrophil influx), following C′ inactivation of these antigens in seminal fluid or cervical mucous.

[0107] In contrast to the results obtained with female genital tissue and primary endo- and ectocervical cells, the presence of CR3 was not detected in vas deferens or male and female urethral tissue. The absence of CR3 in these tissues may be the result of divergent embryonic development that occurs after differentiation of the nephrogenic mesoderm. CR3 belongs to a large family of cell adhesion molecules that exhibit broad ligand specificity, and, in this respect, differential expression of integrin receptors has been implicated to play a role in morphogenesis and differentiation.

[0108] Drosophila spp. differentially express surface antigens, which structurally resemble human integrins, during the course of imaginal disc formation (Hynes, R. O. 1987). These cell surface molecules are hypothesized to influence embryonic development through differential cell adhesion (Hynes, R. O. 1987). In terms of evolutionary development, it is generally accepted that the female urogenital systems of apes and humans are more evolved than their male counterparts. In humans, the nephrogenic mesoderm differentiates to form the mesonephros and the metanephros. The metanephros gives rise to the renal glomerulus while the mesonephros regresses. Remnants of the mesonephric tubules exist in males as the vas deferens and in females as blind tubules in the ovarian dorsal mesentery. Muellerian ducts differentiate in females to form that portion of the female genital tract ranging from the fallopian tubes to the cephalic vagina. A complete division of the cloaca gives rise to the rectum and a urogenital sinus in both males and females. In males the muellerian ducts regress, and the urogenital sinus receives the mesonephric ducts, after which the rectum elongates and differentiation occurs. In females an additional portioning event of the urogenital sinus occurs to form the terminal vagina, the rectum, and the urethra. Since CR3 has been demonstrated on renal glomerular epithelium, rectal epithelium, and (considering the data of Hussain et al. (1995) and herein) the cervical epithelium, it is possible, although speculative, that the presence of CR3 in these tissues may correlate with a higher degree of embryonic development or cellular differentiation.

[0109] The absence of CR3 on the immortalized (End1, HCK) and the malignant (ME180, Hec1B) cell lines used in these studies may be reflective of the functional properties of integrins in general or CR3 specifically. Tumor cells are frequently altered in their integrin expression patterns (Jones et al. 1999) as well as the expression of other cellular receptors, e.g., complement receptor type 1 (CR1) (Seya et al. 1990) and the insulin-like growth factor-II/mannose-6-phosphate receptor (O'Gorman et al. 1999). Generally, adhesion and/or stimulation of integrins initiate signaling events that allow cytoskeletal rearrangements, cellular migration, and immunological activation. Adhesive and cytoskeletal defects are associated with fibronectin loss on transformed cells; these defects are reasoned to be due to altered integrin function (Hynes, R. O. 1987). CR3 initiates a signaling cascade in which PI 3-kinase functions as one effector (Elemer et al. 1994).

[0110] One function of PI-3 kinase is activation of the Rho family of small GTPases that, in turn, activate Jun-N-terminal kinase (JNK) (Hauck et al. 1998; Obermeier et al. 1998). Effector functions of JNK include regulation of gene expression and induction of apoptosis (Hauck et al. 1998). Some tumor cells express proteases most of which have been described to cleave C3 (Jurianz et al. 1999). Binding of C3 cleavage products (e.g., iC3b) to their respective receptors (e.g., CR3) could trigger multiple cellular responses, including apoptosis. Additionally, CR3 can also play a role in antibody-dependent cell-mediated cytotoxicity (ADCC) and complement-dependent cell-mediated cytotoxicity (CDCC) (Perlmann et al. 1983; Ramos et al. 1988; Ramos et al. 1985; W{dot over (a)}hlin et al. 1983), which facilitate tumor killing (Becherer et al. 1989; Erdei et al. 1991). Therefore, it could be reasoned that the absence of CR3 in immortal or malignant cells might confer a survival advantage to these cells.

[0111] A number of microorganisms have adapted mechanisms not only to evade complement-mediated killing but also to pilfer C′ components for their own advantage. Microorganisms that initiate infection via C′ receptors frequently activate C′, which subsequently results in C3 deposition on their cell surface (Hondalus et al. 1993). The effect of C′ deposition is two-fold: 1) it allows for evasion of immune surveillance, and 2) it allows targeting to the appropriate host cell (Cooper, N. R. 1991). Microbial entry of host cells in a CR3 opsonic-dependent manner is thought to lead to a milder respiratory burst thereby promoting increased intracellular survival (Mosser et al. 1987; Würzner, R. 1999). Additionally, complement-mediated endocytosis occurs independently of a proinflammatory response (Caron et al. 1998).

[0112] Asymptomatic gonococcal urethritis develops in a small proportion of men. In contrast, fifty to sixty percent of women with gonorrhea exhibit asymptomatic infections, and seventy percent of women with disseminated gonococcal infection (DGI) lack symptoms of genital track infection (Densen et al. 1982). The ability of pathogenic Neisseria to cause the range of disease states associated with infection requires highly efficient methods of immune avoidance. Although strain specific properties have been associated with resistance to complement-mediated killing (i.e., serum resistance) in vitro, most clinically isolated gonococci initially exhibit serum resistance, a property that is lost with sub-culturing (Densen, P. 1989; de la Paz et al. 1995; Ram et al. 1999; Ram et al. 1998; Vogel et al. 1999).

[0113] Ram et al. (1998) suggest that an increased conversion of C3b to iC3b on the gonococcal surface might contribute to serum resistance in vivo. This idea is supported by in vitro studies of gonococcal infection of neutrophils where a predominance of iC3b is found on the surface of gonococci in comparison to C3b deposition (Jarvis et al. 1999; McQuillen et al. 1999; Vogel et al. 1999). Conversion of C3b to iC3b on the gonococcal surface would permit efficient internalization of infecting gonococci into the cervical epithelium. Standard gentamicin-resistance assays measuring gonococcal invasion of primary endo- and ectocervical cells in the presence of anti-CR3 antibodies demonstrated greater than ninety-three percent invasion inhibition with the antibody inhibitors used.

[0114] Similar studies performed previously in the inventors' laboratory, using antibody inhibitors specific for other gonococcal ligands, failed to inhibit invasion of primary endo- and ectocervical cells. Additional support for a CR3-mediated mode of gonococcal invasion of the cervical epithelium is obtained from LSCM analysis of clinical biopsies derived from women with naturally Acquired gonorrhea. Confirmed co-localization of gonococci with CR3 in these tissue sections provide evidence that CR3-mediated gonococcal invasion probably occurs in vivo. Collectively these data suggest that CR3-mediated phagocytosis may serve as the primary mode of gonococcal invasion of the cervical epithelium.

[0115] Only a small proportion of total cellular CR3 is found on the surface of resting cells (Frank et al. 1991; Ram et al. 1998). This CR3 population is relatively immobile in the plane of the cell membrane (van Kooyk et al. 1999) and is thought to facilitate phagocytosis triggered by other cell surface receptors, e.g. CR1 and Fcγ receptors (Frank et al. 1991). A mobile, intracellular CR3 store is associated with iC3b-dependent adherence (Frank et al. 1991). Upon activation this latent CR3 population, which resides in peroxidase-negative granules, is rapidly released, resulting in up to a ten-fold increase in CR3 surface expression (Elemer et al. 1994; Frank et al. 1991; Kishimoto et al. 1989). Early in the stages of phagocytosis CR3 aggregation also occurs (Caron et al. 1998; Elemer et al. 1994; Frank et al. 1991; Kishimoto et al. 1989; van Kooyk et al. 1999). LSCM analysis of N. gonorrhoeae infected primary endo- and ectocervical cells were reflective of these events. Co-localization of infecting gonococci was readily visible by thirty minutes post-infection of endo- and ectocervical cells, and this association became more pronounced by ninety minutes and three hours post-infection suggesting an increase in surface level expression of CR3. Additionally, co-localization of gonococci with CR3 was evident as clusters on the endo- and ectocervical cell surfaces.

[0116] Several studies have demonstrated that efficient signal transduction mediated through CR3 that subsequently allows phagocytosis may require co-operation among receptors that share adherence to a particular organism (Elemer et al. 1994; Frank et al. 1991; Hayashi et al. 1997; Ingalls et al. 1998; Kishimoto et al. 1989; Mesri et al. 1998; Stocks et al. 1995; Stocks et al. 1996; Wright et al. 1983). Cross-linking of this/these co-receptors to CR3 is thought to induce a conformational change in CR3 that leads to its increased ligand avidity and/or affinity followed by an increase in cell surface expression, a process called inside-out signaling. Studies focusing on the interaction of putative neisserial virulence factors with host cells have clearly demonstrated that the establishment of productive infection is multifactorial and several bacterial products may play a synergistic role in successful invasion.

[0117] Although the present inventors have demonstrated a role for CR3-mediated invasion of primary endo- and ectocervical cells by the gonococcus, the mechanism used by this bacterium to achieve CR3 adherence remains to be elucidated. Anti-CR3 immunoprecipitation studies of infected, primary endo- and ectocervical cell lysates demonstrated that gonococcal porin, pili, and opa proteins associate with CR3. These data may be indicative of opsonic (i.e., iC3b-mediated) adherence, alternatively, unopsonic binding of porin, pili, and opa proteins each to either CR3 or their respective co-receptor may facilitate CR3-mediated entry. CR3 up-regulation can be blocked by neutrophil treatment with an anion-specific channel blocker, but binding of neutrophils to endothelial cells remained unaffected (Kishimoto et al. 1989). N. gonorrhoeae porin proteins are anion selective water-filled channels that are capable of transmigration to and insertion into eukaryotic cell membranes (Bjerknes et al. 1995; Lynch et al. 1984); therefore, it is possible that these proteins play a role in up-regulation of CR3 upon gonococcal attachment.

[0118] Recent data has suggested that an association with selective members of the carcinoembryonic antigen family of cell adhesion molecules (CEACAM) (Stocks et al. 1995; Stocks et al. 1996) may augment CR3 activity. CEACAM are suggested to initiate a priming signal in neutrophils that results in activation of adhesion receptors without the release of inflammatory mediators or the induction of a respiratory burst (Stocks et al. 1995). CEACAM1 and CEACAM5 are also present on epithelial cells and have been shown to bind gonococcal Opa. It is tempting to speculate a role for an Opa-CEACAM interaction in CR3-mediated invasion. However, previous data and unpublished work in the inventors' laboratory has demonstrated that invasion of a N. gonorrhoeae strain FA1090 Opa deletion mutant and strain 1291 Opa phase variant (isolated on the basis of colony morphology) is comparable to their respective wild type counterparts. Additionally, membrane ruffling was observed upon SEM analysis of these Opa strains. Therefore the significance of Opa proteins to these studies is unclear.

[0119] One possibility is that binding of heparin to Opa facilitates fH (which possesses three heparin-binding domains (Zipfel et al. 1999)) adherence to surface bound C3. Support of this idea is that Chen et al. (1995) demonstrated that heparin treatment of gonococci resulted in a fifty-five to eighty-five percent increase in survival in normal human serum. fH has also been demonstrated to bind gonococcal porin. fH possesses a sialic acid binding site that has been shown to bind sialylated gonococcal LOS; consequently, the redundancy of the ability of fH to bind the gonococcus would preclude the absolute requirement for Opa proteins for successful infection by the gonococcus.

[0120] Membrane co-factor protein (CD46) serves as a C′ regulatory protein on the surface of all nucleated cells thereby protecting them from C′ mediated lysis. Similar to fH, CD46 functions on the cell surface as a co-factor for fI-mediated C′ inactivation (Seya et al. 1990). CD46 has been shown to function as a receptor for gonococcus pili on unpolarized ME180 cells (Källström et al. 1997); however, in polarized epithelial cells CD46 exists on the basolateral surface (Maisner et al. 1997). Additionally, CD46 is not efficiently endocytosed and those surface molecules that are internalized are rapidly degraded (Maisner et al. 1997). These findings preclude the possibility of receptor recycling to the apical cell surface. The inventors' unpublished data and the work of others strongly suggests that gonococcal pili play a crucial role in gonococcal pathogenesis. A soluble form of CD46 (sCD46) also exists (Jurianz et al. 1999) and is present in seminal fluid (Vanderpuye et al. 1992); however, the significance of this molecule is unclear. In view of this work, its intriguing to speculate that the interaction of gonococcal pili with sCD46 may augment the function of CR3 possibly by binding to or near the divalent cation binding domain of CR3.

[0121] The presence of Mn2+ and Ca2+ are speculated to directly induce integrin changes required for efficient ligand binding by circumventing physiological triggering events (Altieri, D. C. 1991; Stewart et al. 1996; Violette et al. 1995). Kallstrom et al. (2000) recently demonstrated that adherence of non-piliated N. gonorrhoeae strain MS11 could be induced to occur on ME180 cells in the presence of Ca2+. Although the inventors were unable to detect CR3 in any of the immortalized or malignant cell lines examined in this work (including ME180 cells), the Ca2+-mediated invasion of non-piliated gonococci observed by Kallstom et al. might have occurred through an alternative integrin receptor. The cation-dependent induction of receptor function is a property attributed to integrins in general (Altieri, D.C. 1991).

[0122] SEM analysis demonstrated that the addition of anti-CR3 antibodies to CHO-CR3 and primary endo- and ectocervical cell monolayers resulted in membrane ruffles, suggesting that this phenomenon is elicited by CR3 activation. Upon gonococcal infection of primary human endo- and ectocervical cells membrane ruffling is induced to occur (Edwards et al. 2000). TEM analysis of clinical, cervical biopsies, which were derived from women with documented gonococcal cervicitis, suggested that membrane ruffling also occurred in vivo (Edwards et al. 2000). Additionally, membrane ruffling was predominately accompanied by a concentrated accumulation of the actin-associated proteins ezrin and vinculin (Edwards et al. 2000).

[0123] Jones et al. (1998) recently described two CR3 signaling pathways: 1) FcγR-induced, PI-3 kinase dependent and 2) formylmethionylleucylphenylalanine (fMLP)-induced, PI-3 kinase independent pathways. Both modes of CR3 signaling lead to the activation of p21 activating kinase 1 (PAK1) (Jones et al. 1998). PAK1 is a serine/threonine kinase demonstrated to exhibit multiple effector functions. PAK1 can regulate membrane ruffling both independently and dependently of the action of Rac (Obermeier et al. 1998; Sells 1997). Additionally, PAK1 regulates the formation of vinculin-containing focal complexes (Obermeier et al. 1998; Sells 1997). The ability of PAK1 to regulate membrane ruffling and vinculin accumulation through a CR3-dependent signaling cascade corresponds well with previously described data, and data presented herein. Additionally, this supports evidence for the induction of membrane ruffling of primary, human endo- and ectocervical cells by the binding of the gonococcus to CR3.

[0124] It is interesting to note that Shigella are capable of membrane ruffle induction and that these organisms parasitize the rectal epithelium (Tran Van Mhieu et al. 1999), which also exhibits CR3 expression (Hussain et al. 1995). Also of interest is that the sexually transmitted organisms, Candida and HIV, are both capable of CR3-mediated internalization of host cells (Cooper, N. R. 1991; Hussain et al. 1995; Würzner, R. 1999). The pathogenic Neisseria have evolved multiple efficient mechanisms by which to evade host defense mechanisms. Among these immune avoidance mechanisms are the strain-specific attributes that confer serum-resistance e.g., sialylation of some LOS glycoforms and a P.1A porin serotype (Densen, P. 1989; Ram et al. 1999; Vogel et al. 1999; et al. 1992). In vitro gonococcal infection studies and examination of clinically isolated gonococci have revealed C′ components (predominately iC3b) on the surface of gonococci (Densen, P. 1989; Jarvis et al. 1999; McQuillen et al. 1999; Ross et al. 1985). Additionally, gonococci have been demonstrated to activate both the classical and alternative C′ pathways; however, gonococcal killing primarily occurs via the CP (Densen et al. 1982). This would suggest a role for AP inactivation (and possibly subsequent CR3-mediated internalization) as one mechanism by which the gonococcus persists within its primary niche, the human reproductive tract. The inventors' data suggests that CR3-mediated invasion serves as a primary mechanism by which N gonorrhoeae invades the cervical epithelium. This process involves ruffling of the cervical epithelium, which appears to be triggered by CR3 engagement.

[0125] Vaccine Preparations

[0126] The present invention thus provides a vaccine for use to protect mammals against Neisseria gonorrhoeae colonization or infection in women. For example, the vaccine may contain an immunogenic amount of polypeptide p177, p88, p64, p55 or p46 from N. gonorrhoeae, in combination with a physiologically-acceptable, non-toxic vehicle. Vaccines of the present invention can also include effective amounts of immunological adjuvants, known to enhance an immune response.

[0127] The neisserial protein can be conjugated or linked to another peptide or to a polysaccharide. For example, immunogenic proteins well-known in the art, also known as “carriers,” may be employed. Useful immunogenic proteins include keyhole limpet hemocyanin (KLH), bovine serum albumin (BSA), ovalbumin, human serum albumin, human gamma globulin, chicken immunoglobulin G and bovine gamma globulin.

[0128] Further provided are isolated and purified nucleic acid molecules, e.g., DNA molecules, comprising a preselected nucleic acid segment that encodes at least a portion of a neisserial protein. For example, the invention provides an expression cassette comprising a preselected DNA segment that codes for an RNA molecule that is substantially identical (sense) to all or a portion of a messenger RNA (“target” mRNA), i.e., an endogenous or “native” neisserial protein mRNA. The preselected DNA segment in the expression cassette is operably linked to a promoter. As used herein, “substantially identical” in sequence means that two nucleic acid sequences have at least about 65%, preferably about 70%, more preferably about 90%, and even more preferably about 98%, contiguous nucleotide sequence identity to each other. Preferably, the preselected DNA segment hybridizes under hybridization conditions, preferably under stringent hybridization conditions, to a nucleic acid molecule encoding the corresponding native neisserial protein.

[0129] As used herein, “substantially pure” means an object species is the predominant species present (i.e., on a molar basis it is more abundant than any other individual species in the composition), and preferably a substantially purified fraction is a composition wherein the object species comprises at least about 50 percent (on a molar basis) of all macromolecular species present. Generally, a substantially pure composition will comprise more than about 80 percent of all macromolecular species present in the composition, more preferably more than about 85%, about 90%, about 95%, and about 99%. Most preferably, the object species is purified to essential homogeneity (contaminant species cannot be detected in the composition by conventional detection methods) wherein the composition consists essentially of a single macromolecular species.

[0130] As used herein, the term “recombinant nucleic acid” or “preselected nucleic acid,” e.g., “recombinant DNA sequence or segment” or “preselected DNA sequence or segment” refers to a nucleic acid, e.g., to DNA, that has been derived or isolated from any appropriate source, that may be subsequently chemically altered in vitro, so that its sequence is not naturally occurring, or corresponds to naturally occurring sequences that are not positioned as they would be positioned in a genome that has not been transformed with exogenous DNA. An example of preselected DNA “derived” from a source, would be a DNA sequence that is identified as a useful fragment within a given organism, and which is then chemically synthesized in essentially pure form. An example of such DNA “isolated” from a source would be a useful DNA sequence that is excised or removed from said source by chemical means, e.g., by the use of restriction endonucleases, so that it can be further manipulated, e.g., amplified, for use in the invention, by the methodology of genetic engineering.

[0131] Recovery or isolation of a given fragment of DNA from a restriction digest can employ separation of the digest on polyacrylamide or agarose gel by electrophoresis, identification of the fragment of interest by comparison of its mobility versus that of marker DNA fragments of known molecular weight, removal of the gel section containing the desired fragment, and separation of the gel from DNA. See Lawn et al., Nucleic Acids Res., 2, 6103 (1981), and Goeddel et al., Nucleic Acids Res., 8, 4057 (1980). Therefore, “preselected DNA” includes completely synthetic DNA sequences, semi-synthetic DNA sequences, DNA sequences isolated from biological sources, and DNA sequences derived from RNA, as well as mixtures thereof As used herein, the term “derived” with respect to a RNA molecule means that the RNA molecule has complementary sequence identity to a particular DNA molecule.

[0132] Nucleic acid molecules encoding amino acid sequence variants of a neisserial protein are prepared by a variety of methods known in the art. These methods include, but are not limited to, isolation from a natural source (in the case of naturally occurring amino acid sequence variants) or preparation by oligonucleotide-mediated (or site-directed) mutagenesis, PCR mutagenesis, and cassette mutagenesis of an earlier prepared variant or a non-variant version of the neisserial protein.

[0133] To immunize a subject, the neisserial protein is administered parenterally, usually by intramuscular or subcutaneous injection in an appropriate vehicle. Other modes of administration, however, are also acceptable. For example, the vaccine may be administered orally, or via a mucosal route, such as a nasal, gastrointestinal or genital site. Vaccine formulations will contain an effective amount of the active ingredient in a vehicle. The effective amount is sufficient to prevent, ameliorate or reduce the incidence of N. gonorrhoeae colonization in the target mammal. The effective amount is readily determined by one skilled in the art. The active ingredient may typically range from about 1% to about 95% (w/w) of the composition, or even higher or lower if appropriate. The quantity to be administered depends upon factors such as the age, weight and physical condition of the human subject considered for vaccination. The quantity also depends upon the capacity of the person's immune system to synthesize antibodies, and the degree of protection desired. Effective dosages can be readily established by one of ordinary skill in the art through routine trials establishing dose response curves. The subject is immunized by administration of the neisserial protein in one or more doses. Multiple doses may be administered as is required to maintain a state of immunity to streptococci.

[0134] To prepare a vaccine, the purified neisserial protein can be isolated, lyophilized and stabilized. The neisserial protein may then be adjusted to an appropriate concentration, optionally combined with a suitable vaccine adjuvant, and packaged for use. Suitable adjuvants include but are not limited to surfactants, e.g., hexadecylamine, octadecylamine, lysolecithin, dimethyldioctadecylammonium bromide, N,N-dioctadecyl-N′-N-bis(2-hydroxyethyl-propane di-amine), methoxyhexadecyl-glycerol, and pluronic polyols; polanions, e.g., pyran, dextran sulfate, poly IC, polyacrylic acid, carbopol; peptides, e.g., muramyl dipeptide, MPL, aimethylglycine, tuftsin, oil emulsions, alum, and mixtures thereof. Other potential adjuvants include the B peptide subunits of E. coli heat labile toxin or of the cholera toxin. McGhee, J. R., et al., “On vaccine development,” Sem. Hematol., 30:3-15 (1993). Finally, the immunogenic product may be incorporated into liposomes for use in a vaccine formulation, or may be conjugated to proteins such as keyhole limpet hemocyanin (KLH) or human serum albumin (HSA) or other polymers.

[0135] Antibodies

[0136] The antibodies of the invention are prepared by using standard techniques. To prepare polyclonal antibodies or “antisera,” an animal is inoculated with an antigen, i.e., a purified immunogenic CR3 peptide or polypeptide, and immunoglobulins are recovered from a fluid, such as blood serum, that contains the immunoglobulins, after the animal has had an immune response. For inoculation, the antigen is preferably bound to a carrier peptide and emulsified using a biologically suitable emulsifying agent, such as Freund's incomplete adjuvant. A variety of mammalian or avian host organisms may be used to prepare polyclonal antibodies against CR3.

[0137] Following immunization, Ig is purified from the immunized bird or mammal, e.g., goat, rabbit, mouse, rat, or donkey and the like. For certain applications particularly certain pharmaceutical applications, it is preferable to obtain a composition in which the antibodies are essentially free of antibodies that do not react with the immunogen. This composition is composed virtually entirely of the high titer, monospecific, purified polyclonal antibodies to CR3, or peptides thereof. Antibodies can be purified by affinity chromatography, using purified CR3, or peptides thereof. Purification of antibodies by affinity chromatography is generally known to those skilled in the art (see, for example, U.S. Pat. No. 4,533,630). Briefly, the purified antibody is contacted with the purified CR3, or peptide thereof, bound to a solid support for a sufficient time and under appropriate conditions for the antibody to bind to the polypeptide or peptide. Such time and conditions are readily determinable by those skilled in the art. The unbound, unreacted antibody is then removed, such as by washing. The bound antibody is then recovered from the column by eluting the antibodies, so as to yield purified, monospecific polyclonal antibodies.

[0138] Monoclonal antibodies can be also prepared, using known hybridoma cell culture techniques. In general, this method involves preparing an antibody-producing fused cell line, e.g., of primary spleen cells fused with a compatible continuous line of myeloma cells, and growing the fused cells either in mass culture or in an animal species, such as a murine species, from which the myeloma cell line used was derived or is compatible. Such antibodies offer many advantages in comparison to those produced by inoculation of animals, as they are highly specific and sensitive and relatively “pure” immunochemically. Immunologically active fragments of the present antibodies are also within the scope of the present invention, e.g., the F(ab) fragment scFv antibodies, as are partially humanized monoclonal antibodies.

[0139] Thus, it will be understood by those skilled in the art that the hybridomas herein referred to may be subject to genetic mutation or other changes while still retaining the ability to produce monoclonal antibody of the same desired specificity. The present invention encompasses mutants, other derivatives and descendants of the hybridomas.

[0140] It will be further understood by those skilled in the art that a monoclonal antibody may be subjected to the techniques of recombinant DNA technology to produce other derivative antibodies, humanized or chimeric molecules or antibody fragments that retain the specificity of the original monoclonal antibody. Such techniques may involve combining DNA encoding the immunoglobulin variable region, or the complementarity determining regions (CDRs), of the monoclonal antibody with DNA coding the constant regions, or constant regions plus framework regions, of a different immunoglobulin, for example, to convert a mouse-derived monoclonal antibody into one having largely human immunoglobulin characteristics (see EP 184187A, 2188638A, herein incorporated by reference).

[0141] Inhibitory Compounds

[0142] The present invention provides a method of preventing entry of Neisseria gonorrhoeae into a cell (or treating an existing infection) by administering a compound that binds to a CR3 receptor on the cell. In particular, it has been discovered that it is possible to prevent the infection of cervical cells (endocervical or ectocervical cells) by blocking the access of N gonorrhoeae to the CR3 receptor on the surface of the cell. Any inhibitor could be used. The inhibitor could be an antibody (e.g., a monoclonal or polyclonal antibody, or a fragment of an antibody). Alternatively, the compound could be peptide, as discussed in detail in Example 3 below. For example the compound could be a Clostridium neurotoxin, such as the Clostridium C3 neurotoxin. The compound could be Clostridium neurotoxin type 3, Cytochalsin D, wortmannin, an anion channel blocker, a divalent cation chelator (such as EDTA or EGTA), inhibitors of serine/threonine proteases, and/or LY294002.

[0143] Formulations of Compounds and Methods of Administration

[0144] In cases where compounds are sufficiently basic or acidic to form stable nontoxic acid or base salts, Administration of the compounds as salts may be appropriate. Examples of pharmaceutically acceptable salts are organic acid addition salts formed with acids that form a physiological acceptable anion, for example, tosylate, methanesulfonate, acetate, citrate, malonate, tartarate, succinate, benzoate, ascorbate, α-ketoglutarate, and α-glycerophosphate. Suitable inorganic salts may also be formed, including hydrochloride, sulfate, nitrate, bicarbonate, and carbonate salts.

[0145] Pharmaceutically acceptable salts are obtained using standard procedures well known in the art, for example by reacting a sufficiently basic compound such as an amine with a suitable acid affording a physiologically acceptable anion. Alkali metal (for example, sodium, potassium or lithium) or alkaline earth metal (for example calcium) salts of carboxylic acids also are made.

[0146] The compounds may be formulated as pharmaceutical compositions and administered to a mammalian host, such as a human patient in a variety of forms adapted to the chosen route of administration, i.e., orally or parenterally, by intravenous, intramuscular, topical or subcutaneous routes.

[0147] Thus, the present compounds may be systemically administered, e.g., orally, in combination with a pharmaceutically acceptable vehicle such as an inert diluent or an assimilable edible carrier. They may be enclosed in hard or soft shell gelatin capsules, may be compressed into tablets, or may be incorporated directly with the food of the patient's diet. For oral therapeutic administration, the active compound may be combined with one or more excipients and used in the form of ingestible tablets, buccal tablets, troches, capsules, elixirs, suspensions, syrups, wafers, and the like. Such compositions and preparations should contain at least 0.1% of active compound. The percentage of the compositions and preparations may, of course, be varied and may conveniently be between about 2 to about 60% of the weight of a given unit dosage form. The amount of active compound in such therapeutically useful compositions is such that an effective dosage level will be obtained.

[0148] The tablets, troches, pills, capsules, and the like may also contain the following: binders such as gum tragacanth, acacia, corn starch or gelatin; excipients such as dicalcium phosphate; a disintegrating agent such as corn starch, potato starch, alginic acid and the like; a lubricant such as magnesium stearate; and a sweetening agent such as sucrose, fructose, lactose or aspartame or a flavoring agent such as peppermint, oil of wintergreen, or cherry flavoring may be added. When the unit dosage form is a capsule, it may contain, in addition to materials of the above type, a liquid carrier, such as a vegetable oil or a polyethylene glycol. Various other materials may be present as coatings or to otherwise modify the physical form of the solid unit dosage form. For instance, tablets, pills, or capsules may be coated with gelatin, wax, shellac or sugar and the like. A syrup or elixir may contain the active compound, sucrose or fructose as a sweetening agent, methyl and propylparabens as preservatives, a dye and flavoring such as cherry or orange flavor. Of course, any material used in preparing any unit dosage form should be pharmaceutically acceptable and substantially non-toxic in the amounts employed. In addition, the active compound may be incorporated into sustained-release preparations and devices.

[0149] The active compound may also be administered intravenously or intraperitoneally by infusion or injection. Solutions of the active compound or its salts may be prepared in water, optionally mixed with a nontoxic surfactant. Dispersions can also be prepared in glycerol, liquid polyethylene glycols, triacetin, and mixtures thereof and in oils. Under ordinary conditions of storage and use, these preparations contain a preservative to prevent the growth of microorganisms.

[0150] The pharmaceutical dosage forms suitable for injection or infusion can include sterile aqueous solutions or dispersions or sterile powders comprising the active ingredient that are adapted for the extemporaneous preparation of sterile injectable or infusible solutions or dispersions, optionally encapsulated in liposomes. In all cases, the ultimate dosage form should be sterile, fluid and stable under the conditions of manufacture and storage. The liquid carrier or vehicle can be a solvent or liquid dispersion medium comprising, for example, water, ethanol, a polyol (for example, glycerol, propylene glycol, liquid polyethylene glycols, and the like), vegetable oils, nontoxic glyceryl esters, and suitable mixtures thereof. The proper fluidity can be maintained, for example, by the formation of liposomes, by the maintenance of the required particle size in the case of dispersions or by the use of surfactants. The prevention of the action of microorganisms can be brought about by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, sorbic acid, thimerosal, and the like. In many cases, it will be preferable to include isotonic agents, for example, sugars, buffers or sodium chloride. Prolonged absorption of the injectable compositions can be brought about by the use in the compositions of agents delaying absorption, for example, aluminum monostearate and gelatin.

[0151] Sterile injectable solutions are prepared by incorporating the active compound in the required amount in the appropriate solvent with various of the other ingredients enumerated above, as required, followed by filter sterilization. In the case of sterile powders for the preparation of sterile injectable solutions, the preferred methods of preparation are vacuum drying and the freeze drying techniques, which yield a powder of the active ingredient plus any additional desired ingredient present in the previously sterile-filtered solutions.

[0152] For topical administration, the present compounds may be applied in pure form, i.e., when they are liquids. However, it will generally be desirable to administer them to the skin as compositions or formulations, in combination with a dermatologically acceptable carrier, which may be a solid or a liquid.

[0153] Useful solid carriers include finely divided solids such as talc, clay, microcrystalline cellulose, silica, alumina and the like. Useful liquid carriers include water, alcohols or glycols or water-alcohol/glycol blends, in which the present compounds can be dissolved or dispersed at effective levels, optionally with the aid of non-toxic surfactants. Adjuvants such as fragrances and additional antimicrobial agents can be added to optimize the properties for a given use. The resultant liquid compositions can be applied from absorbent pads, used to impregnate bandages and other dressings, or sprayed onto the affected area using pump-type or aerosol sprayers.

[0154] Thickeners such as synthetic polymers, fatty acids, fatty acid salts and esters, fatty alcohols, modified celluloses or modified mineral materials can also be employed with liquid carriers to form spreadable pastes, gels, ointments, soaps, and the like, for application directly to the skin of the user.

[0155] Examples of useful dermatological compositions that can be used to deliver the compounds of the present invention to the skin are known to the art; for example, see Jacquet et al. (U.S. Pat. No. 4,608,392), Geria (U.S. Pat. No. 4,992,478), Smith et al. (U.S. Pat. No. 4,559,157) and Wortzman (U.S. Pat. No. 4,820,508).

[0156] Useful dosages of the compounds of the present invention can be determined by comparing their in vitro activity, and in vivo activity in animal models. Methods for the extrapolation of effective dosages in mice, and other animals, to humans are known to the art; for example, see U.S. Pat. No. 4,938,949.

[0157] Generally, the concentration of the compound(s) of the present invention in a liquid composition, such as a lotion, will be from about 0.1-25 wt-%, preferably from about 0.5-10 wt-%. The concentration in a semi-solid or solid composition such as a gel or a powder will be about 0.1-5 wt-%, preferably about 0.5-2.5 wt-%.

[0158] The amount of the compound, or an active salt or derivative thereof, required for use in treatment will vary not only with the particular salt selected but also with the route of administration, the nature of the condition being treated and the age and condition of the patient and will be ultimately at the discretion of the attendant physician or clinician.

[0159] In general, however, a suitable dose will be in the range of from about 0.5 to about 100 mg/kg, e.g., from about 10 to about 75 mg/kg of body weight per day, such as 3 to about 50 mg per kilogram body weight of the recipient per day, preferably in the range of 6 to 90 mg/kg/day, most preferably in the range of 15 to 60 mg/kg/day.

[0160] The compound is conveniently administered in unit dosage form; for example, containing 5 to 1000 mg, conveniently 10 to 750 mg, most conveniently, 50 to 500 mg of active ingredient per unit dosage form.

[0161] Ideally, the active ingredient should be administered to achieve peak plasma concentrations of the active compound of from about 0.5 to about 75 μM, preferably, about 1 to 50 μM, most preferably, about 2 to about 30 μM. This may be achieved, for example, by the intravenous injection of a 0.05 to 5% solution of the active ingredient, optionally in saline, or orally administered as a bolus containing about 1-100 mg of the active ingredient. Desirable blood levels may be maintained by continuous infusion to provide about 0.01-5.0 mg/kg/hr or by intermittent infusions containing about 0.4-15 mg/kg of the active ingredient(s).

[0162] The desired dose may conveniently be presented in a single dose or as divided doses administered at appropriate intervals, for example, as two, three, four or more sub-doses per day. The sub-dose itself may be further divided, e.g., into a number of discrete loosely spaced administrations; such as multiple inhalations from an insufflator or by application of a plurality of drops into the eye.

[0163] The following examples are intended to illustrate but not limit the invention.

EXAMPLE 1

Membrane Ruffling and Cytoskeletal Rearrangements in Neisseria gonorrhoeae

[0164] The sexually transmitted pathogen Neisseria gonorrhoeae, the causative agent in gonorrhea, can infect the male and female genital tract. Studies have shown that the organism can discriminate between the sexes and uses different mechanisms for infection of men than for infection of women. During the course of female infection, it appears that the organism releases a group of proteins that initiate a process called membrane ruffling on endocervical and exocervical epithelial cells. Organisms adherent to or proximal to the ruffled area invade the epithelial cell. The gonococcus can proliferate within the intracellular environment, cause the death of the infected cell and are released. They re-enter new cells and the cycle continues until an inflammatory response ensues or the organisms spreads to the endometrium and fallopian tubes.

[0165] Bacteria: N. gonorrhoeae strains 1291, 1291-green (1291 expressing green fluorescent protein and to be described elsewhere, the plasmid pLES98 was a gift from V. Clark), FA1090, MS11-A, and MS11mkC were used in these infection studies. These strains are P+ and Opa+. Strains 1291, 1291-green, MS11-A, and MS11mkC contain the pathogenicity island recently described by Dillard (Dillard, J. 1999).

[0166] Development of Primary Cervical Cell Culture Systems: Surgical biopsies were obtained from 30 pre-menopausal women undergoing hysterectomy at the University of Iowa Hospitals and Clinics (Iowa City, Iowa). Endocervical (proximal to the cervical os) and ectocervical (distal to the cervical os) tissue biopsies were obtained in 4-6 mm2 sections and further subdivided into 2-3 mm2 sections. Sectioned tissues were rinsed twice for 10 min in Hanks Balanced Salt Solution (HBSS) supplemented with 1% fungizone (Irvine Scientific, Santa Ana, Calif.) and 1% penicillin (100 U/ml)-streptomycin (1 mg/ml). The tissue was placed with the epithelium downward on polystyrene, 35 mm tissue culture dishes (Falcon, Becton Dickinson; Franklin Lake, N.J.). Tissue explants were incubated in filtered airway medium (1 part Dulbecco Modified Eagle Medium, 1 part Ham's F12, 5% fetal calf serum (FCS), 1% nonessential amino acids (Sigma-Aldrich, St. Louis, Mo.), 1% penicillin-streptomycin, and insulin (10 g/ml)). After 48 h, airway medium was replaced with keratinocyte growth medium (KGM)-2 Bullet Kit (Clonetics, San Diego, Calif.). KGM-2 was replaced every 2-3 days until near-confluence was obtained (1-2 weeks) at which time the cells were passaged as outlined below. Although variability exists among tissue samples, this process allows for an average of three passages of cell growth to fresh tissue culture dishes from a single tissue explant prior to fibroblast development, at which time tissue explants were discarded.

[0167] Cell Passage: At near-confluent growth cells were passaged by a 5 min, 37° C. incubation in HBSS-0.25% Trypsin-0.1% EDTA. Cell suspensions were collected and centrifuged at 5000 rpm for 5 min. The resulting cell pellet was rinsed in HBSS, resuspended in KGM-2, and used to seed transwell membrane systems (Biocoat Cell Environments, Becton Dickinson, Bedford, Mass.) (to allow for polarized cell growth); glass, 8-well chamber slides (Nalge Nunc International, Naperville, Ill.); or human, placental collagen-coated, 12 mm glass coverslips previously placed in 24-well tissue culture dishes (Falcon). Primary cervical cells were maintained in KGM-2 until near-confluence was again obtained at which time they were infected with N. gonorrhoeae as outlined below. Where applicable, cellular polarity was determined as an electrical resistance greater than 2KΩ/cm2 as measured across the cell monolayer. Infected and uninfected (i.e., control) cervical cell-harboring membranes (from transwell systems) were subsequently subdivided into equal sections. Sections to be used for scanning electron microscopy (SEM) were processed while attached to the well apparatus so that the cellular orientation would be maintained. Remaining sections were removed from the well structure and subsequently processed independently for either confocal, transmission electron, or bright-field light microscopy.

[0168] Infection of the Primary Cells: N. gonorrhoeae cells allowed to grow overnight (37° C., 5% CO2) on GC-IsoVitaleX agar plates were harvested using a sterile swab and resuspended in sterile saline. Culture density was determined spectrophotometrically where an optical density (OD) of 1 at 600 nm was equivalent to 109 bacteria ml−1 of cell culture. Bacterial cells were then diluted to a concentration of 107 bacteria ml−1 in KGM-2 lacking gentamycin and used to infect 105 primary cervical cells (maintained as outlined above). Gonococcal infection was allowed to progress for variable time periods after which the infection was stopped by the removal of the infection medium, rinsing infected cervical cells with phosphate buffered saline (PBS), and cell fixation. Samples to be used in laser scanning confocal microscopy (LSCM) or differential interference contrast (DIC) analysis were immunolabeled directly following fixation. SEM, transmission electron microscopy (TEM), and bright field light microscopy (BFLM) samples were further processed by graded ethanol dehydration and resin (TEM) or paraffin (BFLM) embedment. Embedded samples were sectioned and immunolabeled as noted. Where indicated, the infection medium was harvested from the cervical cell monolayer and reused to infect fresh, uninfected cell cultures, which were subsequently processed for SEM analysis.

[0169] Invasion Assays in the Presence of Inhibitors of Cytoskeletal Motility and Protein Synthesis: Cervical cells were passed to 12 mm collagen-coated coverslips as outlined above. Prior to infection with N. gonorrhoeae 1291 wild-type cells, primary cell cultures were left untreated, or they were pre-incubated with 300 nM wortmannin (Sigma), 1 M cytochalasin D (Sigma), or 400 mM ethylene glycol bis-(2-aminoethyl ether)-N,N, N′, N′tetraacetic acid ((EGTA) Amresco, Solon, Ohio) for 2 h, 30 min, and 30 min, respectively, or they were pretreated with 100 g/ml nocodazole (Calbiochem-Novabiochem Corp., La Jolla, Calif.) for 1 h at 4° C. followed by a 30 min incubation at 37° C. The requirement for de novo protein synthesis, either by the bacteria or by the primary cervical cells, was tested by pretreatment (30 min, 37° C.) of the bacterial cultures or cervical cell monolayers with 4 g/ml chloramphenicol (Sigma) or 25 mM cycloheximide (Calbiochem-Novabiochem Corp.), respectively. All chemical reagents used were maintained in the infection medium throughout the course of the infection. Trypan blue exclusion revealed no significant toxicity to the primary cervical cells at the indicated concentrations for each of the chemical reagents used. Infection was allowed to progress at 37° C., 5% CO2, for 1.5 h after which the medium was removed, the cells were rinsed with PBS, and then incubated with KGM-2 containing 100 g/ml gentamycin to kill extracellular bacteria. Post incubation the cervical cells were lysed with 0.5% saponin to release invasive bacteria. Percent invasion was determined as a function of the original inoculum and the number of colonies formed with subsequent plating of the cellular lysate. A Kruskal-Wallace ANOVA was used to determine the statistical significance of the calculated percent invasion for each of the cytoskeletal motility inhibitors used with respect to the untreated, infected cell cultures.

[0170] Microscopy: Samples were processed for LSCM, SEM, or TEM as previously described (Ketterer et al. 1999). Samples to be analyzed by BFLM were paraffin embedded using an automated tissue processor (RMC 1530 Paraffin Tissue Processor, Tucson, Ariz.), cut into thick (1 m) sections, and mounted onto glass microscope slides. Immunolabeling of infected and uninfected cervical cells for TEM analysis was performed using the monoclonal antibody 2C3, which specifically recognizes the H.8 gonococcal surface protein, or the anti-gonococcal porin monoclonal antibody, 3H1 (a gift from Mylan Blake); in conjunction with a polyclonal antibody to filamentous (F) actin. Secondary labeling proceeded with the use of 30 nm and 10 nm colloidal gold-beaded antibody conjugates (Amersham Pharmacia Biotech, Piscataway, N.J.) to the bacterial- and actin-specific antibodies, respectively. B. A. Evans generously provided clinical biopsies used in TEM analysis. The samples were viewed with an H-7000 Hitachi Transmission Electron Microscope (Hitachi Corporation, Mountain View, Calif.).

[0171] Primary antibodies used for LSCM or DIC microscopy were as follows: anti-cytokeratin 8.12 (Sigma), -cytokeratin 4 (Sigma), -talin (Sigma), -vinculin (Sigma), -α-actinin (Sigma), -myosin (Sigma), -ezrin (Santa Cruz Biotechnology, Santa Cruz, Calif.), -CD66 (DAKO, Carpinteria, Calif.), -CD46 (Santa Cruz Biotechnology), and 2C3. Immunolabeling of cervical cell monolayers with anti-cytokeratin, -talin, -vinculin, -myosin, -ezrin, and -α-actinin occurred subsequent to a 15 min incubation in 0.2% Triton X-100 to allow cervical cells to become permeable. Where indicated, counter staining occurred at room temperature (RT) for 6 min. Counter stains used were specific for nucleic acids and consisted of YOYO-1 (Molecular Probes, Eugene, Oreg.) or ethidium bromide. Samples were viewed using the BioRad MRC-1024 or the Zeiss 510 Laser Scanning Confocal viewing systems.

[0172] Cervical tissue biopsies (obtained as outlined above) to be used for LSCM cytokeratin analysis were processed (within 1-2 h of obtaining the tissue specimen) for cyrosectioning by a 30 min incubation in 1% paraformaldehyde followed by infiltration with 30% sucrose prior to embedment in Tissue-Tek O. C. T. compound (Sakura Finetek USA, Inc., Torrance, Calif.) and sectioning (6-8 nm). Frozen sections were allowed to stand at RT for 1 h prior to immunolabeling with the indicated anti-cytokeratin antibody. A fluoroscein isothiocyanate (FITC)-conjugated secondary antibody was applied and tissues were subsequently counter-stained with ethidium bromide (0.5 ng/ml, 6 min).

[0173] Cervical cells passaged to 12 mm coverslips were used to assay for gonococcal-induced macropinocytosis. Cervical cell monolayers were infected with 1291-green for variable time periods in the presence of 1 mg/ml tetramethylrhodamine B isothiocyanate (TRITC)-dextran (MW 150,000). Infection was stopped by the removal of the infection medium. Infected monolayers were extensively washed prior to fixation with 2% paraformaldehyde. Coverslips were mounted onto glass microscope slides and viewed using the BioRad MRC-1024 Laser Scanning Confocal viewing system.

[0174] Slides prepared for BFLM were hematoxylin-eosin stained using a standard protocol and viewed with a Leitz Diaplan microscope with an Optronics Engineering viewing system. SEM analysis was performed using an H-4000 Hitachi Scanning Electron Microscope (Hitachi).

[0175] Results

[0176] Characterization of Primary Human Endocervical Epithelial Cells: Primary cervical epithelial cells were allowed to grow as described above. Epithelial cells could be seen extending from the cervical explants within two to three days from the start of the cultures. Growth radiated from the tissue foci in a contiguous monolayer, and confluence was observed within ten to fourteen days. Transfer of endocervical-derived cells to transwell membrane systems resulted in polarized cell growth.

[0177] The cytokeratin expression pattern of the normal human uterine cervix has been well characterized. LSCM was used to determine the cytokeratin expression pattern of the primary cervical cell monolayers with respect to the tissue from which they were derived. Sectioned tissue biopsies (obtained from the endo- and ectocervix) and the cervical-derived cell monolayers were immunohistochemically examined with antibodies to cytokeratins 4, 13, 15, and 16. The results of these studies can be seen in FIG. 4. The specific cytokeratin staining character of the endo- and ectocervical tissue was retained in the primary cell monolayers (FIG. 4).

[0178] LSCM analysis of sectioned tissue biopsies and cervical-derived cell monolayers demonstrated the expression of CD66 and CD46 in both the endo- and ectocervix.

[0179]

N. gonorrhoeae
Infection of Primary Cervical Epithelial Cells: SEM analysis of N. gonorrhoeae 1291 infected polarized and non-polarized cells showed bacteria could adhere to both types of primary cervical cells. Bacteria were found distributed across the monolayer surface. The interaction of the bacteria with the cervical cell surface appeared to occur by multiple mechanisms. At approximately ten minutes post infection gonococci could be found associated with the cervical cell membrane both dependent (FIG. 5A) and independent of microvilli (FIG. 5B). Small tufts of microvilli were associated with bacteria on some cervical cells. Gonococci associated with the cervical cells independent of microvilli appeared to be entering the cervical cell by an endocytic process. At approximately 20 and 30 minutes post-infection, filopodia and lamellipodia formation was readily observed (FIG. 5C) and bacteria appeared to be undergoing internalization (FIG. 5D). Additionally, a visible smoothing of the cervical cell membrane was evident around the periphery of some sites of bacterial infection (FIG. 5E). By 60 minutes post-infection, the filopodia and lamellipodia became less prominent. Large membrane ruffles (FIGS. 5F and 5G) became prominent at about 90 minutes post infection of cervical cells. Membrane ruffles were abutting and contiguous with gonococci. Generally, ruffles could be readily identified by a smoothing of the cervical cell membrane that encircled the ruffle (FIG. 5H). At 3 h post-gonococcal infection, membrane ruffles and bacteria associated with microvilli were still evident. Perturbations of the cell membrane that were reminiscent of ruffles were also evident. Ruffling could be induced to occur at approximately thirty minutes post-gonococcal infection in both primary cell systems when uninfected cervical cells were infected with a primed infection inoculum (i.e., infection medium transferred from an immediately prior N. gonorrhoeae cervical cell infection) derived from one hour (ectocervical) (FIG. 5G) and ninety minute (endocervical) infections.

[0180] Bright-field light microscopy and TEM analysis of polarized endocervical cells infected with N. gonorrhoeae 1291 confirmed the observation made with SEM analysis (FIG. 6). Actin-filled membrane protrusions were readily observed encompassing gonococci at ninety minutes and three hours post infection. Clusters of bacteria were found breaching the superficial cervical epithelial layer; however, bacteria entered the cervical cells as single entities with each bacterium being surrounded by its own actin-lined vacuole (FIG. 6B). Consistent with SEM analysis, gonococcus-associated membrane ruffles were readily observed at 3 h post-infection by both high-powered (TEM, FIG. 6C) and low-powered (BFLM, FIG. 6D) magnification with microscopy. TEM analysis revealed that, within the host cell cytoplasm, bacteria-containing vacuoles appeared to coalesce prior to bacterial exocytosis to the subepithelial space. TEM analysis of epon-embedded, clinically-derived cervical biopsies from women naturally infected with gonococci revealed similar processes (FIG. 7). Large membrane protrusions (indicative of ruffles) (FIG. 7B) and smaller, less organized membrane structures (FIG. 7A), were readily observed. Gonococci were, again, observed to enter the cervical cells as single entities in spacious vacuoles.

[0181] Primary cell monolayers infected with gonococci in the presence of a TRITC-conjugated dextran, which would be excluded by non-macropinocytic cellular events, demonstrated that, upon invasion, gonococci reside within macropinosomes.

[0182] LSCM analysis of infection studies performed using polarized endocervical cells and ectocervical cell monolayers suggested co-localization of CD66 and CD46 with gonococci. With extended infection (i.e., six hours) clustering of CD46 molecules, which was not observed to occur at earlier time points in the infection, became prevalent in response to gonococci.

[0183] Cytoskeletal Changes Occur in Cervical Cells with Gonococcal Infection: Immunolabeling of N. gonorrhoeae infected primary cells with antibody-conjugates to actin-associated proteins confirmed that changes of the cervical cell cytoskeletal network were occurring (FIG. 8). Antibodies to talin, vinculin, ezrin, myosin, and α-actinin demonstrated a focused accumulation of these proteins, in membrane projections, at ten minutes post infection with gonococci. Membrane projections were also observed to co-localize with gonococci. This effect was most pronounced with the use of vinculin and ezrin; however, a modest accumulation of talin and α-actinin was also observed to occur. Immunolabeled projections were not observed upon analysis of uninfected cervical cells.

[0184] Gonococcal Invasion of Cervical Cells Occurs Primarily in an Actin-Dependent Manner and Does Not Require de novo Protein Synthesis: Standard gentamycin-resistance assays performed with endo- and ectocervical-derived cells confirmed results obtained by BFLM and TEM analysis and the invasive nature of gonococci with respect to both the endo- and ectocervix. Gonococci were found to invade endocervical-derived cells at a proportion of 1.57% (table 1). A slightly higher percentage (2.70%) was observed to occur with gonococcal invasion of the ectocervical-derived cells (table 1). The inclusion of wortmannin, cytochalasin D, and EGTA in the invasion assay prohibited bacterial entry into both cell types (table 1). Pretreatment of primary cervical cell monolayers with the microtubule-specific depolymerizing agent, nocodazole, resulted in an approximate 67% decrease in gonococcal invasion (table 1). Chloramphenicol and cycloheximide, which inhibit gonococcal and eukaryotic cell protein synthesis (respectively), did not inhibit gonococcal invasion of the primary cervical cell monolayers (table 1).

1TABLE 1Percent invasion of N. gonorrhoeae 1291 in primary cervical cellsEndocervical cellsEctocervical cellsVari-Vari-MeananceMeanance%of the%of theCell treatmentinvasionameanpbinvasionameanpbNone1.55170.3030NAc2.69531.3569NACytochalasin D0.03580.01860.050.02330.00460.025Wortmannin0.01770.01800.050.02600.01580.025EGTA0.04310.00870.050.03030.00520.025NocodazoleNDdNDND0.90000.79060.25CycloheximideNDNDND2.56011.88160.75Chloram-NDNDND2.66881.95900.50phenicolaThe mean is the average percentage of at least three trials in which the percent invasion was determined as a function of the original inoculum and the subsequent CFU. bP values given were determined using a Kruskal-Wallis κ-sample test of the percent gonococcal invasion determined for each cellular treatment applied to primary cervical cells in comparison to the percent gonococcal invasion of untreated, primary cervical cells. cNA, not applicable. dND, not determined.

[0185] Discussion

[0186] Primary human ecto- and endocervical epithelial cell models have been described whose cytokeratin, CD66, and CD46 profiles are identical to the tissue from which they were derived. Confocal and electron microscopic analysis of primary, human, cervical cells infected with N. gonorrhoeae 1291, FA1090, and MS11 have demonstrated the ability of gonococci to adhere to and to induce cytoskeletal changes within both of these cell systems. Bacteria were found to associate with the primary cervical cells by more than one mechanism as evidenced by microvillus-dependent and -independent modes of bacterial attachment. Membrane perturbations resulted in the formation of membrane ruffles, which became prominent by ninety minutes post infection and after which ruffles remained readily observable. Ruffling could be induced to occur at thirty minutes post gonococcal infection in both primary cell systems when uninfected cervical cells were infected with a primed infection inoculum; however, de novo protein synthesis was not required to prime the infection process for invasion. Actin-associated proteins were also observed to accumulate in response to gonococcal infection. Gonococci were found to be internalized within the cervical cells in actin-lined spacious vacuoles.

[0187] The ability of gonococci to attach to the endocervical epithelium is well accepted. In contrast, attachment to the stratified squamous epithelium of the ectocervix and to transitional cells of the cervical squamocolumnar junction (Draper et al. 1980; Evans, B. A. 1977) remains controversial. Studies, in vitro, with the inventors' primary cell culture systems demonstrated gonococcal adherence to both the endo- and ectocervix. Considerable anatomical variation exists in the length of the squamocolumnar transition zone of the cervix (Fluhmann, C. F. 1959). Additionally, to a variable measure, columnar epithelium may overlap the stratified squamous epithelium (of the ectocervix) at the transition zone. This may, in part, account for the controversy associated with gonococcal attachment to the cervical epithelium. Cervical biopsies, used in the studies described herein, were obtained from sites distinct from the transformation zone i.e., greater than 0.5 cm from the squamocolumnar junction. Of the thirty cervical specimens used to generate primary cell cultures for use in these studies, all have supported gonococcal adherence with minimal variability. Gonococcal adherence, to date, has primarily been associated with microvilli formation; however, gonococci associated with the cervical epithelium were found both dependent and independent of microvilli.

[0188] Attachment is not synonymous with tissue damage or with the initiation of a diseased state; it is a discrete event from phagocytic internalization i.e., invasion. Four general mechanisms of bacterial invasion of host cells have been proposed to occur: receptor mediated endocytosis (Robinson, M. S. 1994), microtubule-dependent endocytosis (Mukherjee et al. 1997; Oelschlager et al. 1993; Silverstein et al. 1977), zippering (Griffin, Jr., et al. 1976; Griffin, Jr., et al. 1975), and triggering (Dramsi et al. 1998; Finlay et al. 1997; Moulder, J. W. 1985; Rabinovitch, M. 1995; Watarai et al. 1996). Several eukaryotic cell surface molecules have been proposed to serve as receptors for gonococcal invasion (for review Dehio et al. 1998; Dramsi et al. 1998; Jerse et al. 1997; McGee et al. 1983; Meyer, T. F. 1999; Nassif et al. 1999; Nassif et al. 1995; Naumann et al. 1999). In fallopian tube organ culture (FTOC) gonococcal invasion has been proposed to occur in a manner reminiscent of “zipper” type phagocytosis. (Dramsi et al. 1998; McGee et al. 1983; Stephens, D. S. 1989).

[0189] The observation that gonococci appear to induce membrane ruffling is a novel finding. Ruffling is the result of a complex interaction that occurs between a bacterium and a host cell and is associated with a triggering mechanism (Silverstein et al. 1977) that leads to macropinocytosis (Alpuche-Aranda et al., 1994; Francis et al. 1993; Garcia-del Portiilo et al. 1994; Swanson et al. 1995). Infection of the inventors' primary cell culture systems resulted in ruffling of both the endo- and ectocervical-derived cells. Ruffling was evident in the endocervical cells as convoluted spheres whereas ruffling of the ectocervical cells was observed to occur as long, ribbon-like folds. The characteristic structural morphology of endo- and ectocervical-associated ruffles appeared to be specific for each of their respective cell types; hence, the ruffles found on the ectocervical cells were termed “ribbons.”

[0190] Salmonella and Shigella have been shown to induce membrane ruffling in a contact-dependent manner in which a (highly conserved) type III secretion system (TTSS) allows for the secretion of numerous effector proteins that initiate the cellular response required for the observed cytoskeletal rearrangements (Finlay et al. 1991; Rosqvist et al. 1995; Tran Van Mhieu et al. 1999). A TTSS has not been described for N. gonorrhoeae. A search of the N. gonorrhoeae strain FA 1090 genome data base (University of Oklahoma Advanced Center for Genome Technology) for the possible existence of Salmonella and Shigella TTSS and effector protein homologs yielded no significant matches to ruffling-associated proteins. Dillard et al. (1999) recently described the existence of a pathogenicity island in N. gonorrhoeae strain MS11, which encodes a secretion system. This pathogenicity island is also present in N. gonorrhoeae strain 1291, but it is absent in N. gonorrhoeae strain FA 1090. This pathogenicity island (and its encoded secretion system) may, therefore, share homology to Salmonella and Shigella TTSS and effector proteins; however, this data is currently unavailable.

[0191] Ruffling and subsequent invasion by Salmonella and Shigella shows an actin-dependence but occurs independent of microtubules. It has previously been demonstrated that gonococcal invasion of tissue culture cell lines is dependent upon microtubules and a functional actin cytoskeleton (Bessen et al. 1986; Grassme et al. 1996; Richardson et al. 1998). Using standard gentamycin-resistance assays endo- and ectocervical cells were examined to determine if these primary cells displayed a microtubule- or actin-dependence for gonococcal invasion. Cytochalasin D, wortmannin, and EGTA brought invasion levels down to (essentially) zero in both cell systems suggesting that gonococcal entry is dependent upon actin rearrangements. TEM analysis of N. gonorrhoeae infected polarized cervical cells supported a role for actin in the gonococcal invasion process in that actin-filled ruffles and large, spacious, actin-lined vacuoles encompassed invading gonococci. The latter finding is in contrast to Grassme et al. (1996) who demonstrated that gonococcal association with actin was transient. In multiple experiments, using cervical cell monolayers derived from different patients, invasion was not significantly inhibited when primary cervical cells were pretreated with nocadazole to disrupt microtubules.

[0192] A concentrated accumulation of actin-associated proteins has been demonstrated to occur in response to membrane ruffling (Clerc et al. 1987; Finlay et al 1991; Skoudy et al. 1999). To the knowledge of the present inventors, the role of actin-associated proteins in gonococcal infection has not been examined. It was found that in response to gonococcal invasion a concentrated accumulation of predominately ezrin and vinculin occurs in a manner analogous to Shigella. A modest accumulation of talin and α-actinin also was observed during gonococcal infection of cervical cells. Additionally, although myosin was observed to accumulate in response to, and co-localize with, gonococci at five and ten minutes post infection, myosin was also observed to be fairly diffuse throughout some of the infected cervical cells. This may reflect the relative abundance of this protein in comparison to the other actin-associated proteins that were examined. Alternatively, the observed myosin distribution may be indicative of the initiation of a concurrent change occurring in the actin cytoskeleton, or it is possible that gonococci elicit only a minimal recruitment of myosin upon ruffle induction.

[0193] The host cell surface molecule exploited by Salmonella to initiate ruffling has, to date, not been elucidated. The Shigella protein complex of IpaB/C/D has been shown to bind the fibronectin receptor, integrin α5β1 (Watarai et al. 1996). The predominant accumulation of ezrin and vinculin in N. gonorrhoeae infected primary cervical cells and the ability of these actin-associated proteins to directly interact with integrin molecules to initiate cellular responses (Clarke et al. 1977; Schmidt et al. 1998) make integrin molecules attractive candidates as potential gonococcal receptors that serve to initiate gonococcal-induced ruffling. Studies using the larynx carcinoma cell line, HEp-2, have demonstrated that gonococcal binding of fibronectin results in co-ligation of heparan sulphate proteoglycan (HSPG) to gonococcal Opa proteins and subsequent binding to the α5β1 integrin (Naumann et al. 1999). Ruffling was not observed to occur in these cells suggesting that gonococcal induction of ruffles may be unique to the cervical epithelium. Investigation of male primary urethral cells has shown that some gonococci can enter these cells by focal macropinocytosis, but no evidence of ruffling was seen. This would suggest that perhaps a cell surface molecule unique to the cervical epithelium may be involved in ruffle induction and that gonococci invoke membrane ruffles by a mechanism distinct from that observed for Shigella. Salmonella and Shigella share many common characteristics with respect to their ability to induce membrane ruffles; however, they each also display ruffling characteristics that are unique to their genus.

[0194] Through co-evolution with their exclusive human hosts the pathogenic Neisseria have developed several mechanisms by which they successfully persist in the general population. Previous studies of N. gonorrhoeae have demonstrated the ability of these organisms to invade eukaryotic cells by receptor-mediated endocytosis, microtubule-dependent endocytosis, and zippering. Here yet another mechanism by which gonococci are able to exploit their human host is described. Ruffling, via a triggering mechanism, has not been observed to occur in male primary urethral cells, tissue culture cell lines, or FTOC nor has ruffling been described to occur with Neisseria meningiditis infections. Ruffling of primary cervical cells, which is induced with gonococcal infection, therefore, is a novel finding.

EXAMPLE 2

Complement Receptor 3 (CR3) is the Factor Responsible for Ruffling

[0195] Tissues and Cell Culture. Surgical biopsies derived from the endo- and the ectocervix that were used to seed primary cervical epithelial cell systems were procured and maintained as described (Example 1 above) in Defined Keratinocyte Serum Free Medium (dk-SFM) (Life Technologies, Rockville, Md.). Urethra epithelia was obtained from adult males undergoing urologic surgery at the University of Iowa Hospitals and Clinics and used to seed primary urethral cell culture systems as described by Harvey et al. (1997). Primary male urethral cells were immortalized with the E6 and E7 genes from the Human Papilloma Virus prior to use. E6E7 immortalized human ectocervical keratinocytes (HCK) and endocervical (End1) cells (generously provided by A. Klinglehutz (University of Iowa, Iowa City, Iowa) and D. Anderson (Fearing Research Laboratory, Boston, Mass.), respectively) were cultured in dk-SFM. ME180 cervical carcinoma cells (ATCC # HTB-33) were cultured in McCoy's 5A medium (Life Technologies) according to ATCC recommendations. Hec1B endometrial carcinoma cells, Chinese hamster ovary cells (CHO-K1), and K562 myeloid cells were maintained in RPMI tissue culture medium (Life Technologies). CR3-expressing CHO(CHO-CR3) and K562 (K562-CR3) cells were maintained in RPMI-G418 (100 μg/ml). CHO cells were generously provided by L. A. Allen and L. Schlsinger (University of Iowa) with permission from D. Golenbock (Boston Medical Center, Boston, Mass.). E. Brown (University of Calif., San Francisco, Calif.) generously provided K562 and K562-CR3 cells. McCoy's 5A and RPMI media were replaced with dk-SFM 48 h prior to infection studies. Surgical biopsies derived from the fallopian tube, endometrium, endocervix, ectocervix, vas deferens, and the male and the female urethra that were to be used for immunohistochemical tissue analysis were processed for cryosectioning as previously described in Example 1 above. Clinical biopsies derived from the cervix of women with documented gonorrhea were provided by D. Fortenberry (Indiana University School of Medicine, Indianapolis, Ind.) and were processed for immunohistochemical analysis as previously described in Example 1 above.

[0196] Bacteria and Infection Studies. N. gonorrhoeae strains 1291, 1291-green, FA1090-green, and MS11-green were used in the infection studies described below. N. gonorrhoeae strains 1291-green, FA1090-green, and MS11-green express green fluorescent protein and will be described elsewhere; the plasmid pLES98 was a gift from V. Clark (University of Rochester, Rochester, N.Y.). N. gonorrhoeae 1291 and FA1090- and MS11-green parental strains (N. gonorrhoeae FA1090 and MS11-A, respectively) are clinically isolated gonococci. N. gonorrhoeae FA1090 is a serum-resistant, genital isolate from a patient with disseminated gonococcal infection. N gonorrhoeae 1291 is a serum-sensitive, urethral isolate obtained from a male patient with gonococcal urethritis. N. gonorrhoeae 1291, 1291-green, and MS11-green contain the pathogenicity island described by Dillard et al. (1999). For infection studies bacteria were allowed to grow overnight (37° C., 5% CO2) on GC-IsoVitaleX agar plates prior to harvesting with a sterile swab and resuspending in sterile saline. Culture density was determined spectrophotometrically where an optical density of 1 at 600 nm was equivalent to 109 bacteria/ml. Bacterial cultures were further diluted in dk-SFM to a density of 107 bacteria/ml and used to infect cell monolayers at a multiplicity of infection of 100. Infection was allowed to progress for variable time periods after which the infection medium was removed and the cell monolayers were extensively washed with phosphate-buffered saline (PBS) prior to fixation with 2% paraformaldehyde. Uninfected, control cell monolayers were simultaneously processed with challenged cell monolayers. Infected and uninfected (control) cell monolayers were subsequently processed for Laser Scanning Confocal Microscopy (LSCM), Scanning Electron Microscopy (SEM), or Transmission Electron Microscopy (TEM) as described previously in Example 1 above; or the cells were harvested for immunoprecipitation assays.

[0197] Immunolabeling and Microscopy. Immunolabeling of frozen tissue sections and cell monolayers was performed as described in Example 1 above. Primary antibodies used for immunolabeling were specific for CD11b (H5A4 (Developmental Studies Hybridoma Bank (DSHB), the University of Iowa, Iowa City, Iowa) and Bear1 (Immunotech, Marseille, France)) or CD18 (anti-CD18 (Santa Cruz Biotechnology, Santa Cruz, Calif.) and IB4, generously provided by E. Brown (University of Calif.)). Tetramethyl rhodamine isothiocyanate (TRITC)- or fluorescein isothiocyanate (FITC)-conjugated secondary antibodies were applied to cell monolayers and bacteria, as noted. Uninfected, tissue cryosections were labeled with FITC-conjugated secondary antibodies and counter stained with ethidium bromide (0.5 ng/ml, 6 min). Clinical biopsy cryosections were incubated with 2C3 and anti-CD18 primary antibodies followed by immunolabeling with TRITC- and FITC-conjugated secondary antibodies, respectively. The 2C3 monoclonal antibody recognizes the H.8 gonococcal surface protein. Infected and uninfected (control) K562 and K562-CR3 cells to be used for TEM analysis were labeled with colloidal-gold secondary antibodies as indicated. Immunolabeled cryosections, cell monolayers, and K562 cells were viewed using the Bio-Rad MRC-1024, the Zeiss 510 Laser Scanning Confocal, or the H-7000 (Hitachi Corp., CA) transmission electron viewing systems. Primary cervical cell and CHO cell monolayers processed for SEM analyses were viewed using the Hitachi S-4000 scanning electron microscope.

[0198] Immunoprecipitation and Western Blot Analysis. Immunoprecipitation was performed as described by Wen et al. (2000). Anti-CD18 or H5A4 were used as capture antibodies. Western blotting was subsequently performed using monoclonal antibodies to gonococcal porin (3H1), pili (IE8G8), or to the opacity associated outer membrane proteins, Opa, (4B 12), all of which were generously provided by M. Blake (North American Vaccine, Beltsville, Md.). Antibody 6B4, which recognizes the Galβ1-4GlcNAc conserved epitope of gonococcal lipooligosaccharide (LOS), was used to probe for the association of LOS with CR3.

[0199] Inhibition of N. gonorrhoeae Attachment and Invasion. Primary cervical cell monolayers, CHO-CR3 and -K1 cells, and K562-CR3 and K562 cells were pretreated (30 min, 4° C.) with 20 μg/ml H5A4, Bear1, IB4, or anti-CD18 antibody competitors prior to infection with gonococci as outlined above. Where indicated anti-CD18 blocking peptide (Santa Cruz Biotechnology) was included in the inhibition assay. Infected, control cell assays (devoid of antibody competitors) and uninfected, control cell assays (with anti-CR3 antibodies) were treated in parallel with inhibition assays. The ability of gonococci to bind primary cervical, K562-CR3, or CHO-CR3 cells in the presence or absence of antibody competitors was assessed by LSCM, TEM, or SEM qualitative analysis. Quantitative analysis of the ability of gonococci to invade primary endo- and ectocervical cells and CHO-CR3 and -K1 cells was determined by standard gentimicin-resistance assays as described previously in Example 1 above and in which antibody competitors were included or excluded from the invasion assay as described above. Where indicated primary endo- and ectocervical cell monolayers were pretreated (2 h, 37° C.) with 10 ng/ml Clostridium C3 neurotoxin prior to infection. The ability of anti-CR3 antibodies to inhibit gonococcal invasion was determined as a normalized function of the ability of gonococci to invade primary endo- and ectocervical cells and CHO cells in the absence of antibody inhibitors. A Kruskal-Wallis non-parametric analysis of variance was used to determine the statistical significance of invasion assays performed in the presence of the C3 neurotoxin.

[0200] Results

[0201] Analysis of CR3 Expression in Tissue Biopsies. LSCM of surgical biopsies derived from the ectocervix, endocervix, endometrium, and fallopian tube revealed the presence of both the alpha and beta subunits of CR3. Immunolabeling of tissue sections with anti-CD18 and anti-CD11b (H5A4) antibodies revealed comparable levels of immunofluorescence for each antibody in each of the tissues examined. CR3 expression appeared to be greatest in the ectocervix. Expression levels decreased progressively from the ectocervix to the upper female genital tract with a low level of CR3 expression being observed in the fallopian tube tissue. Immunohistological examination of male urethra and vas deferens tissues failed to reveal the presence of either CR3 subunit. Similarly, tissue derived from the female urethra failed to label positively for CR3. An isotype control antibody yielded no immunofluorescence.

[0202] Analysis of CR3 expression in Primary Human Cervical Epithelial Cells. Consistent with results obtained by immunohistochemical examination of endocervical and ectocervical tissue biopsies, primary endo- and ectocervical epithelial cells labeled positive for both CD11b and CD18, and no immunofluorescence was observed with an isotype control. Equivalent fluorescence was observed with either anti-CD18 or H5A4 antibodies. Immunofluorescence paralleled results obtained with immunohistological examination of tissue biopsies in that a lower level of expression was qualitatively observed in endocervical-derived cells in comparison to ectocervical-derived cells. LSCM analysis of infection studies using N. gonorrhoeae strains 1291, 1291-green, MS11-green, and FA1090-green suggested that a higher level of CR3 surface expression occurred in the presence of the gonococcus. However, the level of CR3 expression in infected endocervical cells did not obtain that level observed for infected ectocervical cells. Infected ectocervical cells exhibited very high levels of CR3 expression. Co-localization of gonococci with CR3 was observed to occur by thirty minutes post-infection; however, the gonococcus-CR3 association became more prominent by ninety minutes and three hours post-infection.

[0203] Analysis of CR3 Expression in Immortalized Epithelial Cells. In contrast to results obtained with primary cervical epithelial cells, cervical and endometrial carcinoma cell lines (ME180 and Hec1B, respectively) failed to demonstrate CR3 expression as determined by LSCM. CR3 could not be identified on E6E7 transfected endo- and ectocervical or male urethral cells by immunofluorescence using anti-CD18 antibody or monoclonal antibody H5A4. Infection of these cell lines with gonococci revealed the presence of minimal amounts of CD18 after ninety minutes and three hours; however, in comparison to results obtained with the primary cervical cells, the level of CR3 expression in the immortalized and carcinoma-derived cells was negligible. CD11b expression was not observed in ME 180, Hec1B, HCK, or End1 cells subsequent to gonococcal infection.

[0204] Western Blot Analysis Confirmed the Presence of CR3 in Primary Cervical Cells. To confirm the presence of CR3 in primary cervical epithelial cells immunoprecipitation was performed in which an antibody to CD11b or CD18 was used to capture CR3. Confirmation of CR3 expression was subsequently demonstrated by Western Blot analysis using antibodies to CD18 or CD11b and chemiluminescence. Immunoprecipitation using the monoclonal antibody, H5A4, specific for CD11b and subsequent western blotting with anti-CD18 antibody revealed the presence of an approximately 90 kDa band consistent with CD18. The reverse experiment, in which immunoprecipitation was performed with an anti-CD18 antibody and which the respective western blot was probed with H5A4, demonstrated the presence of an approximately 150 kDa band indicative of CD11b. Parallel immunoprecipitation and Western Blot experiments using male urethral epithelial cells did not reveal the presence of either CR3 subunit. Control immunoprecipitation experiments in which the H5A4 or anti-CD18 capture antibody was omitted, or in which an isotype control was used as the capture antibody, failed to show the 90 or 150 kDa bands with subsequent western blotting.

[0205] CR3 Associates with N. gonorrhoeae Porin, Pilus, and Opa Proteins. To confirm LSCM analysis of gonococcal co-localization with CR3, immunoprecipitation was performed in which antibodies to CD11b or CD18 were used to capture CR3 on infected and uninfected primary endo- and ectocervical cells. The association of gonococci with CR3 was subsequently examined by Western Blot analysis using antibodies to gonococcal porin, opa, or pili proteins or to LOS. Membranes probed with antibodies to LOS failed to reveal a CR3 association. Western blots probed with the monoclonal antibodies; 3H 1, specific for gonococcal porin, IE8G8, specific for gonococcal pili, or 4B12, which recognizes a conserved epitope of gonococcal Opa proteins, revealed that these proteins associated with CR3 present on primary endo- and ectocervical epithelial cells. Antibody probes to porin, Opa, pili, and LOS did not reveal the presence of these N. gonorrhoeae-associated molecules in uninfected endo- and ectocervical cells. Immunoprecipitation (control) experiments in which the antibody to CR3 was omitted also failed to demonstrate the presence of the gonococcal-associated molecules examined.

[0206] Anti-CR3 Antibodies Inhibit N. gonorrhoeae Binding to Cell Surfaces.

[0207] To more closely examine the association of the gonococcus with CR3 TEM and SEM analysis was performed of the ability of N. gonorrhoeae to bind CR3-transformed K562 myeloid cells and CHO cells in the presence of antibodies to both the alpha and beta subunits of CR3. TEM analysis demonstrated N. gonorrhoeae binding to K562-CR3 cells and inhibition of N. gonorrhoeae binding in the presence of the anti-CR3 antibodies H5A4, Bear1, IB4, and anti-CD18. Similar results were obtained with SEM analysis of infected endo- and ectocervical cells and CHO-CR3 cells. Binding of gonococci could be inhibited by the addition of the same anti-CR3 antibodies. Binding inhibition that occurred in the presence of anti-CD18 could be reversed by the addition of the anti-CD18 blocking peptide to the infection assay. Binding of gonococci to CHO-K1 (control) cells, which do not express CR3, was not observed.

[0208]

N. gonorrhoeae
Co-localizes with CD18 in vivo. The studies outlined above demonstrate that CR3 serves as a receptor for gonococcal attachment and invasion of the cervical epithelium in vitro. To determine if CR3 is bound by the gonococcus in vivo, LSCM analysis was performed of cervical biopsies derived from women with documented gonorrhea. Immunolabeling of these tissue cryosections demonstrated the presence of CD18 as a green fluorescence and gonococci as a red fluorescence. Gonococci were found to co-localize with CD18, which was visible as a yellow fluorescence. Co-localization was confirmed as a profile plot where the individual fluorescence of each fluorophore (within a designated area of presumed co-localization) was recorded and plotted, individually, by the Zeiss 510 Laser Scanning Confocal viewing system (FIGS. 9A, B). These studies confirm in vitro studies using primary endo- and ectocervical cells and provide evidence that CR3 can serve as a receptor for N. gonorrhoeae infection in vivo.

[0209] Binding of CR3 Stimulates Membrane Ruffling. Extensive membrane ruffling of N. gonorrhoeae-infected K562-CR3, CHO-CR3, and primary cervical cells was observed by TEM, SEM, and LSCM analysis. Ruffles were observed in the presence of gonococci or gonococci in the presence of anti-CR3 antibody, but membrane ruffles were not observed in uninfected cells to which antibody had not been added. Uninfected endocervical, ectocervical, and CHO-CR3 cell monolayers treated with the anti-CR3 antibodies H5A4, Bear1, IB4, and anti-CD18 also revealed extensive membrane ruffling by SEM analysis. Membrane ruffling was most pronounced with the use of the anti-CD18 antibody, IB4. Control assays using CHO-K1 cells failed to reveal the presence of membrane ruffles. These studies suggest that engagement of these cells by anti-CR3 antibodies can initiate membrane ruffling.

[0210]

N. gonorrhoeae
Invasion of Primary Endocervical and Ectocervical Cells is Dependent on CR3. Standard gentamicin-resistance assays of infected endo- and ectocervical cells performed in the presence of antibodies to both the alpha and beta subunits of CR3 confirmed results obtained by TEM and SEM analysis of CR3-transfected myeloid and CHO cells. The addition of anti-CD11b and anti-CD18 antibodies to the invasion assays resulted in greater than 93% invasion inhibition of both endo- and ectocervical cells (FIG. 2) with greatest inhibition (99.86% for endocervical cells, 100% for ectocervical cells) being observed with the addition of the anti-CD11b monoclonal antibody, H5A4. Invasion inhibition that occurred in the presence of the anti-CD18 antibody could be reversed by the addition (to the invasion assay) of a blocking peptide to the anti-CD18 antibody. Pretreatment of endo- and ectocervical cells with Clostridium C3 neurotoxin, which inactivates the effector domain of the Rho subfamily of GTPases, also significantly inhibited gonococcal invasion supporting a role for CR3-mediated phagocytosis (FIG. 3).

EXAMPLE 3

Identification of Inhibitory Peptides

[0211] The present inventors have a phage display library that contains 100 million different copies of 15-mer amino acids. This library is used to screen for phage particles that bind to the CR3 receptor. Briefly, the library is amplified and approximately 1012 phage are applied to a petri dish contain CHO cells expressing CR3. The phage are allowed to interact with the cells for 1 hour and the dish is washed to remove unbound phage. The bound phage are released with a high pH (9.6-10) buffer, reamplified and the process repeated six more times to enrich for phages particles specific for the CHO-CR3 cells. After the final enrichment, the resulting phage are placed over CHO cells lacking CR3. In this case, the unbound phage (containing CR3 binding peptides) are collected after one hour and amplified, and this process repeated six times.

[0212] At that point, enriched CR3 binding phage are plaque purified and tested for the ability to inhibit gonococcal interaction with CHO-CR3 cells. It is estimated that 100 plaque purified phages will be examined to find a phage that inhibits this interaction. When this phage is identified, the 15 mer peptide is sequenced and the peptide synthesized. Gonococcal-CHO-CR3 inhibition studies are then performed with the purified peptide.

EXAMPLE 4

Radiolabeling and Collection of Gonococcal Products Released with Infection of Primary Cervical Cells

[0213] Gonococci allowed to grow overnight on GC agar were harvested with a sterile swab and used to inoculate 5 ml cultures of Morse's Defined Medium (MDM). MDM was prepared such that half the recommended methionine and cysteine was replaced with 125 μCi Redivue Pro-mix L-[35S] in vitro cell labeling mix (Amersham Pharmacia Biotech Inc, Piscataway, N.J.). After approximately 4 h gonococci were collected by centrifugation (4000 rpm, 5 min), rinsed with sterile physiological saline to remove excess label, and resuspended in cold MDM such that a culture density of 107 bacteria ml−1 was obtained. MDM containing the 35S-labeled gonococci was then used to infect approximately 105 primary, human, ecto- and endocervical cells or 35 mm tissue culture dishes devoid of cervical cells. Prior to infection ecto- and endocervical cells were pretreated (30 min, 37° C.) with 250 mM cycloheximide to inhibit cervical cell protein synthesis. Cycloheximide was maintained in the culture medium through out the course of the infection. Cervical cells and tissue culture plates lacking cervical cells were challenged with gonococci for 90 min and 3 h time periods after which the culture supernatants were collected. Gonococci were removed from the culture supernatants by filtration through low-protein binding 0.22 mm syringe filter units. Supernatant filtrates were concentrated using Centricon YM-3 centrifugal filter units (Millipore Corporation, Bedford, Mass.) prior to suspension in 1M Tris-1% SDS. Concentrated supernatants were separated on a SDS 12% to 4% polyacrylamide gradient gel prior to gel-extraction for mass spectrometry at the Mass Spectrometry Facility located at the University of California (San Francisco, Calif.). Analysis of mass data was performed using Protein Prospector (University of California San Francisco, Calif.) (Clauser et al., 1999) and ProFound (Rockefeller University, New York, N.Y.) (Zhang et al., 2000) database systems for protein identification.

[0214] During in vitro infection of primary endocervical and exocervical cells, the inventors have found that there is a 60 to 90 minute delay in the onset of ruffle formation after infection begins. This suggested as one possibility that the gonococcus must be releasing a factor that needed to be at a critical concentration to be effective to induce ruffling. Using bacteria labeled with 35S cysteine/methionine, the inventors studied the tissue culture supernatant being released by the bacteria (FIG. 10). Using mass spectroscopy and proteomic analysis of a SDS-Gel, the inventors identified a number of the proteins being released by the bacteria. These proteins include the following (see, FIG. 11): gonococcal protein p177, gonococcal protein p88, gonococcal protein p64, gonococcal protein p55, gonococcal protein p46, gonococcal porin, gonococcal pilE, and gonococcal pilC.

[0215] Five of these proteins have not been previously described as important in gonococcal pathogenesis (p177, p88, p64, p55, and p46). Homologues of three of the five genes are present in the Neisseria meningitidis genomic database. The inventors have confirmed that the genes for two of the proteins (p177 and p55) were present in gonococcal DNA. Protein p177 encodes a 100 amino acid region that has high homology to the filamentous hemagglutinin of Bordetella pertussis. This protein is a bridging molecules (can span two structures) that has been shown capable of engaging and activating CR3. Protein p55 has enzymatic activity that involves modification of phospholipid membranes and could be involved in modification of the cell membrane enhancing bacterial entry.

EXAMPLE 5

Inhibition of Cellular Invasion by Neisseria gonorrhoeae

[0216] Experiments have been performed showing that recombinant murine I-domain from the Alpha-subunit of the complement type 3 receptor inhibits Neisseria gonorrhoeae from invading primary human cervical cells.

[0217] The recombinant murine I-domain (rI domain) is a 23 kilodalton peptide that contains Myc and His domains. It is recognized by monoclonal antibodies specific for human CR3 I-domain. The amino acid identity to the human I domain is over 90%. The amino acid sequence of the peptide is given below (SEQ ID NO:11).

2FPQQESDIVFLIDGSGSINNIDFQKMKEFVSTVMEQFKKSKTLFSLMQYSDEFRIHFTFNDFKRNPSPRSHVSPIKQLNGRTKTASGIRKVVRELFHKTNGARENAAKILVVITDGEKFGDPLDYKDVIPEADRAGVIRYVIGVGNAFNKPQSRRELDTIASKPAGEHVFQVDNFEALNTIQNQLQEKIFAIPAAASFL

[0218] The peptide is encoded by the nucleotide sequence given below (SEQ ID NO:12).

3TTCCCTCAGCAGGAGAGTGACATTCTCTTCTTGATTGATGGCTCCGGTAGCATCAACAACATTGACTTTCAGAAGATGAAGGAGTTTGTCTCAACTGTGATGGAGCAGTTCAAAAAGTCTAAAACCTTGTTCTCTTTGATGCAGTACTCGGACGAGTTCCGGATTCACTTCACCTTCAATGACTTCAAGAGAAACCCTAGCCCAAGATCACATGTGAGCCCCATAAAGCAGCTGAATGGGAGGACAAAAACTGCCTCAGGGATCCGGAAAGTAGTGAGAGAACTGTTTCACAAAACCAATGGGGCCCGGGAGAATGCTGCCAAGATCCTAGTTGTCATCACAGATGGAGAAAAATTCGGTGATCCCTTGGATTATAAGGATGTCATCCCCGAGGCAFACAGAGCAGGGGTCATTCGCTACGTAATTGGGGTGGGAAATGCCTTCAACAAACCACAGTCCCGCAGAGAGCTCGACACCATCGCATCTAAGCCAGCTGGTGAACACGTGTTCCAAGTGGACAACTTTGAAGCCCTGAATACCATTCAGAACCAGCTTCAGGAAAAGATCTTTGCAATTCCCGCGGCCGCCAGCTTTCTA

[0219] Studies were performed evaluating the ability of the rI-domain to inhibit adherence and invasion of primary human ectocervical cells by Neisseria gonorrhoeae. The cervical cells were infected with 107 N. gonorrhoeae strain 1291. The results of these studies are shown in table 2 below. Recombinant I-domain is a potent inhibitor of ectocervical cell association by Neisseria gonorrhoeae. As little as 1 ng of rI-domain gives over 90% inhibition of invasion. With decreasing amounts of rI-domain the inhibition decreases in a dose dependent fashion.

4TABLE 2% inhibition of invasionof primary exocervicalrI domain concentrationcells1μg/ml98.56100ng/ml96.810ng/ml94.61ng/ml92.1100pg/ml77.510pg/ml56.31pg/ml17.4

[0220] Individual, smaller peptides based on the sequence of rI-domain duplicate the inhibitory activity of the rI-domain. [fill in once studies completed]

[0221] All publications, patents and patent documents are incorporated by reference herein, as though individually incorporated by reference. The invention has been described with reference to various specific and preferred embodiments and techniques. However, it should be understood that many variations and modifications may be made while remaining within the scope of the invention.

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Number	Date	Country
60266070	Jan 2001	US
60310356	Aug 2001	US
60344452	Oct 2001	US

Vaccine and compositions for the prevention and treatment of neisserial infections

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