Vaccines for Pseudomonas aeruginosa: a long and winding road

Abstract

Despite the recognition of Pseudomonas aeruginosa as an opportunistic pathogen, no vaccine against this bacteria has come to market. This review describes the current state-of-the-art in vaccinology for this bacterium. This includes a discussion of those at risk for infection, the types of vaccines and the approaches for empirical and targeted antigen selection under development, as well as a perspective on where the field should go. In addition, the challenges in developing a vaccine for those individuals at risk are discussed.

Keywords::

• alginate
• flagella
• lipopolysaccharide
• neutrophil
• Pseudomonas aeruginosa
• Th17
• vaccine

Disclosure

The authors dedicate this review to the memory of Gerd Döring who had a passion for helping CF patients through his insight and understanding of Pseudomonas aeruginosa infections and his development of new vaccine approaches to combat diseases caused by this important pathogen.

Financial & competing interests disclosure

JB Goldberg is supported by grants from the NIH and the Cystic Fibrosis Foundation. GP Priebe is supported by grants from the NIH, the Cystic Fibrosis Foundation, and the William F. Milton Fund of Harvard Medical School. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Pseudomonas aeruginosa is known as an important pathogen causing life-threatening infections in immunocompromised individuals and those with cystic fibrosis. More recently, it has been gaining recognition as a nosocomial pathogen in the elderly and in combat-related wounds suggesting the appropriate target populations to vaccinate.

• Historically, antigens for vaccine development such as lipopolysaccharide, alginate and flagella have been selected empirically, but more recently, high-throughput approaches have been utilized.

• Despite years of effort, to date, no P. aeruginosa vaccine is available.

• Passive immunotherapy may be advantageous for treating P. aeruginosa in patients unable to mount an effective immune response or in patients with established infection.

• Issues with performing an adequate clinical trial are also discussed.

Notes