Immunogenic Compositions and Vaccines in the Treatment and Prevention of Infections
20230201326 · 2023-06-29
Assignee
Inventors
Cpc classification
A61K39/215
HUMAN NECESSITIES
C12N2770/20034
CHEMISTRY; METALLURGY
C12N2760/16134
CHEMISTRY; METALLURGY
C12N2770/20022
CHEMISTRY; METALLURGY
C12N2760/16122
CHEMISTRY; METALLURGY
International classification
Abstract
The invention is directed to portions of proteins of gram-positive bacteria, gram-negative, acid-fast bacteria (Mycobacteria, Staphylococcus) and/or virus (SARS-COV-2, Influenza), and antibodies reactive against these portions that can be formulated as immunogenic compositions and vaccines for the treatment and prevention of a microbial and/or viral infections. Preferably, compositions of the invention contain one or more portions of selected microbial and/or viral proteins that, upon administration to a subject, generate an effective cellular and/or humoral immune response, modulate immunity and a cytokine response. Effective responses involve an increased generation of antibodies that enhance immunity against an infection and promote an enhanced a phagocytic response. Monoclonal antibodies produced against these peptides enhance phagocytosis and killing of bacteria, viruses, and other microbes by phagocytic cells, and enhance clearance from the blood.
Claims
1. An immunogenic peptide comprised of a contiguous sequence of any one of the sequences of SEQ ID NOs 1-4, 18-24, or a combination thereof.
2. The peptide of claim 1, wherein the contiguous sequence further includes one or more of the sequences selected from the group consisting of the sequences of SEQ ID NOs 5-17 and 25-41.
3. The peptide of claim 1, which contains a sequence of a viral antigen, a bacterial antigen, a parasitic antigen, a composite antigen, or a combination thereof.
4. The peptide of claim 3, wherein the bacterial antigen comprises an antigen of a gram-positive microorganism, a gram-negative microorganism, both gram-positive and gram-negative microorganisms, or an acid-fast microorganism.
5. The peptide of claim 1, which contains the sequence of a T-cell stimulating epitope.
6. The peptide of claim 1, which contains the sequence of a composite epitope.
7. The peptide of claim 1, wherein the composite epitope comprises a bacterial or viral epitope.
8. A nucleic acid that encodes the peptide of claim 1.
9. An immunogenic composition comprising the peptide of claim 1.
10. The immunogenic composition of claim 9, comprising one or more of a pharmaceutically acceptable carriers, a chemical agent, a diluent, an excipient, or an adjuvant.
11. The immunogenic composition of claim 10, wherein the pharmaceutically acceptable carrier, chemical agent, diluent, or excipient comprises water, fatty acids, lipids, polymers, carbohydrates, gelatin, solvents, saccharides, buffers, stabilizing agents, surfactants, wetting agents, lubricating agents, emulsifiers, suspending agents, preservatives, antioxidants, opaquing agents, glidants, processing aids, colorants, sweeteners, perfuming agents, flavoring agents, or a combination thereof.
12. The immunogenic composition of claim 10, wherein the adjuvant comprises alum, oil in water emulsion, amino acids, proteins, carbohydrates, Freund’s, a liposome, saponin, lipid A, squalene, liposomes adsorbed to aluminum hydroxide, liposomes containing QS21 saponin, liposomes containing QS21 saponin and adsorbed to aluminum hydroxide, liposomes containing saturated phospholipids, cholesterol, and/or monophosphoryl, ALFQ, ALFA, AS01, and/or modifications or derivatives thereof.
13. The immunogenic composition of claim 9, which is a vaccine.
14. An antibody that is reactive against the peptide of claim 1.
15. The antibody of claim 14, which comprises IgG, IgA, IgD, IgE, IgM or fragments or combinations thereof.
16. The antibody of claim 14, which is a polyclonal, a monoclonal, or a humanized antibody.
17. A hybridoma that expresses the monoclonal antibody of claim 16.
18. An antibody that is reactive against the peptide of claim 2.
19. The antibody of claim 18, which comprises IgG, IgA, IgD, IgE, IgM or fragments or combinations thereof.
20. The antibody of claim 18, which is a polyclonal, a monoclonal, or a humanized antibody.
21. A hybridoma that expresses the monoclonal antibody of claim 20.
22. An immunogenic peptide comprised of a contiguous sequence of any one of the sequences of SEQ ID NOs 25, 30, 32, 36, 38, 39, 41, or a combination thereof.
23. The peptide of claim 22, wherein the contiguous sequence further includes one or more of the sequences selected from the group consisting of the sequences of SEQ ID NOs 1-24, 26-29, 31, 33-35, 37, and 40.
24. The peptide of claim 22, which contains a sequence of a viral antigen, a bacterial antigen, a parasitic antigen, a composite antigen, or a combination thereof.
25. The peptide of claim 22, which contains the sequence of a T-cell stimulating epitope.
26. The peptide of claim 22, which contains the sequence of a composite epitope.
27. The peptide of claim 26, wherein the composite epitope comprises a bacterial or viral epitope.
28. A nucleic acid that encodes the peptide of claim 22.
29. An immunogenic composition comprising the peptide of claim 22.
30. The immunogenic composition of claim 29, comprising one or more of a pharmaceutically acceptable carriers, a chemical agent, a diluent, an excipient, or an adjuvant.
31. The immunogenic composition of claim 30, wherein the pharmaceutically acceptable carrier, chemical agent, diluent, or excipient comprises water, fatty acids, lipids, polymers, carbohydrates, gelatin, solvents, saccharides, buffers, stabilizing agents, surfactants, wetting agents, lubricating agents, emulsifiers, suspending agents, preservatives, antioxidants, opaquing agents, glidants, processing aids, colorants, sweeteners, perfuming agents, flavoring agents, or a combination thereof.
32. The immunogenic composition of claim 30, wherein the adjuvant comprises alum, oil in water emulsion, amino acids, proteins, carbohydrates, Freund’s, a liposome, saponin, lipid A, squalene, liposomes adsorbed to aluminum hydroxide, liposomes containing QS21 saponin, liposomes containing QS21 saponin and adsorbed to aluminum hydroxide, liposomes containing saturated phospholipids, cholesterol, and/or monophosphoryl, ALFQ, ALFA, AS01, and/or modifications or derivatives thereof.
33. The immunogenic composition of claim 29, which is a vaccine.
34. An antibody that is reactive against the peptide of claim 22.
35. The antibody of claim 34, which comprises IgG, IgA, IgD, IgE, IgM or fragments or combinations thereof.
36. The antibody of claim 34, which is a polyclonal, a monoclonal, or a humanized antibody.
37. A hybridoma that expresses the monoclonal antibody of claim 36.
38. An antibody that is reactive against the peptide of claim 23.
39. The antibody of claim 38, which comprises IgG, IgA, IgD, IgE, IgM or fragments or combinations thereof.
40. The antibody of claim 38, which is a polyclonal, a monoclonal, or a humanized antibody.
41. A hybridoma that expresses the monoclonal antibody of claim 40.
42. A contiguous peptide sequence comprising an epitope of a bacterium and an epitope of a virus which includes one or more of the sequences selected from the group of sequences consisting of SEQ ID NOs. 1-41.
43. A contiguous peptide sequence comprising an epitope of a first bacterium and an epitope of a second bacterium, wherein the first bacterium and the second bacterium are of different serotypes, species or genera, which includes one or more of the sequences selected from the group of sequences consisting of SEQ ID NOs. 1-24.
44. A contiguous peptide sequence comprising an epitope of a first virus and an epitope of a second virus, wherein the first virus and the second virus are of different serotypes, species or genera, which includes one or more of the sequences selected from the group of sequences consisting of SEQ ID NOs. 25-41.
Description
DESCRIPTION OF THE DRAWINGS
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DESCRIPTION OF THE INVENTION
[0097] Approximately one third of the world population is infected with Mycobacterium tuberculosis (MTB). Current treatment includes a long course of antibiotics and often requires quarantining of the patient. Resistance is common in many bacteria and viruses and an ever-increasing problem, as is the ability to maintain the quarantine of infected patients. Present vaccines include BCG which is prepared from a strain of attenuated (virulence-reduced) live bovine tuberculosis bacillus, Mycobacterium bovis, and live non-MTB organisms. BCG carries substantial associated risks, especially in immune compromised individuals, and has proved to be only modestly effective and for limited periods. It is generally believed that a humoral response to infection by MTB is ineffective and optimal control of infection must involve activation of T cells and macrophages.
[0098] It has been surprisingly discovered that certain regions of Mycobacterial proteins generate an immune response against Mycobacteria in mammals that can be useful in treatment or protective against infection. Proteins which contain these regions include peptidoglycan, mycolic acid, LTA, LAM, heat shock proteins, a surface antigen, a composite peptide, which may contain a composite epitope, a mimotope, a fusion peptide, a peptide conjugate, or synthetic peptide sequence. Regions of peptides that generate an immune response are antigenic regions or epitopes and peptides may contain one or more epitopes. A surface antigen is a protein that contains one or more epitopes within or outside of the membrane of a microbe or otherwise exposed or becomes exposed after a treatment on the microbe. A composite peptide is a peptide sequence that contains two or more epitopes which may be similar or dissimilar from the same of different microbes. A composite epitope is a single epitope that combines two similar epitopes creating a unique sequence and is similarly immunogenically reactive as both similar epitopes. A mimotope is an antigenic structure that possesses the same antigenic profile of a peptide or one or more epitopes, but contains a different sequence from the peptide or epitope. A fusion peptide is a peptide that comprises one or more epitopes whose construction involves enzymatic fusion or ligation. A peptide conjugate is a peptide that is chemically conjugated to another molecule that may be a peptide or a polysaccharide. A synthetic peptide is any peptide disclosed here that is chemically or otherwise synthetically manufactured.
[0099] These peptides may be obtained or copied from many different strains and/or serotypes of gram-positive bacteria, including but not limited to a Staphylococcus spp. such as Staphylococcus aureus, or a Mycobacteria spp. such as Mycobacterium tuberculosis, Mycobacterium leprae, Mycobacterium bovis, Mycobacterium avium, or Mycobacterium smegmatis. Peptides as disclosed herein can be incorporated into immunogenic composition and vaccines for the treatment of gram-positive bacterial infections including, but not limited to Staphylococcal and/or Mycobacterial infections. Immunogenic composition, vaccines, and antibodies that are reactive against the peptides can each be used to treat a Mycobacterial infection. Short-term or long-term prevention or protection from infection can be achieved with immunogenic compositions and vaccines, although often times the subject has an existing infection that requires more immediate treatment. In such instances, treatment can be administered with peptide and/or antibodies that are reactive to peptides as disclosed herein. The antibodies function immediately to clear and kill gram-positive bacteria and Mycobacteria from the blood and the peptides can induce an immune response that provides short-term or long-term protection from repeat infection.
[0100] One embodiment of the invention comprises one or more portions of gram-positive bacterial proteins and Mycobacterial proteins which include portions of peptidoglycan, mycolic acid, LTA, LAM, heat shock proteins, or a surface antigen, including a composite peptide, which may contain a composite epitope, mimotope, a fusion peptide, a peptide conjugate, and a synthetic peptide sequence thereof, and immunogenic compositions containing peptides as disclosed herein. Peptides may be from a single organism or composites of different sequences from multiple microbes to include, but not limited to viruses such as influenza virus, gram positive bacteria such as Staphylococcus or Mycobacteria (acid fast) or gram-negative bacteria. Composites can include a peptide as disclosed herein plus a carrier protein.
[0101] Preferably, the immunogenic peptide comprised of a contiguous sequence of any one of the sequences of SEQ ID NOs 1-4, 18-24, or a combination thereof. The contiguous sequence may further include one of more of the sequences selected from the group consisting of the sequences of SEQ ID NOs 5-17 and 25-41. Also preferably, the immunogenic peptide comprised of a contiguous sequence of any one of the sequences of SEQ ID NOs 25, 30, 32, 36, 38, 39, 41, or a combination thereof. The contiguous sequence may further include one or more of the sequences selected from the group consisting of the sequences of SEQ ID NOs 1-24, 26-29, 31, 33-35, 37, and 40.
[0102] Preferably the peptide contains a sequence of a viral antigen, a bacterial antigen, a parasitic antigen, a composite antigen, or a combination thereof. Also preferably, the bacterial antigen comprises an antigen of a gram-positive microorganism, a gram-negative microorganism, both gram-positive and gram-negative microorganisms, or acid-fast microorganism and may contain the sequence of a T-cell stimulating epitope, a composite epitope. Also preferably, the composite epitope comprises a bacterial or viral epitope.
[0103] Peptides of this disclosure may be coupled with carrier proteins. Preferred carrier proteins include, for example, native or recombinant cross-reactive material (CRM) or a domain of CRM, CRM197, tetanus toxin, tetanus toxin heavy chain proteins, diphtheria toxoid, tetanus toxoid, Pseudomonas exoprotein A, Pseudomonas aeruginosa toxoid, Bordetella pertussis toxoid, Clostridium perfringens toxoid, Escherichia coli heat-labile toxin B subunit, Neisseria meningitidis outer membrane complex, Hemophilus influenzae protein D, Flagellin Fli C, Horseshoe crab Haemocyanin, and fragments, derivatives, and modifications thereof. These peptides can be used for the treatment or prevention of a microbial infection. Peptide portions may be included in immunogenic composition which may further comprise one or more pharmaceutically acceptable carriers, chemical agents, diluents, excipients, or adjuvants. Preferably the pharmaceutically acceptable carrier, chemical agent, diluent, or excipient comprises water, fatty acids, lipids, polymers, carbohydrates, gelatin, solvents, saccharides, buffers, stabilizing agents, surfactants, wetting agents, lubricating agents, emulsifiers, suspending agents, preservatives, antioxidants, opaquing agents, glidants, processing aids, colorants, sweeteners, perfuming agents, flavoring agents or a combination thereof. Preferred carriers include components designated as generally recognized as safe (GRAS) by the U.S. Food and Drug Administration or another appropriate authority. Preferably the adjuvant comprises alum, oil in water emulsion, amino acids, proteins, carbohydrates, Freund’s, a liposome, saponin, lipid A, squalene, liposomes adsorbed to aluminum hydroxide, liposomes containing QS21 saponin, liposomes containing QS21 saponin and adsorbed to aluminum hydroxide, liposomes containing saturated phospholipids, cholesterol, and/or monophosphoryl, ALFQ, ALFA, AS01, and/or modifications or derivatives thereof. Immunogenic compositions also include vaccines.
[0104] Another embodiment of the invention comprises antibodies that are reactive against a peptide disclosed herein. Preferred are antibodies that are reactive against peptides of gram-positive bacteria such as Staphylococcus and/or Mycobacteria. Preferably the antibody comprises IgG, IgA, IgD, IgE, IgM or fragments (e.g., Fhv, Fc, Fab, etc.) or combinations thereof. Preferably the antibody is a polyclonal, monoclonal, or humanized antibody, or an Fc portion or variable or hypervariable portion of an antibody molecule. Antibodies may be produced through recombinant techniques, such as humanization of murine antibodies preferably including a pharmaceutically acceptable carrier. Preferably the monoclonal antibody is fully or partly humanized. Preferred monoclonal antibodies include but are not limited to monoclonals identified herein as LD7, CA6, JG7, GG9, and MD11 (see U.S. Pat. No. 9,821,047 issued Nov. 21, 2017 and entitled “Enhancing Immunity to Tuberculosis,” which is incorporated by reference, and identifies JG7 as produced by hybridoma ATCC Deposit No. PTA-124416, GG9 as produced by hybridoma ATCC Deposit No. PTA-124417, and AB9 as produced by hybridoma ATCC Deposit No. PTA-124418). Another embodiment of the invention is directed to a hybridoma that expresses monoclonal antibodies as disclosed herein.
[0105] Another embodiment of the invention is directed to methods of treatment comprising administering peptides disclosed herein, immunogenic compositions disclosed herein, and/or antibodies disclosed herein to a subject in need thereof. Administering is preferably via injection into the bloodstream of the subject and can be through other routes as appropriate (e.g., IM, SQ, ID, IP). Preferably the subject is a mammal such as a human, that, after administration, generates an immune response against Mycobacteria. Preferably the immune response comprises serum antibody titers, opsonization, phagocytosis and/or killing of gram-positive bacteria or Mycobacteria. Preferably the immune response generated results in the formation of opsonizing antibodies. Also preferably, the immune response comprises the generation of memory T cells against gram-positive bacteria or Mycobacteria. Preferably the methods comprise treating or preventing latent and/or drug-resistant Mycobacteria infections such as but not limited to MTB infections. Mammals with latent infection may otherwise appear healthy, but still retain an MTB infection that often, although not always, is infectious to others. Such methods may involve administering an immunogenic composition and antibodies reactive to peptides of this disclosure such as monoclonal antibodies to the subject. Preferably the immunogenic compositions or antibodies are administered to a patient intravenously or subcutaneously and generates a humoral response that comprises generation of antibodies specifically reactive against gram-positive bacteria or preferably Mycobacterial moieties that impede host immunity or induce antibodies that enhance host immunity.
[0106] Antibodies may be fully human or produced through recombinant techniques, such as humanization of murine antibodies preferably including a pharmaceutically acceptable carrier. Preferably the antibody is specifically reactive to a peptide as disclosed herein. Preferably the peptide comprises epitopes of one or more of the gram-positive bacterial proteins such as Mycobacterial proteins, which may be produced recombinantly, synthetically, or obtained from in vitro growth of microorganisms, or a combination thereof. Preferably the pharmaceutically acceptable carrier comprises water, oil, fatty acid, carbohydrate, lipid, cellulose, or a combination thereof. Preferably peptides and antigen targets may be conjugated to other molecules such as proteins or other moieties and delivered with adjuvants such as alum, squalene oil in water emulsion amino acids, proteins, carbohydrates and/or other adjuvants.
[0107] Another embodiment of the invention is directed to monoclonal antibodies that are specifically reactive against PGN, HSPX, or mycolic acid of drug-resistant Mycobacterial infections and preferably opsonizing antibodies. Preferably the monoclonal antibody is an IgA, IgD, IgE, IgG or IgM, or an Fc fragment or variable or hypervariable region of an antibody molecule and may be derived from most any mammal such as, for example, rabbit, guinea pig, mouse, human, fully or partly humanized, chimeric or single chain of any of the above. The DNA encoding the antibodies may be utilized in any appropriate cell line to produce the encoded MABs. Another embodiment comprises hybridoma cultures that produce the monoclonal antibodies. Another embodiment of the invention comprises non-naturally occurring polyclonal antibodies that are specifically reactive against a protein of Mycobacteria.
[0108] Nucleic acid sequences that encode portions of gram-positive bacterial proteins such as Mycobacterial proteins are preferably recombinantly produced and/or synthetically manufactured. These sequences may be developed as immunogenic compositions or vaccines against gram-positive bacteria or Mycobacteria. Also preferred are nucleic acid aptamers and peptide aptamers and other molecules that mimic the structure and/or function of the portions. Also preferred are peptide and/or nucleic acid sequences that contain or encode one or more epitopes of these peptides.
[0109] Preferably, vaccines of the disclosure provide protection to the patient for greater than about one year, more preferably greater than about two years, more preferably greater than about three years, more preferably greater than about five years, more preferably greater than about seven years, more preferably greater than about ten years, and more preferably greater than about fifteen or twenty years.
[0110] Preferably the immune response generated upon the administration of an immunogenic composition or vaccine of the disclosure is protective against gram-positive bacterial infections, MTB, multi-drug resistant and/or latent TB, or another infection and enhance and/or prime the immune system of the patient to be immunologically responsive to an infection such as by promoting recognition of the pathogen, a greater and/or more rapid immunological response to an infection, phagocytosis of the pathogen or killing of pathogen-infected cells, thereby promoting overall immune clearance of the infection, including latent TB infection and reactivation TB. Preferably, a vaccination of an infected mammal promotes the activation of a humoral and/ or cellular response of the mammalian immune system. For example, administering an immunogenic composition as disclosed herein to an infected mammal promotes the sensing of the infection and then clears the infection, including latent infection, from the mammalian system by inducing or increasing phagocytic activity. Preferably this sensing and clearance activity is effective to clear the body of both active organisms and latent or dormant organisms and thereby prevent a later resurgence of the infection.
[0111] Vaccines of the invention may contain one or multiple sequences and/or portions of proteins or peptides that are derived from the same or from different source materials or organisms. Source materials include, for example, proteins, peptides, mimotopes, toxins, cell wall components, membrane components, polymers, carbohydrates, nucleic acids including DNA and RNA, lipids, fatty acids, and combinations thereof. Immunogenic compositions and vaccines with multiple portions wherein each portion comprises a different source material are referred to herein as composite peptide antigens and may include portions derived from, for example, proteins and lipids, peptides and fatty acids, and lipids and nucleic acids. Vaccine conjugates may contain portions derived from distinct organisms, such as, for example, any combination of bacteria (e.g., MTB, Strep, Staph, Pseudomonas, Clostridium), virus (e.g., RNA or DNA viruses, influenza, HIV, RSV, Zika, poliomyelitis), fungal or mold, and parasite (e.g. malaria). These conjugates may be composed of, for example, a portion of mycolic acid of MTB coupled to serum albumin (e.g., bovine serum albumin or BSA). Exemplary conjugate vaccines include, but are not limited to composite peptide antigens of MTB, peptidoglycan, mycolic acid, or LAM with a protein such as tetanus toxin or diphtheria toxin. Exemplary conjugate vaccines also include but are not limited to conjugates of a surface protein of gram-positive bacteria such as LTA with a protein such as tetanus toxin or diphtheria toxin.
[0112] Although the peptides of the disclosure may be complete vaccines against an infection in and of themselves, it has also been discovered that the peptide vaccines of the invention enhance the immune response when administered in conjunction with other vaccines against the same or a similar infection such as, for example, BCG against a TB infection. As a secondary vaccine or adjunctive treatment in conjunction with an existing primary vaccine treatment, secondary vaccines (which may be antibodies or antigens) of the invention provide a two-punch defense against infection which is surprisingly effective to prevent or extend the period of protection available from the conventional primary vaccine. The primary vaccine (i.e., conventional vaccine) and secondary vaccines (vaccines of the invention) may be administered about simultaneously, or in staggered fashion in an order determined empirically or by one skilled in the art. Preferably the peptide vaccine is administered in advance of an attenuated or killed whole cell vaccine but may also be administered after or simultaneously (e.g., collectively as a single vaccination or as separate vaccination compositions). Preferably the peptide vaccine is administered from between about two to about thirty days in advance or after administration of the whole cell vaccine, and more preferably from between about four to about fourteen days in advance or after. Without being limited as to theory, it is currently believed that the first vaccine primes the immune system of the subject, and the second vaccine provides the boost to the immune system creating a protective immunological response in the patient.
[0113] Antibodies and antibody fragments disclosed herein can be distinguished from naturally occurring antibodies and can be isolated, identified, and characterized. In addition, these antibodies may bind to chemically or structurally altered epitopes or epitopes that become exposed after the chemical treatment. For example, natural Mycobacteria possess biological material that prevents a host immune system from immunologically seeing and recognizing certain Mycobacterial antigens such as proteins and lipids, peptides, fatty acids, polysaccharides, lipids and nucleic acids. Protein or peptide examples include but are not limited to the heat-shock proteins, peptidoglycan, mycolic acid, lipoarabinomannan (LAM) and LTA. Antibodies to one or more of these biological materials induce opsonization and/or killing of microorganisms.
[0114] Another embodiment is directed to the utilization of multiple antibodies (polyclonal, monoclonal or fractions such as Fab fragments, amino acid sequences of the variable binding antibody regions, single chains, etc.) that are combined or combined with conventional antibodies (polyclonal, monoclonal or fractions such as Fab fragments, single chains, etc.) into an antibody cocktail for the treatment and/or prevention of an infection. Combinations can include two, three, four, five or many more different antibody combinations with each directed to a different peptide sequence.
[0115] Antibodies to one or more different peptides may be monoclonal or polyclonal and may be derived from any mammal such as, for example but not limited to, mouse, rabbit, goat, pig, guinea pig, rat and preferably human. Polyclonal antibodies may be collected from the serum of infected or carrier mammals (e.g., typically human, although equine, bovine, porcine, ovine, or caprine may also be utilized) and preserved for subsequent administration to patients with existing infections. Administration of antibodies for treatment against infection, whether polyclonal or monoclonal, may be through a variety of available mechanisms including, but not limited to inhalation, ingestion, and/or subcutaneous (SQ), intravenous (IV), intraperitoneal (IP), intradermal (ID), and/or intramuscular (IM) injection, and may be administered at regular or irregular intervals, or as a bolus dose.
[0116] Monoclonal antibodies may be of one or more of the classes IgA, IgD, IgE, IgG, or IgM, containing alpha, delta, epsilon, gamma or mu heavy chains and kappa or lambda light chains, or any combination heavy and light chains including effective fractions thereof, such as, for example, single-chain antibodies, isolated variable regions, isolated Fab or Fc fragments, isolated complement determining regions (CDRs), and isolated antibody monomers. Monoclonal antibodies may be created or derived from human or non-human cells and, if non-human cells, they may be chimeric MABs or humanized. Non-human antibodies are preferably humanized by modifying the amino acid sequence of the heavy and/or light chains of peptides to be similar to human variants, or genetic manipulation or recombination of the non-coding structures from non-human to human origins. The invention further comprises recombinant plasmids and nucleic acid constructions used in creating a recombinant vector and a recombinant expression vector the expresses a peptide vaccine of the invention. The invention further comprises hybridoma cell lines created from the fusion of antibody producing cells with a human or other cell lines for the generation of monoclonal antibodies of the invention. Antibodies disclosed herein promote the cell killing mechanisms of the immune system including, but not limited to phagocytosis, apoptosis, macrophage and natural-killer cell activation, cytokine and T-cell modulation and complement-initiated cell lysis.
[0117] Another embodiment of the invention is directed to the prophylactic administration of immunogenic compositions and/or antibodies to protect health care workers who administer to TB patients and, in particular, patients with multi or extreme drug resistant MTB infections. At present, a health care professional, or most anyone, who treats or cares for a patient infected with multi-drug resistant or extreme-drug resistant TB is at extreme risk for acquiring the same infection as those he or she cares for. There is also a substantial risk to all persons within a general health care facility that such a TB infection will be acquired by other health care workers at the facility or visitor who otherwise have no contact or interaction with such patients. With the prophylactic administration of antibodies or vaccines of the invention to health care workers, they are able to care for and attend these patients. With the administration of immunogenic compositions of the invention, preferably monoclonal antibodies or vaccines, a health care worker may be protected from nosocomial and occupationally acquired TB or gram-positive bacterial infections for weeks, months and longer.
[0118] Additionally the vaccine antigens and/or antibodies of the invention may be administered in conjunction with conventional vaccines against gram-positive bacteria and MTB (e.g., BCG) or as a Prime Boost with another vaccine such as, for example BCG. This combined vaccine of the invention provides an enhancement of the immune response generated and/or extends the effectiveness and/or length of period of immunity. Enhancement is preferably an increase in the immune response to MTB infection such as an increase in the cellular or humoral response generated by the host’s immune system. An effective amount of vaccine, adjuvant and enhancing antigen of the invention is that amount which generates an infection clearing immune response or stimulates phagocytic activity. Upon administration of the combined vaccine, an increase of the cellular response may include the generation of targeted phagocytes, targeted and primed natural killer cells, and/or memory T cells that are capable of maintaining and/or promoting an effective response to infection for longer periods of time than the conventional vaccine would provide alone. An increase in the humoral response may include the generation of a more diverse variety of antibodies including, but not limited to different IgG isotypes or antibodies to more than one microbe or more than one MTB molecule that are capable of providing an effective response to prevent infection by MTB and/or another microbe as compared to the humoral response that would be generated from just a conventional MTB vaccine. Administration preferably comprises combining BCG vaccine and a vaccine antigen that generates a humoral response in the patient to a surface antigen of MTB. Preferably the response is to mycolic acid, peptidoglycan, lipoarabinomannan and/or another component of the microorganism, preferably one that presents or is otherwise exposed on the surface of MTB or secreted during infection. Some substances produced by MTB may be toxic to the host immune system or impede immune function. Antibodies that clear or neutralize these toxic substances (such as released or free mycolic acid components) can further act to enhance and improve host immunity.
[0119] Treatment of subjects may be combined with antibiotics, cytokines and other bactericidal and/or bacteriostatic substances (e.g., substances that inhibit protein or nucleic acid synthesis, substances that injury membrane or other microorganism structures, substances that inhibit synthesis of essential metabolites of the microorganism), or one or more substances that attacks the cell wall structure or synthesis of the cell wall of the microorganism. Effective amounts of antibiotics are expected to be less than the manufacture recommended amount or higher dose, but for short periods of time (e.g., about one hour, about 4 hours, about 6 hours, less than one or two day). Examples of such antibiotics include but are not limited to one or more of the chemical forms, derivatives and analogs of penicillin, amoxicillin, Augmentin (amoxicillin and clavulanate), polymyxin B, cycloserine, autolysin, bacitracin, cephalosporin, vancomycin, and beta lactam. Antibiotics work synergistically with the antigens of the invention to provide an efficient and effective preventative or treatment of an infection. The antibiotics are not needed in bacteriostatic or bactericidal quantities, which is not only advantageous with regard to expense, availability and disposal, these lower dosages do not necessarily encourage development of resistance to the same degree, together a tremendous benefit of the invention.
[0120] Antibodies may be administered directly to a patient to treat or prevent infection via inhalation, oral, SQ, IM, IP, ID, IV or another effective route, often determined by the physical location of the infection and/or the infected cells. Treatment is preferably one in which the patient does not develop or develops only reduced symptoms (e.g., reduced in severity, strength, period of time, and/or number) associated with infection and/or does not become otherwise contagious. Antibodies used alone or in conjunction with anti-Mycobacterial antibiotics will increase the clearance of organisms from the blood or other tissues, or inactivate substances that impede immunity as measured by a more rapid reduction of symptoms, more rapid time to smear negativity and improved weight gain and general health. In addition, treatment provides an effective reduction in the severity of symptoms, the generation of immunity to Mycobacteria, and/or the reduction of infective period of time. Preferably the patient is administered an effective amount of antibodies to prevent or overcome an infection alone or as adjunctive therapy with antibiotics.
[0121] Although the invention is generally described in reference to human infection by Mycobacterium tuberculosis, as is clear to those skilled in the art the compositions including many of the antibodies, tools and methodology is generally and specifically applicable to the treatment and prevention of gram-positive bacterial infections and many other diseases and infections in many other subjects (e.g., cats, dogs, pets, horses, cattle, pigs, farm animals, etc.) and most especially diseases wherein the causative agent is of viral, bacterial, fungal and parasitic origins.
[0122] The following examples illustrate embodiments of the invention but should not be viewed as limiting the scope of the invention.
EXAMPLES
Example 1
[0123] Monoclonal Antibodies (MABs) JG7, GG9, and MD11 were developed against a Mycobacterium tuberculosis (MTB) and gram-positive bacteria cell wall component peptidoglycan (PGN). Mouse splenocytes were fused with SP2/0 myeloma cells for production of hybridomas and MABs. MAB JG7 (IgG1) was derived from BALB/c MS 1323 immunized intravenously with Ethanol-killed Mycobacterium tuberculosis (EK-MTB), without adjuvant. Killing of MTB using Ethanol may have altered the MTB capsule exposing deeper cell wall epitopes. MAB GG9 (IgG1) was derived from BALB/c MS 1420 immunized subcutaneously with EK-MTB, without adjuvant. MAB MD11 (IgG2b) was derived from ICR MS 190 immunized subcutaneously with ultrapure Peptidoglycan (PGN), conjugated to CRM197 and adjuvanted with TITERMAX® Gold. EK-MTB and PGN were immunogenic in mice. Serum antibodies that bound to gram-positive bacteria and MTB and promoted opsonophagocytic killing (OPKA) of the bacteria by phagocytic effector cells. Monoclonal antibodies (MABs) JG7 and GG9 produced (from mice 1323 and 1420. respectively), bound to M. smegmatis, multiple MTB strains and susceptible. MDR, and XDR clinical isolates (
[0124] MABs JG7 and GG9 showed binding activity to killed MTB. live Mycobacterium smegmatis (SMEG) and several strains of live MTB - susceptible. MDR and XDR. In addition. JG7 and GG9 promoted opsonophagocytic killing of SMEG and MTB using macrophage and granulocytic cell lines and enhanced clearance of MTB from blood (
[0125] Binding activities of supernatants from hybridomas JG7 and GG9 to Mycobacterium tuberculosis (MTB) and Mycobacterium smegmatis (SMEG), evaluated at dilutions 1:10. 1:100 and 1:1000 on fixed mycobacteria at 1x10.sup.5 CFU/well.
[0126] Binding activity of purified anti-Mycobacterium tuberculosis monoclonal antibodies (anti-MTB MABs) GG9 and JG7 to live Mycobacterium smegmatis (SMEG) and live susceptible MTB H37Ra (1ab strain) and STB 1 and STB2 (susceptible clinical isolates) as demonstrated in a Live Bacteria ELISA (see
[0127] Binding activity of purified anti-Mycobacterium tuberculosis monoclonal antibodies (anti-MTB MABs) JG7 and GG9 to fixed MTB at 1x10.sup.5 CFU/well.
[0128] Binding activity of anti-MTB MABs JG7 & GG9 to various live gram-positive bacteria grown to either log phase or stationary phase as screened in the Live Bacteria ELISA (see
[0129] Enhanced OPKA of MABS JG7 and GG9 against Mycobacterium smegmatis (SMEG) using HL60 granulocytes and Clq (
[0130] OPKA of MAB JG7 against live Mycobacterium tuberculosis (MTB) clinical isolate STB1, using U-937 macrophages (without C1q) was significantly enhanced at MAB levels 2.5 -25 .Math.g/mL (see
[0131] Using qPCR, rapid clearance of Mycobacterium tuberculosis (MTB) in blood was observed in all groups from the in vivo study with N=76 ICR mice. While MAB GG9 (
[0132] MABs JG7 and GG9 and anti-LTA MAB (96-110) were analyzed for binding to a cell wall mixture and Ultrapure PGN, both from Staphylococcus aureus (
[0133] MAB MD11 showed binding activity to Peptidoglycan, killed MTB, and various strains of gram-positive bacteria (see
Example 2
[0134] MABs JG7, GG9 and MD11 were analyzed for binding to small, synthesized peptides (see
TABLE-US-00001 PGN Peptide Sequences SEQ ID NO Peptide number Peptide ID Peptide Sequence 1 PGN Pep01 LVD-PSEQ-A-PGN Pep 01 AEKAGGGGGAEKA 2 PGN Pep02 LVD-PSEQ-A-PGN Pep 02 AEKAEKAGGGGGAEKAEKA 3 PGN Pep03 LVD-PSEQ-A-PGN Pep 03 QYIKANSKFIGITEAEKAGGGGAEKA 4 PGN Pep04 LVD-PSEQ-A-PGN Pep 04 AEKAGGGGGAEKAQYIKANSKFIGITE 5 PGN Pep05 LVD-PSEQ-A-PGN Pep 05 AEKA 6 PGN Pep06 LVD-PSEQ-A-PGN Pep 06 AEKAGGGGG SEQ ID NO 7: QYIKANSKFIGITE = tetanus universal T cell epitope SEQ ID NO. 8: GGGGG = pentaglycine bridge
Example 3
[0135] Monoclonal antibodies (MABs) were developed against Mycobacterium tuberculosis Alpha Crystallin Heat Shock Protein. MAB LD7 (IgG2a) was derived from BALB/c MS 1435 immunized subcutaneously with TB Pep01 (Conserved Alpha Crystallin HSP), with Freund’s adjuvant. MAB CA6 (IgG2b) was derived from BALB/c MS 1435 immunized subcutaneously with TB Pep01 (Conserved Alpha Crystallin HSP), with Freund’s adjuvant.
[0136] PGN epitopes shown in Table 1 can be mixed and matched in varied combinations such as with or without a T cell epitope, to produce composite peptides and mixtures that could be formulated with adjuvants as MTB or Staph/Gram positive bacterial vaccines.
TABLE-US-00002 MTB, LAM, and Staphylococcus LTA Peptide Sequences SEQ ID NO Peptide number Peptide ID Peptide Sequence Description 9 TB Pep01 LvD-PSEQ-A-TB Pep 01 SEFAYGSFVRTVSLPVGADE Conserved MTB Alpha Crystallin HSP Epitope 10 TB Pep02 LvD-PSEQ-A-TB Pep 02 SEFAYGSFVRTVSLPVGADEGNLFIAPWGVIHHPHYEECSCY Conserved MTB Alpha Crystallin HSP Epitope and 2 conserved influenza HA epitopes and 1 conserved NA Epitope 11 LAM Pep01 LvD-PSEQ-A-LAM Pep 01 HSFKWLDSPRLR Conserved MTB Lipoarabinomanin Mimotope 12 LAM Pep02 LvD-PSEQ-A-LAM Pep 02 ISLTEWSMWYRH Conserved MTB Lipoarabinomanin Mimotope 13 LTA Pep01 LvD-PSEQ-A-LTA Pep 01 WRMYFSHRHAHLRSP LTA Epitope 14 LTA Pep02 LvD-PEQ-A-LTA Pep 02 WHWRHRIPLQLAAGR LTA Epitope SEQ ID No. 15: GNLFIAPWGVIHHPHYEECSCY = composite influenza peptide comprising HA and NA epitopes SEQ ID No. 16: SEFAYGSFMRSVTLPPGADE = M. smegmatis peptide sequence
[0137] MTB, LAM and Staphylococcus LTA epitopes shown in Table 2 are mixed and matched in combinations such as with or without a T cell epitope, to produce composite peptides and mixtures that are formulated with adjuvants as MTB or Staph/Gram positive bacterial vaccines.
[0138] MABs LD7 and CA6 showed highly specific binding to the alpha crystallin HSP (TB Pep01) and promoted opsonophagocytic killing of M. smegmatis (SMEG) (see
[0139]
[0140]
[0141]
[0142]
[0143] Mouse 1435 immunized with a conserved MTB alpha crystallin heat shock protein epitope developed serum antibodies that bound to a small synthesized alpha crystallin HSP peptide (TB Pep01). MAB LD7 (IgG2a) and MAB CA6 (IgG2b) that were subsequently produced from MS 1435 bound broadly to TB Pep01, TB Pep02 (composite peptide that constitutes TB Pep01, two conserved influenza hemagglutinin epitopes, and one conserved neuraminidase epitope), and M. smegmatis (
[0144] The HSP epitope elicited strong humoral responses in mice, with high serum antibody titers and subsequently generated two MABs - LD7 and CA6 (IgG2a and IgG2b isotypes, respectively). These MABs bound strongly to the HSP epitope (OD450nm of 3.0-3.5) but had low binding activity to fixed mycobacteria (OD450nm < 0.25). Notably, MABs LD7 and CA6 showed significantly increased binding activity to live SMEG, compared to fixed SMEG, and surprisingly demonstrated significant OPKA against SMEG at both low (0.1 .Math.g/mL) and high (200 .Math.g/mL) antibody concentrations.
[0145] The small conserved synthetic HSP epitope induced a robust humoral response in mice and generated two MABs that recognized live SMEG and demonstrated significant OPKA against SMEG at MAB concentrations as low as 0.1 .Math.g/mL. Immunization with this small conserved synthetic HSP epitope generates opsonic antibody responses against mycobacteria and provide important strategies for TB vaccines and therapeutics.
Example 4
Composite Peptide TB, Gram Positive Bacteria and Influenza/Coronavirus Vaccines
[0146] The 16.3 KD alpha crystallin heat shock protein (HSP16.3) belongs to the small heat shock protein (HSP20) family. It plays a major role for MTB survival, growth, virulence, and cell wall thickening. TB Pep 01 is a highly conserved region of HSP16.3 and immunization of mice induced antibodies that bind to mycobacteria and promote opsonophagocytic killing of M. smegmatis (see Example 3). Peptidoglycan is a cell wall component that is common across many bacteria and antibodies to PGN bind to MTB (and other gram-positive bacteria). Immunization of mice with ethanol killed MTB induced anti-PGN antibodies that promoted phagocytic killing of MTB. In addition, these antibodies bind to small PGN epitopes and composite antigens (Table 1). Cell wall PGN composite peptides and HSP16.3 the highly conserved peptide (TB Pep 01) are mixed and matched to produce composite peptides and mixtures with or without an added T cell epitope to provide vaccines to produce broadly protective immunity across large groups of bacteria (Table 3). In addition, combining HSP16.3 with PGN epitopes provides a TB vaccine that targets active MTB infection and latency. This vaccine is used alone or in combination with BCG as a booster vaccine with BCG, or other TB vaccines. In a similar fashion, LTA mimotopes combined with PGN epitopes provide an example of a broad composite peptide gram positive bacterial vaccine, while mixing coronavirus and influenza peptides provides a prototype composite peptide vaccine for prevention or treatment of infections by these viruses. (Table 3)
TABLE-US-00003 MTB, PGN, and Other Microbial Peptides and Composite Peptide Antigens SEQ ID NO Peptide number Peptide ID Peptide Sequence 17 TB Pep01 LVD-PSEQ-A-TB Pep 01 SEFAYGSFVRTVSLPVGADE 18 PGN.TB Pep01 LVD-PSEQ-A-PGN.TB Pep01 AEKAGGGGGAEKASEFAYGSFVRTVSLPVGADE 19 PGN.TB Pep02 LD-PSEQ-A-PGN.TB Pep02 AEKAGGGGGAEKASEFAYGSFVRTVSLPVGADEQYIKANSKFIGITE 20 PGN.TB Pep03 LD-PSEQ-A-PGN.TB Pep03 SEFAYGSFVRTVSLPVGADEAEKAGGGGGAEKA 21 PGN.TB Pep04 LD-PSEQ-A-PGN.TB Pep04 AEKAGGGGGSEFAYGSFVRTVSLPVGADEGGGGGAEKA 22 PGN.TB Pep05 LVD-PSEQ-A-PGN.TB Pep05 AEKAGGGGGSEFAYGSFVRTVSLPVGADEGGGGGAEKAQYIKANSKFIGITE 23 PGN.LT A Pep01 LVD-PSEQ-A-PGN.LTA PepOl WRMYFSHRHAHLRSPGGGGGAEKAGGGGGQYIKANSKFIGITE 24 PGN.LT A Pep02 LVD-PSEQ-A-PGN.LTA Pep02 WHWRHRIPLQLAGRAEKAGGGGGWRMYFSHRHAHLRSPQYIKANSKFIGITE 25 Coronavirus Pep05 LVD-PSEQ-A-Coronavirus Pep06 WDYPKCDRATEVETPIRNEHYEECSCYQYIKANSKFIGITE 26 Flu Pep03 LVD-PSEQ-A-Flu Pep03 GNLFIAP 27 Flu Pep06 LVD-PSEQ-A-Flu Pep06 WGVIHHP 28 Flu Pep 10 LVD-PSEQ-A-Flu Pep10 HYEECSCY 29 Coronavirus Pep13 LVD-PSEQ-A-Coronavirus Pep 13 YFPLQSYGFQPTNGVGYQPYR 30 Coronavirus Pep14 LVD-PSEQ-A-Coronavirus Pep 14 YFPLQSYGFQPTNGVGYQPYRQYIKANSKFIGITE 31 Coronavirus Pep15 LVD-PSEQ-A-Coronavirus Pep15 YQAGSTPCNGVEGFNCYFPLQ 32 Coronavirus Pep16 LVD-PSEQ-A-Coronavirus Pep16 YQAGSTPCNGVEGFNCYFPLQYIKANSKFIGITE 33 Flu Pep52 LVD-PSEQ-A-Flu Pep52 ETPIRNE 34 Flu Pep53 LVD-PSEQ-A-Flu Pep53 TEVETPIRNE 35 Flu Pep57 LVD-PSEQ-A-Flu Pep57 SLLTEVETPIRNEWGLLTEVETPIR 36 Coronavirus Pep 11 LVD-PSEQ-A-Coronavirus Pep 11 ENQKLIANTEVETPIRNEHYEECSCYQYIKANSKFIGITE
Description of Sequences Listed in Table 3
[0147] SEQ ID NO: 17. TB Pep 01- MTB 16.3HSP Conserved Region (CR).
[0148] SEQ ID NO: 18-23. PGN epitopes and MTB 16.3HSP (CR) with and without a T cell epitope. SEQ ID NO: 24 and 25. PGN and LTA peptides with a T cell epitope.
[0149] SEQ ID NO: 26. Coronavirus RNA polymerase and influenza matrix and neuraminidase (NA) peptides, with a T cell epitope.
[0150] SEQ ID NO: 27-28. Influenza peptides - 3 (Hemagglutinin, HA), 6 (HA), and 10 (NA).
[0151] SEQ ID NO: 29-32. Coronavirus peptides with and without a T cell epitope.
[0152] SEQ ID NO: 33-34. Influenza peptides - 52 and 53.
[0153] SEQ ID NO: 35. Influenza peptide 57.
[0154] SEQ ID NO: 36. Coronavirus spike protein epitope and influenza matrix and NA peptides with a T cell epitope.
Example 5
Composite Peptide Vaccines for Influenza and Other Viruses
[0155] An influenza composite vaccine comprising small-conserved epitopes such as HA, NA, or matrix peptide sequences induce broadly neutralizing antibodies across Group 1 and 2 Influenza A viruses. Combining one or more of these peptides with one or more small-conserved peptide sequences from two or more viruses (such as influenza and coronavirus) provides a prototype composite virus peptide vaccine that broadens the vaccine’s prevention or treatment capabilities to include more than one virus (Table 4). Combined influenza and coronavirus composite peptide vaccine antigens were synthesized and included the conserved influenza matrix and NA peptides plus the conserved coronavirus polymerase peptide (Cor Pep 05), or spike protein conserved sequence (Cor Pep 11) and a T cell epitope sequence (Table 4). The polymerase conserved epitope was also sequenced alone with the T cell epitope (Cor Pep 02). Mice were immunized with one, or more of these peptides formulated with ADDAVAX™ adjuvant and given by either subcutaneous (SQ) injection at a dose of 20 .Math.g,or Intradermal (ID) injection at 1 .Math.g,10 .Math.g,or 20 .Math.gon days 0, 21 and 35. Robust serum IgG1 and IgG2b antibodies were induced to the conserved influenza and coronavirus epitopes. In addition, the serum antibodies induced by both SQ (Study Q:
TABLE-US-00004 Microbial Peptides and Composite Peptide Antigens SEQ ID NO Peptide number Peptide ID Peptide Sequence 37 CorPep01 LVD-PSEQ-A-Cor Pep 01 WDYPKCDRA 38 CorPep02 LVD-PSEQ-A-Cor Pep 02 WDYPKCDRAQYIKANSKFIGITE 39 CorPep05 LVD-PSEQ-A-Cor Pep 05 WDYPKCDRATEVETPIRNEHYEECSCYQYIKANSKFIGITE 40 CorPep09 LVD-PSEQ-A-Cor Pep 09 ENQKLIAN 41 CorPep11 LVD-PSEQ-A-Cor Pep 11 ENQKLIANTEVETPIRNEHYEECSCYQYIKANSKFIGITE
Description of Sequences Listed in Table 4
[0156] SEQ ID NO: 37. RNA polymerase region, non-spike.
[0157] SEQ ID NO: 38. Conserved regions from the RNA polymerase, Tetanus T-cell epitope.
[0158] SEQ ID NO: 39. Conserved regions from the RNA polymerase + Flu Pep53 (M2), Flu Pep10, Tetanus T-cell epitope.
[0159] SEQ ID NO: 40. Epitopes on spike protein.
[0160] SEQ ID NO: 41. Conserved SARS epitopes, Flu Pep53 (M2), Flu Pep10, Tetanus T-cell epitope.
[0161] Other embodiments and uses of the invention will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. All references cited herein, including all publications and U.S. and foreign patents and patent applications, are specifically and entirely incorporated by reference including U.S. Pat. No. 9,821,047 entitled “Enhancing Immunity to Tuberculosis,” which issued Nov. 21, 2017, U.S. Pat. No. 9,598.462 entitled “Composite Antigenic Sequences and Vaccines” which issued Mar. 21, 2017, U.S. Pat. No. 10,004,799 entitled “Composite Antigenic Sequences and Vaccines” which issued Jun. 26, 2018, U.S. Pat. No. 8,652,782 entitled “Compositions and Method for Detecting, Identifying and Quantitating Mycobacterial-Specific Nucleic Acid,” which issued Feb. 18, 2014, U.S. Pat. No. 9,481,912 entitled “Compositions and Method for Detecting, Identifying and Quantitating Mycobacterial-Specific Nucleic Acid,” which issued Nov. 1, 2016, U.S. Pat. No. 8,821,885 entitled “Immunogenic Compositions and Methods,” which issued Sep. 2, 2014, U.S. Application Publication No. 2021/0246174 entitled Immunogenic Compositions to Treat and Prevent Microbial Infections published Aug. 12, 2021, U.S. Application Publication No. 2022/0118079 entitled Immunogenic Antigens published Apr. 21, 2022, and U.S. Application Publication No. 2022/0280634 entitled Vaccines for the Treatment and Prevention of Zoonotic Infections published Sep. 8, 2022, and all corresponding U.S. Provisional and continuation applications relating to any of the foregoing patents. The term comprising, wherever used, is intended to include the terms consisting and consisting essentially of. Furthermore, the terms comprising, including, containing and the like are not intended to be limiting. It is intended that the specification and examples be considered exemplary only with the true scope and spirit of the invention indicated by the following claims.