Direct intranodal tonsil vaccination with modified vaccinia Ankara vaccine protects macaques from highly pathogenic SIVmac251

Human immunodeficiency virus (HIV) is a mucosally transmitted virus that causes immunodeficiency and AIDS. Developing efficacious vaccines to prevent infection is essential to control the epidemic. Protecting the vaginal and rectal mucosa, the primary routes of HIV entry has been a challenge given the significant compartmentalization between the mucosal and peripheral immune systems. We hypothesized that direct intranodal vaccination of mucosa associated lymphoid tissue (MALT) such as the readily accessible palatine tonsils could overcome this compartmentalization. Here we show that rhesus macaques primed with plasmid DNA encoding SIVmac251-env and gag genes followed by an intranodal tonsil MALT boost with MVA encoding the same genes protects from a repeated low dose intrarectal challenge with highly pathogenic SIVmac251; 43% (3/7) of vaccinated macaques remained uninfected after 9 challenges as compared to the unvaccinated control (0/6) animals. One vaccinated animal remained free of infection even after 22 challenges. Vaccination was associated with a similar to 2 log decrease in acute viremia that inversely correlated with anamnestic immune responses. Our results suggest that a combination of systemic and intranodal tonsil MALT vaccination could induce robust adaptive and innate immune responses leading to protection from mucosal infection with highly pathogenic HIV and rapidly control viral breakthroughs.

Automated summary

HIV is a virus that causes immunodeficiency and AIDS, and developing vaccines to prevent infection is crucial. We hypothesized that vaccinating mucosa associated lymphoid tissue (MALT) such as the palatine tonsils could overcome the compartmentalization between mucosal and peripheral immune systems. Our study in rhesus macaques showed that priming with plasmid DNA and boosting with MVA in the tonsil MALT protected against SIVmac251 infection, with 43% remaining uninfected after 9 challenges. Vaccination was associated with reduced viremia and enhanced immune responses. This combination approach could provide protection from mucosal infection with highly pathogenic HIV.