Immunization of cats to induce neutralizing antibodies against Fel d 1, the major feline allergen in human subjects Franziska Thoms, PhD, Gary T. Jennings,

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Immunization of cats to induce neutralizing antibodies against Fel d 1, the major feline allergen in human subjects Franziska Thoms, PhD, Gary T. Jennings, PhD, Melanie Maudrich, Monique Vogel, PhD, Stefanie Haas, MSc, Andris Zeltins, PhD, Regina Hofmann-Lehmann, DVM, Barbara Riond, DVM, Jonas Grossmann, PhD, Peter Hunziker, PhD, Antonia Fettelschoss-Gabriel, PhD, Gabriela Senti, MD, Thomas M. Kündig, MD, Martin F. Bachmann, PhD Journal of Allergy and Clinical Immunology Volume 144, Issue 1, Pages 193-203 (July 2019) DOI: 10.1016/j.jaci.2019.01.050 Copyright © 2019 The Authors Terms and Conditions

Journal of Allergy and Clinical Immunology 2019 144, 193-203DOI: (10 Journal of Allergy and Clinical Immunology 2019 144, 193-203DOI: (10.1016/j.jaci.2019.01.050) Copyright © 2019 The Authors Terms and Conditions

Fig 1 Expression of vaccine intermediates Fel d 1 protein and CuMVTT-VLP and Fel-CuMVTT vaccine analysis. A, Profile of SEC analysis of recombinantly expressed Fel d 1 after purification with PBS. B, Capture ELISA (INDOOR Biotechnology) showing OD values (450 nm) of a series of different concentrations of recombinant (rec) and natural (nat) Fel d 1. C, Basophil Activation Test. Upregulation of the degranulation marker CD63 of blood-derived basophils from patients with cat allergy on incubation with either recombinant or natural Fel d 1 protein was measured. Controls included unstimulated, anti-FcεRI antibody stimulation, and N-formyl-methionyl-leucyl-phenylalanine (fMLP). D, Electron microscopic image of purified CuMVTT-VLP. E, SDS-PAGE analysis (NuPAGE 4-12% Bis-Tris) under denaturing and reducing conditions of the Fel-CuMVTT vaccine. Lane 1, Molecular weight marker (Invitrogen SeeBlue Pre-stained); lane 2, CuMVTT-CP, approximately 24.5-kDa monomer, 5 μg; lane 3, CuMVTT-CP crosslinked with SMPH, 5 μg; lane 4, Fel d 1, 20 kDa, 5 μg; and lane 5, Fel-CuMVTT vaccine, 5 μg of VLP or 8.6 μg of total protein. Journal of Allergy and Clinical Immunology 2019 144, 193-203DOI: (10.1016/j.jaci.2019.01.050) Copyright © 2019 The Authors Terms and Conditions

Fig 2 Immunization of cats with Fel-CuMVTT vaccine. A, Immunization scheme describing the immunization and subsequent boosting study. B-H, Antibody titers determined by using an indirect ELISA are reported as OD50 values. B, Serum IgG antibody titers against natural Fel d 1 protein of cats 1 to 3 (group 1). C, Serum IgG antibody titers against CuMVTT-VLP of cats 1 to 3 (group 1). D, Serum IgG antibody titers against natural Fel d 1 protein of cats 4 to 6 (group 2). E, Serum IgG antibody titers against CuMVTT-VLP for cats 4 to 6 (group 2). F, Serum IgG antibody titers against natural Fel d 1 protein of cats 2, 3, and 5. G, Serum IgG antibody titers against CuMVTT-VLP of cats 2, 3, and 5. H, Anti–Fel d 1 IgG in cat sera of 54 cats obtained from 4 different cat studies. Significance was determined by using a 2-tailed paired t test comparing all 54 cats before immune serum with first vaccination, first with second vaccination, and second with third vaccination. Journal of Allergy and Clinical Immunology 2019 144, 193-203DOI: (10.1016/j.jaci.2019.01.050) Copyright © 2019 The Authors Terms and Conditions

Fig 3 Characterization of antibodies induced by Fel-CuMVTT vaccination in cats. A and B, Mean OD50 antibody titers measured against natural (nat) and recombinant (rec) Fel d 1 by using a capture ELISA (Fig 3, A) or indirect ELISA (Fig 3, B; n = 3). C, Interaction of serum antibodies from immunized cats with Fel d 1 antigen measured by using surface plasmon resonance. D, Three-dimensional structure of Fel d 1 tetramer (or homodimer) exhibiting the identified epitopes of antibodies found in cat sera upon Fel-CuMVTT vaccination by using linear epitope mapping. Green denotes chain 1 and blue denotes chain 2 of the Fel d 1 heterodimer. The location of the consensus epitope is shown in red, and the minor epitope is shown in orange. Journal of Allergy and Clinical Immunology 2019 144, 193-203DOI: (10.1016/j.jaci.2019.01.050) Copyright © 2019 The Authors Terms and Conditions

Fig 4 Neutralizing ability of Fel d 1–specific antibodies induced in cats on Fel-CuMVTT vaccination. A, Neutralization assay based on a capture ELISA to measure Fel d 1 protein. Recombinant (rec) Fel d 1 was assayed either alone or mixed with preimmune (day 0) serum or postimmune (day 42) serum from a cat immunized with 100 μg of Fel-CuMVTT on days 0 and 21, or 100 ng/mL anti–Fel d 1 mAb A044. OD values at 450 nm are shown. P values were obtained by using a paired t test. B, Ear skin prick test. Mice received anti–Fel d 1 IgE clones A044 and F127. Transfer of IgG-purified preimmune or postimmune serum from 2 cats enrolled to a Fel-CuMVTT immunogenicity study were performed. The control group received only the anti–Fel d 1 IgE. Extravasation of Evan's blue dye was quantified by using OD measurements at 595 nm. There were 3 mice in the control group. Mice tested with preimmune sera of 2 cats, n = 6; mice tested with postimmune sera of 2 cats, n = 6. Significance was determined by using a 2-tailed Mann-Whitney test. Journal of Allergy and Clinical Immunology 2019 144, 193-203DOI: (10.1016/j.jaci.2019.01.050) Copyright © 2019 The Authors Terms and Conditions

Fig 5 Reduction of Fel d 1 in cat tear extracts. Tears of immunized cats were collected by using STT stripes and analyzed for Fel d 1 levels. A, Meta-analysis of Fel d 1 in tear extracts of 18 immunized cats from 3 different studies measured by using a quantitative ELISA (INDOOR Biotechnologies). Fel d 1 levels were normalized to milligrams of tears. Significance was determined by using a 1-way ANOVA, followed by a Wilcoxon matched-pairs signed-rank test. B, Measurement of Fel d 1 levels in tear extracts of a group of 4 cats in a previous cat study. Fel d 1 amounts were normalized to milligrams of tears. P values were obtained by using a Wilcoxon matched-pairs signed-rank test. C, Reduction of Fel d 1 levels in percentages in tear extract solutions before (day 0) and after (day 42) immunization of 4 cats measured by means of ELISA or mass spectrometry. Significance was determined by using a 2-tailed paired t test. D, Spectrum of the mass spectrometric analysis of light and heavy peptide ALPVVLENAR to quantify Fel d 1 in tear extract solutions collected on day 0 or day 42. E, Basophil Activation Test assay was performed with blood from patients with cat allergy mixed with tear extracts from cats from before (day 0) and after (day 42) immunization. Tear extract solutions were diluted to the same Fel d 1 concentrations and tested to determine at which dilution 50% of basophil activation was achieved. The dilution of a certain Fel d 1 concentration that achieved 50% basophil activation was then related to the actual collected amount of the tear sample (milligrams of tears to achieve 50% activation). Significance was obtained by using a paired t test. Journal of Allergy and Clinical Immunology 2019 144, 193-203DOI: (10.1016/j.jaci.2019.01.050) Copyright © 2019 The Authors Terms and Conditions