| Abstract: | The four dengue virus (DENV) serotypes, DENV-1, -2, -3, and -4, are endemic throughout tropical and subtropical regions of the world, with an estimated 390 million acute infections annually. Infection confers long-term protective immunity against the infecting serotype, but secondary infection with a different serotype carries a greater risk of potentially fatal severe dengue disease, including dengue hemorrhagic fever and dengue shock syndrome. The single most effective measure to control this threat to global health is a tetravalent DENV vaccine. To date, attempts to develop a protective vaccine have progressed slowly, partly because the targets of type-specific human neutralizing antibodies (NAbs), which are critical for long-term protection, remain poorly defined, impeding our understanding of natural immunity and hindering effective vaccine development. Here, we show that the envelope glycoprotein domain I/II hinge of DENV-3 and DENV-4 is the primary target of the long-term type-specific NAb response in humans. Transplantation of a DENV-4 hinge into a recombinant DENV-3 virus showed that the hinge determines the serotype-specific neutralizing potency of primary human and nonhuman primate DENV immune sera and that the hinge region both induces NAbs and is targeted by protective NAbs in rhesus macaques. These results suggest that the success of live dengue vaccines may depend on their ability to stimulate NAbs that target the envelope glycoprotein domain I/II hinge region. More broadly, this study shows that complex conformational antibody epitopes can be transplanted between live viruses, opening up similar possibilities for improving the breadth and specificity of vaccines for influenza, HIV, hepatitis C virus, and other clinically important viral pathogens.The four dengue virus serotypes (DENV-1, -2, -3, and -4), transmitted by Aedes spp. mosquitoes, are endemic throughout tropical and subtropical regions of the world, with an estimated 390 million new infections annually (1). Primary infection with one serotype confers long-term immunity against that serotype, but repeat infection with a different serotype has an increased risk of potentially fatal severe dengue disease (2), including dengue hemorrhagic fever and dengue shock syndrome. This risk has been attributed, at least in part, to the ability of some cross-reactive antibodies to enhance infection of Fc-receptor bearing cells. The consensus is that, to be safe and effective, any dengue vaccine must simultaneously induce neutralizing antibodies (NAbs) to all four serotypes. However, DENV vaccine development has progressed slowly, highlighted by the disappointing results of the live-attenuated Sanofi Pasteur tetravalent DENV vaccine trial in Thailand (3). Progress is hindered, in part, because the epitopes targeted by the type-specific human NAbs critical for long-term protection (4, 5) remain poorly defined, limiting our understanding of natural DENV immunity and slowing effective vaccine development.The DENV envelope glycoprotein (E) () is the major surface-exposed DENV antigen and the principle target of NAbs. The E structure consists of three distinct domains: I, II, and III (EDI, EDII, and EDIII) (6, 7); EDIII is a continuous peptide extending from domain I and forming an Ig-like fold, whereas EDI and EDII are discontinuous and connect by four peptide linkers that form the EDI/EDII hinge. We and others have recently described potent human DENV NAbs that bind to epitopes around the EDI/EDII hinge (8, 9). To more fully explore the significance of this antigenic region, we used reverse genetics and synthetic biology to transplant the EDI/EDII antigenic region from DENV-4 into a DENV-3 background and showed by both gain- and loss-of-function assays that the EDI/EDII hinge region is the primary target of the long-lived DENV serotype-specific NAb response.Open in a separate window(A) Cartoon representation of the DENV-3 E dimer with EDI (red), EDII (yellow), and EDIII (blue). The EDI/EDII hinge region is circled. Location of the critical residues associated with escape mutations and mutagenesis-mapped 5J7 residues are shown. Residues critical for 5J7 binding identified by shotgun mutagenesis loss of binding of E glycoprotein expressed in HEK-293T cells are shown in magenta. Mutations associated with both viral escape from 5J7 and loss of binding in HEK-293T cells (L53 and K128) are shown in orange, and the single residue identified by escape mutation alone (Q269K270_insK) is shown in cyan. All critical residues were individually identified but are shown on a single E dimer for simplicity. (B) Cartoon representation of the DENV E dimer with the locations of variable EDI/EDII hinge residues transplanted between rDENV-3 and rDENV-4 to make rDENV-3/4 shown in green. (C) Primary sequence alignment and secondary structure of rDENV-3 E, rDENV-3/4 E, and rDENV-4 E. Secondary structure is indicated above the primary sequence and color-coded to the corresponding domains on the tertiary structure (A and B). Arrows indicate β-sheets, cylinders indicate helices, and lines indicate spanning loops and strands. Binding, escape, and hinge residues shown in A and B are indicated by corresponding colors in the rDENV-3 sequence. Amino acid residues transplanted between rDENV-3/4 and rDENV-4 are indicated in green for both sequences. |
