Pediatric Measles Vaccine Expressing a Dengue Antigen Induces Durable Serotype-specific Neutralizing Antibodies to Dengue Virus

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Abstract
Dengue disease is an increasing global health problem that threatens one-third of the world's population. Despite decades of efforts, no licensed vaccine against dengue is available. With the aim to develop an affordable vaccine that could be used in young populations living in tropical areas, we evaluated a new strategy based on the expression of a minimal dengue antigen by a vector derived from pediatric live-attenuated Schwarz measles vaccine (MV). As a proof-of-concept, we inserted into the MV vector a sequence encoding a minimal combined dengue antigen composed of the envelope domain III (EDIII) fused to the ectodomain of the membrane protein (ectoM) from DV serotype-1. Immunization of mice susceptible to MV resulted in a long-term production of DV1 serotype-specific neutralizing antibodies. The presence of ectoM was critical to the immunogenicity of inserted EDIII. The adjuvant capacity of ectoM correlated with its ability to promote the maturation of dendritic cells and the secretion of proinflammatory and antiviral cytokines and chemokines involved in adaptive immunity. The protective efficacy of this vaccine should be studied in non-human primates. A combined measles–dengue vaccine might provide a one-shot approach to immunize children against both diseases where they co-exist. Dengue is a tropical emerging disease that threatens one-third of the world's population, mainly children under the age of 15. The development of an affordable pediatric vaccine that could provide long-term protection against all four dengue serotypes remains a global public health priority. To address this challenge, we evaluated a strategy based on the expression of a minimal dengue antigen by live attenuated measles vaccine (MV), one of the most safe, stable, and effective human vaccines. As a proof-of-concept, we constructed a MV vector expressing a secreted dengue antigen composed of the domain III of the envelope glycoprotein (EDIII), which contains major serotype-specific neutralizing epitopes, fused to the ectodomain of the membrane protein (ectoM) from DV-1, as an adjuvant. This vector induced in mice durable serotype-specific virus-neutralizing antibodies against DV1. The remarkable adjuvant capacity of ectoM to EDIII immunogenicity was correlated to its capacity to mature dendritic cells, known to initiate immune response, and to activate the secretion of a panel of cytokines and chemokines determinant for the establishment of specific adaptive immunity. Such strategy might offer pediatric vaccines to immunize children simultaneously against measles and dengue in areas of the world where the diseases co-exist.