Development of subunit vaccines for group A streptococcus

Abstract

There is currently no available vaccine to prevent infection with Streptococcus pyogenes (also known as group A streptococcus, GAS), which can lead to the life-threatening diseases rheumatic fever (RF) and rheumatic heart disease (RHD). RF and RHD occur worldwide with many populations of developing countries and indigenous populations of developed countries experiencing particularly high rates of these diseases. The majority of research efforts to develop a GAS vaccine are based on targeting the bacterial surface antigen called M protein. However, since the M protein contains host tissue cross-reactive B and T cell epitopes, whole M protein antigen vaccine approaches are not a viable option because of the potential to induce autoimmunity. This chapter will discuss the various subunit vaccine approaches based on the M protein that are being investigated towards the development of a highly effi cacious GAS vaccine that includes the different delivery technologies, formulations and adjuvants used to administer these vaccine candidates in preclinical studies, and clinical development.