Vaccination with mycobacterial lipid loaded nanoparticle leads to lipid antigen persistence and memory differentiation of antigen-specific T cells

Reviewer #1 (Public Review):

It is well established that tuberculosis (TB), which is caused by Mycobacterium tuberculosis (Mtb), is a leading cause of mortality and morbidity worldwide. However, the only vaccine licensed against tuberculosis is Bacille Calmette Guerin (BCG), has been around for nearly a century, and has limited efficacy in adults. Herein, the authors sought to investigate the effectiveness of a nanoparticle-based formulation of a subunit vaccine composed of Mtb lipid and protein antigens. The authors found that they were able to load the lipid, mycolic acid, into their nanoparticles without disrupting the architecture, and that the loaded particles activated T cells both in vitro and in vivo. Moreover, when they vaccinated with particles loaded with both lipid and protein antigens, they found that the lipid antigen persisted, and mycolic acid-specific T cells were able to be activated 6 weeks post-vaccination, in contrast to peptide-specific T cells. The authors investigated further and found that persistence required the nanoparticle encapsulation, rather than free lipid, and that it was independent of route (intratracheal, intravenous, or subcutaneous) of administration. To address the mechanisms underlying antigen persistence, the authors loaded the nanoparticles with a dye and demonstrated that the nanoparticle encapsulated lipid antigen was primarily stored in lung alveolar macrophages and that CD1b+ dendritic cells presented the antigen to mycolic acid specific T cells. Finally, the authors conducted mixed bone marrow chimera studies to examine the phenotype of the mycolic acid specific T cells and found that the memory T cell population phenotypically resembled T follicular helper, regulatory T cells, and exhausted T cells. Interestingly, while a large percentage of these lipid antigen specific T cells in the lymph nodes, lung and spleen were CXCR5+PD1+, the cells were still proliferating (Ki67+). Overall, this is a comprehensive study that has the potential to significantly enhance the field.

Reviewer #2 (Public Review):

The work presented here by Morgun et al is performed in the context of vaccine development, a field especially active in the context of tuberculosis (TB). The generation of a new vaccine either enhancing or replacing the 100-year-old BCG is urgently needed.

Most subunit vaccines integrate protein antigens formulated with adjuvants and there are few examples on the performance of subunit vaccines integrating lipid antigens. Considering the hydrophobic and lipid nature of the mycobacterial cell envelope studies assessing the suitability of mycobacterial lipids in vaccine formulations may contribute to generate new vaccines to tackle the disease.

The mycobacterial lipid antigens under study are mycolic acids (MA), which are located at the cell wall covalently linked to arabinogalactan. These lipids carry extremely long chain fatty acids of up to 60-90 carbons.

The group has previously shown that formulating MA into micellar nanocarriers and vaccinating mice intranasally it could activate CD1-restricted T cells. However, this formulation did not allow for the incorporation of protein antigens.

This work is novel, and it brings new data of high relevance for the TB vaccine field pointing to alternative formulations and antigens and immune mechanisms.

Authors assay different routes of vaccination but the main results are obtained using non-conventional vaccination routes. Although, it maybe out of the scope of the paper, no protection studies are provided.

Several recommendations are given to improve the quality and the readability of the manuscript.

1. Authors elaborate the introduction solely highlighting the relevance of antigen persistence in the context of vaccination. However, it is well known that several mycobacterial antigens (Lipids and proteins) can cause detrimental responses when overexposed to the immune system. In this regard, it would be appropriate to introduce the possibility of the occurrence of exhaustion when prolonged exposure to antigens is happening, which is the main theme of this paper.

2. Authors need to provide more information about the source of MA. It is briefly mentioned in the materials and methods section that it was obtained from Sigma. If that is the case, it would be ideal to show the integrity of the polysaccharide in term of balance and abundance between different MA species.

3. Building up on the previous comment, MA is a complex mixture of polysaccharides including multiple lengths of fatty acids and modifications. Could the authors comments on the potential variability of MA structure and potential impact on immune responses?

4. How do the authors explain the lack of stimulation of cell proliferation induced by MA-PLGA formulation? Does this result contradict previous findings?

5. Fig 3. Authors switch to IT administration simply arguing against the limitation of IN delivery regarding its low volume. However, administration via IN could be done in an iterative manner. According to this change, this reviewer asks whether the performance of MA-PLGA could now be comparable to BCN-MA using IT instead.

6. What would be the reasons of the no role of encapsulating NP in the persistence of MA?

7. Authors need to discuss to what extent the MA location into AM is route dependent.

8. Also, AM are programmed to sustain low immune responses because of their unique location in the lung. In fact, Mtb uses this to replicate while immune response is mounted. In this regard, accumulation of MA into this compartment may not be relevant for the overall immune response. In other words, what would be the contribution of this population to the T cell activation?

9. Could the T cells responses measured be due to the reduced fraction of DC loaded with BCN-MA at initial time points?