DISEASE STATES AND VACCINES: SELECTED CASES

Compared with conventional microbiological approaches, the genome analysis of meningococcus B allowed the identification of a higher number of novel surface-exposed proteins, which are highly conserved among distantly related strains and serotypes, and are also able to induce bactericidal antibodies. These antigens are the basis for the clinical development of a vaccine not only against group B N. meningitidis, but also against serogroups, and species of pathogenic Neisseria. When meningococcus causes invasive disease in a susceptible individual, the process involves invasion of the respiratory tract epithelia, and the underlying endothelia of the microvascular system, followed by systemic dissemination via bloodstream. The outcome is life-threatening septicemia, and metastatic spread to the meninges, and cerebrospinal fluid (meningitis). The meningococcus experience represents the first success of reverse vaccinology, and shows the potential of the use of genome analysis for vaccine development, suggesting an approach applied to microorganisms for which vaccines are not available. In fact, the success of the MenB project has been recently used to identify potential vaccine candidates for Streptococcus pneumoniae and Porphyromonas gingivalis. © 2003 Elsevier Inc. All rights reserved.