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Background  The mediators of protection against cholera, a severe dehydrating illness of humans caused by  Vibrio cholerae , are unknown. We have previously shown that plasma IgA as well as memory B IgG cells targeting lipopolysaccharide (LPS) of  Vibrio cholerae  O1 correlate with protection against  V .  cholerae  O1 infection among household contacts of cholera patients. Protection against cholera is serogroup specific, and serogroup specificity is defined by the O-specific polysaccharide (OSP) component of LPS. Therefore, we prospectively followed household contacts of cholera patients to determine whether OSP-specific immune responses present at the time of enrollment are associated with protection against  V .  cholerae  infection.    Methodology  In this study, we enrolled two hundred forty two household contacts of one hundred fifty index patients who were infected with  Vibrio cholerae . We determined OSP-specific memory B cells and plasma IgA, IgG and IgM antibody responses on study entry (day 2).    Principle findings  The presence of OSP-specific plasma IgA, IgM, and IgG antibody responses on study entry were associated with a decrease in the risk of infection in household contacts (IgA, p = 0.015; IgM, p = 0.01, and IgG, p = 0.024). In addition, the presence of OSP-specific IgG memory B cell responses in peripheral blood on study entry was also associated with a decreased risk of infection (44% reduction; 95% CI: 31.1 to 99.8) in contacts. No protection was associated with cholera toxin B subunit (CtxB)-specific memory B cell responses.    Conclusion  These results suggest that immune responses that target OSP, both in plasma and memory responses, may be important in mediating protection against infection with  V .  cholerae  O1.

plos neglected tropical diseases

Plasma and memory B cell responses targeting O-specific polysaccharide (OSP) are associated with protection against Vibrio cholerae O1 infection among household contacts of cholera patients in Bangladesh