Adjuvant Mucosal Strategies Confer Safe and Effective Immunity Against Mycoplasma pneumoniae and Overcome...

The global spread of Mycoplasma pneumoniae (MP) poses a significant threat to public health; however, no licensed vaccine for human use is currently available. The development of a safe and effective vaccine is a critical priority. This study systematically evaluated the protective efficacy and safety of an inactivated MP vaccine using different adjuvants and immunization routes.

Mice were immunized with inactivated vaccines via either intramuscular (IM) injection with aluminum hydroxide (alum) or a combination of CpG+QS21 (CQ) or via intranasal (IN) administration of Flagellin from Salmonella Typhimurium (FLA-ST), a potent Toll-like receptor 5 (TLR5) agonist, as a mucosal adjuvant. Vaccine-induced immunogenicity, protective efficacy against MP challenge, and associated lung pathology were assessed.

Both IM-vaccinated groups (alum and CQ) exhibited robust systemic immune responses. However, upon subsequent MP challenge, these groups exhibited significant inflammatory pathology in the lung tissues. Notably, the CQ-adjuvanted group displayed severe pulmonary inflammatory infiltration. In stark contrast, compared with the IM-vaccinated group, the IN-immunized group with the FLA-ST mucosal adjuvant achieved significant clearance of MP from the lungs and showed markedly milder histopathological lung damage.

Our findings suggest that IM immunization with CQ-adjuvanted inactivated vaccines may represent a suboptimal strategy for MP, given the risk of exacerbating lung immunopathology. Conversely, a mucosal immunization approach using the FLA-ST adjuvant demonstrates considerable promise, offering an effective balance between bacterial clearance and an improved safety profile, highlighting its potential for future MP vaccine development.