CA3147314A1 - Methods of making and using lipooligosaccharide compositions and vaccines - Google Patents

Abstract

The present invention relates generally to compositions and methods for treating and/or preventing gonococcal infection and/or gonorrhea disease in a subject. The invention further relates to providing transformed microbial host cells (e.g., bacterial cells) that have been engineered to produce modified and/or non-naturally occurring neisserial lipooligosaccharides through stable integration of genetic sequences. The invention still further relates to immunogenic compositions and vaccines that comprise, in pertinent part, N. gonorrhoeae derived lipooligosaccharide(s).

Description

METHODS OF MAKING AND USING LIPOOLIGOSACCHARIDE
COMPOSITIONS AND VACCINES
CROSS REFERNCE TO RELATED APPLICATIONS
This application claims the benefit of U.S. Provisional Application No.
62/871,472, filed 8 July 2019 and U.S. Provisional Application No. 62/872,973, filed 11 July 2019 each of which is incorporated by reference herein in its entirety.
FIELD OF THE INVENTION
The present invention relates generally to compositions and methods for treating and/or preventing gonococcal infection and/or gonorrhea disease in a subject The invention further relates to providing transformed microbial host cells (e.g., bacterial cells) that have been engineered to produce modified and/or non-naturally occurring Neisseria lipooligosaccharides through stable integration of genetic sequences. The invention still further relates to immunogenic compositions and vaccines that comprise, in pertinent part, Neisseria gonorrhoeae derived lipooligosaccharide(s).
BACKGROUND OF THE INVENTION
Neisseria gonorrhoeae ("N. gonorrhoeae") is a Gram-negative bacterial pathogen that is the causative agent of the sexually transmitted disease known as gonorrhea.
Gonorrhea is a common infection especially among sexually active 15-24 year-old individuals. In fact, gonococcal infection and gonorrhea disease are major public health concerns in the U.S. and globally that are exacerbated by growing multiple drug-resistance in the causative organism.
In 2017 more than 550,000 new cases of gonorrhea were reported to the U.S.
Centers for Disease Control 'CDC"), representing a 67% percent increase from 2013, while the World Health Organization ("WHO") estimates the global yearly incidence of gonorrhea at approximately 106.1 million cases and some experts think the number is even higher at around 176 million cases.
N. gonorrhoeae typically infects the mucosal surfaces of the genitals, rectum, throat, and in rare circumstances, the infection can spread through the bloodstream resulting in a disseminated gonococcal infection ("DGr). Men infected with gonorrhea typically experience painful and/or frequent urination, off colored and purulent discharge, and inflammation of the genitals. Women typically also suffer discomfort during urination as well as inter menses bleeding, abnormal vaginal discharge, and abdominal or pelvic pain. Similar symptoms effect both sexes when the infection is localized in the eyes (conjunctivitis), throat, (painful and swollen lymph nodes), and rectum (discharge and itching). A percentage of men infected with the disease are asymptomatic. And some infected women fail to experience or outwardly present with any symptoms of infection. Often the symptoms experienced by women are only mild and can be mistaken for more common bladder or vaginal infections.
Serious long-term complications in women suffering with N. gonorrhoea&
infection include pelvic inflammatory disease, ectopic pregnancy, and infertility.
While the prevalence of the disease in pregnant women in the U.S. is generally low (less than 1%), its prevalence in certain subsets of the population remains a matter of great concern. Indeed, rates of nearly 10% have been observed in some central city adolescent prenatal clinics. Outside of the U.S., especially in developing countries, the incidence of pregnant women infected with gonorrhea can be even greater. Pregnant women infected with gonorrhea can pass the disease to their babies during labor and delivery.
The risk of transmitting the disease to a newborn is well studied in the case of ophthalmia neonatorum and runs about 30%-40%. The risk of disseminated gonococcal infection (e.g., sepsis or arthritis) in newborns has not been widely studied, and while probably relatively rare, it is not negligible. (See, Alexander ER, "Gonorrhea in the newborn," Ann. N.Y. Acad.
Sci., 549:180-186 (1988)).
Antibiotic treatment of gonorrhea has been complicated by the ability of the causative organism to develop resistance to antibiotics used for treatment. Resistance in N.
gonorrhoea& to fluoroquinolones began to emerge in the U.S. in the 1990s and 2000s, and by 2007 the CDC stopped recommending fluoroquinolones for treatment. This move left the cephalosporin antibiotics as the only remaining class of antimicrobials recommended for treating the disease. Further, in 2010 the CDC's gonorrhea treatment guidelines were again amended to reflect the concern about the growing antibiotic resistance in frequently co-occurring pathogens (e.g., Chlamydia trachomatis) to thusly include oral administration of azithromycin or doxycycline in addition to third generation cephalosporins (e.g., ceftriaxone 250 mg or cefixime 400 mg).
Antimicrobial resistance in N. gonoffhoeae is not a new phenomena, it has been growing steadily since the 1940s and there have been frequent emergence of multidrug-resistant strains. (See, Lewis DA, "Global resistance of Neisseria gonorrhoeae: when theory becomes reality," Curr. Opin. Infect. Dis., 27(1):62-67 (2014); and Bolan GA, et aL, "The Emerging Threat of Untreatable Gonococcal Infection," N. Engl. J. Med., 366:485-487 (2012)). As N. gonorrhoeae resistance to ceftriaxone increases and high-level macrolide resistance spreads, the state of treatment is precariously disposed to return to the pre-antibiotics era where this common infection could not be treated and there was considerable morbidity (pelvic inflammatory disease) and infertility in women and urethral strictures and renal insufficiency in men.

2 Several challenges to developing a successful gonorrhea vaccine exist in the laboratory and in the characteristics of causative organism itself. These challenges include the lack of strong correlates of protection, the lack of suitable animal models, the organism's high antigenic variability, and the typical confinement of the gonococcal infection to mucosa!
surfaces. Additionally, N. gonorrhoeae interacts with innate immune cells such as macrophage and dendritic cells to elicit inflammatory responses while suppressing Th1iTh2 mediated specific immune responses, although localized non-specific and non-memory inducing antibody responses do occur. (See, Jerse AE, et at, "Vaccines against gonorrhea:
current status and future challenges," Vaccine, 32(14):1579-1587 (2014)).
Gonococcal infection does not induce protective immunity and repeated infections are common.
(Plummer FA, et at, "Epidenniologic evidence for the development of serovar-specific immunity after gonococcal infection," J. Clin. Invest., 83:1472-1476(1989)).
Thus far, the administration of meningococcal vaccines has not provided protection against gonococcal infection or gonorrhea and the innmunogens in meningococcal vaccines have, again thus far, generally been considered unsuitable for protection against N.
gonorrhoeae. (Jerse, et at, supra).
The increase of antibiotic resistance and emergence of untreatable gonococcal strains emphasizes the need for the development of new and efficacious vaccines against N.
gonorrhoeae. Accordingly, there is a need for compositions (e.g., immunogenic compositions and vaccines) and therapeutic methods that protect against N. gonorrhoeae infection and gonorrhea. Preferred compositions and methods in this regard would be administered in one or more doses as vaccines (e.g., to prevent and/or attenuate infection) or as therapeutic compositions (e.g., to treat and/or cure disease).
BRIEF DESCRIPTION OF TFIE DRAWINGS
Figure 1 shows an exemplary LOS molecule with a Lacto-N-neotetraose (nLc4) a chain and no 13 chain extension. The nLc4 a chain consists of lactose (Lc2) and N-acetyl lactosamine (LacNAc) and extends from Hep1. The p chain would extend from C3 of Hep2, which is substituted by the Ra phosphoethanolamine (PEA) in the Figure. The N-acetyl glucosamine (GIcNAc) is the y chain, which is not extended_ Figure 2 shows the GaINAc-nLc4 a chain and the addition of the non-reducing terminal GaINAc. Each sugar conforms a separate antigen: the nLc4 a chain presents four separate antigens, in order from the non-reducing terminus, nLc4, nLc3, Lc2 and 6-Glc.
(Plummer FA, et al., "Epidemiologic evidence for the development of serovar-specific immunity after gonococcal infection," J. Clin. Invest., 83:1472-1476(1989);
and Schmidt KA, et at, "Experimental gonococcal urethritis and reinfection with homologous gonococci in male volunteers," Sex Transm. Dis., 28(10):555-564 (2001)). The GaINAc-nLc4 a chain has

3 a fifth antigen, the terminal GaINAc, and the I and y chains present additional antigens.
(Schneider H, et at, "Expression of paragloboside-like lipooligosaccharides may be a necessary component of gonococcal pathogenesis in men," J. Exp. Med., 174:1601-(1991)). This Figure further shows Lc2 conforms the antigen recognized by mAb wherein binding of this mAb to Lc2 is enhanced by the presence of a parallel a-lactose 13 chain. N. gonorrhoeae strains isolated from blood cultures (DGI strains) frequently make LOS with a-lactose 13. chains (Gibson BW, et al., "Structure and heterogeneity of the oligosaccharides from the lipooligosaccharides of a pyocin-resistant Neisseria gonorrhoeae,"
Proc. Natl. Acad. Sci. USA, 86:17-21 (1989); Yamasaki R, etal., "The structure of lipooligosaccharide produced by Neisseria gonorrhoeae, strain 15253 isolated from a patient with disseminated infection: Evidence for a new glycosylation pathway of the gonococcal lipooligosaccharide" J. Biol. Chem., 269(48):30345-30351 (1994); and Yamasaki R, at at, "Structural and immunochemical characterization of a Neisseria gonorrhoeae epitope defined by a monoclonal antibody 2C7; the antibody recognizes a conserved epitope on specific lipooligosaccharides in spite of the presence of human carbohydrate epitopes," J.
Biol. Chem., 274(51):36550-36558 (1999)).
Figure 3 shows the high-level organization of the Neisseria Igt operon.
Figure 4 shows an exemplary organization of the Neisseria lgt operon as described in Braun DC and Stein DC. (See, Braun DC and Stein DC, "The IgtABCDE gene cluster, involved in lipooligosaccharide biosynthesis in Neisseria gonorrhoeae, contains multiple promoter sequences," J. Bacteriol., 186(4):1038-1049 (2004)).
Figure 5 shows silver-stained F62 LOS separated through SDS-PAGE.
Figure 6 shows an assay using LOS from pyocin-selected mutants of gonococcal strain 1291, denominated 1291a-e to charge immunofluorescent microspheres that bind antibodies specific for four of the five LOS a chain antigens, nLc4, nLc3, Lc2 and 13-G1c.
SUMMARY OF THE INVENTION
The present invention relates generally to compositions and methods for treating and/or preventing gonococcal infection and/or gonorrhea disease in a subject.
The invention further relates to providing transformed microbial host cells (e.g., bacterial cells) that have been engineered to produce modified and/or non-naturally occurring Neisseria lipooligosaccharides through stable integration of genetic sequences. The invention still further relates to immunogenic compositions and vaccines that comprise, in pertinent part, Neissetia gonoffhoeae derived lipooligosaccharide(s).
The present invention further relates to methods of producing and administering immunogenic compositions and/or vaccines to prevent infection by N.
gonorrhoeae in a subject. More particularly, the present invention provides methods of and compositions

4

5 wherein said immunogenic compositions and/or vaccines are produced in a commensal species of Neisseria bacteria.
Compositions and methods are still further provided for preventing gonorrhea and/or associated pathological conditions caused by N. gonorrhoeae in a human subject The present invention further provides a number of embodiments of compositions (e.g., vaccines, immunogenic compositions, pharmaceutical compositions comprising fusions or conjugates of LOS molecules with one or more carrier proteins).
Compositions and methods are provided for treating (e.g., lessening the severity, duration, or (re)occurrence of complications or sequelae related to a disease) caused in a subject (e.g., a human) by infection by N. gonorrhoeae.
The present invention provides immunogenic compositions (and N. gonorrhoeae vaccines) comprising a GaINAc-nLc4 a chain and an nLc4 a chain from a strain of N.
gonorrhoeae. The invention still further provides immunogenic composition (and N.
gonorrhoeae vaccines) further comprising a lipid A moiety from a strain of N.
gonorrhoeae.
Additionally, the immunogenic compositions (and N. gonorrhoeae vaccines) optionally comprise an adjuvant. Preferred embodiments, in this regard, comprise adjuvants comprising metallic salt(s) (e.g., an aluminum salt selected from the group comprising aluminum hydroxide, aluminum oxy hydroxide, aluminum hydroxyphosphate, aluminum hydroxyphosphate sulfate, aluminum phosphate, and/or potassium aluminum phosphate).
Additionally provided are methods of making immunogenic compositions (and N.
gonorrhoeae vaccines) in commensal N. gonorrhoeae species (e.g., a commensal selected from the group comprising/consisting of: N. cinerea, N. elongata, N.
flavescens, N.
lactamica, N. mucosa, N. polysaccharea, N. sicca, N. subtlava, N. perflava, and/or N. !lava).
In a preferred embodiment, the commensal species is N. Iactamica. In a particularly preferred embodiment, the commensal species of N. tactamica is transformed (i.e., genetically engineered to express) one or more genes from pathogenic N.
gonorrhoeae strain F62.
Further additional methods provide medical uses of the immunogenic compositions (and N. gonorrhoeae vaccines) in subjects in one or more doses or over one or more dosing or administration schedules. Schemes for providing booster doses or administrations of the instant compositions are contemplated as well.
It is desirable to identify antigens and immunogenic components for incorporation into the compositions of the present invention (e.g., vaccines) that elicit protective immunity, immunological responses, and/or immunological modulation upon infection, or prior to infection, of a host with a pathogenic bacteria, especially infection of said host with a pathogenic bacteria selected from the Neisseriaceae family of Gram negative bacteria, for example, N. gonorrhoeae. It is also desirable to provide a vaccine that confers protective immunity to infants as well as adults and whose protection is long-term. It may also be of advantage to provide a vaccine that protects against sub-clinical infection, i.e., where symptoms of ineningococcal or gonococcal infection are not immediately apparent and the infected individual may act as a carrier of the pathogen. It would further be of advantage to protect against all or a wide range of strains Neisseria, notably N_ gonorrhoeae.
DEFINITIONS
The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be generally limiting of the invention.
As used herein, the singular forms "a", "an" and "the" are intended to include the plural forms as well, unless the context dearly indicates otherwise.
Furthermore, to the extent that the terms "induding," "includes," "having," "has," and "with," or variants thereof, are used in either the detailed description and/or the claims, such terms are intended to be inclusive in a manner similar to the term "comprising" unless otherwise noted.
In this application, the use of "or" means "and/or' unless stated otherwise.
Also, terms such as "element," "component," "moiety" encompass both elements and components comprising one unit and elements and components that comprise more than one subunit unless specifically stated otherwise.
The term "about" or "approximately' means within an acceptable error range for the particular value as determined by one of ordinary skill in the art, which will depend in part on how the value is measured or determined, La, the limitations of the measurement system.
For example, "about" can mean within 1 or more than 1 standard deviation, per the practice in the art Alternatively, "about" can mean a range of up to 20%, up to 10%, up to 5%, or up to 1% of a given value. Alternatively, particularly with respect to biological systems or processes, the term can mean within an order of magnitude, preferably within 5-fold, and more preferably within 2-fold, of a value. Where particular values are described in the application and claims, unless otherwise stated the term "about meaning within an acceptable error range for the particular value should be assumed.
The term "infection," as used herein, is intended to include the proliferation of a pathogenic organism within and/or on the tissues of a host organism and especially the proliferation of N. gonorrhoeae in a host. Pathogenic organisms typically include bacteria, viruses, fungi and protozoans, although growth of any microbe within and/or on the tissues of an organism are considered to fall within the term "infection."
As used herein the term "gonorrhea" refers to a sexually transmitted disease ("STD") caused by infection with the N. gonorrhoeae. N. gonorrhoeae infects the mucosal epithelium membranes of the reproductive tract, including the cervix (i.e., gonococcal cervicitis), uterus, and fallopian tubes in women, and the urethra in women and men (La, gonococcal

6 urethritis). N. gonorrhoeae can also infect the mucous membranes of the mouth, throat, eyes, and rectum and in a small subset of cases lead to disseminated gonococcal infection.
As used herein, a "connnnensal(s)" or a "commensal micro-organism(s)" are those that microorganisms (e.g., bacteria) can colonize a host organism without causing disease.
A number of different commensal bacteria exist. Commensal Neisseria are suitable for use in the invention, and these commensal Neisseria are typically selected from the group consisting of N. lactemica, N. cinema, N. elongate, N. flavescens, N. mucosa, N.
polysaccharea, IQ sicca, N. perflava and N. sub flava. Different species of these commensal organisms are known to colonize the buccal or nasal areas or other mucosal. In preferred embodiments the "commensal" species (e.g., N. lactamica) does not possess a capsule.
As used herein, the term "antigen" or "immunogenic polypeptide/peptide" is a molecule capable of being bound by an antibody or T-cell receptor. An antigen is additionally capable of inducing a humoral immune response and/or cellular immune response leading to the production of B- and/or T-lymphocytes in a subject (e.g., a human).
Similarly, the term "immunogen" refers to an antigen that is recognized as unwanted, undesired, and/or foreign in a subject (e.g., a human). A "vaccine antigen" is an antigen that when included in a vaccine composition elicits protective immunity to bacterial infection. The vaccine compositions of the present invention are particularly suited to vaccination against infection of an animal (e.g., a mammal, and more particularly, a human).
As used herein, the term "adjuvant" refers to an agent (e.g., metals, metal salts, mineral salt amino acid, saccharides, oligosaccharides, polysaccharides, lipids, oils, oil in water emulsions, polynucleotides, peptides, polypeptides, proteins, and the like) that stimulates and/or enhances an immune response in a subject (e.g., a human). An adjuvant can stimulate and/or enhance an immune response in the absence of an immunogen (i.e., antigen) and/or can stimulate and/or enhance an immune response in the presence of an immunogen. In the present invention, a preferred adjuvant is aluminum hydroxyphosphate.
A used herein, the term "immune response" includes a response by a subject's immune system to an immunogenic composition or vaccine of the present invention. Immune responses include both cell-mediated immune responses (responses mediated by antigen-specific T cells and non-specific cells of the immune system) and hunnoral immune responses (responses mediated by antibodies present in the plasma lymph, and tissue fluids). The term "immune response" further encompasses both the initial responses to an immunogen as well as potential memory responses that are a result of "acquired immunity."
As used herein, the phrase "stimulating an immune response" refers to an increase in an immune response in the subject following administration of an immunogenic composition or vaccine composition of the present invention relative to the level of immune

7 response in the subject when a composition of the present invention has not been administered.
As used herein, the term "immunogenic composition" refers to a composition that elicits an endogenous immune response in a subject (e.g., a human). The endogenous immune response may result in, for example, the switching of a Th1 biased immune response to a Th2 biased immune response, the activation or enhancement of T
effector cell responses and/or the reduction of T regulatory cell response, the activation of antigen-specific naive lymphocytes that may then give rise to antibody-secreting B
cells or antigen-specific effector and memory T cells or both, and/or the direct activation of antibody-secreting B cells. Similarly, as used herein the term "vaccine" or "vaccine composition" refer to an immunogenic composition as above that elicits an immune response in a subject sufficient to protect the subject from acquiring a disease for a period of time (e.g., gonorrhea).
As used herein, "prophylactic" and "preventive" immunogenic compositions, vaccines, or compositions are compositions designed and administered to prevent infection, disease, and/or any related sequelae caused by or associated with a pathogenic organism (e.g., N. gonorrhoeae) in a subject (e.g., a human).
The term "administering" includes any method of delivery of a pharmaceutical composition or agent (i.e., an immunogenic composition or vaccine) into a subject's system or to a particular region in or on a subject In certain embodiments of the invention, immunogenic compositions and vaccines are administered intramuscularly, subcutaneously, intradermally, intranasally, orally, subcutaneously, transcutaneously, or transmucosally to a subject. As used herein, and as based on context, the terms "administration"
or "administrations" encompass a singular and multiple instances of delivery of an agent to a subject over time such that an immunogenically effective singular delivery as well as a priming delivery (first dose or administration) and a subsequent (second, third, etc., doses or administrations) boosting delivery of an agent are encompassed.
As used herein, the following terms, "treatment," "treating," "palliating" and "ameliorating," are used interchangeably as context indicates. These terms refer to an approach for obtaining beneficial or desired results induding, but not limited to, a therapeutic benefit. "Therapeutic benefit" is meant to encompass the eradication or amelioration of the underlying disease or disorder being treated. Also, a therapeutic benefit is achieved with the eradication or amelioration of one or more of the physiological symptoms associated with the underlying disease or disorder such that an improvement is observed in the subject, notwithstanding that the subject may still be afflicted with the underlying disease or disorder For prophylactic benefit, the compositions may be administered to a subject at risk of

8 developing a particular disease, or to a subject reporting one or more of the physiological symptoms of a disease, even though a diagnosis of this disease may not have been made.
As used herein, the term "synergism" refers to at least two substances working together to increase the total effect, the combination is more effective than either substance alone. A "synergistically effective" therapeutic amount or "synergistically effective" amount of an agent or therapy is an amount which, when combined with an effective or sub-therapeutic amount of another agent or therapy, produces a greater effect than when either of the two agents are used alone. In some embodiments, a synergistically effective therapeutic amount of an agent or therapy produces a greater effect when used in combination than the additive effects of each of the two agents or therapies when used alone. The term "greater effect"
encompasses not only a reduction in symptoms of the disorder to be treated, but also an improved side effect profile, improved tolerability, improved patient compliance, improved efficacy, or any other improved clinical outcome.
The terms "co-administration," "administered in combination with," and their grammatical equivalents, encompass administration of two or more agents to a subject so that both agents and/or their metabolites are present in the subject at the same time. Co-administration includes simultaneous administration in separate compositions, administration at different times in separate compositions, or administration in a composition in which both agents are present. Co-administered agents may be in the same formulation. Co-administered agents may also be in different formulations.
A "therapeutic amount," as used herein, encompasses the amount of a substance (e.g., the compositions of the present invention) that is sufficient to elicit or promote the desired therapeutic benefit and/or prophylactic benefit. A prophylactic effect includes delaying or eliminating the appearance of a disease or condition, delaying or eliminating the onset of symptoms of a disease or condition, slowing, halting, or reversing the progression of a disease or condition, or any combination thereof. Specifically, as used herein, a "therapeutic amount" of the present compositions is sufficient to successfully prevent infection in a subject (e.g., human) with N. gonorrhoeae.
As used herein, the term "immunologically effective amount" is that amount sufficient to treat or prevent a disease and/or affect an endogenous immune response in a subject but not causing side effects or severe or excessive immune responses. The accurate dosage may vary depending on the antigen(s) to be administered and the desired effect to be obtained, and may be readily determined by those skilled in the art according to factors known in medicine and vaccinology, including the patients age, weight, health state, gender and sensitivity to any components of the intended administration(s), administration routes, and various administration methods. Thus, as used herein, an "immunologically effective amount" is the amount of composition sufficient to produce the desired "immunological

9 efficacy" desired as a clinical result (e.g., disease/infection treatment and/or prevention) in a subject. An "immunologically effective amount" can be administered in one or more administrations over a set period of time, including, seconds, minutes, days, or years.
A "sub-therapeutic amount of a substance (e.g., the compositions of the present invention) or therapy using the substance is an amount or application less than the effective amount for that substance or therapy, but when combined with an effective or sub-therapeutic amount of another substance or therapy can produce a result desired by the physician, due to, for example, synergy in the resulting efficacious effects, or reduced side effects.
As used herein, the phrase "pharmacologically effective carrier refers to any carrier approved for use in humans which facilitates delivery of the compositions of the instant invention without interfering with their therapeutic effect. The carrier preferably is an inert vehicle that exhibits no pharmacologic or therapeutic action.
The term "pharmaceutically acceptable salt' refers to salts derived from a variety of organic and inorganic counter ions well known in the art. Pharmaceutically acceptable acid addition salts can be formed with inorganic adds and organic acids. Inorganic adds from which salts can be derived include, for example, hydrochloric acid, hydrobromic acid, sulfuric add, nitric add, phosphoric add, and the like. Organic adds from which salts can be derived include, for example, acetic acid, propionic acid, glycolic acid, pyruvic add, oxalic add, maleic acid, malonic acid, succinic acid, fumaric acid, tartaric acid, citric acid, benzoic acid, cinnamic acid, mandelic acid, methanesulfonic acid, ethanesulfonic acid, p-toluenesulfonic acid, salicylic acid, and the like. Pharmaceutically acceptable base addition salts can be formed with inorganic and organic bases. Inorganic bases from which salts can be derived include, for example, sodium, potassium, lithium, ammonium, calcium, magnesium, iron, zinc, copper, manganese, aluminum, and the like. Organic bases from which salts can be derived include, for example, primary, secondary, and tertiary amines, substituted amines including naturally occurring substituted amines, cyclic amines, basic ion exchange resins, and the like, specifically such as isopropylamine, trimethylamine, diethylamine, triethylamine, tripropylamine, and ethanolamine. In some embodiments, the pharmaceutically acceptable base addition salt is chosen from ammonium, potassium, sodium, calcium, and magnesium salts. "Pharmaceutically acceptable carrier" or "pharmaceutically acceptable excipient"
includes, but is not limited to, polysorbates, as well as polymers, more generally, thickening agents, solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents and the like. Exemplary pharmaceutical formulation methods and methods of producing pharmaceuticals useful in certain embodiments are described in U.S. 20030211046A1; U.S. 20030004182A1; U.S. 2002060356384; U.S.
20020015728A1;
U.S. 6,511,660; U.S. 6,406,745; U.S. 6,346,269; U.S. 6,039,977; U.S.
5,858,408; U.S.

5,631,023; U.S. 5,476,667; 5,044,091; U.S. 4,867,970; and WO 0028969A2 (each of which is incorporated herein by reference in its entirety). The use of such media and agents for pharmaceutically active substances is well known in the art. Except insofar as any conventional media or agent is incompatible with the active ingredient, its use in the therapeutic compositions of the invention is contemplated. Supplementary active ingredients can also be incorporated into the compositions. The phrase "pharmaceutically acceptable"
further denotes those substances, compounds, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for use in the administration of the immunogenic compositions and vaccines of the present invention in subjects (e.g., humans) without excessive toxicity, irritation, allergic response, reactogenicity, or other problems or complications commensurate with a reasonable benefit/risk ratio.
As used herein, the term "subject" refers to an animal, such as a mammal, for example, a human. In preferred embodiments, the subject is a mammal, and in particularly preferred embodiments, the subject is human.
The term "in vitro" refers to an event that takes places outside of a subjects body.
For example, an in vitro assay encompasses any assay run outside of a subject.
In vitro assays encompass cell-based assays in which cells alive or dead are employed.
In vitro assays also encompass cell-free assays in which no intact cells are employed.
The term "in vivo" refers to an event that takes place in a subject's body. In the limited sense of the term "in vivo," a subject is understood to include both laboratory animals (e.g., mice, rats, monkeys, dogs, and the like) as well humans as in conducting human clinic trials or approved experimental uses.
The term "sample," as used herein, refers to any sample suitable for testing or assaying according to the methods of the present invention or to routine analytic and/or diagnostic techniques for determining disease and/or the identity of cultured microorganisms. The term "sample" is not limited to bacterial cultures, but can also be used to describe collected fluids, exudates, tissues, cell, and/or collected microorganisms, viruses, prions, or any portion or subunit thereof of the aforementioned, that are suitably obtained, processed, transported and stored using various standard procedures. For examples, the samples can be stored in suitable storage or transportation devices, refrigerated, frozen, desiccated, diluted, cultured, divided, passaged, separated, mixed with various additives, mounted on slides, subjected to common molecular or immunological techniques (e.g., amplification, sequencing, immunoprecipitation, and the like) or physicochemical techniques (e.g., spectroscopy, electrophoresis, chromatography, microscopy, nuclear magnetic resonance, and the like).

Recitation of ranges of values herein are merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein.
All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., "such as") provided herein, is intended merely to better illuminate the invention and does not pose a limitation on the scope of the invention unless otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of the invention.
Unless otherwise defined herein, scientific and technical terms used in connection with the present invention shall have the meanings that are commonly understood by those of ordinary skill in the art. The meaning and scope of the terms should be clear, however, in the event of any latent ambiguity, definitions provided herein take precedent over any dictionary or extrinsic definition.
That the present invention may be more readily understood, additional select terms may be defined functional as mentioned below.
DESCRIPTION OF THE INVENTION
The present invention relates generally to compositions and methods for treating ancVor preventing gonococcal infection and/or gonorrhea disease in a subject.
The invention further relates to providing transformed microbial host cells (e.g., bacterial cells) that have been engineered to produce modified and/or non-naturally occurring Neisseria lipooligosaccharides through stable integration of genetic sequences. The invention still further relates to immunogenic compositions and vaccines that comprise, in pertinent part, N. gonorrhoeae derived lipooligosaccharide(s). In preferred embodiments, these transformed microbial host cells are alternatively described as being LOS
production systems and/or the component cells and cell cultures thereof.
1. LOS ANTIGENIC STRUCTURES
N. gonorrhoeae lipooligosaccharide is an antigenically complex triantennary glycolipid molecule comprising three glycose antennae designated as a, 13, and y chains.
While the present invention is not limited to any particular mechanisms, sequences, or structures whether antigenic or not, a general structure for N. gonorrhoeae lipooligosaccharide is discussed, for example, by Schneider H., etal., and thusly incorporated herein. (See, Schneider H, "Expression of paragloboside-like lipooligosaccharides may be a necessary component of gonococcal pathogenesis in men,"

J. Exp. Med., 174(6):1601-1605 (1991)). Fig.1 and Fig 2. show potential antigenic compositions and lipooligosaccharide structures contemplated by the present invention and are discussed more fully herein.
The compositions of the present invention comprise immunogenic, and more preferably vaccinal (Le., as a prophylactic or therapeutic vaccine), LOS
molecules comprising one or more a,13, or y chains, and a Lipid A moiety and optionally one or more additional constituents such, but not limited to, adjuvants, enteric coatings, and/or antigens.
In certain embodiments, the compositions of the present invention comprise LOS
molecules further comprising an a chain and a Lipid A moiety. In certain other embodiments, the compositions of the present invention comprise LOS molecules further comprising a 13 chain.
In still further embodiments, the compositions of the present invention comprise LOS
molecules further comprising a y chain. More typical embodiments, the compositions comprise one each of a, 13, and y chains, and a Lipid A moiety.
While the present invention is not limited to any particular mechanism(s) or mode(s) of action, it is contemplated that although the mAb 2C7 a chain epitope is most strongly conformed in the presence of the 13 chain extensions that are frequently made by gonococcal isolates from blood, that the a chain is found on virtually all first pass gonococcal cultures, even if it is rapidly lost on subculture. (See, Gibson BW, et al., "Structure and heterogeneity of the oligosaccharides from the lipooligosaccharides of a pyocin-resistant Neisseria gonorrhoeae," Proc. Natl. Acad. Sci. USA, 86(1):17-21 (1989); Yamasaki R, etal., "The structure of lipooligosaccharide produced by Neisseria gonorrhoeae, strain 15253 isolated from a patient with disseminated infection: Evidence for a new glycosylation pathway of the gonococcal lipooligosaccharide" J. Biol. Chem., 269(48):30345-30351 (1994);
Yamasaki R, et at, "Structural and immunochemical characterization of a Neisseria gonorrhoeae epitope defined by a monoclonal antibody 2C7; the antibody recognizes a conserved epitope on specific lipooligosaccharides in spite of the presence of human carbohydrate epitopes," J.
Biol. Chem., 274(51):36550-36558 (1999); and Chakraborti 5, et al., "Phase-variable heptose I glycan extensions modulate efficacy of 2C7 vaccine antibody directed against Neisseria gonorrhoeae lipooligosaccharide" J. Immunol., 196:4576-4586 (2016)).
Additionally, those skilled in the art will understand there are a variety of methods, protocols, and techniques (e.g., chemical, enzymatic, NMR, and the like) used separately or in combination to characterize the LOS molecules and thus determine a,13, and y chain structure. (See e.g., Yamasaki R, et at, "Structural determination of oligosaccharides derived from lipooligosaccharide of Neisseria gonorrhoeae F62 by chemical, enzymatic, and two-dimensional NMR methods," Biochemistry, 30(43)10566-10575 (1991)).
In preferred embodiments, the immunogenic, and more preferably vaccinal LOS
compositions of the present invention comprise GaINAc-nLc4 and nLc4 a chains.

Accordingly, some embodiments provide LOS molecules having GaINAc-nLc4 a chains as well as molecules having nLc4 a chains. Thus, the final compositions of the invention, i.e., those formulated and intended for administration, are preferably formulated to encompass LOS molecules having: 1) GaINAc-nLc4 a chain(s); or 2) nLc4 a chain(s); or 3) combination products having a ratio of both GaINAc-nLc4 a chain(s) and nLc4 a chain(s).
Suitable ratios, when a combined product is desired, comprise both GaINAc-nLc4 a chains and nLc4 a chains formulated, respectively, in ratios from: 0.0001:99.9999, 0.001:99.999, 0.01:99.99, 0.1:99.9,... 0.5:99.50,... 1:99,... 5:95,... 10:90,... 25:75,... 50:50, and likewise from, 50:50,... 25:75,... 10:90,... 5:95,... 1:99,... 0.5:99.50,... 0.1:99.9,...
0.01:99.99,...
0.001:99.999,... 0.0001:99.9999, and any ratio(s) there between.
2. N. gonorrhoeae STRAIN F62 N. gonorrhoeae strain F62 uniquely makes LOS with both nLc4 and GaINAc-nLc4 a chains. (Fig. 5). (See, Schneider H, et at, "Stability of expression of Neisseria gonorrhoeae lipooligosaccharides. Infect Immun., 54(3):924-927 (1986)). In further regard to Fig. 5, silver stained LOS from strain F62 is shown in an SDS-PAGE gel. F62 IgtC is 00F, but its polyG
tract optimally splits the promoter, so that the downstream IgtD, which is IF, is re-promoted and strongly expressed. F62 makes two LOS molecules, one with nLc4 a chains (faster migrating) and one with GaINAc-nLc4 a chains (slower migrating). In preferred embodiments, engineered LOS production systems (e.g., engineered bacteria) are thus modified to make the F62 LOS molecules with nLc4 and GaINAc-nLc4 a chains.
In preferred embodiments, the LOS production systems of the present invention are selected from harmless commensal Neisseria species (e.g., N. lactamica). In some of these embodiments, a suitable strain N. lactamica is engineered to stably express immunogenic (Le., vaccine!) LOS nLc4 and GaINAc-nLc4 a chain glycoforms as contemplated by the present invention; wherein the particular glycoforms are the same as, or substantially similar to, those in strain F62.
3. LOS PRODUCTION SYSTEMS
In certain preferred embodiments, the compositions of the present invention are produced in prokaryotic host cells, and more particularly, in bacterial host cells. However, certain compositions of the present invention may be produced in eukaryotic cells (e.g., fungi, yeast etc.) instead of, or in addition to, being produced in prokaryotic cells. In some embodiments, a bacteria host is selected from one or more bacterial species of known commensal species of Neisseria. There are 10 identified species of Neisseria, wherein eight of these are classified as human commensal organisms that are generally nonpathogenic in healthy non-immunocompromised individuals.

While production of the compositions of the present invention is possible directly in N.
gonorrhoeae, in preferred embodiments, other cells are utilized as LOS
production systems mainly because N. gonorrhoeae is a BSL2 bacterium and it grows poorly in liquid media.
Accordingly, in certain embodiments, the bacterial LOS production system is selected from a species of commensal Neisseria, including, but not limited to: N.
cinema, N. elongata, N. flavescens, N. lactamica, N. mucosa, N. polysaccharea, N. sicca, and N.
sub/lava, with N.
perflava and N. f/ava considered biovars of N. sub/lava. In still further embodiments, the bacterial host of choice (S., the LOS production system) is selected from Neisseria commensals consisting of: N. lactamica, N. cinema, N. flavescens, N. sub/lava, or N.
perflava. In particularly preferred embodiments, the bacterial host comprises N. lactamica. N.
lactamica, like N. gonorrhoeae, is a Gram-negative diplococcic bacteria. N.
lactamica however is a strictly commensal species that colonizes the human nasopharynx.
It is especially common in young children and forms part of normal healthy placental microbiome.
Colonization with N. lactamica very rarely leads to invasive disease, and then only in severely immunocompromised individuals. Genetically engineering a strain of Neisseria commensal to express the relevant LOS antigens of the present invention (e.g., N.
gonorrhoeae F62 LOS) provides a solution to the difficulty of growing large volumes of gonococci necessary for commercial scale vaccine production.
Production in N. lactamica is contemplated to have several additional advantages over other potential LOS production systems. In addition to be being a harmless commensal, the endotoxin moiety of N. lactamica can be further attenuated by deleting the tptA gene.
N. Iactamica can also be grown in liquid culture for large scale production and most strains of the bacteria make LOS with nLc4 a chains while lacking igtD. (See, Kim JJ, et at, "Neisseria lactamica and Neisseria meningitidis share lipooligosaccharide epitopes but lack common capsular and class 1, 2 and 3 protein epitopes," Infect. Immun., 57(2):602-608 (1989); and Stein DC, et at, "Sequence-based predictions of lipooligosaccharide diversity in the Neisseriaceae and their implication in pathogenicity," PLoS One 6(4):e18923 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3078933/pdf/pone.0018923.pdf)).
Nevertheless, the regions flanking the genes needed for GaINAc-nLc4 a chain synthesis in N. lactamica are typically highly conserved.
Furthermore, N. lactamica is colistin-resistant, grows well on gonococcal selective medium, and is characterized by its ability to produce acid from glucose, maltose, and lactose as well as for its ability to produce beta-galactosidase. N. lactamica is the only species of Neisseria that produces beta-galactosidase and acid from lactose;
however, one lactose-negative strain of N. lactamica is known to exist. While growth media requirements are generally similar for the various species of Neisseria (e.g., Mueller Hinton medium, Thayer-Marlin medium, American Type Culture Collection ("ATCC") Medium 814:GC

Agar/Broth Medium, or Columbia Blood Media 693), the respective species have slightly different nutritional profiles that can be used for differentiation and identification. The nutritional requirements for many of the Neisseria species, including, N.
gonorrhoeae, N.
meningitidis, and N. lactamica, have been previously described. (See, Thayer JD and Martin JE, "A selective medium for the cultivation of N. gonorrhoeae and N_ meningitidis," Public Health Rep., 79(1):49-57 (1964); Thayer and Martin, "Improved medium selective for cultivation of N. gonorrhoeae and N. meningitidis," Public Health Rep., 81(6):559-562 (1966); and B.W. Catlin, "Nutritional Profiles of Neisseria gonorrhoeae, Neisseria meningitidis, and Neisseria lactamica in Chemically Defined Media and the Use of Growth Requirements for Gonococcal Typing, J. Infect. Dis., 128(2):178-194 (1973)).
In certain preferred embodiments, a growth media is preferentially supplied as a liquid broth that is supplemented (e.g., with minerals, amino acids, peptones, hemoglobin, sugars, salts, and/or antibiotics, and the like) that is held under a CO2 enriched atmosphere (e.g., 3-7% CO2) at or near 37 C to preferentially sustain the particular species of bacteria (e.g., N. lactamica).
A number of strains of N. lactamica have been, at least partially, sequenced and/or are available as live cultures, including, but not limited to: N. lactamica ST640 (Wellcome Trust Sanger Institute, Hinxton, UK, ftp://ftp.sanger. ac_ukipub/pathogens/Neisseria/lactamical); N. lactamica Y92-1009 (K. Anish, et al., "Neisseria lactamica Y92-1009 complete genome sequence," Standards in Genomic Sci., 12(41):1-9 (2017)); and N. lactamica Hollis et al., Strains ATCC 23970, 23971, 23972 /
NCTC 10617, 10618, 10616 (American Type Culture Collection ("ATCC"), Manassas, VA
and National Collection of Type Cultures ("NCTC"), Public Health England, Salisbury, UK).
When commensal bacterial species are used for producing the modified LOS
compositions of the present invention, preferably, the cells are from a suitable strain of the species N. (actamica, and more preferably, the strain has been engineered and/or selected to exhibit: 1) low lipid phosphate substitutions; 2)10w inflammatory profile;
3) good growth in liquid media; and 4) sufficient genetic mutability to be engineered to express high levels of immunogenic gonococcal lipooligosaccharides (e.g., N. gonorrhoeae strain F62 GaINAc-nLc4 and nLc4 a chains).
In preferred methods when a species of commensal Neisseria (e.g., N.
lactamica, N.
cinerea, or N. flavescens) is selected for production of the LOS compositions of the present invention, the strain has been engineered to contain a deletion of a portion, or substantially a deletion of all, of IptA gene and/or corresponding operon. In these embodiments, the LOS
production system cells comprise AlptA strains of a Neisseria commensal, and more preferably, comprise a AlptA strain of N. lactamica, N. cinerea, or N.
flavescens. In general, factors that contribute to the cells of LOS production systems being deemed to have suitably low lipid phosphate substitutions and/or low inflammatory profiles include, but are not limited to, a lack of (or intended reduction therein) of pyrophosphorylation and/or phosphoethanolanninylation of the lipid A moiety of LOS, in pertinent part, leading to observation of a functional change(s) in signal transduction through TLR4 and/or the expression of inflammatory cytokines, and/or induction of TN F-a in human THP-1 cells. (See e.g., John CM, et at, "Lack of Lipid A Pyrophosphorylation and Functional LOA
Reduces Inflammation by Neisseria Commensals," Infect. Innmun., 80(11):4014-4026 (2012)). In certain embodiments, lipid phosphates preferably are from 1-3 phosphates, and more preferably two phosphates.
Methods for selecting and/or quantifying the inflammatory profile of expression products from Neisseria species (e.g., N. lactamica) are known in the art For example, 400-1000 pg/mL of TNF-a released from 104 of the human monocytic leukemia cell line, THP-1, after incubation for 18 h with 100 ng/mL of LOS. (See e.g., Fowler MI, et at, "Comparison of the Inflammatory Responses of Human Meningeal Cells following Challenge with Neisseria lactamica and with Neisseria meningitidis," Infect. Immun., 74(11):6467-6478 (2006); John CM, et al., "Lack of Lipid A Pyrophosphorylation and Functional LptA Reduces Inflammation by Neisseria Commensals," Infect. lmmun., 80(11):4014-4026 (2012); and John CM, et at, "Natural phosphoryl and acyl variants of lipid A from Neisseria nneningitidis strain 891 differentially induce tumor necrosis factor-a in human monocytes", J. Biol.
Chem., 280:21515-21525 (2009)).
The present invention further contemplates that LOS productions systems (e.g., bacterial host cells) are selected, or subsequently modified, to exhibit good growth characteristics in liquid growth media, for example, from 30-60 min.
generation times, and preferably about a 45 min. generation time.
4. ENGINEERED NEISSERIA COMMENSALS AND TRANSFORMATION OF
PRODUCTION STRAINS
The present invention provides one or more stably transformed commensal Neisseria species. In preferred embodiments, the commensal strain comprises N.
lactamica, and further comprise a functional igtA-E operon integrated into the strain for the reliable, safe, and efficient production of LOS antigens of interest. More particularly, the invention provides stably transformed Neisseria commensal species used to make LOS molecules comprising F62 nLc4 and GaINAC-nLc4 a chains.
Transforming (i.e., genetically engineering) a commensal Neisseria species is preferentially done using one or more of the various primers and methods described in: 1) Cheng H, et at, 1-luman lipooligosaccharide IgG that prevents endemic meningococcal disease recognizes and internal lacto-N-neotetraose structure," J. Biol.
Chem., 286:43622-43633 (2011); 2) Braun and Stein DC "The IgtABCDE gene cluster, involved in lipooligosaccharide biosynthesis in Neisseria gonorrhoeae, contains multiple promoter sequences," J. Bacteriol., 186:1038-1049 (2004); 3) Song W, et al., "Role of lipooligosaccharide in opa-independent invasion of Neisseria gonorrhoeae into human epithelial cells," J. Exp. Med., 191(6):949-59 (2000); 4) Burch CL, et at, "Antigenic variation in Neisseria gonorrhoeae: production of multiple lipooligosaccharides," J.
Bacteriol., 179(3):982-986 (1997); 5) Danaher RJ, et at, "Genetic basis of Neisseria gonorrhoeae lipooligosaccharide antigenic variation," J. Bacteriol., 177(24):7275-7279 (1995); 6) Gotschlich EC, "Genetic locus for the biosynthesis of the variable portion of Neisseria gonorrhoeae lipooligosaccharide." J. Exp. Med., 180(6):2181-2190 (1994);
and/or 7) Schneider HA, et at, Heterogeneity of molecular size and antigenic expression within lipooligosaccharides of individual strains of Neisseria gonorrhoeae and Neisseria meningitidis," Infect. Immun., 45(3):544549 (1984), and the sequences described therein, and more particularly, the exemplary sequences provided in Table 1.
Table Exemplary Primer Sequences PRIMER SEQUENCE
SEQ ID SOURCE
NOs.

Gotschlich EC, et NO.1 at, 1994, supra SEQ ID NO. Schneider HA, et at, 1984, supra SEQ ID NO. Danaher RJ, etal., 1995, supra SEQ ID NO. Danaher RJ, et at, 1995, supra One contemplated aspect of these engineering methods involves the amplification of the Igt gene cluster from a N. gonorrhoeae strain (e.g., F62) and modification of the lgtA, IgtC and IgtD coding sequences. A further contemplated aspect of these engineering methods involves providing fixed polyguanine tracts that resist slip, produced by replacing every third guanine nucleotide with an alternative nucleotide thus preferentially, avoiding, or minimizing, subsequent changes to the translated protein products so that IgtA, IgtC and lgtD are phase invariant (e.g., GGGGGGGGG becomes GGCGGAGGT). A still further aspect of these engineering methods, is the internal promoter found in IgtC is modified to promote (e.g., strongly promote) IgtD expression.
In preferred embodiments, the final annplicon is introduced into the commensal Neisseria specie(s) (e.g., N. lactamica) using the spot transformation method described by JS Gun and DC Stein. (Gunn JS and Stein DC, "Use of a non-selectable transformation technique to construct a multiple restriction modification deficient mutant of Neisseria gonorrhoeae," Mol. Gen. Genet., 251(5):509-517 (1996)). The Gunn and Stein method permits introduction of DNA sequence alterations into the neisserial chromosome without having to use antibiotic selection. Using this method, LOS production strains with defined chromosomal changes can be constructed without regard to potential polarity effects caused by the insertion of antibiotic resistance cassettes, the availability of antibiotic resistance cassettes, and/or the common problems associated with using antibiotic resistant organisms for production.
DNA sequencing methods are used to validate intended modifications to the production strains. Likewise, SDS-PAGE/Western blot analysis with mAb 1-1M is used to validate the stable expression of GaINAc-nLc4 a chains as per the methods described in Song et at (Song W, et at, supra).
The reactogenicity of neisserial LOS is mediated in part by the addition of PEA to the lipoidal moiety and is catalyzed by LptA. (Zariri A, et at, "Modulating endotoxin activity by combinatorial bioengineering of meningococcal lipopolysaccharide," Sci. Rep., 6:36575 (2016)). Alone among commensal Neisseria species, strains of N. lactamica have a functional IptA and their Lipid A is phosphoethanolaminylatecl. (John CM, et aL, "Lack of lipid A pyrophosphorylation and of a functional IptA reduce inflammation by Neisseria commensals," Infect. lmmun., 80(11):4014-4026 (2012)). In preferred embodiments, the LOS lipid A of pathogenic Neisseria is substituted with 2-3 P and 1-2 PEA;
where phosphorylation correlates with the inflammatory potential of both LOS and bacteria. Lipid A
of some N. lactamica strains is highly phosphorylatecl and moderately inflammatory.
Accordingly, the present invention contemplates using high mass resolution mass spectrometry to discriminate phosphoforms of lipid A from the spectra of various N.
lactamica strains as part of LOS production system selection. (See, John CM., et at, "Lack of Lipid A Pyrophosphorylation and Functional LptA Reduces Inflammation by Neisseria Commensals," Infect. Immun., 80(11):40144026 (2012)).
It is further contemplated that known DNA sequencing methods (e.g., PCR) be used to determine the IptA status of the candidate Neisseria commensal (e.g., N.
lactamica) as part of the LOS production system strain selection. (See e.g., Zarin A, et at, supra and John CM, et at, supra). Should a candidate LOS production strain contain IptA, the spot transformation method mentioned above is used to delete the gene.

5. LOS BIOSYNTHESIS
While the present invention is not limited to any particular mechanism(s) or mode(s) of action, it is contemplated that LOS biosynthesis is regulated primarily by the IgtA-E operon that consists of five genes promoted by upstream and internal promoters. (See, Fig. 3). The size of the operon depicted in Fig. 3 is about 5.8 kb. IgtE and IgtB encode galactosyl transferases that complete the nLc4 basal lactose and terminal LacNAc, respectively, they are invariant. The other three genes, IgtA, IgtC and IgtD, each have a homopolymeric guanine (polyG) tract that causes slip-strand mispairing during DNA
replication. As a result, these genes slip in and out of frame and the enzymes they encode (glycosyl transferases) may or may not be functional. These slip-strand nnispairings result in the production of a different LOS chemotypes. The positioning of the polyG tract between two halves of a Pribnow box of an internal promoter found in IgtC can also effect LOS
biosynthesis. (See, Braun DC and Stein DC, "The IgtABCDE gene duster, involved in lipooligosaccharide biosynthesis in Neisseria gonorrhoeae, contains multiple promoter sequences,"
J. Bacteriol., 186(4):1038-1049 (2004)). This results in an increase in downstream promotion when the number of guanines is optimal for a strong promoter. This provides the bacteria with considerable biosynthetic flexibility and the ability to make multiple LOS
structures with use of only five genes_ And it enables the gonococcus to undergo microevolution in a particular biological niche, such as the female genitourinary tract and the male urethra.
The skilled artisan will consider these features, and others, to beneficially engineer an optimal LOS
production system.
Fig. 4, as compared to Fig. 3, provides a more detailed representation of an exemplary organization of the Neisseria Igt operon described in Braun DC and Stein DC.
More particularly, the diagram in Fig. 4 was derived from the DNA sequence of the Igt gene duster originally published by Gotschlich under NCB! accession number U14554.
The sequence numbers given in Fig. 4 correspond to those described in that accession. The features identified in Fig. 4 are indicated as follows: al, glyS stop codon;
a2, IgtC stop codon; b, BsrGI restriction site; c, potential stem-loop structure than could function as a transcriptional terminator d, putative ribosome-binding site; el, putative IgtA start codon;
and e2, putative Igtel start codon. (See, Gotschlich EC, "Genetic locus for the biosynthesis of the variable portion of Neisseria gonorrhoeae lipooligosaccharide." J. Exp.
Med., 180(6):2181-2190 (1994)).
6. LOS PURIFICATION
In one embodiment, the immunogenic compositions (i.e., F62 LOS comprising GaINAc-nLc4 and nLc4 a chains) are extracted and purified from the production system using a modification (See, Apicella MA, Griffiss JMcL and Schneider H, "Isolation and characterization of Iipopolysaccharides, lipooligosaccharides, and lipid A,"
Methods Enzyrnol. 235:242-252 (1994)) of the hot aqueous phenol method described by Westphal and Jann. (Bacterial lipopolysaccharides. Extraction with phenol-water and further application of the procedure. p. 83-91. In R. L Whistler (ed.), Methods in carbohydrate chemistry, Vol. 5, Academic Press Inc., New York, NY (1965)). Purified LOS is characterized by gel-electrophoresis, Western blot with monoclonal antibodies and mass spectroscopy.
(Schneider, et al 1991, supra, Apicella, et at , supra, and John CM, et at, supra).
7. GENDER-SPECIFIC LOS IgG INDUCTION DURING N. GONORRHOEAE
INFECTION
While the present invention is not limited to any particular mechanism(s) or mode(s) of action, it is contemplated that protective LOS immune responses vary between males and females (i.e., gender-specific protective LOS IgG induction during gonococcal infection). In preferred embodiments, the present invention provides vaccine compositions that are substantially as effective for preventing (or treating) gonococcal infections and/or gonorrhea in both men and women. In other embodiments, a vaccine product is provided that is tailored to the immunological responses and gonorrhea disease pathogenesis in either a male or a female.
In an unpublished study, Schneider found that 10/12 (83%) of primary gonococcal isolates from women made LOS with GaINAc-nLc4 a chains as compared with 19/37 (51%) isolates from men seen at the same clinic, but who were not known consorts.
Expression of LOS with GaINAc-nLc4 a chains by isolates from these women were lost on sub-culture.
(See, Schmidt KA, et at, "Experimental gonococcal urethritis and reinfection with homologous gonococci in male volunteers," Sex Transm. Dis., 28(10):555-564 (2001); and Schneider H, et at, "Expression of paragloboside-like lipooligosaccharides may be a necessary component of gonococcal pathogenesis in men," J. Exp. Med., 174:1601-(1991)). In contrast, it has been further determined that GaINAc-nLc4 a chains are seldom made by gonococci within polynuclear white cells in the discharge of men with gonorrhea.
(See, McLaughlin SE, et aL, "Urethral exudates of men with Neissetia gonorrhoeae infections select a restricted lipooligosaccharide phenotype during transmission," J. Infect.
Dis., 206(8):1227-32 (2012)). IgtA, IgtC and IgtD were amplified from gonococci scraped from diagnostic slides of urethral exudates and their polyguanine tracts sequenced. LgtA, which encodes the glucosaminyl transferase that initiates the nLc4 LacNAc is in-frame (IF) in bacteria from the male urethra while IgtC is out of frame (00F). The frame of IgtD, the galactosaminyl transferase that adds GaINAc to nLc4, varied widely: it was OOF
in most, but not all cases. This genotype would result in the predominant synthesis of nLc4 a chains;

however, an active 100 in a few bacteria would enable replication within female cervical epithelial cells of bacteria with GaINAc-nLc4 a chains.
The present invention thus contemplates providing effective gonococcal LOS
vaccines that induce IgG that binds the nLc4 a chains made by gonococci in the male urethra (La, urethral discharge) to protect women, and also binds the GaINAc-nLc4 a chains made by gonococci shed from the female cervix to protect men. In preferred embodiments, the immunogenic, and more preferably vaccinal, compositions of the present invention comprise both GaINAc-nLc4 and nLc4 a chains. Accordingly, certain embodiments provide LOS molecules comprising GaINAc-nLc4 a chains as well as nLc4 a chains.
In one preferred embodiment, the present invention provides methods that use multiplexed indirect innnnunofluorescent assays based on the LUMINEX
(ThernnoFisher Scientific, Waltham, MA) platform for LOS IgG profiling. (See, Pickering JW, et at, "A
multiplexed fluorescent microsphere immunoassay for antibodies to pneumococcal capsular polysaccharides," Am. J. Clin. Pathol., 117:589-596 (2002)). This particular assay uses LOS
from pyocin-selected mutants of gonococcal strain 1291, denominated 1291a-e (Fig. 6), to charge immunofluorescent microspheres that bind antibodies specific for four of the five LOS
a chain antigens, nLc4, nLc3, Lc2 and 13-G1c. (Cheng H, etal., 2011, supra).
See also, Braun DC and Stein DC, 2004, supra; and McLaughlin SE, 2012, supra). Anti-human IgG is used as the detection antibody, in preferred embodiments. Figure 6 shows a SDS-PAGE of LOS made by the 1291 mutants, wherein the columns read left to right represent mutants:
1291, 1291a, 1291b, 1291c, 1291d, and 1291e, respectively.
The 1291 mutants make LOS with a single glycose deletion in the a chain. (See, Fig.
6). In contrast, 1291wt makes nLc4 a chains, but not GaINAc-nLc4 a chains;
1291a makes nLc3 a chains (nLc3 is lacto-N-neotriaose, without the nLc4 terminal Gal);
1291b makes Gb3 a chains (not made by gonococci within urethral discharge PMNs) (McLaughlin SE, 2012, supra); 1291c makes Lc2 a chains (lactose, Fig. 2); and, 1291e makes13-Glc a chains and LOS without an a chain (Cheng H, et at, 2011, supra). Cheng H, et aL, provide a detailed discussion of the 1291 mutants. The assay was further validated by quantifying LOS IgG
specific for nLc4, nLc3 and Lc2 a chains in the sera of Baltimore City Health Department clients who reported as contacts of persons with gonococcal infections. (See, McLaughlin SE, et at, "Risk of gonococcal infection during vaginal exposure is associated with high vaginal pH and active menstruation," Sex. Transm. Dis., 46:86-90 (2019)).
In preferred embodiments, the invention contemplates IgG that binds 291wt LOS
represents the total IgG that binds any of the 1291wt antigens. In order to quantify IgG
specific for the nLc4 terminal Gal residue, IgG binding to 1291a (nLc3) LOS
was subtracted from 1291wt LOS IgG. And to quantify IgG specific for the nLc3 internal GIcNAc residue, IgG
binding to 1291c (Lc2) LOS was subtracted from 1291a LOS IgG. The results are shown in Table 2 and are presented in pg/mL. Table 2 shows the accuracy of the assays used in this aspect of the invention.
Table 2 Comparison of LOS IgG in sera of infected contacts seen >7 days after exposure with those in sera of contacts seen within 7 days Infected Contacts Infected Contacts IgG LOS
seen >7 days after seen within 7 days p exposure (N=8) of exposure (N=16) nLc4 1291wt 28.62 21.37 0.07 nLc4-nLc3 1291wt- 8.13 6.15 0.04 1291a nLc3-Lc2 1291a- 5.48 3.92 0.10 1291c Lc2 1291c 14.93 11.30 0.09 Concentrations of IgG, in pg/mL, specific for the nLc4 terminal Gal (nLc4-nLc3), the internal GIcNAc of the nLc4 LacNAc (nLc3-Lc2) and the antigens of the lactose a chain and basal PEA-diheptoside glycolipid and y chain GIcNAc (Braun DC and Stein DC, 2004, supra; and Schneider H, 1991, supra) sum to the concentrations bound by the native 1291wt LOS
(nLc4) - .28.54 v. 28.62 and 21.37 v. 21.37.
Table 2 also shows the induction of LOS IgG antibodies during acute gonococcal infection. Concentrations of the four specificities in the sera of infected contacts who were seen within seven days of exposure, before an immune response would have produced new antibodies, were less than those in the sera of infected contacts seen after seven days.
While the present invention is not limited to any particular theories related to infection or epidemiology, it is contemplated that these data support to the hypothesis that early treatment contributes to recidivism by preventing induction of protective antibodies.
Still further embodiments of the present invention include IgG specific for the GaINAc-nLc4 and mAb 2C7 antigens by conjugating 1291e, F62 and 15253 LOS to the microspheres, and incorporating them in the assay. (See, Yamasaki R, et at, 1991, supra, and Yamasaki R, et at, 1994, supra). N. gonorrhoeae strain F62 makes LOS
molecules with nLc4 and GaINAc-nLc4 a chains in nearly equal abundance; 15253 makes LOS with truncated and parallel 13-lactose a chains and a-lactosel3 chains; it strongly binds mAb 2C7.
In order to quantify GaINAc-nLc4 a chain Ige, the concentrations of IgG bound by 1291wt LOS (nLc4) are subtracted from those bound to F62 LOS, as described above.
In still other embodiments of the methods of the present invention, mAb 2C7-like IgG
are quantified in two ways: 1) by subtracting concentrations that bind 1291e LOS (13-Gic a chain and basal antigens) from those that bind 1291c LOS (Lc2); and 2) by subtracting concentrations that bind 1291e LOS from those that bind 15253 LOS. Since the a and 13 chains of 15253 LOS are truncated at lactose (Fig. 2), they will not bind the distal nLc3, nLc4 and GaINAc-nLc4 a chains.
8. ADJUVANTA11ON
In preferred embodiments, the immunogenic and/or vaccinal compositions of the present invention optionally further comprise one or more adjuvants or adjuvant systems as a means of enhancing the immune response or immunomodulatory effects of the administered compositions in the intended subject. The compositions of the present invention can be associated (e.g., chemically linked) to the adjuvant(s) by a coordinate, covalent, hydrophilic, or hydrophobic bonds. The association can optionally proceed through an activated moiety or chemical group on the adjuvant or the immunogenic composition and, at least in part, through a fluoride, phosphate, sulfate, carbonate group, or like chemically reactive group or moiety, or through one or more linker molecules. In some of these embodiments, the compositions of the present invention are absorbed to the chosen adjuvant(s); while in other embodiments, the compositions are adsorbed to the adjuvant(s).
The present invention is not intended to be limited however by the method of association between the compositions and the chosen adjuvant(s) and/or adjuvant system(s).
Examples of suitable adjuvants include, but are not limited to, aluminum salts, 3D-MPL, oil in water emulsions including, but not limited, to AS03, AF03, AF04, MF-59, and 0S21. Suitable oil in water emulsions can be comprised a-tocopherol, squalene, and polysorbates, TVVEEN (ag., 20, 80, etc., Sigma Aldrich, St. Louis, MO), SPAN
(e.g., 20, 601 80, 85, etc., Sigma-Aldrich), and the like.
In particularly preferred embodiments, the adjuvant comprises one or more metallic adjuvants such as an aluminum adjuvant comprising aluminum hydroxide, aluminum oxy hydroxide, aluminum hydroxyphosphate, aluminum hydroxyphosphate sulfate, aluminum phosphate, or alum (potassium aluminum phosphate) or combinations thereof. In addition to aluminum, other metallic salts have been used to adsorb antigens, including salts of zinc, calcium, cerium, chromium, iron, and beryllium. And these metal salts find use in some embodiments. The hydroxide and phosphate salts of aluminum are the most common adjuvants and as such have been widely studied and generally approved for use by regulatory agencies worldwide.
The use of aluminum oxyhydroxide adjuvant is especially preferred in the compositions of the present invention, but it is not required. The skilled artisan will select a suitable adjuvant/adjuvant system based on consideration of various factors including, but not limited to, the desired immune response in the recipient, potential antigen/adjuvant interactions, and potential issues related to immunogenicity (e.g., potency, Th1/2 bias), ease of formulation (e.g., adsorption state, charge), purification, final product distribution and storage, regulatory acceptability, and the like.
In some embodiments comprising oil in water emulsions (e.g., squalene), the final product might lack the desired stability due to the emulsion's hydrophobic nature.
Accordingly, in certain of these embodiments, one or more nonionic surfactant emulsifiers, such as TWEENO 80 and/or SPAN 85, are used to prepare stable emulsions;
wherein, the two phases are prepared separately then mixed to make the emulsion. Desired homogeneity in these products (e.g., sub-micron particle sizes) for example, <0.2 microns, preferably, 40-80 nm (0.04-0.08 microns, is obtained by using standard methods, including, rnicrofluidization, sheer force, and/or temperature induced phase inversion(s). These methods yield products that can be sterilized by terminal filtration and stored ready for administration with, or without refrigeration. In certain embodiments, products comprising squalene adjuvants are stored cold (or refrigerated) to retard oxidation of the squalene. The stability of products comprising emulsions can be monitored by standard methods, such as, Light Scatter (DLS), gel-electrophoresis, and/or ELISA.
9. POTENCY AND IMMUNOGENICITY
In some embodiments, the potency of adsorbed and non-adsorbed LOS can be compared by producing a series of charged aluminum surfaces ranging from positively charged aluminum hydroxide adjuvant to negatively charged aluminum phosphate.
Aluminum hydroxide adjuvant can be treated with increasing amounts of phosphate ion to decrease the surface charge of the adjuvant Phosphate in solution can exchange with surface hydroxyls of aluminum hydroxide adjuvant due to higher affinity for aluminum causing the change in surface charge. (See e.g., lyer S. at at, "Effect of the degree of phosphate substitution in aluminum hydroxide adjuvant on the adsorption of phosphorylated proteins," Pharm. Dev. Technol., 8(1):81-86 (2003); and Hansen B, "Relationship between the strength of antigen adsorption to an aluminum-containing adjuvant and the immune response," Vaccine, 25(36):6618-6624 (2007)). In a preferred embodiment, various formulations are prepared with each of these adjuvant surfaces and the adsorption stability is monitored over time under accelerated conditions (e.g., elevated temperature) using standard methods, including, but not limited to, DLS, gel-electrophoresis, and/or ELISA.

10. PRODUCT FILTRATION
Product formulations (e.g., immunogenic compositions and vaccines) comprising aluminum containing adjuvants typically cannot be sterilized using standard methods due to the particle size of the adjuvant being greater than 0.2 pm. Materials used to prepare vaccines with aluminum containing adjuvants are thus preferentially sterilized prior to adjuvantation and subsequently handled aseptically during final formulation and filling processes.
Because components of product formulations can interact with the filter membrane materials during processing, it should be determined if any of these interactions will detrimentally effect to the final product (e.g., vaccine). Thus, preferred methods used during production consider and monitor a number of product parameters including, but not limited to, quantifying the amount of antigen (e.g., GaINAc-nLc4 and nLc4 a chains) lost during filtration, determining the amount of product effectively filtered before changing filters, and the ability of filters to retain biological contaminants (e.g., microbial organisms) and other undesirable compounds during filtration. Similarly, ideal formulations are optimized for their stability and efficacy based upon consideration of pH and any buffers or excipients used therein. In one preferred embodiment LOS antigens are dissolved in 20 mM
succinate, 130 mM NaCI, and adjusted to a of about pH 6.5 and further prepared according to the methods described herein and known in the art.
In certain formulations, isolated gonococcal LOS is provided in an aggregated state when reconstituted (e.g., as micelles). Micelle formations can be reduced by adding about 0.02% of a polysorbate-type nonionic surfactant (e.g., polysorbate 20).
MiceIlar formulated LOS molecules are then formulated (e.g., conjugated, aggregated, and the like) with one or more suitable protein carriers to achieve the desired level of immunogenicity.

11. pH STABILIZATION
In preferred embodiments, the bulk product is purified in buffered saline at from about pH 5 to about pH 9. The pH stability of the bulk product is determined using common methods such as DLS, gel-electrophoresis, ELISA, and endotoxin activity assays.
Preferably, the final product (e.g., immunogenic composition and/or vaccine) is isotonic with body fluid. Accordingly, the pH of the bulk/final product is adjusted with one or more agents generally regarded as safe (Le., GRAS) such as salts and sugars or sugar alcohols (e.g., sodium chloride, sucrose, sorbitol, mannitol, and the like) or surfactants (e.g., polysorbate 80, TRITON IN x-100 (Sigma-Aldrich), or deoxycholic add ("DOC") and the like) and amino acids. In preferred embodiments, the potential impact of buffering agents/osmolytes on the physical stability and/or immunogenicity of the bulk product is determined experimentally before filling.
DOC can be included in the bulk/final product formulation to beneficially reduce the reactogenicity of the endotoxin portion of the LOS molecule. Consequently, in certain embodiments, the buffing agent comprises DOC.

Amino acids are also suitable for use as stabilizers in certain formulations.
In particular, lysine, histidine, glycine, arginine, praline, aspartic acid as well as poly-lysine, and combinations thereof, are further contemplated for use in certain embodiments.
Poly-lysine can also bind the endotoxin portion of the LOS molecule and can reduce or minimize potential reactogenicity.
During production, the final/bulk product formulations are stored under various temperature conditions (e.g., 25 , 37 , to 45 C) and subsequently monitored over time using common methods such as DLS, gel-electrophoresis, ELISA, and endotoxin activity. It is contemplated that high temperature storage accelerates antigen degradation thus aiding proper stabilizer selection. Similarly, DLS analysis is used to detect antigen aggregation, while gel electrophoresis and ELISA are used to monitor antigen stability.

12. IMMUNOGENICITY ASSAYS
In preferred embodiments, the potency of final or candidate products is generally determined using one or more in vivo and/or in vitro methods. In one of these embodiments, the present invention contemplates in vivo testing in mice wherein test animals are administered either an adsorbed or non-adsorbed formulation at one or more relevant times (e.g., days 0 and 14). Sera is collected from the animals (e.g., day 28) and the resulting immune responses evaluated using standard ELISA techniques.
In a more particular aspect of the invention, mice receive high, medium, or low doses of final products or candidate formulations comprising either an aluminum or oil in water emulsion adjuvant, wherein a prime dose of the composition is delivered on day 0, and a booster dose on day 14. Sera is collected on day 28 and analyzed for antibody response and any Th1/Th2 bias according to standard protocols. It is contemplated that aluminum adjuvanted product will produce a Th2 biased response while emulsion adjuvanted systems will produce a more Th1 biased response.
In yet other aspects of the invention, the immune response to final products or candidate formulations produced in N. lactamica is compared to LOS antigens produced in N. gonorrhoeae strain F62. For example, in one embodiments C57BU6 mice are administered a vaccine formulated with LOS produced from either N. lactamica or N.
gonorrhoeae on days 0 and 14. Sera is collected on day 28 and the resulting immune responses are evaluated by ELISA and confirmed by multiplex assays.

13. EXEMPLARY PHARMACEUTICAL FORMULATIONS, ADDMONAL
CONSTITUENTS, and ADMINISTRATION AND DOSING CONSIDERATIONS
The practice of the present invention will employ, unless otherwise indicated, conventional techniques of preparing pharmaceutical and/or vaccinal formulations as well as drug delivery and dosing techniques which are well known in the art. Generally speaking, the compositions of the present invention may be prepared by means standard in the art. A
number of standard text are known in the art regarding preparation and formulation considerations. (See e.g., Remington's Pharmaceutical Sciences).
In preferred embodiments, the compositions (e.g., immunogenic compositions and vaccines) of the present disclosure are sterile and, optionally, preservative-free (e.g., mercurial and/or organornercurial compounds such as thimerosal). In other embodiments the compositions are sterile, optionally preservative-free, and formulated in a single-use or unit-dose formats. In still further embodiments the sterile formulations contain one or more preservatives, stabilizers, sugars, or sugar alcohols.
The methods and compositions of the present invention provide immunogenic compositions and vaccines for use in a subject (e.g., a human) in order to confer a medicinal or therapeutic benefit (e.g., treating or preventing infection with N.
gonorrhoeee and/or gonorrhea disease) in the subject upon administration of an effective dose of the one or more of compositions described herein. Methods of administering the compounds of the invention may be by metered dose by one or more injection devices. The compositions may be filled in unit dosage forms suitable for single administration of a precise dosage.
In some embodiments, the concentration of one or more of the component antigens, or other constituents, provided in the pharmaceutical compositions of the present invention is less than 100%, 90%, 80%, 70%, 60%, 50%, 40%, 30%, 20%, 19%, 18%, 17%, 16%, 15%,

14%, 13%, 12%, 11%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0.5%, 0.4%, 0.3%, 0.2%, 0.1%, 0.09%, 0.08%, 0.07%, 0.06%, 0.05%, 0.04%, 0.03%, 0.02%, 0.01%, 0.009%, 0.008%, 0.007%, 0.006%, 0.005%, 0.004%, 0.003%, 0.002%, 0.001%, 0.0009%, 0.0008%, 0.0007%, 0.0006%, 0.0005%, 0.0004%, 0.0003%, 0.0002%, or 0.0001% w/w, w/v or v/v.
In yet some other embodiments, the concentration of one or more of the component antigens, or other constituents, of the present invention is greater than 90%, 80%, 70%, 60%, 50%, 40%, 30%, 20%, 19.75%, 19.50%, 19.25% 19%, 18.75%, 18.50%, 18.25%
18%, 17.75%, 17.50%, 17.25% 17%, 16.75%, 16.50%, 16.25% 16%, 15.75%, 15.50%, 15.25%

15%, 14.75%, 14.50%, 14.25% 14%, 1a75%, 13.50%, 13.25% 13%, 12.75%, 12.50%, 12.25% 12%, 11.75%, 11.50%, 11.25% 11%, 10_75%, 10.50%, 10.25% 10%, 9.75%, 9.50%, 9.25% 9%, 8.75%, 8.50%, 8.25% 8%, 7.75%, 7.50%, 7.25% 7%, 6.75%, 6.50%, 6.25%
6%, 5.75%, 5.50%, 5.25% 5%, 4.75%, 4.50%, 4.25%, 4%, 3.75%, 3.50%, 3.25%, 3%, 2.75%, 2.50%, 2.25%, 2%, 1.75%, 1.50%, 125%, 1%, 0.5%, 0.4%, 0.3%, 0.2%, 0.1%, 0.09%, 0.08%, 0.07%, 0.06%, 0.05%, 0.04%, 0.03%, 0.02%, 0.01%, 0.009%, 0.008%, 0.007%, 0.006%, 0.005%, 0.004%, 0.003%, 0.002%, 0.001%, 0.0009%, 0.0008%, 0.0007%, 0.0006%, 0.0005%, 0.0004%, 0.0003%, 0.0002%, or 0.0001% w/w, w/v, or v/v.

In still some other embodiments, the concentration of one or more of the component antigens, or other constituents, of the present invention is in the range from approximately 0.0001% to approximately 50%, approximately 0_001% to approximately 40%, approximately 0.01% to approximately 30%, approximately 0.02% to approximately 29%, approximately 0.03% to approximately 28%, approximately 0.04% to approximately 27%, approximately 0.05% to approximately 26%, approximately 0.06% to approximately 25%, approximately 0.07% to approximately 24%, approximately 0.08% to approximately 23%, approximately 0.09% to approximately 22%, approximately 0.1% to approximately 21%, approximately 0.2% to approximately 20%, approximately 0.3% to approximately 19%, approximately 0.4%
to approximately 18%, approximately 0.5% to approximately 17%, approximately 0.6% to approximately 16%, approximately 0.7% to approximately 15%, approximately 0.8%
to approximately 14%, approximately 0.9% to approximately 12%, approximately 1%
to approximately 10% w/w, w/v or v/v.
In some embodiments, the concentration of one or more of the component antigens, or other constituents, of the present invention is in the range from approximately 0.001% to approximately 10%, approximately 0.01% to approximately 5%, approximately 0.02% to approximately 4.5%, approximately 0.03% to approximately 4%, approximately 0.04% to approximately 3.5%, approximately 0.05% to approximately 3%, approximately 0.06% to approximately 2.5%, approximately 0.07% to approximately 2%, approximately 0.08% to approximately 1.5%, approximately 0.09% to approximately 1%, approximately 0.1cY0 to approximately 0.9% w/w, w/v or v/v.
In some other embodiments, the amount of one or more of the component antigens, or other constituents, of the present invention is equal to or less than 10 g, 9.5 g, 9.0 g, 8.5 g, 8.0 g, 7.5 g, 7.09, 6.5 g, 6.0 g, 5.5 g, 5.0 g, 4.5 g, 4.0g, 3.5 g, 3.0 g, 2.5 g, 2.0 g, 1.5 g, 1.0 9, 0.95 9, 0.9 9, 0.85 g, 0.8 g, 0.75 g, 0.79, 0.65 9, 0.69, 0.559, 0.5g, 0.45 9, 0.49, 0.35 g, 0.3 g, 0259, 0_2 g, 0.159, 0.1 g, 0.09 g, 0_08 g, 0.079, 0.06 g, 0.05 g, 0.04 g, 0.03 g, 0.02 91 0.01 g, 0.0099, 0.008 g, 0.00791 0.00691 0.005 g, 0.004 g, 0.0039, 0.002 g, 0.001 g, 0.0009 g, 0.0008 g, 0.00079, 0.0006 g, 0.0005 g, 0.0004 g, 0.00039, 0.0002 g, or 0.0001 g.
In some embodiments, the amount of one or more of the component antigens, or other constituents, of the present invention is more than 0.0001 g, 0.0002g, 0.00039, 0.000491 0.0005 g, 0.0006 g, 0.0007 g, 0.000891 0.0009 g, 0.001 g, 0.0015 g, 0.002 g, 0.0025 g, 0.003 g, 0_0035 g, 0.004 g, 0.0045 g, 0.005 g, 0_0055 g, 0.0069, 0.0065 g, 0.007 g, 0.007591 0.008 g, 0.0085 g, 0.009 g, 0.009591 0.01 g, 0.015 g, 0.02 g, 0.025 g, 0.039, 0.035 g, 0.04 g, 0.0459, 0.059, 0.055 g, 0.06 g, 0.065 g, 0.07 g, 0.075 g, 0.08 g, 0.085 g, 0.09 g, 0.095 g, 0.1 g, 0.15g, 0.2 g, 0.259, 0.3 g, 0.35 g, 0.4 g, 0.45g, 0.59, 0.55 g, 0.69, 0.65 g, 0.7 g, 0.759, 0.8 g, 0.85 g, 0.9 g, 0.95 g, 1 g, 1.59, 2 g, 2.5, 3 g, 3.5, 4 g, 4.5 g, 5 g, 5.5 g, 6 g, 6.5 g, 7 g, 7.5 g, 8 g, 8.5 g, 9 g, 9.5 g, or 10 g.
Other embodiments provide, amounts of one or more of the component antigens, or other constituents, of the present invention in the range of 0.0001-10 g, 0.0005-9 g, 0.001-8 g, 0.005-7 g, 0.01-6 g, 1105-59, 0.1-4g. 0.5-4 g, 1-39, or 1-10 g.
The target dose may be administered in a single dose. Alternatively, the target dose may be administered in about or more than about 1, 2, or 3, or more, doses.
The administration schedule may be repeated according to any prescribed regimen, including any administration schedule described herein. The composifions of the present invention may be administered in one dose or multiple dosages. Methods of determining the most effective means and dosage of administration are well known to those of skill in the art and will vary with the particular compositions used, the purpose of the use, the target cells or tissues infected, and the subject being treated. Single or multiple administrations (e.g., about or more than about 1, 2, 3, or more doses) over the course of from 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, or 50, or more, minutes, hours, days, weeks, or months.
In some particularly preferred embodiments, one or more doses of the composition is/are administered (e.g., intramuscularly, subcutaneously, and the like) as prescribed by a physician or as otherwise deemed necessary for maintaining health.
Administration can be carried out with the dose level and pattern being selected by the treating physician. It is known in the art that due to intersubject variability in compound pharmacokinetics, individualization of dosing regimens is often necessary. Dosing for compositions of the present invention may be found by routine experimentation considering the instant disclosure and one's skill in the art.
Additionally, it is to be noted that, similar to the approaches described in the fields of medicinal and pharmaceutical chemistry, a suitable pharmaceutical preparation may also indude, optionally, in addition to one or more compounds of the present invention, other agents, including, but not limited to, excipients, diluents, stabilizers, formulating agents (e.g., gels and thickeners), antioxidants, chelating agents, preservatives, sterile aqueous solutions, buffers, sugars, and the like, as are generally known and accepted.
Exemplary diluents include, but are not limited to, calcium carbonate, sodium carbonate, calcium phosphate, dicalcium phosphate, calcium sulfate, calcium hydrogen phosphate, sodium phosphate lactose, sucrose, cellulose, microcrystalline cellulose, kaolin, mannitol, sorbitol, inositol, sodium chloride, dry starch, cornstarch, powdered sugar, and combinations thereof.
Exemplary preservatives include, but are not limited to, antioxidants, chelating agents, antimicrobial preservatives, antifungal preservatives, alcohol preservatives, acidic preservatives, and other preservatives. Exemplary antioxidants include, but are not limited to, alpha tocopherol, ascorbic acid, acorbyl palmitate, butylated hydroxyanisole, butylated hydroxytoluene, monothioglycerol, potassium metabisulfite, propionic acid, propyl gallate, sodium ascorbate, sodium bisulfite, sodium metabisulfite, and sodium sulfite.
Exemplary chelating agents include ethylenediaminetetraacetic acid (EDTA), citric acid monohydrate, disodium edetate, dipotassium edetate, edetic acid, fumaric acid, malic acid, phosphoric acid, sodium edetate, tartaric acid, and trisodium edetate. Exemplary antimicrobial preservatives include, but are not limited to, benzalkonium chloride, benzethonium chloride, benzyl alcohol, bronopol, cetrimide, cetylpyridinium chloride, chlorhexidine, chlorobutanol, chlorocresol, chloroxylenol, cresol, ethyl alcohol, glycerin, hexetidine, imidurea, phenol, phenoxyethanol, phenylethyl alcohol, phenylmercuric nitrate, propylene glycol, and thinnerosal. Exemplary antifungal preservatives include, but are not limited to, butyl paraben, methyl paraben, ethyl paraben, propyl paraben, benzoic acid, hydroxybenzoic add, potassium benzoate, potassium sorbate, sodium benzoate, sodium propionate, and sorbic acid. Exemplary alcohol preservatives include, but are not limited to, ethanol, polyethylene glycol, phenol, phenolic compounds, bisphenol, chlorobutanol, hydroxybenzoate, and phenylethyl alcohol. Exemplary acidic preservatives include, but are not limited to, vitamin A, vitamin C, vitamin E, beta-carotene, citric acid, acetic acid, dehydroacetic acid, ascorbic add, sorbic acid, and phytic acid. Other preservatives include, but are not limited to, t000pherol, t000pherol acetate, deteroxime mesylate, cetrimide, butylated hydroxyanisol (BHA), butylated hydroxytoluened (BHT), ethylenediamine, sodium lauryl sulfate (SLS), sodium lauryl ether sulfate (SLES), sodium bisulfite, sodium metabisulfite, potassium sulfite, and potassium metabisulfite. In certain embodiments, the preservative is an antioxidant. In certain other embodiments, the preservative is a chelating agent.
Exemplary buffering agents include, but are not limited to, citrate buffer solutions, acetate buffer solutions, phosphate buffer solutions, ammonium chloride, calcium carbonate, calcium chloride, calcium citrate, calcium glubionate, calcium gluceptate, calcium gluconate, D-gluconic acid, calcium glycerophosphate, calcium lactate, propanoic acid, calcium levulinate, pentanoic acid, dibasic calcium phosphate, phosphoric acid, tribasic calcium phosphate, calcium hydroxide phosphate, potassium acetate, potassium chloride, potassium gluconate, potassium mixtures, dibasic potassium phosphate, monobasic potassium phosphate, potassium phosphate mixtures, sodium acetate, sodium bicarbonate, sodium chloride, sodium citrate, sodium lactate, dibasic sodium phosphate, monobasic sodium phosphate, sodium phosphate mixtures, trimethamine, magnesium hydroxide, aluminum hydroxide, alginic acid, pyrogen-free water, isotonic saline, Ringers solution, and ethyl alcohol, and combinations thereof.
In other embodiments, one or more additional small molecule drug and/or biological agents may be preferentially combined with the one or more compounds of the present invention to achieve a beneficial, or even synergistic, outcome in the subject. Certain compounds of the present invention are also useful as co-therapeutic compounds for use in combination with other one or more additional agents/drug substances, immunogenic compositions, and/or vaccines against other STDs available now or as they become available (e.g., T pailidum, C. tachomatis, HPV- 6, 11, 16, 18, 31, 33,45, 52, and 58, HSV-2, AIDS, and the like).
It will be readily apparent to those skilled in the art that other suitable modifications and adaptations of the compositions and methods of the invention described herein are obvious and may be made using suitable equivalents without departing from the scope of the invention or the embodiments disclosed herein.
Typically, compositions of present invention are administered in a manner consistent with vaccine formulations, and in such amounts as will be therapeutically effective and/or immunogenic. The quantity to be administered depends on the subject to be treated, including the capacity of the individual's immune system to synthesize antibodies and the degree of protection desired. Precise amounts of active ingredient required to be administered depend on the judgment of the practitioner. Typically, from about 0.1, to 1, to 5, to 10, to 20, to 30, to 40, to 50, to 60, to 70, to 80, to 90, to 100 ng, rig, or mg may be administered per vaccination or administration.
Suitable regimes for initial administration and booster shots are also variable, but are typified by an initial administration followed by subsequent inoculations or other administrations. In some embodiments, from 1, 2, 3, 4, 5, . . 10, . . 20,. . .
35, . . . 55, . .
100, . . 1,000, . . 10,000, or more, units of time (e.g., minutes, hours, days, weeks, etc.) pass between the first administration of a composition and subsequent administration(s) to a subject. In some of these embodiments, the interval(s) between any two or more administrations are constant (e.g., of equal duration). In still other embodiments, the interval(s) between any two or more administrations are varied (e.g., not of equal duration).
Varied intervals can be either random or repeating and formulaic.
More particularly, the compositions and methods of the present invention are immunogenic and/or prophylactic and are administered to a subject to treat and more preferably prevent infection with and/or disease caused AL gonorrhoeae.
Accordingly, the present invention specifically contemplates providing a first administration of the immunogenic con-positions/vaccines at a time zero, and a subsequent second, third, fourth, etc., administration from 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, ... 30, ... 60, ... 90, or more months subsequent, respectively, between subsequent administration(s).
Thusly, an administration schedule can proceed with administrations occurring every 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, ... 30, ... 60, ... 90, or more, days or months apart. In preferred embodiments, a first administration of the present immunogenic compositions/vaccines is followed by a subsequent booster administration.
A single dose of the present compositions will normally be in the range of from about .001 mL to about 5.0 mL of the composition; preferably the single dose is about 0.03 mL to about 0.05 mL. (See, e.g., Griffiss JMcL, et al., "Relationship of dose to the reactogenicity and immunogenicity of meningococcal polysaccharide vaccines in adults."
Military Med. 150 (10): 529-533(1985)).
Of course, doses higher or lower than these amounts can be used if desired and the skilled administering physician or healthcare consultant (e.g., nurse, nurse practitioner, pharmacist, and the like) will be able to readily adjust dosing amounts and frequencies to obtain the desired results. Indeed, those skilled in the art will appreciate the steps necessary for designing and adjusting the dosing schedules and/or the dosing order of compositions or therapies as mentioned herein. Physicians can use standard tests to determine the efficacy of the various embodiments of the inventive compositions and methods. However, in addition to these standard tests, the physician may also consider quality of life, comfort, hygiene related issues, and prevention of disease transmission in evaluating efficacy of a particular treatment regime and adjust specific administration schedules.
Methods and schemes for administering and sufficiently dosing the immunological compositions and vaccines of the present invention are known within the art and are described herein. Other therapeutic regimens or agents can be used in conjunction with the methods and compositions, proteins or polypeptides of the present invention.
Exemplary routes of administration to the subject can be through the eyes (ophthalmic), mouth (oral), skin (transdermal), nose (nasal), lungs (inhalant), oral mucosa (buccal), ear, etc., by injection (e.g., intravenously, subcutaneously, inlratumorally, intraperitoneally, etc.) and the like. In specific embodiments, suitable routes of administration indude, for example, oral or transmucosal administration as well as parenteral delivery (e.g., intramuscular, subcutaneous, intramedullary, intrathecal, intraventricular, intravenous, intraperitoneal, or intranasal administration). A brief review of methods for drug delivery is provided by Langer, Science, 249:1527-1533 (1990).
The present invention further provides embodiments comprising injectable preparations for example, sterile injectable aqueous or oleaginous suspensions. A sterile injectable preparation may be a sterile injectable solution, suspension or emulsion in a nontoxic parenterally acceptable diluent or solvent, for example, as a solution in 1,3-butanediol, using physiological saline, aqueous solutions such as Ringers solution, U.S.P., isotonic sodium chloride solution, and non-aqueous solutions, such as vegetable oils, high fatty acid esters (e.g., ethyl oleic acid, etc.), alcohols (e.g., ethanol, benzyl alcohol, propylene glycol and glycerin, etc.). The injectable preparation(s) may be supplemented with pharmaceutical carriers, which are exemplified by a stabilizer for preventing degeneration (e.g., ascorbic acid, sodium hydrogen sulfite, sodium pyrosulfite, BHA, tocopherol, EDTA, eta), or reagents, and techniques, for facilitating solidification/semi-solidification of the preparation(s) (e.g., foam drying, freeze-foam drying, spray drying (atomization), spray-freeze-drying, evaporative drying, percolative drying, vacuum drying, lyophilization, micropelleting, pilling, and variations thereof, eta), an emulsifier(s), an excipient(s), a buffering agent for pH adjustment, and a preservative for inhibiting contamination, including but not limited to, microbial growth (e.g., phenylmercury nitrate, thimerosal, benzalkonium chloride, phenol, cresol, benzyl alcohol, eta), and other appropriate GRAS
reagents.
Injectable formulations can be sterilized, for example, by filtration through a bacterial-retaining filter, or by incorporating sterilizing agents in the form of sterile solid compositions which can be dissolved or dispersed in sterile water or other sterile injectable medium prior to use.
In addition to standard needle delivered formulations and methods of administration (e.g., intramuscular and transcutaneous and the like), certain formulations and embodiments of the compositions and methods of the present invention are suitable for delivery using intradermal delivery devices (Le., short singular or plural needle arrays) such as those described in U.S. 4,886,499; U.S.5,190,521; U.S. 5,328,483; U.S. 5,527,288;
U.S.
4,270,537; U.S. 5,015,235; U.S. 5,141,496; and U.S. 5,417,662 (each of which is specifically incorporated by reference in its entirety). Accordingly, compositions formulated for intradermal delivery may be administered by devices that limit the effective penetration of a needle into the skin, such as those described in PCT publication W099/34850 and functional equivalents thereof. In still further embodiments, jet injection devices which deliver liquid vaccines to the dermis via a liquid jet injector and/or via a needle which pierces the stratum coraeum and produces a jet which reaches the dermis are suitable. Jet injection devices are described, for example, in U.S. 5,480,381; U.S. 5,599,302; U.S. 5,334,144;
U.S. 5,993,412;
U.S. 5,649,912; U.S. 5,569,189; U.S. 5,704,911; U.S. 5,383,851; U.S.
5,893,397; U.S.
5,466,220; U.S. 5,339,163; U.S. 5,312,335; U.S. 5,503,627; U.S. 5,064,413;
U.S. 5,520,639;
U.S. 4,596,556; U.S. 4,790,824; U.S. 4,941,880; and U.S. 4,940,460; and PCT
publications WO 97/37705 and WO 97/13537 (each of which is incorporated by reference in its entirety).
In yet other embodiments, ballistic powder/particle delivery devices that use compressed gas to accelerate a vaccine in powder form through the outer layers of the skin to the dermis are suitable. Alternatively, or additionally, conventional syringes may be used in the classical Mantoux method of intradermal administration.
Compositions for oral administration are typically liquid or in solid dosage forms.
Compositions for oral administration may include protease inhibitors, including organic acids such as citric acid, in order to inhibit pancreatic and brush border proteases. Compositions for oral administration may additionally include absorption enhancers, such as acylcarnitine and lauroylcarnitine, to facilitate the uptake of the peptide through the lumen of the intestine into the systemic circulation by a paracellular transport mechanism.
Compositions for oral administration may additionally include detergents to improve the solubility of the peptides and excipients and to decrease interactions with intestinal mucus. Solid form compositions for oral administration, such as tablets or capsules, may typically comprise an enteric coating which further protects the peptides from stomach proteases and permits passage of the tablet or capsule into the small intestine. The solid form composition may additionally comprise a subcoat such as a non-ionic polymer. Examples of preparation of such orally available formulations are disclosed in U.S. 5,912,014; U.S. 6,086,918; and U.S. 6,673,574.
The disclosure of each of these documents is hereby incorporated herein by reference in its entirety.
In particular solid formulation embodiments intended for oral administration, the compositions are presented as capsules, tablets, pills, powders, or granules.
In certain of these solid dosage forms, the active ingredients (e.g., LOS antigens and/or adjuvant(s)) are mixed with at least one inert, pharmaceutically acceptable excipient or carrier such as sodium citrate or dicalcium phosphate and/or a) fillers or extenders such as starches, lactose, sucrose, glucose, rnannitol, and silicic acid, b) binders such as, for example, carboxymethylcellulose, alginates, gelatin, polyvinylpyrrolidinone, sucrose, and acacia, c) humectants such as glycerol, d) disintegrating agents such as agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, and sodium carbonate, e) solution retarding agents such as paraffin, f) absorption accelerators such as quaternary ammonium compounds, g) wetting agents such as, for example, cetyl alcohol and glycerol monostearate, h) absorbents such as kaolin and bentonite clay, and i) lubricants such as talc, calcium stearate, magnesium stearate, solid polyethylene glycols, sodium lauryl sulfate, and mixtures thereof. In the case of capsules, tablets and pills, the dosage form may comprise buffering agents.
Solid compositions of a similar type may be employed as fillers in soft- and hard-filled gelatin capsules using such excipients as lactose or milk sugar as well as high molecular weight polyethylene glycols and the like. The solid dosage forms of tablets, dragees, capsules, pills, and granules can be prepared with coatings and shells such as enteric coatings and other coatings well known in the pharmaceutical formulating art.
They may optionally comprise pacifying agents and can be of a composition that they release the active ingredient(s) only, or preferentially, in a certain part of the intestinal tract, optionally, in a delayed manner. Examples of embedding compositions which can be used include polymeric substances and waxes. Solid compositions of a similar type may be employed as fillers in soft- and hard-filled gelatin capsules using such excipients as lactose or milk sugar as well as high molecular weight polyethylene glycols and the like.
The solid dosage forms of tablets, dragees, capsules, pills, and granules can be prepared with coatings and shells such as enteric coatings, release controlling coatings and other coatings well known in the pharmaceutical formulating art. In such solid dosage forms the active ingredient may be admixed with at least one inert diluent such as sucrose, lactose or starch. Such dosage forms may comprise, as is normal practice, additional substances other than inert diluents, e.g., tableting lubricants and other tableting aids such a magnesium stearate and microcrystalline cellulose. In the case of capsules, tablets and pills, the dosage forms may comprise buffering agents. They may optionally comprise opacifying agents and can be of a composition that they release the active ingredient(s) only, or preferentially, in a certain part of the intestinal tract, optionally, in a delayed manner.
Examples of embedding compositions which can be used include polymeric substances and waxes.
In certain embodiments, exemplary techniques and reagents for solidification/semi-solidification of the compositions in particular embodiments may be found in, for example, U.S. 5,307,640; U.S. 5,897,852; U.S. 6,106,836; U.S. 6,458,363; U.S.
7,836,606; U.S.
20080060213; U.S. 12/397,140; U.S. 12/500,156; and EP 0 689 867B1; EP 0 799 61361;
EP 1 140 152B1; EP 1 794 524B1; WO 2003/072016; WO 2004/073652; WO
2006/008006;
FR 1054443; and FR 1056961, each of which is incorporated herein by reference in its entirety.
In still other embodiments, for aerosol administration, the compositions and vaccines of the present invention are preferably supplied in finely divided form along with a surfactant and propellant. The surfactant must, of course, be nontoxic, and preferably soluble in the propellant. Representatives of such agents are the esters or partial esters of fatty acids containing from 6 to 22 carbon atoms, such as caproic, octanoic, lauric, palmitic, stearic, linoleic, linolenic, olesteric and oleic acids with an aliphatic polyhydric alcohol or its cyclic anhydride. Mixed esters, such as mixed or natural glycerides may be employed.
A carrier can also be included, as desired, such as the inclusion of lecithin for intranasal delivery.
Formulations suitable for nasal administration may, for example, comprise from about as little as 0.1% (w/w) and as much as 100% (w/w) of the active ingredient, and may comprise one or more of the additional ingredients described herein. A vaccine of the invention may be prepared, packaged, and/or sold in a formulation suitable for buccal administration. Such formulations may, for example, be in the form of tablets and/or lozenges made using conventional methods, and may, for example, comprise about 0.1% to 20% (w/w) active ingredient, the balance comprising an orally dissolvable and/or degradable composition and, optionally, one or more of the additional ingredients.
Alternately, formulations suitable for administration to buccal mucosa may comprise a powder and/or an aerosolized and/or atomized solution and/or suspension comprising the active ingredient.
Such powdered, aerosolized, and/or aerosolized formulations, when dispersed, may have an average particle and/or droplet size in the range from about 0.1 pm to about 200 pm, and may further comprise one or more of the additional ingredients (constituents).
All constituents of the compositions whether biologically, or more particularly immunologically active (i.e., immunogens, antigens, adjuvants, and the like) or conversely inert (e.g., excipients, diluents, buffers, and the like) are selected such that they do not deleteriously react (e.g., acutely diminish stability or immunological efficacy and the like) with other constituents of the composition or produce untoward or adverse reactions in a subject.
Depending on the condition being treated, preferred embodiments of the present invention are formulated and administered systemically or locally.
INCORPORATION BY REFERENCE
The contents of all cited references including literature references as well as all foreign patents and foreign patent applications that are cited throughout this application are hereby expressly and specifically incorporated by reference in their entireties. Additionally, all U.S. Patent Publications, U.S. Patent Applications, and U.S. Patents and any international patent documents mentioned are hereby expressly and specifically incorporated by reference in their entireties.

Claims (23)

What is claimed is:

1. An immunogenic composition comprising a GalNAc-nLc4 a chain and an nLc4 a chain from a strain of N. gononhoeae.

2. The immunogenic composition of claim 1, further comprising a lipid A moiety from a strain of N. gononhoeae.

3. The immunogenic composition of claim 2, further comprising an adjuvant.

4. The immunogenic composition of claim 3, wherein said adjuvant is a metallic salt.

5. The immunogenic composition of claim 4, wherein said metallic salt comprises an aluminum salt.

6. The immunogenic composition of claim 5, wherein said aluminum salt is selected from the group consisting of aluminum hydroxide, aluminum oxyhydroxide, aluminum hydroxyphosphate, aluminum hydroxyphosphate sulfate, aluminum phosphate, or potassium aluminum phosphate.

7. The immunogenic composition of claim 3, for use as a vaccine against gonococcal infection in a subject.

8. The immunogenic composition of claim 3, further comprising at least one buffer, diluent, solvent, or excipient.

9. An N. gonon-hoeae vaccine comprising a GalNAc-nLc4 a chain and an nLc4 a chain from a strain of N. gonorrhoeae.

10. The N. gonorrhoeae vaccine of claim 9, further comprising a lipid A moiety from a strain of N. gononhoeae.

11. The AI gonorrhoeae vaccine of claim 10, further comprising an adjuvant.

12. The N. gonorrhoeae vaccine of claim 11, wherein said adjuvant is a metallic salt.

13. The N. gonorrhoeae vaccine of claim 12, wherein said metallic salt comprises an aluminum salt.

14. The N. gonorrhoeae vaccine of claim 13, wherein said aluminum salt is selected from the group consisting of aluminum hydroxide, aluminum oxyhydroxide, aluminum hydroxyphosphate, aluminum hydroxyphosphate sulfate, aluminum phosphate, or potassium aluminum phosphate.

15. The N. gonorrhoeae vaccine of claim 11, further comprising at least one buffer, diluent, solvent, or excipient.

16. A method for preparing an N. gonorrhoeae vaccine comprising a GalNAc-nLc4 a chain, an nLc4 a chain, and a lipid A moiety from a strain of N. gonorrhoeae in a nonpathogenic human commensal species of Neisseria.

17. The method of claim 16, wherein said commensal species is selected from the group consisting of N. cinerea, N. elongate, N. flavescens, N. lactamica, N. mucosa, N.
polysaccharea, N.. sicca, N. subflava, N. perflava, and N. flava.

18. The method of claim 17, wherein said commensal species is N. lactamica.

19. The method of claim 18, wherein said N. lactamica is transformed with an operon derived from N. gonotrhoeae strain F62.

20. A medical use of the N. gonorrhoeae vaccine.

21. The medical use of claim 20, wherein infection by N. gonorrhoeae is prevented in a subject.

22. A method for preventing infection by N. gonorrhoeae in a subject comprising administering a first dose of the N. gonorrhoeae vacdne of claim 11 to said subject.

23. The method for preventing infection by N. gononhoeae in a subject in claim 22, further comprising administering a second dose of said N. gonorrhoeae vaccine.