Nowadays, the technology of multi-epitope antigens is widespread. Design and construction of multi-epitope DNA and protein antigens can serve as (i) a vaccine candidate against different cancers like breast cancer and cervical cancer (
27,
28), (ii) a vaccine candidate for the prevention and control of some infectious diseases like Toxoplasmosis, Influenza, and HIV-1 (
29-
31), and (iii) an antigen in diagnostic kits for
Trypanosoma cruzi,
Toxoplasma gondii,
Hepatitis C, and Tuberculosis (
32-
35). Several virulence genes of
H. pylori have been identified, some of which including UreB, HpaA, NapA, FlaA, and FlaB have been investigated as vaccines and serologic diagnostic candidates for
H. pylori infection (
36-
39).
The prevalence of these antigens in
H. pylori isolated strains is 100%, 100%, 93.6%, 100%, and 99%, respectively. Therefore, among proteins,
UreB is the optimal antigen and others can be potential antigens for developing
H. pylori diagnostic kits and vaccines (
40). The benefits of this protein in stimulating immune responses include the same nucleotide sequence and high prevalence among strains, high molecular weight, high expression rate, and strong antigenicity of urea protein (
41). Previous research on this antigen showed despite these benefits, oral immunization with a dual antigen was achieved using a combination of
H. pylori heat-shock protein and urease in
H. felis-infected mice models and induced a strong immune response.
Similarly, in another study, immunization with
HpaA or
UreB alone induced weak immune responses; however, when both antigens were used together, a stronger immune response was produced (
42-
45). These results indicate that combining antigens can be a good strategy for developing vaccines against
H. pylori infection. Moreover, a mixture of antigens in diagnostic kits provides higher sensitivity and specificity than a single antigen (
12-
15). The 100%
FlaA expression rate among different
H. pylori isolates and 98.4% of its specific antibody positive rate in infected patients (with the highest expression rate and specific antibody positive rate in the second rank after
UreB) make it appropriate for selection compared to other antigens of
H. pylori (
40).
The construction of many epitope proteins involves several proteins or domains of proteins. The linker sequence is particularly important for the construction of functional fusion proteins. Several studies have investigated the linker sequence, showing that the flexibility and hydrophilicity of the linker were important in the function of domains. For this reason, we chose LAAA as a peptide linker for making a recombinant multi-epitope protein (
46).
Therefore, in this study, we decided to design and construct a multi-epitope antigen via combining the hyperantigenic regions of
UreB with the hyperantigenic regions of
FlaA in order to increase the specific immune response and safety and decrease side effects of unfavorable epitopes associated with complete antigens. Conserved epitopes of
UreB and
FlaA with appropriate antigen properties were determined by bioinformatics methods and used instead of whole antigens (
11). These regions were confirmed by four software applications, as mentioned earlier. Based on the results, the recombinant protein had high antigenicity and could stimulate the immune response.
In this study, the antigenicity of the specified regions was evaluated through the production of recombinant rFlaA-UreB. Then, the antigenicity of the protein was examined by immunoblotting, performed on the patients’ sera with H. pylori infection. Therefore, it can be concluded although rFlaA-UreB is much smaller than normal UreB and FlaA, it has the same antigenic properties. Thus, it seems this recombinant protein can be effectively used for vaccines. Moreover, it could be applied as a diagnostic antigen for H. pylori infections in different kits.
5.1. Conclusions
In summary, the study identified the antigenic areas of recombinant rFlaA-UreB protein by human sera infected with H. pylori. It can be concluded that the antigenic areas of this multi-epitope protein have an antigenic property that can be further used for the development of H. pylori vaccines and diagnostic kits.