# Analysis of the Short- and Long-Term Immune Response in BALB/c Mice Immunized with Total Naegleria fowleri Extract Co-Administered with Cholera Toxin

## TL;DR

A vaccine using Naegleria fowleri extract and cholera toxin protects mice from a deadly brain infection, both short-term and long-term.

## Contribution

The study demonstrates that intranasal immunization with N. fowleri extract and cholera toxin induces durable immune protection against PAM.

## Key findings

- Complete survival in mice immunized 24 hours before challenge and 60% protection after three months.
- IgA and IgG antibodies recognized key N. fowleri antigens.
- Increased activated/memory B cells and specific receptor expression in nasal tissues.

## Abstract

Background: Naegleria fowleri is a free-living amoeba that inhabits warm freshwater and causes primary amoebic meningoencephalitis (PAM), a rapidly fatal infection with >95% mortality. Due to the lack of early diagnosis and effective therapy, preventive vaccination represents a promising strategy. Methods: This study evaluated short- and long-term immune protection in BALB/c mice (20 mice per group) immunized intranasally with total N. fowleri extract co-administered with cholera toxin (CT). Mice were challenged with a lethal dose of trophozoites either 24 h (short-term) or three months (long-term) after the fourth immunization; the latter group received a booster 24 h before challenge. Serum and nasal washes were analyzed for IgA and IgG antibodies by immunoblot, and lymphocyte subsets from nasal-associated lymphoid tissue (NALT) and nasal passages (NPs) were characterized by flow cytometry. Results: Immunization conferred complete (100%) survival in the 24 h group and 60% protection in the 3-month group, whereas all control mice died. Immunoblotting showed that IgA and IgG antibodies recognized major N. fowleri antigens of 37, 45, 48 and 19, 37, and 100 kDa, respectively. Flow cytometry revealed increased activated and memory B lymphocytes, dendritic cells, and expression of CCR10, integrin α4β1, and FcγRIIB receptors, particularly in the 24 h group. Conclusions: Intranasal immunization with N. fowleri extract plus CT elicited both systemic and mucosal immune responses capable of short- and long-term protection. These findings highlight the potential of this immunization strategy as a foundation for developing effective vaccines against PAM.