Mucosal ACP subunit vaccine formulated with a small molecule STING agonist drives protective TH1/TH17 responses and serum bactericidal antibodies against Neisseria gonorrhoeae

STING agonists are emerging vaccine adjuvants; however, only cyclic dinucleotides (low permeability and stability) have been tested against pathogenic bacteria. We examined diABZI, a non-nucleotide STING agonist active in human and murine orthologs, combined with the Neisseria gonorrhoeae (Ng) Adhesin Complex Protein, a conserved adhesin and human lysozyme C inhibitor, as a gonococcal vaccine. Intranasal administration of recombinant ACP (rACP)+diABZI accelerated gonococcal clearance, in contrast to rACP or rACP+CpG+MPLA, despite comparable antibody responses. While both diABZI and CpG+MPLA induced TH1, diABZI also induced TH17 polarization. Peptide mapping localized the immunodominant T cell epitopes to the ACP-lysozyme C interface. rACP+diABZI elicited higher human serum bactericidal activity (hSBA), that correlated with Ng clearance, and antibodies that reversed human lysozyme C inhibition and interfered with Ng adhesion and invasion in 3D human vaginal/urethral mucosal models. Passive serum transfer did not recapitulate protection, implicating mucosal antibodies and cellular immunity over circulating IgG.