AUTHOR=Gary Ebony N. , Tursi Nicholas J. , Warner Bryce M. , Cuismano Gina , Connors Jennifer , Parzych Elizabeth M. , Griffin Bryan D. , Bell Matthew R. , Ali Ali R. , Frase Drew , Hojecki Casey E. , Canziani Gabriela A. , Chaiken Irwin , Kannan Toshitha , Moffat Estella , Embury-Hyatt Carissa , Wooton Sarah K. , Kossenkov Andrew , Patel Ami , Kobasa Darwyn , Kutzler Michele A. , Haddad Elias K. , Weiner David B. TITLE=Adenosine deaminase augments SARS-CoV-2 specific cellular and humoral responses in aged mouse models of immunization and challenge JOURNAL=Frontiers in Immunology VOLUME=Volume 14 - 2023 YEAR=2023 URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1138609 DOI=10.3389/fimmu.2023.1138609 ISSN=1664-3224 ABSTRACT=Despite numerous clinically available vaccines and therapeutics, aged patients remain at increased risk for COVID-19 morbidity. Furthermore, the aged patient population has suboptimal responses to SARS-CoV-2 vaccine antigens. Here, we characterized vaccine-induced responses to SARS-CoV-2 synthetic DNA vaccine antigens in aged mice. Aged mice had altered cellular responses, including decreased IFNγ secretion and increased TNFα and IL-4 secretion suggestive of increased TH2-type responses. Aged mice had significantly decreased total binding and neutralizing antibodies in their serum but significantly increased TH2-type spike-specific IgG1 antibody compared to their young counterparts and increased. Co-immunization with the plasmid-encoded molecular adjuvant adenosine deaminase-1 (pADA) enhanced IFNγ secretion while decreasing TNFα and IL-4 secretion and expanded the breadth and affinity SARS-CoV-2 spike-specific antibodies while supporting robust TH1-type humoral responses in aged mice. scRNAseq analysis of aged lymph nodes revealed that pADA co-immunization supported a strong TH1 gene profile and decreased FoxP3 gene expression. Upon challenge pADA co-immunization resulted in similarly decreased viral loads and age-associated morbidity and mortality in SARS-CoV-2 challenge models. These data support the use of aged mice as a model for age-associated decreased vaccine immunogenicity and infection-mediated morbidity and mortality in the context of SARS-CoV-2 and provide further support for the use of adenosine deaminase as a molecular adjuvant.