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      Pre-clinical evaluation of a P. berghei-based whole-sporozoite malaria vaccine candidate

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          Abstract

          Whole-sporozoite vaccination/immunization induces high levels of protective immunity in both rodent models of malaria and in humans. Recently, we generated a transgenic line of the rodent malaria parasite P. berghei ( Pb) that expresses the P. falciparum ( Pf) circumsporozoite protein ( PfCS), and showed that this parasite line ( PbVac) was capable of (1) infecting and developing in human hepatocytes but not in human erythrocytes, and (2) inducing neutralizing antibodies against the human Pf parasite. Here, we analyzed PbVac in detail and developed tools necessary for its use in clinical studies. A microbiological contaminant-free Master Cell Bank of PbVac parasites was generated through a process of cyclic propagation and clonal expansion in mice and mosquitoes and was genetically characterized. A highly sensitive qRT-PCR-based method was established that enables PbVac parasite detection and quantification at low parasite densities in vivo. This method was employed in a biodistribution study in a rabbit model, revealing that the parasite is only present at the site of administration and in the liver up to 48 h post infection and is no longer detectable at any site 10 days after administration. An extensive toxicology investigation carried out in rabbits further showed the absence of PbVac-related toxicity. In vivo drug sensitivity assays employing rodent models of infection showed that both the liver and the blood stage forms of PbVac were completely eliminated by Malarone ® treatment. Collectively, our pre-clinical safety assessment demonstrates that PbVac possesses all characteristics necessary to advance into clinical evaluation.

          Malaria: Pre-clinical characterization of transgenic malaria vaccine

          PbVac is a transgenic malaria parasite expressing circumsporozoite antigen from the human parasite Plasmodium falciparum. PbVac elicits neutralizing P. falciparum antibodies and can infect human hepatocytes but not erythrocytes, suggesting that humans would be non-permissive. Miguel Prudêncio and colleagues at the Institute of Molecular Medicine in Lisbon perform a detailed in vivo analysis and toxicology of PbVac. Extensive biodistribution analysis using a highly sensitive qPCR in non-permissive rabbit hosts shows PbVac are present at the initial bite site early on with later appearance in the liver, but by day 10 is undetectable. Importantly no PbVac could be detected in the blood at any time-point. PbVac was well tolerated with no apparent pathological signatures. In permissive mouse hosts PbVac could be effectively eliminated from both the blood and liver and could thereby act as a potential clinical ‘safety net’ in the event of an erythrocytic stage or persistence in the liver.

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          Most cited references38

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          A comprehensive survey of the Plasmodium life cycle by genomic, transcriptomic, and proteomic analyses.

          Plasmodium berghei and Plasmodium chabaudi are widely used model malaria species. Comparison of their genomes, integrated with proteomic and microarray data, with the genomes of Plasmodium falciparum and Plasmodium yoelii revealed a conserved core of 4500 Plasmodium genes in the central regions of the 14 chromosomes and highlighted genes evolving rapidly because of stage-specific selective pressures. Four strategies for gene expression are apparent during the parasites' life cycle: (i) housekeeping; (ii) host-related; (iii) strategy-specific related to invasion, asexual replication, and sexual development; and (iv) stage-specific. We observed posttranscriptional gene silencing through translational repression of messenger RNA during sexual development, and a 47-base 3' untranslated region motif is implicated in this process.
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            Protection against a malaria challenge by sporozoite inoculation.

            An effective vaccine for malaria is urgently needed. Naturally acquired immunity to malaria develops slowly, and induction of protection in humans can be achieved artificially by the inoculation of radiation-attenuated sporozoites by means of more than 1000 infective mosquito bites. We exposed 15 healthy volunteers--with 10 assigned to a vaccine group and 5 assigned to a control group--to bites of mosquitoes once a month for 3 months while they were receiving a prophylactic regimen of chloroquine. The vaccine group was exposed to mosquitoes that were infected with Plasmodium falciparum, and the control group was exposed to mosquitoes that were not infected with the malaria parasite. One month after the discontinuation of chloroquine, protection was assessed by homologous challenge with five mosquitoes infected with P. falciparum. We assessed humoral and cellular responses before vaccination and before the challenge to investigate correlates of protection. All 10 subjects in the vaccine group were protected against a malaria challenge with the infected mosquitoes. In contrast, patent parasitemia (i.e., parasites found in the blood on microscopical examination) developed in all five control subjects. Adverse events were mainly reported by vaccinees after the first immunization and by control subjects after the challenge; no serious adverse events occurred. In this model, we identified the induction of parasite-specific pluripotent effector memory T cells producing interferon-gamma, tumor necrosis factor alpha, and interleukin-2 as a promising immunologic marker of protection. Protection against a homologous malaria challenge can be induced by the inoculation of intact sporozoites. (ClinicalTrials.gov number, NCT00442377.) 2009 Massachusetts Medical Society
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              Live attenuated malaria vaccine designed to protect through hepatic CD8⁺ T cell immunity.

              Our goal is to develop a vaccine that sustainably prevents Plasmodium falciparum (Pf) malaria in ≥80% of recipients. Pf sporozoites (PfSPZ) administered by mosquito bites are the only immunogens shown to induce such protection in humans. Such protection is thought to be mediated by CD8(+) T cells in the liver that secrete interferon-γ (IFN-γ). We report that purified irradiated PfSPZ administered to 80 volunteers by needle inoculation in the skin was safe, but suboptimally immunogenic and protective. Animal studies demonstrated that intravenous immunization was critical for inducing a high frequency of PfSPZ-specific CD8(+), IFN-γ-producing T cells in the liver (nonhuman primates, mice) and conferring protection (mice). Our results suggest that intravenous administration of this vaccine will lead to the prevention of infection with Pf malaria.
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                Author and article information

                Contributors
                +351217999513 , mprudencio@medicina.ulisboa.pt
                Journal
                NPJ Vaccines
                NPJ Vaccines
                NPJ Vaccines
                Nature Publishing Group UK (London )
                2059-0105
                27 November 2018
                27 November 2018
                2018
                : 3
                : 54
                Affiliations
                [1 ]ISNI 0000 0001 2181 4263, GRID grid.9983.b, Instituto de Medicina Molecular, Faculdade de Medicina, , Universidade de Lisboa, ; Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
                [2 ]ISNI 0000 0004 0444 9382, GRID grid.10417.33, Department of Medical Microbiology, , Radboud University Medical Center, ; Geert Grooteplein 28, Microbiology 268, 6500 HB Nijmegen, The Netherlands
                [3 ]ISNI 0000 0004 0606 5382, GRID grid.10306.34, Parasite Genomics, , Wellcome Trust Sanger Institute, ; Hinxton, Cambridge, CB10 1SA UK
                [4 ]ISNI 0000000089452978, GRID grid.10419.3d, Leiden Malaria Research Group, Parasitology, Center of Infectious Diseases, , Leiden University Medical Center, ; Leiden, The Netherlands
                [5 ]PATH’s Malaria Vaccine Initiative, 455 Massachusetts Ave, Washington, DC 20001 USA
                [6 ]ISNI 0000 0001 2193 314X, GRID grid.8756.c, Present Address: Centre of Immunobiology, Institute of Infection, Immunity & Inflammation, MVLS, , University of Glasgow, ; Glasgow, UK
                Author information
                http://orcid.org/0000-0001-6562-5325
                http://orcid.org/0000-0002-1783-0735
                http://orcid.org/0000-0002-9763-8857
                http://orcid.org/0000-0002-1246-7404
                http://orcid.org/0000-0001-5571-8616
                http://orcid.org/0000-0003-1746-6029
                Article
                91
                10.1038/s41541-018-0091-3
                6258718
                2b8b3b2c-27b5-42dc-af0c-a62bae5976d0
                © The Author(s) 2018

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 4 June 2018
                : 17 October 2018
                Funding
                Funded by: PATH - Malaria Vaccine Initiative
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                © The Author(s) 2018

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