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      Is Open Access

      Strains used in whole organism Plasmodium falciparum vaccine trials differ in genome structure, sequence, and immunogenic potential

      research-article
      1 , 2 , 1 , 1 , 3 , 1 , 3 , 3 , 3 , 4 , 5 , 6 , 6 , 1 , 3 , 1 , 1 , 3 , 1 , 1 , 7 , 7 , 7 , 7 , 8 , 5 , 3 , 9 , 3 , 3 , 10 , 3 , 1 , 4 , 4 , 3 , 9 , 1 , 11 ,
      Genome Medicine
      BioMed Central
      P. falciparum, Malaria, Genome assembly, PfSPZ vaccine, Whole-sporozoite vaccine

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          Abstract

          Background

          Plasmodium falciparum (Pf) whole-organism sporozoite vaccines have been shown to provide significant protection against controlled human malaria infection (CHMI) in clinical trials. Initial CHMI studies showed significantly higher durable protection against homologous than heterologous strains, suggesting the presence of strain-specific vaccine-induced protection. However, interpretation of these results and understanding of their relevance to vaccine efficacy have been hampered by the lack of knowledge on genetic differences between vaccine and CHMI strains, and how these strains are related to parasites in malaria endemic regions.

          Methods

          Whole genome sequencing using long-read (Pacific Biosciences) and short-read (Illumina) sequencing platforms was conducted to generate de novo genome assemblies for the vaccine strain, NF54, and for strains used in heterologous CHMI (7G8 from Brazil, NF166.C8 from Guinea, and NF135.C10 from Cambodia). The assemblies were used to characterize sequences in each strain relative to the reference 3D7 (a clone of NF54) genome. Strains were compared to each other and to a collection of clinical isolates (sequenced as part of this study or from public repositories) from South America, sub-Saharan Africa, and Southeast Asia.

          Results

          While few variants were detected between 3D7 and NF54, we identified tens of thousands of variants between NF54 and the three heterologous strains. These variants include SNPs, indels, and small structural variants that fall in regulatory and immunologically important regions, including transcription factors (such as PfAP2-L and PfAP2-G) and pre-erythrocytic antigens that may be key for sporozoite vaccine-induced protection. Additionally, these variants directly contributed to diversity in immunologically important regions of the genomes as detected through in silico CD8 + T cell epitope predictions. Of all heterologous strains, NF135.C10 had the highest number of unique predicted epitope sequences when compared to NF54. Comparison to global clinical isolates revealed that these four strains are representative of their geographic origin despite long-term culture adaptation; of note, NF135.C10 is from an admixed population, and not part of recently formed subpopulations resistant to artemisinin-based therapies present in the Greater Mekong Sub-region.

          Conclusions

          These results will assist in the interpretation of vaccine efficacy of whole-organism vaccines against homologous and heterologous CHMI.

          Electronic supplementary material

          The online version of this article (10.1186/s13073-019-0708-9) contains supplementary material, which is available to authorized users.

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          Most cited references52

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          Analysis of Plasmodium falciparum diversity in natural infections by deep sequencing

          Malaria elimination strategies require surveillance of the parasite population for genetic changes that demand a public health response, such as new forms of drug resistance. 1,2 Here we describe methods for large-scale analysis of genetic variation in Plasmodium falciparum by deep sequencing of parasite DNA obtained from the blood of patients with malaria, either directly or after short term culture. Analysis of 86,158 exonic SNPs that passed genotyping quality control in 227 samples from Africa, Asia and Oceania provides genome-wide estimates of allele frequency distribution, population structure and linkage disequilibrium. By comparing the genetic diversity of individual infections with that of the local parasite population, we derive a metric of within-host diversity that is related to the level of inbreeding in the population. An open-access web application has been established for exploration of regional differences in allele frequency and of highly differentiated loci in the P. falciparum genome.
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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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              Independent emergence of artemisinin resistance mutations among Plasmodium falciparum in Southeast Asia.

              The emergence of artemisinin-resistant Plasmodium falciparum in Southeast Asia threatens malaria treatment efficacy. Mutations in a kelch protein encoded on P. falciparum chromosome 13 (K13) have been associated with resistance in vitro and in field samples from Cambodia. P. falciparum infections from artesunate efficacy trials in Bangladesh, Cambodia, Laos, Myanmar, and Vietnam were genotyped at 33 716 genome-wide single-nucleotide polymorphisms (SNPs). Linear mixed models were used to test associations between parasite genotypes and parasite clearance half-lives following artesunate treatment. K13 mutations were tested for association with artemisinin resistance, and extended haplotypes on chromosome 13 were examined to determine whether mutations arose focally and spread or whether they emerged independently. The presence of nonreference K13 alleles was associated with prolonged parasite clearance half-life (P = 1.97 × 10(-12)). Parasites with a mutation in any of the K13 kelch domains displayed longer parasite clearance half-lives than parasites with wild-type alleles. Haplotype analysis revealed both population-specific emergence of mutations and independent emergence of the same mutation in different geographic areas. K13 appears to be a major determinant of artemisinin resistance throughout Southeast Asia. While we found some evidence of spreading resistance, there was no evidence of resistance moving westward from Cambodia into Myanmar. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
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                Author and article information

                Contributors
                kmoser@umaryland.edu
                elliott.drabek@gmail.com
                adwivedi@som.umaryland.edu
                emily.stucke@umaryland.edu
                jcrabtree@som.umaryland.edu
                tonydara@icermali.org
                zshah@som.umaryland.edu
                madams@som.umaryland.edu
                tli@sanaria.com
                priscilathihara@usp.br
                sergey.koren@nih.gov
                adam.phillippy@nih.gov
                jmunro@som.umaryland.edu
                amouattara@som.umaryland.edu
                BSparklin@som.umaryland.edu
                jdhotopp@som.umaryland.edu
                klyke@som.umaryland.edu
                lsadzewicz@som.umaryland.edu
                ljtallon@som.umaryland.edu
                Michele.Spring.ctr@afrims.org
                KrisadaJ.fsn@afrims.org
                chanthapl.ca@afrims.org
                david.l.saunders.mil@mail.mil
                muferrei@gmail.com
                myaing.nyunt@duke.edu
                mlaufer@som.umaryland.edu
                mtravass@som.umaryland.edu
                Robert.Sauerwein@radboudumc.nl
                STakala@som.umaryland.edu
                cmfraser@som.umaryland.edu
                ksim@sanaria.com
                slhoffman@sanaria.com
                chris.plowe@duke.edu
                jcsilva@som.umaryland.edu
                Journal
                Genome Med
                Genome Med
                Genome Medicine
                BioMed Central (London )
                1756-994X
                8 January 2020
                8 January 2020
                2020
                : 12
                : 6
                Affiliations
                [1 ]ISNI 0000 0001 2175 4264, GRID grid.411024.2, Institute for Genome Sciences, , University of Maryland School of Medicine, ; Baltimore, MD 21201 USA
                [2 ]ISNI 0000000122483208, GRID grid.10698.36, Present address: Institute for Global Health and Infectious Diseases, , University of North Carolina Chapel Hill, ; Chapel Hill, USA
                [3 ]ISNI 0000 0001 2175 4264, GRID grid.411024.2, Center for Vaccine Development and Global Health, , University of Maryland School of Medicine, ; Baltimore, MD 21201 USA
                [4 ]GRID grid.280962.7, Sanaria, Inc., ; Rockville, MD 20850 USA
                [5 ]ISNI 0000 0004 1937 0722, GRID grid.11899.38, Department of Parasitology, Institute of Biomedical Sciences, , University of São Paulo, ; São Paulo, Brazil
                [6 ]ISNI 0000 0001 2233 9230, GRID grid.280128.1, Genome Informatics Section, Computational and Statistical Genomics Branch, , National Human Genome Research Institute, ; Bethesda, MD 20892 USA
                [7 ]ISNI 0000 0004 0419 1772, GRID grid.413910.e, Department of Bacterial and Parasitic Diseases, , Armed Forces Research Institute of Medical Sciences, ; Bangkok, Thailand
                [8 ]Present address: Warfighter Expeditionary Medicine and Treatment, US Army Medical Material Development Activity, Frederick, USA
                [9 ]ISNI 0000 0004 1936 7961, GRID grid.26009.3d, Present address: Duke Global Health Institute, , Duke University, ; Durham, NC 27708 USA
                [10 ]ISNI 0000 0004 0444 9382, GRID grid.10417.33, Department of Medical Microbiology, , Radboud University Medical Center, ; Nijmegen, Netherlands
                [11 ]ISNI 0000 0001 2175 4264, GRID grid.411024.2, Department of Microbiology and Immunology, , University of Maryland School of Medicine, ; Baltimore, MD 21201 USA
                Author information
                http://orcid.org/0000-0001-6502-7026
                Article
                708
                10.1186/s13073-019-0708-9
                6950926
                31915075
                f0472539-19a0-467c-908c-4caea10e7adc
                © The Author(s). 2020

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided 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 Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 26 June 2019
                : 19 December 2019
                Funding
                Funded by: National Institute of Allergy and Infectious Diseases (US)
                Award ID: AI110820
                Award ID: AI141900
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/100000060, National Institute of Allergy and Infectious Diseases;
                Award ID: R44AI058375
                Award ID: R44AI055229-09A1
                Award ID: AI089683
                Award ID: R01 AI125579
                Award Recipient :
                Funded by: Armed Forces Health Surveillance Center
                Award ID: WR1576
                Award ID: WR2017
                Funded by: FundRef http://dx.doi.org/10.13039/100000051, National Human Genome Research Institute;
                Award ID: 1ZIAHG200398
                Categories
                Research
                Custom metadata
                © The Author(s) 2020

                Molecular medicine
                p. falciparum,malaria,genome assembly,pfspz vaccine,whole-sporozoite vaccine
                Molecular medicine
                p. falciparum, malaria, genome assembly, pfspz vaccine, whole-sporozoite vaccine

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