Current scenario of malaria vaccine
Keywords:
Malaria-vaccine, pre-erythrocytic (PE), blood-stage (BS), circumsporozoite protein (CSP), merozoite surface protein (MSP)Abstract
Malaria is one of the deadliest infectious diseases that affects millions of people worldwide including India. As an addition to chemoprophylaxis and other antimalarial interventions malaria vaccine is under extensive research since decades. The vaccine development is more difficult to predict than drug development and presents a unique challenge as already there has been no vaccine effective against a parasite. Effective malaria vaccine could help eliminate and eradicate malaria; there are currently 63 vaccine candidates, 41 in preclinical and clinical stages of development. Vaccines are being designed to target pre-erythrocytic stages, erythrocytic stage or the sexual stages of Plasmodium taken up by a feeding mosquito, or the multiple stages. Two vaccines in preclinical and clinical development target P. falciparum; and the most advanced candidate is the pre-erythrocytic vaccine RTS,S which is in phase-III clinical trials. It is likely that world’s first malaria vaccine will be available by 2015 at the country level. More efficacious second generation malaria vaccines are on the way to development. Safety, efficacy, cost and provision of the vaccine to all communities are major concerns in malaria vaccine issue.
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References
Moree M, Ewart S. Policy challenges in malaria vaccine introduction. Am J Trop Med Hyg 2004 Aug; 71(Suppl 2):248-52.
WHO. WHO Global Malaria Programme: The World Malaria Report 2010. World health Organization 2010. Available at http://whqlibdoc.who.int/publications/2010/9789241564106_eng.pdf. Accessed 19 August 2012.
Ie Sueur D, Sharp BL, Gouws E, Ngoxongo S. Malaria in South Africa. S Afr Med J 1996;86:936-9.
WHO. World Health Report: Reducing Risks, Promoting Healthy Life. Geneva: World Health Organization 2002.
Aide P, Bassat Q, Alonso PL. Towards an effective malaria vaccine. Arch Dis Child 2007;92(6):476-9.
Bonn D. Filling the vaccine gap. Lancet Infect Dis 2005;5(1):7.
Gupta S, Snow RW, Donnelly CA, et al. Immunity to non-cerebral severe malaria is acquired after one or two infections. Nat Med 1999;5(3):340-3.
Rieckmann KH, Beaudoin RL, Causells JS, et al. Use of attenuated sporozoites in the immunization of human volunteers against falciparum malaria. Bull World Health Organ 1979:57(Suppl 1):261-5.
Alonso PL, Sacarlal J, Aponte JJ, et al. Efficacy of RTS,S/AS02A vaccine against plasmodium falciparum infection and disease in young African children: randomized controlled trial. Lancet 2004;364(9443):1411-20.
Alonso PL, Smith T, Schellenberg JR, et al. Randomized trial of efficacy of SPf66 vaccine against plasmodium falciparum malaria in children in southern Tanzania. Lancet 1994;344(8931):1175-81.
Engers HD, Godal T. Malaria vaccine development: current status. Parasitol Today 1998;14:56-64.
Beverley PC. Immunology of vaccination. Br Med Bull 2002;62:15-28.
Malaria Vaccine Technology Roadmap. Available at http://www.malariavaccine.org/malvac-roadmap.php. Accessed 2 March 2012.
McGregor IA. Mechanism of acquired immunity and epidemiological patterns of antibody responses in malaria in man. Bull World Health Organization 1974;50:259-66.
Cohen S, McGregor IA, Carrington S. Gamma globulin and acquired immunity to malaria. Nature 1961;192:733-7.
Marsh K, Howard RJ. Antigens induced on erythrocytes by P. falciparum: expression of diverse and conserved determinants. Science 1986;231:150-3.
Bouharoun-Tayoun H, Attanath P, Sabchareon A, Chongsuphajaisiddhi T, Druilhe P. Antibodies that protect humans against Plasmodium falciparum blood stages do not on their own inhibit parasite growth and invasion in vitro, but act in cooperation with mosquitos. J Exp Med 1990;172:1633-41.
Doolan DL, Hoffman SL. DNA-based vaccines against malaria: status and promise of the Multi-Stage Malaria DNA vaccine operations. Int J Parasitol 2001;31:753-62.
PATH malaria vaccine initiative (MVI). Available at http://www.malariavaccine.org/malvac-approaches.php. Accessed 2 March 2012.
Stoute JA, Slaoui M, Heppner DG, et al. A preliminary evaluation of a recombinant circumsporozoite protein vaccine against P. falciparum malaria. RTS,S Malaria vaccine evaluation group. N Engl J Med 1997;336(2):86-91.
Potocnjak P, Yoshida N, Nussenzweig RS, Nussenzweig V. Monovalent fragments (Fab) of monoclonal antibodies to a sporozoites surface antigen (Pb 44) protect mice against malarial infection. J Exp Med 1980;151:1504-13.
Nardin EH, Nussenzweig V, Nussenzweig RS, et al. Circumsporozoite proteins of human malarial parasites Plasmodium falciparum and Plasmodium vivax. J Exp Med 1982;156:20-30.
Hill AV. Vaccines against malaria. Philos Trans R Soc Lond B Biol Sci 2011;366:2806-14.
Birkett A, Lyons K, Schmidt A, et al. A modified hepatitis b virus core particle containing multiple epitomes of the P. falciparum CSP protein provides a highly immunogenic malaria vaccine in preclinical analysis in rodent and primate hosts. Infect Immun 2002;70:6860-70.
Hoffman SL, Goh LM, Luke TC, Schneider I, et al. Protection of humans against malaria by immunization with radiation-attenuated Plasmodium falciparum sporozoites. J Infect Dis 2002;185:1155-64.
Moorthy VS, Good MF, Hill AV. Malaria vaccine developments. Lancet 2004;363:150-6.
Holder AA, Guevara Patino JA, Uthaipibull C, et al. Merozoite surface protein 1, immune evasion, and vaccines against sexual blood stage malaria. Parassitologia 1999;41:409-14.
Ockenhouse CF, Sun PF, Lanar DE, et al. Phase I/IIa safety, immunogenicity, and efficacy trial of NYVAC-Pf7, a pox-vectored, multiantigen, multistage vaccine candidate for P. falciparum malaria. J Infect Dis 1998;177:1664-73.
Oeuvray C, Theisen M, Rogier C, Trape JF, Druilhe P. Cytophilic immunoglobulin responses to plasmodium falciparum glutamate rich protein are correlated with protection against clinical malaria in Dielmo, Senegal. J Infect Immun 2000;68:2617-20.
Oeuvray C, Bouharoun-Tayoun H, Gras-Masse H, et al. Merozoite surface protein-3: a malaria protein inducing antibodies that promote P. falciparum killing by cooperation with blood monocytes. Blood 1994;84(5):1594-602.
Briefing Document: National decision-making framework for malaria vaccines. Available at http://malvacdecision.net/wp-content/uploads/2012/03/D-MakingBrief-Impact-Final.pdf. Accessed 10 March 2012.
Genton B, Corradin B. Malaria vaccines: from laboratory to the field. Curr Drug Targets Immune Endocr Metabol Disord 2002;2:255-67.
Abdulla S, Oberholzer R, Juma O, et al. Safety and immunogenicity of RTS,S/AS02D malaria vaccine in infants. N Engl J Med 2008;359:2533-44.
Alonso PL, Sacarlal J, Aponte JJ, et al. Duration of protection with RTS,S/AS02A malaria vaccine in prevention of Plasmodium falciparum disease in Mozambican children: single-blind extended follow-up of a randomised controlled trial. Lancet 2005;366(9502):2012-18.
Aponte JJ, Aide P, Renom M, et al. Safety of the RTS,S/AS02D candidate malaria vaccine in infants living in a highly endemic area of Mozambique: a double blind randomised controlled phase I/IIb trial. Lancet 2007;370(9598):1543-51.
Bejon P, Lusingu J, Olotu A, et al. Efficacy of RTS,S/AS01E vaccine against malaria in children 5 to 17 months of age. N Engl J Med 2008;359:2521-32.
Sacarlal J, Aide P, Aponte JJ, Renom M, Leach A, Mandomando I, et al. Long-term safety and efficacy of RTS,S/AS02A malaria vaccine in Mozambican children. J Infect Dis 2009;200:329-36.
Guinovart C, Aponte JJ, Sacarlal J, Aide P, Leach A, Bassat Q, et al. Insights into log-lasting protection induced by RTS,S/AS02A malaria vaccine: further results from a phase IIb trial in Mozambican children. PLoS One. 2009;4(4):e5165.
Olotu A, Lusingu J, Leach A, Lievens M, Vekemans J, Msham S, et al. Efficacy of RTS,S/AS01E malaria vaccine and exploratory analysis on anti-circumsporozoite antibody titres and protection in children aged 5-17 months in Kenya and Tanzania: a randomised controlled trial. Lancet Infect Dis 2011;11(2):102-9.
Stoute JA, Kester KE, Krzych U, Wellde BT, Hall T, White K, et al. Long-term efficacy and immune responses following immunization with the RTS,S malaria vaccine. J Infect Dis 1998:178:1139-44.
WHO. Initiative for Vaccine Research (IVR) Available at http://www.who.int/vaccine_research/links/Rainbow/en/index.html. Accessed 11 September 2012.