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Wong G, Bienes KM, Xiii A, Fausther-Bovendo H, Kobinger GP. Ebola-specific therapeutic antibodies from lab to clinic: The example of ZMapp. Antiviral Res 2024; 226:105873. [PMID: 38580170 DOI: 10.1016/j.antiviral.2024.105873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/07/2024]
Abstract
In the 1990s, monoclonal antibodies (mAbs) progressed from scientific tools to advanced therapeutics, particularly for the treatment of cancers and autoimmune and inflammatory disorders. In the arena of infectious disease, the inauguration of mAbs as a post-exposure treatment in humans against Ebola virus (EBOV) occurred in response to the 2013-2016 West Africa outbreak. This review recounts the history of a candidate mAb treatment, ZMapp, beginning with its emergency use in the 2013-2016 outbreak and advancing to randomized controlled trials into the 2018-2020 African outbreak. We end with a brief discussion of the hurdles and promise toward mAb therapeutic use against infectious disease.
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Affiliation(s)
- Gary Wong
- Virology Unit, Institut Pasteur Du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Kathrina Mae Bienes
- Virology Unit, Institut Pasteur Du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Ara Xiii
- Department of Immunology and Microbiology, The Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, USA.
| | - Hugues Fausther-Bovendo
- Department of Immunology and Microbiology, The Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, USA
| | - Gary P Kobinger
- Department of Immunology and Microbiology, The Galveston National Laboratory, University of Texas Medical Branch, Galveston, TX, USA
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Kosko M, Wang L, Santacatterina M. A fast bootstrap algorithm for causal inference with large data. Stat Med 2024. [PMID: 38738397 DOI: 10.1002/sim.10075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 11/18/2023] [Accepted: 03/22/2024] [Indexed: 05/14/2024]
Abstract
Estimating causal effects from large experimental and observational data has become increasingly prevalent in both industry and research. The bootstrap is an intuitive and powerful technique used to construct standard errors and confidence intervals of estimators. Its application however can be prohibitively demanding in settings involving large data. In addition, modern causal inference estimators based on machine learning and optimization techniques exacerbate the computational burden of the bootstrap. The bag of little bootstraps has been proposed in non-causal settings for large data but has not yet been applied to evaluate the properties of estimators of causal effects. In this article, we introduce a new bootstrap algorithm called causal bag of little bootstraps for causal inference with large data. The new algorithm significantly improves the computational efficiency of the traditional bootstrap while providing consistent estimates and desirable confidence interval coverage. We describe its properties, provide practical considerations, and evaluate the performance of the proposed algorithm in terms of bias, coverage of the true 95% confidence intervals, and computational time in a simulation study. We apply it in the evaluation of the effect of hormone therapy on the average time to coronary heart disease using a large observational data set from the Women's Health Initiative.
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Affiliation(s)
- Matthew Kosko
- Department of Statistics, George Washington University, Washington, DC
| | - Lin Wang
- Department of Statistics, Purdue University, West Lafayette, Indiana
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Kayentao K, Ongoiba A, Preston AC, Healy SA, Hu Z, Skinner J, Doumbo S, Wang J, Cisse H, Doumtabe D, Traore A, Traore H, Djiguiba A, Li S, Peterson ME, Telscher S, Idris AH, Adams WC, McDermott AB, Narpala S, Lin BC, Serebryannyy L, Hickman SP, McDougal AJ, Vazquez S, Reiber M, Stein JA, Gall JG, Carlton K, Schwabl P, Traore S, Keita M, Zéguimé A, Ouattara A, Doucoure M, Dolo A, Murphy SC, Neafsey DE, Portugal S, Djimdé A, Traore B, Seder RA, Crompton PD. Subcutaneous Administration of a Monoclonal Antibody to Prevent Malaria. N Engl J Med 2024; 390:1549-1559. [PMID: 38669354 DOI: 10.1056/nejmoa2312775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
BACKGROUND Subcutaneous administration of the monoclonal antibody L9LS protected adults against controlled Plasmodium falciparum infection in a phase 1 trial. Whether a monoclonal antibody administered subcutaneously can protect children from P. falciparum infection in a region where this organism is endemic is unclear. METHODS We conducted a phase 2 trial in Mali to assess the safety and efficacy of subcutaneous administration of L9LS in children 6 to 10 years of age over a 6-month malaria season. In part A of the trial, safety was assessed at three dose levels in adults, followed by assessment at two dose levels in children. In part B of the trial, children were randomly assigned, in a 1:1:1 ratio, to receive 150 mg of L9LS, 300 mg of L9LS, or placebo. The primary efficacy end point, assessed in a time-to-event analysis, was the first P. falciparum infection, as detected on blood smear performed at least every 2 weeks for 24 weeks. A secondary efficacy end point was the first episode of clinical malaria, as assessed in a time-to-event analysis. RESULTS No safety concerns were identified in the dose-escalation part of the trial (part A). In part B, 225 children underwent randomization, with 75 children assigned to each group. No safety concerns were identified in part B. P. falciparum infection occurred in 36 participants (48%) in the 150-mg group, in 30 (40%) in the 300-mg group, and in 61 (81%) in the placebo group. The efficacy of L9LS against P. falciparum infection, as compared with placebo, was 66% (adjusted confidence interval [95% CI], 45 to 79) with the 150-mg dose and 70% (adjusted 95% CI, 50 to 82) with the 300-mg dose (P<0.001 for both comparisons). Efficacy against clinical malaria was 67% (adjusted 95% CI, 39 to 82) with the 150-mg dose and 77% (adjusted 95% CI, 55 to 89) with the 300-mg dose (P<0.001 for both comparisons). CONCLUSIONS Subcutaneous administration of L9LS to children was protective against P. falciparum infection and clinical malaria over a period of 6 months. (Funded by the National Institute of Allergy and Infectious Diseases; ClinicalTrials.gov number, NCT05304611.).
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MESH Headings
- Adult
- Child
- Female
- Humans
- Male
- Dose-Response Relationship, Drug
- Double-Blind Method
- Endemic Diseases/prevention & control
- Injections, Subcutaneous
- Kaplan-Meier Estimate
- Malaria, Falciparum/drug therapy
- Malaria, Falciparum/epidemiology
- Malaria, Falciparum/prevention & control
- Mali/epidemiology
- Plasmodium falciparum
- Treatment Outcome
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/therapeutic use
- Directly Observed Therapy
- Artemether, Lumefantrine Drug Combination/administration & dosage
- Artemether, Lumefantrine Drug Combination/therapeutic use
- Young Adult
- Middle Aged
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Affiliation(s)
- Kassoum Kayentao
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Aissata Ongoiba
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Anne C Preston
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Sara A Healy
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Zonghui Hu
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Jeff Skinner
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Safiatou Doumbo
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Jing Wang
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Hamidou Cisse
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Didier Doumtabe
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Abdrahamane Traore
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Hamadi Traore
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Adama Djiguiba
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Shanping Li
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Mary E Peterson
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Shinyi Telscher
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Azza H Idris
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - William C Adams
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Adrian B McDermott
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Sandeep Narpala
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Bob C Lin
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Leonid Serebryannyy
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Somia P Hickman
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Andrew J McDougal
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Sandra Vazquez
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Matthew Reiber
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Judy A Stein
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Jason G Gall
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Kevin Carlton
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Philipp Schwabl
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Siriman Traore
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Mamadou Keita
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Amatigué Zéguimé
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Adama Ouattara
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - M'Bouye Doucoure
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Amagana Dolo
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Sean C Murphy
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Daniel E Neafsey
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Silvia Portugal
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Abdoulaye Djimdé
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Boubacar Traore
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Robert A Seder
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
| | - Peter D Crompton
- From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) - all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.)
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Miura K, Flores-Garcia Y, Long CA, Zavala F. Vaccines and monoclonal antibodies: new tools for malaria control. Clin Microbiol Rev 2024:e0007123. [PMID: 38656211 DOI: 10.1128/cmr.00071-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
SUMMARYMalaria remains one of the biggest health problems in the world. While significant reductions in malaria morbidity and mortality had been achieved from 2000 to 2015, the favorable trend has stalled, rather significant increases in malaria cases are seen in multiple areas. In 2022, there were 249 million estimated cases, and 608,000 malaria-related deaths, mostly in infants and children aged under 5 years, globally. Therefore, in addition to the expansion of existing anti-malarial control measures, it is critical to develop new tools, such as vaccines and monoclonal antibodies (mAbs), to fight malaria. In the last 2 years, the first and second malaria vaccines, both targeting Plasmodium falciparum circumsporozoite proteins (PfCSP), have been recommended by the World Health Organization to prevent P. falciparum malaria in children living in moderate to high transmission areas. While the approval of the two malaria vaccines is a considerable milestone in vaccine development, they have much room for improvement in efficacy and durability. In addition to the two approved vaccines, recent clinical trials with mAbs against PfCSP, blood-stage vaccines against P. falciparum or P. vivax, and transmission-blocking vaccine or mAb against P. falciparum have shown promising results. This review summarizes the development of the anti-PfCSP vaccines and mAbs, and recent topics in the blood- and transmission-blocking-stage vaccine candidates and mAbs. We further discuss issues of the current vaccines and the directions for the development of next-generation vaccines.
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Affiliation(s)
- Kazutoyo Miura
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA
| | - Yevel Flores-Garcia
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Malaria Research Institute, Baltimore, Maryland, USA
| | - Carole A Long
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA
| | - Fidel Zavala
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Malaria Research Institute, Baltimore, Maryland, USA
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Ogwang R, Murugu L, Nkumama IN, Nyamako L, Kai O, Mwai K, Murungi L, Idro R, Bejon P, Tuju J, Kinyanjui SM, Osier FHA. Bi-isotype immunoglobulins enhance antibody-mediated neutrophil activity against Plasmodium falciparum parasites. Front Immunol 2024; 15:1360220. [PMID: 38650925 PMCID: PMC11033408 DOI: 10.3389/fimmu.2024.1360220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/19/2024] [Indexed: 04/25/2024] Open
Abstract
Background Malaria remains a major global health priority, and monoclonal antibodies (mAbs) are emerging as potential new tools to support efforts to control the disease. Recent data suggest that Fc-dependent mechanisms of immunity are important mediators of protection against the blood stages of the infection, but few studies have investigated this in the context of mAbs. We aimed to isolate mAbs agnostic to cognate antigens that target whole merozoites and simultaneously induce potent neutrophil activity measured by the level of reactive oxygen species (ROS) production using an antibody-dependent respiratory burst (ADRB) assay. Methods We used samples from semi-immune adults living in coastal Kenya to isolate mAbs that induce merozoite-specific ADRB activity. We then tested whether modifying the expressed IgG1 isotype to an IgG-IgA Fc region chimera would enhance the level of ADRB activity. Results We isolated a panel of nine mAbs with specificity to whole merozoites. mAb J31 induced ADRB activity in a dose-dependent fashion. Compared to IgG1, our modified antibody IgG-IgA bi-isotype induced higher ADRB activity across all concentrations tested. Further, we observed a negative hook effect at high IgG1 mAb concentrations (i.e., >200 µg/mL), but this was reversed by Fc modification. We identified MSP3.5 as the potential cognate target of mAb J31. Conclusions We demonstrate an approach to engineer mAbs with enhanced ADRB potency against blood-stage parasites.
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Affiliation(s)
- Rodney Ogwang
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Lewis Murugu
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Biological Sciences, Pwani University, Kilifi, Kenya
| | - Irene N. Nkumama
- Centre of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Lydia Nyamako
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Oscar Kai
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Kennedy Mwai
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Linda Murungi
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Richard Idro
- College of Health Sciences, Makerere University, Kampala, Uganda
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Philip Bejon
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - James Tuju
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Biological Sciences, Pwani University, Kilifi, Kenya
| | - Sam Muchina Kinyanjui
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Faith H. A. Osier
- Department of Life Sciences, Imperial College London, London, United Kingdom
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Friedman-Klabanoff DJ, Adu-Gyasi D, Asante KP. Malaria prevention in children: an update. Curr Opin Pediatr 2024; 36:164-170. [PMID: 38299986 PMCID: PMC10932812 DOI: 10.1097/mop.0000000000001332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
PURPOSE OF REVIEW Malaria cases and deaths decreased from 2000 to 2015 but remain increased since 2019. Several new developments and strategies could help reverse this trend. The purpose of this review is to discuss new World Health Organization (WHO) guidelines and recent research on malaria prevention in children. RECENT FINDINGS Fifteen countries have now rolled out seasonal malaria chemoprophylaxis (SMC) in children at highest risk for severe malaria, and new WHO recommendations provide more flexibility for SMC implementation in terms of target age groups, geographic region, and number of cycles. Recent studies confirm that malaria burden in school aged children, and their contribution to transmission, is high. New guidelines permit expanded chemoprevention options for these children. Two vaccines have been approved for use in malaria endemic countries, RTS,S/AS01 E and R21/Matrix-M. Additionally, pyrethroid-chlorfenapyr bed nets are being deployed to combat resistant mosquitoes. SUMMARY While challenges remain in malaria control towards elimination, new guidelines and recently approved vaccines offer hope. Monitoring for continued vaccine and chemoprevention effectiveness, and for possible epidemiologic shifts in severe malaria presentation and deaths as additional prevention efforts roll out will be paramount.
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Affiliation(s)
- DeAnna J Friedman-Klabanoff
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Dennis Adu-Gyasi
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
- Centre for Research in Applied Biology, School of Sciences, University of Energy and Natural Resources, Sunyani, Bono Region, Ghana, West Africa
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana
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7
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Stump WH, Klingenberg HJ, Ott AC, Gonzales DM, Burns JM. Design and Evaluation of Chimeric Plasmodium falciparum Circumsporozoite Protein-Based Malaria Vaccines. Vaccines (Basel) 2024; 12:351. [PMID: 38675734 PMCID: PMC11053680 DOI: 10.3390/vaccines12040351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024] Open
Abstract
Efficacy data on two malaria vaccines, RTS,S and R21, targeting Plasmodium falciparum circumsporozoite protein (PfCSP), are encouraging. Efficacy may be improved by induction of additional antibodies to neutralizing epitopes outside of the central immunodominant repeat domain of PfCSP. We designed four rPfCSP-based vaccines in an effort to improve the diversity of the antibody response. We also evaluated P. falciparum merozoite surface protein 8 (PfMSP8) as a malaria-specific carrier protein as an alternative to hepatitis B surface antigen. We measured the magnitude, specificity, subclass, avidity, durability, and efficacy of vaccine-induced antibodies in outbred CD1 mice. In comparison to N-terminal- or C-terminal-focused constructs, immunization with near full-length vaccines, rPfCSP (#1) or the chimeric rPfCSP/8 (#2), markedly increased the breadth of B cell epitopes recognized covering the N-terminal domain, junctional region, and central repeat. Both rPfCSP (#1) and rPfCSP/8 (#2) also elicited a high proportion of antibodies to conformation-dependent epitopes in the C-terminus of PfCSP. Fusion of PfCSP to PfMSP8 shifted the specificity of the T cell response away from PfCSP toward PfMSP8 epitopes. Challenge studies with transgenic Plasmodium yoelii sporozoites expressing PfCSP demonstrated high and consistent sterile protection following rPfCSP/8 (#2) immunization. Of note, antibodies to conformational C-terminal epitopes were not required for protection. These results indicate that inclusion of the N-terminal domain of PfCSP can drive responses to protective, repeat, and non-repeat B cell epitopes and that PfMSP8 is an effective carrier for induction of high-titer, durable anti-PfCSP antibodies.
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Affiliation(s)
| | | | | | | | - James M. Burns
- Center for Molecular Parasitology, Department of Microbiology and Immunology, Drexel University College of Medicine, 2900 Queen Lane, Philadelphia, PA 19129, USA; (W.H.S.); (H.J.K.); (A.C.O.); (D.M.G.)
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8
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Long B, MacDonald A, Liang SY, Brady WJ, Koyfman A, Gottlieb M, Chavez S. Malaria: A focused review for the emergency medicine clinician. Am J Emerg Med 2024; 77:7-16. [PMID: 38096639 DOI: 10.1016/j.ajem.2023.11.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/18/2023] [Accepted: 11/23/2023] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION Malaria is a potentially fatal parasitic disease transmitted by the Anopheles mosquito. A resurgence in locally acquired infections has been reported in the U.S. OBJECTIVE This narrative review provides a focused overview of malaria for the emergency clinician, including the epidemiology, presentation, diagnosis, and management of the disease. DISCUSSION Malaria is caused by Plasmodium and is transmitted by the Anopheles mosquito. Disease severity can range from mild to severe. Malaria should be considered in any returning traveler from an endemic region, as well as those with unexplained cyclical, paroxysms of symptoms or unexplained fever. Patients most commonly present with fever and rigors but may also experience cough, myalgias, abdominal pain, fatigue, vomiting, and diarrhea. Hepatomegaly, splenomegaly, pallor, and jaundice are findings associated with malaria. Although less common, severe malaria is precipitated by microvascular obstruction with complications of anemia, acidosis, hypoglycemia, multiorgan failure, and cerebral malaria. Peripheral blood smears remain the gold standard for diagnosis, but rapid diagnostic tests are available. Treatment includes specialist consultation and antimalarial drugs tailored depending on chloroquine resistance, geographic region of travel, and patient comorbidities. Supportive care may be required, and patients with severe malaria will require resuscitation. Most patients will require admission for treatment and further monitoring. CONCLUSION Emergency medicine clinicians should be aware of the presentation, diagnosis, evaluation, and management of malaria to ensure optimal outcomes.
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Affiliation(s)
- Brit Long
- Department of Emergency Medicine, Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
| | - Austin MacDonald
- Department of Emergency Medicine, Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA
| | - Stephen Y Liang
- Divisions of Emergency Medicine and Infectious Diseases, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, USA.
| | - William J Brady
- Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA.
| | - Alex Koyfman
- Department of Emergency Medicine, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, USA
| | - Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Summer Chavez
- Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, USA.
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Locke E, Flores-Garcia Y, Mayer BT, MacGill RS, Borate B, Salgado-Jimenez B, Gerber MW, Mathis-Torres S, Shapiro S, King CR, Zavala F. Establishing RTS,S/AS01 as a benchmark for comparison to next-generation malaria vaccines in a mouse model. NPJ Vaccines 2024; 9:29. [PMID: 38341502 DOI: 10.1038/s41541-024-00819-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
New strategies are needed to reduce the incidence of malaria, and promising approaches include vaccines targeting the circumsporozoite protein (CSP). To improve upon the malaria vaccine, RTS,S/AS01, it is essential to standardize preclinical assays to measure the potency of next-generation vaccines against this benchmark. We focus on RTS,S/AS01-induced antibody responses and functional activity in conjunction with robust statistical analyses. Transgenic Plasmodium berghei sporozoites containing full-length P. falciparum CSP (tgPb-PfCSP) allow two assessments of efficacy: quantitative reduction in liver infection following intravenous challenge, and sterile protection from mosquito bite challenge. Two or three doses of RTS,S/AS01 were given intramuscularly at 3-week intervals, with challenge 2-weeks after the last vaccination. Minimal inter- and intra-assay variability indicates the reproducibility of the methods. Importantly, the range of this model is suitable for screening more potent vaccines. Levels of induced anti-CSP antibody 2A10 equivalency were also associated with activity: 105 μg/mL (95% CI: 68.8, 141) reduced liver infection by 50%, whereas 285 μg/mL (95% CI: 166, 404) is required for 50% sterile protection from mosquito bite challenge. Additionally, the liver burden model was able to differentiate between protected and non-protected human plasma samples from a controlled human malaria infection study, supporting these models' relevance and predictive capability. Comparison in animal models of CSP-based vaccine candidates to RTS,S/AS01 is now possible under well controlled conditions. Assessment of the quality of induced antibodies, likely a determinant of durability of protection in humans, should be possible using these methods.
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Affiliation(s)
- Emily Locke
- Center for Vaccine Innovation and Access, PATH, Washington, DC, 20001, USA
| | - Yevel Flores-Garcia
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bryan T Mayer
- Vaccine and Infectious Disease Division, Fred Hutchison Cancer Research Center, Seattle, WA, 98109, USA
| | - Randall S MacGill
- Center for Vaccine Innovation and Access, PATH, Washington, DC, 20001, USA
| | - Bhavesh Borate
- Vaccine and Infectious Disease Division, Fred Hutchison Cancer Research Center, Seattle, WA, 98109, USA
| | - Berenice Salgado-Jimenez
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Monica W Gerber
- Vaccine and Infectious Disease Division, Fred Hutchison Cancer Research Center, Seattle, WA, 98109, USA
| | - Shamika Mathis-Torres
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sarah Shapiro
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - C Richter King
- Center for Vaccine Innovation and Access, PATH, Washington, DC, 20001, USA
| | - Fidel Zavala
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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10
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Friedman-Klabanoff DJ, Berry AA, Travassos MA, Shriver M, Cox C, Butts J, Lundeen JS, Strauss KA, Joshi S, Shrestha B, Mo AX, Nomicos EYH, Deye GA, Regules JA, Bergmann-Leitner ES, Pasetti MF, Laurens MB. Recombinant full-length Plasmodium falciparum circumsporozoite protein-based vaccine adjuvanted with GLA-LSQ: Results of Phase 1 testing with malaria challenge. J Infect Dis 2024:jiae062. [PMID: 38330357 DOI: 10.1093/infdis/jiae062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION Malaria is preventable yet causes >600,000 deaths annually. RTS, S, the first marketed malaria vaccine, has modest efficacy, but improvements are needed for eradication. METHODS We conducted an open-label, dose escalation Phase 1 study of a recombinant, full-length circumsporozoite protein vaccine (rCSP) administered with adjuvant GLA-LSQ on days 1, 29, and 85 or 1 and 490 to healthy, malaria-naïve adults. Primary endpoints were safety and reactogenicity. Secondary endpoints were antibody responses and Plasmodium falciparum parasitemia after homologous controlled human malaria infection (CHMI). RESULTS Participants were enrolled into four groups receiving rCSP/GLA-LSQ: 10 µg x 3 (n = 20), 30 µg x 3 (n = 10), 60 µg x 3 (n = 10) or 60 µg x 2 (n = 9); ten participants received 30 µg rCSP alone x 3; and six infectivity controls. Participants experienced no serious adverse events. Rates of solicited and unsolicited adverse events were similar among groups. All 26 participants who underwent CHMI 28 days after final vaccinations developed malaria. Increasing vaccine doses induced higher IgG titers, but did not achieve previously established RTS, S benchmarks. CONCLUSIONS rCSP/GLA-LSQ had favorable safety results. However, tested regimens did not induce protective immunity. Further investigation could assess if adjuvant or schedule adjustments improve efficacy. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT03589794.
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Affiliation(s)
- DeAnna J Friedman-Klabanoff
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Andrea A Berry
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Mark A Travassos
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Mallory Shriver
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | | | | | | - Kathleen A Strauss
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Sudhaunshu Joshi
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Biraj Shrestha
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Annie X Mo
- Parasitology and International Programs Branch, Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Effie Y H Nomicos
- Parasitology and International Programs Branch, Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Gregory A Deye
- Parasitology and International Programs Branch, Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Jason A Regules
- Biologics Research & Development, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Elke S Bergmann-Leitner
- Biologics Research & Development, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Marcela F Pasetti
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Matthew B Laurens
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
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11
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de Jong HK, Grobusch MP. Monoclonal antibody applications in travel medicine. Trop Dis Travel Med Vaccines 2024; 10:2. [PMID: 38221606 PMCID: PMC10789029 DOI: 10.1186/s40794-023-00212-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/21/2023] [Indexed: 01/16/2024] Open
Abstract
For decades, immunoglobulin preparations have been used to prevent or treat infectious diseases. Since only a few years, monoclonal antibody applications (mAbs) are taking flight and are increasingly dominating this field. In 2014, only two mAbs were registered; end of October 2023, more than ten mAbs are registered or have been granted emergency use authorization, and many more are in (pre)clinical phases. Especially the COVID-19 pandemic has generated this surge in licensed monoclonal antibodies, although multiple phase 1 studies were already underway in 2019 for other infectious diseases such as malaria and yellow fever. Monoclonal antibodies could function as prophylaxis (i.e., for the prevention of malaria), or could be used to treat (tropical) infections (i.e., rabies, dengue fever, yellow fever). This review focuses on the discussion of the prospects of, and obstacles for, using mAbs in the prevention and treatment of (tropical) infectious diseases seen in the returning traveler; and provides an update on the mAbs currently being developed for infectious diseases, which could potentially be of interest for travelers.
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Affiliation(s)
- Hanna K de Jong
- Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Location AMC, Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Martin P Grobusch
- Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Location AMC, Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Institute of Tropical Medicine & Deutsches Zentrum Für Infektionsforschung, University of Tübingen, Tübingen, Germany
- Centre de Recherches Médicales, (CERMEL), Lambaréné, Gabon
- Masanga Medical Research Unit (MMRU), Masanga, Sierra Leone
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
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12
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Lampejo T. Monoclonal antibodies for the prevention of Plasmodium falciparum malaria: a multi-target approach? Infect Dis (Lond) 2024; 56:73-77. [PMID: 37921336 DOI: 10.1080/23744235.2023.2274897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 10/19/2023] [Indexed: 11/04/2023] Open
Abstract
This article discusses the need for novel additional preventative strategies in malaria focusing on the potential role for monoclonal antibodies in disease prevention and putative strategies for their development and use in Plasmodium falciparum malaria.
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Affiliation(s)
- Temi Lampejo
- Department of Infection Sciences, King's College Hospital, London, UK
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13
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Williams KL, Guerrero S, Flores-Garcia Y, Kim D, Williamson KS, Siska C, Smidt P, Jepson SZ, Li K, Dennison SM, Mathis-Torres S, Chen X, Wille-Reece U, MacGill RS, Walker M, Jongert E, King CR, Ockenhouse C, Glanville J, Moon JE, Regules JA, Tan YC, Cavet G, Lippow SM, Robinson WH, Dutta S, Tomaras GD, Zavala F, Ketchem RR, Emerling DE. A candidate antibody drug for prevention of malaria. Nat Med 2024; 30:117-129. [PMID: 38167935 PMCID: PMC10803262 DOI: 10.1038/s41591-023-02659-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 10/20/2023] [Indexed: 01/05/2024]
Abstract
Over 75% of malaria-attributable deaths occur in children under the age of 5 years. However, the first malaria vaccine recommended by the World Health Organization (WHO) for pediatric use, RTS,S/AS01 (Mosquirix), has modest efficacy. Complementary strategies, including monoclonal antibodies, will be important in efforts to eradicate malaria. Here we characterize the circulating B cell repertoires of 45 RTS,S/AS01 vaccinees and discover monoclonal antibodies for development as potential therapeutics. We generated >28,000 antibody sequences and tested 481 antibodies for binding activity and 125 antibodies for antimalaria activity in vivo. Through these analyses we identified correlations suggesting that sequences in Plasmodium falciparum circumsporozoite protein, the target antigen in RTS,S/AS01, may induce immunodominant antibody responses that limit more protective, but subdominant, responses. Using binding studies, mouse malaria models, biomanufacturing assessments and protein stability assays, we selected AB-000224 and AB-007088 for advancement as a clinical lead and backup. We engineered the variable domains (Fv) of both antibodies to enable low-cost manufacturing at scale for distribution to pediatric populations, in alignment with WHO's preferred product guidelines. The engineered clone with the optimal manufacturing and drug property profile, MAM01, was advanced into clinical development.
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Affiliation(s)
| | | | - Yevel Flores-Garcia
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Dongkyoon Kim
- Atreca, Inc., San Carlos, CA, USA
- Initium Therapeutics, Inc., Natick, MA, USA
| | | | | | | | | | - Kan Li
- Duke Center for Human Systems Immunology, Department of Surgery, Duke University, Durham, NC, USA
| | - S Moses Dennison
- Duke Center for Human Systems Immunology, Department of Surgery, Duke University, Durham, NC, USA
| | - Shamika Mathis-Torres
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Ulrike Wille-Reece
- BioNTech US, Inc., Cambridge, MA, USA
- PATH Center for Vaccine Innovation and Access, Washington DC, USA
| | | | | | | | - C Richter King
- PATH Center for Vaccine Innovation and Access, Washington DC, USA
| | | | | | - James E Moon
- Center for Enabling Capabilities, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Jason A Regules
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Yann Chong Tan
- Atreca, Inc., San Carlos, CA, USA
- Nuevocor Pte. Ltd, Singapore, Singapore
| | - Guy Cavet
- Atreca, Inc., San Carlos, CA, USA
- Paramune, Inc., San Carlos, CA, USA
| | | | - William H Robinson
- Division of Immunology and Rheumatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Sheetij Dutta
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Georgia D Tomaras
- Duke Center for Human Systems Immunology, Department of Surgery, Duke University, Durham, NC, USA
- Departments of Immunology, Molecular Genetics and Microbiology, Human Vaccine Institute, Duke University, Durham, NC, USA
| | - Fidel Zavala
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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14
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Taylor TE, Osier F. Integrating vaccines and monoclonal antibodies into malaria prevention. Nat Med 2024; 30:37-38. [PMID: 38200257 DOI: 10.1038/s41591-023-02745-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Affiliation(s)
- Terrie E Taylor
- Michigan State University College of Osteopathic Medicine, East Lansing, MI, USA.
- Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi.
| | - Faith Osier
- Department of Life Sciences, Imperial College London, London, UK
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15
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Poespoprodjo JR, Douglas NM, Ansong D, Kho S, Anstey NM. Malaria. Lancet 2023; 402:2328-2345. [PMID: 37924827 DOI: 10.1016/s0140-6736(23)01249-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 05/22/2023] [Accepted: 06/16/2023] [Indexed: 11/06/2023]
Abstract
Malaria is resurging in many African and South American countries, exacerbated by COVID-19-related health service disruption. In 2021, there were an estimated 247 million malaria cases and 619 000 deaths in 84 endemic countries. Plasmodium falciparum strains partly resistant to artemisinins are entrenched in the Greater Mekong region and have emerged in Africa, while Anopheles mosquito vectors continue to evolve physiological and behavioural resistance to insecticides. Elimination of Plasmodium vivax malaria is hindered by impractical and potentially toxic antirelapse regimens. Parasitological diagnosis and treatment with oral or parenteral artemisinin-based therapy is the mainstay of patient management. Timely blood transfusion, renal replacement therapy, and restrictive fluid therapy can improve survival in severe malaria. Rigorous use of intermittent preventive treatment in pregnancy and infancy and seasonal chemoprevention, potentially combined with pre-erythrocytic vaccines endorsed by WHO in 2021 and 2023, can substantially reduce malaria morbidity. Improved surveillance, better access to effective treatment, more labour-efficient vector control, continued drug development, targeted mass drug administration, and sustained political commitment are required to achieve targets for malaria reduction by the end of this decade.
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Affiliation(s)
- Jeanne Rini Poespoprodjo
- Centre for Child Health and Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; Timika Malaria Research Facility, Papuan Health and Community Development Foundation, Timika, Indonesia; Mimika District Hospital and District Health Authority, Timika, Indonesia; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
| | - Nicholas M Douglas
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; Department of Infectious Diseases, Christchurch Hospital, Te Whatu Ora Waitaha, Christchurch, New Zealand; Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Daniel Ansong
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Steven Kho
- Timika Malaria Research Facility, Papuan Health and Community Development Foundation, Timika, Indonesia; Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Nicholas M Anstey
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; Department of Infectious Diseases, Royal Darwin Hospital, Darwin, NT, Australia
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16
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Bolton JS, MacGill RS, Locke E, Regules JA, Bergmann-Leitner ES. Novel antibody competition binding assay identifies distinct serological profiles associated with protection. Front Immunol 2023; 14:1303446. [PMID: 38152401 PMCID: PMC10752609 DOI: 10.3389/fimmu.2023.1303446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/21/2023] [Indexed: 12/29/2023] Open
Abstract
Introduction Pre-erythrocytic malaria vaccines hold the promise of inducing sterile protection thereby preventing the morbidity and mortality associated with Plasmodium infection. The main surface antigen of P. falciparum sporozoites, i.e., the circumsporozoite protein (CSP), has been extensively explored as a target of such vaccines with significant success in recent years. Systematic adjuvant selection, refinements of the immunization regimen, and physical properties of the antigen may all contribute to the potential of increasing the efficacy of CSP-based vaccines. Protection appears to be dependent in large part on CSP antibodies. However due to a knowledge gap related to the exact correlates of immunity, there is a critical need to improve our ability to down select candidates preclinically before entering clinical trials including with controlled human malaria infections (CHMI). Methods We developed a novel multiplex competition assay based on well-characterized monoclonal antibodies (mAbs) that target crucial epitopes across the CSP molecule. This new tool assesses both, quality and epitope-specific concentrations of vaccine-induced antibodies by measuring their equivalency with a panel of well-characterized, CSP-epitope-specific mAbs. Results Applying this method to RTS,S-immune sera from a CHMI trial demonstrated a quantitative epitope-specificity profile of antibody responses that can differentiate between protected vs. nonprotected individuals. Aligning vaccine efficacy with quantitation of the epitope fine specificity results of this equivalency assay reveals the importance of epitope specificity. Discussion The newly developed serological equivalence assay will inform future vaccine design and possibly even adjuvant selection. This methodology can be adapted to other antigens and disease models, when a panel of relevant mAbs exists, and could offer a unique tool for comparing and down-selecting vaccine formulations.
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Affiliation(s)
- Jessica S. Bolton
- Biologics Research & Development, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD, United States
| | - Randall S. MacGill
- Center for Vaccine Innovation and Access, PATH, Washington, DC, United States
| | - Emily Locke
- Center for Vaccine Innovation and Access, PATH, Washington, DC, United States
| | - Jason A. Regules
- Biologics Research & Development, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD, United States
| | - Elke S. Bergmann-Leitner
- Biologics Research & Development, Walter Reed Army Institute of Research (WRAIR), Silver Spring, MD, United States
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17
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Girgis ST, Adika E, Nenyewodey FE, Senoo Jnr DK, Ngoi JM, Bandoh K, Lorenz O, van de Steeg G, Harrott AJR, Nsoh S, Judge K, Pearson RD, Almagro-Garcia J, Saiid S, Atampah S, Amoako EK, Morang'a CM, Asoala V, Adjei ES, Burden W, Roberts-Sengier W, Drury E, Pierce ML, Gonçalves S, Awandare GA, Kwiatkowski DP, Amenga-Etego LN, Hamilton WL. Drug resistance and vaccine target surveillance of Plasmodium falciparum using nanopore sequencing in Ghana. Nat Microbiol 2023; 8:2365-2377. [PMID: 37996707 PMCID: PMC10686832 DOI: 10.1038/s41564-023-01516-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 10/06/2023] [Indexed: 11/25/2023]
Abstract
Malaria results in over 600,000 deaths annually, with the highest burden of deaths in young children living in sub-Saharan Africa. Molecular surveillance can provide important information for malaria control policies, including detection of antimalarial drug resistance. However, genome sequencing capacity in malaria-endemic countries is limited. We designed and implemented an end-to-end workflow to detect Plasmodium falciparum antimalarial resistance markers and diversity in the vaccine target circumsporozoite protein (csp) using nanopore sequencing in Ghana. We analysed 196 clinical samples and showed that our method is rapid, robust, accurate and straightforward to implement. Importantly, our method could be applied to dried blood spot samples, which are readily collected in endemic settings. We report that P. falciparum parasites in Ghana are mostly susceptible to chloroquine, with persistent sulfadoxine-pyrimethamine resistance and no evidence of artemisinin resistance. Multiple single nucleotide polymorphisms were identified in csp, but their significance is uncertain. Our study demonstrates the feasibility of nanopore sequencing for malaria genomic surveillance in endemic countries.
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Affiliation(s)
- Sophia T Girgis
- Wellcome Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | - Edem Adika
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Felix E Nenyewodey
- Navrongo Health Research Centre (NHRC), Ghana Health Service, Navrongo, Upper East Region, Ghana
| | - Dodzi K Senoo Jnr
- Navrongo Health Research Centre (NHRC), Ghana Health Service, Navrongo, Upper East Region, Ghana
| | - Joyce M Ngoi
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Kukua Bandoh
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Oliver Lorenz
- Wellcome Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | - Guus van de Steeg
- Wellcome Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | | | - Sebastian Nsoh
- Navrongo Health Research Centre (NHRC), Ghana Health Service, Navrongo, Upper East Region, Ghana
| | - Kim Judge
- Wellcome Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | - Richard D Pearson
- Wellcome Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | | | - Samirah Saiid
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Solomon Atampah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Enock K Amoako
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Collins M Morang'a
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | - Victor Asoala
- Navrongo Health Research Centre (NHRC), Ghana Health Service, Navrongo, Upper East Region, Ghana
| | - Elrmion S Adjei
- Ledzokuku Krowor Municipal Assembly (LEKMA) Hospital, Accra, Ghana
| | - William Burden
- Wellcome Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | | | - Eleanor Drury
- Wellcome Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | - Megan L Pierce
- Wellcome Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | - Sónia Gonçalves
- Wellcome Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
| | | | - Lucas N Amenga-Etego
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Ghana.
| | - William L Hamilton
- Wellcome Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK.
- Department of Medicine, University of Cambridge, Cambridge, UK.
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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18
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Thai E, Murugan R, Binter Š, Burn Aschner C, Prieto K, Kassardjian A, Obraztsova AS, Kang RW, Flores-Garcia Y, Mathis-Torres S, Li K, Horn GQ, Huntwork RHC, Bolscher JM, de Bruijni MHC, Sauerwein R, Dennison SM, Tomaras GD, Zavala F, Kellam P, Wardemann H, Julien JP. Molecular determinants of cross-reactivity and potency by VH3-33 antibodies against the Plasmodium falciparum circumsporozoite protein. Cell Rep 2023; 42:113330. [PMID: 38007690 PMCID: PMC10720262 DOI: 10.1016/j.celrep.2023.113330] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/29/2023] [Accepted: 10/06/2023] [Indexed: 11/27/2023] Open
Abstract
IGHV3-33-encoded antibodies are prevalent in the human humoral response against the Plasmodium falciparum circumsporozoite protein (PfCSP). Among VH3-33 antibodies, cross-reactivity between PfCSP major repeat (NANP), minor (NVDP), and junctional (NPDP) motifs is associated with high affinity and potent parasite inhibition. However, the molecular basis of antibody cross-reactivity and the relationship with efficacy remain unresolved. Here, we perform an extensive structure-function characterization of 12 VH3-33 anti-PfCSP monoclonal antibodies (mAbs) with varying degrees of cross-reactivity induced by immunization of mice expressing a human immunoglobulin gene repertoire. We identify residues in the antibody paratope that mediate cross-reactive binding and delineate four distinct epitope conformations induced by antibody binding, with one consistently associated with high protective efficacy and another that confers comparably potent inhibition of parasite liver invasion. Our data show a link between molecular features of cross-reactive VH3-33 mAb binding to PfCSP and mAb potency, relevant for the development of antibody-based interventions against malaria.
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Affiliation(s)
- Elaine Thai
- Program in Molecular Medicine, The Hospital for Sick Children Research Institute, Toronto, ON M5G 0A4, Canada; Department of Biochemistry, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Rajagopal Murugan
- B Cell Immunology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Špela Binter
- Kymab Ltd./Sanofi, The Bennet Building (B930), Babraham Research Campus, Cambridge CB22 3AT, UK; RQ Biotechnology Limited, 7th Floor Lynton House, 7-12 Tavistock Square, London WC1H 9LT, UK
| | - Clare Burn Aschner
- Program in Molecular Medicine, The Hospital for Sick Children Research Institute, Toronto, ON M5G 0A4, Canada
| | - Katherine Prieto
- Program in Molecular Medicine, The Hospital for Sick Children Research Institute, Toronto, ON M5G 0A4, Canada
| | - Audrey Kassardjian
- Program in Molecular Medicine, The Hospital for Sick Children Research Institute, Toronto, ON M5G 0A4, Canada; Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Anna S Obraztsova
- B Cell Immunology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; Biosciences Faculty, University of Heidelberg, 69117 Heidelberg, Germany
| | - Ryu Won Kang
- Program in Molecular Medicine, The Hospital for Sick Children Research Institute, Toronto, ON M5G 0A4, Canada; Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Yevel Flores-Garcia
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Shamika Mathis-Torres
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Kan Li
- Departments of Surgery, Integrative Immunobiology, Molecular Genetics, and Microbiology, Center for Human Systems Immunology, Duke University, Durham, NC 27710, USA
| | - Gillian Q Horn
- Departments of Surgery, Integrative Immunobiology, Molecular Genetics, and Microbiology, Center for Human Systems Immunology, Duke University, Durham, NC 27710, USA
| | - Richard H C Huntwork
- Departments of Surgery, Integrative Immunobiology, Molecular Genetics, and Microbiology, Center for Human Systems Immunology, Duke University, Durham, NC 27710, USA
| | | | | | | | - S Moses Dennison
- Departments of Surgery, Integrative Immunobiology, Molecular Genetics, and Microbiology, Center for Human Systems Immunology, Duke University, Durham, NC 27710, USA
| | - Georgia D Tomaras
- Departments of Surgery, Integrative Immunobiology, Molecular Genetics, and Microbiology, Center for Human Systems Immunology, Duke University, Durham, NC 27710, USA
| | - Fidel Zavala
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Paul Kellam
- Kymab Ltd./Sanofi, The Bennet Building (B930), Babraham Research Campus, Cambridge CB22 3AT, UK; RQ Biotechnology Limited, 7th Floor Lynton House, 7-12 Tavistock Square, London WC1H 9LT, UK; Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London SW7 2BX, UK
| | - Hedda Wardemann
- B Cell Immunology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.
| | - Jean-Philippe Julien
- Program in Molecular Medicine, The Hospital for Sick Children Research Institute, Toronto, ON M5G 0A4, Canada; Department of Biochemistry, University of Toronto, Toronto, ON M5S 1A8, Canada; Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada.
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19
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Siqueira-Neto JL, Wicht KJ, Chibale K, Burrows JN, Fidock DA, Winzeler EA. Antimalarial drug discovery: progress and approaches. Nat Rev Drug Discov 2023; 22:807-826. [PMID: 37652975 PMCID: PMC10543600 DOI: 10.1038/s41573-023-00772-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 09/02/2023]
Abstract
Recent antimalarial drug discovery has been a race to produce new medicines that overcome emerging drug resistance, whilst considering safety and improving dosing convenience. Discovery efforts have yielded a variety of new molecules, many with novel modes of action, and the most advanced are in late-stage clinical development. These discoveries have led to a deeper understanding of how antimalarial drugs act, the identification of a new generation of drug targets, and multiple structure-based chemistry initiatives. The limited pool of funding means it is vital to prioritize new drug candidates. They should exhibit high potency, a low propensity for resistance, a pharmacokinetic profile that favours infrequent dosing, low cost, preclinical results that demonstrate safety and tolerability in women and infants, and preferably the ability to block Plasmodium transmission to Anopheles mosquito vectors. In this Review, we describe the approaches that have been successful, progress in preclinical and clinical development, and existing challenges. We illustrate how antimalarial drug discovery can serve as a model for drug discovery in diseases of poverty.
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Affiliation(s)
| | - Kathryn J Wicht
- Holistic Drug Discovery and Development (H3D) Centre, University of Cape Town, Rondebosch, South Africa
- South African Medical Research Council Drug Discovery and Development Research Unit, Department of Chemistry and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Rondebosch, South Africa
| | - Kelly Chibale
- Holistic Drug Discovery and Development (H3D) Centre, University of Cape Town, Rondebosch, South Africa
- South African Medical Research Council Drug Discovery and Development Research Unit, Department of Chemistry and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Rondebosch, South Africa
| | | | - David A Fidock
- Department of Microbiology and Immunology and Center for Malaria Therapeutics and Antimicrobial Resistance, Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
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20
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Bansal V, Munjal J, Lakhanpal S, Gupta V, Garg A, Munjal RS, Jain R. Epidemiological shifts: the emergence of malaria in America. Proc AMIA Symp 2023; 36:745-750. [PMID: 37829240 PMCID: PMC10566419 DOI: 10.1080/08998280.2023.2255514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/01/2023] [Indexed: 10/14/2023] Open
Abstract
Plasmodium is a genus of parasites that comprises different species. The species falciparum, vivax, malariae, ovale, and knowlesi are known to cause a vector-borne illness called malaria, and among these, falciparum is known to cause major complications. The vector, the Anopheles mosquito, is commonly found in warmer regions close to the equator, and hence transmission and numbers of cases tend to be higher in Sub-Saharan Africa, South Asia, and Central America. The number of cases of malaria in the United States has remained stable over the years with low transmission rates, and the disease is mostly seen in the population with a recent travel history to endemic regions. The main reason behind this besides the weather conditions is that economically developed countries have eliminated mosquitos. However, there have been reports of locally reported cases with Plasmodium vivax in areas such as Florida and Texas in patients with no known travel history. This paper aims to familiarize US physicians with the pathophysiology, clinical features, and diagnostic modalities of malaria, as well as available treatment options.
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Affiliation(s)
- Vasu Bansal
- Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Jaskaran Munjal
- Internal Medicine, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
| | | | - Vasu Gupta
- Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OhioUSA
| | - Ashwani Garg
- Penn State Milton S. Hershey Medical Center, Hershey, PennsylvaniaUSA
| | | | - Rohit Jain
- Penn State Milton S. Hershey Medical Center, Hershey, PennsylvaniaUSA
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21
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Nema S, Nitika N. Monoclonal antibody: future of malaria control and prevention. Trans R Soc Trop Med Hyg 2023; 117:673-674. [PMID: 37093779 DOI: 10.1093/trstmh/trad027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/24/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023] Open
Abstract
Monoclonal antibodies (mAbs) are extremely specialized proteins that are cloned from B cells and bind to pathogen epitopes. There are currently no known prophylactic immune-based strategies or efficient, widespread treatments to stop the spread of malaria. In order to lower the prevalence of malaria and its associated mortality, we need mAbs that are capable of offering immediate passive protection against the disease. mAbs have become more crucial in the treatment or prevention of several other infectious diseases. Recently, mAb development for malaria prevention and control has greatly evolved and widespread use in public health settings is now a possibility.
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Affiliation(s)
- Shrikant Nema
- Parasite-Host Biology Group, ICMR-National Institute of Malaria Research, Sector 8, Dwarka 110077, New Delhi, India
| | - Nitika Nitika
- Parasite-Host Biology Group, ICMR-National Institute of Malaria Research, Sector 8, Dwarka 110077, New Delhi, India
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22
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Su X, Stadler RV, Xu F, Wu J. Malaria Genomics, Vaccine Development, and Microbiome. Pathogens 2023; 12:1061. [PMID: 37624021 PMCID: PMC10459703 DOI: 10.3390/pathogens12081061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023] Open
Abstract
Recent advances in malaria genetics and genomics have transformed many aspects of malaria research in areas of molecular evolution, epidemiology, transmission, host-parasite interaction, drug resistance, pathogenicity, and vaccine development. Here, in addition to introducing some background information on malaria parasite biology, parasite genetics/genomics, and genotyping methods, we discuss some applications of genetic and genomic approaches in vaccine development and in studying interactions with microbiota. Genetic and genomic data can be used to search for novel vaccine targets, design an effective vaccine strategy, identify protective antigens in a whole-organism vaccine, and evaluate the efficacy of a vaccine. Microbiota has been shown to influence disease outcomes and vaccine efficacy; studying the effects of microbiota in pathogenicity and immunity may provide information for disease control. Malaria genetics and genomics will continue to contribute greatly to many fields of malaria research.
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Affiliation(s)
- Xinzhuan Su
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20852, USA; (R.V.S.); (F.X.); (J.W.)
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23
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Genito CJ, Brooks K, Smith A, Ryan E, Soto K, Li Y, Warter L, Dutta S. Protective antibody threshold of RTS,S/AS01 malaria vaccine correlates antigen and adjuvant dose in mouse model. NPJ Vaccines 2023; 8:114. [PMID: 37563255 PMCID: PMC10415390 DOI: 10.1038/s41541-023-00714-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 08/01/2023] [Indexed: 08/12/2023] Open
Abstract
Mouse models are useful for the early down-selection of malaria vaccine candidates. The Walter Reed Army Institute of Research has optimized a transgenic Plasmodium berghei sporozoite challenge model to compare the efficacy of Plasmodium falciparum circumsporozoite protein (CSP) vaccines. GSK's RTS,S vaccine formulated in the adjuvant AS01 can protect malaria-naïve individuals against malaria. We report that the RTS,S/AS01 vaccine induces high level sterile protection in our mouse model. Down titration of the antigen at a constant AS01 dose revealed a potent antigen dose-sparing effect and the superiority of RTS,S/AS01 over a soluble CSP antigen. RTS,S-mediated protective immunity was associated with a threshold of major repeat antibody titer. Combined titration of the antigen and adjuvant showed that reducing the adjuvant could improve antibody boosting post-3rd vaccination and reduce the threshold antibody concentration required for protection. Mouse models can provide a pathway for preclinical assessment of strategies to improve CSP vaccines against malaria.
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Affiliation(s)
- Christopher J Genito
- Structural Vaccinology Laboratory, Biologics Research and Development Branch, Walter Reed Army Institute of Research, Silver Spring, MD, 20910, USA
| | - Katherine Brooks
- Structural Vaccinology Laboratory, Biologics Research and Development Branch, Walter Reed Army Institute of Research, Silver Spring, MD, 20910, USA
| | - Alexis Smith
- Structural Vaccinology Laboratory, Biologics Research and Development Branch, Walter Reed Army Institute of Research, Silver Spring, MD, 20910, USA
| | - Emma Ryan
- Structural Vaccinology Laboratory, Biologics Research and Development Branch, Walter Reed Army Institute of Research, Silver Spring, MD, 20910, USA
| | - Kim Soto
- Structural Vaccinology Laboratory, Biologics Research and Development Branch, Walter Reed Army Institute of Research, Silver Spring, MD, 20910, USA
| | - Yuanzhang Li
- Center for Enabling Capabilities, Walter Reed Army Institute of Research, Silver Spring, MD, 20910, USA
| | | | - Sheetij Dutta
- Structural Vaccinology Laboratory, Biologics Research and Development Branch, Walter Reed Army Institute of Research, Silver Spring, MD, 20910, USA.
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24
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Velayutham M, Poncelet M, Perini JA, Kupec JT, Dietz MJ, Driesschaert B, Khramtsov VV. EPR Viscometric Measurements Using a 13C-Labeled Triarylmethyl Radical in Protein-based Biotherapeutics and Human Synovial Fluids. APPLIED MAGNETIC RESONANCE 2023; 54:779-791. [PMID: 38707765 PMCID: PMC11068027 DOI: 10.1007/s00723-023-01556-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/22/2023] [Accepted: 06/22/2023] [Indexed: 05/07/2024]
Abstract
The viscosity measurements are of clinical significance for evaluation of the potential pathological conditions of biological lubricants such as synovial fluids of joints, and for formulation and characterization of peptide- and protein-based biotherapeutics. Due to inherent potential therapeutic activity, protein drugs have proven to be one of the most efficient therapeutic agents in treatment of several life-threatening disorders, such as diabetes and autoimmune diseases. However, home-use applications for treating chronic inflammatory diseases, such as diabetes and rheumatoid arthritis, necessitate the development of high-concentration insulin and monoclonal antibodies formulations for patient self-administration. High protein concentrations can affect viscosity of the corresponding drug solutions complicating their manufacture and administration. The measurements of the viscosity of new insulin analogs and monoclonal antibodies solutions under development is of practical importance to avoid unwanted highly viscous, and therefore, painful for injection drug formulations. Recently, we have demonstrated capability of the electron paramagnetic resonance (EPR) viscometry using viscosity-sensitive 13C-labeled trityl spin probe (13C1-dFT) to report the viscosity of human blood, and interstitial fluids measured in various organs in mice ex-vivo and in anesthetized mice, in vivo. In the present work, we demonstrate utility of the EPR viscometry using 13C1-dFT to measure microviscosity of commercial insulin samples, antibodies solution, and human synovial fluids using small microliter volume samples (5-50 μL). This viscometry analysis approach provides useful tool to control formulations and administration of new biopharmaceuticals, and for evaluation of the state of synovial fluids of importance for clinical applications.
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Affiliation(s)
- Murugesan Velayutham
- In Vivo Multifunctional Magnetic Resonance center, Robert C. Byrd Health Sciences Center
- Department of Biochemistry and Molecular Medicine
| | - Martin Poncelet
- In Vivo Multifunctional Magnetic Resonance center, Robert C. Byrd Health Sciences Center
- Department of Pharmaceutical Sciences
| | | | | | | | - Benoit Driesschaert
- In Vivo Multifunctional Magnetic Resonance center, Robert C. Byrd Health Sciences Center
- Department of Pharmaceutical Sciences
- C. Eugene Bennett Department of Chemistry, West Virginia University, Morgantown, WV 26506, USA
| | - Valery V. Khramtsov
- In Vivo Multifunctional Magnetic Resonance center, Robert C. Byrd Health Sciences Center
- Department of Biochemistry and Molecular Medicine
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25
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Martin GM, Torres JL, Pholcharee T, Oyen D, Flores-Garcia Y, Gibson G, Moskovitz R, Beutler N, Jung DD, Copps J, Lee WH, Gonzalez-Paez G, Emerling D, MacGill RS, Locke E, King CR, Zavala F, Wilson IA, Ward AB. Affinity-matured homotypic interactions induce spectrum of PfCSP structures that influence protection from malaria infection. Nat Commun 2023; 14:4546. [PMID: 37507365 PMCID: PMC10382551 DOI: 10.1038/s41467-023-40151-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
The generation of high-quality antibody responses to Plasmodium falciparum (Pf) circumsporozoite protein (PfCSP), the primary surface antigen of Pf sporozoites, is paramount to the development of an effective malaria vaccine. Here we present an in-depth structural and functional analysis of a panel of potent antibodies encoded by the immunoglobulin heavy chain variable (IGHV) gene IGHV3-33, which is among the most prevalent and potent antibody families induced in the anti-PfCSP immune response and targets the Asn-Ala-Asn-Pro (NANP) repeat region. Cryo-electron microscopy (cryo-EM) reveals a remarkable spectrum of helical antibody-PfCSP structures stabilized by homotypic interactions between tightly packed fragments antigen binding (Fabs), many of which correlate with somatic hypermutation. We demonstrate a key role of these mutated homotypic contacts for high avidity binding to PfCSP and in protection from Pf malaria infection. Together, these data emphasize the importance of anti-homotypic affinity maturation in the frequent selection of IGHV3-33 antibodies and highlight key features underlying the potent protection of this antibody family.
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Affiliation(s)
- Gregory M Martin
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Jonathan L Torres
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Tossapol Pholcharee
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
- Department of Biochemistry, University of Oxford, Oxford, OX1 3DR, UK
| | - David Oyen
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
- Pfizer Inc, San Diego, CA, 92121, USA
| | - Yevel Flores-Garcia
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Grace Gibson
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Re'em Moskovitz
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Nathan Beutler
- Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Diana D Jung
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Jeffrey Copps
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Wen-Hsin Lee
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Gonzalo Gonzalez-Paez
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | | | | | - Emily Locke
- PATH's Malaria Vaccine Initiative, Washington, DC, 20001, USA
| | - C Richter King
- PATH's Malaria Vaccine Initiative, Washington, DC, 20001, USA
| | - Fidel Zavala
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Ian A Wilson
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
- The Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Andrew B Ward
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA.
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26
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Aguirre-Botero MC, Wang LT, Formaglio P, Aliprandini E, Thiberge JM, Schön A, Flores-Garcia Y, Mathis-Torres S, Flynn BJ, da Silva Pereira L, Le Duff Y, Hurley M, Nacer A, Bowyer PW, Zavala F, Idris AH, Francica JR, Seder RA, Amino R. Cytotoxicity of human antibodies targeting the circumsporozoite protein is amplified by 3D substrate and correlates with protection. Cell Rep 2023; 42:112681. [PMID: 37389992 PMCID: PMC10468621 DOI: 10.1016/j.celrep.2023.112681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 04/14/2023] [Accepted: 06/06/2023] [Indexed: 07/02/2023] Open
Abstract
Human monoclonal antibodies (hmAbs) targeting the Plasmodium falciparum circumsporozoite protein (PfCSP) on the sporozoite surface are a promising tool for preventing malaria infection. However, their mechanisms of protection remain unclear. Here, using 13 distinctive PfCSP hmAbs, we provide a comprehensive view of how PfCSP hmAbs neutralize sporozoites in host tissues. Sporozoites are most vulnerable to hmAb-mediated neutralization in the skin. However, rare but potent hmAbs additionally neutralize sporozoites in the blood and liver. Efficient protection in tissues mainly associates with high-affinity and high-cytotoxicity hmAbs inducing rapid parasite loss-of-fitness in the absence of complement and host cells in vitro. A 3D-substrate assay greatly enhances hmAb cytotoxicity and mimics the skin-dependent protection, indicating that the physical stress imposed on motile sporozoites by the skin is crucial for unfolding the protective potential of hmAbs. This functional 3D cytotoxicity assay can thus be useful for downselecting potent anti-PfCSP hmAbs and vaccines.
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Affiliation(s)
- Manuela C Aguirre-Botero
- Institut Pasteur, Université Paris Cité, Malaria Infection and Immunity, BioSPC, F-75015, Paris, France
| | - Lawrence T Wang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Pauline Formaglio
- Institut Pasteur, Université Paris Cité, Malaria Infection and Immunity, BioSPC, F-75015, Paris, France
| | - Eduardo Aliprandini
- Institut Pasteur, Université Paris Cité, Malaria Infection and Immunity, BioSPC, F-75015, Paris, France
| | - Jean-Michel Thiberge
- Institut Pasteur, Université Paris Cité, Malaria Infection and Immunity, BioSPC, F-75015, Paris, France
| | - Arne Schön
- Department of Biology, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Yevel Flores-Garcia
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Shamika Mathis-Torres
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Barbara J Flynn
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Lais da Silva Pereira
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Yann Le Duff
- Centre for Aids Reagents, National Institute for Biological Standards and Control (NIBSC), Medicines and Healthcare products Regulatory Agency (MHRA), Blanche Lane, South Mimms, Potters Bar, EN6 3QG, UK
| | - Mathew Hurley
- Centre for Aids Reagents, National Institute for Biological Standards and Control (NIBSC), Medicines and Healthcare products Regulatory Agency (MHRA), Blanche Lane, South Mimms, Potters Bar, EN6 3QG, UK
| | - Adéla Nacer
- Division of Bacteriology, National Institute for Biological Standards and Control (NIBSC), Medicines and Healthcare products Regulatory Agency (MHRA), Blanche Lane, South Mimms, Potters Bar, EN6 3QG, UK
| | - Paul W Bowyer
- Division of Bacteriology, National Institute for Biological Standards and Control (NIBSC), Medicines and Healthcare products Regulatory Agency (MHRA), Blanche Lane, South Mimms, Potters Bar, EN6 3QG, UK
| | - Fidel Zavala
- Department of Molecular Microbiology and Immunology, Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Azza H Idris
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Joseph R Francica
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Robert A Seder
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
| | - Rogerio Amino
- Institut Pasteur, Université Paris Cité, Malaria Infection and Immunity, BioSPC, F-75015, Paris, France.
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González-Sanz M, Berzosa P, Norman FF. Updates on Malaria Epidemiology and Prevention Strategies. Curr Infect Dis Rep 2023; 25:1-9. [PMID: 37361492 PMCID: PMC10248987 DOI: 10.1007/s11908-023-00805-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 06/28/2023]
Abstract
Purpose of Review The objective of this review was to provide an update on recent malaria epidemiology, both globally and in non-endemic areas, to identify the current distribution and repercussions of genetically diverse Plasmodium species and summarize recently implemented intervention and prevention tools. Recent Findings Notable changes in malaria epidemiology have occurred in recent years, with an increase in the number of total cases and deaths globally during 2020-2021, in part attributed to the COVID-19 pandemic. The emergence of artemisinin-resistant species in new areas and the expanding distribution of parasites harbouring deletions of the pfhrp2/3 genes have been concerning. New strategies to curb the burden of this infection, such as vaccination, have been implemented in certain endemic areas and their performance is currently being evaluated. Summary Inadequate control of malaria in endemic regions may have an effect on imported malaria and measures to prevent re-establishment of transmission in malaria-free areas are essential. Enhanced surveillance and investigation of Plasmodium spp. genetic variations will contribute to the successful diagnosis and treatment of malaria in future. Novel strategies for an integrated One Health approach to malaria control should also be strengthened.
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Affiliation(s)
- Marta González-Sanz
- Infectious Diseases Department, National Referral Unit for Tropical Diseases, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Pedro Berzosa
- Malaria and Neglected Tropical Diseases Laboratory, National Centre for Tropical Medicine, Carlos III Health Institute, CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Francesca F. Norman
- Infectious Diseases Department, National Referral Unit for Tropical Diseases, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid, Spain
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Martin GM, Fernández-Quintero ML, Lee WH, Pholcharee T, Eshun-Wilson L, Liedl KR, Pancera M, Seder RA, Wilson IA, Ward AB. Structural basis of epitope selectivity and potent protection from malaria by PfCSP antibody L9. Nat Commun 2023; 14:2815. [PMID: 37198165 PMCID: PMC10192352 DOI: 10.1038/s41467-023-38509-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/04/2023] [Indexed: 05/19/2023] Open
Abstract
A primary objective in malaria vaccine design is the generation of high-quality antibody responses against the circumsporozoite protein of the malaria parasite, Plasmodium falciparum (PfCSP). To enable rational antigen design, we solved a cryo-EM structure of the highly potent anti-PfCSP antibody L9 in complex with recombinant PfCSP. We found that L9 Fab binds multivalently to the minor (NPNV) repeat domain, which is stabilized by a unique set of affinity-matured homotypic, antibody-antibody contacts. Molecular dynamics simulations revealed a critical role of the L9 light chain in integrity of the homotypic interface, which likely impacts PfCSP affinity and protective efficacy. These findings reveal the molecular mechanism of the unique NPNV selectivity of L9 and emphasize the importance of anti-homotypic affinity maturation in protective immunity against P. falciparum.
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Affiliation(s)
- Gregory M Martin
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Monica L Fernández-Quintero
- Department of General, Inorganic, and Theoretical Chemistry, Center for Chemistry and Biomedicine, The University of Innsbruck; Innrain 80-82/III, 6020, Innsbruck, Austria
| | - Wen-Hsin Lee
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Tossapol Pholcharee
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
- Department of Biochemistry, University of Oxford, Oxford, OX1 3DR, UK
| | - Lisa Eshun-Wilson
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Klaus R Liedl
- Department of General, Inorganic, and Theoretical Chemistry, Center for Chemistry and Biomedicine, The University of Innsbruck; Innrain 80-82/III, 6020, Innsbruck, Austria
| | - Marie Pancera
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA
| | - Robert A Seder
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Ian A Wilson
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
- The Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA
| | - Andrew B Ward
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA.
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29
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Sampei Z, Koo CX, Teo FJ, Toh YX, Fukuzawa T, Gan SW, Nambu T, Ho A, Honda K, Igawa T, Ahmed F, Wang CI, Fink K, Nezu J. Complement Activation by an Anti-Dengue/Zika Antibody with Impaired Fcγ Receptor Binding Provides Strong Efficacy and Abrogates Risk of Antibody-Dependent Enhancement. Antibodies (Basel) 2023; 12:antib12020036. [PMID: 37218902 DOI: 10.3390/antib12020036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/12/2023] [Accepted: 05/10/2023] [Indexed: 05/24/2023] Open
Abstract
To combat infectious diseases, vaccines are considered the best prophylactic strategy for a wide range of the population, but even when vaccines are effective, the administration of therapeutic antibodies against viruses could provide further treatment options, particularly for vulnerable groups whose immunity against the viruses is compromised. Therapeutic antibodies against dengue are ideally engineered to abrogate binding to Fcγ receptors (FcγRs), which can induce antibody-dependent enhancement (ADE). However, the Fc effector functions of neutralizing antibodies against SARS-CoV-2 have recently been reported to improve post-exposure therapy, while they are dispensable when administered as prophylaxis. Hence, in this report, we investigated the influence of Fc engineering on anti-virus efficacy using the anti-dengue/Zika human antibody SIgN-3C and found it affected the viremia clearance efficacy against dengue in a mouse model. Furthermore, we demonstrated that complement activation through antibody binding to C1q could play a role in anti-dengue efficacy. We also generated a novel Fc variant, which displayed the ability for complement activation but showed very low FcγR binding and an undetectable level of the risk of ADE in a cell-based assay. This Fc engineering approach could make effective and safe anti-virus antibodies against dengue, Zika and other viruses.
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Affiliation(s)
- Zenjiro Sampei
- Chugai Pharmaceutical Co., Ltd., Yokohama 244-8602, Japan
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
| | | | - Frannie Jiuyi Teo
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore 138648, Singapore
| | - Ying Xiu Toh
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore 138648, Singapore
| | - Taku Fukuzawa
- Chugai Pharmaceutical Co., Ltd., Yokohama 244-8602, Japan
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
| | - Siok Wan Gan
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
| | - Takeru Nambu
- Chugai Pharmaceutical Co., Ltd., Yokohama 244-8602, Japan
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
| | - Adrian Ho
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
| | - Kiyofumi Honda
- Chugai Pharmaceutical Co., Ltd., Yokohama 244-8602, Japan
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
| | - Tomoyuki Igawa
- Chugai Pharmaceutical Co., Ltd., Yokohama 244-8602, Japan
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
| | - Fariyal Ahmed
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore 138648, Singapore
| | - Cheng-I Wang
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore 138648, Singapore
| | - Katja Fink
- Singapore Immunology Network, Agency for Science, Technology and Research, Singapore 138648, Singapore
| | - Junichi Nezu
- Chugai Pharmaceutical Co., Ltd., Yokohama 244-8602, Japan
- Chugai Pharmabody Research Pte. Ltd., Singapore 138623, Singapore
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30
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Lyke KE, Berry AA, Mason K, Idris AH, O'Callahan M, Happe M, Strom L, Berkowitz NM, Guech M, Hu Z, Castro M, Basappa M, Wang L, Low K, Holman LA, Mendoza F, Gordon IJ, Plummer SH, Trofymenko O, Strauss KS, Joshi S, Shrestha B, Adams M, Chagas AC, Murphy JR, Stein J, Hickman S, McDougal A, Lin B, Narpala SR, Vazquez S, Serebryannyy L, McDermott A, Gaudinski MR, Capparelli EV, Coates EE, Wu RL, Ledgerwood JE, Dropulic LK, Seder RA. Low-dose intravenous and subcutaneous CIS43LS monoclonal antibody for protection against malaria (VRC 612 Part C): a phase 1, adaptive trial. THE LANCET. INFECTIOUS DISEASES 2023; 23:578-588. [PMID: 36708738 PMCID: PMC10121890 DOI: 10.1016/s1473-3099(22)00793-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Human monoclonal antibodies might offer an important new approach to reduce malaria morbidity and mortality. In the first two parts of a three-part clinical trial, the antimalarial monoclonal antibody CIS43LS conferred high protection against parasitaemia at doses of 20 mg/kg or 40 mg/kg administered intravenously followed by controlled human malaria infection. The ability of CIS43LS to confer protection at lower doses or by the subcutaneous route is unknown. We aimed to provide data on the safety and optimisation of dose and route for the human antimalaria monoclonal antibody CIS43LS. METHODS VRC 612 Part C was the third part of a three-part, first-in-human, phase 1, adaptive trial, conducted at the University of Maryland, Baltimore Center for Vaccine Development and Global Health, Baltimore, MD, USA. We enrolled adults aged 18-50 years with no previous malaria vaccinations or infections, in a sequential, dose-escalating manner. Eligible participants received the monoclonal antibody CIS43LS in a single, open-label dose of 1 mg/kg, 5 mg/kg, or 10 mg/kg intravenously, or 5 mg/kg or 10 mg/kg subcutaneously. Participants underwent controlled human malaria infection by the bites of five mosquitoes infected with Plasmodium falciparum 3D7 strain approximately 8 weeks after their monoclonal antibody inoculation. Six additional control participants who did not receive CIS43LS underwent controlled human malaria infection simultaneously. Participants were followed-up daily on days 7-18 and day 21, with qualitative PCR used for P falciparum detection. Participants who tested positive for P falciparum were treated with atovaquone-proguanil and those who remained negative were treated at day 21. Participants were followed-up until 24 weeks after dosing. The primary outcome was safety and tolerability of CIS43LS at each dose level, assessed in the as-treated population. Secondary outcomes included protective efficacy of CIS43LS after controlled human malaria infection. This trial is now complete and is registered with ClinicalTrials.gov, NCT04206332. FINDINGS Between Sept 1, 2021, and Oct 29, 2021, 47 people were assessed for eligibility and 31 were enrolled (one subsequently withdrew and was replaced) and assigned to receive doses of 1 mg/kg (n=7), 5 mg/kg (n=4), and 10 mg/kg (n=3) intravenously and 5 mg/kg (n=4) and 10 mg/kg (n=4) subcutaneously, or to the control group (n=8). CIS43LS administration was safe and well tolerated; no serious adverse events occurred. CIS43LS protected 18 (82%) of 22 participants who received a dose. No participants developed parasitaemia following dosing at 5 mg/kg intravenously or subcutaneously, or at 10 mg/kg intravenously or subcutaneously. All six control participants and four of seven participants dosed at 1 mg/kg intravenously developed parasitaemia after controlled human malaria infection. INTERPRETATION CIS43LS was safe and well tolerated, and conferred protection against P falciparum at low doses and by the subcutaneous route, providing evidence that this approach might be useful to prevent malaria across several clinical use cases. FUNDING National Institute of Allergy and Infectious Diseases, National Institutes of Health.
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Affiliation(s)
- Kirsten E Lyke
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Andrea A Berry
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kaitlin Mason
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Azza H Idris
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Mark O'Callahan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Myra Happe
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Larisa Strom
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Nina M Berkowitz
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Mercy Guech
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Zonghui Hu
- Biostatistics Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Mike Castro
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Manjula Basappa
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Lu Wang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Kwang Low
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - LaSonji A Holman
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Floreliz Mendoza
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Ingelise J Gordon
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Sarah H Plummer
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Olga Trofymenko
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Kathleen S Strauss
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sudhaunshu Joshi
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Biraj Shrestha
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Matthew Adams
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Jittawadee R Murphy
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Judy Stein
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Somia Hickman
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Andrew McDougal
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Bob Lin
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Sandeep R Narpala
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Sandra Vazquez
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Leonid Serebryannyy
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Adrian McDermott
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Martin R Gaudinski
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA; United States Public Health Service Commissioned Corps, Rockville, MD, USA
| | - Edmund V Capparelli
- School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego, CA, USA
| | - Emily E Coates
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Richard L Wu
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA; United States Public Health Service Commissioned Corps, Rockville, MD, USA
| | - Julie E Ledgerwood
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Lesia K Dropulic
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Robert A Seder
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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Tripathi P, Bender MF, Lei H, Da Silva Pereira L, Shen CH, Bonilla B, Dillon M, Ou L, Pancera M, Wang LT, Zhang B, Batista FD, Idris AH, Seder RA, Kwong PD. Cryo-EM structures of anti-malarial antibody L9 with circumsporozoite protein reveal trimeric L9 association and complete 27-residue epitope. Structure 2023; 31:480-491.e4. [PMID: 36931276 PMCID: PMC10237622 DOI: 10.1016/j.str.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/17/2023] [Accepted: 02/13/2023] [Indexed: 03/18/2023]
Abstract
Monoclonal antibody L9 recognizes the Plasmodium falciparum circumsporozoite protein (PfCSP) and is highly protective following controlled human malaria challenge. To gain insight into its function, we determined cryoelectron microscopy (cryo-EM) structures of L9 in complex with full-length PfCSP and assessed how this recognition influenced protection by wild-type and mutant L9s. Cryo-EM reconstructions at 3.6- and 3.7-Å resolution revealed L9 to recognize PfCSP as an atypical trimer. Each of the three L9s in the trimer directly recognized an Asn-Pro-Asn-Val (NPNV) tetrapeptide on PfCSP and interacted homotypically to facilitate L9-trimer assembly. We analyzed peptides containing different repeat tetrapeptides for binding to wild-type and mutant L9s to delineate epitope and homotypic components of L9 recognition; we found both components necessary for potent malaria protection. Last, we found the 27-residue stretch recognized by L9 to be highly conserved in P. falciparum isolates, suggesting the newly revealed complete L9 epitope to be an attractive vaccine target.
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Affiliation(s)
- Prabhanshu Tripathi
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Michael F Bender
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Haotian Lei
- Research Technology Branch Electron Microscopy Unit, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Lais Da Silva Pereira
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Chen-Hsiang Shen
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Brian Bonilla
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Marlon Dillon
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Li Ou
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Marie Pancera
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Lawrence T Wang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Baoshan Zhang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Facundo D Batista
- Departments of Immunology and Microbiology, Harvard Medical School, Boston, MA 02139, USA
| | - Azza H Idris
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Robert A Seder
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Peter D Kwong
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
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Monoclonals against malaria: the promise of passive protection. THE LANCET. INFECTIOUS DISEASES 2023; 23:514-516. [PMID: 36708739 DOI: 10.1016/s1473-3099(22)00828-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 01/27/2023]
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Jelínková L, Roberts B, Ajayi DT, Peabody DS, Chackerian B. The Immunogenicity of a VLP-based Malaria Vaccine Targeting CSP in Pregnant and Neonatal Mice. Biomolecules 2023; 13:202. [PMID: 36830571 PMCID: PMC9953288 DOI: 10.3390/biom13020202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Maternal antibodies are passively transferred to the fetus via the placenta during gestation and can play an important role in protecting the newborn from infection. For example, in malaria-endemic regions, maternal antibodies likely provide substantial protection against Plasmodium falciparum malaria in the first 6 months of life. However, circulating maternal antibodies can also interfere with vaccine efficacy. Here, we used a mouse maternal transfer model to evaluate whether maternal antibodies interfere with the responsiveness to a virus-like particle (VLP)-based vaccine targeting the CIS43 epitope of the malaria circumsporozoite protein (CSP). We found immunized dams passively transfer to pups high levels of anti-CSP IgG antibodies that steadily decline as the animals age. We also found that the neonatal offspring of immunized mice do not respond to de novo immunization with the CIS43-targeted VLP vaccine until maternal antibody titers decline below an inhibitory threshold. These findings may have important implications for delineating the delicate balance between protection conferred by maternal antibodies and the offspring's ability to respond to immunization.
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Affiliation(s)
| | | | | | | | - Bryce Chackerian
- Department of Molecular Genetics and Microbiology, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
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Chandley P, Ranjan R, Kumar S, Rohatgi S. Host-parasite interactions during Plasmodium infection: Implications for immunotherapies. Front Immunol 2023; 13:1091961. [PMID: 36685595 PMCID: PMC9845897 DOI: 10.3389/fimmu.2022.1091961] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Abstract
Malaria is a global infectious disease that remains a leading cause of morbidity and mortality in the developing world. Multiple environmental and host and parasite factors govern the clinical outcomes of malaria. The host immune response against the Plasmodium parasite is heterogenous and stage-specific both in the human host and mosquito vector. The Plasmodium parasite virulence is predominantly associated with its ability to evade the host's immune response. Despite the availability of drug-based therapies, Plasmodium parasites can acquire drug resistance due to high antigenic variations and allelic polymorphisms. The lack of licensed vaccines against Plasmodium infection necessitates the development of effective, safe and successful therapeutics. To design an effective vaccine, it is important to study the immune evasion strategies and stage-specific Plasmodium proteins, which are targets of the host immune response. This review provides an overview of the host immune defense mechanisms and parasite immune evasion strategies during Plasmodium infection. Furthermore, we also summarize and discuss the current progress in various anti-malarial vaccine approaches, along with antibody-based therapy involving monoclonal antibodies, and research advancements in host-directed therapy, which can together open new avenues for developing novel immunotherapies against malaria infection and transmission.
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Affiliation(s)
- Pankaj Chandley
- Department of Biosciences and Bioengineering, Indian Institute of Technology, Roorkee, India
| | - Ravikant Ranjan
- Department of Biosciences and Bioengineering, Indian Institute of Technology, Roorkee, India
| | - Sudhir Kumar
- Center for Global Infectious Disease Research, Seattle Children’s Research Institute, Seattle, WA, United States
| | - Soma Rohatgi
- Department of Biosciences and Bioengineering, Indian Institute of Technology, Roorkee, India,*Correspondence: Soma Rohatgi,
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Richie TL, Church LWP, Murshedkar T, Billingsley PF, James ER, Chen MC, Abebe Y, KC N, Chakravarty S, Dolberg D, Healy SA, Diawara H, Sissoko MS, Sagara I, Cook DM, Epstein JE, Mordmüller B, Kapulu M, Kreidenweiss A, Franke-Fayard B, Agnandji ST, López Mikue MSA, McCall MBB, Steinhardt L, Oneko M, Olotu A, Vaughan AM, Kublin JG, Murphy SC, Jongo S, Tanner M, Sirima SB, Laurens MB, Daubenberger C, Silva JC, Lyke KE, Janse CJ, Roestenberg M, Sauerwein RW, Abdulla S, Dicko A, Kappe SHI, Lee Sim BK, Duffy PE, Kremsner PG, Hoffman SL. Sporozoite immunization: innovative translational science to support the fight against malaria. Expert Rev Vaccines 2023; 22:964-1007. [PMID: 37571809 PMCID: PMC10949369 DOI: 10.1080/14760584.2023.2245890] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 08/04/2023] [Indexed: 08/13/2023]
Abstract
INTRODUCTION Malaria, a devastating febrile illness caused by protozoan parasites, sickened 247,000,000 people in 2021 and killed 619,000, mostly children and pregnant women in sub-Saharan Africa. A highly effective vaccine is urgently needed, especially for Plasmodium falciparum (Pf), the deadliest human malaria parasite. AREAS COVERED Sporozoites (SPZ), the parasite stage transmitted by Anopheles mosquitoes to humans, are the only vaccine immunogen achieving >90% efficacy against Pf infection. This review describes >30 clinical trials of PfSPZ vaccines in the U.S.A., Europe, Africa, and Asia, based on first-hand knowledge of the trials and PubMed searches of 'sporozoites,' 'malaria,' and 'vaccines.' EXPERT OPINION First generation (radiation-attenuated) PfSPZ vaccines are safe, well tolerated, 80-100% efficacious against homologous controlled human malaria infection (CHMI) and provide 18-19 months protection without boosting in Africa. Second generation chemo-attenuated PfSPZ are more potent, 100% efficacious against stringent heterologous (variant strain) CHMI, but require a co-administered drug, raising safety concerns. Third generation, late liver stage-arresting, replication competent (LARC), genetically-attenuated PfSPZ are expected to be both safe and highly efficacious. Overall, PfSPZ vaccines meet safety, tolerability, and efficacy requirements for protecting pregnant women and travelers exposed to Pf in Africa, with licensure for these populations possible within 5 years. Protecting children and mass vaccination programs to block transmission and eliminate malaria are long-term objectives.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Sara A. Healy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Halimatou Diawara
- Malaria Research and Training Center, Mali-NIAID ICER, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Mahamadou S. Sissoko
- Malaria Research and Training Center, Mali-NIAID ICER, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Issaka Sagara
- Malaria Research and Training Center, Mali-NIAID ICER, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - David M. Cook
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Judith E. Epstein
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Benjamin Mordmüller
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Melissa Kapulu
- Biosciences Department, Kenya Medical Research Institute KEMRI-Wellcome Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Andrea Kreidenweiss
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
| | | | - Selidji T. Agnandji
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | | | - Matthew B. B. McCall
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Laura Steinhardt
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Martina Oneko
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya
| | - Ally Olotu
- Bagamoyo Research and Training Center, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Ashley M. Vaughan
- Center for Global Infectious Disease Research, Seattle Children’s Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - James G. Kublin
- Department of Global Health, University of Washington, Seattle, WA, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Sean C. Murphy
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
- Center for Emerging and Re-emerging Infectious Diseases and Department of Microbiology, University of Washington, Seattle, WA, USA
| | - Said Jongo
- Bagamoyo Research and Training Center, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Marcel Tanner
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Matthew B. Laurens
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Claudia Daubenberger
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Joana C. Silva
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kirsten E. Lyke
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Chris J. Janse
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Meta Roestenberg
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Robert W. Sauerwein
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Salim Abdulla
- Bagamoyo Research and Training Center, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Alassane Dicko
- Malaria Research and Training Center, Mali-NIAID ICER, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Stefan H. I. Kappe
- Center for Global Infectious Disease Research, Seattle Children’s Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | | | - Patrick E. Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Peter G. Kremsner
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
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Grace PS, Gunn BM, Lu LL. Engineering the supernatural: monoclonal antibodies for challenging infectious diseases. Curr Opin Biotechnol 2022; 78:102818. [PMID: 36242952 PMCID: PMC9612313 DOI: 10.1016/j.copbio.2022.102818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/31/2022] [Accepted: 09/04/2022] [Indexed: 12/14/2022]
Abstract
The COVID-19 pandemic demonstrated that monoclonal antibodies can be deployed faster than antimicrobials and vaccines. However, the majority of mAbs treat cancer and autoimmune diseases, whereas a minority treat infection. This is in part because targeting a single antigen by the antibody Fab domain is insufficient to stop the dynamic microbial life cycle. Thus, finding the 'right' antigens remains the focus of intense investigations. Equally important is the antibody-Fc domain that has the capacity to induce immune responses that enhance neutralization, and limit pathology and transmission. While Fc-effector functions have been less deeply studied, conceptual and technical advances reveal previously underappreciated antibody potential to combat diseases from microbes difficult to address with current diagnostics, therapeutics, and vaccines, including S. aureus, P. aeruginosa, P. falciparum, and M. tuberculosis. What is learned about engineering antibodies for these challenging organisms will enhance our approach to new and emerging infectious diseases.
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Affiliation(s)
- Patricia S Grace
- Harvard T.H. Chan School of Public Health, Boston, MA, United States; Ragon Institute of MGH, MIT and Harvard, Boston, MA, United States
| | - Bronwyn M Gunn
- Paul G. Allen School of Global Health, Washington State University, Pullman, WA, United States
| | - Lenette L Lu
- Division of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, United States; Department of Immunology, UT Southwestern Medical Center, Dallas, TX, United States; Parkland Health & Hospital System, United States.
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D'Alessandro U. Monoclonal Antibodies against Malaria. N Engl J Med 2022; 387:1898-1899. [PMID: 36317785 DOI: 10.1056/nejme2213148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Umberto D'Alessandro
- From the Medical Research Council Unit the Gambia at the London School of Hygiene and Tropical Medicine, Banjul, Gambia
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Kayentao K, Ongoiba A, Preston AC, Healy SA, Doumbo S, Doumtabe D, Traore A, Traore H, Djiguiba A, Li S, Peterson ME, Telscher S, Idris AH, Kisalu NK, Carlton K, Serebryannyy L, Narpala S, McDermott AB, Gaudinski M, Traore S, Cisse H, Keita M, Skinner J, Hu Z, Zéguimé A, Ouattara A, Doucoure M, Dolo A, Djimdé A, Traore B, Seder RA, Crompton PD. Safety and Efficacy of a Monoclonal Antibody against Malaria in Mali. N Engl J Med 2022; 387:1833-1842. [PMID: 36317783 PMCID: PMC9881676 DOI: 10.1056/nejmoa2206966] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND CIS43LS is a monoclonal antibody that was shown to protect against controlled Plasmodium falciparum infection in a phase 1 clinical trial. Whether a monoclonal antibody can prevent P. falciparum infection in a region in which the infection is endemic is unknown. METHODS We conducted a phase 2 trial to assess the safety and efficacy of a single intravenous infusion of CIS43LS against P. falciparum infection in healthy adults in Mali over a 6-month malaria season. In Part A, safety was assessed at three escalating dose levels. In Part B, participants were randomly assigned (in a 1:1:1 ratio) to receive 10 mg of CIS43LS per kilogram of body weight, 40 mg of CIS43LS per kilogram, or placebo. The primary efficacy end point, assessed in a time-to-event analysis, was the first P. falciparum infection detected on blood-smear examination, which was performed at least every 2 weeks for 24 weeks. At enrollment, all the participants received artemether-lumefantrine to clear possible P. falciparum infection. RESULTS In Part B, 330 adults underwent randomization; 110 were assigned to each trial group. The risk of moderate headache was 3.3 times as high with 40 mg of CIS43LS per kilogram as with placebo. P. falciparum infections were detected on blood-smear examination in 39 participants (35.5%) who received 10 mg of CIS43LS per kilogram, 20 (18.2%) who received 40 mg of CIS43LS per kilogram, and 86 (78.2%) who received placebo. At 6 months, the efficacy of 40 mg of CIS43LS per kilogram as compared with placebo was 88.2% (adjusted 95% confidence interval [CI], 79.3 to 93.3; P<0.001), and the efficacy of 10 mg of CIS43LS per kilogram as compared with placebo was 75.0% (adjusted 95% CI, 61.0 to 84.0; P<0.001). CONCLUSIONS CIS43LS was protective against P. falciparum infection over a 6-month malaria season in Mali without evident safety concerns. (Funded by the National Institute of Allergy and Infectious Diseases; ClinicalTrials.gov number, NCT04329104.).
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Affiliation(s)
- Kassoum Kayentao
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Aissata Ongoiba
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Anne C Preston
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Sara A Healy
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Safiatou Doumbo
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Didier Doumtabe
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Abdrahamane Traore
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Hamadi Traore
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Adama Djiguiba
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Shanping Li
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Mary E Peterson
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Shinyi Telscher
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Azza H Idris
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Neville K Kisalu
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Kevin Carlton
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Leonid Serebryannyy
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Sandeep Narpala
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Adrian B McDermott
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Martin Gaudinski
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Siriman Traore
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Hamidou Cisse
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Mamadou Keita
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Jeff Skinner
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Zonghui Hu
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Amatigué Zéguimé
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Adama Ouattara
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - M'Bouye Doucoure
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Amagana Dolo
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Abdoulaye Djimdé
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Boubacar Traore
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Robert A Seder
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Peter D Crompton
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
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Nekkab N, Penny MA. Accelerated development of malaria monoclonal antibodies. Cell Rep Med 2022; 3:100786. [PMID: 36260982 PMCID: PMC9589116 DOI: 10.1016/j.xcrm.2022.100786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
L9LS, a potent and safe antimalarial monoclonal antibody, demonstrated 88% protective efficacy against infection in a phase 1 trial in healthy adults.1 These promising results are the first of many to usher in a potential new era of malaria prevention.
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Affiliation(s)
- Narimane Nekkab
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland,University of Basel, Basel, Switzerland
| | - Melissa A. Penny
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland,University of Basel, Basel, Switzerland,Corresponding author
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Biselli R, Nisini R, Lista F, Autore A, Lastilla M, De Lorenzo G, Peragallo MS, Stroffolini T, D’Amelio R. A Historical Review of Military Medical Strategies for Fighting Infectious Diseases: From Battlefields to Global Health. Biomedicines 2022; 10:2050. [PMID: 36009598 PMCID: PMC9405556 DOI: 10.3390/biomedicines10082050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 11/17/2022] Open
Abstract
The environmental conditions generated by war and characterized by poverty, undernutrition, stress, difficult access to safe water and food as well as lack of environmental and personal hygiene favor the spread of many infectious diseases. Epidemic typhus, plague, malaria, cholera, typhoid fever, hepatitis, tetanus, and smallpox have nearly constantly accompanied wars, frequently deeply conditioning the outcome of battles/wars more than weapons and military strategy. At the end of the nineteenth century, with the birth of bacteriology, military medical researchers in Germany, the United Kingdom, and France were active in discovering the etiological agents of some diseases and in developing preventive vaccines. Emil von Behring, Ronald Ross and Charles Laveran, who were or served as military physicians, won the first, the second, and the seventh Nobel Prize for Physiology or Medicine for discovering passive anti-diphtheria/tetanus immunotherapy and for identifying mosquito Anopheline as a malaria vector and plasmodium as its etiological agent, respectively. Meanwhile, Major Walter Reed in the United States of America discovered the mosquito vector of yellow fever, thus paving the way for its prevention by vector control. In this work, the military relevance of some vaccine-preventable and non-vaccine-preventable infectious diseases, as well as of biological weapons, and the military contributions to their control will be described. Currently, the civil-military medical collaboration is getting closer and becoming interdependent, from research and development for the prevention of infectious diseases to disasters and emergencies management, as recently demonstrated in Ebola and Zika outbreaks and the COVID-19 pandemic, even with the high biocontainment aeromedical evacuation, in a sort of global health diplomacy.
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Affiliation(s)
- Roberto Biselli
- Ispettorato Generale della Sanità Militare, Stato Maggiore della Difesa, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Roberto Nisini
- Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy
| | - Florigio Lista
- Dipartimento Scientifico, Policlinico Militare, Comando Logistico dell’Esercito, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Alberto Autore
- Osservatorio Epidemiologico della Difesa, Ispettorato Generale della Sanità Militare, Stato Maggiore della Difesa, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Marco Lastilla
- Istituto di Medicina Aerospaziale, Comando Logistico dell’Aeronautica Militare, Viale Piero Gobetti 2, 00185 Roma, Italy
| | - Giuseppe De Lorenzo
- Comando Generale dell’Arma dei Carabinieri, Dipartimento per l’Organizzazione Sanitaria e Veterinaria, Viale Romania 45, 00197 Roma, Italy
| | - Mario Stefano Peragallo
- Centro Studi e Ricerche di Sanità e Veterinaria, Comando Logistico dell’Esercito, Via S. Stefano Rotondo 4, 00184 Roma, Italy
| | - Tommaso Stroffolini
- Dipartimento di Malattie Infettive e Tropicali, Policlinico Umberto I, 00161 Roma, Italy
| | - Raffaele D’Amelio
- Dipartimento di Medicina Clinica e Molecolare, Sapienza Università di Roma, Via di Grottarossa 1035-1039, 00189 Roma, Italy
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