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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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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Awan SF, Pegu A, Strom L, Carter CA, Hendel CS, Holman LA, Costner PJ, Trofymenko O, Dyer R, Gordon IJ, Rothwell RSS, Hickman SP, Conan-Cibotti M, Doria-Rose NA, Lin BC, O'Connell S, Narpala SR, Almasri CG, Liu C, Ko S, Kwon YD, Namboodiri AM, Pandey JP, Arnold FJ, Carlton K, Gall JG, Kwong PD, Capparelli EV, Bailer RT, McDermott AB, Chen GL, Koup RA, Mascola JR, Coates EE, Ledgerwood JE, Gaudinski MR. Phase 1 trial evaluating safety and pharmacokinetics of HIV-1 broadly neutralizing mAbs 10E8VLS and VRC07-523LS. JCI Insight 2024; 9:e175375. [PMID: 38587079 DOI: 10.1172/jci.insight.175375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/27/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUNDBroadly neutralizing monoclonal antibodies (bNAbs) represent a promising strategy for HIV-1 immunoprophylaxis and treatment. 10E8VLS and VRC07-523LS are bNAbs that target the highly conserved membrane-proximal external region (MPER) and the CD4-binding site of the HIV-1 viral envelope glycoprotein, respectively.METHODSIn this phase 1, open-label trial, we evaluated the safety and pharmacokinetics of 5 mg/kg 10E8VLS administered alone, or concurrently with 5 mg/kg VRC07-523LS, via s.c. injection to healthy non-HIV-infected individuals.RESULTSEight participants received either 10E8VLS alone (n = 6) or 10E8VLS and VRC07-523LS in combination (n = 2). Five (n = 5 of 8, 62.5%) participants who received 10E8VLS experienced moderate local reactogenicity, and 1 participant (n = 1/8, 12.5%) experienced severe local reactogenicity. Further trial enrollment was stopped, and no participant received repeat dosing. All local reactogenicity resolved without sequelae. 10E8VLS retained its neutralizing capacity, and no functional anti-drug antibodies were detected; however, a serum t1/2 of 8.1 days was shorter than expected. Therefore, the trial was voluntarily stopped per sponsor decision (Vaccine Research Center, National Institute of Allergy and Infectious Diseases [NIAID], NIH). Mechanistic studies performed to investigate the underlying reason for the reactogenicity suggest that multiple mechanisms may have contributed, including antibody aggregation and upregulation of local inflammatory markers.CONCLUSION10E8VLS resulted in unexpected reactogenicity and a shorter t1/2 in comparison with previously tested bNAbs. These studies may facilitate identification of nonreactogenic second-generation MPER-targeting bNAbs, which could be an effective strategy for HIV-1 immunoprophylaxis and treatment.TRIAL REGISTRATIONClinicaltrials.gov, accession no. NCT03565315.FUNDINGDivision of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH.
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Affiliation(s)
- Seemal F Awan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Amarendra Pegu
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Larisa Strom
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Cristina A Carter
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Cynthia S Hendel
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - LaSonji A Holman
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Pamela J Costner
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Olga Trofymenko
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Renunda Dyer
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Ingelise J Gordon
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Ro Shauna S Rothwell
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Somia P Hickman
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Michelle Conan-Cibotti
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Nicole A Doria-Rose
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Bob C Lin
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Sarah O'Connell
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Sandeep R Narpala
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Cassandra G Almasri
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Cuiping Liu
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Sungyoul Ko
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Young D Kwon
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Aryan M Namboodiri
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Janardan P Pandey
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Frank J Arnold
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Kevin Carlton
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Jason G Gall
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Peter D Kwong
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Edmund V Capparelli
- School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego, California, USA
| | - Robert T Bailer
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Adrian B McDermott
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Grace L Chen
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Richard A Koup
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - John R Mascola
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Emily E Coates
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Julie E Ledgerwood
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Martin R Gaudinski
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
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Mwesigwa B, Houser KV, Hofstetter AR, Ortega-Villa AM, Naluyima P, Kiweewa F, Nakabuye I, Yamshchikov GV, Andrews C, O'Callahan M, Strom L, Schech S, Anne Eller L, Sondergaard EL, Scott PT, Amare MF, Modjarrad K, Wamala A, Tindikahwa A, Musingye E, Nanyondo J, Gaudinski MR, Gordon IJ, Holman LA, Saunders JG, Costner PJM, Mendoza FH, Happe M, Morgan P, Plummer SH, Hickman SP, Vazquez S, Murray T, Cordon J, Dulan CNM, Hunegnaw R, Basappa M, Padilla M, Gajjala SR, Swanson PA, Lin BC, Coates EE, Gall JG, McDermott AB, Koup RA, Mascola JR, Ploquin A, Sullivan NJ, Kibuuka H, Ake JA, Ledgerwood JE. Safety, tolerability, and immunogenicity of the Ebola Sudan chimpanzee adenovirus vector vaccine (cAd3-EBO S) in healthy Ugandan adults: a phase 1, open-label, dose-escalation clinical trial. Lancet Infect Dis 2023; 23:1408-1417. [PMID: 37544326 PMCID: PMC10837320 DOI: 10.1016/s1473-3099(23)00344-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Sudan Ebola virus can cause severe viral disease, with an average case fatality rate of 54%. A recent outbreak of Sudan Ebola virus in Uganda caused 55 deaths among 164 confirmed cases in the second half of 2022. Although vaccines and therapeutics specific for Zaire Ebola virus have been approved for use during outbreak situations, Sudan Ebola virus is an antigenically distinct virus with no approved vaccines available. METHODS In this phase 1, open-label, dose-escalation trial we evaluated the safety, tolerability, and immunogenicity of a monovalent chimpanzee adenovirus 3 vaccine against Sudan Ebola virus (cAd3-EBO S) at Makerere University Walter Reed Project in Kampala, Uganda. Study participants were recruited from the Kampala metropolitan area using International Review Board-approved written and electronic media explaining the trial intervention. Healthy adults without previous receipt of Ebola, Marburg, or cAd3 vectored-vaccines were enrolled to receive cAd3-EBO S at either 1 × 1010 or 1 × 1011 particle units (PU) in a single intramuscular vaccination and were followed up for 48 weeks. Primary safety and tolerability endpoints were assessed in all vaccine recipients by reactogenicity for the first 7 days, adverse events for the first 28 days, and serious adverse events throughout the study. Secondary immunogenicity endpoints included evaluation of binding antibody and T-cell responses against the Sudan Ebola virus glycoprotein, and neutralising antibody responses against the cAd3 vector at 4 weeks after vaccination. This study is registered with ClinicalTrials.gov, NCT04041570, and is completed. FINDINGS 40 healthy adults were enrolled between July 22 and Oct 1, 2019, with 20 receiving 1 × 1010 PU and 20 receiving 1 × 1011 PU of cAd3-EBO S. 38 (95%) participants completed all follow-up visits. The cAd3-EBO S vaccine was well tolerated with no severe adverse events. The most common reactogenicity symptoms were pain or tenderness at the injection site (34 [85%] of 40), fatigue (29 [73%] of 40), and headache (26 [65%] of 40), and were mild to moderate in severity. Positive responses for glycoprotein-specific binding antibodies were induced by 2 weeks in 31 (78%) participants, increased to 34 (85%) participants by 4 weeks, and persisted to 48 weeks in 31 (82%) participants. Most participants developed glycoprotein-specific T-cell responses (20 [59%, 95% CI 41-75] of 34; six participants were removed from the T cell analysis after failing quality control parameters) by 4 weeks after vaccination, and neutralising titres against the cAd3 vector were also increased from baseline (90% inhibitory concentration of 47, 95% CI 30-73) to 4 weeks after vaccination (196, 125-308). INTERPRETATION The cAd3-EBO S vaccine was safe at both doses, rapidly inducing immune responses in most participants after a single injection. The rapid onset and durability of the vaccine-induced antibodies make this vaccine a strong candidate for emergency deployment in Sudan Ebola virus outbreaks. FUNDING National Institutes of Health via interagency agreement with Walter Reed Army Institute of Research.
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Affiliation(s)
- Betty Mwesigwa
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Katherine V Houser
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
| | - Amelia R Hofstetter
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Ana M Ortega-Villa
- Biostatistics Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | - Galina V Yamshchikov
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Charla Andrews
- 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
| | - Larisa Strom
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Steven Schech
- Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Leigh Anne Eller
- Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Erica L Sondergaard
- Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Paul T Scott
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Mihret F Amare
- Walter Reed Army Institute of Research, Silver Spring, MD, USA; Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | | | - Amir Wamala
- Makerere University Walter Reed Project, Kampala, Uganda
| | | | - Ezra Musingye
- Makerere University Walter Reed Project, Kampala, Uganda
| | | | - Martin R Gaudinski
- 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
| | - LaSonji A Holman
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Jamie G Saunders
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Pamela J M Costner
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Floreliz H Mendoza
- 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
| | - Patricia Morgan
- 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
| | - Somia P Hickman
- 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
| | - Tamar Murray
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Jamilet Cordon
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Caitlyn N M Dulan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Ruth Hunegnaw
- 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
| | - Marcelino Padilla
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Suprabhath R Gajjala
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Phillip A Swanson
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Bob C Lin
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Emily E Coates
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Jason G Gall
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Adrian B McDermott
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Richard A Koup
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - John R Mascola
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Aurélie Ploquin
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Nancy J Sullivan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Hannah Kibuuka
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Julie A Ake
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Julie E Ledgerwood
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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4
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Wu RL, Idris AH, Berkowitz NM, Happe M, Gaudinski MR, Buettner C, Strom L, Awan SF, Holman LA, Mendoza F, Gordon IJ, Hu Z, Campos Chagas A, Wang LT, Da Silva Pereira L, Francica JR, Kisalu NK, Flynn BJ, Shi W, Kong WP, O'Connell S, Plummer SH, Beck A, McDermott A, Narpala SR, Serebryannyy L, Castro M, Silva R, Imam M, Pittman I, Hickman SP, McDougal AJ, Lukoskie AE, Murphy JR, Gall JG, Carlton K, Morgan P, Seo E, Stein JA, Vazquez S, Telscher S, Capparelli EV, Coates EE, Mascola JR, Ledgerwood JE, Dropulic LK, Seder RA. Low-Dose Subcutaneous or Intravenous Monoclonal Antibody to Prevent Malaria. N Engl J Med 2022; 387:397-407. [PMID: 35921449 PMCID: PMC9806693 DOI: 10.1056/nejmoa2203067] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND New approaches for the prevention and elimination of malaria, a leading cause of illness and death among infants and young children globally, are needed. METHODS We conducted a phase 1 clinical trial to assess the safety and pharmacokinetics of L9LS, a next-generation antimalarial monoclonal antibody, and its protective efficacy against controlled human malaria infection in healthy adults who had never had malaria or received a vaccine for malaria. The participants received L9LS either intravenously or subcutaneously at a dose of 1 mg, 5 mg, or 20 mg per kilogram of body weight. Within 2 to 6 weeks after the administration of L9LS, both the participants who received L9LS and the control participants underwent controlled human malaria infection in which they were exposed to mosquitoes carrying Plasmodium falciparum (3D7 strain). RESULTS No safety concerns were identified. L9LS had an estimated half-life of 56 days, and it had dose linearity, with the highest mean (±SD) maximum serum concentration (Cmax) of 914.2±146.5 μg per milliliter observed in participants who had received 20 mg per kilogram intravenously and the lowest mean Cmax of 41.5±4.7 μg per milliliter observed in those who had received 1 mg per kilogram intravenously; the mean Cmax was 164.8±31.1 in the participants who had received 5 mg per kilogram intravenously and 68.9±22.3 in those who had received 5 mg per kilogram subcutaneously. A total of 17 L9LS recipients and 6 control participants underwent controlled human malaria infection. Of the 17 participants who received a single dose of L9LS, 15 (88%) were protected after controlled human malaria infection. Parasitemia did not develop in any of the participants who received 5 or 20 mg per kilogram of intravenous L9LS. Parasitemia developed in 1 of 5 participants who received 1 mg per kilogram intravenously, 1 of 5 participants who received 5 mg per kilogram subcutaneously, and all 6 control participants through 21 days after the controlled human malaria infection. Protection conferred by L9LS was seen at serum concentrations as low as 9.2 μg per milliliter. CONCLUSIONS In this small trial, L9LS administered intravenously or subcutaneously protected recipients against malaria after controlled infection, without evident safety concerns. (Funded by the National Institute of Allergy and Infectious Diseases; VRC 614 ClinicalTrials.gov number, NCT05019729.).
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Affiliation(s)
- Richard L Wu
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Azza H Idris
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Nina M Berkowitz
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Myra Happe
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Martin R Gaudinski
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Christian Buettner
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Larisa Strom
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Seemal F Awan
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - LaSonji A Holman
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Floreliz Mendoza
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Ingelise J Gordon
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Zonghui Hu
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Andrezza Campos Chagas
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Lawrence T Wang
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Lais Da Silva Pereira
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Joseph R Francica
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Neville K Kisalu
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Barbara J Flynn
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Wei Shi
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Wing-Pui Kong
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Sarah O'Connell
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Sarah H Plummer
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Allison Beck
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Adrian McDermott
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Sandeep R Narpala
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Leonid Serebryannyy
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Mike Castro
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Rosa Silva
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Marjaan Imam
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Iris Pittman
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Somia P Hickman
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Andrew J McDougal
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Ashly E Lukoskie
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Jittawadee R Murphy
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Jason G Gall
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Kevin Carlton
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Patricia Morgan
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Ellie Seo
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Judy A Stein
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Sandra Vazquez
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Shinyi Telscher
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Edmund V Capparelli
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Emily E Coates
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - John R Mascola
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Julie E Ledgerwood
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Lesia K Dropulic
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
| | - Robert A Seder
- From the Vaccine Research Center (R.L.W., A.H.I., N.M.B., M.H., M.R.G., C.B., L. Strom, S.F.A., L.A.H., F.M., I.J.G., L.T.W., L.D.S.P., J.R.F., N.K.K., B.J.F., W.S., W.-P.K., S.O., S.H.P., A.B., A.M., S.R.N., L. Serebryannyy, M.C., R.S., M.I., I.P., S.P.H., A.J.M., A.E.L., J.G.G., K.C., P.M., E.S., J.A.S., S.V., S.T., E.E.C., J.R. Mascola, J.E.L., L.K.D., R.A.S.) and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, the U.S. Public Health Service Commissioned Corps, Rockville (R.L.W., M.R.G.), and the Entomology Branch, Walter Reed Army Institute of Research, Silver Spring (A.C.C., J.R. Murphy) - all in Maryland; the Ragon Institute, Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, MA (A.H.I.); and the School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, San Diego (E.V.C.)
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Mukhamedova M, Wrapp D, Shen CH, Gilman MSA, Ruckwardt TJ, Schramm CA, Ault L, Chang L, Derrien-Colemyn A, Lucas SAM, Ransier A, Darko S, Phung E, Wang L, Zhang Y, Rush SA, Madan B, Stewart-Jones GBE, Costner PJ, Holman LA, Hickman SP, Berkowitz NM, Doria-Rose NA, Morabito KM, DeKosky BJ, Gaudinski MR, Chen GL, Crank MC, Misasi J, Sullivan NJ, Douek DC, Kwong PD, Graham BS, McLellan JS, Mascola JR. Vaccination with prefusion-stabilized respiratory syncytial virus fusion protein induces genetically and antigenically diverse antibody responses. Immunity 2021; 54:769-780.e6. [PMID: 33823129 DOI: 10.1016/j.immuni.2021.03.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/21/2021] [Accepted: 03/05/2021] [Indexed: 12/14/2022]
Abstract
An effective vaccine for respiratory syncytial virus (RSV) is an unrealized public health goal. A single dose of the prefusion-stabilized fusion (F) glycoprotein subunit vaccine (DS-Cav1) substantially increases serum-neutralizing activity in healthy adults. We sought to determine whether DS-Cav1 vaccination induces a repertoire mirroring the pre-existing diversity from natural infection or whether antibody lineages targeting specific epitopes predominate. We evaluated RSV F-specific B cell responses before and after vaccination in six participants using complementary B cell sequencing methodologies and identified 555 clonal lineages. DS-Cav1-induced lineages recognized the prefusion conformation of F (pre-F) and were genetically diverse. Expressed antibodies recognized all six antigenic sites on the pre-F trimer. We identified 34 public clonotypes, and structural analysis of two antibodies from a predominant clonotype revealed a common mode of recognition. Thus, vaccination with DS-Cav1 generates a diverse polyclonal response targeting the antigenic sites on pre-F, supporting the development and advanced testing of pre-F-based vaccines against RSV.
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Affiliation(s)
- Maryam Mukhamedova
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA; Department of Biology, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Daniel Wrapp
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX 78712, USA
| | - Chen-Hsiang Shen
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Morgan S A Gilman
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX 78712, USA
| | - Tracy J Ruckwardt
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Chaim A Schramm
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Larissa Ault
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Lauren Chang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Alexandrine Derrien-Colemyn
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Sarah A M Lucas
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Amy Ransier
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Samuel Darko
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Emily Phung
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA; Institute for Biomedical Sciences, George Washington University, Washington, DC 20052, USA
| | - Lingshu Wang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Yi Zhang
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Scott A Rush
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX 78712, USA
| | - Bharat Madan
- Department of Pharmaceutical Chemistry, The University of Kansas, Lawrence, KS 66045, USA
| | - Guillaume B E Stewart-Jones
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Pamela J Costner
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - LaSonji A Holman
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Somia P Hickman
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Nina M Berkowitz
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Nicole A Doria-Rose
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Kaitlyn M Morabito
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Brandon J DeKosky
- Department of Pharmaceutical Chemistry, The University of Kansas, Lawrence, KS 66045, USA; Department of Chemical Engineering, The University of Kansas, Lawrence, KS 66045, USA
| | - Martin R Gaudinski
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Grace L Chen
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Michelle C Crank
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - John Misasi
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Nancy J Sullivan
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Daniel C Douek
- 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
| | - Barney S Graham
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Jason S McLellan
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX 78712, USA
| | - John R Mascola
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
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Muňoz FM, Swamy GK, Hickman SP, Agrawal S, Piedra PA, Glenn GM, Patel N, August AM, Cho I, Fries L. Safety and Immunogenicity of a Respiratory Syncytial Virus Fusion (F) Protein Nanoparticle Vaccine in Healthy Third-Trimester Pregnant Women and Their Infants. J Infect Dis 2020; 220:1802-1815. [PMID: 31402384 DOI: 10.1093/infdis/jiz390] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/31/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is the leading cause of infant lower respiratory tract disease and hospitalization worldwide. METHODS Safety and immunogenicity of RSV fusion (F) protein nanoparticle vaccine or placebo were evaluated in 50 healthy third-trimester pregnant women. Assessments included vaccine tolerability and safety in women and infants, and RSV-specific antibody measures in women before and after vaccination, at delivery and post partum. RESULTS The vaccine was well tolerated; no meaningful differences in pregnancy or infant outcomes were observed between study groups. RSV-specific antibody levels increased significantly among vaccine recipients, including responses competitive with well-described monoclonal antibodies specific for multiple RSV neutralizing epitopes. No significant antibody increase was seen among placebo recipients, although a shallow upward trend across the RSV season was noted. Transplacental antibody transfer was 90%-120% across assays for infants of vaccinated women. Women with an interval of ≥30 days between vaccination and delivery demonstrated higher placental antibody transfer rates than women with an interval <30 days. Half-lives of RSV-specific antibodies in infants approximated 40 days. There was no evidence of severe RSV disease in infants of vaccinated mothers. CONCLUSIONS Data from this phase 2 study support a maternal immunization strategy to protect infants from RSV disease. CLINICAL TRIALS REGISTRATION NCT02247726.
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Affiliation(s)
| | - Geeta K Swamy
- Duke University School of Medicine, Durham, North Carolina
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7
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Crank MC, Ruckwardt TJ, Chen M, Morabito KM, Phung E, Costner PJ, Holman LA, Hickman SP, Berkowitz NM, Gordon IJ, Yamshchikov GV, Gaudinski MR, Kumar A, Chang LA, Moin SM, Hill JP, DiPiazza AT, Schwartz RM, Kueltzo L, Cooper JW, Chen P, Stein JA, Carlton K, Gall JG, Nason MC, Kwong PD, Chen GL, Mascola JR, McLellan JS, Ledgerwood JE, Graham BS. A proof of concept for structure-based vaccine design targeting RSV in humans. Science 2019; 365:505-509. [DOI: 10.1126/science.aav9033] [Citation(s) in RCA: 141] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 03/15/2019] [Accepted: 07/08/2019] [Indexed: 12/14/2022]
Abstract
Technologies that define the atomic-level structure of neutralization-sensitive epitopes on viral surface proteins are transforming vaccinology and guiding new vaccine development approaches. Previously, iterative rounds of protein engineering were performed to preserve the prefusion conformation of the respiratory syncytial virus (RSV) fusion (F) glycoprotein, resulting in a stabilized subunit vaccine candidate (DS-Cav1), which showed promising results in mice and macaques. Here, phase I human immunogenicity data reveal a more than 10-fold boost in neutralizing activity in serum from antibodies targeting prefusion-specific surfaces of RSV F. These findings represent a clinical proof of concept for structure-based vaccine design, suggest that development of a successful RSV vaccine will be feasible, and portend an era of precision vaccinology.
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8
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August A, Glenn GM, Kpamegan E, Hickman SP, Jani D, Lu H, Thomas DN, Wen J, Piedra PA, Fries LF. A Phase 2 randomized, observer-blind, placebo-controlled, dose-ranging trial of aluminum-adjuvanted respiratory syncytial virus F particle vaccine formulations in healthy women of childbearing age. Vaccine 2017; 35:3749-3759. [PMID: 28579233 DOI: 10.1016/j.vaccine.2017.05.045] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 04/19/2017] [Accepted: 05/16/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Respiratory syncytial virus (RSV) causes significant morbidity and mortality in infants. We are developing an RSV fusion (F) protein nanoparticle vaccine for immunization of third trimester pregnant women to passively protect infants through transfer of RSV-specific maternal antibodies. The present trial was performed to assess the immunogenicity and safety of several formulations of RSV F vaccine in 1-dose or 2-dose schedules. METHODS Placebo, or vaccine with 60μg or 120μg RSV F protein and 0.2, 0.4, or 0.8mg aluminum, were administered intramuscularly on Days 0 and 28 to healthy women 18-35years old. Immunogenicity was assessed from Days 0 through 91 based on anti-F IgG and palivizumab-competitive antibody (PCA) by ELISA, and RSV A and B neutralizing antibodies by microneutralization (MN) assay. Solicited adverse events were collected through Day 7 and unsolicited adverse events through Day 91. RESULTS All formulations were well-tolerated, with no treatment-related serious adverse events. Anti-F IgG and PCA responses were correlated and increased after both doses, while MN increased significantly only after the first dose, then plateaued. The timeliest and most robust antibody responses followed one dose of 120μg RSV F protein and 0.4mg aluminum, but persistence through 91days was modestly (∼25%) superior following two doses of 60μg RSV F protein and 0.8mg aluminum. Western blot analysis showed RSV infections in active vaccinees were reduced by 52% overall (p=0.009 overall) over the Day 0 through 90 period. CONCLUSIONS RSV F nanoparticle vaccine formulations were well tolerated and immunogenic. The optimal combination of convenience and rapid response for immunization in the third trimester occurred with 120μg RSV F and 0.4mg aluminum, which achieved peak immune responses in 14days and sufficient persistence through 91days to allow for passive transfer of IgG antibodies to the fetus. NCT01960686.
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MESH Headings
- Adjuvants, Immunologic
- Adolescent
- Adult
- Antibodies, Neutralizing/blood
- Antibodies, Viral/blood
- Dose-Response Relationship, Immunologic
- Female
- Humans
- Immunogenicity, Vaccine
- Immunoglobulin G/blood
- Pregnancy
- Pregnancy Complications, Infectious/prevention & control
- Respiratory Syncytial Virus Infections/immunology
- Respiratory Syncytial Virus Infections/prevention & control
- Respiratory Syncytial Virus Vaccines/administration & dosage
- Respiratory Syncytial Virus Vaccines/adverse effects
- Respiratory Syncytial Virus Vaccines/immunology
- Vaccines, Virus-Like Particle/administration & dosage
- Vaccines, Virus-Like Particle/adverse effects
- Vaccines, Virus-Like Particle/genetics
- Vaccines, Virus-Like Particle/immunology
- Viral Fusion Proteins/administration & dosage
- Viral Fusion Proteins/immunology
- Young Adult
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Affiliation(s)
- Allison August
- Novavax, Inc., 20 Firstfield Road, Gaithersburg, MD 20878, USA.
| | - Gregory M Glenn
- Novavax, Inc., 20 Firstfield Road, Gaithersburg, MD 20878, USA.
| | - Eloi Kpamegan
- Novavax, Inc., 20 Firstfield Road, Gaithersburg, MD 20878, USA.
| | - Somia P Hickman
- Novavax, Inc., 20 Firstfield Road, Gaithersburg, MD 20878, USA.
| | - Dewal Jani
- Novavax, Inc., 20 Firstfield Road, Gaithersburg, MD 20878, USA.
| | - Hanxin Lu
- Novavax, Inc., 20 Firstfield Road, Gaithersburg, MD 20878, USA.
| | - D Nigel Thomas
- Novavax, Inc., 20 Firstfield Road, Gaithersburg, MD 20878, USA.
| | - Judy Wen
- Novavax, Inc., 20 Firstfield Road, Gaithersburg, MD 20878, USA.
| | - Pedro A Piedra
- Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
| | - Louis F Fries
- Novavax, Inc., 20 Firstfield Road, Gaithersburg, MD 20878, USA.
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9
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Fries L, Shinde V, Stoddard JJ, Thomas DN, Kpamegan E, Lu H, Smith G, Hickman SP, Piedra P, Glenn GM. Immunogenicity and safety of a respiratory syncytial virus fusion protein (RSV F) nanoparticle vaccine in older adults. Immun Ageing 2017; 14:8. [PMID: 28413427 PMCID: PMC5389002 DOI: 10.1186/s12979-017-0090-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/28/2017] [Indexed: 12/11/2022]
Abstract
Background A preventative strategy for Respiratory Syncytial Virus (RSV) infection constitutes an under-recognized unmet medical need among older adults. Four formulations of a novel recombinant RSV F nanoparticle vaccine (60 or 90 μg RSV F protein, with or without aluminum phosphate adjuvant) administered concurrently with a licensed inactivated trivalent influenza vaccine (TIV) in older adult subjects were evaluated for safety and immunogenicity in this randomized, observer-blinded study. Results A total of 220 healthy males and females ≥ 60 years of age, without symptomatic cardiopulmonary disease, were vaccinated concurrently with TIV and RSV F vaccine or placebo. All vaccine formulations produced an acceptable safety profile, with no vaccine-related serious adverse events or evidence of systemic toxicity. Vaccine-induced immune responses were rapid, rising as early as 7 days post-vaccination; and were comparable in all formulations in terms of magnitude, with maximal levels attained within 28 (unadjuvanted) or 56 (adjuvanted) days post-vaccination. Peak anti-F protein IgG antibody levels rose 3.6- to 5.6-fold, with an adjuvant effect observed at the 60 μg dose, and a dose-effect observed between the unadjuvanted 60 and 90 μg regimens. The anti-F response persisted through 12 months post-vaccination. Palivizumab-competitive antibodies were below quantifiable levels (<33 μg/mL) at day 0. The rise of antibodies with specificity for Site II peptide, and the palivizumab-competitive binding activity, denoting antibodies binding at, or in proximity to, antigenic Site II on the F protein, closely paralleled the anti-F response. However, a larger proportion of antibodies in adjuvanted vaccine recipients bound to the Site II peptide at high avidity. Day 0 neutralizing antibodies were high in all subjects and rose 1.3- to 1.7-fold in response to vaccination. Importantly, the RSV F vaccine co-administered with TIV did not impact the serum hemagglutination inhibition antibody responses to a standard-dose TIV, and TIV did not impact the immune response to the RSV F vaccine. Conclusions RSV F protein nanoparticle vaccine induced increases in measures of functional immunity to RSV in older adults and demonstrated an acceptable safety profile. Adjuvanted formulations provided additional immunogenicity benefit as compared to increasing antigen dose alone. This trial was registered with ClinicalTrials.gov number NCT01709019.
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Affiliation(s)
- Louis Fries
- Novavax, Inc, 20 Firstfield Road, Gaithersburg, MD 20878 USA
| | - Vivek Shinde
- Novavax, Inc, 20 Firstfield Road, Gaithersburg, MD 20878 USA
| | | | - D Nigel Thomas
- Novavax, Inc, 20 Firstfield Road, Gaithersburg, MD 20878 USA
| | - Eloi Kpamegan
- Novavax, Inc, 20 Firstfield Road, Gaithersburg, MD 20878 USA
| | - Hanxin Lu
- Novavax, Inc, 20 Firstfield Road, Gaithersburg, MD 20878 USA
| | - Gale Smith
- Novavax, Inc, 20 Firstfield Road, Gaithersburg, MD 20878 USA
| | - Somia P Hickman
- Novavax, Inc, 20 Firstfield Road, Gaithersburg, MD 20878 USA
| | - Pedro Piedra
- Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030 USA
| | - Gregory M Glenn
- Novavax, Inc, 20 Firstfield Road, Gaithersburg, MD 20878 USA
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10
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Glenn GM, Fries LF, Thomas DN, Smith G, Kpamegan E, Lu H, Flyer D, Jani D, Hickman SP, Piedra PA. A Randomized, Blinded, Controlled, Dose-Ranging Study of a Respiratory Syncytial Virus Recombinant Fusion (F) Nanoparticle Vaccine in Healthy Women of Childbearing Age. J Infect Dis 2015; 213:411-22. [PMID: 26259809 DOI: 10.1093/infdis/jiv406] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 07/20/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a leading cause of infant morbidity and mortality. A recombinant RSV fusion protein nanoparticle vaccine (RSV F vaccine) candidate for maternal immunization was tested for safety and immunogenicity in women of childbearing age. METHODS Three hundred thirty women (18-35 years) were randomized to receive 1 or 2 doses of RSV F vaccine (60 or 90 µg) with or without aluminum phosphate adjuvant, or placebo at days 0 and 28. Safety was evaluated over 180 days; immunogenicity and RSV infection rates were evaluated over 112 days. RESULTS All vaccine formulations were well tolerated, without vaccine-related serious adverse events. Anti-F immunoglobulin G antibodies rose 6.5-15.6-fold, with significantly higher levels in 2-dose, adjuvanted regimens at day 56. Palivizumab-competitive antibody levels were undetectable at day 0 but increased up to 325 µg/mL at day 56. A 2.7- and 3.5-fold rise in RSV/A and RSV/B microneutralization antibodies were noted at day 56. Between days 56 and 112, 21% (12/56) of placebo recipients and 11% of vaccinees (26/244) showed evidence of a recent RSV infection (P = .04). CONCLUSIONS The vaccine appeared safe, immunogenic, and reduced RSV infections. Further development as a vaccine for use in maternal immunization is warranted. CLINICAL TRIALS REGISTRATION NCT01704365.
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Affiliation(s)
| | | | | | | | | | - Hanxin Lu
- Novavax, Inc, Gaithersburg, Maryland
| | | | | | | | - Pedro A Piedra
- Department of Molecular Virology and Microbiology, and Pediatrics, Baylor College of Medicine, Houston, Texas
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11
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Glenn GM, Smith G, Fries L, Raghunandan R, Lu H, Zhou B, Thomas DN, Hickman SP, Kpamegan E, Boddapati S, Piedra PA. Safety and immunogenicity of a Sf9 insect cell-derived respiratory syncytial virus fusion protein nanoparticle vaccine. Vaccine 2012; 31:524-32. [PMID: 23153449 DOI: 10.1016/j.vaccine.2012.11.009] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 10/31/2012] [Accepted: 11/04/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE We performed a Phase 1 randomized, observer-blinded, placebo-controlled trial to evaluate the safety and immunogenicity of a recombinant respiratory syncytial virus (RSV) fusion (F) protein nanoparticle vaccine. METHODS Six formulations with (5, 15, 30 and 60 μg) and without (30 and 60 μg) aluminum phosphate (AdjuPhos) were administered intramuscularly on day 0 and 30 in a dose escalating fashion to healthy adults 18-49 years of age. Solicited and unsolicited events were collected through day 210. Immunogenicity measures taken at day 0, 30 and 60 included RSV A and B microneutralization, anti-F IgG, antigenic site II peptide and palivizumab competitive antibodies. RESULTS The vaccine was well-tolerated, with no evident dose-related toxicity or attributable SAEs. At day 60 both RSV A and B microneutralization was significantly increased in vaccinees versus placebo. Across all vaccinees there was a 7- to 19-fold increase in the anti-F IgG and a 7- to 24-fold increase in the antigenic site II binding and palivizumab competitive antibodies. CONCLUSIONS The RSV F nanoparticle vaccine candidate was well tolerated without dose-related increases in adverse events. Measures of immunity indicate that neutralization, anti-RSV F IgG titers and palivizumab competing antibodies were induced at levels that have been associated with decreased risk of hospitalization. NCT01290419.
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12
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Hickman SP, Yang J, Thomas RM, Wells AD, Turka LA. Defective activation of protein kinase C and Ras-ERK pathways limits IL-2 production and proliferation by CD4+CD25+ regulatory T cells. J Immunol 2006; 177:2186-94. [PMID: 16887978 DOI: 10.4049/jimmunol.177.4.2186] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Naturally occurring CD4+CD25+ regulatory T cells (Tregs), which play an important role in the maintenance of self-tolerance, proliferate poorly and fail to produce IL-2 following stimulation in vitro with peptide-pulsed or anti-CD3-treated APCs. When TCR proximal and distal signaling events were examined in Tregs, we observed impairments in the amplitude and duration of tyrosine phosphorylation when compared with the response of CD4+CD25- T cells. Defects were also seen in the activity of phospholipase C-gamma and in signals downstream of this enzyme including calcium mobilization, NFAT, NF-kappaB, and Ras-ERK-AP-1 activation. Enhanced stimulation of diacylglycerol-dependent pathways by inhibition of diacylglycerol metabolism could overcome the "anergic state" and support the ability of Tregs to up-regulate CD69, produce IL-2, and proliferate. Our results demonstrate that Tregs maintain their hyporesponsive state by suppressing the induction and propagation of TCR-initiated signals to control the accumulation of second messengers necessary for IL-2 production and proliferation.
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Affiliation(s)
- Somia P Hickman
- Department of Medicine, University of Pennsylvania, 415 Curie Boulevard, Philadelphia, PA 19104, USA
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13
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King CG, Kobayashi T, Cejas PJ, Kim T, Yoon K, Kim GK, Chiffoleau E, Hickman SP, Walsh PT, Turka LA, Choi Y. TRAF6 is a T cell-intrinsic negative regulator required for the maintenance of immune homeostasis. Nat Med 2006; 12:1088-92. [PMID: 16921377 DOI: 10.1038/nm1449] [Citation(s) in RCA: 170] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2006] [Accepted: 06/16/2006] [Indexed: 01/31/2023]
Abstract
TRAF6 has a key role in the regulation of innate immune responses by mediating signals from both TNF receptor and interleukin-1 receptor/Toll-like receptor superfamilies. Here we show that T cell-specific deletion of TRAF6 unexpectedly results in multiorgan inflammatory disease. TRAF6-deficient T cells exhibit hyperactivation of the phosphatidylinositol 3-kinase (PI3K)-Akt pathway compared with wild-type T cells and, as a result, become resistant to suppression by CD4+ CD25+ regulatory T cells. These data identify a previously unrecognized role for TRAF6 in the maintenance of peripheral tolerance, and suggest the presence of a T cell-intrinsic control mechanism to render responder T cells susceptible to tolerizing signals.
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Affiliation(s)
- Carolyn G King
- Department of Pathology and Laboratory Medicine, Abramson Family Cancer Research Institute, Philadelphia, Pennsylvania 19104, USA
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14
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Abstract
The maintenance of T cell numbers in the periphery is mediated by distinct homeostatic mechanisms that ensure the proper representation of naïve and memory T cells. Homeostatic proliferation refers to the process by which T cells in lymphopenic hosts divide in the absence of cognate antigen to reconstitute the peripheral lymphoid compartment. During this process T cells acquire effector-memory like properties, including the ability to respond to low doses of antigen in the absence of CD28 costimulation. Furthermore, this capacity is retained long after proliferation has ceased. Accumulating data implicates homeostatic proliferation in autoimmune diseases and transplant rejection, and suggests that it may represent a barrier to tolerance in protocols that use T cell depletion. Implementing combination therapies that aim to promote the development and expansion of regulatory T cell populations while specifically targeting alloresponsive T cells may be the soundest approach to attaining allograft tolerance in the aftermath of T cell depletion and homeostatic proliferation.
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