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Amoah LE, Nuvor SV, Obboh EK, Acquah FK, Asare K, Singh SK, Boampong JN, Theisen M, Williamson KC. Natural antibody responses to Plasmodium falciparum MSP3 and GLURP(R0) antigens are associated with low parasite densities in malaria patients living in the Central Region of Ghana. Parasit Vectors 2017; 10:395. [PMID: 28835262 PMCID: PMC5569498 DOI: 10.1186/s13071-017-2338-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 08/16/2017] [Indexed: 12/20/2022] Open
Abstract
Background Plasmodium falciparum genetic diversity and multiplicity of infection (MOI) are parasite features that have been suggested to influence the acquisition of protective immunity against malaria. This study sought to assess the relationship between MOI and parasite density (PD) in malaria patients living in the Central Region of Ghana and to determine whether naturally occurring antibody levels against P. falciparum GLURP (PF3D7_1035300) and MSP3 (PF3D7_1035400) antigens are associated with decreased parasite load. Methods Dried filter paper blood blots were obtained from children and adults diagnosed with uncomplicated P. falciparum malaria. Microscopy was used to estimate P. falciparum parasite density and polymerase chain reaction (PCR) amplification of the polymorphic regions of msp1 (PF3D7_0930300) and msp2 (PF3D7_0206800) was used for parasite genotyping and MOI determination. ELISA was used to measure the serum IgG concentration of R0 fragment of GLURP (GLURP(R0)) and MSP3 antibodies. Results All 115 samples were positive for P. falciparum by PCR using either the msp1 or msp2 genotyping primer sets. The most prevalent msp1 and msp2 alleles were KI and 3D7, respectively. The geometric mean (GM) for MOI determined by both msp1 and msp2 genotyping was 1.3 for the entire population and was generally higher in children than in adults. Seropositivity was estimated at 67 and 63% for GLURP(R0) and MSP3 antibodies, respectively, and antibody titers were negatively correlated with parasite density. Conclusions The negative correlation between naturally occurring GLURP(R0) and MSP3 antibody levels and parasite density observed in this study suggest that augmenting the antibody response with the GMZ2 vaccine could enhance protection in the Central Region of Ghana. Electronic supplementary material The online version of this article (doi:10.1186/s13071-017-2338-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- L E Amoah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
| | - S V Nuvor
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - E K Obboh
- School of Medical Sciences University of Cape Coast, Cape Coast, Ghana
| | - F K Acquah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - K Asare
- Department of Biomedical Sciences University of Cape Coast, Cape Coast, Ghana
| | - S K Singh
- Department for Congenital disorders, Statens Serum Institut, Copenhagen, Denmark.,Centre for Medical Parasitology, Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - J N Boampong
- Department of Biomedical Sciences University of Cape Coast, Cape Coast, Ghana
| | - M Theisen
- Department for Congenital disorders, Statens Serum Institut, Copenhagen, Denmark.,Centre for Medical Parasitology, Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - K C Williamson
- Loyola University Chicago, Chicago, IL, USA.,Uniform Services University of the Health Sciences, Bethesda, MD, USA
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Abstract
INTRODUCTION GMZ2 is a recombinant protein consisting of conserved domains of GLURP and MSP3, two asexual blood-stage antigens of Plasmodium falciparum, and is designed with the aim of mimicking naturally acquired anti-malarial immunity. The rationale for combining these two antigens is based on a series of immune epidemiological studies from geographically diverse malaria endemic regions; functional in vitro studies; and pre-clinical studies in rodents and New World monkeys. GMZ2 adjuvanted with alhydrogel® (alum) was well tolerated and immunogenic in three phase 1 studies. The recently concluded phase 2 trial of GMZ2/alum, involving 1849 participants 12 to 60 month of age in four countries in West, Central and Eastern Africa, showed that GMZ2 is well tolerated and has some, albeit modest, efficacy in the target population. Areas covered: PubMed ( www.ncbi.nlm.nih.gov/pubmed ) was searched to review the progress and future prospects for clinical development of GMZ2 sub-unit vaccine. We will focus on discovery, naturally acquired immunity, functional activity of specific antibodies, sequence diversity, production, pre-clinical and clinical studies. Expert commentary: GMZ2 is well tolerated and has some, albeit modest, efficacy in the target population. More immunogenic formulations should be developed.
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Affiliation(s)
- Michael Theisen
- a Department for Congenital Disorders , Statens Serum Institut , Copenhagen , Denmark.,b Centre for Medical Parasitology at Department of International Health, Immunology and Microbiology , University of Copenhagen , Copenhagen , Denmark.,c Department of Infectious Diseases , Copenhagen University Hospital , Rigshospitalet , Denmark
| | - Bright Adu
- d Noguchi Memorial Institute for Medical Research , University of Ghana , Legon , Ghana
| | - Benjamin Mordmüller
- e Institute of Tropical Medicine and Center for Infection Research, partner site Tübingen , University of Tübingen , Tübingen , Germany
| | - Subhash Singh
- f Indian Institute of Integrative Medicine , Jammu , India
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Kana IH, Adu B, Tiendrebeogo RW, Singh SK, Dodoo D, Theisen M. Naturally Acquired Antibodies Target the Glutamate-Rich Protein on Intact Merozoites and Predict Protection Against Febrile Malaria. J Infect Dis 2017; 215:623-630. [PMID: 28329101 DOI: 10.1093/infdis/jiw617] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [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: 10/27/2016] [Accepted: 01/05/2017] [Indexed: 11/14/2022] Open
Abstract
Background Plasmodium species antigens accessible at the time of merozoite release are likely targets of biologically functional antibodies. Methods Immunoglobulin G (IgG) antibodies against intact merozoites were quantified in the plasma of Ghanaian children from a longitudinal cohort using a novel flow cytometry-based immunofluorescence assay. Functionality of these antibodies, as well as glutamate-rich protein (GLURP)-specific affinity-purified IgG from malaria hyperimmune Liberian adults, was assessed by the opsonic phagocytosis (OP) assay. Results Opsonic phagocytosis activity was strongly associated (hazard ratio [HR] = 0.46; 95% confidence interval [CI] = .30-.73; P = .0008) with protection against febrile malaria. Of the antimerozoite-specific antibodies, only IgG3 was significantly associated with both OP and protection (HR = 0.53; 95% CI = .34-.84; Pcorrected = .03) against febrile malaria. Similarly, GLURP-specific antibodies previously shown to be protective against febrile malaria in this same cohort were significantly associated with OP activity in this study. GLURP-specific antibodies recognized merozoites and also mediated OP activity. Conclusions These findings support previous studies that found OP of merozoites to be associated with protection against malaria and further shows IgG3 and GLURP antibodies are key in the OP mechanism, thus giving further impetus for the development of malaria vaccines targeting GLURP.
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Affiliation(s)
- Ikhlaq Hussain Kana
- Department for Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark,Centre for Medical Parasitology at Department of International Health, Immunology and Microbiology, University of Copenhagen.,Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Bright Adu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon
| | - Régis Wendpayangde Tiendrebeogo
- Department for Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark,Centre for Medical Parasitology at Department of International Health, Immunology and Microbiology, University of Copenhagen.,Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Susheel Kumar Singh
- Department for Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark,Centre for Medical Parasitology at Department of International Health, Immunology and Microbiology, University of Copenhagen.,Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Daniel Dodoo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon
| | - Michael Theisen
- Department for Congenital Disorders, Statens Serum Institute, Copenhagen, Denmark,Centre for Medical Parasitology at Department of International Health, Immunology and Microbiology, University of Copenhagen.,Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Sirima SB, Mordmüller B, Milligan P, Ngoa UA, Kironde F, Atuguba F, Tiono AB, Issifou S, Kaddumukasa M, Bangre O, Flach C, Christiansen M, Bang P, Chilengi R, Jepsen S, Kremsner PG, Theisen M; GMZ2 Trial Study Group. A phase 2b randomized, controlled trial of the efficacy of the GMZ2 malaria vaccine in African children. Vaccine 2016; 34:4536-42. [PMID: 27477844 DOI: 10.1016/j.vaccine.2016.07.041] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 07/07/2016] [Accepted: 07/20/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND GMZ2 is a recombinant protein malaria vaccine, comprising two blood-stage antigens of Plasmodium falciparum, glutamate-rich protein and merozoite surface protein 3. We assessed efficacy of GMZ2 in children in Burkina Faso, Gabon, Ghana and Uganda. METHODS Children 12-60months old were randomized to receive three injections of either 100μg GMZ2 adjuvanted with aluminum hydroxide or a control vaccine (rabies) four weeks apart and were followed up for six months to measure the incidence of malaria defined as fever or history of fever and a parasite density ⩾5000/μL. RESULTS A cohort of 1849 children were randomized, 1735 received three doses of vaccine (868 GMZ2, 867 control-vaccine). There were 641 malaria episodes in the GMZ2/Alum group and 720 in the control group. In the ATP analysis, vaccine efficacy (VE), adjusted for age and site was 14% (95% confidence interval [CI]: 3.6%, 23%, p-value=0.009). In the ITT analysis, age-adjusted VE was 11.3% (95% CI 2.5%, 19%, p-value=0.013). VE was higher in older children. In GMZ2-vaccinated children, the incidence of malaria decreased with increasing vaccine-induced anti-GMZ2 IgG concentration. There were 32 cases of severe malaria (18 in the rabies vaccine group and 14 in the GMZ2 group), VE 27% (95% CI -44%, 63%). CONCLUSIONS GMZ2 is the first blood-stage malaria vaccine to be evaluated in a large multicenter trial. GMZ2 was well tolerated and immunogenic, and reduced the incidence of malaria, but efficacy would need to be substantially improved, using a more immunogenic formulation, for the vaccine to have a public health role.
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Mbengue B, Kpodji P, Sylla Niang M, Varela ML, Thiam A, Sow A, Ndiaye K, Aidara M, Thiam F, Ndiaye R, Diop G, Nguer CM, Perraut R, Dièye A. [Profiles of IgG responses against CSP, GLURP and LSA-3NR2 in urban malaria (Dakar): relations with haemoglobin levels and parasite densities]. Bull Soc Pathol Exot 2016; 109:91-98. [PMID: 27100862 DOI: 10.1007/s13149-016-0485-2] [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] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/23/2016] [Indexed: 06/05/2023]
Abstract
Malaria remains a major health problem in sub- Saharan African countries despite substantial decreases in morbidity and mortality due to sustained control programs. Vaccines candidates were mainly tested in rural endemic setting; however increasing proportion of the population is living in urban area. Evaluation of the qualitative or quantitative immune responses to key targets of anti-Plasmodium immunity requires further investigation in urban area. In a cohort of 144 patients with mild malaria living in Dakar, we analyzed IgG responses against target antigens of P. falciparum: CSP, LSA-3NR2 and GLURP by ELISA. A mean age of 15 yrs (4-65 yrs) was found and patients were separated in 59 adults (<15yrs) and 85 children (≤15 yrs). Parasites densities (0,01-15%) did not differ between the two age groups. In contrast, haemoglobin levels appeared lower in children (4.5-16.6 g/dl) (p<0.01). For the immune results, the most recognized antigens were GLURP and CSP compared to LSA-3NR2. Levels of IgG against these antigens were significantly different between the two age groups and they were positively correlated (rho = 0.32; p<0.001). In addition, levels of IgG anti-GLURP were associated with low parasitemia (≤1%) and absence of anemia (≥11g/dl), particularly in adults (p<0.001). In a multiple regression analysis, no significant relationship was found between parasite densities and IgG responses against all the tested antigens. Our study shows the implication of IgG anti-GLURP in humoral immune response against the parasite. The present work contributes to determine IgG levels that can be used as relevant immunologic biomarkers in urban clinical malaria.
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Affiliation(s)
- B Mbengue
- Service d'immunologie FMPO, Université Cheikh Anta Diop, Dakar, Sénégal.
- Unité d'immunogénétique, Institut Pasteur de Dakar, Dakar, Sénégal.
| | - P Kpodji
- Unité d'immunogénétique, Institut Pasteur de Dakar, Dakar, Sénégal
| | - M Sylla Niang
- Service d'immunologie FMPO, Université Cheikh Anta Diop, Dakar, Sénégal
| | - M L Varela
- Unité d'immunologie, Institut Pasteur de Dakar, Dakar, Sénégal
| | - A Thiam
- Unité d'immunogénétique, Institut Pasteur de Dakar, Dakar, Sénégal
| | - A Sow
- Unité d'immunogénétique, Institut Pasteur de Dakar, Dakar, Sénégal
| | - K Ndiaye
- Unité d'immunogénétique, Institut Pasteur de Dakar, Dakar, Sénégal
| | - M Aidara
- Unité d'immunogénétique, Institut Pasteur de Dakar, Dakar, Sénégal
| | - F Thiam
- Unité d'immunogénétique, Institut Pasteur de Dakar, Dakar, Sénégal
| | - R Ndiaye
- Unité d'immunogénétique, Institut Pasteur de Dakar, Dakar, Sénégal
| | - G Diop
- Unité d'immunogénétique, Institut Pasteur de Dakar, Dakar, Sénégal
| | - C M Nguer
- Département génie chimique et biologie appliquée, ESP, Université Cheikh Anta Diop, Dakar, Sénégal
| | - R Perraut
- Unité d'immunologie, Institut Pasteur de Dakar, Dakar, Sénégal
| | - A Dièye
- Unité d'immunogénétique, Institut Pasteur de Dakar, Dakar, Sénégal
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Singh SK, Roeffen W, Andersen G, Bousema T, Christiansen M, Sauerwein R, Theisen M. A Plasmodium falciparum 48/45 single epitope R0.6C subunit protein elicits high levels of transmission blocking antibodies. Vaccine 2015; 33:1981-6. [PMID: 25728318 DOI: 10.1016/j.vaccine.2015.02.040] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [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: 01/05/2015] [Revised: 02/11/2015] [Accepted: 02/15/2015] [Indexed: 10/23/2022]
Abstract
The sexual stage Pfs48/45 antigen is a well-established lead candidate for a transmission blocking (TB) vaccine because of its critical role in parasite fertilization. We have recently produced the carboxy-terminal 10C-fragment of Pfs48/45 containing three known epitopes for TB antibodies as a chimera with the N-terminal region of GLURP (R0). The resulting fusion protein elicited high titer TB antibodies in rodents. To increase the relatively low yield of correctly folded Pfs48/45 we have generated a series of novel chimera truncating the 10C-fragments to 6 cysteine residues containing sub-units (6C). All constructs harbor the major epitope I for TB antibodies. One of these sub-units (R0.6Cc), produced high yields of correctly folded conformers, which could be purified by a simple 2-step procedure. Purified R0.6Cc was stable and elicits high titer TB antibodies in rats. The yield, purity and stability of R0.6Cc allows for further clinical development.
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Affiliation(s)
- Susheel K Singh
- Department of Clinical Biochemistry, Immunology and Genetics, Statens Serum Institut, Copenhagen, Denmark; Centre for Medical Parasitology at Department of International Health, Immunology, and Microbiology, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Will Roeffen
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gorm Andersen
- Centre for Medical Parasitology at Department of International Health, Immunology, and Microbiology, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Teun Bousema
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Immunology & Infection, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Michael Christiansen
- Department of Clinical Biochemistry, Immunology and Genetics, Statens Serum Institut, Copenhagen, Denmark
| | - Robert Sauerwein
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Michael Theisen
- Department of Clinical Biochemistry, Immunology and Genetics, Statens Serum Institut, Copenhagen, Denmark; Centre for Medical Parasitology at Department of International Health, Immunology, and Microbiology, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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Adu B, Jepsen MPG, Gerds TA, Kyei-Baafour E, Christiansen M, Dodoo D, Theisen M. Fc gamma receptor 3B (FCGR3B-c.233C>A-rs5030738) polymorphism modifies the protective effect of malaria specific antibodies in Ghanaian children. J Infect Dis 2013; 209:285-9. [PMID: 23935200 DOI: 10.1093/infdis/jit422] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Immunoglobulin G (IgG) cross-linking with Fc gamma receptor IIIB (FcγRIIIB) triggers neutrophil degranulation, releasing reactive oxygen species with high levels associated with protection against malaria. The FCGR3B-c.233C>A polymorphism thought to influence the interaction between IgG and FcγRIIIB was recently associated with malaria. We studied the statistical interaction between glutamate rich protein antibodies and FCGR3B-c.233C>A genotypes on risk of malaria in a cohort of Ghanaian children. The absolute risk of malaria decreased more rapidly with increasing antibody levels for 233AA/AC individuals compared with 233CC children. This genotype related effect modification may significantly influence malaria sero-epidemiological and vaccine trial studies.
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Affiliation(s)
- Bright Adu
- Department of Clinical Biochemistry and Immunology, Statens Serum Institut
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