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Cummings JF, Polhemus ME, Kester KE, Ockenhouse CF, Gasser RA, Coyne P, Wortmann G, Nielsen RK, Schaecher K, Holland CA, Krzych U, Tornieporth N, Soisson LA, Angov E, Heppner DG. A phase IIa, randomized, double-blind, safety, immunogenicity and efficacy trial of Plasmodium falciparum vaccine antigens merozoite surface protein 1 and RTS,S formulated with AS02 adjuvant in healthy, malaria-naïve adults. Vaccine 2024; 42:3066-3074. [PMID: 38584058 DOI: 10.1016/j.vaccine.2024.03.072] [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: 06/13/2023] [Revised: 03/15/2024] [Accepted: 03/25/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND To improve the efficacy of Plasmodium falciparum malaria vaccine RTS,S/AS02, we conducted a study in 2001 in healthy, malaria-naïve adults administered RTS,S/AS02 in combination with FMP1, a recombinant merozoite surface-protein-1, C-terminal 42kD fragment. METHODS A double-blind Phase I/IIa study randomized N = 60 subjects 1:1:1:1 to one of four groups, N = 15/group, to evaluate safety, immunogenicity, and efficacy of intra-deltoid half-doses of RTS,S/AS02 and FMP1/AS02 administered in the contralateral (RTS,S + FMP1-separate) or same (RTS,S + FMP1-same) sites, or FMP1/AS02 alone (FMP1-alone), or RTS,S/AS02 alone (RTS,S-alone) on a 0-, 1-, 3-month schedule. Subjects receiving three doses of vaccine and non-immunized controls (N = 11) were infected with homologous P. falciparum 3D7 sporozoites by Controlled Human Malaria Infection (CHMI). RESULTS Subjects in all vaccination groups experienced mostly mild or moderate local and general adverse events that resolved within eight days. Anti-circumsporozoite antibody levels were lower when FMP1 and RTS,S were co-administered at the same site (35.0 µg/mL: 95 % CI 20.3-63), versus separate arms (57.4 µg/mL: 95 % CI 32.3-102) or RTS,S alone (62.0 µg/mL: 95 % CI: 37.8-101.8). RTS,S-specific lymphoproliferative responses and ex vivo ELISpot CSP-specific interferon-gamma (IFN-γ) responses were indistinguishable among groups receiving RTS,S/AS02. There was no difference in antibody to FMP1 among groups receiving FMP1/AS02. After CHMI, groups immunized with a RTS,S-containing regimen had ∼ 30 % sterile protection against parasitemia, and equivalent delays in time-to-parasitemia. The FMP1/AS02 alone group showed no sterile immunity or delay in parasitemia. CONCLUSION Co-administration of RTS,S and FMP1/AS02 reduced anti-RTS,S antibody, but did not affect tolerability, cellular immunity, or efficacy in a stringent CHMI model. Absence of efficacy or delay of patency in the sporozoite challenge model in the FMP1/AS02 group did not rule out efficacy of FMP1/AS02 in an endemic population. However, a Phase IIb trial of FMP1/AS02 in children in malaria-endemic Kenya did not demonstrate efficacy against natural infection. CLINICALTRIALS gov identifier: NCT01556945.
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Affiliation(s)
- J F Cummings
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - M E Polhemus
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - K E Kester
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - C F Ockenhouse
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - R A Gasser
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - P Coyne
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - G Wortmann
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - R K Nielsen
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - K Schaecher
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - C A Holland
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - U Krzych
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | - L A Soisson
- Malaria Vaccine Development Program, United States Agency for International Development, Washington, DC, USA
| | - E Angov
- Walter Reed Army Institute of Research, Silver Spring, MD, USA.
| | - D G Heppner
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
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Chera BS, Schaecher K, Ray S, Rocchini A, Imam S, Ali S, Banik N. Spinal cord neuron death in methyl-4-phenyl-1,2,3,6 tetrahydropyridine induced Parkinsonism. J Neurochem 2008. [DOI: 10.1046/j.1471-4159.81.s1.20_3.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Schaecher K, Rocchini A, Dinkins J, Matzelle DD, Banik NL. Calpain expression and infiltration of activated T cells in experimental allergic encephalomyelitis over time: increased calpain activity begins with onset of disease. J Neuroimmunol 2002; 129:1-9. [PMID: 12161014 DOI: 10.1016/s0165-5728(02)00142-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Calpain activity and expression at the protein level were examined in inflammatory cells, activated microglia, and astrocytes prior to or at onset of symptomatic experimental allergic encephalomyelitis (EAE), an animal model for the human demyelinating disease multiple sclerosis (MS). EAE was induced in Lewis rats by injection of guinea pig spinal cord homogenate and myelin basic protein (MBP) emulsified with Complete Freund's Adjuvant (CFA). Calpain translational expression, determined by Western blot and immunocytochemistry, was correlated with calpain activity, infiltration of inflammatory cells, and myelin loss at 2-11 days following challenge with antigen. Controls (CFA only) did not show any changes over time in these parameters and very few changes (CD11+ microglia/mononuclear phagocytes) were seen in either group from days 2 to 8 post-induction. In contrast, from days 9 to 11, the animals that developed the disease (at least grade 1) demonstrated extensive cellular infiltration (CD4+, CD25+, and CD11+ as well as increased calpain expression (content) and activity. This study demonstrates that cell infiltration and increased calpain activity do not begin in the CNS until the onset of clinical signs.
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MESH Headings
- Animals
- Antigens, CD
- Antigens, Neoplasm
- Antigens, Surface
- Avian Proteins
- Basigin
- Blood Proteins
- CD4-Positive T-Lymphocytes/immunology
- CD4-Positive T-Lymphocytes/metabolism
- Calpain/immunology
- Calpain/metabolism
- Central Nervous System/immunology
- Central Nervous System/pathology
- Central Nervous System/physiopathology
- Chemotaxis, Leukocyte/immunology
- Disease Models, Animal
- Encephalomyelitis, Autoimmune, Experimental/immunology
- Encephalomyelitis, Autoimmune, Experimental/metabolism
- Encephalomyelitis, Autoimmune, Experimental/physiopathology
- Fluorescent Antibody Technique
- Freund's Adjuvant/pharmacology
- Male
- Membrane Glycoproteins/metabolism
- Myelin Basic Protein/immunology
- Myelin Basic Protein/metabolism
- Neurofilament Proteins/immunology
- Neurofilament Proteins/metabolism
- Neuroglia/immunology
- Neuroglia/metabolism
- Phagocytes/immunology
- Phagocytes/metabolism
- Rats
- Rats, Inbred Lew
- Receptors, Interleukin-2/immunology
- Spectrin/immunology
- Spectrin/metabolism
- T-Lymphocytes/immunology
- T-Lymphocytes/metabolism
- Up-Regulation/immunology
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Affiliation(s)
- K Schaecher
- Department of Neurology, Medical University of South Carolina (MUSC), Box 250606, Suite 307, 96 Jonathan Lucas Street, Charleston, SC 29425, USA
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