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Jongo S, Church LP, Milando F, Qassim M, Schindler T, Rashid M, Tumbo A, Nyaulingo G, Bakari BM, Athuman Mbaga T, Mohamed L, Kassimu K, Simon BS, Mpina M, Zaidi I, Duffy PE, Swanson PA, Seder R, Herman JD, Mendu M, Zur Y, Alter G, KC N, Riyahi P, Abebe Y, Murshedkar T, James ER, Billingsley PF, Sim BKL, Richie TL, Daubenberger C, Abdulla S, Hoffman SL. Safety and protective efficacy of PfSPZ Vaccine administered to HIV-negative and -positive Tanzanian adults. J Clin Invest 2024; 134:e169060. [PMID: 38194272 PMCID: PMC10940097 DOI: 10.1172/jci169060] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 12/20/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUNDSanaria PfSPZ Vaccine, composed of attenuated Plasmodium falciparum (Pf) sporozoites (SPZ), protects against malaria. We conducted this clinical trial to assess the safety and efficacy of PfSPZ Vaccine in HIV-positive (HIV+) individuals, since the HIV-infection status of participants in mass vaccination programs may be unknown.METHODSThis randomized, double-blind, placebo-controlled trial enrolled 18- to 45-year-old HIV-negative (HIV-) and well-controlled HIV+ Tanzanians (HIV viral load <40 copies/mL, CD4 counts >500 cells/μL). Participants received 5 doses of PfSPZ Vaccine or normal saline (NS) over 28 days, followed by controlled human malaria infection (CHMI) 3 weeks later.RESULTSThere were no solicited adverse events in the 9 HIV- and 12 HIV+ participants. After CHMI, 6 of 6 NS controls, 1 of 5 HIV- vaccinees, and 4 of 4 HIV+ vaccinees were Pf positive by quantitative PCR (qPCR). After immunization, anti-Pf circumsporozoite protein (anti-PfCSP) (isotype and IgG subclass) and anti-PfSPZ antibodies, anti-PfSPZ CD4+ T cell responses, and Vδ2+ γδ CD3+ T cells were nonsignificantly higher in HIV- than in HIV+ vaccinees. Sera from HIV- vaccinees had significantly higher inhibition of PfSPZ invasion of hepatocytes in vitro and antibody-dependent complement deposition (ADCD) and Fcγ3B binding by anti-PfCSP and ADCD by anti-cell-traversal protein for ookinetes and SPZ (anti-PfCelTOS) antibodies.CONCLUSIONSPfSPZ Vaccine was safe and well tolerated in HIV+ vaccinees, but not protective. Vaccine efficacy was 80% in HIV- vaccinees (P = 0.012), whose sera had significantly higher inhibition of PfSPZ invasion of hepatocytes and enrichment of multifunctional PfCSP antibodies. A more potent PfSPZ vaccine or regimen is needed to protect those living with HIV against Pf infection in Africa.TRIAL REGISTRATIONClinicalTrials.gov NCT03420053.FUNDINGEquatorial Guinea Malaria Vaccine Initiative (EGMVI), made up of the Government of Equatorial Guinea Ministries of Mines and Hydrocarbons, and Health and Social Welfare, Marathon Equatorial Guinea Production Limited, Noble Energy, Atlantic Methanol Production Company, and EG LNG; Swiss government, through ESKAS scholarship grant no. 2016.0056; Intramural Research Program of the National Institute of Allergy and Infectious Diseases, NIH; NIH grant 1U01AI155354-01.
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Affiliation(s)
- Said Jongo
- Ifakara Health Institute (IHI), Bagamoyo, Tanzania
| | | | | | | | - Tobias Schindler
- Swiss Tropical Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Anneth Tumbo
- Ifakara Health Institute (IHI), Bagamoyo, Tanzania
- Swiss Tropical Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | | | | | | | | | | | - Maxmillian Mpina
- Ifakara Health Institute (IHI), Bagamoyo, Tanzania
- Swiss Tropical Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Irfan Zaidi
- Laboratory of Malaria Immunology and Vaccinology and
| | | | | | - Robert Seder
- Vaccine Research Center, NIH, Bethesda, Maryland, USA
| | - Jonathan D. Herman
- Division of Infectious Disease, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- The Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts, USA
| | - Maanasa Mendu
- The Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts, USA
| | - Yonatan Zur
- The Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts, USA
| | - Galit Alter
- The Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts, USA
| | - Natasha KC
- Sanaria Inc., Rockville, Maryland, USA
- Protein Potential LLC, Rockville, Maryland, USA
| | | | | | | | | | | | - B. Kim Lee Sim
- Sanaria Inc., Rockville, Maryland, USA
- Protein Potential LLC, Rockville, Maryland, USA
| | | | - Claudia Daubenberger
- Swiss Tropical Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Nyandele JP, Kibondo UA, Issa F, Van Geertruyden JP, Warimwe G, Jongo S, Abdulla S, Olotu A. Pre-vaccination monocyte-to-lymphocyte ratio as a biomarker for the efficacy of malaria candidate vaccines: A subgroup analysis of pooled clinical trial data. PLoS One 2023; 18:e0291244. [PMID: 37708143 PMCID: PMC10501550 DOI: 10.1371/journal.pone.0291244] [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] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/24/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Pre-vaccination monocyte-to-lymphocyte ratio was previously suggested as a marker for malaria vaccine effectiveness. We investigated the potential of this cell ratio as a marker for malaria vaccine efficacy and effectiveness. Effectiveness was investigated by using clinical malaria endpoint, and efficacy was investigated by using surrogate endpoints of Plasmodium falciparum prepatent period, parasite density, and multiplication rates in a controlled human malaria infection trial (CHMI). METHODS We evaluated the correlation between monocyte-to-lymphocyte ratio and RTS,S vaccine effectiveness using Cox regression modeling with clinical malaria as the primary endpoint. Of the 1704 participants in the RTS,S field trial, data on monocyte-to-lymphocyte ratio was available for 842 participants, of whom our analyses were restricted. We further used Spearman Correlations and Cox regression modeling to evaluate the correlation between monocyte-to-lymphocyte ratio and Whole Sporozoite malaria vaccine efficacy using the surrogate endpoints. Of the 97 participants in the controlled human malaria infection vaccine trials, hematology and parasitology information were available for 82 participants, of whom our analyses were restricted. RESULTS The unadjusted efficacy of RTS,S malaria vaccine was 54% (95% CI: 37%-66%, p <0.001). No correlation was observed between monocyte-to-lymphocyte ratio and RTS,S vaccine efficacy (Hazard Rate (HR):0.90, 95%CI:0.45-1.80; p = 0.77). The unadjusted efficacy of Whole Sporozoite malaria vaccine in the appended dataset was 17.6% (95%CI:10%-28.5%, p<0.001). No association between monocyte-to-lymphocyte ratio and the Whole Sporozoite malaria vaccine was found against either the prepatent period (HR = 1.16; 95%CI:0.51-2.62, p = 0.72), parasite density (rho = 0.004, p = 0.97) or multiplication rates (rho = 0.031, p = 0.80). CONCLUSION Monocyte-to-lymphocyte ratio alone may not be an adequate marker for malaria vaccine efficacy. Further investigations on immune correlates and underlying mechanisms of immune protection against malaria could provide a clearer explanation of the differences between those protected in comparison with those not protected against malaria by vaccination.
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Affiliation(s)
- Jane Paula Nyandele
- Global Health Institute, University of Antwerp, Antwerp, Belgium
- Ifakara Health Institute, Bagamoyo Clinical Trial Unit, Bagamoyo, Tanzania
| | - Ummi Abdul Kibondo
- Ifakara Health Institute, Bagamoyo Clinical Trial Unit, Bagamoyo, Tanzania
| | - Fatuma Issa
- Ifakara Health Institute, Bagamoyo Clinical Trial Unit, Bagamoyo, Tanzania
| | | | | | - Said Jongo
- Ifakara Health Institute, Bagamoyo Clinical Trial Unit, Bagamoyo, Tanzania
| | - Salim Abdulla
- Ifakara Health Institute, Bagamoyo Clinical Trial Unit, Bagamoyo, Tanzania
| | - Ally Olotu
- Ifakara Health Institute, Bagamoyo Clinical Trial Unit, Bagamoyo, Tanzania
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Alani AH, Miller L, Darji B, Waweru I, Atwiine AB, Tonelli M, Mogga JLK, Adams A, Ndinda L, Jongo S, Kiapi L. Assessment of the WHO non-communicable diseases kit for humanitarian emergencies in South Sudan: a retrospective, prospective, observational study. Confl Health 2023; 17:27. [PMID: 37277827 PMCID: PMC10241119 DOI: 10.1186/s13031-023-00525-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 05/23/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND The WHO Non-Communicable Diseases Kit (NCDK) was developed to support care for non-communicable diseases (NCDs) in humanitarian settings. Targeting primary healthcare, each kit contains medicines and supplies that are forecasted to meet the needs of 10,000 people for 3 months. This study aimed to evaluate the NCDK deployment process, contents, usage and limitations, and to explore its acceptability and effectiveness among healthcare workers (HCWs) in South Sudan. METHODS This mixed-method observational study captured data from pre-and-post NCDK deployment. Six data collection tools included: (i) contextual analysis, (ii) semi-structured interviews, in addition to surveys measuring/assessing (iii) healthcare workers' knowledge about NCDs, and healthcare workers' perceptions of: (iv) health facility infrastructure, (v) pharmaceutical supply chain, and (vi) NCDK content. The pre- and post-deployment evaluations were conducted in four facilities (October-2019) and three facilities (April-2021), respectively. Descriptive statistics were used for quantitative data and content analysis for open-ended questions. A thematic analysis was applied on interviews findings and further categorized into four predetermined themes. RESULTS Compared to baseline, two of the re-assessed facilities had improved service availability for NCDs. Respondents described NCDs as a growing problem that is not addressed at a national level. After deployment, the same struggles were intensified with the COVID-19 pandemic. The delivery process was slow and faced delays associated with several barriers. After deployment, poor communications and the "push system" of inventories were commonly perceived by stakeholders, leading to expiry/disposal of some contents. Despite being out-of-stock at baseline, at least 55% of medicines were found to be unused post-deployment and the knowledge surveys demonstrated a need for improving HCWs knowledge of NCDs. CONCLUSIONS This assessment further confirmed the NCDK role in maintaining continuity of care on a short-term period. However, its effectiveness was dependent on the health system supply chain in place and the capacity of facilities to manage and treat NCDs. Availability of medicines from alternative sources made some of the NCDK medicines redundant or unnecessary for some health facilities. Several learnings were identified in this assessment, highlighting barriers that contributed to the kit underutilization.
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Affiliation(s)
- Ahmad Hecham Alani
- International Rescue Committee, London, UK
- Independent Researcher, London, UK
| | - Laura Miller
- International Rescue Committee, New York City, NY, USA
| | - Bhavika Darji
- International Rescue Committee, New York City, NY, USA
| | | | | | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Ali Adams
- International Rescue Committee, Juba, South Sudan
| | | | - Said Jongo
- International Rescue Committee, Juba, South Sudan
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Richie TL, Church LWP, Murshedkar T, Billingsley PF, James ER, Chen MC, Abebe Y, KC N, Chakravarty S, Dolberg D, Healy SA, Diawara H, Sissoko MS, Sagara I, Cook DM, Epstein JE, Mordmüller B, Kapulu M, Kreidenweiss A, Franke-Fayard B, Agnandji ST, López Mikue MSA, McCall MBB, Steinhardt L, Oneko M, Olotu A, Vaughan AM, Kublin JG, Murphy SC, Jongo S, Tanner M, Sirima SB, Laurens MB, Daubenberger C, Silva JC, Lyke KE, Janse CJ, Roestenberg M, Sauerwein RW, Abdulla S, Dicko A, Kappe SHI, Lee Sim BK, Duffy PE, Kremsner PG, Hoffman SL. Sporozoite immunization: innovative translational science to support the fight against malaria. Expert Rev Vaccines 2023; 22:964-1007. [PMID: 37571809 PMCID: PMC10949369 DOI: 10.1080/14760584.2023.2245890] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 08/04/2023] [Indexed: 08/13/2023]
Abstract
INTRODUCTION Malaria, a devastating febrile illness caused by protozoan parasites, sickened 247,000,000 people in 2021 and killed 619,000, mostly children and pregnant women in sub-Saharan Africa. A highly effective vaccine is urgently needed, especially for Plasmodium falciparum (Pf), the deadliest human malaria parasite. AREAS COVERED Sporozoites (SPZ), the parasite stage transmitted by Anopheles mosquitoes to humans, are the only vaccine immunogen achieving >90% efficacy against Pf infection. This review describes >30 clinical trials of PfSPZ vaccines in the U.S.A., Europe, Africa, and Asia, based on first-hand knowledge of the trials and PubMed searches of 'sporozoites,' 'malaria,' and 'vaccines.' EXPERT OPINION First generation (radiation-attenuated) PfSPZ vaccines are safe, well tolerated, 80-100% efficacious against homologous controlled human malaria infection (CHMI) and provide 18-19 months protection without boosting in Africa. Second generation chemo-attenuated PfSPZ are more potent, 100% efficacious against stringent heterologous (variant strain) CHMI, but require a co-administered drug, raising safety concerns. Third generation, late liver stage-arresting, replication competent (LARC), genetically-attenuated PfSPZ are expected to be both safe and highly efficacious. Overall, PfSPZ vaccines meet safety, tolerability, and efficacy requirements for protecting pregnant women and travelers exposed to Pf in Africa, with licensure for these populations possible within 5 years. Protecting children and mass vaccination programs to block transmission and eliminate malaria are long-term objectives.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Sara A. Healy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Halimatou Diawara
- Malaria Research and Training Center, Mali-NIAID ICER, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Mahamadou S. Sissoko
- Malaria Research and Training Center, Mali-NIAID ICER, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Issaka Sagara
- Malaria Research and Training Center, Mali-NIAID ICER, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - David M. Cook
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Judith E. Epstein
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Benjamin Mordmüller
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Melissa Kapulu
- Biosciences Department, Kenya Medical Research Institute KEMRI-Wellcome Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Andrea Kreidenweiss
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
| | | | - Selidji T. Agnandji
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | | | - Matthew B. B. McCall
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Laura Steinhardt
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Martina Oneko
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya
| | - Ally Olotu
- Bagamoyo Research and Training Center, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Ashley M. Vaughan
- Center for Global Infectious Disease Research, Seattle Children’s Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - James G. Kublin
- Department of Global Health, University of Washington, Seattle, WA, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Sean C. Murphy
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
- Center for Emerging and Re-emerging Infectious Diseases and Department of Microbiology, University of Washington, Seattle, WA, USA
| | - Said Jongo
- Bagamoyo Research and Training Center, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Marcel Tanner
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Matthew B. Laurens
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Claudia Daubenberger
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Joana C. Silva
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kirsten E. Lyke
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Chris J. Janse
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Meta Roestenberg
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Robert W. Sauerwein
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Salim Abdulla
- Bagamoyo Research and Training Center, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Alassane Dicko
- Malaria Research and Training Center, Mali-NIAID ICER, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | - Stefan H. I. Kappe
- Center for Global Infectious Disease Research, Seattle Children’s Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | | | - Patrick E. Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Peter G. Kremsner
- Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
- German Center for Infection Research (DZIF), partner site Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
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Kassimu K, Milando F, Omolo J, Mdemu A, Nyaulingo G, Mbarak H, Mohamed L, Rashid R, Ahmed S, Rashid M, Msami H, Damiano D, Simon B, Mbaga T, Issa F, Lweno O, Balige N, Hassan O, Mwalimu B, Hamad A, Olotu A, Mårtensson A, Machumi F, Jongo S, Ngasala B, Abdulla S. Safety and Tolerability of an Antimalarial Herbal Remedy in Healthy Volunteers: An Open-Label, Single-Arm, Dose-Escalation Study on Maytenus senegalensis in Tanzania. Trop Med Infect Dis 2022; 7:tropicalmed7120396. [PMID: 36548651 PMCID: PMC9787516 DOI: 10.3390/tropicalmed7120396] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Though Maytenus senegalensis is one of the medicinal plants widely used in traditional medicine to treat infectious and inflammatory diseases in Africa, there is a lack of safety data regarding its use. Therefore, the study aimed to asselss the safety and tolerability of the antimalarial herbal remedy M. senegalensis. MATERIAL AND METHODS The study design was an open-label, single-arm, dose-escalation. Twelve eligible male healthy Tanzanians aged 18 to 45 years were enrolled in four study dose groups. Volunteers' safety and tolerability post-investigational-product administration were monitored on days 0 to 7,14, and 56. RESULTS There were no deaths or serious adverse events in any of the study groups, nor any adverse events that resulted in premature discontinuation. The significant mean changes observed in WBC (p = 0.003), Neutrophils (p = 0.02), Lymphocytes (p = 0.001), Eosinophils (p = 0.009), Alanine aminotransferase (p = 0.002), Creatinine (p = 0.03) and Total bilirubin (p = 0.004) laboratory parameters were not associated with any signs of toxicity or clinical symptoms. CONCLUSIONS M. senegalensis was demonstrated to be safe and tolerable when administered at a dose of 800 mg every eight hours a day for four days. This study design may be adapted to evaluate other herbal remedies.
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Affiliation(s)
- Kamaka Kassimu
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
- Correspondence: or ; Tel.: +255-713-488-238
| | - Florence Milando
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Justin Omolo
- Department of Traditional Medicine, National Institute for Medical Research, Dar es Salaam P.O. Box 9653, Tanzania
| | - Abel Mdemu
- Department of Traditional Medicine, National Institute for Medical Research, Dar es Salaam P.O. Box 9653, Tanzania
| | - Gloria Nyaulingo
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Hussein Mbarak
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Latipha Mohamed
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Ramla Rashid
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Saumu Ahmed
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Mohammed Rashid
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Hania Msami
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - David Damiano
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Beatus Simon
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Thabit Mbaga
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Fatuma Issa
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Omar Lweno
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Neema Balige
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Omary Hassan
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Bakari Mwalimu
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Ali Hamad
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Ally Olotu
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Andreas Mårtensson
- Department of Women’s and Children’s Health, International Maternal and Child Health (IMCH), Uppsala University, S-751 85 Uppsala, Sweden
| | - Francis Machumi
- Institute of Traditional Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
| | - Said Jongo
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
| | - Billy Ngasala
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
- Department of Women’s and Children’s Health, International Maternal and Child Health (IMCH), Uppsala University, S-751 85 Uppsala, Sweden
| | - Salim Abdulla
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo P.O. Box 74, Tanzania
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Kassimu KR, Milando FA, Omolo JJ, Nyaulingo G, Mbarak H, Mohamed L, Rashid R, Ahmed S, Rashid M, Abdallah G, Mbaga T, Issa F, Lweno O, Balige N, Mwalimu B, Hamad A, Olotu A, Jongo S, Ngasala B, Abdulla S. Motivations and barriers for healthy participants to participate in herbal remedy clinical trial in Tanzania: A qualitative study based on the theory of planned behaviour. PLoS One 2022; 17:e0271828. [PMID: 35862395 PMCID: PMC9302811 DOI: 10.1371/journal.pone.0271828] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/07/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The success of any randomized clinical trial relies on the willingness of people to be recruited in the trial. However, 90% of all clinical trials worldwide have been reported to have failed to recruit the required number of trial participants within the scheduled time. This study aimed to qualitatively explore the motivations and barriers for healthy participants to participate in herbal remedy clinical trials in Tanzania. MATERIALS AND METHODS This study used a qualitative descriptive research design based on the theory of planned behaviour. A total of five Focus Group Discussions (FGD) were conducted at Bagamoyo Clinical Trial Facility from 29 to 30 May 2021. Each group consisted of 5 to 10 participants. The participants of the study were 30 healthy males aged 18 to 45 male who participated in the clinical trial that evaluated the safety, tolerability, and efficacy of Maytenus Senegalensis. The focus group discussions were recorded audio-recorded. Verbatim transcription and thematic analysis were performed on the data. RESULTS The prominent motivations mentioned were the opportunity for self-development, altruism, flexible study visit schedule, and financial compensation. Furthermore, the Participants' mothers and friends were reported as those most likely to approve of participation in an herbal remedy. The most mentioned barriers were inconvenience related to time commitment requirements, possible side effects, inflexible study visit schedule, and having other commitments. Moreover, the participants' father was reported to be more likely to disapprove of participation in a clinical trial of herbal remedy clinical trial. CONCLUSIONS The results of this study showed that the motivations and barriers of healthy participants to participate in clinical trials of herbal remedies are varied and that participants are motivated by more than financial gains. The identified motivations and barriers can be used as a guideline to improve the design of recruitment and retention strategies for herbal remedy clinical trials.
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Affiliation(s)
- Kamaka R. Kassimu
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
- Department of Parasitology, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | - Florence A. Milando
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Justin J. Omolo
- Department of traditional medicine, National Institute for Medical Research, Dar es salaam, Tanzania
| | - Gloria Nyaulingo
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Hussein Mbarak
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Latipha Mohamed
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Ramla Rashid
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Saumu Ahmed
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Mohammed Rashid
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Gumi Abdallah
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Thabit Mbaga
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Fatuma Issa
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Omar Lweno
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Neema Balige
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Bakari Mwalimu
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Ali Hamad
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Ally Olotu
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Said Jongo
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Billy Ngasala
- Department of Parasitology, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | - Salim Abdulla
- Bagamoyo Clinical Trial Facility, Ifakara Health Institute, Bagamoyo, Tanzania
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7
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Mpina M, Stabler TC, Schindler T, Raso J, Deal A, Acuche Pupu L, Nyakarungu E, Del Carmen Ovono Davis M, Urbano V, Mtoro A, Hamad A, Lopez MSA, Pasialo B, Eyang MAO, Rivas MR, Falla CC, García GA, Momo JC, Chuquiyauri R, Saverino E, Preston Church LW, Kim Lee Sim B, Manguire B, Tanner M, Maas C, Abdulla S, Billingsley PF, Hoffman SL, Jongo S, Richie TL, Daubenberger CA. Diagnostic performance and comparison of ultrasensitive and conventional rapid diagnostic test, thick blood smear and quantitative PCR for detection of low-density Plasmodium falciparum infections during a controlled human malaria infection study in Equatorial Guinea. Malar J 2022; 21:99. [PMID: 35331251 PMCID: PMC8943516 DOI: 10.1186/s12936-022-04103-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 11/08/2021] [Accepted: 02/23/2022] [Indexed: 12/02/2022] Open
Abstract
Background Progress towards malaria elimination has stagnated, partly because infections persisting at low parasite densities comprise a large reservoir contributing to ongoing malaria transmission and are difficult to detect. This study compared the performance of an ultrasensitive rapid diagnostic test (uRDT) designed to detect low density infections to a conventional RDT (cRDT), expert microscopy using Giemsa-stained thick blood smears (TBS), and quantitative polymerase chain reaction (qPCR) during a controlled human malaria infection (CHMI) study conducted in malaria exposed adults (NCT03590340). Methods Blood samples were collected from healthy Equatoguineans aged 18–35 years beginning on day 8 after CHMI with 3.2 × 103 cryopreserved, infectious Plasmodium falciparum sporozoites (PfSPZ Challenge, strain NF54) administered by direct venous inoculation. qPCR (18s ribosomal DNA), uRDT (Alere™ Malaria Ag P.f.), cRDT [Carestart Malaria Pf/PAN (PfHRP2/pLDH)], and TBS were performed daily until the volunteer became TBS positive and treatment was administered. qPCR was the reference for the presence of Plasmodium falciparum parasites. Results 279 samples were collected from 24 participants; 123 were positive by qPCR. TBS detected 24/123 (19.5% sensitivity [95% CI 13.1–27.8%]), uRDT 21/123 (17.1% sensitivity [95% CI 11.1–25.1%]), cRDT 10/123 (8.1% sensitivity [95% CI 4.2–14.8%]); all were 100% specific and did not detect any positive samples not detected by qPCR. TBS and uRDT were more sensitive than cRDT (TBS vs. cRDT p = 0.015; uRDT vs. cRDT p = 0.053), detecting parasitaemias as low as 3.7 parasites/µL (p/µL) (TBS and uRDT) compared to 5.6 p/µL (cRDT) based on TBS density measurements. TBS, uRDT and cRDT did not detect any of the 70/123 samples positive by qPCR below 5.86 p/µL, the qPCR density corresponding to 3.7 p/µL by TBS. The median prepatent periods in days (ranges) were 14.5 (10–20), 18.0 (15–28), 18.0 (15–20) and 18.0 (16–24) for qPCR, TBS, uRDT and cRDT, respectively; qPCR detected parasitaemia significantly earlier (3.5 days) than the other tests. Conclusions TBS and uRDT had similar sensitivities, both were more sensitive than cRDT, and neither matched qPCR for detecting low density parasitaemia. uRDT could be considered an alternative to TBS in selected applications, such as CHMI or field diagnosis, where qualitative, dichotomous results for malaria infection might be sufficient. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04103-y.
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Affiliation(s)
- Maxmillian Mpina
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,Ifakara Health Institute, Ifakara, Tanzania.
| | - Thomas C Stabler
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Tobias Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Jose Raso
- Medical Care Development International, Malabo, Equatorial Guinea.,Equatorial Guinea Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Anna Deal
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | - Elizabeth Nyakarungu
- Ifakara Health Institute, Ifakara, Tanzania.,Medical Care Development International, Malabo, Equatorial Guinea
| | | | - Vicente Urbano
- Medical Care Development International, Malabo, Equatorial Guinea.,Equatorial Guinea Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Ali Mtoro
- Ifakara Health Institute, Ifakara, Tanzania.,Medical Care Development International, Malabo, Equatorial Guinea
| | - Ali Hamad
- Ifakara Health Institute, Ifakara, Tanzania.,Medical Care Development International, Malabo, Equatorial Guinea
| | - Maria Silvia A Lopez
- Medical Care Development International, Malabo, Equatorial Guinea.,Equatorial Guinea Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Beltran Pasialo
- Medical Care Development International, Malabo, Equatorial Guinea.,Equatorial Guinea Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Marta Alene Owono Eyang
- Medical Care Development International, Malabo, Equatorial Guinea.,Equatorial Guinea Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Matilde Riloha Rivas
- Equatorial Guinea Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | | | | | - Juan Carlos Momo
- Medical Care Development International, Malabo, Equatorial Guinea.,Equatorial Guinea Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Raul Chuquiyauri
- Medical Care Development International, Malabo, Equatorial Guinea.,Sanaria Inc., 9800 Medical Center Drive, Rockville, MD, 20850, USA
| | | | | | - B Kim Lee Sim
- Sanaria Inc., 9800 Medical Center Drive, Rockville, MD, 20850, USA
| | | | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Carl Maas
- Marathon EG production Ltd., Houston, USA
| | | | | | | | - Said Jongo
- Ifakara Health Institute, Ifakara, Tanzania.,Medical Care Development International, Malabo, Equatorial Guinea
| | - Thomas L Richie
- Sanaria Inc., 9800 Medical Center Drive, Rockville, MD, 20850, USA
| | - Claudia A Daubenberger
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
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8
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Duffy FJ, Du Y, Carnes J, Epstein JE, Hoffman SL, Abdulla S, Jongo S, Mpina M, Daubenberger C, Aitchison JD, Stuart K. Early whole blood transcriptional responses to radiation-attenuated Plasmodium falciparum sporozoite vaccination in malaria naïve and malaria pre-exposed adult volunteers. Malar J 2021; 20:308. [PMID: 34243763 PMCID: PMC8267772 DOI: 10.1186/s12936-021-03839-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 06/29/2021] [Indexed: 12/03/2022] Open
Abstract
Background Vaccination with radiation-attenuated Plasmodium falciparum sporozoites is known to induce protective immunity. However, the mechanisms underlying this protection remain unclear. In this work, two recent radiation-attenuated sporozoite vaccination studies were used to identify potential transcriptional correlates of vaccination-induced protection. Methods Longitudinal whole blood RNAseq transcriptome responses to immunization with radiation-attenuated P. falciparum sporozoites were analysed and compared across malaria-naïve adult participants (IMRAS) and malaria-experienced adult participants (BSPZV1). Parasite dose and method of delivery differed between trials, and immunization regimens were designed to achieve incomplete protective efficacy. Observed protective efficacy was 55% in IMRAS and 20% in BSPZV1. Study vaccine dosings were chosen to elicit both protected and non-protected subjects, so that protection-associated responses could be identified. Results Analysis of comparable time points up to 1 week after the first vaccination revealed a shared cross-study transcriptional response programme, despite large differences in number and magnitude of differentially expressed genes between trials. A time-dependent regulatory programme of coherent blood transcriptional modular responses was observed, involving induction of inflammatory responses 1–3 days post-vaccination, with cell cycle responses apparent by day 7 in protected individuals from both trials. Additionally, strongly increased induction of inflammation and interferon-associated responses was seen in non-protected IMRAS participants. All individuals, except for non-protected BSPZV1 participants, showed robust upregulation of cell-cycle associated transcriptional responses post vaccination. Conclusions In summary, despite stark differences between the two studies, including route of vaccination and status of malaria exposure, responses were identified that were associated with protection after PfRAS vaccination. These comprised a moderate early interferon response peaking 2 days post vaccination, followed by a later proliferative cell cycle response steadily increasing over the first 7 days post vaccination. Non-protection is associated with deviations from this model, observed in this study with over-induction of early interferon responses in IMRAS and failure to mount a cell cycle response in BSPZV1. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03839-3.
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Affiliation(s)
- Fergal J Duffy
- Center for Global Infectious Disease Research, Seattle Children's Hospital, Seattle, WA, USA.
| | - Ying Du
- Center for Global Infectious Disease Research, Seattle Children's Hospital, Seattle, WA, USA
| | - Jason Carnes
- Center for Global Infectious Disease Research, Seattle Children's Hospital, Seattle, WA, USA
| | - Judith E Epstein
- Malaria Department, Naval Medical Research Center, Silver Spring, MD, USA
| | | | | | - Said Jongo
- Ifakara Health Institute, Bagamoyo, Tanzania
| | - Maxmillian Mpina
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, 4002, Basel, Switzerland.,University of Basel, Petersplatz 1, 4001, Basel, Switzerland.,Ifakara Health Institute, Bagamoyo, Tanzania
| | - Claudia Daubenberger
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, 4002, Basel, Switzerland.,University of Basel, Petersplatz 1, 4001, Basel, Switzerland
| | - John D Aitchison
- Center for Global Infectious Disease Research, Seattle Children's Hospital, Seattle, WA, USA
| | - Ken Stuart
- Center for Global Infectious Disease Research, Seattle Children's Hospital, Seattle, WA, USA.
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9
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Tumbo AM, Schindler T, Dangy JP, Orlova-Fink N, Bieri JR, Mpina M, Milando FA, Juma O, Hamad A, Nyakarungu E, Chemba M, Mtoro A, Ramadhan K, Olotu A, Makweba D, Mgaya S, Stuart K, Perreau M, Stapleton JT, Jongo S, Hoffman SL, Tanner M, Abdulla S, Daubenberger C. Role of human Pegivirus infections in whole Plasmodium falciparum sporozoite vaccination and controlled human malaria infection in African volunteers. Virol J 2021; 18:28. [PMID: 33499880 PMCID: PMC7837505 DOI: 10.1186/s12985-021-01500-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 01/20/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Diverse vaccination outcomes and protection levels among different populations pose a serious challenge to the development of an effective malaria vaccine. Co-infections are among many factors associated with immune dysfunction and sub-optimal vaccination outcomes. Chronic, asymptomatic viral infections can contribute to the modulation of vaccine efficacy through various mechanisms. Human Pegivirus-1 (HPgV-1) persists in immune cells thereby potentially modulating immune responses. We investigated whether Pegivirus infection influences vaccine-induced responses and protection in African volunteers undergoing whole P. falciparum sporozoites-based malaria vaccination and controlled human malaria infections (CHMI). METHODS HPgV-1 prevalence was quantified by RT-qPCR in plasma samples of 96 individuals before, post vaccination with PfSPZ Vaccine and after CHMI in cohorts from Tanzania and Equatorial Guinea. The impact of HPgV-1 infection was evaluated on (1) systemic cytokine and chemokine levels measured by Luminex, (2) PfCSP-specific antibody titers quantified by ELISA, (3) asexual blood-stage parasitemia pre-patent periods and parasite multiplication rates, (4) HPgV-1 RNA levels upon asexual blood-stage parasitemia induced by CHMI. RESULTS The prevalence of HPgV-1 was 29.2% (28/96) and sequence analysis of the 5' UTR and E2 regions revealed the predominance of genotypes 1, 2 and 5. HPgV-1 infection was associated with elevated systemic levels of IL-2 and IL-17A. Comparable vaccine-induced anti-PfCSP antibody titers, asexual blood-stage multiplication rates and pre-patent periods were observed in HPgV-1 positive and negative individuals. However, a tendency for higher protection levels was detected in the HPgV-1 positive group (62.5%) compared to the negative one (51.6%) following CHMI. HPgV-1 viremia levels were not significantly altered after CHMI. CONCLUSIONS HPgV-1 infection did not alter PfSPZ Vaccine elicited levels of PfCSP-specific antibody responses and parasite multiplication rates. Ongoing HPgV-1 infection appears to improve to some degree protection against CHMI in PfSPZ-vaccinated individuals. This is likely through modulation of immune system activation and systemic cytokines as higher levels of IL-2 and IL17A were observed in HPgV-1 infected individuals. CHMI is safe and well tolerated in HPgV-1 infected individuals. Identification of cell types and mechanisms of both silent and productive infection in individuals will help to unravel the biology of this widely present but largely under-researched virus.
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Affiliation(s)
- Anneth-Mwasi Tumbo
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Tobias Schindler
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jean-Pierre Dangy
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Nina Orlova-Fink
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jose Raso Bieri
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Maximillian Mpina
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Florence A Milando
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Omar Juma
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Ali Hamad
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Elizabeth Nyakarungu
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Mwajuma Chemba
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Ali Mtoro
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Kamaka Ramadhan
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Ally Olotu
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Damas Makweba
- Dar-Es-Salaam Institute of Technology, Dar-Es-Salaam, Tanzania
- Tanzania Education and Research Networks, Dar-Es-Salaam, Tanzania
- Tanzania Commission for Science and Technology, Dar-Es-Salaam, Tanzania
| | - Stephen Mgaya
- Tanzania Education and Research Networks, Dar-Es-Salaam, Tanzania
- Tanzania Commission for Science and Technology, Dar-Es-Salaam, Tanzania
| | - Kenneth Stuart
- Center for Global Infectious Disease Research, Seattle Children's Research Institute, 307 Westlake Avenue, N. Suite 500, Seattle, WA, 98109, USA
| | | | - Jack T Stapleton
- Iowa City Veterans Administration and the University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Said Jongo
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | | | - Marcel Tanner
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Salim Abdulla
- Department of Intervention and Clinical Trials, Ifakara Health Institute, Bagamoyo, Tanzania
- Equatorial Guinea Malaria Vaccine Initiative, Malabo, Bioko Norte, Equatorial Guinea
| | - Claudia Daubenberger
- Department of Medical Parasitology and Infection Biology, Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Socinstr. 57, 4002, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
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10
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Camponovo F, Campo JJ, Le TQ, Oberai A, Hung C, Pablo JV, Teng AA, Liang X, Sim BKL, Jongo S, Abdulla S, Tanner M, Hoffman SL, Daubenberger C, Penny MA. Proteome-wide analysis of a malaria vaccine study reveals personalized humoral immune profiles in Tanzanian adults. eLife 2020; 9:53080. [PMID: 32662772 PMCID: PMC7386907 DOI: 10.7554/elife.53080] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 10/26/2019] [Accepted: 07/10/2020] [Indexed: 12/31/2022] Open
Abstract
Tanzanian adult male volunteers were immunized by direct venous inoculation with radiation-attenuated, aseptic, purified, cryopreserved Plasmodium falciparum (Pf) sporozoites (PfSPZ Vaccine) and protective efficacy assessed by homologous controlled human malaria infection (CHMI). Serum immunoglobulin G (IgG) responses were analyzed longitudinally using a Pf protein microarray covering 91% of the proteome, providing first insights into naturally acquired and PfSPZ Vaccine-induced whole parasite antibody profiles in malaria pre-exposed Africans. Immunoreactivity was identified against 2239 functionally diverse Pf proteins, showing a wide breadth of humoral response. Antibody-based immune ‘fingerprints’ in these individuals indicated a strong person-specific immune response at baseline, with little changes in the overall humoral immunoreactivity pattern measured after immunization. The moderate increase in immunogenicity following immunization and the extensive and variable breadth of humoral immune response observed in the volunteers at baseline suggest that pre-exposure reduces vaccine-induced antigen reactivity in unanticipated ways.
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Affiliation(s)
- Flavia Camponovo
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | | | - Amit Oberai
- Antigen Discovery Inc, Irvine, United States
| | | | | | - Andy A Teng
- Antigen Discovery Inc, Irvine, United States
| | | | | | - Said Jongo
- Ifakara Health Institute, Dar es Salaam, United Republic of Tanzania
| | - Salim Abdulla
- Ifakara Health Institute, Dar es Salaam, United Republic of Tanzania
| | - Marcel Tanner
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | - Claudia Daubenberger
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Melissa A Penny
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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11
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Rutishauser T, Lepore M, Di Blasi D, Dangy JP, Abdulla S, Jongo S, Ramadhani K, Sim BKL, Hoffman SL, Tanner M, Daubenberger C, De Libero G. Activation of TCR Vδ1 + and Vδ1 -Vδ2 - γδ T Cells upon Controlled Infection with Plasmodium falciparum in Tanzanian Volunteers. J Immunol 2019; 204:180-191. [PMID: 31801816 DOI: 10.4049/jimmunol.1900669] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 11/04/2019] [Indexed: 01/05/2023]
Abstract
Our understanding of the human immune response to malaria remains incomplete. Clinical trials using whole-sporozoite-based vaccination approaches such as the Sanaria PfSPZ Vaccine, followed by controlled human malaria infection (CHMI) to assess vaccine efficacy offer a unique opportunity to study the immune response during Plasmodium falciparum infection. Diverse populations of T cells that are not restricted to classical HLA (unconventional T cells) participate in the host response during Plasmodium infection. Although several populations of unconventional T cells exist, the majority of studies focused on TCR Vγ9Vδ2 cells, the most abundant TCR γδ cell population in peripheral blood. In this study, we dissected the response of three TCR γδ cell subsets and mucosal-associated invariant T cells in healthy volunteers immunized with PfSPZ Vaccine and challenged by CHMI using Sanaria PfSPZ Challenge. Using a flow cytometry-based unbiased analysis followed by T cell cloning, several findings were made. Whereas major ex vivo alterations were not detectable after immunization with PfSPZ Vaccine, TCR Vδ2, and mucosal-associated invariant T cells expanded after asexual blood-stage parasitemia induced by CHMI. CHMI, but not vaccination, also induced the activation of TCR Vδ1 and Vδ1-Vδ2- γδ T cells. The activated TCR Vδ1 cells were oligoclonal, suggesting clonal expansion, and upon repeated CHMI, showed diminished response, indicating long-term alterations induced by blood-stage parasitemia. Some TCR Vδ1 clones recognized target cells in the absence of parasite-derived Ags, thus suggesting recognition of self-molecules. These findings reveal the articulate participation of different populations of unconventional T cells to P. falciparum infection.
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Affiliation(s)
- Tobias Rutishauser
- Clinical Immunology Unit, Swiss Tropical and Public Health Institute, 4002 Basel, Switzerland.,University of Basel, 4001 Basel, Switzerland.,Experimental Immunology, Department of Biomedicine, University Hospital Basel, University of Basel, 4031 Basel, Switzerland
| | - Marco Lepore
- Experimental Immunology, Department of Biomedicine, University Hospital Basel, University of Basel, 4031 Basel, Switzerland
| | - Daniela Di Blasi
- Experimental Immunology, Department of Biomedicine, University Hospital Basel, University of Basel, 4031 Basel, Switzerland
| | - Jean-Pierre Dangy
- Clinical Immunology Unit, Swiss Tropical and Public Health Institute, 4002 Basel, Switzerland.,University of Basel, 4001 Basel, Switzerland
| | - Salim Abdulla
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, Tanzania; and
| | - Said Jongo
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, Tanzania; and
| | - Kamaka Ramadhani
- Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamoyo, Tanzania; and
| | | | | | - Marcel Tanner
- Clinical Immunology Unit, Swiss Tropical and Public Health Institute, 4002 Basel, Switzerland.,University of Basel, 4001 Basel, Switzerland
| | - Claudia Daubenberger
- Clinical Immunology Unit, Swiss Tropical and Public Health Institute, 4002 Basel, Switzerland; .,University of Basel, 4001 Basel, Switzerland
| | - Gennaro De Libero
- Experimental Immunology, Department of Biomedicine, University Hospital Basel, University of Basel, 4031 Basel, Switzerland;
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12
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Zenklusen I, Jongo S, Abdulla S, Ramadhani K, Lee Sim BK, Cardamone H, Flannery EL, Nguyen T, Fishbaugher M, Steel RWJ, Betz W, Carmago N, Mikolajczak S, Kappe SHI, Hoffman SL, Sack BK, Daubenberger C. Immunization of Malaria-Preexposed Volunteers With PfSPZ Vaccine Elicits Long-Lived IgM Invasion-Inhibitory and Complement-Fixing Antibodies. J Infect Dis 2019; 217:1569-1578. [PMID: 29438525 DOI: 10.1093/infdis/jiy080] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 02/06/2018] [Indexed: 01/17/2023] Open
Abstract
Background The assessment of antibody responses after immunization with radiation-attenuated, aseptic, purified, cryopreserved Plasmodium falciparum sporozoites (Sanaria PfSPZ Vaccine) has focused on IgG isotype antibodies. Here, we aimed to investigate if P. falciparum sporozoite binding and invasion-inhibitory IgM antibodies are induced following immunization of malaria-preexposed volunteers with PfSPZ Vaccine. Methods Using serum from volunteers immunized with PfSPZ, we measured vaccine-induced IgG and IgM antibodies to P. falciparum circumsporozoite protein (PfCSP) via ELISA. Function of this serum as well as IgM antibody fractions was measured via in vitro in an inhibition of sporozoite invasion assay. These IgM antibody fractions were also measured for binding to sporozoites by immunofluorescence assay and complement fixation on whole sporozoites. Results We found that in addition to anti-PfCSP IgG, malaria-preexposed volunteers developed anti-PfCSP IgM antibodies after immunization with PfSPZ Vaccine and that these IgM antibodies inhibited P. falciparum sporozoite invasion of hepatocytes in vitro. These IgM plasma fractions also fixed complement to whole P. falciparum sporozoites. Conclusions This is the first finding that PfCSP and P. falciparum sporozoite-binding IgM antibodies are induced following immunization of PfSPZ Vaccine in malaria-preexposed individuals and that IgM antibodies can inhibit P. falciparum sporozoite invasion into hepatocytes in vitro and fix complement on sporozoites. These findings indicate that the immunological assessment of PfSPZ Vaccine-induced antibody responses could be more sensitive if they include parasite-specific IgM in addition to IgG antibodies. Clinical Trials Registration NCT02132299.
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Affiliation(s)
- Isabelle Zenklusen
- Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Switzerland
| | - Said Jongo
- Ifakara Health Institute, Clinical Trial Unit, Bagamoyo, Tanzania
| | - Salim Abdulla
- Ifakara Health Institute, Clinical Trial Unit, Bagamoyo, Tanzania
| | - Kamaka Ramadhani
- Ifakara Health Institute, Clinical Trial Unit, Bagamoyo, Tanzania
| | | | | | | | - Thao Nguyen
- Center for Infectious Disease Research, Seattle, Washington
| | | | - Ryan W J Steel
- Center for Infectious Disease Research, Seattle, Washington
| | - Will Betz
- Center for Infectious Disease Research, Seattle, Washington
| | - Nelly Carmago
- Center for Infectious Disease Research, Seattle, Washington
| | | | - Stefan H I Kappe
- Center for Infectious Disease Research, Seattle, Washington.,Department of Global Health, University of Washington, Seattle
| | | | - Brandon K Sack
- Center for Infectious Disease Research, Seattle, Washington
| | - Claudia Daubenberger
- Clinical Immunology Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Switzerland
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13
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Schindler T, Jongo S, Studer F, Mpina M, Mwangoka G, Mswata S, Ramadhani K, Sax J, Church LWP, Richie TL, Tanner M, Hoffman SL, Abdulla S, Daubenberger C. Two cases of long-lasting, sub-microscopic Plasmodium malariae infections in adults from coastal Tanzania. Malar J 2019; 18:149. [PMID: 31036014 PMCID: PMC6489319 DOI: 10.1186/s12936-019-2787-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 03/06/2019] [Accepted: 04/22/2019] [Indexed: 01/29/2023] Open
Abstract
Background Malaria is endemic in Tanzania with majority of clinical cases caused by Plasmodium falciparum. Additionally, Plasmodium malariae and Plasmodium ovale spp. are also present and clinical manifestations caused by these infections are not well described. Clinical episodes caused by P. malariae infections are often characterized by a relatively mild illness with a low number of parasites, which can persist for long periods. In this report, two cases of P. malariae infections that were identified during a clinical trial evaluating the P. falciparum malaria vaccine candidate, PfSPZ Vaccine are described. The two participants were followed up and monitored for clinical and laboratory parameters to assess vaccine safety providing the opportunity to study clinical manifestations of P. malariae over 4 months. Case presentation Two young, healthy Tanzanian men infected with low density asexual blood stage P. malariae diagnosed by quantitative polymerase chain reaction (qPCR) are described. Retrospective analysis of collected and stored blood samples revealed that the two volunteers had constant asexual blood stage parasitaemia for more than 4 months. During the 132 days of infection, the volunteers’ vital signs, body temperature and serum biochemistry all remained within normal ranges. Haematological abnormalities, which were transiently outside normal ranges, were regarded as not clinically significant. During this time period, four consecutive evaluations of blood samples by thick blood smear microscopy conducted by an experienced microscopist were all negative, indicating the presence of low-density sub-microscopic infections. Conclusions The two cases of P. malariae infections presented here confirm the ability of this Plasmodium species to persist at low density in the human host for extended time periods without causing clinical symptoms. The presented data also demonstrate that clinical study sites in malaria endemic regions need to have a strong malaria diagnostic infrastructure, including the ability of capturing sub-microscopic parasitaemia and differentiation of Plasmodium species. Trial registration ClinicalTrials.gov: NCT02613520, https://clinicaltrials.gov/ct2/show/NCT02613520, Registered: November 24th 2015, Enrolment of the first participant to the trial: December 15th 2015, Trial was registered before the first participant was enrolled
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Affiliation(s)
- Tobias Schindler
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Said Jongo
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, United Republic of Tanzania.
| | - Fabian Studer
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Maximilian Mpina
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, United Republic of Tanzania
| | - Grace Mwangoka
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, United Republic of Tanzania
| | - Sarah Mswata
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, United Republic of Tanzania
| | - Kamaka Ramadhani
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, United Republic of Tanzania
| | - Julian Sax
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | | | - Marcel Tanner
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | - Salim Abdulla
- Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, United Republic of Tanzania
| | - Claudia Daubenberger
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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14
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Pieper K, Tan J, Piccoli L, Foglierini M, Barbieri S, Chen Y, Silacci-Fregni C, Wolf T, Jarrossay D, Anderle M, Abdi A, Ndungu FM, Doumbo OK, Traore B, Tran TM, Jongo S, Zenklusen I, Crompton PD, Daubenberger C, Bull PC, Sallusto F, Lanzavecchia A. Public antibodies to malaria antigens generated by two LAIR1 insertion modalities. Nature 2017; 548:597-601. [PMID: 28847005 PMCID: PMC5635981 DOI: 10.1038/nature23670] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 07/25/2017] [Indexed: 01/07/2023]
Abstract
We previously described two donors in whom the extracellular domain of LAIR1, a
collagen-binding inhibitory receptor encoded on chromosome 191, was inserted between the V and the DJ segments of an antibody. This
insertion generated, through somatic mutations, broadly reactive antibodies against
RIFINs, a type of variant antigen expressed on the surface of Plasmodium
falciparum-infected erythrocytes (IEs)2.
To investigate how frequently such antibodies are produced in response to malaria
infection, we screened plasma from two large cohorts of individuals living in
malaria-endemic regions. We report that 5-10% of malaria-exposed individuals, but none of
the European blood donors tested, have high levels of LAIR1-containing antibodies that
dominate the response to IEs without conferring enhanced protection against febrile
malaria. By analyzing the antibody-producing B cell clones at the protein, cDNA and gDNA
level, we characterized additional LAIR1 insertions between the V and DJ
segments and discovered a second insertion modality whereby the LAIR1
exon encoding the extracellular domain and flanking intronic sequences are inserted into
the switch region. By exon shuffling, this mechanism leads to the production of bispecific
antibodies in which the LAIR1 domain is precisely positioned at the elbow between the VH
and CH1 domains. Additionally, in one donor the gDNA encoding the VH and CH1 domains was
deleted, leading to the production of a camel-like LAIR1-containing antibody. Sequencing
of the switch regions of memory B cells from European blood donors revealed frequent
templated inserts originating from transcribed genes that, in rare cases, comprised exons
with orientation and frame compatible with expression. Collectively, these results reveal
different modalities of LAIR1 insertion that lead to public and dominant
antibodies against IEs and suggest that insertion of templated DNA represents an
additional mechanism of antibody diversification that can be selected in the immune
response against pathogens and exploited for B cell engineering.
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Affiliation(s)
- Kathrin Pieper
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Via Vincenzo Vela 6, 6500 Bellinzona, Switzerland
| | - Joshua Tan
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Via Vincenzo Vela 6, 6500 Bellinzona, Switzerland.,Nuffield Department of Clinical Medicine, University of Oxford, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK
| | - Luca Piccoli
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Via Vincenzo Vela 6, 6500 Bellinzona, Switzerland
| | - Mathilde Foglierini
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Via Vincenzo Vela 6, 6500 Bellinzona, Switzerland.,Swiss Institute of Bioinformatics (SIB), 1015 Lausanne, Switzerland
| | - Sonia Barbieri
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Via Vincenzo Vela 6, 6500 Bellinzona, Switzerland
| | - Yiwei Chen
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Via Vincenzo Vela 6, 6500 Bellinzona, Switzerland.,Institute for Microbiology, ETH Zurich, Wolfgang-Pauli-Strasse 10, 8093 Zurich, Switzerland
| | - Chiara Silacci-Fregni
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Via Vincenzo Vela 6, 6500 Bellinzona, Switzerland
| | - Tobias Wolf
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Via Vincenzo Vela 6, 6500 Bellinzona, Switzerland.,Institute for Microbiology, ETH Zurich, Wolfgang-Pauli-Strasse 10, 8093 Zurich, Switzerland
| | - David Jarrossay
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Via Vincenzo Vela 6, 6500 Bellinzona, Switzerland
| | - Marica Anderle
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Via Vincenzo Vela 6, 6500 Bellinzona, Switzerland
| | - Abdirahman Abdi
- KEMRI-Wellcome Trust Research Programme, CGMRC, PO Box 230, 80108 Kilifi, Kenya
| | - Francis M Ndungu
- KEMRI-Wellcome Trust Research Programme, CGMRC, PO Box 230, 80108 Kilifi, Kenya
| | - Ogobara K Doumbo
- Malaria Research and Training Centre, University of Sciences, Technique, and Technology of Bamako, 91094 Bamako, Mali
| | - Boubacar Traore
- Malaria Research and Training Centre, University of Sciences, Technique, and Technology of Bamako, 91094 Bamako, Mali
| | - Tuan M Tran
- Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, 46202 Indianapolis, Indiana, USA
| | - Said Jongo
- Ifakara Health Institute, Bagamoyo Clinical Trial Unit, P.O. Box 74, Bagamoyo, Tanzania
| | - Isabelle Zenklusen
- Swiss Tropical and Public Health Institute, Clinical Immunology Unit, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Peter D Crompton
- Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland 20852, USA
| | - Claudia Daubenberger
- Swiss Tropical and Public Health Institute, Clinical Immunology Unit, 4002 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Peter C Bull
- Department of Pathology, University of Cambridge, Cambridge CB2 1QP, UK
| | - Federica Sallusto
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Via Vincenzo Vela 6, 6500 Bellinzona, Switzerland.,Institute for Microbiology, ETH Zurich, Wolfgang-Pauli-Strasse 10, 8093 Zurich, Switzerland
| | - Antonio Lanzavecchia
- Institute for Research in Biomedicine, Università della Svizzera Italiana, Via Vincenzo Vela 6, 6500 Bellinzona, Switzerland.,Institute for Microbiology, ETH Zurich, Wolfgang-Pauli-Strasse 10, 8093 Zurich, Switzerland
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15
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Mwakasungula S, Schindler T, Jongo S, Moreno E, Kamaka K, Mohammed M, Joseph S, Rashid R, Athuman T, Tumbo AM, Hamad A, Lweno O, Tanner M, Shekalaghe S, Daubenberger CA. Red blood cell indices and prevalence of hemoglobinopathies and glucose 6 phosphate dehydrogenase deficiencies in male Tanzanian residents of Dar es Salaam. Int J Mol Epidemiol Genet 2014; 5:185-194. [PMID: 25755846 PMCID: PMC4348704] [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] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 11/12/2014] [Indexed: 06/04/2023]
Abstract
Hemoglobinopathies, disorders of hemoglobin structure and production, are one of the most common monogenic disorders in humans. Glucose 6 phosphate dehydrogenase deficiency (G6PD) is an inherited enzymopathy resulting in increased oxygen stress susceptibility of red blood cells. The distributions of these genetic traits in populations living in tropical and subtropical regions where malaria has been or is still present are thought to result from survival advantage against severe life threatening malaria disease. 384 male Tanzanian volunteers residing in Dar es Salaam were typed for G6PD, sickle cell disease and α-thalassemia. The most prominent red blood cell polymorphism was heterozygous α(+)-thalassemia (37.8%), followed by the G6PD(A) deficiency (16.4%), heterozygous sickle cell trait (15.9%), G6PD(A-) deficiency (13.5%) and homozygous α(+)-thalassemia (5.2%). 35%, 45%, 17% and 3% of these volunteers were carriers of wild type gene loci, one, two or three of these hemoglobinopathies, respectively. We find that using a cut off value of 28.6 pg. for mean corpuscular hemoglobin (MCH), heterozygous α(+)-thalassemia can be predicted with a sensitivity of 84% and specificity of 72% in this male population. All subjects carrying homozygous α(+)-thalassemia were identified based on their MCH value < 28.6 pg.
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Affiliation(s)
- Solomon Mwakasungula
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health InstituteSocinstrasse 57, 4002 Basel, Switzerland
- University of BaselBasel, Petersplatz 1, CH-4003 Basel, Switzerland
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Tobias Schindler
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health InstituteSocinstrasse 57, 4002 Basel, Switzerland
- University of BaselBasel, Petersplatz 1, CH-4003 Basel, Switzerland
| | - Said Jongo
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Elena Moreno
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Kasimu Kamaka
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Mgeni Mohammed
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Selina Joseph
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Ramla Rashid
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Thabit Athuman
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Anneth Mwasi Tumbo
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Ali Hamad
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Omar Lweno
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Marcel Tanner
- University of BaselBasel, Petersplatz 1, CH-4003 Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health InstituteSocinstrasse 57, 4002 Basel, Switzerland
| | - Seif Shekalaghe
- Ifakara Health Institute, Bagamoyo Research and Training CentreBagamoyo, P.O. Box 74, Tanzania
| | - Claudia A Daubenberger
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health InstituteSocinstrasse 57, 4002 Basel, Switzerland
- University of BaselBasel, Petersplatz 1, CH-4003 Basel, Switzerland
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