期刊
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE
卷 104, 期 1, 页码 283-293出版社
AMER SOC TROP MED & HYGIENE
DOI: 10.4269/ajtmh.20-0435
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资金
- EGMVI of the government of EG Ministry of Mines and Hydrocarbons
- EGMVI of the government of EG Ministry of Health and Social Welfare
- Marathon EG Production Limited
- Noble Energy
- Atlantic Methanol Production Company
- EG LNG
In African vaccinees, Plasmodium falciparum sporozoite-CVac recipients demonstrated a higher vaccine efficacy, likely due to later stage parasite maturation leading to induction of cellular immunity against a broader array of antigens.
Plasmodium falciparum sporozoite (PfSPZ) Vaccine (radiation-attenuated, aseptic, purified, cryopreserved PfSPZ) and PfSPZ-CVac (infectious, aseptic, purified, cryopreserved PfSPZ administered to subjects taking weekly chloroquine chemoprophylaxis) have shown vaccine efficacies (VEs) of 100% against homologous controlled human malaria infection (CHMI) in nonimmune adults. Plasmodium falciparum sporozoite-CVac has never been assessed against CHMI in African vaccinees. We assessed the safety, immunogenicity, and VE against homologous CHMI of three doses of 2.7 x 10(6) PfSPZ of PfSPZ Vaccine at 8-week intervals and three doses of 1.0 x 10(5) PfSPZ of PfSPZ-CVac at 4 week intervals with each arm randomized, double-blind, placebo-controlled, and conducted in parallel. There were no differences in solicited adverse events between vaccinees and normal saline controls, or between PfSPZ Vaccine and PfSPZ-CVac recipients during the 6 days after administration of investigational product. However, from days 7-13, PfSPZ-CVac recipients had significantly more AEs, probably because of Pf parasitemia. Antibody responses were 2.9 times higher in PfSPZ Vaccine recipients than PfSPZ-CVac recipients at time of CHMI. Vaccine efficacy at a median of 14 weeks after last PfSPZ-CVac dose was 55% (8 of 13, P = 0.051) and at a median of 15 weeks after last PfSPZ Vaccine dose was 27% (5 of 15, P = 0.32). The higher VE in PfSPZ-CVac recipients of 55% with a 27-fold lower dose was likely a result of later stage parasite maturation in the liver, leading to induction of cellular immunity against a greater quantity and broader array of antigens.
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