Abstract
A therapeutic preconceptional vaccine against Chagas disease: A novel indication that could reduce congenital transmission and accelerate vaccine development.
Highlights
Among the 222 children born to untreated women, 34 were infected with T. cruzi (15.3%), whereas no infection was found among the 132 children of previously treated women
Extensive preclinical studies using a variety of vaccine formulations—such as live-attenuated parasites, recombinant proteins, DNA or viral vectors with a diverse set of adjuvants and carriers ranging from cytokines, TLR agonists or nanoparticles—have evidenced the ability of some vaccine formulations to control T. cruzi infection in mouse models [22,23,24]
Some of these vaccine candidates have been tested as preventative vaccines, others as therapeutic vaccines, that are able to redirect the immune response to increase its efficacy at controlling the parasite in an infected host
Summary
Several retrospective observational studies suggest that infected women treated at a young age do not transmit T. cruzi when pregnant later in life [9,10,11,12,13]. Among the 222 children born to untreated women, 34 were infected with T. cruzi (15.3%), whereas no infection was found among the 132 children of previously treated women Another small observational study found no congenital transmission among 15 women who became pregnant from 1 to 8 years after treatment [11]. Preconceptional treatment appears very promising, the frequency of side effects limits its use and alternative approaches to reduce parasitemia before conception should be investigated These include treatments with reduced doses and/or shorter regimens, combination therapies, and therapeutic vaccination for the prevention of congenital transmission
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