Abstract
Globally, malaria is one of the leading causes of mortality and morbidity where the brunt of the disease burden is borne by children under five years of age and pregnant women in sub-Saharan Africa. According to WHO, the cases of malaria in 2014 declined, despite cases of parasite resistance to available anti-malarial drugs and anopheline mosquitoes resistant to insecticides being reported. Therefore, there is need for an improved malaria control strategy including an effective malaria vaccine which can confer blood stage immunity and prevent development of clinical malaria. This venture has been explored for several decades resulting in discovery of promising antigen candidates but we lack appropriate adjuvants for human use capable of boosting immunogenicity of this antigens. In this review, we highlight limitations of various antigens in conjunction with adjuvants used and provide insight on new strategies of improving vaccine immunogenicity by incorporating immunomodulatory molecules and epitopes.
Highlights
Malaria infection is caused by four human infective Plasmodium species: P. falciparum, P. ovale, P. malariae, P. vivax and one zoonotic simian species P. knowlesi [1]
In 2014, the World Health Organization (WHO) estimated that 3.2 billion people are at a risk of malaria infection with estimated 438 000 deaths of which 90% occur in sub-Saharan Africa (SSA) [2]
Studies were included in the review if they explicitly reported on malaria vaccine developments in respect to (i) status; (ii) safety of malaria antigens, (iii) immunogenicity of malarial antigens, and (iv) future approaches in malaria vaccine development
Summary
Malaria infection is caused by four human infective Plasmodium species: P. falciparum, P. ovale, P. malariae, P. vivax and one zoonotic simian species P. knowlesi [1]. Passive immunization of immune adults living in malarious areas confers protection against P. falciparum in children recrudescence of malaria infection has been reported [10] This is in addition to the interesting find that experimental vaccination of humans with attenuated sporozoites confers immunity to patients against subsequent malaria infections [11]. Development of a malaria vaccine is feasible since the Plasmodium genome has been completed and shows that there are more than 5200 parasite proteins expressed in its life cycle [13]. In humans, varied immunological spectacle complicates characterization of malarial antigen immunogenicity [14] Despite these challenges, the use of sub-unit vaccines with adjuvant approaches have been employed in the development of malaria vaccines targeting pre-erythrocytic and erythrocytic stages as well as in transmission blocking or combinations of both [15]
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