Characterizing the Plasma IgG Antibody Repertoire of Malaria-Naïve United Kingdom Adults Vaccinated with Novel Blood Stage Vaccine RH5.1/AS01 B

Abstract

Abstract Plasmodium falciparum, the most lethal species of human malaria, is susceptible to vaccine-induced antibodies, yet current efforts are challenged by limited efficacy, lack of durability, and parasite evasion. A promising blood-stage vaccine antigen, Reticulocyte Binding Protein Homologue 5 (RH5), has low polymorphism frequencies and uses a non-redundant red blood cell (RBC) invasion pathway. The Draper Lab (Oxford University) clinically tested RH5.1, an engineered variant of RH5, in AS01 Badjuvant (GSK) designed to boost long-lasting, protective antibody titers. RH5-specific B cell receptors (BCRs) from United Kingdom malaria–naïve adult volunteers vaccinated with RH5.1/AS01 Bwere sequenced. Monoclonal antibodies (mAbs) were found to inhibit in vitrogrowth of RBC-invading parasite merozoites. Notably, the polyclonal plasma IgG of the volunteers exhibited high neutralizing potency, exceeding that of individual mAbs from the same donors, which raises the question: what is the disconnect between the BCR and circulating IgG repertoires? To examine this further, our lab completed BCR sequencing coupled with plasma IgG proteomics to characterize the plasma antibody repertoires of volunteers. Plasma mAbs were identified that bind to known growth inhibitory epitopes, including those that block binding between RH5 and its RBC coreceptor, CD147, alongside a population of non-neutralizing, synergizing mAbs. Additionally, non-neutralizing mAbs targeting cryptic epitopes on the N- and C-terminus were found at consistently high levels. This dynamic between neutralizing and non-neutralizing plasma mAbs suggests a role for non-neutralizing mAbs, which should be further explored in future RH5 vaccine engineering. Supported by grants from U.S. Agency for International Development (USAID) contract no. 7200AA20C00017 and the National Science Foundation Graduate Research Fellowship Program (NSF GRFP).