Differential sex-specific immune responses following Prime-and-Trap vaccination alters protection against malaria in mice

Abstract

Abstract Generating liver resident-memory CD8+ T cells (TRM cells) is critical for effective liver-stage malaria vaccine. The role of biological sex in liver-stage vaccine protection is understudied. Here we report sex-specific immune responses and protection outcomes for the two-step heterologous ‘Prime-and-Trap’ liver-stage malaria vaccine designed to induce liver TRM cells. The Prime-and-Trap strategy combines sporozoite antigen DNA priming with a single intravenous dose of liver-homing radiation-attenuated sporozoites (RAS) to direct and “trap” activated and expanding T cells in the liver. This strategy induces robust liver CD8+ TRM cell responses and confers sterile protection in the P. yoelii (Py) rodent malaria model in female mice. However, when tested in male mice, it induces weaker liver CD8+ TRM cell responses and little to no protection from sporozoite challenge. We examined sex-divergent immune responses in the spleen and liver following each step of the Prime-and-Trap regimen. We found that sexually dimorphic activation of certain immune pathways drives attenuated downstream retention of TRM cells in the liver, leading male mice to generate a sub-optimal immune response that ultimately fails to protect from Py sporozoite challenge. Our findings emphasize the importance of incorporating sex as a variable for evaluation in the design of robust liver-stage malaria vaccines. Supported by grants from NIH (R01 AI141857).