VAR2CSA protein for malaria vaccine or anticancer drug delivery? A review of preclinical and clinical research

Abstract

Variant surface antigen 2- chondroitin sulfate A (VAR2CSA) is a protein belonging to the Plasmodium falciparum Erythrocyte Membrane Protein 1 (PfEMP1) family. Since the discovery of the protein, various studies have been carried out to utilize VAR2CSA in the clinical field. The typical application is the development of malaria vaccines and anticancer drug carriers based on VAR2CSA. Will anticancer drugs (with VAR2CSA vehicle) work effectively in patients who have already received the VAR2CSA-based malaria vaccine? Given that theoretically, the presence of antibodies triggered by the VAR2CSA vaccine might be against anticancer drugs delivered by VAR2CSA. Therefore, a review regarding the development of research on VAR2CSA, especially as a vaccine or anticancer drug vehicle, is needed. This paper provides an overview of current knowledge about VAR2CSA including its structure and function, biochemical aspects, research approaches both in vitro, ex vivo and in vivo, and the development of potential studies of VAR2CSA in the field of medicine. The literature search was carried out systematically from the PubMed database with the keywords “VAR2CSA”, “VAR2CSA” AND “vaccine”, "VAR2CSA" AND "drug delivery", "VAR2CSA" AND "cancer", "VAR2CSA" AND "placental malaria", "VAR2CSA" AND "review". A Study of VAR2CSA shows promising results, especially in the development of VAR2CSA as the main candidate for the placental malaria vaccine and anticancer drug carrier. Current findings reveal that both studies will carry out clinical trials soon. However, limitations of the study should be considered in future clinical applications for more effective cancer treatment, such as the administration of anticancer drugs by VAR2CSA vehicles on patients who have already received VAR2CSA-based antimalarial vaccines. Furthermore, an example of promising future research is leveraging other domains of VAR2CSA that have not been explored yet.