Attenuated Sporozoite Vaccine Research Articles

Infectious sporozoite challenge modulates radiation attenuated sporozoite vaccine-induced memory CD8+ T cells for better survival characteristics.

Radiation attenuated sporozoite (RAS), a whole-parasite vaccine approach, provides sterile protection against malaria. However, RAS immunization does not confer protection for long, and that has been correlated with the waning parasite-induced memory CD8+ T-cell responses. Interestingly, an intermittent infectious (wild type) sporozoite challenge to the RAS-vaccinated mice lengthened the protection period from 6 to 18 months. Herein, we have studied the changes induced by the infectious sporozoites in RAS-induced memory CD8+ T cells for conferring lengthened protection. We observed that the infectious sporozoite challenge boosted the frequency of foreign antigen-experienced memory CD8+ T cells. In those CD8+ T cells, it has reduced the Annexin-V reactivity, raised Bcl-2 expression, and also more cells undergo homeostatic proliferation (Ki-67+ ). It has also scaled down the frequency of Nur77 and CX3CR1 high expressing cells in those memory CD8+ T-cell populations which we further correlated with better survival signals.

Chemoprophylaxis vaccination with a Plasmodium liver stage autophagy mutant affords enhanced and long-lasting protection

Genetically attenuated sporozoite vaccines can elicit long-lasting protection against malaria but pose risks of breakthrough infection. Chemoprophylaxis vaccination (CVac) has proven to be the most effective vaccine strategy against malaria. Here, we demonstrate that a liver stage-specific autophagy mutant of Plasmodium berghei (ATG8 overexpressor), when used as a live vaccine under a CVac regimen, provides superior long-lasting protection, in both inbred and outbred mice, as compared to WT-CVac. Uniquely, the protection elicited by this mutant is predominantly dependent on a CD8+ T-cell response through an IFN-γ-independent mechanism and is associated with a stable population of antigen-experienced CD8+ T cells. Jointly, our findings support the exploitation of liver-stage mutants as vaccines under a CVac protocol. This vaccination strategy is also a powerful model to study the mechanisms of protective immunity and discover new protective antigens.

Clustering and Erratic Movement Patterns of Syringe-Injected versus Mosquito-Inoculated Malaria Sporozoites Underlie Decreased Infectivity.

ABSTRACTMalaria vaccine candidates based on live, attenuated sporozoites have led to high levels of protection. However, their efficacy critically depends on the sporozoites’ ability to reach and infect the host liver. Administration via mosquito inoculation is by far the most potent method for inducing immunity but highly impractical. Here, we observed that intradermal syringe-injected Plasmodium berghei sporozoites (syrSPZ) were 3-fold less efficient in migrating to and infecting mouse liver than mosquito-inoculated sporozoites (msqSPZ). This was related to a clustered dermal distribution (2-fold-decreased median distance between syrSPZ and msqSPZ) and, more importantly, a 1.4-fold (significantly)-slower and more erratic movement pattern. These erratic movement patterns were likely caused by alteration of dermal tissue morphology (>15-μm intercellular gaps) due to injection of fluid and may critically decrease sporozoite infectivity. These results suggest that novel microvolume-based administration technologies hold promise for replicating the success of mosquito-inoculated live, attenuated sporozoite vaccines.IMPORTANCE Malaria still causes a major burden on global health and the economy. The efficacy of live, attenuated malaria sporozoites as vaccine candidates critically depends on their ability to migrate to and infect the host liver. This work sheds light on the effect of different administration routes on sporozoite migration. We show that the delivery of sporozoites via mosquito inoculation is more efficient than syringe injection; however, this route of administration is highly impractical for vaccine purposes. Using confocal microscopy and automated imaging software, we demonstrate that syringe-injected sporozoites do cluster, move more slowly, and display more erratic movement due to alterations in tissue morphology. These findings indicate that microneedle-based engineering solutions hold promise for replicating the success of mosquito-inoculated live, attenuated sporozoite vaccines.

Synthetic DNA Vaccines Adjuvanted with pIL-33 Drive Liver-Localized T Cells and Provide Protection from Plasmodium Challenge in a Mouse Model.

The need for a malaria vaccine is indisputable. A single vaccine for Plasmodium pre-erythrocytic stages targeting the major sporozoite antigen circumsporozoite protein (CSP) has had partial success. Additionally, CD8+ T cells targeting liver-stage (LS) antigens induced by live attenuated sporozoite vaccines were associated with protection in human challenge experiments. To further evaluate protection mediated by LS antigens, we focused on exported pre-erythrocytic proteins (exported protein 1 (EXP1), profilin (PFN), exported protein 2 (EXP2), inhibitor of cysteine proteases (ICP), transmembrane protein 21 (TMP21), and upregulated in infective sporozoites-3 (UIS3)) expressed in all Plasmodium species and designed optimized, synthetic DNA (synDNA) immunogens. SynDNA antigen cocktails were tested with and without the molecular adjuvant plasmid IL-33. Immunized animals developed robust T cell responses including induction of antigen-specific liver-localized CD8+ T cells, which were enhanced by the co-delivery of plasmid IL-33. In total, 100% of mice in adjuvanted groups and 71%–88% in non-adjuvanted groups were protected from blood-stage disease following Plasmodium yoelii sporozoite challenge. This study supports the potential of synDNA LS antigens as vaccine components for malaria parasite infection.

Quantification of wild-type and radiation attenuated Plasmodium falciparum sporozoite motility in human skin

Given the number of global malaria cases and deaths, the need for a vaccine against Plasmodium falciparum (Pf) remains pressing. Administration of live, radiation-attenuated Pf sporozoites can fully protect malaria-naïve individuals. Despite the fact that motility of these attenuated parasites is key to their infectivity and ultimately protective efficacy, sporozoite motility in human tissue (e.g. skin) remains wholly uncharacterized to date. We show that the ability to quantitatively address the complexity of sporozoite motility in human tissue provides an additional tool in the development of attenuated sporozoite vaccines. We imaged Pf movement in the skin of its natural host and compared wild-type and radiation-attenuated GFP-expressing Pf sporozoites. Using custom image analysis software and human skin explants we were able to quantitatively study their key motility features. This head-to-head comparison revealed that radiation attenuation impaired the capacity of sporozoites to vary their movement angle, velocity and direction, promoting less refined movement patterns. Understanding and overcoming these changes in motility will contribute to the development of an efficacious attenuated parasite malaria vaccine.

Irradiated sporozoite vaccination induces sex-specific immune responses and protection against malaria in mice

In both preclinical animal studies and human clinical trials, adult females tend to develop greater adaptive immune responses than males following receipt of either viral or bacterial vaccines. While there is currently no approved malaria vaccine, several anti-sporozoite vaccines, including RTS,S/AS01 and attenuated sporozoite vaccines, are in development, but the impact of sex and age on their efficacy remains undefined. To examine sex differences in the efficacy of anti-sporozoite stage malaria vaccination, adult (10 weeks of age) or juvenile (11 days of age) male and female C3H mice were twice vaccinated with irradiated transgenic Plasmodium berghei sporozoites expressing the P. falciparum circumsporozoite (CSP) protein and 45 days post boost vaccination, mice were challenged with transgenic P. berghei via mosquito bite or intradermal challenge. Immunization with irradiated sporozoites resulted in greater protection against challenge in adult females, which was associated with greater anti-CSP antibody production and avidity, as well as greater hepatic, but not splenic, CD8+ T cell IFNƴ production in adult females than adult males. No sex differences in adaptive immune responses or protection were observed in mice vaccinated prior to puberty, suggesting a role for sex steroid hormones. Depletion of testosterone in males increased, whereas rescue of testosterone decreased, anti-CSP antibody production, the number of antigen-specific CD8+ T cells isolated from the liver, and protection following parasite challenge. Conversely, depletion of sex steroids in female mice did not alter vaccine-induced responses or protection following challenge. These data suggest that elevated testosterone concentrations in males reduce adaptive immunity and contribute to sex differences in malaria vaccine efficacy.

Novel sporozoite-based ELISpot assay to assess frequency of parasite-specific B cells after vaccination with irradiated sporozoites

BackgroundWhole parasite vaccination is an efficacious strategy to induce sterile immunity and to prevent malaria transmission. Understanding the mechanism and response of immune cells to vaccines plays a critical role in deciphering correlates of protection against infection and disease. Immunoassays, such as ELISpot, are commonly used to assess the immunogenicity of vaccines towards T cells and B cells. To date, these assays only analyse responses to specific antigens since they are based on recombinant parasite-derived proteins or peptides. There is the need for an agnostic approach that allows the evaluation of all sporozoite-associated antigens.MethodsELISpot plates coated with a defined amount of lysed Plasmodium falciparum sporozoites were used to assess the frequency of sporozoite-specific B cells in peripheral blood mononuclear cells from donors immunized with either a recombinant malaria vaccine or irradiated sporozoites.ResultsThis report describes the assay conditions for a specific and sensitive sporozoite-based B cell ELISpot assay. The assay development considers the quality of sporozoite preparation as well as the detection threshold of the frequency of antigen-specific B cells. The assay enables the detection of sporozoite-specific IgM and IgG-producing B cells. Moreover, the assay can detect sporozoite-reactive B cells from subjects that were either vaccinated with the radiation attenuated sporozoite vaccine or a recombinant pre-erythrocytic vaccine.ConclusionThe newly developed sporozoite-based B cell ELISpot enables the monitoring of changes in the frequency of sporozoite-specific B cells. Applying this assay to assess the potency of vaccination regimens or seasonal changes in B cell populations from subjects residing in malaria-endemic areas will provide an opportunity to gain insight into immune mechanisms involved in protection and/or disease.

Editorial: Breaking the cycle: attacking the malaria parasite in the liver.

Editorial: Breaking the cycle: attacking the malaria parasite in the liver.

Protection Against Malaria by Intravenous Immunization with a Nonreplicating Sporozoite Vaccine

Consistent, high-level, vaccine-induced protection against human malaria has only been achieved by inoculation of Plasmodium falciparum (Pf) sporozoites (SPZ) by mosquito bites. We report that the PfSPZ Vaccine--composed of attenuated, aseptic, purified, cryopreserved PfSPZ--was safe and well tolerated when administered four to six times intravenously (IV) to 40 adults. Zero of six subjects receiving five doses and three of nine subjects receiving four doses of 1.35 × 10(5) PfSPZ Vaccine and five of six nonvaccinated controls developed malaria after controlled human malaria infection (P = 0.015 in the five-dose group and P = 0.028 for overall, both versus controls). PfSPZ-specific antibody and T cell responses were dose-dependent. These data indicate that there is a dose-dependent immunological threshold for establishing high-level protection against malaria that can be achieved with IV administration of a vaccine that is safe and meets regulatory standards.

A key role for lipoic acid synthesis duringPlasmodiumliver stage development

The successful navigation of malaria parasites through their life cycle, which alternates between vertebrate hosts and mosquito vectors, requires a complex interplay of metabolite synthesis and salvage pathways. Using the rodent parasite Plasmodium berghei, we have explored the synthesis and scavenging pathways for lipoic acid, a short-chain fatty acid derivative that regulates the activity of α-ketoacid dehydrogenases including pyruvate dehydrogenase. In Plasmodium, lipoic acid is either synthesized de novo in the apicoplast or is scavenged from the host into the mitochondrion. Our data show that sporozoites lacking the apicoplast lipoic acid protein ligase LipB are markedly attenuated in their infectivity for mice, and in vitro studies document a very late liver stage arrest shortly before the final phase of intra-hepaticparasite maturation. LipB-deficient asexual blood stage parasites show unimpaired rates of growth in normal in vitro or in vivo conditions. However, these parasites showed reduced growth in lipid-restricted conditions induced by treatment with the lipoic acid analogue 8-bromo-octanoate or with the lipid-reducing agent clofibrate. This finding has implications for understanding Plasmodium pathogenesis in malnourished children that bear the brunt of malarial disease. This study also highlights the potential of exploiting lipid metabolism pathways for the design of genetically attenuated sporozoite vaccines.

Protective CD8+ T lymphocytes in Primates Immunized with Malaria Sporozoites

Live attenuated malaria vaccines are more potent than the recombinant protein, bacterial or viral platform vaccines that have been tested, and an attenuated sporozoite vaccine against falciparum malaria is being developed for humans. In mice, attenuated malaria sporozoite vaccines induce CD8+ T cells that kill parasites developing in the liver. We were curious to know if CD8+ T cells were also important in protecting primates against malaria. We immunized 9 rhesus monkeys with radiation attenuated Plasmodium knowlesi sporozoites, and found that 5 did not develop blood stage infections after challenge with live sporozoites. We then injected 4 of these protected monkeys with cM-T807, a monoclonal antibody to the CD8 molecule which depletes T cells. The fifth monkey received equivalent doses of normal IgG. In 3 of the 4 monkeys receiving cM-T807 circulating CD8+ T cells were profoundly depleted. When re-challenged with live sporozoites all 3 of these depleted animals developed blood stage malaria. The fourth monkey receiving cM-T807 retained many circulating CD8+ T cells. This monkey, and the vaccinated monkey receiving normal IgG, did not develop blood stage malaria at re-challenge with live sporozoites. Animals were treated with antimalarial drugs and rested for 4 months. During this interval CD8+ T cells re-appeared in the circulation of the depleted monkeys. When all vaccinated animals received a third challenge with live sporozoites, all 5 monkeys were once again protected and did not develop blood stage malaria infections. These data indicate that CD8+ T cells are important effector cells protecting monkeys against malaria sporozoite infection. We believe that malaria vaccines which induce effector CD8+ T cells in humans will have the best chance of protecting against malaria.

Assessing the adequacy of attenuation of genetically modified malaria parasite vaccine candidates

The critical first step in the clinical development of a malaria vaccine, based on live-attenuated Plasmodium falciparum sporozoites, is the guarantee of complete arrest in the liver. We report on an approach for assessing adequacy of attenuation of genetically attenuated sporozoites in vivo using the Plasmodium berghei model of malaria and P. falciparum sporozoites cultured in primary human hepatocytes. We show that two genetically attenuated sporozoite vaccine candidates, Δp52+p36 and Δfabb/f, are not adequately attenuated. Sporozoites infection of mice with both P. berghei candidates can result in blood infections. We also provide evidence that P. falciparum sporozoites of the leading vaccine candidate that is similarly attenuated through the deletion of the genes encoding the proteins P52 and P36, can develop into replicating liver stages. Therefore, we propose a minimal set of screening criteria to assess adequacy of sporozoite attenuation necessary before advancing into further clinical development and studies in humans.

Complete abrogation of sporozoite-induced sterile immunity by blood stage parasites of homologous and heterologous malaria species

Immunisation of mice and humans with attenuated sporozoites has been shown to confer sterile immunity against infection. There are ongoing efforts to develop a vaccine based on this system. Attenuation of sporozoites may be achieved via irradiation, genetic modification, or through the use of drugs targeting the blood stage parasite. Recently, it has been shown that the administration of chloroquine, a drug that acts exclusively against the erythrocytic stages of malaria parasites, concurrently with live sporozoites can induce sterile immunity against homologous challenge with Plasmodium falciparum sporozoites in humans. However, it is not known whether the protection achieved against P. falciparum will also protect against other species of human malaria parasites, which are almost always endemic in the same region. Given the high amount of antigen diversity within malaria parasite species, coupled with the large evolutionary distances between the human species, it seems unlikely that immunity to heterologous species would be achieved. Of concern is whether the development of an acute blood stage infection of a heterologous species may abrogate the immunity achieved against the vaccine target species. This phenomenon would have serious consequences for the deployment of an attenuated sporozoite vaccine in a multispecies endemic area. Here, we describe the results of experiments aimed at determining whether immunity achieved against one species of malaria parasite by sporozoite immunisation is protective against a secondary species, and whether the development of acute blood stage infections of the heterologous species abrogates the immunity achieved against the vaccine target species. As such experiments are currently impossible using human malaria parasite species, we have used the rodent malaria parasite species Plasmodium vinckei and Plasmodium yoelii. These two species were selected as they offer the widest possible evolutionary distance between rodent malaria parasites, although they are still much more closely related than any two of the human species. We found that although there was some cross protection between the species following sporozoite immunisation in conjunction with mefloquine treatment, the major component of this immunity was species specific. Mice immunised with P. yoelii sporozoites were completely protected against the development of blood stage infection following P. yoelii sporozoite challenge, whereas they were completely susceptible to infection with P. vinckei. Crucially, we found that the development of a blood stage infection of either species completely removed the sterile protection achieved via sporozoite immunisation.

Development of an attenuated sporozoite vaccine to prevent and eliminate Plasmodium falciparum malaria

An ideal vaccine for malaria would target all stages of the parasite life cycle, and thereby prevent infection, severe disease and transmission. However, most malariologists agree that if only one stage is to be targeted, it should be the pre-erythrocytic stage, because induction of highly protective immune responses against this stage will prevent blood stage infection and thus disease and parasite transmission. Our consortium is working to develop such a vaccine. The first-generation vaccine is a metabolically active, non-replicating Plasmodium falciparum sporozoite (PfSPZ) vaccine that is attenuated by irradiation. The first major challenge was to manufacture adequate quantities of such a vaccine that met regulatory standards for initial clinical trials, and demonstrate that it was safe, well tolerated and immunogenic in humans. This has been accomplished. The second major challenge is to determine how to administer for the first time in humans an unprecedented, non-replicating and metabolically active (live) whole-organism vaccine formulation composed of PfSPZ that measure 0.5-1.0 μm x 7-10 μm, to induce > 85% protection. Volunteers immunized by intradermal (ID) or subcutaneous (SC) routes were protected in the first clinical trial. However, the number of protected subjects was low, and despite a dose response immunogenicity was sub-optimal. Animal studies show that intravenous (IV) immunization induces much better immunity and protection than immunization by the SC or ID routes. These data have been used to inform the design of the next clinical trial. Parallel efforts are underway to optimize non-IV administration of PfSPZ, and the efficiency and scale-up of manufacture. We are also determining whether genetic targeting techniques can be used to create a parasite clone that will produce attenuated PfSPZ that are not only more potent, but also as safe as radiation-attenuated PfSPZ. Such PfSPZ could be non-replicating (as are radiation-attenuated PfSPZ), replication deficient, or replication competent, but avirulent. Our goal is to develop, license and deploy a highly effective pre-erythrocytic stage PfSPZ vaccine that prevents blood stage infection, disease, and transmission. Such a vaccine could be used at the community level in Pf elimination campaigns, and at the individual level for prevention of Pf malaria in infants, young children, and pregnant women in endemic areas, as well as individuals of all ages who travel to malaria-endemic areas.

The Effects of radiation on the safety and protective efficacy of an attenuated Plasmodium yoelii sporozoite malaria vaccine

We are developing a radiation attenuated Plasmodium falciparum sporozoite (PfSPZ) malaria vaccine. An important step was to determine the minimum dose of irradiation required to adequately attenuate each sporozoite. This was studied in the Plasmodium yoelii rodent model system. Exposure to 100 Gy completely attenuated P. yoelii sporozoites (PySPZ). Next we demonstrated that immunization of mice intravenously with 3 doses of 750 PySPZ that had received 200 Gy, double the radiation dose required for attenuation, resulted in 100% protection. These results support the contention that a radiation attenuated sporozoite vaccine for malaria will be safe and effective at a range of radiation doses.

Preerythrocytic malaria vaccine development

This review examines the potential of current preerythrocytic stage malaria vaccine approaches to reduce the global burden of malaria. Radiation-attenuated parasite vaccines induce lasting sterile protection in all models tested. Inherent safety concerns in conjunction with challenges to produce and deliver a radiation-attenuated parasite vaccine have prevented its mass production and application. Recent advances in genetic engineering and initiatives in production process development of live attenuated malaria vaccines, however, will overcome roadblocks that currently prevent their large-scale application. Development of preerythrocytic subunit vaccines has focused on the circumsporozoite protein and the thrombospondin related anonymous protein, yet the most advanced circumsporozoite protein-based vaccine confers limited protection against infection in malaria endemic areas. Work in rodent malaria models demonstrated that circumsporozoite protein-based immunity is not required for to achieve sterile protection. We conclude that preerythrocytic malaria vaccine efforts should focus on two major areas: development of a safe live attenuated sporozoite vaccine with its accelerated testing in malaria endemic areas and identification of as yet unknown antigens that reproduce sterilizing immune responses induced by vaccination with whole parasites. The sporozoite challenge model provides a unique opportunity to rapidly test preerythrocytic vaccine candidates.

New concepts in vaccine development in malaria

To focus on recent novel concepts in the development of malaria vaccines. There is a renewed interest in whole attenuated sporozoite vaccines, either as irradiated or genetically modified sporozoites, because they consistently elicit solid protection against challenge infections. Enthusiasm about these vaccines is, however, tempered by technical, logistical, safety and even cultural hurdles that might need to be surmounted. Less than a score of Plasmodium falciparum proteins are currently in the development pipeline as malaria vaccines. There is an urgent need to ratchet up the process of candidate vaccine discovery, and reverse vaccinology and genome-wide surveys remain promising strategies. The development of malaria vaccines for placental malaria is an active area and chondroitin sulfate A-binding epitopes of the variant PfEMP1 have been identified. Live bacteria and viral vectors hold special promise for vaccine delivery. Attenuated sporozoite vaccines have made a resurgence to center stage in malaria vaccine development. There is an urgent need to identify more subunit vaccine candidates that can enter into the development pipeline, identify surrogate markers of immunity and design vaccines which induce long-lasting immunity.

Progress and Challenges towards the Development of Malaria Vaccines

The promise afforded by attenuated sporozoite vaccines in the 1970s led many researchers to believe that an efficacious malaria vaccine was an attainable medium-term goal. Over 30 years later, no licensed vaccine is currently available for public health intervention. This is despite global expenditure on research and development for malaria vaccines that is estimated to have increased from $US42 million in 1999 to $US84 million in 2004. Serious questions must therefore be asked: is this a good investment of research and public health funds, and are we really any nearer to producing a viable product for global use?Proponents of a malaria vaccine promote this technology as a viable way to combat both the current economic and humanitarian burden of malaria and the decreasing efficacy of many front-line antimalaria drug therapies. The recent successful phase IIb trial of the RTS,S/AS02A vaccine showed that the production of a subunit vaccine with significant efficacy is technically possible. The combined efforts and financial commitment of researchers, pharmaceutical companies, and not-for-profit organizations, including the Malaria Vaccines Initiative, have resulted in a significant scaling up in the number of products suitable for testing in humans. In addition, new technologies, such as genetically attenuated vaccines and the exploitation of malaria genomes, offer exciting possibilities for vaccine development. There is now a real possibility of producing a malaria vaccine licensed for public health. However, this positive outlook must be tempered with the challenges facing vaccine development and distribution. The efficacy levels seen with RTS,S/AS02A are well below those of all vaccines currently in use for public health. Furthermore, poor preclinical and clinical predictors of efficacy, allele-specific immunity, and an imperfect understanding of natural and induced immunity to malaria may yet delay (or even prevent) the development of a vaccine suitable for global use.

The development of molecular vaccines against malaria sporozoites.

The successful development of an efficacious molecular vaccine against malaria has long been a major research goal of the Walter Reed Army Institute of Research, the World Health Organization and major international public health agencies. Although this goal has not yet been achieved, immense progress has been made in the area of sporozoite vaccines since the gene encoding the Plasmodium falciparum circumsporozoite (CS) protein was cloned and sequenced in 1984 (Dame et al., 1984). The basis for a subunit approach to sporozoite immunity was established in the early 1970’s in a series of landmark studies demonstrating that mice, primates, and humans could be protected against sporozoite challenge by immunization with radiation-attenuated sporozoites (Nussenzweig et al. 1969; Clyde et al., 1975; Rieckman et al., 1979). These studies demonstrated that protective immunity was species and stage specific, but since large numbers of sporozoites were required for its induction, it was not feasible to develop live attenuated sporozoite vaccines for general use. Moreover, the mechanism of immunity to irradiated sporozoites is complex, and includes the induction of both humoral and cellular immune responses.