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  • Evaluation of the Efficacy ...
    Hodgson, Susanne H.; Ewer, Katie J.; Bliss, Carly M.; Edwards, Nick J.; Rampling, Thomas; Anagnostou, Nicholas A.; de Barra, Eoghan; Havelock, Tom; Bowyer, Georgina; Poulton, Ian D.; de Cassan, Simone; Longley, Rhea; Illingworth, Joseph J.; Douglas, Alexander D.; Mange, Pooja B.; Collins, Katharine A.; Roberts, Rachel; Gerry, Stephen; Berrie, Eleanor; Moyle, Sarah; Colloca, Stefano; Cortese, Riccardo; Sinden, Robert E.; Gilbert, Sarah C.; Bejon, Philip; Lawrie, Alison M.; Nicosia, Alfredo; Faust, Saul N.; Hill, Adrian V. S.

    The Journal of infectious diseases, 04/2015, Letnik: 211, Številka: 7
    Journal Article

    Background. Circumsporozoite protein (CS) is the antigenic target for RTS, S, the most advanced malaria vaccine to date. Heterologous prime-boost with the viral vectors simian adenovirus 63 (ChAd63)-modified vaccinia virus Ankara (MVA) is the most potent inducer of T-cells in humans, demonstrating significant efficacy when expressing the preerythrocytic antigen insert multiple epitope-thrombospondin-related adhesion protein (ME-TRAP). We hypothesized that ChAd63-MVA containing CS may result in a significant clinical protective efficacy. Methods. We conducted an open-label, 2-site, partially randomized Plasmodium falciparum sporozoite controlled human malaria infection (CHMI) study to compare the clinical efficacy of ChAd63-MVA CS with ChAd63-MVA ME-TRAP. Results. One of 15 vaccinées (7%) receiving ChAd63-MVA CS and 2 of 15 (13%) receiving ChAd63-MVA METRAP achieved sterile protection after CHMI. Three of 15 vaccinées (20%) receiving ChAd63-MVA CS and 5 of 15 (33%) receiving ChAd63-MVA ME-TRAP demonstrated a delay in time to treatment, compared with unvaccinated controls. In quantitative polymerase chain reaction analyses, ChAd63-MVA CS was estimated to reduce the liver parasite burden by 69%-79%, compared with 79%-84% for ChAd63-MVA ME-TRAP. Conclusions. ChAd63-MVA CS does reduce the liver parasite burden, but ChAd63-MVA ME-TRAP remains the most promising antigenic insert for a vectored liver-stage vaccine. Detailed analyses of parasite kinetics may allow detection of smaller but biologically important differences in vaccine efficacy that can influence future vaccine development. Clinical Trials Registration. NCT01623557.