1. Phase Ia clinical evaluation of the safety and immunogenicity of the Plasmodium falciparum blood-stage antigen AMA1 in ChAd63 and MVA vaccine vectors
- Author
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Sheehy, S, Duncan, C, Elias, S, Biswas, S, Collins, K, O'Hara, G, Halstead, F, Ewer, K, Mahungu, T, Spencer, A, Miura, K, Poulton, I, Dicks, M, Edwards, N, Berrie, E, Moyle, S, Colloca, S, Cortese, R, Gantlett, K, Long, C, Lawrie, A, Gilbert, S, Doherty, T, Nicosia, A, Hill, A, Draper, S, Sheehy, Sh, Duncan, Cj, Elias, Sc, Biswas, S, Collins, Ka, O'Hara, Ga, Halstead, Fd, Ewer, Kj, Mahungu, T, Spencer, Aj, Miura, K, Poulton, Id, Dicks, Md, Edwards, Nj, Berrie, E, Moyle, S, Colloca, S, Cortese, R, Gantlett, K, Long, Ca, Lawrie, Am, Gilbert, Sc, Doherty, T, Nicosia, Alfredo, Hill, Av, and Draper, Sj
- Subjects
Male ,ADJUVANT VACCINES ,Enzyme-Linked Immunospot Assay ,T-Lymphocytes ,VIRUS ANKARA ,Antibodies, Protozoan ,lcsh:Medicine ,Protozoology ,Malaria, Falciparum ,lcsh:Science ,Vaccination ,Middle Aged ,Infectious Diseases ,Medicine ,Female ,Research Article ,Adult ,RHESUS-MACAQUES ,Adolescent ,Clinical Research Design ,Genetic Vectors ,Plasmodium falciparum ,MALARIA VACCINE ,Antigens, Protozoan ,Vaccinia virus ,NATURAL IMMUNE-RESPONSES ,Microbiology ,complex mixtures ,PARASITE GROWTH ,Interferon-gamma ,Young Adult ,Malaria Vaccines ,parasitic diseases ,Parasitic Diseases ,Animals ,Humans ,Biology ,Life Cycle Stages ,MEROZOITE SURFACE PROTEIN-1 ,lcsh:R ,Immunity ,Tropical Diseases (Non-Neglected) ,IN-VITRO ,Antibodies, Neutralizing ,Malaria ,PRIME-BOOST IMMUNIZATION ,Adenoviruses, Simian ,Parastic Protozoans ,Immunization ,Clinical Immunology ,lcsh:Q ,APICAL MEMBRANE ANTIGEN-1 - Abstract
BACKGROUND: Traditionally, vaccine development against the blood-stage of Plasmodium falciparum infection has focused on recombinant protein-adjuvant formulations in order to induce high-titer growth-inhibitory antibody responses. However, to date no such vaccine encoding a blood-stage antigen(s) alone has induced significant protective efficacy against erythrocytic-stage infection in a pre-specified primary endpoint of a Phase IIa/b clinical trial designed to assess vaccine efficacy. Cell-mediated responses, acting in conjunction with functional antibodies, may be necessary for immunity against blood-stage P. falciparum. The development of a vaccine that could induce both cell-mediated and humoral immune responses would enable important proof-of-concept efficacy studies to be undertaken to address this question. METHODOLOGY: We conducted a Phase Ia, non-randomized clinical trial in 16 healthy, malaria-naïve adults of the chimpanzee adenovirus 63 (ChAd63) and modified vaccinia virus Ankara (MVA) replication-deficient viral vectored vaccines encoding two alleles (3D7 and FVO) of the P. falciparum blood-stage malaria antigen; apical membrane antigen 1 (AMA1). ChAd63-MVA AMA1 administered in a heterologous prime-boost regime was shown to be safe and immunogenic, inducing high-level T cell responses to both alleles 3D7 (median 2036 SFU/million PBMC) and FVO (median 1539 SFU/million PBMC), with a mixed CD4(+)/CD8(+) phenotype, as well as substantial AMA1-specific serum IgG responses (medians of 49 µg/mL and 41 µg/mL for 3D7 and FVO AMA1 respectively) that demonstrated growth inhibitory activity in vitro. CONCLUSIONS: ChAd63-MVA is a safe and highly immunogenic delivery platform for both alleles of the AMA1 antigen in humans which warrants further efficacy testing. ChAd63-MVA is a promising heterologous prime-boost vaccine strategy that could be applied to numerous other diseases where strong cellular and humoral immune responses are required for protection. TRIAL REGISTRATION: ClinicalTrials.gov NCT01095055.
- Published
- 2012