[HTML][HTML] A next-generation genetically attenuated Plasmodium falciparum parasite created by triple gene deletion

SA Mikolajczak, V Lakshmanan, M Fishbaugher… - Molecular therapy, 2014 - cell.com
SA Mikolajczak, V Lakshmanan, M Fishbaugher, N Camargo, A Harupa, A Kaushansky
Molecular therapy, 2014cell.com
Immunization with live-attenuated Plasmodium sporozoites completely protects against
malaria infection. Genetic engineering offers a versatile platform to create live-attenuated
sporozoite vaccine candidates. We previously generated a genetically attenuated parasite
(GAP) by deleting the P52 and P36 genes in the NF54 wild-type (WT) strain of Plasmodium
falciparum (Pf p52−/p36− GAP). Preclinical assessment of p52−/p36− GAP in a humanized
mouse model indicated an early and severe liver stage growth defect. However, human …
Immunization with live-attenuated Plasmodium sporozoites completely protects against malaria infection. Genetic engineering offers a versatile platform to create live-attenuated sporozoite vaccine candidates. We previously generated a genetically attenuated parasite (GAP) by deleting the P52 and P36 genes in the NF54 wild-type (WT) strain of Plasmodium falciparum (Pf p52/p36 GAP). Preclinical assessment of p52/p36 GAP in a humanized mouse model indicated an early and severe liver stage growth defect. However, human exposure to >200 Pf p52/p36 GAP-infected mosquito bites in a safety trial resulted in peripheral parasitemia in one of six volunteers, revealing that this GAP was incompletely attenuated. We have now created a triple gene deleted GAP by additionally removing the SAP1 gene (Pf p52/p36/sap1 GAP) and employed flippase (FLP)/flippase recognition target (FRT) recombination for drug selectable marker cassette removal. This next-generation GAP was indistinguishable from WT parasites in blood stage and mosquito stage development. Using an improved humanized mouse model transplanted with human hepatocytes and human red blood cells, we show that despite a high-dose sporozoite challenge, Pf p52/p36/sap1 GAP did not transition to blood stage infection and appeared to be completely attenuated. Thus, clinical testing of Pf p52/p36/sap1 GAP assessing safety, immunogenicity, and efficacy against sporozoite challenge is warranted.
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