[HTML][HTML] Malaria prevention: from immunological concepts to effective vaccines and protective antibodies

IA Cockburn, RA Seder - Nature immunology, 2018 - nature.com
IA Cockburn, RA Seder
Nature immunology, 2018nature.com
Abstract Development of a malaria vaccine remains a critical priority to decrease clinical
disease and mortality and facilitate eradication. Accordingly, RTS, S, a protein-subunit
vaccine, has completed phase III clinical trials and confers~ 30% protection against clinical
infection over 4 years. Whole-attenuated-sporozoite and viral-subunit vaccines induce
between 20% and 100% protection against controlled human malaria infection, but there is
limited published evidence to date for durable, high-level efficacy (> 50%) against natural …
Abstract
Development of a malaria vaccine remains a critical priority to decrease clinical disease and mortality and facilitate eradication. Accordingly, RTS,S, a protein-subunit vaccine, has completed phase III clinical trials and confers ~30% protection against clinical infection over 4 years. Whole-attenuated-sporozoite and viral-subunit vaccines induce between 20% and 100% protection against controlled human malaria infection, but there is limited published evidence to date for durable, high-level efficacy (>50%) against natural exposure. Importantly, fundamental scientific advances related to the potency, durability, breadth and location of immune responses will be required for improving vaccine efficacy with these and other vaccine approaches. In this Review, we focus on the current understanding of immunological mechanisms of protection from animal models and human vaccine studies, and on how these data should inform the development of next-generation vaccines. Furthermore, we introduce the concept of using passive immunization with monoclonal antibodies as a new approach to prevent and eliminate malaria.
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