Malaria vaccine updates

 Table 1: List of malaria vaccines

Type of Vaccines

Name:

Compositions

Beneficial / Limitations

Pre-erythrocytic vaccines

1.       RTS,S/AS01E

·         Adenovirus (Ad35) vectored circumsporozoite (CS) protein in prime boost with RTS,S/AS01E

·         Multiple epitope constructs (ME-TRAP); a pre-erythrocytic fusion antigen consisting of 17 B-cell, CD4+, CD8+ T cell epitopes of 6 Pf antigens fused to the T9/96 allele of TRAP (Thrombospondin related adhesion protein)

 

·         Only the vaccine in Phase 3 clinical trial

·         Low efficacy but decreases mortality

2.       AdCh63/MVA ME-TRAP

·         Simian Adenovirus (Ad35) encoding ME-TRAP boosted with modified vaccinia virus Ankara (MVA)

 

·         Long lasting CD8+ T cell responses

3.       Polyepitope DNA EP1300

·         DNA vaccine includes multiple epitopes with linker sequences from four pre-erythrocytic antigens CS, SSP2/TRAP, liver stage antigen-1 (LSA-1) and Exported protein-1 (EP-1)

 

·         Immunogenicity is not enhanced in human as compared to animals  

 

4.       PfSPZ

·         Metabolically active non-replicating malaria sporozoite vaccine (Pf sporozoites prepared by thawing from liquid nitrogen)

 

·         Not protective but need to revised in terms of dose and route of administration

 

5.       Genetically Attenuated sporozoites-GAS

 

·         Safe and immunogenic

6.       FP9 CS/MVA CS

·         Attenuated fowl pox strain (FP9) expressing CS protein boosted with MVA coding CS protein

 

·         Didn’t boost the T-cell response

 

7.       DNA CS/MVA CS

·         Plasmid DNA encoding CS protein replace fowl pox strain (FP9) boosted with MVA coding CS protein

 

·         Modest T-cell response

 

8.       RTS,S/AS02 + MVA CS

·         Boosting RTS,S/AS02 with MVA encoding CS

 

·         Greater CMI response

·          

9.       CS DNA Immunization or VCL-2510

·         Gene for full length CS protein in Plasmid DNA

 

·         No anti-CS antibodies

 

10.   MUST DO5

·         Multi-Stage DNA vaccine operation 5 antigens

·         5 antigens; CS, SSP2/TRAP, LSA-1, LSA-3 and EP-1 adjuvanted with GM-CSF (Granulocyte Macrophage colony stimulating factor)

 

·         No efficacy

 

11.   DNA CS / RTS,S/AS02

·         DNA vaccine VCL-2510 containing full length CS gene and adjuvanted with RTS,S/AS02

·         No significant improvement than using alone

 

12.   RTS,S/AS02 TRAP

·         Combination of CS with TRAP

 

·         Improve efficacy

 

13.   HepB Core Ag CS VLP

·         Also called ICC-1132 or Malariavax

·         Hepatis B core antigen modified to include B-cell and 2 CD4+ epitopes of CS protein

 

·         No efficacy to sporozoites

 

14.   PfCS102

·         Chemically synthesized Pf CS protein with C-terminus (Amino acids 282-383)

 

·         Don’t reduce parasitemia

 

15.   FP9/MVA polyprotein

·         Prime Boosting with FP9 and MVA viruses with six antigens polyprotein (STARP, TRAP, LSA-1, LSA-3, Pfs16 and EP-1)

 

·         Low efficacy with sporozoite challenge

 

16.   FMP011/AS01B

·         LAS-1 E. coli expressed evaluated with AS01B and AS02A

 

·         Associated with acute coronary syndrome

 

 

 

Blood Stage (Erythrocytic) vaccines

1.       AdCh63/MVA MSP-1

·         Pf Merozoite Surface Protein-1 (MSP-1) expressed and boosted with AdCh63 and MVA vectors

 

·         Low IgG response

 

2.       FMP010/AS01B

·         E. coli expressing FVO allele 42kD C terminus of MSP-1 and adjuvants AS01B

 

·         Good immunogenicity but inadequate clinical efficacy

 

3.       FMP2.1/AS02A

·         FMP2.1, in which E. coli expressed Apical membrane antigen (AMA-1) and adjuvant AS02A

 

·         Strong Th-2 biased response

 

4.       FMP2.1/AS01B

·         FMP2.1, in which E. coli expressed Apical membrane antigen (AMA-1) and adjuvant AS01B

 

·         Adverse effect (rashes after 18 days of vaccination)

 

5.       AMA-C1/Alhydrogel + CPG 7909

·         Pichia pastoris expressed Apical membrane antigen (AMA-1) with both FVO and 3D7 strains and adjuvants Alhydrogel + CPG 7909

 

·         Reduction of hemoglobin

·          

6.       AdCh63 AMA-1/MVA AMA-1

·         Apical membrane antigen-1 (AMA-1) expressed and boosted with AdCh63 and MVA vectors

 

·         CD4+ responses are higher than CD8+ response

 

7.       EBA175RII

·         Erythrocyte binding antigen (EBA) in merozoites and highly conserved region of Pf

 

·         Safe and immunogenic

 

8.       SERA5

·         Blood stage antigen in trophozoites and schizonts (SE36 expressed in E. coli acts as fragment of SERA5 antigen)

 

·         Safe and 100% seroconversion

 

9.       BSAM-2/Alhydrogel +CPG

·         combination vaccine including MSP1 and AMA1 components. It contains a mixture of recombinant proteins with equal parts P. pastoris expressing FVO and 3D7 strains of AMA1 and E. coli expressing the FVO and 3D7 strains of MSP1.

 

·         Under evaluation

10.   JAIVAC

·         This combination vaccine consists of MSP1 and EBA175, each of which is an E. coli expressed recombinant protein adjuvanted with Montanide ISA 720

 

·         Synergistic effects

11.   GMZ2

·         L. lactis expressed recombinant fusion protein of glutamate rich protein (GLURP) and MSP-3 adjuvanted with Al(OH)3

 

·         Acceptable safety

·         Both IgG and memory B cell response

12.   Combination B (RESA, MSP-1, MSP-2)

13.   FMP1/AS02A

14.   MSP-1-C1/AlOH/AlOH + CPG

15.   MSP2-C1/ISA720

16.   AMA1-C1/ISA720

17.   AMA-FVO

18.   PfCP2.9

 

·         Already terminated (No succeed)

 

 

 

 

Gametocyte (Transmission Blocking) Vaccines

1.       Pfs25

·         Ookinete surface protein Pfs25

·         The antigen preparations including ookinete surface protein Pfs25, and the gametocyte antigens Pfs48/45 and Pfs230 are used in the TBV vaccines. Pfs25 was the first antigen to progress clinically but the reactogenicity was found to be very low.

 

·         Low reactogenicity

2.       Pfs48/45 and Pfs230

·         Contain the gametocyte antigens Pfs48/45 and Pfs230

 

·         Low reactogenicity

 

 

 

 

Combined Vaccines

1.       NMRC-M3V-D/Ad-PfCA Prime/Boost and NMRC-M3V-Ad-PfCA

·         DNA based vaccine containing CS antigen with AMA-1 antigen boosted with Adenovirus-5-vectors

 

·         Increase CD8+ T cell response but no sterile protection

2.       CS AMA1 Virosomes

·         Synthetic peptide vaccines

·         Phosphatidylethanolamine (PE) conjugates on the surface of immunopotentiating reconstituted influenza virosomes (PEV301 and PEV302)

 

·         No sterile protection

3.       SPf66

·         Synthetic polypeptide vaccine consisting of CS and merozoites protein1 (MSP1) epitopes adjuvanted with alum

 

·         Low vaccine efficacy

4.       RTS,S/AS02 (CS) and FMP-1/AS02 (MSP1)

·         Mixing RTS,S/AS02 (CS) and FMP-1/AS02 (MSP1) with both CS and MSP1 antigens

 

·         FMP1 gave no protection in the challenge model

 

 

 

 

P. vivax Vaccines

1.       PvCSP

·         Circumsporozoite protein from P. vivax

 

·         Under clinical trails

2.       ChAd63-MVA PvDBP RII and PvDBP RII/GLA-SE

·         Extracellular, cysteine-rich region II (P. vivax Duffy-binding protein; PvDBP_RII)

 

·         Under clinical trails

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