Concentration and avidity of antibodies to different circumsporozoite epitopes correlate with RTS,S/AS01E malaria vaccine efficacy

Nat Commun. 2019 May 15;10(1):2174. doi: 10.1038/s41467-019-10195-z.

Abstract

RTS,S/AS01E has been tested in a phase 3 malaria vaccine study with partial efficacy in African children and infants. In a cohort of 1028 subjects from one low (Bagomoyo) and two high (Nanoro, Kintampo) malaria transmission sites, we analysed IgG plasma/serum concentration and avidity to CSP (NANP-repeat and C-terminal domains) after a 3-dose vaccination against time to clinical malaria events during 12-months. Here we report that RTS,S/AS01E induces substantial increases in IgG levels from pre- to post-vaccination (p < 0.001), higher in NANP than C-terminus (2855 vs 1297 proportional change between means), and higher concentrations and avidities in children than infants (p < 0.001). Baseline CSP IgG levels are elevated in malaria cases than controls (p < 0.001). Both, IgG magnitude to NANP (hazard ratio [95% confidence interval] 0.61 [0.48-0.76]) and avidity to C-terminus (0.07 [0.05-0.90]) post-vaccination are significantly associated with vaccine efficacy. IgG avidity to the C-terminus emerges as a significant contributor to RTS,S/AS01E-mediated protection.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Africa South of the Sahara
  • Antibodies, Protozoan / blood
  • Antibodies, Protozoan / immunology
  • Antibodies, Protozoan / isolation & purification
  • Antibody Affinity / immunology
  • Antigens, Protozoan / immunology*
  • Epitopes / immunology
  • Female
  • Humans
  • Immunogenicity, Vaccine
  • Infant
  • Malaria Vaccines / immunology*
  • Malaria Vaccines / therapeutic use
  • Malaria, Falciparum / blood
  • Malaria, Falciparum / immunology
  • Malaria, Falciparum / parasitology
  • Malaria, Falciparum / prevention & control*
  • Male
  • Plasmodium falciparum / immunology*
  • Protozoan Proteins / immunology*
  • Treatment Outcome

Substances

  • Antibodies, Protozoan
  • Antigens, Protozoan
  • Epitopes
  • Malaria Vaccines
  • Protozoan Proteins
  • RTS,S-AS01E vaccine
  • circumsporozoite protein, Protozoan