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A statistical interaction between circumsporozoite protein-specific T cell and antibody responses and risk of clinical malaria episodes following vaccination with RTS,S/AS01E.

Abstract
The candidate malaria vaccine RTS,S/AS01(E) provides significant but partial protection from clinical malaria. On in vitro circumsporozoite protein (CSP) peptide stimulation and intra-cellular cytokine staining of whole blood taken from 407 5-17 month-old children in a phase IIb trial of RTS,S/AS01(E), we identified significantly increased frequencies of two CSP-specific CD4+ T cells phenotypes among RTS,S/AS01(E) vaccinees (IFNγ-IL2+TNF- and IFNγ-IL2+TNF+ CD4+ T cells), and increased frequency of IFNγ-IL2-TNF+ CD4+ T cells after natural exposure. All these T cells phenotypes were individually associated with reductions in the risk of clinical malaria, but IFNγ-IL2-TNF+ CD4+ T cells independently predicted reduced risk of clinical malaria on multi-variable analysis (HR = 0.29, 95% confidence intervals 0.15-0.54, p<0.0005). Furthermore, there was a strongly significant synergistic interaction between CSP-specific IFNγ-IL2-TNF+ CD4+ T cells and anti-CSP antibodies in determining protection against clinical malaria (p = 0.002). Vaccination strategies that combine potent cellular and antibody responses may enhance protection against malaria.
AuthorsFrancis M Ndungu, Jedidah Mwacharo, Domtila Kimani, Oscar Kai, Philippe Moris, Erik Jongert, Johan Vekemans, Ally Olotu, Philip Bejon
JournalPloS one (PLoS One) Vol. 7 Issue 12 Pg. e52870 ( 2012) ISSN: 1932-6203 [Electronic] United States
PMID23300801 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Antibodies, Protozoan
  • Cytokines
  • Malaria Vaccines
  • Protozoan Proteins
  • RTS,S-AS01E vaccine
  • circumsporozoite protein, Protozoan
Topics
  • Antibodies, Protozoan (blood)
  • Antibody Formation
  • CD4-Positive T-Lymphocytes (immunology, metabolism)
  • CD8-Positive T-Lymphocytes (immunology, metabolism)
  • Clinical Trials, Phase II as Topic
  • Cytokines (blood)
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Malaria Vaccines
  • Malaria, Falciparum (blood, immunology, prevention & control)
  • Plasmodium falciparum (immunology)
  • Proportional Hazards Models
  • Protozoan Proteins (immunology, metabolism)
  • Randomized Controlled Trials as Topic
  • Risk
  • Sporozoites (immunology)
  • Vaccination

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