Safety, tolerability, and antibody responses in humans after sequential immunization with a PfCSP DNA vaccine followed by the recombinant protein vaccine RTS,S/AS02A

• DOI: 10.1016/j.vaccine.2004.01.031
• Publication Date: 2004-02-13T10:06:52Z
• Authors: Judith E Epstein; Yupin Charoenvit; Kent E Kester; Ruobing Wang; Rhonda Newcomer; Steve Fitzpatrick; Thomas L Richie; Nadia Tornieporth; D.Gray Heppner; Chris Ockenhouse; Victoria Majam; Carolyn Holland; Esteban Abot; Harini Ganeshan; Mara Berzins; Trevor Jones; C.Nicole Freydberg; Jennifer Ng; Jon Norman; Daniel J Carucci; Joe Cohen; Stephen L Hoffman
• Keywords: Adult; Male; 0301 basic medicine; B-Lymphocytes; Vaccines, Synthetic; 0303 health sciences; Hepatitis B Surface Antigens; Adolescent; T-Lymphocytes; Plasmodium falciparum; Spores, Protozoan; Antibodies, Protozoan; 3. Good health; 03 medical and health sciences; Malaria Vaccines; Vaccines, DNA; Animals; Humans; Female; Hepatitis B Antibodies; Immunization Schedule

Optimal protection against malaria may require induction of high levels of protective antibody and CD8(+) and CD4(+) T cell responses. In humans, malaria DNA vaccines elicit CD8(+) cytotoxic T cells (CTL) and IFNgamma responses as measured by short-term (ex vivo) ELISPOT assays, and recombinant proteins elicit antibodies and excellent T cell responses, but no CD8(+) CTL or CD8(+) IFNgamma-producing cells as measured by ex vivo ELISPOT. Priming with DNA and boosting with recombinant pox virus elicits much better T cell responses than DNA alone, but not antibody responses. In an attempt to elicit antibodies and enhanced T cell responses, we administered RTS,S/AS02A, a partially protective Plasmodium falciparum recombinant circumsporozoite protein (CSP) vaccine in adjuvant, to volunteers previously immunized with a P. falciparum CSP DNA vaccine (VCL-2510) and to naïve volunteers. This vaccine regimen was well tolerated and safe. The volunteers who received RTS,S/AS02A alone had, as expected, antibody and CD4(+) T cell responses, but no CD8(+) T cell responses. Volunteers who received PfCSP DNA followed by RTS,S/AS02A had antibody and CD8(+) and CD4(+) T cell responses (Wang et al., submitted). Sequential immunization with DNA and recombinant protein, also called heterologous prime-boost, led to enhanced immune responses as compared to DNA or recombinant protein alone, suggesting that it might provide enhanced protective immunity.