Based on this observation, we explored the potential for developing a bivalent malaria-typhoid vaccine through chemical conjugation of Vi polysaccharide antigen to a malaria antigen
Based on this observation, we explored the potential for developing a bivalent malaria-typhoid vaccine through chemical conjugation of Vi polysaccharide antigen to a malaria antigen. For this initial effort, we conjugated transmission blocking vaccine antigen, Pfs25, to Vi polysaccharide. fever. Keywords: Malaria, Pfs25, Transmission blocking vaccine, Vi capsular polysaccharide, Typhoid fever, Conjugate vaccine 1.?Introduction Malaria and typhoid fever are co-endemic in large parts of the world, particularly in tropical areas [1C3]. Despite significant control efforts, approximately 21 million typhoid cases and 222 000 typhoid-related deaths were reported in 2014 [3], while 214 million malaria cases and 438 000 malaria-related deaths were reported in 2015 [4]. Typhoid fever results from Typhi infection transmitted through contaminated water and food [5]. Malaria is a parasitic infection transmitted by female mosquito [6]. Though the source and route of these two infections are different, their prevalence has significant regional overlap in Africa and other tropical countries, and disproportionately affect children under 5 years of age [7,8]. In co-endemic regions, malaria infection may enhance susceptibility to typhoid fever, and co-infection may lead to misdiagnosis due to similar symptoms [9C11]. Currently, two typhoid vaccines, Vi capsular polysaccharide vaccine (Typhim Vi?) and oral live attenuated vaccine (type b (Hib) vaccine, the first conjugate vaccine licensed in 1987 [12C14]. Conjugation technology has CP 471474 enabled the development of more immunogenic typhoid conjugate vaccines. Two Vi-TT (Tetanus Toxoid) conjugate vaccines, Typbar TCV? (Bharat Biotech) and Peda Typh? (Bio-Med), have been licensed and marketed in India [15,16], while Vi-rEPA (recombinant ExoProtein A), [17C19], Vi-DT (diphtheria toxoid) [20,21], and Vi-CRM197 (nontoxic mutant of diphtheria toxin) are being evaluated for use in infants and children [22]. In studies exploring the immunogenicity of Vi conjugated to carrier proteins such as PspA (pneumococcal surface protein A), HBsAg (Hepatitis B virus surface antigen) and DT (Diphtheria Toxoid), all proteins were found to enhance the antibody response to Vi. Interestingly, conjugation also enhanced immune responses to PspA and HBsAg but not DT [23,24]. These findings suggested the potential of Vi conjugation to enhance responses to some protein antigens. Based on this observation, we explored development of a bivalent conjugate vaccine against both typhoid fever and malaria. Malaria vaccine development CP 471474 has been hindered by the complexity of the parasite and its life cycle, as well as poor immunogenicity of many malaria antigens. The most advanced malaria vaccine candidate is a pre-erythrocytic vaccine called RTS,S, CP 471474 which is a virus-like particle formulated in AS01 adjuvant. RTS,S has demonstrated partial efficacy against clinical malaria in infants and young children in Phase 3 trials that wanes with time [25]. Other major vaccine efforts against malaria include pre-erythrocytic whole organism vaccines, blood stage vaccines, and transmission blocking vaccines (TBV) [26C29]. TBV have received increased attention owing to renewed interest in malaria elimination and eradication. TBV antigens are expressed in the mosquito stages of the parasite life cycle and induce antibodies that, when taken up by mosquitoes during blood meals, can prevent mosquito infection SAPK3 and subsequent transmission [30]. TBV might be developed as stand-alone products, or can be combined with components that prevent human infection as vaccines to interrupt malaria transmission (VIMT) [31]. Among the antigens identified as targets for TBV, Pfs25 has CP 471474 been the most extensively studied vaccine candidate and has received most attention for clinical development [32,33]. Pfs25 is poorly immunogenic and strategies to enhance immunogenicity have included conjugation to carrier proteins [34,35] or Outer Membrane Vesicles [36], and incorporation in virus like particles [37] or.