Malaria, a disease caused by the parasite Plasmodium, is one of the world's major infectious diseases. With approximately 627.000 deaths a year, it is both a chief cause of morbidity and mortality as well as a significant contribution to ongoing poverty in endemic countries. Ultimately, the key to malaria control, and hopefully eradication, would be an effective vaccine. Though a number of vaccine-candidates have entered the pipeline of pre-clinical and clinical development, they have yet to achieve the level of efficacy necessary for effective malaria prevention. It has been shown previously that if healthy human volunteers taking chloroquine chemoprophylaxis are repeatedly exposed to Plasmodium parasites through the bites of infected mosquitoes, they are fully protected against a later challenge infection with a 'homologous' (genetically similar) Plasmodium parasite. This process is known as ChemoProphylaxis and Sporozoites, or CPS-immunization. One of the obstacles to developing an effective vaccine is the genetic heterogeneity of malaria parasites. To further consider the development of whole-parasite based vaccines against malaria and in order to better understand the protective immunity induced by CPS-immunization, it is essential to investigate whether heterologous protection against genetically diverse (heterologous) P. falciparum clones can be induced. This is a single center, randomized, double-blind study to determine whether healthy volunteers immunized with P. falciparum NF54 parasites under chloroquine prophylaxis are protected against a challenge infection with the genetically distinct NF135.C10 or NF166.C8 P. falciparum clones.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
40
Subjects will be exposed 3 times to bites from 15 NF54 Plasmodium infected mosquitoes during each immunization, while taking chloroquin prophylaxis.
Subjects will receive bites from 5 Anopheles mosquitoes infected with Plasmodium falciparum NF135.C10 sporozoites.
Subjects will receive bites from 5 Anopheles mosquitoes infected with Plasmodium falciparum NF166.C8 sporozoites.
Subjects will receive bites from 5 Anopheles mosquitoes infected with Plasmodium falciparum NF54 sporozoites.
All participants will be treated with atovaquone/proguanil when they develop a malaria infection or on day 28 after malaria challenge infection.
Radboud university medical center
Nijmegen, Gelderland, Netherlands
Parasitemia
The effectiveness of CPS-immunization with NF54 sporozoites to protect against malaria challenge infection with heterologous NF135.C10 or NF166.C8 sporozoites will be determined by the time to parasitemia in immunized versus non-immunized volunteers after the challenge infection.
Time frame: day 1 - 28 after malaria challenge infection
Antigen specificity of CPS-immunization induced antibodies against P. falciparum
Blood will be drawn to isolate plasmablast for further delineation of the antibody responses following CPS-immunization.
Time frame: 6-10 days after challenge infection
Specificity of CPS-immunization induced T-cell responses against P. falciparum
Blood will be drawn to isolate monocytes and T cells, which will be used to determine the activity of T cells against specific target antigens of the pre-erythrocytic stages of Plasmodium falciparum.
Time frame: 14 days after each CPS-immunization
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