Ellis Ruth D, Sagara Issaka, Doumbo Ogobara, Wu Yimin
Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, USA.
Hum Vaccin. 2010 Aug;6(8):627-34. doi: 10.4161/hv.6.8.11446.
Since the recent call for a shift from malaria control to eradication, the role of asexual blood stage vaccines for falciparum malaria, which are not expected to prevent infection, has become less clear. However, blood stage antigens remain likely to be a critical component of a highly effective malaria vaccine. The inclusion of a blood stage component in a multistage malaria vaccine would not only prevent disease caused by “leaky” pre-erythrocytic immunity, but would also protect against epidemics in newly vulnerable populations. Recent clinical results of blood stage vaccine candidates have shown strain specific and partial efficacy, although no protection against clinical outcomes has been demonstrated in experimental infection or field trials to date. The current status of Plasmodium falciparum blood stage vaccine development is summarized and the potential role of these vaccines in the changed malaria landscape is discussed. Alternative preclinical and clinical development paths will speed iterative development.
自从最近呼吁从疟疾控制转向根除疟疾以来，恶性疟原虫无性血液阶段疫苗的作用变得不那么明确了，这类疫苗预计无法预防感染。然而，血液阶段抗原仍可能是高效疟疾疫苗的关键组成部分。在多阶段疟疾疫苗中加入血液阶段成分，不仅可以预防由“渗漏性”的红细胞前期免疫所导致的疾病，还能保护新出现的易感染人群免受疫情影响。尽管迄今为止在实验性感染或现场试验中尚未证明血液阶段候选疫苗对临床结果有保护作用，但近期的临床结果显示出了菌株特异性和部分疗效。本文总结了恶性疟原虫血液阶段疫苗的研发现状，并讨论了这些疫苗在不断变化的疟疾形势中的潜在作用。替代的临床前和临床开发路径将加速迭代开发。
