Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Hum Vaccin Immunother. 2020;16(1):33-41. doi: 10.1080/21645515.2019.1643675. Epub 2019 Aug 15.
: RTS,S/AS01 is currently the most advanced malaria vaccine but provides incomplete, short-term protection. It was developed for use within the expanded program on immunizations (EPI) for African children. Another use could be adding mass RTS,S/AS01 vaccination to the integrated malaria elimination strategy in the Greater Mekong Subregion (GMS), where multidrug-resistant strains have emerged and spread. Prior to evaluating RTS,S/AS01 in large-scale trials we assessed whether the vaccine, administered with and without antimalarial drugs, is safe and immunogenic in Asian populations.: An open-label, randomized, controlled phase 2 trial was conducted in healthy, adult Thai volunteers. Seven vaccine regimens with and without antimalarial drugs (dihydroartemisinin-piperaquine plus a single low dose primaquine) were assessed. Antibody titres against the CSP full-length (NANP) 6, CSP anti-C-term, CSP full-length (N + C-Terminal) were measured by standard enzyme-linked immunosorbent assays. Liquid chromatography was used to measure piperaquine, primaquine and carboxy-primaquine concentrations.: 193 volunteers were enrolled and 186 study participants completed the 6 months follow-up period. One month after the last vaccination all study participants had seroconverted to the CSP (NANP)6, and the CSP Full Length (N + C-Terminal). More than 90% had seroconverted to the anti-C-Term CSP. There was no indication that drug concentrations were influenced by vaccine regimens or the antibody levels by the drug regimens. Adverse events were similarly distributed between the seven treatment groups. No serious adverse events attributable to the study interventions were detected.: This study found that RTS,S/AS01 with and without dihydroartemisinin-piperaquine plus a single low dose primaquine was safe and immunogenic in a healthy, adult Asian population.
RTS,S/AS01 是目前最先进的疟疾疫苗,但提供的保护并不完整且持续时间短。它是为非洲儿童扩大免疫规划(EPI)开发的。另一种用途是在大湄公河次区域(GMS)将大规模 RTS,S/AS01 疫苗接种添加到综合疟疾消除战略中,那里已经出现并传播了耐多药株。在进行大规模试验评估 RTS,S/AS01 之前,我们评估了在亚洲人群中,无论是否使用抗疟药物,疫苗单独或联合使用的安全性和免疫原性。
一项在健康成年泰国志愿者中进行的开放标签、随机、对照 2 期试验。评估了 7 种疫苗方案,包括是否使用抗疟药物(双氢青蒿素-哌喹加单次低剂量伯氨喹)。使用标准酶联免疫吸附试验测量针对全长 CSP(NANP)6、CSP 抗 C 末端、全长 CSP(N + C 末端)的抗体滴度。使用液相色谱法测量哌喹、伯氨喹和羧基伯氨喹的浓度。
共纳入 193 名志愿者,186 名研究参与者完成了 6 个月的随访期。最后一次接种后 1 个月,所有研究参与者均对 CSP(NANP)6 和全长 CSP(N + C 末端)产生血清转化。超过 90%的人对 C 末端 CSP 产生血清转化。没有迹象表明药物浓度受疫苗方案影响,也没有证据表明药物方案影响抗体水平。不良事件在七个治疗组之间分布相似。未发现与研究干预措施相关的严重不良事件。
这项研究发现,在健康的成年亚洲人群中,无论是否联合使用双氢青蒿素-哌喹加单次低剂量伯氨喹,RTS,S/AS01 均安全且具有免疫原性。
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