Measuring naturally acquired immune responses to candidate malaria vaccine antigens in Ghanaian adults

<p>Abstract</p> <p>Background</p> <p>To prepare field sites for malaria vaccine trials, it is important to determine baseline antibody and T cell responses to candidate malaria vaccine antigens. Assessing T cell responses is especially challenging, given genetic restriction, low responses observed in endemic areas, their variability over time, potential suppression by parasitaemia and the intrinsic variability of the assays.</p> <p>Methods</p> <p>In Part A of this study, antibody titres were measured in adults from urban and rural communities in Ghana to recombinant <it>Plasmodium falciparum </it>CSP, SSP2/TRAP, LSA1, EXP1, MSP1, MSP3 and EBA175 by ELISA, and to sporozoites and infected erythrocytes by IFA. Positive ELISA responses were determined using two methods. T cell responses to defined CD8 or CD4 T cell epitopes from CSP, SSP2/TRAP, LSA1 and EXP1 were measured by <it>ex vivo </it>IFN-γ ELISpot assays using HLA-matched Class I- and DR-restricted synthetic peptides. In Part B, the reproducibility of the ELISpot assay to CSP and AMA1 was measured by repeating assays of individual samples using peptide pools and low, medium or high stringency criteria for defining positive responses, and by comparing samples collected two weeks apart.</p> <p>Results</p> <p>In Part A, positive antibody responses varied widely from 17%-100%, according to the antigen and statistical method, with blood stage antigens showing more frequent and higher magnitude responses. ELISA titres were higher in rural subjects, while IFA titres and the frequencies and magnitudes of e<it>x vivo </it>ELISpot activities were similar in both communities. DR-restricted peptides showed stronger responses than Class I-restricted peptides. In Part B, the most stringent statistical criteria gave the fewest, and the least stringent the most positive responses, with reproducibility slightly higher using the least stringent method when assays were repeated. Results varied significantly between the two-week time-points for many participants.</p> <p>Conclusions</p> <p>All participants were positive for at least one malaria protein by ELISA, with results dependent on the criteria for positivity. Likewise, ELISpot responses varied among participants, but were relatively reproducible by the three methods tested, especially the least stringent, when assays were repeated. However, results often differed between samples taken two weeks apart, indicating significant biological variability over short intervals.</p

UN Peace operations and conflicting legitimacies

Analyses of UN peacekeeping increasingly consider legitimacy a key factor for success, conceiving of it as a resource that operations should seek and use in the pursuit of their goals. However, these analyses rarely break down legitimacy by source. Because the UN is an organization with multiple identities and duties however, different legitimacy sources—in particular output and procedural legitimacy—and the UN’s corresponding legitimation practices come into conflict in the context of peacekeeping. Drawing on a range of examples and a specific case of the UN mission in Congo, this article argues that looking at different legitimacy sources and linking them to the institutional identity of the UN is thus critical and it shows how the UN’s in contradictory legitimation practices can reduce overall legitimacy perceptions

Evaluation of larvicides for the control of simulium damnosum s.l. (diptera: simuliidae) in west africa

The Onchocerciasis Control Program of the World Health Organisation is carrying out an extensive screening program in a search for new larvicides to be used for control of Simulium damnosum s.l. Emphasis has been given to finding a pyrethroid and a carbamate to supplement the organophosphates currently in use. These Chemicals with differing modes of action, together with Bacillus thuringiensis H-14, are being used in an attempt to cope with the development and spread of resistance to the organophosphates temephos and chlorphoxim

Safety and Immunogenicity of EBA-175 RII-NG Malaria Vaccine Administered Intramuscularly in Semi-Immune Adults: A Phase 1, Double-Blinded Placebo Controlled Dosage Escalation Study

<div><p>The erythrocyte binding antigen region II (EBA-175 RII) is a <i>Plasmodium falciparum</i> ligand that mediates erythrocyte invasion and is considered an important malaria vaccine candidate. A phase Ia trial in malaria naïve adults living in the United States found the recombinant non-glycosylated vaccine antigen, EBA-175 RII-NG adjuvanted with aluminium phosphate to be safe, immunogenic and capable of inducing biologically active antibodies that can inhibit parasite growth <i>in vitro</i>. The aim of the current study was to assess the safety and immunogenicity of this vaccine in malaria exposed semi-immune healthy adults living in a malaria endemic country, Ghana. In this double-blinded, placebo controlled, dose escalation phase I trial, eighteen subjects per group received ascending dose concentrations (5 μg, 20 μg or 80 μg) of the vaccine intramuscularly at 0, 1 and 6 months, while 6 subjects received placebo (normal saline). The primary end point was the number of subjects experiencing Grade 3 systemic or local adverse events within 14 days post-vaccination. Serious adverse events were assessed throughout the study period. Blood samples for immunological analyses were collected at days 0, 14, 28, 42, 180 and 194. A total of 52 subjects received three doses of the vaccine in the respective groups. No serious adverse events were reported. The majority of all adverse events reported were mild to moderate in severity, with local pain and tenderness being the most common. All adverse events, irrespective of severity, resolved without any sequelae. Subjects who received any of the EBA-175 RII-NG doses had high immunoglobulin G levels which moderately inhibited <i>P</i>. <i>falciparum</i> growth <i>in vitro</i>, compared to those in the placebo group. In conclusion, the EBA-175 RII-NG vaccine was safe, well tolerated and immunogenic in malaria semi-immune Ghanaian adults. Its further development is recommended.</p><p>Trial registration</p><p>ClinicalTrials.gov. Identifier: <a href="https://clinicaltrials.gov/ct2/show/NCT01026246" target="_blank">NCT01026246</a></p></div

Proportion of subjects with 4-fold increase from baseline in anti-EBA175 antibody response.

<p>Proportion of subjects with 4-fold increase from baseline in anti-EBA175 antibody response.</p