Impacts of Ecology, Parasite Antigenic Variation, and Human Genetics on RTS,S/AS01e Malaria Vaccine Efficacy.
Impacts of Ecology, Parasite Antigenic Variation, and Human Genetics on RTS,S/AS01e Malaria Vaccine Efficacy.
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DOI：
10.1007/s40471-021-00271-8
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发表时间：
2021
影响因子：
3.3
通讯作者：
Bailey JA
中科院分区：
文献类型：
--
作者：
Bell GJ;Agnandji ST;Asante KP;Ghansah A;Kamthunzi P;Emch M;Bailey JA
如果没有有效的疫苗，全球消除疟疾的成功机会微乎其微。第一种疟疾疫苗 RTS,S/AS01e 在 III 期试验中表现出对临床疟疾的中等功效，并且正在非洲进行大规模有效性试验。重要的是，该疫苗在 III 期研究地点之间的表现并不相同。尽管功效中等和这种变化的原因尚不清楚，但已经提出了多种机制。本综述总结了有关此类机制的最新文献，重点关注涉及景观生态、寄生虫抗原变异和人类宿主遗传差异的文献。传播强度可能在疫苗接种前和疫苗接种后调节对疫苗的免疫反应中发挥作用。此外，生活在高传播强度环境中的接种疫苗人群中，疟疾发病率可能会“反弹”。越来越多的证据表明，寄生虫环子孢子蛋白的遗传变异和人类宿主遗传因素的变异都会影响 RTS,S 疫苗的功效。这些遗传因素可能以复杂的方式相互作用，导致自然免疫反应和疫苗诱导的免疫反应发生变化，从而预防疟疾。由于 RTS,S/AS01e 的功效有限，必须清楚地了解影响其有效性的因素（生态、寄生虫、人类宿主）的组合，因为这些信息对于实施政策和未来的疫苗设计至关重要。
Global malaria elimination has little chance of success without an effective vaccine. The first malaria vaccine, RTS,S/AS01e, demonstrated moderate efficacy against clinical malaria in phase III trials and is undergoing large-scale effectiveness trials in Africa. Importantly, the vaccine did not perform equally well between phase III study sites. Though reasons for the moderate efficacy and this variation are unclear, various mechanisms have been suggested. This review summarizes the recent literature on such mechanisms, with a focus on those involving landscape ecology, parasite antigenic variation, and human host genetic differences. Transmission intensity may have a role pre- and post-vaccination in modulating immune responses to the vaccine. Furthermore, malaria incidence may “rebound” in vaccinated populations living in high transmission intensity settings. There is growing evidence that both genetic variation in the parasite circumsporozoite protein and variation of human host genetic factors affect RTS,S vaccine efficacy. These genetic factors may be interacting in complex ways to produce variation in the natural and vaccine-induced immune responses that protect against malaria. Due to the modest efficacy of RTS,S/AS01e, the combinations of factors (ecological, parasite, human host) impacting its effectiveness must be clearly understood, as this information will be critical for implementation policy and future vaccine designs.
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影响因子：
3.8
作者：
Farmer P;Almazor CP;Bahnsen ET;Barry D;Bazile J;Bloom BR;Bose N;Brewer T;Calderwood SB;Clemens JD;Cravioto A;Eustache E;Jérôme G;Gupta N;Harris JB;Hiatt HH;Holstein C;Hotez PJ;Ivers LC;Kerry VB;Koenig SP;Larocque RC;Léandre F;Lambert W;Lyon E;Mekalanos JJ;Mukherjee JS;Oswald C;Pape JW;Gretchko Prosper A;Rabinovich R;Raymonville M;Réjouit JR;Ronan LJ;Rosenberg ML;Ryan ET;Sachs JD;Sack DA;Surena C;Suri AA;Ternier R;Waldor MK;Walton D;Weigel JL
通讯作者：
Weigel JL
影响因子：
3
作者：
Depinay, JMO;Mbogo, CM;McKenzie, FE
通讯作者：
McKenzie, FE
影响因子：
168.9
作者：
Feachem, Richard G. A.;Phillips, Allison A.;Targett, Geoffrey A.;Snow, Robert W.
通讯作者：
Snow, Robert W.
DOI：
10.1084/jem.20101488
发表时间：
2011-02-14
期刊：
The Journal of experimental medicine
影响因子：
--
作者：
Coppi A;Natarajan R;Pradel G;Bennett BL;James ER;Roggero MA;Corradin G;Persson C;Tewari R;Sinnis P
通讯作者：
Sinnis P
影响因子：
3.7
作者：
Ansong, Daniel;Asante, Kwaku P.;Owusu-Agyei, Seth
通讯作者：
Owusu-Agyei, Seth