Background malaria incidence and parasitemia during the three-dose RTS,S/AS01 vaccination series do not reduce magnitude of antibody response nor efficacy against the first case of malaria.
Background malaria incidence and parasitemia during the three-dose RTS,S/AS01 vaccination series do not reduce magnitude of antibody response nor efficacy against the first case of malaria.
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DOI：
10.1186/s12879-023-08699-7
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发表时间：
2023-10-23
影响因子：
3.7
通讯作者：
Bailey, Jeffrey A.
中科院分区：
文献类型：
--
作者：
Bell, Griffin J.;Gyaase, Stephaney;Goel, Varun;Adu, Bright;Mensah, Benedicta;Essone, Paulin;Dosoo, David;Osei, Musah;Niare, Karamoko;Wiru, Kenneth;Brandt, Katerina;Emch, Michael;Ghansah, Anita;Asante, Kwaku Poku;Mvalo, Tisungane;Agnandji, Selidji Todagbe;Juliano, Jonathan J.;Bailey, Jeffrey A.
世卫组织建议在中至高度疟疾传播环境中广泛实施RTS、S/AS01。以前的分析指出，在较高的传播环境中，疫苗效力较低，可能是由于对照组自然获得性免疫发展较快。为了研究疫苗接种免疫反应降低是高传播地区疫苗效力降低背后的潜在机制，我们使用2009-2014年第三阶段试验(NCT00866619)的三个研究地区(加纳金坦波、马拉维利隆圭和加蓬兰巴莱内)的数据，检查了针对首例疟疾病例的初始疫苗抗体(抗CSP IgG)反应和疫苗效力(以排除自然获得免疫的影响)。我们的主要接触是接种系列疫苗期间的寄生虫血症和背景疟疾发病率。我们使用COX比例风险模型计算疫苗效力(1减去风险比)，并考虑到RTS的时变效应，S/AS01。我们发现，加纳对初级三剂疫苗接种系列的抗体反应高于马拉维和加蓬，但对首例疟疾病例的抗体水平和疫苗效力都不会因初级接种系列期间的背景发病率或寄生虫血症而变化。我们发现，疫苗效力与接种过程中的感染无关。我们的结果加剧了相互矛盾的文献，我们的结果表明，疫苗效力也与接种前的感染无关，这意味着控制组免疫可能是高传播环境下效力较低的主要原因，而不是对RTS的免疫反应减少，S/AS01。尽管还需要进一步的研究，但这对于在高传输环境中的实施可能是令人放心的。网上版载有补充材料，可在10.1186/s12879-023-08699-7查阅。
RTS,S/AS01 has been recommended by WHO for widespread implementation in medium to high malaria transmission settings. Previous analyses have noted lower vaccine efficacies in higher transmission settings, possibly due to the more rapid development of naturally acquired immunity in the control group. To investigate a reduced immune response to vaccination as a potential mechanism behind lower efficacy in high transmission areas, we examine initial vaccine antibody (anti-CSP IgG) response and vaccine efficacy against the first case of malaria (to exclude the effect of naturally acquired immunity) using data from three study areas (Kintampo, Ghana; Lilongwe, Malawi; Lambaréné, Gabon) from the 2009–2014 phase III trial (NCT00866619). Our key exposures are parasitemia during the vaccination series and background malaria incidence. We calculate vaccine efficacy (one minus hazard ratio) using a cox-proportional hazards model and allowing for the time-varying effect of RTS,S/AS01. We find that antibody responses to the primary three-dose vaccination series were higher in Ghana than in Malawi and Gabon, but that neither antibody levels nor vaccine efficacy against the first case of malaria varied by background incidence or parasitemia during the primary vaccination series. We find that vaccine efficacy is unrelated to infections during vaccination. Contributing to a conflicting literature, our results suggest that vaccine efficacy is also unrelated to infections before vaccination, meaning that control-group immunity is likely a major reason for lower efficacy in high transmission settings, not reduced immune responses to RTS,S/AS01. This may be reassuring for implementation in high transmission settings, though further studies are needed. The online version contains supplementary material available at 10.1186/s12879-023-08699-7.
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DOI：
10.1073/pnas.1702944114
发表时间：
2017-11-07
影响因子：
11.1
作者：
Bustamante LY;Powell GT;Lin YC;Macklin MD;Cross N;Kemp A;Cawkill P;Sanderson T;Crosnier C;Muller-Sienerth N;Doumbo OK;Traore B;Crompton PD;Cicuta P;Tran TM;Wright GJ;Rayner JC
通讯作者：
Rayner JC
影响因子：
3.3
作者：
Bell GJ;Agnandji ST;Asante KP;Ghansah A;Kamthunzi P;Emch M;Bailey JA
通讯作者：
Bailey JA
影响因子：
6.4
作者：
Bell, Griffin J.;Goel, Varun;Emch, Michael
通讯作者：
Emch, Michael
影响因子：
9.3
作者：
Ubillos, Itziar;Ayestaran, Aintzane;Dobano, Carlota
通讯作者：
Dobano, Carlota
影响因子：
5.5
作者：
Nielsen CM;Vekemans J;Lievens M;Kester KE;Regules JA;Ockenhouse CF
通讯作者：
Ockenhouse CF