Safety and immunogenicity of an AMA-1 malaria vaccine in Malian adults: results of a phase 1 randomized controlled trial.
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Thera Mahamadou A, Doumbo Ogobara K, Coulibaly Drissa, Diallo Dapa A, Kone Abdoulaye K, Guindo Ando B, Traore Karim, Dicko Alassane, Sagara Issaka, Sissoko Mahamadou S, Baby Mounirou, Sissoko Mady, Diarra Issa, Niangaly Amadou, Dolo Amagana, Daou Modibo, Diawara Sory I, Heppner D Gray, Stewart V Ann, Angov Evelina, Bergmann-Leitner Elke S, Lanar David E, Dutta Sheetij, Soisson Lorraine, Diggs Carter L, Leach Amanda, Owusu Alex, Dubois Marie-Claude, Cohen Joe, Nixon Jason N, Gregson Aric, Takala Shannon L, Lyke Kirsten E, Plowe Christopher V
Аннотация
METHODOLOGY/PRINCIPAL FINDINGS: A phase 1 double blind randomized controlled dose escalation trial was conducted in Bandiagara, Mali, West Africa, a rural town with intense seasonal transmission of Plasmodium falciparum malaria. The malaria vaccine FMP2.1/AS02A is a recombinant protein (FMP2.1) based on apical membrane antigen-1 (AMA-1) from the 3D7 clone of P. falciparum, adjuvanted with AS02A. The comparator vaccine was a cell-culture rabies virus vaccine (RabAvert). Sixty healthy, malaria-experienced adults aged 18-55 y were recruited into 2 cohorts and randomized to receive either a half dose or full dose of the malaria vaccine (FMP2.1 25 microg/AS02A 0.25 mL or FMP2.1 50 microg/AS02A 0.5 mL) or rabies vaccine given in 3 doses at 0, 1 and 2 mo, and were followed for 1 y. Solicited symptoms were assessed for 7 d and unsolicited symptoms for 30 d after each vaccination. Serious adverse events were assessed throughout the study. Titers of anti-AMA-1 antibodies were measured by ELISA and P. falciparum growth inhibition assays were performed on sera collected at pre- and post-vaccination time points. Transient local pain and swelling were common and more frequent in both malaria vaccine dosage groups than in the comparator group. Anti-AMA-1 antibodies increased significantly in both malaria vaccine groups, peaking at nearly 5-fold and more than 6-fold higher than baseline in the half-dose and full-dose groups, respectively.
CONCLUSION/SIGNIFICANCE: The FMP2.1/AS02A vaccine had a good safety profile, was well-tolerated, and was highly immunogenic in malaria-exposed adults. This malaria vaccine is being evaluated in Phase 1 and 2 trials in children at this site.