title: Efficacy of recombinant circumsporozoite protein vaccine regimens against experimental Plasmodium falciparum malaria.
abstract: After initial successful evaluation of the circumsporozoite-based vaccine RTS,S/SBAS2, developed by SmithKline Beecham Biologicals with the Walter Reed Army Institute of Research, protective efficacy of several regimens against Plasmodium falciparum challenge was determined. A controlled phase 1/2a study evaluated 1 or 2 standard doses of RTS,S/SBAS2 in 2 groups whose members received open-label therapy and 3 immunizations in blinded groups who received standard, one-half, or one-fifth doses. RTS,S/SBAS2 was safe and immunogenic in all groups. Of the 41 vaccinees and 23 control subjects who underwent sporozoite challenge, malaria developed in 7 of 10 who received 1 dose, in 7 of 14 who received 2 doses, in 3 of 6 who received 3 standard doses, in 3 of 7 who received 3 one-half doses, in 3 of 4 who received 3 one-fifth doses, and in 22 of 23 control subjects. Overall protective efficacy of RTS,S/SBAS2 was 41% (95% confidence interval, 22%-56%; P=.0006). This and previous studies have shown that 2 or 3 doses of RTS,S/SBAS2 protect against challenge with P. falciparum sporozoites.
authors.affiliation: Dept. of Immunology, Walter Reed Army Institute of Research, 503 Robert Grant Ave., Silver Spring, MD 20910, USA. kent.kester@na.amedd.army.mil
authors.forename: K E
authors.initials: KE
authors.lastname: Kester
authors.forename: D A
authors.initials: DA
authors.lastname: McKinney
authors.forename: N
authors.initials: N
authors.lastname: Tornieporth
authors.forename: C F
authors.initials: CF
authors.lastname: Ockenhouse
authors.forename: D G
authors.initials: DG
authors.lastname: Heppner
authors.forename: T
authors.initials: T
authors.lastname: Hall
authors.forename: U
authors.initials: U
authors.lastname: Krzych
authors.forename: M
authors.initials: M
authors.lastname: Delchambre
authors.forename: G
authors.initials: G
authors.lastname: Voss
authors.forename: M G
authors.initials: MG
authors.lastname: Dowler
authors.forename: J
authors.initials: J
authors.lastname: Palensky
authors.forename: J
authors.initials: J
authors.lastname: Wittes
authors.forename: J
authors.initials: J
authors.lastname: Cohen
authors.forename: W R
authors.initials: WR
authors.lastname: Ballou
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D005260:Female; D006801:Humans; D008213:Lymphocyte Activation; D017780:Malaria Vaccines / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology; D016778:Malaria, Falciparum / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010963:Plasmodium falciparum / Q000276:immunology*; D015800:Protozoan Proteins / Q000235:genetics / Q000276:immunology*; D011994:Recombinant Proteins / Q000276:immunology; D014614:Vaccines, Synthetic / Q000008:administration & dosage / Q000276:immunology
chemical_list: D000913:Antibodies, Protozoan; D017780:Malaria Vaccines; D015800:Protozoan Proteins; D011994:Recombinant Proteins; D014614:Vaccines, Synthetic; C041595:circumsporozoite protein, Protozoan