Malaria vaccines: the case for a whole-organism approach.
BACKGROUND
Malaria is a significant health problem causing morbidity and mortality worldwide. Vaccine development has been an imperative for decades. However, the intricacy of the parasite's lifecycle coupled with the lack of evidence for robust infection-induced immunity has made vaccine development exceptionally difficult.


OBJECTIVE
To review some of the key advances in the field and discuss potential ways forward for a whole-organism vaccine.


METHODS
The authors searched PubMed using the words 'malaria and vaccine'. We searched for manuscripts detailing antigen characterisation and vaccine strategies with emphasis on subunit versus whole-parasite approaches. Abstracts were selected and relevant articles are discussed. The searches were not restricted by language or date.


CONCLUSIONS
The early cloning of malaria antigens has fuelled rapid development of subunit vaccines. However, the disappointing results of clinical trials have resulted in reappraisal of current strategies. Whole-parasite approaches have re-emerged as an alternative strategy. Immunization using radiation or genetically attenuated sporozoites has been shown to result in sterile immunity and immunization with blood-stage parasites curtailed by antimalarials has demonstrated delayed parasitemia in rodent models as well as in human malaria.
Pinzon-Charry
Alberto
A
PO Royal Brisbane Hospital, Queensland Institute of Medical Research, Molecular Immunology Laboratory, Brisbane 4029, Australia.
Good
Michael F
MF
D000818:Animals; D000953:Antigens, Protozoan / Q000235:genetics; D015195:Drug Design; D006801:Humans; D017780:Malaria Vaccines; D010961:Plasmodium / Q000276:immunology*; D033761:Spores, Protozoan / Q000276:immunology; D022223:Vaccines, Subunit
D000953:Antigens, Protozoan; D017780:Malaria Vaccines; D022223:Vaccines, Subunit