title: Developing vaccines to prevent malaria in pregnant women.
abstract: BACKGROUND
  Placental malaria (PM) is a major public health problem that constitutes a significant health concern for the mother, and especially for the developing fetus and offspring. Current means of prevention have limitations, including a restricted window of intervention that excludes the first trimester of pregnancy, and the fact that very few drugs can be used for this purpose. The identification of the VAR2CSA antigen, specific to PM parasites, offers an excellent opportunity to develop a vaccine against this disease. Proof of concept of a first-generation vaccine is nearing completion, and two clinical trials are underway.
  
  
  METHODS
  This review focuses on PM, which is mainly caused by Plasmodium falciparum. The review highlights recent advances and the key milestones that led to the identification of the optimal vaccine target within the large VAR2CSA protein. The paper also points out how future improvements can strengthen this process to achieve an effective vaccine in the field.
  
  
  CONCLUSIONS
  The approach taken to develop a P. falciparum erythrocyte membrane protein 1-based vaccine to protect pregnant women is very promising in view of the current difficulties of achieving a sterilizing vaccine against malaria parasite. This approach could help us to control the deleterious effect of malaria infections that characterize severe clinical forms.
authors.affiliation: IRD, UMR216 , 4 avenue de l'observatoire, Paris 75006 , France Philippe.Deloron@ird.fr.
authors.forename: Nicaise
authors.initials: N
authors.lastname: Tuikue-Ndam
authors.forename: Phillipe
authors.initials: P
authors.lastname: Deloron
mesh_terms: D000953:Antigens, Protozoan / Q000276:immunology / Q000378:metabolism; D055808:Drug Discovery / Q000639:trends*; D005260:Female; D006801:Humans; D017780:Malaria Vaccines / Q000008:administration & dosage*; D016778:Malaria, Falciparum / Q000276:immunology / Q000517:prevention & control*; D010920:Placenta / Q000187:drug effects / Q000276:immunology; D010963:Plasmodium falciparum / Q000187:drug effects*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000517:prevention & control*
chemical_list: D000953:Antigens, Protozoan; D017780:Malaria Vaccines; C512601:VAR2CSA protein, Plasmodium falciparum
keywords: PfEMP1; Plasmodium falciparum; VAR2CSA; malaria; pregnancy; vaccine