Sporozoite immunization of human volunteers under mefloquine prophylaxis is safe, immunogenic and protective: a double-blind randomized controlled clinical trial.

oleh: Else M Bijker, Remko Schats, Joshua M Obiero, Marije C Behet, Geert-Jan van Gemert, Marga van de Vegte-Bolmer, Wouter Graumans, Lisette van Lieshout, Guido J H Bastiaens, Karina Teelen, Cornelus C Hermsen, Anja Scholzen, Leo G Visser, Robert W Sauerwein

Format: Article
Diterbitkan: Public Library of Science (PLoS) 2014-01-01

Deskripsi

Immunization of healthy volunteers with chloroquine ChemoProphylaxis and Sporozoites (CPS-CQ) efficiently and reproducibly induces dose-dependent and long-lasting protection against homologous Plasmodium falciparum challenge. Here, we studied whether chloroquine can be replaced by mefloquine, which is the only other licensed anti-malarial chemoprophylactic drug that does not affect pre-erythrocytic stages, exposure to which is considered essential for induction of protection by CPS immunization. In a double blind randomized controlled clinical trial, volunteers under either chloroquine prophylaxis (CPS-CQ, nā€Š=ā€Š5) or mefloquine prophylaxis (CPS-MQ, nā€Š=ā€Š10) received three sub-optimal CPS immunizations by bites from eight P. falciparum infected mosquitoes each, at monthly intervals. Four control volunteers received mefloquine prophylaxis and bites from uninfected mosquitoes. CPS-MQ immunization is safe and equally potent compared to CPS-CQ inducing protection in 7/10 (70%) versus 3/5 (60%) volunteers, respectively. Furthermore, specific antibody levels and cellular immune memory responses were comparable between both groups. We therefore conclude that mefloquine and chloroquine are equally effective in CPS-induced immune responses and protection. Trial registration: ClinicalTrials.gov NCT01422954.