Varying Immunizations With Plasmodium Radiation-Attenuated Sporozoites Alter Tissue-Specific CD8+ T Cell Dynamics.

Whole sporozoite vaccines represent one of the most promising strategies to induce protection against malaria. However, the development of efficient vaccination protocols still remains a major challenge. To understand how the generation of immunity is affected by variations in vaccination dosage and frequency, we systematically analyzed intrasplenic and intrahepatic CD8+ T cell responses following varied immunizations of mice with radiation-attenuated sporozoites. By combining experimental data and mathematical modeling, our analysis indicates a reversing role of spleen and liver in the generation of protective liver-resident CD8+ T cells during priming and booster injections: While the spleen acts as a critical source compartment during priming, the increase in vaccine-induced hepatic T cell levels is likely due to local reactivation in the liver in response to subsequent booster injections. Higher dosing accelerates the efficient generation of liver-resident CD8+ T cells by especially affecting their local reactivation. In addition, we determine the differentiation and migration pathway from splenic precursors toward hepatic memory cells thereby presenting a mechanistic framework for the impact of various vaccination protocols on these dynamics. Thus, our work provides important insights into organ-specific CD8+ T cell dynamics and their role and interplay in the formation of protective immunity against malaria.

Application of gamma irradiation knowledge in tissue sterilisation: inactivation of malaria parasite.

Malaria is one of the exclusion criteria used in selecting tissue donors and the absence of this information can lead to rejection of tissues for transplant. The studies on the malaria parasite have been confined to low dose attenuation of parasites in blood for transfusion purposes. There is no published information relating to the inactivation of malaria parasites with irradiation for the sterilisation of tissues. A dose-surviving parasite population following radiation was replotted using D0 value from a published paper whereby D10 value of 41 Gy was obtained. Calculation of sterilisation dose for achieving SAL 10-6 of malaria parasites demonstrated the effectiveness of the sterilisation dose of 25 kGy being used in tissue banking.

Vaccination using radiation- or genetically attenuated live sporozoites.

The attenuation of Plasmodium parasites by either radiation or targeted gene deletion can result in viable sporozoites that invade the liver and subsequently arrest. The death of the growth-arrested liver stage parasite and the ensuing recognition by the immune system of parasite antigens promotes protective immunity in immunized mice and humans. The methods described below will enable researchers to determine the efficacy of radiation-attenuated and genetically attenuated rodent malaria sporozoite immunizations against infectious sporozoite challenge, and study protective immunity in immunized mice. In addition, by determining the time of arrest of genetically attenuated parasite liver stages and the mechanisms of clearance, researchers will be able to correlate biological features of the growth-arrested parasites with their ability to promote protective immunity.

Targeting Plasmodium liver stages: better late than never.

The worldwide burden of malaria can be substantially reduced using existing public health interventions. However, elimination of Plasmodium will require fundamentally different approaches. Novel experimental attenuation strategies for active immunization using knockout strains have recently stimulated renewed interest in whole-parasite vaccine approaches. Preventive drug administration during transmission of wild-type sporozoites is a complementary strategy for eliciting protective immune responses. These whole-cell immunization strategies are based on one fundamental principle: inducing protection by blocking parasite conversion from the clinically silent liver phase to the pathogenic intra-erythrocytic replication cycle. Here, we review the basis, evidence and targets for whole-cell-based vaccination strategies against the liver stage bottleneck in Plasmodium infections and discuss preclinical and clinical research opportunities.

Conserved protective mechanisms in radiation and genetically attenuated uis3(-) and uis4(-) Plasmodium sporozoites.

Immunization with radiation attenuated Plasmodium sporozoites (RAS) elicits sterile protective immunity against sporozoite challenge in murine models and in humans. Similarly to RAS, the genetically attenuated sporozoites (GAPs) named uis3(-), uis4(-) and P36p(-) have arrested growth during the liver stage development, and generate a powerful protective immune response in mice. We compared the protective mechanisms in P. yoelii RAS, uis3(-) and uis4(-) in BALB/c mice. In RAS and GAPs, sterile immunity is only achieved after one or more booster injections. There were no differences in the immune responses to the circumsporozoite protein (CSP) generated by RAS and GAPs. To evaluate the role of non-CSP T-cell antigens we immunized antibody deficient, CSP-transgenic BALB/c mice, that are T cell tolerant to CSP, with P. yoelii RAS or with uis3(-) or uis4(-) GAPs, and challenged them with wild type sporozoites. In every instance the parasite liver stage burden was approximately 3 logs higher in antibody deficient CSP transgenic mice as compared to antibody deficient mice alone. We conclude that CSP is a powerful protective antigen in both RAS and GAPs viz., uis3(-) and uis4(-) and that the protective mechanisms are similar independently of the method of sporozoite attenuation.

Hitting malaria before it hurts: attenuated Plasmodium liver stages.

Continuous natural exposure to Plasmodium transmission by infectious Anopheles mosquitoes leads to a gradual acquisition of immunological competence against malaria. The partial immunity, observed in adolescents and adults living in endemic areas, reduces morbidity and mortality without preventing parasite infection. In experimental animal models, long-lasting sterilizing immunity can be achieved with genetically attenuated Plasmodium liver stages. Can these findings be translated to accomplish sterile protection against natural malaria transmission in the high-risk group, young infants in sub-Saharan Africa?

Hepatic stages of malaria: specific and non-specific factors inhibiting the development.

Protection against pre-erythrocytic stages of malaria is possible, as demonstrated by the resistance obtained by immunizing with irradiated sporozoites. However, the involved mechanisms are more numerous and intricate than previously believed. Recently, the hepatic stage, rather than the sporozoite stage, has been seen as the target of immune attack.

In vivo induction of the nitric oxide pathway in hepatocytes after injection with irradiated malaria sporozoites, malaria blood parasites or adjuvants.

The mechanisms responsible for malarial immunity induced by repetitive injections of X-irradiated sporozoites have not been fully established. We demonstrate here that a single injection of irradiated sporozoites induced, as soon as 24 h after, a non-permissive state to hepatocyte reinfection with sporozoites in vitro. The same effect was observed when malarial blood forms, irradiated promastigotes of Leishmania infantum, adjuvants (muramyl dipeptide, poly acidylic uridylic) or interferon-gamma was injected. Activation of the nitric oxide (NO) pathway in the hepatocyte by these factors was found to be responsible for hepatocyte refractory status. Additionally, this metabolic pathway is involved in protection given by repeated injections of irradiated sporozoites since protection could be reversed by treating mice at the time of sporozoite challenge with a competitive inhibitor (NG-monomethyl-L-arginine) of the NO pathway. These results suggest that, in view of an antisporozoite vaccine, further studies are needed to find out how to activate specifically a long-lasting nonspecific immune response.

Inability of Plasmodium vinckei-immune spleen cells to transfer protection to recipient mice exposed to vaccine 'vectors' or heterologous species of plasmodium.

Mice can be immunized to Plasmodium vinckei by repeated infections followed by cure. Such immunity is dependent on CD4 T cells and an architecturally modified spleen, but has little requirement for antibody. Thus, athymic mice can be exposed to P. vinckei and cured, but do not develop immunity. They are resistant to challenge with parasites, however, if they are then given spleen cells from euthymic immunized animals. Such immune spleen cells, however, cannot transfer resistance to normal mice which have been exposed to BCG, Salmonella typhimurium, or vaccinia virus, and are only partially effective in transferring resistance to mice which have been previously immunized with heterologous plasmodia, P. yoelii, P. chabaudi and P. berghei. Mice exposed to varying numbers of irradiated P. vinckei-pRBC do not develop immunity and nor are such animals protected following adoptive transfer of immune spleen cells. Cellular immunity to malaria may not only be dependent on a population of immune CD4 T cells, but may require a specifically architecturally modified spleen which may not occur following either exposure to candidate vaccine vectors, heterologous plasmodia or non-viable homologous plasmodia.

Physical characterization of histidine-rich protein from Plasmodium lophurae.

The size and shape of Plasmodium lophurae histidine-rich protein have been determined by analytical centrifugation and electron microscopy. From the partial specific volume of 0.72 cc/g, the molecular weight was determined to be 43,000. The sedimentation velocity studies indicated a coefficient of 1.32 S in 0.9 M acetic acid (pH 3.5), monodispersity and significant asymmetry. Darkfield electron microscopy revealed the major species to be compact oblate spheroids 12 nm in width and extended filamentous particles of average length 35 nm by 1.5 nm. Analysis of the sequence of the protein by the method of Garnier et al. (J. Mol. Biol. (1978) 120, 97-120) predicted that 82% of its residues would be found in three long alpha-helices. The protein's CD spectrum has a strong resemblance to that of poly(L-histidine) at pH 4-5, where the homopolymer is thought to be in a right-handed alpha-helical form. A single helix containing 300 residues would be 45 nm long, the largest length found by electron microscopy. From the electron-microscopic data, sedimentation coefficients of 1.6 and 1.95 S, respectively, were calculated for flexible-coil and extended-rod models, in closer agreement with the measured value of 1.3 S than the value calculated for a spherical model. Thus, the major species in acetic acid is probably an incompletely extended rod which, as the pH is increased to neutrality, condenses to form spherical molecular aggregates seen in the malaria parasite.

Effect of irradiation on Plasmodium sporozoites depends on the species of hepatocyte infected.

The use of models such as rodents immunized with irradiated rodent malaria sporozoites can be helpful in defining the hepatic antigens which elicit a protective response. After "normal" penetration into the hepatocyte, and "normal" transformation, into trophozoites, irradiated sporozoites are known to begin development, but abort after a period of time that depends on the dose of radiation received. Experiments performed with cultured rat, mouse and Thamnomys gazellae hepatocytes infected with Plasmodium yoelii sporozoites demonstrated that the amount of radiation necessary to totally block the passage from the uninuclear to the multinuclear form differs for each species of hepatocyte. These results underline the problem posed by the models used in malaria research.

Plasmodium yoelii: induction of attenuated mutants by irradiation.

When erythrocytic forms of Plasmodium yoelii nigeriensis, which is invariably fatal in mice, were exposed to X rays, the dose to reduce surviving parasites to one millionth was 100 gray (10 Krad). A suspension of 5 X 10(6) per ml of parasitized erythrocyte was irradiated at 100 gray, and 0.2 ml aliquots were inoculated into 22 mice. Eleven mice showed patent parasitemia, and in these the growth curves were less steep than that found in nonirradiated parasites. The infections of 8 mice of the 11 were self-resolving, and the attenuated feature of the parasites maintained following a limited number of blood passages. The parasites were slowly growing even in nude mice and cause self-resolving infections in intact mice. BALB/c mice immunized with the attenuated parasites were protected against subsequent challenge infections with the original virulent erythrocytic and sporogonic forms. These findings indicate that attenuated mutants of malaria parasites can be readily induced by this method.

Development of sporozoite vaccines.

Protective immunity against malaria has been achieved in hosts ranging from birds to man by repeated inoculation of irradiated sporozoites. The main antigens involved in protective immunity to sporozoites are the circumsporozoite (CS) proteins, which are part of a family of proteins, covering the whole surface membrane of the parasite, and which have similar physico-chemical and antigenic properties. Monovalent fragments of monoclonal antibodies to CS proteins neutralize sporozoite infectivity. All monoclonal antibodies recognize a single immunodominant region within the various CS proteins, and this region contains repetitive epitopes. The recurrent immunodominant epitope of the CS protein of P. knowlesi has been identified, and shown to consist of 12 tandemly repeated subunits of 12 amino acids. The dimer of the dodecapeptide was coupled to protein carriers, emulsified in Freund's complete adjuvant, and injected into rodents and monkeys. All animals made anti-peptide antibodies, and most of the antisera reacted with P. knowlesi CS protein.

Vaccination of chicks against Plasmodium gallinaceum by erythrocytic and exoerythrocytic parasites attenuated by gamma irradiation.

Plasmodium gallinaceum-infected blood which received up to 24 krad during exposure to gamma-rays from a cobalt-60 source produced infections of normal course and duration when injected into chickens. The prepatent period advanced with increasing exposure of infected blood to radiation, suggesting some degree of attenuation. At 26, 28 and 30 krad, the infections were transient and the parasites were morphologically abnormal. It is thought that the amount of radiation required to render the parasites non-viable is about 45 krad for an inoculum of 10(6) parasites. There is evidence that exoerythrocytic stages may be more susceptible to gamma-rays than are blood parasites. Chickens were inoculated three times, over a period of four weeks, with vaccines prepared from gamma-irradiated infected blood and brain tissue. Half the birds which had been inoculated with attenuated parasitized blood exhibited mild infections during vaccination, and they were the only birds to show at challenge immunity to both homologous blood and exoerythrocytic parasites.

Recent advances in applied malaria immunology.

Our present knowledge of cellular and humoral factors which are involved in immunity to plasmodial infections are discussed. Immunization against plasmodial infection has been achieved in birds, rodents, simians, and humans. Avian hosts have been immunized against gametocytes which resulted in inhibition of gametocytes within the mosquito vector. Immunization of humans against plasmodial gametocytes would indirectly protect them against malaria by blocking mosquito transmission to other susceptible individuals. Immunization by sporozoites provides short-lived protection against sporozoite challenge, but gives no protection against erythrocytic forms. Some success has been obtained in immunizing avian and mammalian hosts with exoerythrocytic forms obtained from cultured avian cells. The most significant advances have occurred in immunizing simian hosts against simian or human malaria by vaccinating with fresh erythrocytic merozoites or a nonviable lyophilized antigen obtained from intraerythrocytic forms. The development of an antigen preparation suitable for use as a human malaria vaccine is dependent upon prior development of an in vitro system which would provide adequate amounts of parasite material. Efforts to cultivate the sporogonic, exoerythrocytic, and erythrocytic, and erythrocytic phases of plasmodia as well as the feasibility of using these forms for vaccination are discussed.