Developing vaccines to prevent malaria in pregnant women

Abstract

Introduction: 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.

Areas covered: 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.

Expert opinion: 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.

Keywords:

• malaria
• PfEMP1
• Plasmodium falciparum
• pregnancy
• vaccine
• VAR2CSA

Declaration of interest

The authors have undertaken studies in the context of the STOPPAM, ‘Strategies To Prevent Pregnancy Associated Malaria’ and the PLACMALVAC projects ‘Clinical development of a VAR2CSA-based placental malaria vaccine’. STOPPAM and PLACMALVAC are Small & Medium Scale Collaborative Projects supported by the European 7th Framework Programme, contract numbers 200889 and 304815. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Notes

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