A vaccine to combat malaria is a highly desirable public health tool to reduce morbidity and mortality in African children. In order to achieve this goal it will be important to gain a detailed understanding of both the nature of the immune response to the current vaccine candidates as well as the immunological status of individuals living in areas in African where malaria is endemic. Over the reporting period this project represented a collaborative effort between Dr. Pierce, Dr. Louis Miller and his colleague, Dr. Siddartha Mahanty, Malaria Vaccine Development Unit (MVDU), and Drs. Peter Lipsky and Amrie Grammer, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). The immune response at the cellular level was evaluated in individuals in the U.S. enrolled in a clinical trial of the Plasmodium falciparum vaccine candidate, AMA-1 on alum, and in African adults enrolled in a parallel study in Mali. To evaluate the immune status of these individuals, advantage was taken of new and emerging information concerning the function of discrete subsets of lymphocytes in immune responses and the availability of serological reagents to identify these. The B cell antibody response to malaria is believed to be central to the control of parasite infections and thus our initial studies focused on a characterization of B cells in the peripheral blood of individuals enrolled in phase 1 vaccine clinical trials in the U.S. and in Africa. Peripheral blood cells were analyzed by flow cytometry for the B cell markers CD19, CD27, and CD38. Fluorescently labeled AMA-1 was used to identify antigen-specific B cells. Cells were analyzed prior to vaccination and at days 3, 7 and 14 following the primary immunization and the secondary immunization (given either 28 or 56 days after the primary). The results showed that the percentage of CD19+ B cells did not change in response to vaccination. However, the number of plasma cells defined as CD27+ and CD38+ and either CD19+ on CD19-, showed an increase between 7 and 14 days after the first vaccination and 3 days after the second vaccination. The effect of vaccination was also mirrored in an increase in the number of memory B cells, defined as CD27+ cells, 3 to 7 days after both the primary and secondary immunization. Preliminary results indicate that the number of antigen-specific memory B cells increased in the periphery after the primary but not after the secondary immunization. Parallel analyses of the B cells in Africans enrolled in a similar study are in progress. These results are encouraging indicating that discrete changes in relevant B cell subpopulations can be detected in response to vaccination. These changes may ultimately provide important new parameters to monitor the efficacy of vaccines and guide future vaccine strategies. At present, there is little known about the immunological status at the cellular level of the target population for the vaccine, namely children, in Africa chronically infected with malaria. A detailed analysis of the immune cells in the peripheral blood of chronically infected individuals and a comparison of their profiles with that of nonimmune and vaccinated individuals should provide important new information concerning the repercussion of malaria infection on the immune system and the impact of those effects on the potential to respond to current vaccine candidates. We propose to characterize the peripheral blood cells of children and adults in areas in Africa where malaria is endemic. The analyses will be carried out longitudinally correlating the levels of parasitemia and the immune cell profile in individuals.
