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New immunologic technique prevented malaria reinfection for 2.5 years

Roestenberg M. Lancet. 2011;doi:10.1016/S0140-6736(11)60515-1.

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Immunity against malaria endured for 2.5 years in patients infected with malaria simultaneously being treated with prophylactic chloroquine therapy, according to new study findings published in The Lancet.

“We have shown that immunity to infection with Plasmodium falciparum can be induced experimentally in malaria-naive volunteers through immunization by bites of infected mosquitoes while simultaneously preventing disease with chloroquine prophylaxis,” Meta Roestenberg, MD, of the department of medical biology at Radboud University Medical Center in Nijmegen, Netherlands and colleagues, wrote.

In the open-label, follow-up study, the researchers examined the persistence of protection and immune responses in volunteers induced with bites from five mosquitoes infected with P. falciparum. Malaria-naive volunteers served as infection controls. Primary outcome measure was the detection of blood-stage parasitemia by microscopy.

After 2.5 years, four of the six immune volunteers tested negative after being reinfected with P. falciparum; and real-time quantitative PCR-based detection of blood-stage parasites was negative throughout follow-up. Only mild to moderate adverse events were reported among the four volunteers — most commonly reported symptom was headache.

“If malaria immunity induced by whole parasite is very strain-specific, this could pose major problems for those working on vaccines based on this model,” Brian Greenwood, MD, and Geoffrey Targett, MD, both at the London School of Hygiene and Tropical Medicine, wrote in an accompanying editorial. “If, however, previous exposure to malaria is the explanation for this difference, it will be important to vaccinate early in life in endemic regions before any exposure to naturally acquired infections has happened.”

Disclosure: Dr. Roestenberg and colleagues report no relevant financial disclosures.

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