Experimental infection and protection against ... - TI Pharma

Experimental infection and protection against ... - TI Pharma Experimental infection and protection against ... - TI Pharma

31.08.2013 Views

Long-term protection against malaria after experimental sporozoite inoculation 201 Figure 2. Trial profile. Timelines of previous immunisation study in grey. stained with IQTest CD45RO-phycoerythrin Texas Red (Beckman-Coulter), PerCP anti-human CD3 (BioLegend, San Diego, CA, USA) and PE-Cy7 anti-human CD62L (eBioscience) for 20 min at 4°C. After washing, cells were incubated for 15 min at 4°C with fixation Medium A (Caltag, S. San Francisco, CA, USA), washed and stained with FITC anti-human IFNγ (eBioscience) and APC anti-human IL-2 (eBioscience) in permeabilization Medium B (Caltag) for 20 min at 4°C. 100,000 events in the lymphocyte gate, based on forward- and side-scatter, were acquired on a CyAn ADP 9-color flow cytometer (Beckman-Coulter). Flow cytometry analysis was performed using FlowJo software version 9.1. Analysis was performed on CD3+ T cells and effector memory (EM) T cells. The IFNγ and IL-2 gates were set based on negative control samples. Statistical analysis Data analysis was performed using SPSS software version 16.0. Differences in cellular immune responses between subjects in the vaccine group and control group were analyzed by the Mann–Whitney-U test. The correlation between peak temperature and peak d-dimer values was assessed by Pearson correlation analysis. A two-sided P value of less than 0.05 was considered to indicate statistical significance.

202 Chapter 10 Figure 3. Mean number of adverse events per volunteer. Data from controls in black (n=5), volunteers that showed delayed patency in red (n=2) and protected volunteers in green (n=4). Only adverse events possibly or probably related to malaria are included. Results All ten volunteers previously immunised and protected against an experimental malaria infection, were contacted 32 months after the first immunisation [9]. Six of these volunteers passed screening for eligibility and were included in the current follow-up study. Three out of four excluded volunteers were unavailable and one had to be excluded because of a family history of myocardial infarction (second degree relative under 55 years of age). Five healthy volunteers were newly recruited as a control group. Figure 2 shows the trial profile. Eleven volunteers were challenged by the bites of five Pf-infected mosquitoes and all completed follow-up. The average age of participating volunteers was 23.6 years (range 21-28 years old), of whom four were male. Four controls and one immunised volunteer had previously (range 6 months to 9 years) travelled in malaria endemic areas during which time they all used malaria prophylaxis, none of the volunteers was a previous resident of a malaria endemic area. None of the volunteers reported having used antimalarials within the past 6 months and none showed positive serology for Pf. When re-challenged according to the standard protocol by bites of five infected mosquitoes, four out of six of the immunised volunteers never developed bloodstage parasitemia by microscopy during daily follow-up. One of these volunteers requested presumptive treatment with anti-malarials on day 14 post-infection for reasons unrelated to the trial. The remaining two volunteers showed a markedly delayed patent parasitemia on days 15 and 18, respectively.

Long-term <strong>protection</strong> <strong>against</strong> malaria after experimental sporozoite inoculation 201<br />

Figure 2. Trial profile. Timelines of previous immunisation study in grey.<br />

stained with IQTest CD45RO-phycoerythrin Texas Red (Beckman-Coulter), PerCP<br />

anti-human CD3 (BioLegend, San Diego, CA, USA) <strong>and</strong> PE-Cy7 anti-human CD62L<br />

(eBioscience) for 20 min at 4°C. After washing, cells were incubated for 15 min at<br />

4°C with fixation Medium A (Caltag, S. San Francisco, CA, USA), washed <strong>and</strong><br />

stained with FITC anti-human IFNγ (eBioscience) <strong>and</strong> APC anti-human IL-2<br />

(eBioscience) in permeabilization Medium B (Caltag) for 20 min at 4°C. 100,000<br />

events in the lymphocyte gate, based on forward- <strong>and</strong> side-scatter, were<br />

acquired on a CyAn ADP 9-color flow cytometer (Beckman-Coulter). Flow<br />

cytometry analysis was performed using FlowJo software version 9.1. Analysis<br />

was performed on CD3+ T cells <strong>and</strong> effector memory (EM) T cells. The IFNγ <strong>and</strong><br />

IL-2 gates were set based on negative control samples.<br />

Statistical analysis<br />

Data analysis was performed using SPSS software version 16.0. Differences in<br />

cellular immune responses between subjects in the vaccine group <strong>and</strong> control<br />

group were analyzed by the Mann–Whitney-U test. The correlation between<br />

peak temperature <strong>and</strong> peak d-dimer values was assessed by Pearson correlation<br />

analysis. A two-sided P value of less than 0.05 was considered to indicate<br />

statistical significance.

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