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Controlled human malaria infection by intramuscular and direct venous inoculation of cryopreserved Plasmodium falciparum sporozoites in malaria-naïve volunteers: effect of injection volume and dose on infectivity rates
Controlled human malaria infection (CHMI) by mosquito bite is a powerful tool for evaluation of vaccines and drugs against Plasmodium falciparum malaria. However, only a small number of research centres have the facilities required to perform such studies. CHMI by needle and syringe could help to ac...
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Published in: | Malaria journal 2015-08, Vol.14 (1), p.306, Article 306 |
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creator | Gómez-Pérez, Gloria P Legarda, Almudena Muñoz, Jose Sim, B Kim Lee Ballester, María Rosa Dobaño, Carlota Moncunill, Gemma Campo, Joseph J Cisteró, Pau Jimenez, Alfons Barrios, Diana Mordmüller, Benjamin Pardos, Josefina Navarro, Mireia Zita, Cecilia Justino Nhamuave, Carlos Arlindo García-Basteiro, Alberto L Sanz, Ariadna Aldea, Marta Manoj, Anita Gunasekera, Anusha Billingsley, Peter F Aponte, John J James, Eric R Guinovart, Caterina Antonijoan, Rosa M Kremsner, Peter G Hoffman, Stephen L Alonso, Pedro L |
description | Controlled human malaria infection (CHMI) by mosquito bite is a powerful tool for evaluation of vaccines and drugs against Plasmodium falciparum malaria. However, only a small number of research centres have the facilities required to perform such studies. CHMI by needle and syringe could help to accelerate the development of anti-malaria interventions by enabling centres worldwide to employ CHMI.
An open-label CHMI study was performed with aseptic, purified, cryopreserved P. falciparum sporozoites (PfSPZ Challenge) in 36 malaria naïve volunteers. In part A, the effect of the inoculation volume was assessed: 18 participants were injected intramuscularly (IM) with a dose of 2,500 PfSPZ divided into two injections of 10 µL (n = 6), 50 µL (n = 6) or 250 µL (n = 6), respectively. In part B, the injection volume that resulted in highest infectivity rates in part A (10 µL) was used to formulate IM doses of 25,000 PfSPZ (n = 6) and 75,000 PfSPZ (n = 6) divided into two 10-µL injections. Results from a parallel trial led to the decision to add a positive control group (n = 6), each volunteer receiving 3,200 PfSPZ in a single 500-µL injection by direct venous inoculation (DVI).
Four/six participants in the 10-µL group, 1/6 in the 50-µL group and 2/6 in the 250-µL group developed parasitaemia. Geometric mean (GM) pre-patent periods were 13.9, 14.0 and 15.0 days, respectively. Six/six (100%) participants developed parasitaemia in the 25,000 and 75,000 PfSPZ IM and 3,200 PfSPZ DVI groups. GM pre-patent periods were 12.2, 11.4 and 11.4 days, respectively. Injection of PfSPZ Challenge was well tolerated and safe in all groups.
IM injection of 75,000 PfSPZ and DVI injection of 3,200 PfSPZ resulted in infection rates and pre-patent periods comparable to the bite of five PfSPZ-infected mosquitoes. Remarkably, it required 23.4-fold more PfSPZ administered IM than DVI to achieve the same parasite kinetics. These results allow for translation of CHMI from research to routine use, and inoculation of PfSPZ by IM and DVI regimens.
ClinicalTrials.gov NCT01771848. |
doi_str_mv | 10.1186/s12936-015-0817-x |
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An open-label CHMI study was performed with aseptic, purified, cryopreserved P. falciparum sporozoites (PfSPZ Challenge) in 36 malaria naïve volunteers. In part A, the effect of the inoculation volume was assessed: 18 participants were injected intramuscularly (IM) with a dose of 2,500 PfSPZ divided into two injections of 10 µL (n = 6), 50 µL (n = 6) or 250 µL (n = 6), respectively. In part B, the injection volume that resulted in highest infectivity rates in part A (10 µL) was used to formulate IM doses of 25,000 PfSPZ (n = 6) and 75,000 PfSPZ (n = 6) divided into two 10-µL injections. Results from a parallel trial led to the decision to add a positive control group (n = 6), each volunteer receiving 3,200 PfSPZ in a single 500-µL injection by direct venous inoculation (DVI).
Four/six participants in the 10-µL group, 1/6 in the 50-µL group and 2/6 in the 250-µL group developed parasitaemia. Geometric mean (GM) pre-patent periods were 13.9, 14.0 and 15.0 days, respectively. Six/six (100%) participants developed parasitaemia in the 25,000 and 75,000 PfSPZ IM and 3,200 PfSPZ DVI groups. GM pre-patent periods were 12.2, 11.4 and 11.4 days, respectively. Injection of PfSPZ Challenge was well tolerated and safe in all groups.
IM injection of 75,000 PfSPZ and DVI injection of 3,200 PfSPZ resulted in infection rates and pre-patent periods comparable to the bite of five PfSPZ-infected mosquitoes. Remarkably, it required 23.4-fold more PfSPZ administered IM than DVI to achieve the same parasite kinetics. These results allow for translation of CHMI from research to routine use, and inoculation of PfSPZ by IM and DVI regimens.
ClinicalTrials.gov NCT01771848.</description><identifier>ISSN: 1475-2875</identifier><identifier>EISSN: 1475-2875</identifier><identifier>DOI: 10.1186/s12936-015-0817-x</identifier><identifier>PMID: 26245196</identifier><language>eng</language><publisher>England: BioMed Central</publisher><subject>Adolescent ; Adult ; Animals ; Dose-Response Relationship, Drug ; Female ; Humans ; Injections, Intramuscular ; Malaria ; Malaria vaccine ; Malaria, Falciparum - immunology ; Malaria, Falciparum - parasitology ; Male ; Malària ; Middle Aged ; Parasitemia - immunology ; Parasitemia - parasitology ; Plasmodium falciparum ; Plasmodium falciparum - immunology ; Spain ; Sporozoites - immunology ; Vacuna de la malària ; Volunteers ; Young Adult</subject><ispartof>Malaria journal, 2015-08, Vol.14 (1), p.306, Article 306</ispartof><rights>Copyright BioMed Central 2015</rights><rights>cc by (c) Gómez-Pérez et al., 2015 info:eu-repo/semantics/openAccess <a href="http://creativecommons.org/licenses/by/3.0/es/">http://creativecommons.org/licenses/by/3.0/es/</a></rights><rights>Gómez-Pérez et al. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c535t-1f168c4fc4b1257633df5ec1e0e2c373695787c5742477bcd935bdb1a5c7a8b03</citedby><cites>FETCH-LOGICAL-c535t-1f168c4fc4b1257633df5ec1e0e2c373695787c5742477bcd935bdb1a5c7a8b03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4527105/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1780674065?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,315,733,786,790,891,25783,27957,27958,37047,44625,53827,53829</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26245196$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gómez-Pérez, Gloria P</creatorcontrib><creatorcontrib>Legarda, Almudena</creatorcontrib><creatorcontrib>Muñoz, Jose</creatorcontrib><creatorcontrib>Sim, B Kim Lee</creatorcontrib><creatorcontrib>Ballester, María Rosa</creatorcontrib><creatorcontrib>Dobaño, Carlota</creatorcontrib><creatorcontrib>Moncunill, Gemma</creatorcontrib><creatorcontrib>Campo, Joseph J</creatorcontrib><creatorcontrib>Cisteró, Pau</creatorcontrib><creatorcontrib>Jimenez, Alfons</creatorcontrib><creatorcontrib>Barrios, Diana</creatorcontrib><creatorcontrib>Mordmüller, Benjamin</creatorcontrib><creatorcontrib>Pardos, Josefina</creatorcontrib><creatorcontrib>Navarro, Mireia</creatorcontrib><creatorcontrib>Zita, Cecilia Justino</creatorcontrib><creatorcontrib>Nhamuave, Carlos Arlindo</creatorcontrib><creatorcontrib>García-Basteiro, Alberto L</creatorcontrib><creatorcontrib>Sanz, Ariadna</creatorcontrib><creatorcontrib>Aldea, Marta</creatorcontrib><creatorcontrib>Manoj, Anita</creatorcontrib><creatorcontrib>Gunasekera, Anusha</creatorcontrib><creatorcontrib>Billingsley, Peter F</creatorcontrib><creatorcontrib>Aponte, John J</creatorcontrib><creatorcontrib>James, Eric R</creatorcontrib><creatorcontrib>Guinovart, Caterina</creatorcontrib><creatorcontrib>Antonijoan, Rosa M</creatorcontrib><creatorcontrib>Kremsner, Peter G</creatorcontrib><creatorcontrib>Hoffman, Stephen L</creatorcontrib><creatorcontrib>Alonso, Pedro L</creatorcontrib><title>Controlled human malaria infection by intramuscular and direct venous inoculation of cryopreserved Plasmodium falciparum sporozoites in malaria-naïve volunteers: effect of injection volume and dose on infectivity rates</title><title>Malaria journal</title><addtitle>Malar J</addtitle><description>Controlled human malaria infection (CHMI) by mosquito bite is a powerful tool for evaluation of vaccines and drugs against Plasmodium falciparum malaria. However, only a small number of research centres have the facilities required to perform such studies. CHMI by needle and syringe could help to accelerate the development of anti-malaria interventions by enabling centres worldwide to employ CHMI.
An open-label CHMI study was performed with aseptic, purified, cryopreserved P. falciparum sporozoites (PfSPZ Challenge) in 36 malaria naïve volunteers. In part A, the effect of the inoculation volume was assessed: 18 participants were injected intramuscularly (IM) with a dose of 2,500 PfSPZ divided into two injections of 10 µL (n = 6), 50 µL (n = 6) or 250 µL (n = 6), respectively. In part B, the injection volume that resulted in highest infectivity rates in part A (10 µL) was used to formulate IM doses of 25,000 PfSPZ (n = 6) and 75,000 PfSPZ (n = 6) divided into two 10-µL injections. Results from a parallel trial led to the decision to add a positive control group (n = 6), each volunteer receiving 3,200 PfSPZ in a single 500-µL injection by direct venous inoculation (DVI).
Four/six participants in the 10-µL group, 1/6 in the 50-µL group and 2/6 in the 250-µL group developed parasitaemia. Geometric mean (GM) pre-patent periods were 13.9, 14.0 and 15.0 days, respectively. Six/six (100%) participants developed parasitaemia in the 25,000 and 75,000 PfSPZ IM and 3,200 PfSPZ DVI groups. GM pre-patent periods were 12.2, 11.4 and 11.4 days, respectively. Injection of PfSPZ Challenge was well tolerated and safe in all groups.
IM injection of 75,000 PfSPZ and DVI injection of 3,200 PfSPZ resulted in infection rates and pre-patent periods comparable to the bite of five PfSPZ-infected mosquitoes. Remarkably, it required 23.4-fold more PfSPZ administered IM than DVI to achieve the same parasite kinetics. These results allow for translation of CHMI from research to routine use, and inoculation of PfSPZ by IM and DVI regimens.
ClinicalTrials.gov NCT01771848.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Animals</subject><subject>Dose-Response Relationship, Drug</subject><subject>Female</subject><subject>Humans</subject><subject>Injections, Intramuscular</subject><subject>Malaria</subject><subject>Malaria vaccine</subject><subject>Malaria, Falciparum - immunology</subject><subject>Malaria, Falciparum - parasitology</subject><subject>Male</subject><subject>Malària</subject><subject>Middle Aged</subject><subject>Parasitemia - immunology</subject><subject>Parasitemia - parasitology</subject><subject>Plasmodium falciparum</subject><subject>Plasmodium falciparum - immunology</subject><subject>Spain</subject><subject>Sporozoites - immunology</subject><subject>Vacuna de la malària</subject><subject>Volunteers</subject><subject>Young 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titles)</collection><jtitle>Malaria journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gómez-Pérez, Gloria P</au><au>Legarda, Almudena</au><au>Muñoz, Jose</au><au>Sim, B Kim Lee</au><au>Ballester, María Rosa</au><au>Dobaño, Carlota</au><au>Moncunill, Gemma</au><au>Campo, Joseph J</au><au>Cisteró, Pau</au><au>Jimenez, Alfons</au><au>Barrios, Diana</au><au>Mordmüller, Benjamin</au><au>Pardos, Josefina</au><au>Navarro, Mireia</au><au>Zita, Cecilia Justino</au><au>Nhamuave, Carlos Arlindo</au><au>García-Basteiro, Alberto L</au><au>Sanz, Ariadna</au><au>Aldea, Marta</au><au>Manoj, Anita</au><au>Gunasekera, Anusha</au><au>Billingsley, Peter F</au><au>Aponte, John J</au><au>James, Eric R</au><au>Guinovart, Caterina</au><au>Antonijoan, Rosa M</au><au>Kremsner, Peter G</au><au>Hoffman, Stephen L</au><au>Alonso, Pedro L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Controlled human malaria infection by intramuscular and direct venous inoculation of cryopreserved Plasmodium falciparum sporozoites in malaria-naïve volunteers: effect of injection volume and dose on infectivity rates</atitle><jtitle>Malaria journal</jtitle><addtitle>Malar J</addtitle><date>2015-08-07</date><risdate>2015</risdate><volume>14</volume><issue>1</issue><spage>306</spage><pages>306-</pages><artnum>306</artnum><issn>1475-2875</issn><eissn>1475-2875</eissn><abstract>Controlled human malaria infection (CHMI) by mosquito bite is a powerful tool for evaluation of vaccines and drugs against Plasmodium falciparum malaria. However, only a small number of research centres have the facilities required to perform such studies. CHMI by needle and syringe could help to accelerate the development of anti-malaria interventions by enabling centres worldwide to employ CHMI.
An open-label CHMI study was performed with aseptic, purified, cryopreserved P. falciparum sporozoites (PfSPZ Challenge) in 36 malaria naïve volunteers. In part A, the effect of the inoculation volume was assessed: 18 participants were injected intramuscularly (IM) with a dose of 2,500 PfSPZ divided into two injections of 10 µL (n = 6), 50 µL (n = 6) or 250 µL (n = 6), respectively. In part B, the injection volume that resulted in highest infectivity rates in part A (10 µL) was used to formulate IM doses of 25,000 PfSPZ (n = 6) and 75,000 PfSPZ (n = 6) divided into two 10-µL injections. Results from a parallel trial led to the decision to add a positive control group (n = 6), each volunteer receiving 3,200 PfSPZ in a single 500-µL injection by direct venous inoculation (DVI).
Four/six participants in the 10-µL group, 1/6 in the 50-µL group and 2/6 in the 250-µL group developed parasitaemia. Geometric mean (GM) pre-patent periods were 13.9, 14.0 and 15.0 days, respectively. Six/six (100%) participants developed parasitaemia in the 25,000 and 75,000 PfSPZ IM and 3,200 PfSPZ DVI groups. GM pre-patent periods were 12.2, 11.4 and 11.4 days, respectively. Injection of PfSPZ Challenge was well tolerated and safe in all groups.
IM injection of 75,000 PfSPZ and DVI injection of 3,200 PfSPZ resulted in infection rates and pre-patent periods comparable to the bite of five PfSPZ-infected mosquitoes. Remarkably, it required 23.4-fold more PfSPZ administered IM than DVI to achieve the same parasite kinetics. These results allow for translation of CHMI from research to routine use, and inoculation of PfSPZ by IM and DVI regimens.
ClinicalTrials.gov NCT01771848.</abstract><cop>England</cop><pub>BioMed Central</pub><pmid>26245196</pmid><doi>10.1186/s12936-015-0817-x</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1475-2875 |
ispartof | Malaria journal, 2015-08, Vol.14 (1), p.306, Article 306 |
issn | 1475-2875 1475-2875 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4527105 |
source | Publicly Available Content Database; PubMed Central |
subjects | Adolescent Adult Animals Dose-Response Relationship, Drug Female Humans Injections, Intramuscular Malaria Malaria vaccine Malaria, Falciparum - immunology Malaria, Falciparum - parasitology Male Malària Middle Aged Parasitemia - immunology Parasitemia - parasitology Plasmodium falciparum Plasmodium falciparum - immunology Spain Sporozoites - immunology Vacuna de la malària Volunteers Young Adult |
title | Controlled human malaria infection by intramuscular and direct venous inoculation of cryopreserved Plasmodium falciparum sporozoites in malaria-naïve volunteers: effect of injection volume and dose on infectivity rates |
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