A multistage malaria vaccine targeting the pre-erythrocytic and sexual stages of Plasmodium could effectively protect individuals against infection from mosquito bites and provide transmission-blocking (TB) activity against the sexual stages of the parasite, respectively. This strategy could help prevent malaria infections in individuals and, on a larger scale, prevent malaria transmission in communities of endemicity. Here, we describe the development of a multistage Plasmodium vivax vaccine which simultaneously expresses P. vivax circumsporozoite protein (PvCSP) and P25 (Pvs25) protein of this species as a fusion protein, thereby acting as a pre-erythrocytic vaccine and a TB vaccine, respectively. A new-concept vaccine platform based on the baculovirus dual-expression system (BDES) was evaluated. The BDES-Pvs25-PvCSP vaccine displayed correct folding of the Pvs25-PvCSP fusion protein on the viral envelope and was highly expressed upon transduction of mammalian cells in vitro. This vaccine induced high levels of antibodies to Pvs25 and PvCSP and elicited protective (43%) and TB (82%) efficacies against transgenic P. berghei parasites expressing the corresponding P. vivax antigens in mice. Our data indicate that our BDES, which functions as both a subunit and DNA vaccine, can offer a promising multistage vaccine capable of delivering a potent antimalarial pre-erythrocytic and TB response via a single immunization regimen.
Plasmodium vivax is currently the most widely distributed human malaria parasite, with an "at risk" population in 2010 of almost 3 billion people (a third of the global population) and approximately 100 to 300 million clinical cases each year (1, 2). Several factors, including (i) the recent appearance of chloroquine-resistant P. vivax, (ii) the lack of alternatives to primaquine for attacking the dormant liver-stage hypnozoites, and (iii) increasing global temperatures caused by climate change, raise concerns about increases in the risk of severe P. vivax disease (3-6). Although the importance of P. vivax vaccines is recognized, the lack of long-term in vitro culture systems in red blood cells and suitable animal models as well as the complex life cycle of this parasite has hindered advances in the development of a potent vaccine (7,8).The development of malaria vaccines has been focused mostly on single antigens from different stages of the parasite life cycle: (i) the pre-erythrocytic stages (including the liver stages), (ii) the asexual blood stages, and (iii) the mosquito sexual stages, where antigens expressed on the gametocyte, gamete, zygote, or ookinete are targeted to prevent transmission from the human hosts to the mosquito vectors (9). There are concerns that the single-stage vaccine may not be effective because of sequence variability among different parasite isolates, host genetic restriction of immune responses to specific epitopes, and short-lived protective immunity induced by some single-antigen vaccines (10). Therefore, a multistage vaccine, which targets several antigens exp...