Pfs48/45, a member of a Plasmodium-specific protein family, displays conformation-dependent epitopes and is an important target for malaria transmission-blocking (TB) immunity. To design a recombinant Pfs48/45-based TB vaccine, we analyzed the conformational TB epitopes of Pfs48/45. The Pfs48/45 protein was found to consist of a C-terminal six-cysteine module recognized by anti-epitope I antibodies, a middle four-cysteine module recognized by anti-epitopes IIb and III, and an N-terminal module recognized by anti-epitope V antibodies. Refolding assays identified that a fragment of 10 cysteines (10C), comprising the middle four-cysteine and the C-terminal six-cysteine modules, possesses superior refolding capacity. The refolded and partially purified 10C conformer elicited antibodies in mice that targeted at least two of the TB epitopes (I and III). The induced antibodies could block the fertilization of Plasmodium falciparum gametes in vivo in a concentration-dependent manner. Our results provide important insight into the structural organization of the Pfs48/45 protein and experimental support for a Pfs48/45-based subunit vaccine.Malaria parasites are spread in the human population by Plasmodium-infected Anopheles mosquitoes. After a blood meal on infected humans, mosquitoes become infected by ingesting a sexual form of the malaria parasite called gametocytes. Subsequent sporogonic development in the mosquito can be prevented by the presence of anti-malaria, transmissionblocking (TB) 3 antibodies in the ingested blood meal (1-3). Pfs48/45 is a TB vaccine candidate that belongs to a family of malaria-specific proteins that contain conserved motifs with four-or six-cysteine residues (4). Pfs48/45 plays a key role in parasite fertilization (5), and monoclonal antibodies (mAbs) against Pfs48/45 prevent fertilization (6). Anti-Pfs48/45 antibodies are present in human sera from endemic areas, and there is evidence that the presence of anti-Pfs48/45 antibodies in natural sera correlates with TB activity (7). The induction of antibodies after natural infection, as observed in the field, creates the highly beneficial potential of vaccine boosting in the endemic setting. At least four different epitopes (I, IIb, III, and V) on Pfs48/45 are targeted by monoclonal antibodies that block or reduce malaria transmission (8, 9). Apart from epitope V, the TB epitopes are sensitive to reducing agents, which indicates the importance of the disulfide bridges and hence the conformational dependence of these epitopes (8, 10).To design a Pfs48/45-based TB vaccine, we aimed to delineate and characterize the TB epitopes of Pfs48/45. Protease digestion of the native protein, expression in Escherichia coli of truncations, cysteine mutations, and refolding assays were evaluated by immunological analysis of the TB epitopes. An N-terminally truncated protein with higher refolding efficiency was identified, partially purified, and tested in mice immunization experiments. The elicited antibodies recognized the native Pfs48/45 protein, competed ...