Evidence map›Paper›PMID 37024868›Full record

Trial reportBMC medicine2023

Whole sporozoite immunization with Plasmodium falciparum strain NF135 in a randomized trial.

Saskia C van der Boor, Manon Alkema, Geert-Jan van Gemert, Karina Teelen, Marga van de Vegte-Bolmer, Jona Walk, Reinout van Crevel, Quirijn de Mast, Christian F Ockenhouse, Robert W Sauerwein and 1 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03813108 (Safety and Protective Efficacy of Chemoprophylaxis and Sporozoite Immunization With Plasmodium Falciparum NF135 Against Homologous and Heterologous Challenge Infection in Healthy Volunteers in the Netherlands), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03813108 naterminatednot on this map

Safety and Protective Efficacy of Chemoprophylaxis and Sporozoite Immunization With Plasmodium Falciparum NF135 Against Homologous and Heterologous Challenge Infection in Healthy Volunteers in the Netherlands

TypeinterventionalSponsorRadboud University Medical CenterRan2019 to 2021Enrolled43ConditionsMalaria,Falciparum, Controlled Human Malaria Infection, Immunization, InfectionArmsCPS-immunization, malaria challenge infection, P. falciparum NF135.C10, malaria challenge infection, P. falciparum NF54, CPS-immunization (A/L), Atovaquone / Proguanil Oral Tablet [Malarone]
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Gametocyte production and transmission fitness of African and AsianAntimicrobial agents and chemotherapy · 2025
    Article
  2. Gametocyte production and transmission fitness of African and AsianbioRxiv : the preprint server for biology · 2025
    Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Saskia C van der Boor *Department of Medical Microbiology, Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 28, 6525 GA, Nijmegen, The Netherlands.
Manon Alkema *Department of Medical Microbiology, Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 28, 6525 GA, Nijmegen, The Netherlands.
Geert-Jan van GemertDepartment of Medical Microbiology, Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 28, 6525 GA, Nijmegen, The Netherlands.
Karina TeelenDepartment of Medical Microbiology, Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 28, 6525 GA, Nijmegen, The Netherlands.
Marga van de Vegte-BolmerDepartment of Medical Microbiology, Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 28, 6525 GA, Nijmegen, The Netherlands.
Jona WalkDepartment of Medical Microbiology, Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 28, 6525 GA, Nijmegen, The Netherlands.
Reinout van CrevelDepartment of Internal Medicine, Radboud Center for Infectious Diseases, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
Quirijn de MastDepartment of Internal Medicine, Radboud Center for Infectious Diseases, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
Christian F OckenhousePATH Malaria Vaccine Initiative, Washington, DC, 20001, USA.
Robert W Sauerwein *Department of Medical Microbiology, Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 28, 6525 GA, Nijmegen, The Netherlands. R.Sauerwein@tropiq.nl.
Matthew B B McCall *Department of Medical Microbiology, Radboud Center for Infectious Diseases, Radboud University Medical Center, Geert Grooteplein Zuid 28, 6525 GA, Nijmegen, The Netherlands. matthew.mccall@radboudumc.nl.
Radboud University Nijmegen · NLRadboud University Medical Center · NLTropIQ Health Sciences · NLU.S. President's Malaria Initiative · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhole sporozoite immunization under chemoprophylaxis (CPS regime) induces long-lasting sterile homologous protection in the controlled human malaria infection model using Plasmodium falciparum strain NF54. The relative proficiency of liver-stage parasite development may be an important factor determining immunization efficacy. Previous studies show that Plasmodium falciparum strain NF135 produces relatively high numbers of large liver-stage schizonts in vitro. Here, we evaluate this strain for use in CPS immunization regimes.

methodsIn a partially randomized, open-label study conducted at the Radboudumc, Nijmegen, the Netherlands, healthy, malaria-naïve adults were immunized by three rounds of fifteen or five NF135-infected mosquito bites under mefloquine prophylaxis (cohort A) or fifteen NF135-infected mosquito bites and presumptive treatment with artemether/lumefantrine (cohort B). Cohort A participants were exposed to a homologous challenge 19 weeks after immunization. The primary objective of the study was to evaluate the safety and tolerability of CPS immunizations with NF135.

resultsRelatively high liver-to-blood inocula were observed during immunization with NF135 in both cohorts. Eighteen of 30 (60%) high-dose participants and 3/10 (30%) low-dose participants experienced grade 3 adverse events 7 to 21 days following their first immunization. All cohort A participants and two participants in cohort B developed breakthrough blood-stage malaria infections during immunizations requiring rescue treatment. The resulting compromised immunizations induced modest sterile protection against homologous challenge in cohort A (5/17; 29%).

conclusionsThese CPS regimes using NF135 were relatively poorly tolerated and frequently required rescue treatment, thereby compromising immunization efficiency and protective efficacy. Consequently, the full potential of NF135 sporozoites for induction of immune protection remains inconclusive. Nonetheless, the high liver-stage burden achieved by this strain highlights it as an interesting potential candidate for novel whole sporozoite immunization approaches.

trial registrationThe trial was registered at ClinicalTrials.gov under identifier NCT03813108.

Indexed as

AntimalarialsInsect Bites and StingsMalariaMalaria VaccinesAdultAnimalsArtemether, Lumefantrine Drug CombinationHumansImmunizationPlasmodium falciparumSporozoitesAntimalarialsArtemether, Lumefantrine Drug CombinationMalaria VaccinesMalariaNF135Plasmodium falciparumVaccine-induced protectionWhole sporozoite immunization

Identifiers

PMID37024868
PMCPMC10079489
OpenAlexW4362677472

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.