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Malaria Prevention Using Monoclonal Antibodies

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A recent phase 1 study proved monoclonal antibodies effective in preventing malaria. Read the article to know more.

Medically reviewed by

Dr. Arpit Varshney

Published At March 15, 2023
Reviewed AtMarch 28, 2023

Introduction

Malaria is an acute febrile condition caused by Plasmodium falciparum and Plasmodium vivax, which is spread to humans through the bite of infected Anopheles mosquitoes. Malaria cases worldwide were estimated to be 241 million in 2020, with 627000 deaths from the disease. The majority of those affected in Africa were young children. However, many organizations and resources have increased many preventive measures to control the malaria mortality rate over the last decade. Malaria vaccines for children, preventative drugs, and insecticide-treated bed nets are among the preventive measures recommended by the WHO (World Health Organization).

What Is Malaria?

Malaria is a vectorborne disease caused by the Plasmodium parasite and transmitted by the bite of an infected female anopheles mosquito. When a female anopheles mosquito bites a malaria patient, it carries the parasite with the person’s blood. When it bites another person, it injects the parasite into them, causing the disease to spread.

The parasite Plasmodium causes malaria. Plasmodium species that can affect humans include two of the most dangerous, Plasmodium falciparum and Plasmodium vivax. Plasmodium falciparum multiplies rapidly and causes severe blood loss and clogged blood vessels, whereas Plasmodium vivax can remain dormant for months or years after being bitten by a mosquito.

Malaria is not contagious; does not spread from person to person, but it may spread:

  • From a pregnant mother to the fetus.

  • Using shared needles.

  • Blood transfusion.

  • Organ transplant.

Once the parasite reaches the bloodstream, it travels to the liver. It matures and multiplies in the liver, and these mature parasites spread throughout the body through the bloodstream causing the illness.

Where Is Malaria Most Common?

Malaria is often seen in poor tropical and subtropical areas of the world. It is most common in places with warm climates. It is found in:

  • Africa and sub-Saharan Africa.

  • Southeast Asia.

  • Middle East countries.

  • Central and South America.

  • Oceania.

What Are the Signs and Symptoms of Malaria?

The symptoms of malaria usually appear within ten days to a month after the infected mosquito bite. However, the symptoms can vary from mild to severe depending on the Plasmodium species involved. Symptoms may include:

What Are the Different Malaria Prevention Methods?

To prevent malaria, take precautions to avoid mosquito bites. Mosquitoes are usually active between the hours of dusk and dawn. Wear long-sleeved clothing to avoid mosquito bites. Tuck the shirt in and tuck the pant legs into the socks.

The world health organization has recommended various malaria prevention methods and strategies, including vector control, antimalarial drugs, and vaccines.

  • Vector Control: It is a critical component of malaria control and elimination strategies for preventing disease spread. It includes insecticide-treated nets and indoor residual sprays (IRS) (ITN).

  • Medications for Prevention: Drugs are used to prevent malaria infections and their complications, either alone or in combination. Intermittent preventive treatment of infants (IPTi), intermittent preventive treatment of pregnant women (IPTp), chemoprophylaxis, seasonal malaria chemoprevention (SMC), and mass drug administration are all examples of preventative medications (MDA).

  • The Malaria Vaccine: Itis recommended by the WHO for children living in moderate to high-risk areas with Plasmodium falciparum transmission. It has proven to be effective in reducing malaria in young children.

Do Monoclonal Antibodies Help in Malaria Prevention?

A single dose of a new monoclonal antibody discovered and developed at the National Institutes of Health (NIH) effectively prevented malaria in people exposed to the malaria parasite for up to nine months. The small, closely monitored clinical trial is the first to show that a monoclonal antibody can protect against malaria in humans. The trials were sponsored and conducted by scientists from the national institute of allergy and infectious diseases (NIAID), which is part of the National Institutes of Health (NIH) and was funded by NIAID. The results of the clinical trials were published in the New England journal of medicine.

A total of 25 participants were given at least one dose of the antibody CIS43LS, with four receiving a second dose. CIS43LS prevented malaria in adults who had never had malaria infection or vaccination.

In the study, 15 subjects were bitten by mosquitoes carrying the parasite. For several weeks, medical teams kept a close eye on them. The antibody was given to nine of the subjects, and none of them developed malaria. The other six subjects were given placebos, and five developed the disease. A more extensive phase II clinical trial of CIS43LS in adults is underway in Mali during the 6-month malaria season.

What Is CIS43LS?

CIS43LS is a monoclonal antibody with a long half-life directed against a surface protein on Plasmodium falciparum. This protein is an ideal target for antibody neutralization because it is required for parasite motility and host cell invasion.

CIS43LS was derived from CIS43, a naturally occurring neutralizing antibody. CIS43 was isolated from the blood of a volunteer who had received an investigational malaria vaccine by researchers. The researchers discovered that CIS43 binds to a specific site on a parasite surface protein essential for malaria infection and is found on all variants of P. falciparum sporozoites worldwide. The researchers then modified this antibody to make it last longer in the bloodstream, giving rise to CIS43LS.

Conclusion

Malaria is a vectorborne disease caused by the Plasmodium parasite and transmitted by the bite of an infected female anopheles mosquito. According to WHO, Africa accounts for approximately 94 percent of all malaria deaths, with children under five years most commonly affected. It remains a significant cause of illness and death in many parts of the world, particularly among infants and young children; therefore, new tools for preventing this deadly disease are required. The discovery of the monoclonal antibody CIS43LS could be a breakthrough in safe and effective malaria prevention, especially among travelers, military personnel, and healthcare workers traveling to malaria-endemic regions and ultimately in malarial elimination campaigns in African endemic areas.

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Dr. Arpit Varshney
Dr. Arpit Varshney

General Medicine

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