Volume 13 Supplement 1

Challenges in malaria research: Core science and innovation

Open Access

Analysis of peripheral blood B and Tfh cells as predictors of antibody responses in individuals receiving candidate blood-stage malaria vaccines in a Phase Ia clinical trial

  • Sean Elias1,
  • Kathryn Milne1,
  • Cecilia Chui2,
  • Susanne Hodgson1,
  • Persephone Borrow2 and
  • Simon Draper1
Malaria Journal201413(Suppl 1):P28


Published: 22 September 2014


Here we report on a Phase Ia clinical vaccine trial using the AMA1 antigen from the blood-stage Plasmodium falciparum malaria parasite. A variety of promising ‘mixed-modality’ regimens were tested, with all volunteers primed with chimpanzee adenovirus-ChAd63, and then subsequently boosted with the orthopoxvirus MVA and/or protein-in-adjuvant (Alhydrogel ± CPG 7909) using 8 or 16 week prime-boost intervals. The induction of high titre, neutralizing antibodies is deemed essential for protection against blood-stage malaria. Peripheral blood antibody secreting cells (ASC) and memory B cells (mBC) play important roles in antibody production and maintenance. Lymph node (LN) CD4+ follicular helper T cells (Tfh cells) mediate cognate control of antigen-specific antibody responses. Recently Tfh-like cells have been found to be present in the CXCR5+ subset of memory CD4+ T cells in human peripheral blood. This facilitates analysis of the role of Tfh responses in regulation of vaccine-elicited antibody responses, although there is much debate over the relationship between LN and circulating populations. Phenotypic definition of the latter has also proved complex, with recent studies indicating that phenotypically-distinct Tfh populations with different functional profiles are elicited by different antigenic stimuli. Characterizing T cell and B cell populations across a variety of immunisation regimes may lead to greater understanding of their value as quantitative and qualitative predictors of antibody responses.

Materials and methods

ASC and mBC responses were measured using a standardized B cell ELISPOT method, using fresh and frozen PBMC respectively, whilst antibody titre was measured using a standardized ELISA for AMA1. Multiparameter flow cytometry was also subsequently run using frozen PBMC to characterise total peripheral CD4+ Tfh populations and the AMA1-specific CD4+ T cell response.


AMA1 specific ASC, mBC and antibody responses followed classical kinetics at a level comparable to those previously described, with ASC and antibody responses strongly correlating. Notably, inclusion of CPG 7909 tended to lead to earlier detection of peripheral ASC responses at day 4. The relationship between baseline Tfh populations previously described as important in other infections/vaccine regimens, as well as AMA1-specific Tfh-like cells identifiable at post-boost time-points and ASC/mBC/antibody responses is currently being investigated.


Very few significant differences were observed between groups with respect to ASC, mBC and antibody responses. Responses primed with ChAd63 appear to boost comparably whether or not CPG 7909 is included with the Alhydrogel adjuvant, though boosting with MVA trended towards lower responses.

Authors’ Affiliations

Jenner Institute, University of Oxford
Nuffield Dept of Medicine, University of Oxford


© Elias et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.


By submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.