Progress in the development of a recombinant vaccine for human hookworm disease: The Human Hookworm Vaccine Initiative

Hookworm infection is one of the most important parasitic infections of humans, possibly outranked only by malaria as a cause of misery and suffering. An estimated 1.2 billion people are infected with hookworm in areas of rural poverty in the tropics and subtropics. Epidemiological data collected in...

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Published in:	International Journal for Parasitology Vol. 33; no. 11; pp. 1245 - 1258
Main Authors:	Hotez, Peter J, Zhan, Bin, Bethony, Jeffrey M, Loukas, Alex, Williamson, Angela, Goud, Gaddam Narsa, Hawdon, John M, Dobardzic, Azra, Dobardzic, Reshad, Ghosh, Kashinath, Bottazzi, Maria Elena, Mendez, Susana, Zook, Bernard, Wang, Yan, Liu, Sen, Essiet-Gibson, Idong, Chung-Debose, Sophia, Xiao, Shuhua, Knox, David, Meagher, Michael, Inan, Mehmet, Correa-Oliveira, Rodrigo, Vilk, Paul, Shepherd, Herman R, Brandt, Walter, Russell, Philip K
Format:	Book Review Journal Article
Language:	English
Published:	England Elsevier Ltd 30-09-2003
Subjects:	Adolescent Adult Aged Ancylostoma Ancylostomiasis - immunology Ancylostomiasis - prevention & control Animals Antigens, Helminth - isolation & purification Brazil - epidemiology Child China - epidemiology Chronic Disease Expression systems Hookworm Hookworm Infections - epidemiology Hookworm Infections - immunology Hookworm Infections - prevention & control Humans Larva Middle Aged Necator Necatoriasis - immunology Necatoriasis - prevention & control Prevalence Recombinant proteins Research Design Vaccines Vaccines, Synthetic Brazil China Necator Expression systems Hookworm Vaccines Recombinant proteins Ancylostoma
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Summary:	Hookworm infection is one of the most important parasitic infections of humans, possibly outranked only by malaria as a cause of misery and suffering. An estimated 1.2 billion people are infected with hookworm in areas of rural poverty in the tropics and subtropics. Epidemiological data collected in China, Southeast Asia and Brazil indicate that, unlike other soil-transmitted helminth infections, the highest hookworm burdens typically occur in adult populations, including the elderly. Emerging data on the host cellular immune responses of chronically infected populations suggest that hookworms induce a state of host anergy and immune hyporesponsiveness. These features account for the high rates of hookworm reinfection following treatment with anthelminthic drugs and therefore, the failure of anthelminthics to control hookworm. Despite the inability of the human host to develop naturally acquired immune responses to hookworm, there is evidence for the feasibility of developing a vaccine based on the successes of immunising laboratory animals with either attenuated larval vaccines or antigens extracted from the alimentary canal of adult blood-feeding stages. The major antigens associated with each of these larval and adult hookworm vaccines have been cloned and expressed in prokaryotic and eukaryotic systems. However, only eukaryotic expression systems (e.g., yeast, baculovirus, and insect cells) produce recombinant proteins that immunologically resemble the corresponding native antigens. A challenge for vaccinologists is to formulate selected eukaryotic antigens with appropriate adjuvants in order to elicit high antibody titres. In some cases, antigen-specific IgE responses are required to mediate protection. Another challenge will be to produce anti-hookworm vaccine antigens at high yield low cost suitable for immunising large impoverished populations living in the developing nations of the tropics.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Feature-3 ObjectType-Review-1
ISSN:	0020-7519 1879-0135
DOI:	10.1016/S0020-7519(03)00158-9