# The Skin Phase of Malaria Infection

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2021 · $463,034

## Abstract

Project Summary
Malaria remains one of the most important infectious diseases in the world. A fully effective vaccine would be a
huge addition to our armamentarium. The most promising vaccine candidate to date, RTS,S, a subunit vaccine
composed of a portion of the sporozoite's major surface protein, CSP, has shown limited efficacy that wanes
significantly after the first year. Though this falls short of community established goals, RTS,S provides a
substrate upon which we can build to create a more efficacious vaccine. The studies outlined in this proposal
aim to elucidate the interactions between host and parasite at the inoculation site with the goal of improving
future vaccine design. Sporozoites are inoculated into the skin of the mammalian host as mosquitoes search for
blood. Few sporozoites are injected, making this a bottleneck for the parasite. After their inoculation,
sporozoites are actively motile in the skin, and must find and penetrate blood vessels to enter the circulation.
Our studies demonstrate that the majority of sporozoites take 20 to 120 minutes to exit the dermis and only a
small proportion succeed in entering the blood circulation. Once in the circulation, sporozoites go to the liver
and enter hepatocytes within minutes. Sporozoite passage through the dermis is an understudied phase of
malaria infection: Yet, the low numbers of inoculated sporozoites together with the discovery that the
parasite is extracellular for the longest period of time in the skin, suggest that this is a time of extreme
vulnerability. My laboratory has been studying the dynamics of sporozoite transmission for several years and
we are now using quantitative intravital imaging to better understand the requirements for successful exit from
the dermis. In Aim 1, we will perform intravital imaging studies with the human malaria parasite Plasmodium
falciparum, quantitatively analyzing its motility and blood vessel interactions, in both mouse skin and human
skin xenografts. Comparative analysis with rodent malaria sporozoites will identify conserved and species-
specific aspects of dermal exit and define metrics that predict successful exit from the dermis. These studies will
also enable the development of an in vivo platform to screen vaccine candidates with P. falciparum sporozoites.
Previous studies in mice and in RTS,S immunized humans have shown that CSP-specific antibodies correlate
with protection, however, the location and mechanism(s) by which these antibodies impact sporozoites are not
known. In Aims 2 and 3, we will perform intravital imaging and infection studies with rodent and human
malaria sporozoites to determine: a) whether antibodies targeting the two leading sporozoite vaccine candidates
have their its greatest impact in the skin; b) the degree to which functional antibodies rely on their ability to
inhibit sporozoite motility versus their ability to opsonize sporozoites and direct their destruction by innate
immune cells and c) whether f...

## Key facts

- **NIH application ID:** 10201460
- **Project number:** 5R01AI132359-05
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Photini Sinnis
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $463,034
- **Award type:** 5
- **Project period:** 2017-07-06 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10201460

## Citation

> US National Institutes of Health, RePORTER application 10201460, The Skin Phase of Malaria Infection (5R01AI132359-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10201460. Licensed CC0.

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