# Once Bitten: Acquisition of Malaria Adaptive Immunity (OBAMA - Immunity)

> **NIH NIH R01** · DUKE UNIVERSITY · 2024 · $1,206,058

## Abstract

Plasmodium falciparum control has stalled, and further progress reducing infections and deaths will require a
highly-effective malaria vaccine. Individuals exposed to malaria develop protective immune responses
gradually over several infections. Studies of immune responses to P. falciparum have consistently
demonstrated that targets which exhibit very high diversity are critical for these protective responses. However,
immunity to these antigens is dominated by strain-specific responses, which confer partial but imperfect
protection to heterologous strains. This is a challenge for current vaccine candidates, including the first
licensed malaria vaccine RTS,S, which are based on a single antigenic variant for a protein target and suffer
from reduced efficacy to non-vaccine strains. There is evidence for strain-transcendent immunity in naturally
exposed populations where individuals mount broadly protective responses after a few infections, despite the
presence of dozens if not hundreds of different strains. Understanding how to elicit strain-transcendent
immunity towards key, diverse antigenic targets has the potential to transform the next generation of vaccine
products. Prior longitudinal studies of infection and disease are unable to furnish this insight mainly because
they suffer from the inability to distinguish protection from lack of exposure in naturally exposed populations.
As a consequence, there is no clear phenotype of protection, producing an incomplete understanding of the
acquisition of protective immunity. Using our unique, longstanding cohort encompassing ~600 people in 75
households (initiated in 2017) in a high-transmission community in Western Kenya, we are able to pinpoint
parasite transmission events to the individual-level, characterize the variant composition of multi-strain P.
falciparum exposures, and document the outcome (no infection or protected vs. infected with or without
symptoms) at the variant level. By leveraging known exposures to clearly define protection phenotypes within a
natural system that encompasses a high degree of parasite diversity, we are uniquely-positioned to answer
longstanding questions about protective immune responses. The goal of the proposed work is to use our
unique system to advance multi-variant vaccine design. In our first Aim, we will quantify the strain-specific risk
of malaria infection following a confirmed infectious bite (exposure). In the second Aim, we will leverage peri-
exposure and post-exposure samples to correlate strain-specific protection following an infectious bite with
strain-specific immune responses in order to identify strain-transcendent responses, and then identify variants
that most effectively promote strain-transcendent responses. Our hypothesis is that a minimum set of strain-
specific immune responses will be associated with strain-transcendent protection from infection after exposure.
By exploring heterologous versus homologous strain-specific responses to elu...

## Key facts

- **NIH application ID:** 10889259
- **Project number:** 5R01AI179141-02
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Wendy PrudhommeOMeara
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,206,058
- **Award type:** 5
- **Project period:** 2023-07-17 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10889259

## Citation

> US National Institutes of Health, RePORTER application 10889259, Once Bitten: Acquisition of Malaria Adaptive Immunity (OBAMA - Immunity) (5R01AI179141-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10889259. Licensed CC0.

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