Unveiling mismatch of RTS S AS01 and R21 Matrix M malaria vaccines haplotype among Ethiopian Plasmodium falciparum clinical isolates

Abstract Malaria vaccines, RTS, S/AS01 and R21/Matrix which are based on the Plasmodium falciparum circumsporozoite protein (Pfcsp) have been approved by WHO for broad use in children in Africa. However, the extensive genetic diversity of Pfcsp limited its effectiveness, as vaccine efficacy reduced...

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Main Authors: Aynalem Mandefro, Alebachew Messele Kebede, Mitchel Katsvanga, Fatoumatta Cham, Eniyou Oriero, Alfred Amambua-Ngwa, Lemu Golassa
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-00140-0
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author Aynalem Mandefro
Alebachew Messele Kebede
Mitchel Katsvanga
Fatoumatta Cham
Eniyou Oriero
Alfred Amambua-Ngwa
Lemu Golassa
author_facet Aynalem Mandefro
Alebachew Messele Kebede
Mitchel Katsvanga
Fatoumatta Cham
Eniyou Oriero
Alfred Amambua-Ngwa
Lemu Golassa
author_sort Aynalem Mandefro
collection DOAJ
description Abstract Malaria vaccines, RTS, S/AS01 and R21/Matrix which are based on the Plasmodium falciparum circumsporozoite protein (Pfcsp) have been approved by WHO for broad use in children in Africa. However, the extensive genetic diversity of Pfcsp limited its effectiveness, as vaccine efficacy reduced against non-vaccine strains. Using Oxford Nanopore Technology, we conducted amplicon sequencing of the full-length Pfcsp gene from 96 clinical isolates collected from three health centers in Ethiopia and compared the results against a reference genome. The result showed absence of population differentiation among the Ethiopian isolates. The N-terminal region was relatively conserved, with a KLKQP motif was present across all isolates. However, mutation at position A98G and an insertion of amino acids (DGNNNNGDNGREGKDEDKR) were identified in this region. The number of NANP and NVDP repeats of the central region per haplotype ranged from 39 to 42. Additionally, the Th2R and Th3R epitopes in the C-terminal region exhibited extensive polymorphism with at least one amino acid substitution compared to the reference strains. Notably, none of the Ethiopian Pfcsp haplotypes matched the vaccine haplotype. Furthermore, haplotype network and phylogenetic tree analyses shown considerable similarity among local and global isolates. The findings of this study revealed a high Pfcsp genetic diversity highlighting the need for further studies to inform allele selection for universal or region-specific vaccine development as this may influence vaccine efficacy.
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spelling doaj-art-eebd8429ec6f40338560ca6bebc38c0b2025-08-20T02:55:28ZengNature PortfolioScientific Reports2045-23222025-04-0115111010.1038/s41598-025-00140-0Unveiling mismatch of RTS S AS01 and R21 Matrix M malaria vaccines haplotype among Ethiopian Plasmodium falciparum clinical isolatesAynalem Mandefro0Alebachew Messele Kebede1Mitchel Katsvanga2Fatoumatta Cham3Eniyou Oriero4Alfred Amambua-Ngwa5Lemu Golassa6Aklilu Lemma Institute of Pathobiology, Addis Ababa UniversityAklilu Lemma Institute of Pathobiology, Addis Ababa UniversityMedical Research Council Unit the Gambia, London School of Hygiene and Tropical MedicineMedical Research Council Unit the Gambia, London School of Hygiene and Tropical MedicineMedical Research Council Unit the Gambia, London School of Hygiene and Tropical MedicineMedical Research Council Unit the Gambia, London School of Hygiene and Tropical MedicineAklilu Lemma Institute of Pathobiology, Addis Ababa UniversityAbstract Malaria vaccines, RTS, S/AS01 and R21/Matrix which are based on the Plasmodium falciparum circumsporozoite protein (Pfcsp) have been approved by WHO for broad use in children in Africa. However, the extensive genetic diversity of Pfcsp limited its effectiveness, as vaccine efficacy reduced against non-vaccine strains. Using Oxford Nanopore Technology, we conducted amplicon sequencing of the full-length Pfcsp gene from 96 clinical isolates collected from three health centers in Ethiopia and compared the results against a reference genome. The result showed absence of population differentiation among the Ethiopian isolates. The N-terminal region was relatively conserved, with a KLKQP motif was present across all isolates. However, mutation at position A98G and an insertion of amino acids (DGNNNNGDNGREGKDEDKR) were identified in this region. The number of NANP and NVDP repeats of the central region per haplotype ranged from 39 to 42. Additionally, the Th2R and Th3R epitopes in the C-terminal region exhibited extensive polymorphism with at least one amino acid substitution compared to the reference strains. Notably, none of the Ethiopian Pfcsp haplotypes matched the vaccine haplotype. Furthermore, haplotype network and phylogenetic tree analyses shown considerable similarity among local and global isolates. The findings of this study revealed a high Pfcsp genetic diversity highlighting the need for further studies to inform allele selection for universal or region-specific vaccine development as this may influence vaccine efficacy.https://doi.org/10.1038/s41598-025-00140-0VaccinesCircumsporozoite proteinGenetic diversityPlasmodium falciparum
spellingShingle Aynalem Mandefro
Alebachew Messele Kebede
Mitchel Katsvanga
Fatoumatta Cham
Eniyou Oriero
Alfred Amambua-Ngwa
Lemu Golassa
Unveiling mismatch of RTS S AS01 and R21 Matrix M malaria vaccines haplotype among Ethiopian Plasmodium falciparum clinical isolates
Scientific Reports
Vaccines
Circumsporozoite protein
Genetic diversity
Plasmodium falciparum
title Unveiling mismatch of RTS S AS01 and R21 Matrix M malaria vaccines haplotype among Ethiopian Plasmodium falciparum clinical isolates
title_full Unveiling mismatch of RTS S AS01 and R21 Matrix M malaria vaccines haplotype among Ethiopian Plasmodium falciparum clinical isolates
title_fullStr Unveiling mismatch of RTS S AS01 and R21 Matrix M malaria vaccines haplotype among Ethiopian Plasmodium falciparum clinical isolates
title_full_unstemmed Unveiling mismatch of RTS S AS01 and R21 Matrix M malaria vaccines haplotype among Ethiopian Plasmodium falciparum clinical isolates
title_short Unveiling mismatch of RTS S AS01 and R21 Matrix M malaria vaccines haplotype among Ethiopian Plasmodium falciparum clinical isolates
title_sort unveiling mismatch of rts s as01 and r21 matrix m malaria vaccines haplotype among ethiopian plasmodium falciparum clinical isolates
topic Vaccines
Circumsporozoite protein
Genetic diversity
Plasmodium falciparum
url https://doi.org/10.1038/s41598-025-00140-0
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