Discussion
Schistosomiasis is a parasitic disease that affects over 200 million people worldwide resulting from infection with trematode blood flukes of the genus Schistosoma. There are six main human infective species, all of which have a complex life cycle involving aquatic or amphibious snails as intermediate hosts and mammalian definitive hosts. This includes S. mansoni, the causative agent of intestinal schistosomiasis which is characterised by inflammatory abdominal symptoms. The current treatment strategies against schistosomiasis involves mass drug administration (MDA) campaigns with the anthelminthic drug Praziquantel and prevention methods including the reduction of snail hosts and ‘WaSH’ sanitation programmes. However, the effectiveness of these approaches is limited due to the high likelihood of reinfection and the potential for development of drug resistance. This has driven the search for alternative approaches including the production of an effective vaccine. Anti-Schistosoma vaccines have the potential to induce long term immunity, as evidence exists of natural resistance in individuals within schistosome endemic areas, linked to a T-helper 2 (Th2) cell-associated response. Although there is currently no effective vaccine against schistosomiasis, several vaccine candidate antigens have been identified and tested, some of which have passed phase 1 clinical trials indicating safety and potential immune responses. However, all these candidates could be improved to reach the Preferred Product Characteristics (PPC) targets of adult worm and egg burden reduction. This could be achieved using an alternative adjuvant, such as a Virus-like particle (VLP) antigen assembly platform. Our VLP system has previously been identified as highly immunogenic against a range of diseases, including against the helminth Trichuris trichiura, where our initial data indicates that VLP-based delivery of T cell epitopes is a promising approach towards an effective vaccine. Building on this, we are now investigating the potential of this VLP system for development of an effective vaccine against schistosomiasis, through designed assembly of S. mansoni antigens based around a Hepatitis-B core VLP. Three previously tested S. mansoni antigens, Sm14, SmGST28 and Sm-TSP-2, have been chosen through MHC class II T cell epitope prediction (IEDB), which identified several immunogenic T cell epitopes. Through in vivo testing of this multi-component vaccine in a murine schistosomiasis infection model, we aim to interrogate whether VLP-based delivery of these epitopes is successful in generating effective protection against S. mansoni.