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Na-ASP-2 + Alhydrogel is an investigational recombinant protein subunit vaccine developed by the Baylor College of Medicine for the prevention of hookworm infection caused by *Necator americanus*. The vaccine contains a 21 kDa recombinant protein, Ancylostoma Secreted Protein-2 (ASP-2), which is expressed in the yeast *Pichia pastoris* and adsorbed to the adjuvant Alhydrogel (aluminum hydroxide). Its mechanism of action involves the induction of neutralizing antibodies against the ASP-2 protein, which is secreted by infective larvae; these antibodies are intended to interfere with larval migration and the establishment of infection in the host. Although Phase 1 trials in hookworm-naive adults in the United States were successful, a Phase 1 trial in Brazil was terminated because participants with prior hookworm exposure developed immediate generalized urticarial reactions due to pre-existing IgE antibodies against the Na-ASP-2 antigen.
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