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VAR2CSA full-length ectodomain vaccine is a second-generation recombinant protein subunit vaccine candidate designed to prevent placental malaria (PM), also known as pregnancy-associated malaria (PAM). The vaccine targets the full-length extracellular region (ectodomain) of the Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) variant VAR2CSA. VAR2CSA is expressed on the surface of infected erythrocytes and mediates their sequestration in the placenta by binding to chondroitin sulfate A (CSA). Unlike first-generation subunit vaccines (such as PAMVAC and PRIMVAC) that utilize smaller N-terminal fragments of VAR2CSA and primarily induce strain-specific (homologous) antibodies, the full-length ectodomain vaccine displays conserved, structure-based conformational epitopes. This design is intended to elicit broadly neutralizing, strain-transcending antibodies capable of blocking the adhesion of diverse, heterologous placental malaria isolates to CSA.
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