The efficient spread of malaria from infected humans to mosquitoes is a major challenge for malaria elimination initiatives. Gametocytes are the only Plasmodium life stage infectious to mosquitoes. Here, we summarize evidence for naturally acquired anti-gametocyte immunity and the current state of transmission blocking vaccines (TBV). Although gametocytes are intra-erythrocytic when present in infected humans, developing Plasmodium falciparum gametocytes may express proteins on the surface of red blood cells that elicit immune responses in naturally exposed individuals. This immune response may reduce the burden of circulating gametocytes. For both P. falciparum and Plasmodium vivax, there is a solid evidence that antibodies against antigens present on the gametocyte surface, when co-ingested with gametocytes, can influence transmission to mosquitoes. Transmission reducing immunity, reducing the burden of infection in mosquitoes, is a well-acknowledged but poorly quantified phenomenon that forms the basis for the development of TBV. Transmission enhancing immunity, increasing the likelihood or intensity of transmission to mosquitoes, is more speculative in nature but is convincingly demonstrated for P. vivax. With the increased interest in malaria elimination, TBV and monoclonal antibodies have moved to the center stage of malaria vaccine development. Methodologies to prioritize and evaluate products are urgently needed.

中文翻译：

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针对性阶段恶性疟原虫和间日疟原虫寄生虫的免疫力。


疟疾从受感染的人类到蚊子的有效传播是消除疟疾行动的主要挑战。配子体是唯一对蚊子具有传染性的疟原虫生命阶段。在这里，我们总结了自然获得性抗配子体免疫的证据和传播阻断疫苗（TBV）的现状。尽管配子细胞存在于受感染的人体中时位于红细胞内，但发育中的恶性疟原虫配子细胞可能在红细胞表面表达蛋白质，从而在自然暴露的个体中引发免疫反应。这种免疫反应可以减轻循环配子体的负担。对于恶性疟原虫和间日疟原虫，有确凿的证据表明，当与配子体共同摄入时，针对配子体表面存在的抗原的抗体可以影响向蚊子的传播。传播会降低免疫力，减少蚊子的感染负担，这是一种众所周知但缺乏量化的现象，它构成了结核病发展的基础。传播增强免疫力，增加传播给蚊子的可能性或强度，本质上更具推测性，但对于间日疟原虫已得到令人信服的证明。随着人们对消除疟疾的兴趣日益浓厚，TBV 和单克隆抗体已成为疟疾疫苗开发的中心舞台。迫切需要对产品进行优先排序和评估的方法。