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Table 2 The whys and hows of the controlled human infection model. Concepts particular to endemic regions are presented in bold

From: Establishing a controlled hookworm human infection (CHHI) model for Africa: A report from the stakeholders meeting held in Lambaréné, Gabon, November 10–11, 2019

Why? How
Need to develop and assess vaccine and drug candidates • CHHI provides expedient assessment of vaccine and drug candidates
• Allows for mining for vaccine candidates when combined with proteome and glycan arrays
Creates a benchmark for assessing vaccine and drug efficacy in endemic populations
Unwanted/allergic responses to candidate vaccines • Report IgE reactivity to hookworm antigens
De-risks future development of candidates by testing antibody recognition in hookworm endemic population (in particular testing for IgE recognition and eosinophilia with challenge material)
Differing immune profiles between Africans and residents of non-endemic areas where vaccines are often developed • Provides data on innate and adaptive cellular responses to hookworm infection
• Report on IgM, IgG, IgG subclasses, and IgA reactivity to hookworm antigens
• Provides insight into local (skin, airway mucosa, and gut) immune responses
Allows for comparison between responses of volunteers from the Netherlands and Gabon
Need to develop Correlates of protection • Establish a profile of immune responses to hookworm as a surrogate of past exposure
Using vaccine candidates, CHHI allows for the identification of molecular patterns that could correlate with protection
  1. (CHHI) Controlled human hookworm infection model