1
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Kurtis JD, Raj DK, Michelow IC, Park S, Nixon CE, McDonald EA, Nixon CP, Pond-Tor S, Jha A, Taliano RJ, Kabyemela ER, Friedman JF, Duffy PE, Fried M. Maternally-derived Antibodies to Schizont Egress Antigen-1 and Protection of Infants From Severe Malaria. Clin Infect Dis 2020; 68:1718-1724. [PMID: 30165569 DOI: 10.1093/cid/ciy728] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 08/21/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In holoendemic areas, children suffer the most from Plasmodium falciparum malaria, yet newborns and young infants express a relative resistance to both infection and severe malarial disease (SM). This relative resistance has been ascribed to maternally-derived anti-parasite immunoglobulin G; however, the targets of these protective antibodies remain elusive. METHODS We enrolled 647 newborns at birth from a malaria-holoendemic region of Tanzania. We collected cord blood, measured antibodies to Plasmodium falciparum Schizont Egress Antigen-1 (PfSEA-1), and related these antibodies to the risk of severe malaria in the first year of life. In addition, we vaccinated female mice with PbSEA-1, mated them, and challenged their pups with P. berghei ANKA parasites to assess the impact of maternal PbSEA-1 vaccination on newborns' resistance to malaria. RESULTS Children with high cord-blood anti-PfSEA-1 antibody levels had 51.4% fewer cases of SM compared to individuals with lower anti-PfSEA-1 levels over 12 months of follow-up (P = .03). In 3 trials, pups born to PbSEA-1-vaccinated dams had significantly lower parasitemia and longer survival following a P. berghei challenge compared to pups born to control dams. CONCLUSIONS We demonstrate that maternally-derived, cord-blood anti-PfSEA-1 antibodies predict decreased risk of SM in infants and vaccination of mice with PbSEA-1 prior to pregnancy protects their offspring from lethal P. berghei challenge. These results identify, for the first time, a parasite-specific target of maternal antibodies that protect infants from SM and suggest that vaccination of pregnant women with PfSEA-1 may afford a survival advantage to their offspring.
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Affiliation(s)
- Jonathan D Kurtis
- Center for International Health Research, Brown University Medical School, Providence.,Department of Pathology and Laboratory Medicine, Brown University Medical School, Providence
| | - Dipak K Raj
- Center for International Health Research, Brown University Medical School, Providence.,Department of Pathology and Laboratory Medicine, Brown University Medical School, Providence
| | - Ian C Michelow
- Center for International Health Research, Brown University Medical School, Providence.,Department of Pediatrics, Rhode Island Hospital, Brown University Medical School, Providence
| | - Sangshin Park
- Center for International Health Research, Brown University Medical School, Providence.,Department of Pediatrics, Rhode Island Hospital, Brown University Medical School, Providence
| | - Christina E Nixon
- Center for International Health Research, Brown University Medical School, Providence.,Department of Pathology and Laboratory Medicine, Brown University Medical School, Providence
| | - Emily A McDonald
- Center for International Health Research, Brown University Medical School, Providence.,Department of Pediatrics, Rhode Island Hospital, Brown University Medical School, Providence
| | - Christian P Nixon
- Center for International Health Research, Brown University Medical School, Providence.,Department of Pathology and Laboratory Medicine, Brown University Medical School, Providence
| | - Sunthorn Pond-Tor
- Center for International Health Research, Brown University Medical School, Providence.,Department of Pathology and Laboratory Medicine, Brown University Medical School, Providence
| | - Ambrish Jha
- Center for International Health Research, Brown University Medical School, Providence
| | - Ross J Taliano
- Department of Pathology and Laboratory Medicine, Brown University Medical School, Providence
| | - Edward R Kabyemela
- Mother Offspring Malaria Studies (MOMS) Project, Seattle Biomedical Research Institute, Washington.,Muheza Designated District Hospital.,Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Jennifer F Friedman
- Center for International Health Research, Brown University Medical School, Providence.,Department of Pediatrics, Rhode Island Hospital, Brown University Medical School, Providence
| | - Patrick E Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
| | - Michal Fried
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
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2
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Asoba GN, Sumbele IUN, Anchang-Kimbi JK, Metuge S, Teh RN. Influence of infant feeding practices on the occurrence of malnutrition, malaria and anaemia in children ≤5 years in the Mount Cameroon area: A cross sectional study. PLoS One 2019; 14:e0219386. [PMID: 31318896 PMCID: PMC6638998 DOI: 10.1371/journal.pone.0219386] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 06/22/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The objective of this study was to evaluate the influence of different infant feeding habits on the occurrence of malnutrition, Plasmodium falciparum parasitaemia and anaemia in children ≤5 years in the Mount Cameroon area. METHODOLOGY A total of 1227 children ≤5 years of age were recruited in a descriptive cross-sectional study. Socio demographic data and information on the different infant feeding habits was obtained by the use of semi-structured questionnaire. Nutritional status was assessed by the use of anthropometric measurements. Plasmodium was detected by light microscopy and haemoglobin was measured by use of an auto-haematology analyser. Anaemia as well as its severity was classified based on WHO standards. The associations between variables were assessed using logistic regression analysis. RESULTS The prevalence of exclusive breast feeding (EBF) was 22.6%, mixed feeding (MF) was 60.1% and those not breastfed (NBF) at all was 17.3%. The prevalence of malnutrition, P. falciparum parasitaemia and anaemia was 32.6%, 30.4% and 77.3% respectively. Children who had EBF had significantly lower (P <0.001) prevalence of malaria parasite (16.2%) than those NBF at all (61.3%). The prevalence of anaemia was significantly higher (P <0.001) in children who had MF (80.5%) while, severe and moderate anaemia was highest in those NBF at all (6.6%, 67.1% respectively; P = 0.029) than their counterparts. The significant predictors of anaemia were age group (P <0.001), marital status (P <0.001) and educational level of parent (P <0.001), that for malaria parasitaemia was infant feeding habit (MF: P< 0.001 and NBF: P <0.001) and malnutrition was age group (≤2 years: P <0.008 and 2.1-4.0 years: P = 0.028). CONCLUSION The infant feeding habit significantly influenced the occurrence of malaria parasite infection and not malnutrition and anaemia, hence EBF should be encouraged in malaria endemic zones.
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Affiliation(s)
- Gillian Nkeudem Asoba
- Department of Social Economy and Family Management, Higher Technical Teachers' Training College, University of Buea, Kumba, Cameroon
| | | | | | - Samuel Metuge
- Department of Social Economy and Family Management, Higher Technical Teachers' Training College, University of Buea, Kumba, Cameroon
| | - Rene Ning Teh
- Department of Social Economy and Family Management, Higher Technical Teachers' Training College, University of Buea, Kumba, Cameroon
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
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3
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Maurizio PL, Fuseini H, Tegha G, Hosseinipour M, De Paris K. Signatures of divergent anti-malarial treatment responses in peripheral blood from adults and young children in Malawi. Malar J 2019; 18:205. [PMID: 31234875 PMCID: PMC6591936 DOI: 10.1186/s12936-019-2842-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 06/17/2019] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Heterogeneity in the immune response to parasite infection is mediated in part by differences in host genetics, gender, and age group. In infants and young children, ongoing immunological maturation often results in increased susceptibility to infection and variable responses to drug treatment, increasing the risk of complications. Even though significant age-associated effects on host cytokine responses to Plasmodium falciparum infection have been identified, age-associated effects on uncomplicated malaria infection and anti-malarial treatment remain poorly understood. METHODS In samples of whole blood from a cohort of naturally infected malaria-positive individuals with non-severe falciparum malaria in Malawi (n = 63 total; 34 infants and young children < 2 years old, 29 adults > 18 years old), blood cytokine levels and monocyte and dendritic cell frequencies were assessed at two timepoints: acute infection, and 4 weeks post anti-malarial treatment. The effects of age group, gender, and timepoint were modeled, and the role of these factors on infection and treatment outcomes was evaluated. RESULTS Regardless of treatment timepoint, in this population age was significantly associated with overall blood haemoglobin, which was higher in adults, and plasma nitric oxide metabolites, IL-10, and TNF levels, which were higher in young children. There was a significant effect of age on the haemoglobin treatment response, whereby after treatment, levels increased in young children and decreased in adults. Furthermore, there were significant age-associated effects on treatment response for overall parasite load, IFN-γ, and IL-12(p40), and these effects were gender-dependent. Significant age effects on the overall levels and treatment response of myeloid dendritic cell frequencies were observed. In addition, within each age group, results showed continuous age effects on gametocyte levels (Pfs16), TNF, and nitric oxide metabolites. CONCLUSIONS In a clinical study of young children and adults experiencing natural falciparum malaria infection and receiving anti-malarial treatment, age-associated signatures of infection and treatment responses in peripheral blood were identified. This study describes host markers that may indicate, and potentially contribute to, differential post-treatment outcomes for malaria in young children versus adults.
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Affiliation(s)
- Paul L Maurizio
- Department of Medicine, Section of Genetic Medicine, The University of Chicago, Chicago, IL, 60637, USA.
- Department of Genetics, University of North Carolina-Chapel Hill, Chapel Hill, NC, 27599, USA.
- Curriculum in Bioinformatics and Computational Biology, University of North Carolina-Chapel Hill, Chapel Hill, NC, 27599, USA.
| | - Hubaida Fuseini
- Department of Pathology, Microbiology & Immunology, Vanderbilt University, Nashville, TN, USA
| | - Gerald Tegha
- Division of Infectious Diseases, Department of Medicine, University of North Carolina, 130 Mason Farm Rd, Bioinformatics Bldg, Chapel Hill, NC, 27599, USA
| | - Mina Hosseinipour
- Division of Infectious Diseases, Department of Medicine, University of North Carolina, 130 Mason Farm Rd, Bioinformatics Bldg, Chapel Hill, NC, 27599, USA
- University of North Carolina Project-Malawi, Lilongwe, Malawi
| | - Kristina De Paris
- Department of Microbiology and Immunology, University of North Carolina, Chapel Hill, NC, 27599, USA
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4
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Nash SD, Prevots DR, Kabyemela E, Khasa YP, Lee KL, Fried M, Duffy PE. A Malaria-Resistant Phenotype with Immunological Correlates in a Tanzanian Birth Cohort Exposed to Intense Malaria Transmission. Am J Trop Med Hyg 2017; 96:1190-1196. [PMID: 28500801 DOI: 10.4269/ajtmh.16-0554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractMalaria incidence is highly heterogeneous even in areas of high transmission, although no conclusive evidence exists that innate or naturally acquired resistance can prevent infection over an extended period of time. This longitudinal study examined immunoparasitological evidence for a malaria-resistant phenotype in which children do not develop malaria despite an extended period of exposure to parasites. Within a birth cohort followed from 2002 to 2006 in Muheza, Tanzania, an area of intense transmission, children (N = 687) provided blood smears biweekly during infancy and monthly thereafter. Maternal and childhood characteristics were obtained, cord-blood cytokines were measured, and antibody responses were assayed as measures of stage-specific exposure. Sixty-three (9.2%) children had no blood smear-positive slides over 2 years of follow-up (range: 1-3.5 years) and were identified as malaria resistant. Malaria-resistant children were similar to other children with respect to completeness of follow-up and all maternal and childhood characteristics except residence area. Antibody seroprevalence was similar for two sporozoite antigens, but malaria-resistant children had a lower antibody seroprevalence to merozoite antigens merozoite surface protein 1 (5.4% versus 30.2%; P < 0.0001) and apical membrane antigen 1 (7.2% versus 33.3%; P < 0.0001). Malaria-resistant children had higher cytokine levels in cord blood, particularly interleukin-1β. In summary, a subset of children living in an area of intense transmission was exposed to malaria parasites, but never developed patent parasitemia; this phenotype was associated with a distinct cytokine profile at birth and antibody profile during infancy. Further research with malaria-resistant children may identify mechanisms for naturally acquired immunity.
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Affiliation(s)
- Scott D Nash
- Epidemiology Unit, Laboratory of Clinical Infectious Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.,Laboratory of Malaria Immunology and Vaccinology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
| | - D Rebecca Prevots
- Epidemiology Unit, Laboratory of Clinical Infectious Diseases, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | | | - Yogender P Khasa
- Department of Microbiology, University of Delhi South Campus, New Delhi, India
| | - Kun-Lin Lee
- Laboratory of Malaria Immunology and Vaccinology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
| | - Michal Fried
- Laboratory of Malaria Immunology and Vaccinology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
| | - Patrick E Duffy
- Laboratory of Malaria Immunology and Vaccinology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
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5
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Brazeau NF, Tabala M, Kiketa L, Kayembe D, Chalachala JL, Kawende B, Lapika B, Meshnick SR, Yotebieng M. Exclusive Breastfeeding and Clinical Malaria Risk in 6-Month-Old Infants: A Cross-Sectional Study from Kinshasa, Democratic Republic of the Congo. Am J Trop Med Hyg 2016; 95:827-830. [PMID: 27549632 DOI: 10.4269/ajtmh.16-0011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 06/06/2016] [Indexed: 11/07/2022] Open
Abstract
The World Health Organization recommends exclusive breastfeeding (EBF) for the first 6 months of life. However, the effect of EBF on malaria risk remains unclear. In the present study, 137 EBF infants and 358 non-EBF infants from the Democratic Republic of the Congo were assessed for fever and malaria infections by polymerase chain reaction, at 6 months of age. EBF was associated with a reduced risk of clinical malaria (odds ratio = 0.13; 95% confidence interval = 0.00-0.80), suggesting a protective effect of EBF against malaria.
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Affiliation(s)
- Nicholas F Brazeau
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
| | - Martine Tabala
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Landry Kiketa
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Dyna Kayembe
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | | | - Bienvenu Kawende
- School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Bruno Lapika
- Department of Anthropology, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Steven R Meshnick
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
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6
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Sylvester B, Gasarasi DB, Aboud S, Tarimo D, Massawe S, Mpembeni R, Swedberg G. Prenatal exposure to Plasmodium falciparum increases frequency and shortens time from birth to first clinical malaria episodes during the first two years of life: prospective birth cohort study. Malar J 2016; 15:379. [PMID: 27448394 PMCID: PMC4957302 DOI: 10.1186/s12936-016-1417-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 07/04/2016] [Indexed: 11/23/2022] Open
Abstract
Background Prenatal exposure to Plasmodium falciparum affects development of protective immunity and susceptibility to subsequent natural challenges with similar parasite antigens. However, the nature of these effects has not been fully elucidated. The aim of this study was to determine the effect of prenatal exposure to P. falciparum on susceptibility to natural malaria infection, with a focus on median time from birth to first clinical malaria episode and frequency of clinical malaria episodes in the first 2 years of life. Methods A prospective birth cohort study was conducted in Rufiji district in Tanzania, between January 2013 and December 2015. Infants born to mothers with P. falciparum in the placenta at time of delivery were defined as exposed, and infants born to mothers without P. falciparum parasites in placenta were defined as unexposed. Placental infection was established by histological techniques. Out of 206 infants recruited, 41 were in utero exposed to P. falciparum and 165 infants were unexposed. All infants were monitored for onset of clinical malaria episodes in the first 2 years of life. The outcome measure was time from birth to first clinical malaria episode, defined by fever (≥37 °C) and microscopically determined parasitaemia. Median time to first clinical malaria episode between exposed and unexposed infants was assessed using Kaplan–Meier survival analysis and comparison was done by log rank. Association of clinical malaria episodes with prenatal exposure to P. falciparum was assessed by multivariate binary logistic regression. Comparative analysis of mean number of clinical malaria episodes between exposed and unexposed infants was done using independent sample t test. Results The effect of prenatal exposure to P. falciparum infection on clinical malaria episodes was statistically significant (Odds Ratio of 4.79, 95 % CI 2.21–10.38, p < 0.01) when compared to other confounding factors. Median time from birth to first clinical malaria episode for exposed and unexposed infants was 32 weeks (95 % CI 30.88–33.12) and 37 weeks (95 % CI 35.25–38.75), respectively, and the difference was statistically significant (p = 0.003). The mean number of clinical malaria episodes in exposed and unexposed infants was 0.51 and 0.30 episodes/infant, respectively, and the difference was statistically significant (p = 0.038). Conclusions Prenatal exposure to P. falciparum shortens time from birth to first clinical malaria episode and increases frequency of clinical malaria episodes in the first 2 years of life.
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Affiliation(s)
- Boniphace Sylvester
- Department of Parasitology and Medical Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O.BOX 65001, Dar es Salaam, Tanzania.
| | - Dinah B Gasarasi
- Department of Parasitology and Medical Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O.BOX 65001, Dar es Salaam, Tanzania
| | - Said Aboud
- Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, P.O.BOX 65001, Dar es Salaam, Tanzania
| | - Donath Tarimo
- Department of Parasitology and Medical Entomology, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O.BOX 65001, Dar es Salaam, Tanzania
| | - Siriel Massawe
- Department of Obstetrics and Gynaecology, School of Medicine, Muhimbili University of Health and Allied Sciences, P.O.BOX 65001, Dar es Salaam, Tanzania
| | - Rose Mpembeni
- Department of Community Medicine, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O.BOX 65001, Dar es Salaam, Tanzania
| | - Gote Swedberg
- Department of Medical Biochemistry, Biomedical Centre, Uppsala University, Uppsala, Sweden
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7
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Plasmodium falciparum infection and age influence parasite growth inhibition mediated by IgG in Beninese infants. Acta Trop 2016; 159:111-9. [PMID: 27001144 DOI: 10.1016/j.actatropica.2016.03.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 02/10/2016] [Accepted: 03/17/2016] [Indexed: 11/22/2022]
Abstract
Antibodies that impede the invasion of Plasmodium falciparum (P. falciparum) merozoites into erythrocytes play a critical role in anti-malarial immunity. The Growth Inhibition Assay (GIA) is an in vitro measure of the functional capacity of such antibodies to limit erythrocyte invasion and/or parasite growth. Up to now, it is unclear whether growth-inhibitory activity correlates with protection from clinical disease and there are inconsistent results from studies performed with GIA. Studies that have focused on the relationship between IgGs and their in vitro parasite Growth Inhibition Activity (GIAc) in infants aged less than two years old are rare. Here, we used clinical and parasitological data to precisely define symptomatic or asymptomatic infection with P. falciparum in groups of infants followed-up actively for 18 months post-natally. We quantified the levels of IgG1 and IgG3 directed to a panel of candidate P. falciparum vaccine antigens (AMA-1, MSP1, 2, 3 and GLURP) using ELISA and the functional activity of IgG was quantified using GIA. Data were then correlated with individuals' infection status. At 18 months of age, infants harbouring infections at the time of blood sampling had an average 19% less GIAc than those not infected (p=0.004, multivariate linear regression). GIAc decreased from 12 to 18 months of age (p=0.003, Wilcoxon matched pairs test). Antibody levels quantified at 18 months in infants were strongly correlated with their exposure to malarial infection, however GIAc was not correlated with malaria infectious status (asymptomatic and symptomatic groups). In conclusion, both infection status at blood draw and age influence parasite growth inhibition mediated by IgG in the GIA. Both factors must be taken into account when correlations between GIAc and anti-malarial protection or vaccine efficacy have to be made.
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8
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Charnaud SC, McGready R, Herten-Crabb A, Powell R, Guy A, Langer C, Richards JS, Gilson PR, Chotivanich K, Tsuboi T, Narum DL, Pimanpanarak M, Simpson JA, Beeson JG, Nosten F, Fowkes FJI. Maternal-foetal transfer of Plasmodium falciparum and Plasmodium vivax antibodies in a low transmission setting. Sci Rep 2016; 6:20859. [PMID: 26861682 PMCID: PMC4748262 DOI: 10.1038/srep20859] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 01/04/2016] [Indexed: 11/10/2022] Open
Abstract
During pregnancy immunoglobulin G (IgG) antibodies are transferred from mother to neonate across the placenta. Studies in high transmission areas have shown transfer of P. falciparum-specific IgG, but the extent and factors influencing maternal-foetal transfer in low transmission areas co-endemic for both P. falciparum and P. vivax are unknown. Pregnant women were screened weekly for Plasmodium infection. Mother-neonate paired serum samples at delivery were tested for IgG to antigens from P. falciparum, P. vivax and other infectious diseases. Antibodies to malarial and non-malarial antigens were highly correlated between maternal and neonatal samples (median [range] spearman ρ = 0.78 [0.57-0.93]), although Plasmodium spp. antibodies tended to be lower in neonates than mothers. Estimated gestational age at last P. falciparum infection, but not P. vivax infection, was positively associated with antibody levels in the neonate (P. falciparum merozoite, spearman ρ median [range] 0.42 [0.33-0.66], PfVAR2CSA 0.69; P. vivax ρ = 0.19 [0.09-0.3]). Maternal-foetal transfer of anti-malarial IgG to Plasmodium spp. antigens occurs in low transmission settings. P. vivax IgG acquisition is not associated with recent exposure unlike P. falciparum IgG, suggesting a difference in acquisition of antibodies. IgG transfer is greatest in the final weeks of pregnancy which has implications for the timing of future malaria vaccination strategies in pregnant women.
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Affiliation(s)
- Sarah C Charnaud
- Macfarlane Burnet Institute of Medical Research, Melbourne, Australia
| | - Rose McGready
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.,Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Asha Herten-Crabb
- Macfarlane Burnet Institute of Medical Research, Melbourne, Australia.,Department of Medicine, University of Melbourne, Australia
| | - Rosanna Powell
- Macfarlane Burnet Institute of Medical Research, Melbourne, Australia
| | - Andrew Guy
- Macfarlane Burnet Institute of Medical Research, Melbourne, Australia.,Department of Immunology, Monash University, Alfred Medical Research and Education Precinct, Melbourne, Australia
| | - Christine Langer
- Macfarlane Burnet Institute of Medical Research, Melbourne, Australia
| | - Jack S Richards
- Macfarlane Burnet Institute of Medical Research, Melbourne, Australia.,Department of Medicine, University of Melbourne, Australia
| | - Paul R Gilson
- Macfarlane Burnet Institute of Medical Research, Melbourne, Australia
| | - Kesinee Chotivanich
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Thailand
| | - Takafumi Tsuboi
- Division of Malaria Research, Proteo-Science Center, Ehime University, Matsuyama, Japan
| | - David L Narum
- Laboratory of Malaria Immunology and Vaccinology, NIAID/NIH, Rockville, MD, USA
| | - Mupawjay Pimanpanarak
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | - Julie A Simpson
- Centre for Epidemiology and Biostatistics, University of Melbourne, Australia
| | - James G Beeson
- Macfarlane Burnet Institute of Medical Research, Melbourne, Australia.,Department of Medicine, University of Melbourne, Australia
| | - François Nosten
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.,Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Freya J I Fowkes
- Macfarlane Burnet Institute of Medical Research, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.,Department of Infectious Diseases, Monash University, Melbourne, Australia
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9
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Abstract
Malaria is one of the most serious infectious diseases with most of the severe disease
caused by Plasmodium falciparum (Pf). Naturally acquired immunity
develops over time after repeated infections and the development of antimalarial
antibodies is thought to play a crucial role. Neonates and young infants are relatively
protected from symptomatic malaria through mechanisms that are poorly understood. The
prevailing paradigm is that maternal antimalarial antibodies transferred to the fetus in
the last trimester of pregnancy protect the infant from early infections. These
antimalarial antibodies wane by approximately 6 months of age leaving the infant
vulnerable to malaria, however direct evidence supporting this epidemiologically based
paradigm is lacking. As infants are the target population for future malaria vaccines,
understanding how they begin to develop immunity to malaria and the gaps in their
responses is key. This review summarizes the antimalarial antibody responses detected in
infants and how they change over time. We focus primarily on Pf antibody responses and
will briefly mention Plasmodium vivax responses in infants.
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10
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Dechavanne C, Cottrell G, Garcia A, Migot-Nabias F. Placental Malaria: Decreased Transfer of Maternal Antibodies Directed to Plasmodium falciparum and Impact on the Incidence of Febrile Infections in Infants. PLoS One 2015; 10:e0145464. [PMID: 26698578 PMCID: PMC4689360 DOI: 10.1371/journal.pone.0145464] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 12/03/2015] [Indexed: 12/15/2022] Open
Abstract
The efficacy of mother-to-child placental transfer of antibodies specific to malaria blood stage antigens was investigated in the context of placental malaria infection, taking into account IgG specificity and maternal hypergammaglobulinemia. The impact of the resulting maternal antibody transfer on infections in infants up to the age of 6 months was also explored. This study showed that i) placental malaria was associated with a reduced placental transfer of total and specific IgG, ii) antibody placental transfer varied according to IgG specificity and iii) cord blood malaria IgG levels were similar in infants born to mothers with or without placental malaria. The number of malaria infections was negatively associated with maternal age, whereas it was not associated with the transfer of any malaria-specific IgG from the mother to the fetus. These results suggest that i) malaria-specific IgG may serve as a marker of maternal exposure but not as a useful marker of infant protection from malaria and ii) increasing maternal age contributes to diminishing febrile infections diagnosed in infants, perhaps by means of the transmission of an effective antibody response.
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Affiliation(s)
- Celia Dechavanne
- Institut de Recherche pour le Développement (IRD), UMR 216 Mère et enfant face aux infections tropicales, Université Paris Descartes, Paris, France
- COMUE Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France
- * E-mail:
| | - Gilles Cottrell
- Institut de Recherche pour le Développement (IRD), UMR 216 Mère et enfant face aux infections tropicales, Université Paris Descartes, Paris, France
- COMUE Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France
| | - André Garcia
- Institut de Recherche pour le Développement (IRD), UMR 216 Mère et enfant face aux infections tropicales, Université Paris Descartes, Paris, France
- COMUE Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France
| | - Florence Migot-Nabias
- Institut de Recherche pour le Développement (IRD), UMR 216 Mère et enfant face aux infections tropicales, Université Paris Descartes, Paris, France
- COMUE Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France
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Contrasting Patterns of Serologic and Functional Antibody Dynamics to Plasmodium falciparum Antigens in a Kenyan Birth Cohort. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2015; 23:104-16. [PMID: 26656119 PMCID: PMC4744923 DOI: 10.1128/cvi.00452-15] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 11/20/2015] [Indexed: 11/20/2022]
Abstract
IgG antibodies to Plasmodium falciparum are transferred from the maternal to fetal circulation during pregnancy, wane after birth, and are subsequently acquired in response to natural infection. We examined the dynamics of malaria antibody responses of 84 Kenyan infants from birth to 36 months of age by (i) serology, (ii) variant surface antigen (VSA) assay, (iii) growth inhibitory activity (GIA), and (iv) invasion inhibition assays (IIA) specific for merozoite surface protein 1 (MSP1) and sialic acid-dependent invasion pathway. Maternal antibodies in each of these four categories were detected in cord blood and decreased to their lowest level by approximately 6 months of age. Serologic antibodies to 3 preerythrocytic and 10 blood-stage antigens subsequently increased, reaching peak prevalence by 36 months. In contrast, antibodies measured by VSA, GIA, and IIA remained low even up to 36 months. Infants sensitized to P. falciparum in utero, defined by cord blood lymphocyte recall responses to malaria antigens, acquired antimalarial antibodies at the same rate as those who were not sensitized in utero, indicating that fetal exposure to malaria antigens did not affect subsequent infant antimalarial responses. Infants with detectable serologic antibodies at 12 months of age had an increased risk of P. falciparum infection during the subsequent 24 months. We conclude that serologic measures of antimalarial antibodies in children 36 months of age or younger represent biomarkers of malaria exposure rather than protection and that functional antibodies develop after 36 months of age in this population.
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