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Naser RH, Rajaii T, Farash BRH, Seyyedtabaei SJ, Hajali V, Sadabadi F, Saburi E. Hematological changes due to malaria - An update. Mol Biochem Parasitol 2024; 259:111635. [PMID: 38857772 DOI: 10.1016/j.molbiopara.2024.111635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 06/12/2024]
Abstract
Malaria, a parasitic infection caused by the genus Plasmodium, results to over 20 million reported cases annually worldwide. Most individuals exhibit various symptoms, and blood analysis plays a crucial role in determining the appropriate treatment approach. This study discusses various hematologic complications associated with different Plasmodium species. A review of scientific databases including PubMed, Science Direct, Web of Science, Scopus, EMBASE, Magiran, SID, IranMedex was conducted using standard keywords such as Plasmodium, malaria, anemia and blood disorders (hematologic disorder) between 2000 and 2024. The review focused on articles pertaining to clinical trials, prospective cohort, retrospective, cross-sectional and case-control studies. Articles evaluating the effects of malaria on blood cells and indices, with target groups including human and animals, were included. Articles not written in English or Farsi were excluded. Our review revealed that, apart from iron deficiency anemia and vascular dysfunction contributed in part by adhesion of infected RBC to endothelium, decreases in hematocrit and hemoglobin levels, as part of pancytopenia and thrombocytopenia, are characteristic of Plasmodium infection. Additionally, the occurrence of inflammation due to the release of inflammatory cytokines and complement activation can complicate the clinical features of malaria in individuals with hematologic conditions.
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Affiliation(s)
- Rana Hussein Naser
- Department of Science, College of Basic Education, University of Diyala, Iraq
| | - Toktam Rajaii
- Health center no.1, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bibi Razieh Hosseini Farash
- Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Cutaneous Leishmania Research Center, Mashhad University of Medical Sciences, Iran
| | | | - Vahid Hajali
- Department of Neuroscience, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Sadabadi
- Cutaneous Leishmania Research Center, Mashhad University of Medical Sciences, Iran
| | - Ehsan Saburi
- Medical Genetics and Molecular Medicine Department, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Mortazavi SE, Lugaajju A, Nylander M, Danielsson L, Tijani MK, Beeson JG, Persson KEM. Acquisition of complement fixing antibodies targeting Plasmodium falciparum merozoites in infants and their mothers in Uganda. Front Immunol 2023; 14:1295543. [PMID: 38090561 PMCID: PMC10715273 DOI: 10.3389/fimmu.2023.1295543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/10/2023] [Indexed: 12/18/2023] Open
Abstract
Background Antibody-mediated complement fixation has previously been associated with protection against malaria in naturally acquired immunity. However, the process of early-life development of complement-fixing antibodies in infants, both in comparison to their respective mothers and to other immune parameters, remains less clear. Results We measured complement-fixing antibodies in newborns and their mothers in a malaria endemic area over 5 years follow-up and found that infants' complement-fixing antibody levels were highest at birth, decreased until six months, then increased progressively until they were similar to birth at five years. Infants with high levels at birth experienced a faster decay of complement-fixing antibodies but showed similar levels to the low response group of newborns thereafter. No difference was observed in antibody levels between infant cord blood and mothers at delivery. The same result was found when categorized into high and low response groups, indicating placental transfer of antibodies. Complement-fixing antibodies were positively correlated with total schizont-specific IgG and IgM levels in mothers and infants at several time points. At nine months, complement-fixing antibodies were negatively correlated with total B cell frequency and osteopontin concentrations in the infants, while positively correlated with atypical memory B cells and P. falciparum-positive atypical memory B cells. Conclusion This study indicates that complement-fixing antibodies against P. falciparum merozoites are produced in the mothers and placentally-transferred, and they are acquired in infants over time during the first years of life. Understanding early life immune responses is crucial for developing a functional, long lasting malaria vaccine.
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Affiliation(s)
- Susanne E. Mortazavi
- Department of Laboratory Medicine, Lund University, Lund, Sweden
- Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden
| | - Allan Lugaajju
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Maria Nylander
- Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Lena Danielsson
- Department of Laboratory Medicine, Lund University, Lund, Sweden
- Clinical Chemistry and Pharmacology, Laboratory Medicine, Office for Medical Services, Region Skåne, Lund, Sweden
| | - Muyideen Kolapo Tijani
- Department of Laboratory Medicine, Lund University, Lund, Sweden
- Cellular Parasitology Program, Cell Biology and Genetics Unit, Department of Zoology, University of Ibadan, Ibadan, Nigeria
| | - James G. Beeson
- The Burnet Institute, Melbourne, VIC, Australia
- Department of Infectious Diseases, University of Melbourne, Melbourne, VIC, Australia
- Central Clinical School and Department of Microbiology, Monash University, Melbourne, VIC, Australia
| | - Kristina E. M. Persson
- Department of Laboratory Medicine, Lund University, Lund, Sweden
- Clinical Chemistry and Pharmacology, Laboratory Medicine, Office for Medical Services, Region Skåne, Lund, Sweden
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Ansah F, Nyame K, Laryea R, Owusu R, Amon D, Boyetey MJB, Ayeke D, Razak N, Kornu VE, Ashitei S, Owusu-Appiah C, Chirawurah JD, Abugri J, Aniweh Y, Opoku N, Sutherland CJ, Binka FN, Kweku M, Awandare GA, Dinko B. The temporal dynamics of Plasmodium species infection after artemisinin-based combination therapy (ACT) among asymptomatic children in the Hohoe municipality, Ghana. Malar J 2023; 22:271. [PMID: 37710288 PMCID: PMC10500816 DOI: 10.1186/s12936-023-04712-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND The routine surveillance of asymptomatic malaria using nucleic acid-based amplification tests is essential in obtaining reliable data that would inform malaria policy formulation and the implementation of appropriate control measures. METHODS In this study, the prevalence rate and the dynamics of Plasmodium species among asymptomatic children (n = 1697) under 5 years from 30 communities within the Hohoe municipality in Ghana were determined. RESULTS AND DISCUSSION The observed prevalence of Plasmodium parasite infection by polymerase chain reaction (PCR) was 33.6% (571/1697), which was significantly higher compared to that obtained by microscopy [26.6% (451/1697)] (P < 0.0001). Based on species-specific analysis by nested PCR, Plasmodium falciparum infection [33.6% (570/1697)] was dominant, with Plasmodium malariae, Plasmodium ovale and Plasmodium vivax infections accounting for 0.1% (1/1697), 0.0% (0/1697), and 0.0% (0/1697), respectively. The prevalence of P. falciparum infection among the 30 communities ranged from 0.0 to 82.5%. Following artesunate-amodiaquine (AS + AQ, 25 mg/kg) treatment of a sub-population of the participants (n = 184), there was a substantial reduction in Plasmodium parasite prevalence by 100% and 79.2% on day 7 based on microscopy and nested PCR analysis, respectively. However, there was an increase in parasite prevalence from day 14 to day 42, with a subsequent decline on day 70 by both microscopy and nested PCR. For parasite clearance rate analysis, we found a significant proportion of the participants harbouring residual Plasmodium parasites or parasite genomic DNA on day 1 [65.0% (13/20)], day 2 [65.0% (13/20)] and day 3 [60.0% (12/20)] after initiating treatment. Of note, gametocyte carriage among participants was low before and after treatment. CONCLUSION Taken together, the results indicate that a significant number of individuals could harbour residual Plasmodium parasites or parasite genomic DNA after treatment. The study demonstrates the importance of routine surveillance of asymptomatic malaria using sensitive nucleic acid-based amplification techniques.
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Affiliation(s)
- Felix Ansah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Kwamina Nyame
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Rukaya Laryea
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Richard Owusu
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Denick Amon
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Mark-Jefferson Buer Boyetey
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Dzidzor Ayeke
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Nasibatu Razak
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Victor E Kornu
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Sarah Ashitei
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Caleb Owusu-Appiah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Jersley D Chirawurah
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - James Abugri
- Department of Biochemistry and Forensic Sciences, School of Chemical and Biochemical Sciences, C. K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | - Yaw Aniweh
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Nicholas Opoku
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Colin J Sutherland
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Fred N Binka
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Margaret Kweku
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Bismarck Dinko
- Department of Infection Biology, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana.
- Department of Clinical Microbiology, School of Medicine and Dentistry College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti Region, Ghana.
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Leonard CM, Uhomoibhi P, Abubakar A, Ogunniyi A, Mba N, Greby SM, Okoye MI, Iriemenam NC, Ihekweazu C, Steinhardt L, Rogier E. Dynamics of IgG antibody response against Plasmodium antigens among Nigerian infants and young children. Front Immunol 2023; 14:1208822. [PMID: 37691957 PMCID: PMC10484571 DOI: 10.3389/fimmu.2023.1208822] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/24/2023] [Indexed: 09/12/2023] Open
Abstract
Background Plasmodium falciparum malaria is a leading cause of child mortality in Nigeria. Neonates are born with maternal antibodies from placental transfer which may protect against malaria infection in the first months of life. The IgG dynamics of the transition from passively transferred antimalarial antibodies to actively acquired IgG from natural exposure have not been well elucidated. Methods Blood samples collected during a 2018 Nigeria nationwide HIV/AIDS household survey were available for 9,443 children under 5 years of age, with a subset of infants under 2 months of age having maternal samples available (n=41). Samples were assayed for the P. falciparum HRP2 antigen and anti-malarial IgG antibodies. LOESS regression examined the dynamics in IgG response in the first 5 years of life. Correlation with maternal IgG levels was assessed for mother/child pairs. Results Consistent decreases were observed in median IgG levels against all Plasmodium spp. antigen targets for the first months of life. At a population level, P. falciparum apical membrane antigen-1 (AMA1) and merozoite surface protein-1 19kD (PfMSP1) IgG decreased during the first 12 months of life before reaching a nadir, whereas IgGs to other targets only declined for the first 4 months of life. Seropositivity showed a similar decline with the lowest seropositivity against AMA1 and PfMSP1 at 10-12 months, though remaining above 50% during the first 2 years of life in higher transmission areas. No protective association was observed between IgG positivity and P. falciparum infection in infants. Maternal antibody levels showed a strong positive correlation with infant antibody levels for all P. falciparum antigens from birth to 2 months of age, but this correlation was lost by 6 months of age. Discussion Maternally transferred anti-malarial IgG antibodies rapidly decline during the first 6 months of life, with variations among specific antigens and malaria transmission intensity. From 3-23 months of age, there was a wide range in IgG levels for the blood-stage antigens indicating high individual variation in antibody production as children are infected with malaria. Non-falciparum species-specific antigens showed similar patterns in waning immunity and correlation with paired mother's IgG levels compared to P. falciparum antigens.
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Affiliation(s)
- Colleen M. Leonard
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
- Oak Ridge Institute for Science and Education, U.S. Department of Energy, Oak Ridge, TN, United States
| | - Perpetua Uhomoibhi
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria
| | - Ado Abubakar
- Institute of Human Virology (IHVN), Abuja, Nigeria
| | | | - Nwando Mba
- Nigeria Centre for Disease Control (NCDC), Abuja, Nigeria
| | - Stacie M. Greby
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - McPaul I. Okoye
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | - Nnaemeka C. Iriemenam
- Division of Global HIV and Tuberculosis, Center for Global Health, Centers for Disease Control and Prevention, Abuja, Nigeria
| | | | - Laura Steinhardt
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Eric Rogier
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - NMS4 Technical Working Group
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Discrete Survival Model Analysis of Plasmodium falciparum Response to Artemisinin-Based Combination Therapies among Children in Regions of Varying Malaria Transmission in Cameroon. Pathogens 2021; 10:pathogens10091106. [PMID: 34578139 PMCID: PMC8465257 DOI: 10.3390/pathogens10091106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 11/24/2022] Open
Abstract
The need to monitor changes in parasite clearance following treatment with artemisinin-based combination therapies (ACTs) is important in the containment of drug resistance. This study aimed to model Plasmodium falciparum response to ACTs among children in two different transmission settings (Mutengene and Garoua) in Cameroon. Using the step function, a discrete-time survival model was fitted with all the covariates included that might play a role in parasite clearance. The probability of clearing parasites within 24 h following treatment was 21.6% and 70.3% for younger children aged 6 to 59 months and 29.3% and 59.8% for older children aged 60 to 120 months in Mutengene and Garoua, respectively. After two days of treatment, the conditional probability of clearing parasites given that they were not cleared on day 1 was 76.7% and 96.6% for children aged 6–59 months and 83.1% and 93.5% for children aged 60–120 months in Mutengene and Garoua, respectively. The model demonstrated that the ecological setting, age group and pretreatment serum levels of creatinine and alanine aminotransferase were the main factors that significantly influenced parasite clearance in vivo after administration of ACTs (p < 0.05). The findings highlight the need for further investigations on host differential response to ACTs in current practice.
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Dobaño C, Nhabomba AJ, Manaca MN, Berthoud T, Aguilar R, Quintó L, Barbosa A, Rodríguez MH, Jiménez A, Groves PL, Santano R, Bassat Q, Aponte JJ, Guinovart C, Doolan DL, Alonso PL. A Balanced Proinflammatory and Regulatory Cytokine Signature in Young African Children Is Associated With Lower Risk of Clinical Malaria. Clin Infect Dis 2020; 69:820-828. [PMID: 30380038 DOI: 10.1093/cid/ciy934] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 10/30/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The effect of timing of exposure to first Plasmodium falciparum infections during early childhood on the induction of innate and adaptive cytokine responses and their contribution to the development of clinical malaria immunity is not well established. METHODS As part of a double-blind, randomized, placebo-controlled trial in Mozambique using monthly chemoprophylaxis with sulfadoxine-pyrimethamine plus artesunate to selectively control timing of malaria exposure during infancy, peripheral blood mononuclear cells collected from participants at age 2.5, 5.5, 10.5, 15, and 24 months were stimulated ex vivo with parasite schizont and erythrocyte lysates. Cytokine messenger RNA expressed in cell pellets and proteins secreted in supernatants were quantified by reverse-transcription quantitative polymerase chain reaction and multiplex flow cytometry, respectively. Children were followed up for clinical malaria from birth until 4 years of age. RESULTS Higher proinflammatory (interleukin [IL] 1, IL-6, tumor necrosis factor) and regulatory (IL-10) cytokine concentrations during the second year of life were associated with reduced incidence of clinical malaria up to 4 years of age, adjusting by chemoprophylaxis and prior malaria exposure. Significantly lower concentrations of antigen-specific T-helper 1 (IL-2, IL-12, interferon-γ) and T-helper 2 (IL-4, IL-5) cytokines by 2 years of age were measured in children undergoing chemoprophylaxis compared to children receiving placebo (P < .03). CONCLUSIONS Selective chemoprophylaxis altering early natural exposure to malaria blood stage antigens during infancy had a significant effect on T-helper lymphocyte cytokine production >1 year later. Importantly, a balanced proinflammatory and anti-inflammatory cytokine signature, probably by innate cells, around age 2 years was associated with protective clinical immunity during childhood. CLINICAL TRIALS REGISTRATION NCT00231452.
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Affiliation(s)
- Carlota Dobaño
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Barcelona, Spain
| | | | - Maria N Manaca
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Tamara Berthoud
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain
| | - Ruth Aguilar
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Barcelona, Spain
| | - Llorenç Quintó
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Barcelona, Spain
| | - Arnoldo Barbosa
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Mauricio H Rodríguez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Alfons Jiménez
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain.,Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Barcelona, Spain
| | - Penny L Groves
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Rebeca Santano
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain
| | - Quique Bassat
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - John J Aponte
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Barcelona, Spain
| | - Caterina Guinovart
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Barcelona, Spain
| | - Denise L Doolan
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Pedro L Alonso
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain.,Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.,Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Barcelona, Spain
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Variations in killer-cell immunoglobulin-like receptor and human leukocyte antigen genes and immunity to malaria. Cell Mol Immunol 2020; 17:799-806. [PMID: 32541835 PMCID: PMC7294524 DOI: 10.1038/s41423-020-0482-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 05/19/2020] [Indexed: 12/29/2022] Open
Abstract
Malaria is one of the deadliest infectious diseases in the world. Immune responses to Plasmodium falciparum malaria vary among individuals and between populations. Human genetic variation in immune system genes is likely to play a role in this heterogeneity. Natural killer (NK) cells produce inflammatory cytokines in response to malaria infection, kill intraerythrocytic Plasmodium falciparum parasites by cytolysis, and participate in the initiation and development of adaptive immune responses to plasmodial infection. These functions are modulated by interactions between killer-cell immunoglobulin-like receptors (KIRs) and human leukocyte antigens (HLAs). Therefore, variations in KIR and HLA genes can have a direct impact on NK cell functions. Understanding the role of KIRs and HLAs in immunity to malaria can help to better characterize antimalarial immune responses. In this review, we summarize the different KIRs and HLAs associated with immunity to malaria thus far.
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Imported Malaria in Countries where Malaria Is Not Endemic: a Comparison of Semi-immune and Nonimmune Travelers. Clin Microbiol Rev 2020; 33:33/2/e00104-19. [PMID: 32161068 DOI: 10.1128/cmr.00104-19] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The continuous increase in long-distance travel and recent large migratory movements have changed the epidemiological characteristics of imported malaria in countries where malaria is not endemic (here termed non-malaria-endemic countries). While malaria was primarily imported to nonendemic countries by returning travelers, the proportion of immigrants from malaria-endemic regions and travelers visiting friends and relatives (VFRs) in malaria-endemic countries has continued to increase. VFRs and immigrants from malaria-endemic countries now make up the majority of malaria patients in many nonendemic countries. Importantly, this group is characterized by various degrees of semi-immunity to malaria, resulting from repeated exposure to infection and a gradual decline of protection as a result of prolonged residence in non-malaria-endemic regions. Most studies indicate an effect of naturally acquired immunity in VFRs, leading to differences in the parasitological features, clinical manifestation, and odds for severe malaria and clinical complications between immune VFRs and nonimmune returning travelers. There are no valid data indicating evidence for differing algorithms for chemoprophylaxis or antimalarial treatment in semi-immune versus nonimmune malaria patients. So far, no robust biomarkers exist that properly reflect anti-parasite or clinical immunity. Until they are found, researchers should rigorously stratify their study results using surrogate markers, such as duration of time spent outside a malaria-endemic country.
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9
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Barua P, Beeson JG, Maleta K, Ashorn P, Rogerson SJ. The impact of early life exposure to Plasmodium falciparum on the development of naturally acquired immunity to malaria in young Malawian children. Malar J 2019; 18:11. [PMID: 30658632 PMCID: PMC6339377 DOI: 10.1186/s12936-019-2647-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 01/12/2019] [Indexed: 11/23/2022] Open
Abstract
Background Antibodies targeting malaria blood-stage antigens are important targets of naturally acquired immunity, and may act as valuable biomarkers of malaria exposure. Methods Six-hundred and one young Malawian children from a randomized trial of prenatal nutrient supplementation with iron and folic acid or pre- and postnatal multiple micronutrients or lipid-based nutrient supplements were followed up weekly at home and febrile episodes were investigated for malaria from birth to 18 months of age. Antibodies were measured for 601 children against merozoite surface proteins (MSP1 19kD, MSP2), erythrocyte binding antigen 175 (EBA175), reticulocyte binding protein homologue 2 (Rh2A9), schizont extract and variant surface antigens expressed by Plasmodium falciparum-infected erythrocytes (IE) at 18 months of age. The antibody measurement data was related to concurrent malaria infection and to documented episodes of clinical malaria. Results At 18 months of age, antibodies were significantly higher among parasitaemic than aparasitaemic children. Antibody levels against MSP1 19kD, MSP2, schizont extract, and IE variant surface antigens were significantly higher in children who had documented episodes of malaria than in children who did not. Antibody levels did not differ between children with single or multiple malaria episodes before 18 months, nor between children who had malaria before 6 months of age or between 6 and 18 months. Conclusions Antibodies to merozoite and IE surface antigens increased following infection in early childhood, but neither age at first infection nor number of malaria episodes substantially affected antibody acquisition. These findings have implications for malaria surveillance during early childhood in the context of elimination. Trials registration Clinical Trials Registration: NCT01239693 (Date of registration: 11-10-2010). URL: http://www.ilins.org
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Affiliation(s)
- Priyanka Barua
- The Department of Medicine (RMH), Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC, 3000, Australia.,Department of Zoology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - James G Beeson
- The Department of Medicine (RMH), Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC, 3000, Australia.,Burnet Institute, Melbourne, VIC, 3004, Australia.,Department of Microbiology and Central Clinical School, Monash University, Melbourne, VIC, 3800, Australia
| | - Kenneth Maleta
- School of Public Health and Family Medicine, University of Malawi, Blantyre 3, Malawi
| | - Per Ashorn
- Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, 33100, Tampere, Finland.,Research and Development, Maternal, Newborn and Adolescent Health, World Health Organization, Geneva 27, 1211, Switzerland
| | - Stephen J Rogerson
- The Department of Medicine (RMH), Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC, 3000, Australia.
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10
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Saavedra-Langer R, Marapara J, Valle-Campos A, Durand S, Vásquez-Chasnamote ME, Silva H, Pinedo-Cancino V. IgG subclass responses to excreted-secreted antigens of Plasmodium falciparum in a low-transmission malaria area of the Peruvian Amazon. Malar J 2018; 17:328. [PMID: 30200987 PMCID: PMC6131892 DOI: 10.1186/s12936-018-2471-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/30/2018] [Indexed: 11/10/2022] Open
Abstract
Background Malaria in Peru is concentrated in the Amazon region, especially in Loreto, and transmission is focused in rural and peri-urban communities. The government has approved a malaria elimination plan with a community approach and seeks to reduce the risk of transmission through preventive interventions, but asymptomatic and low-parasite-density infections are challenges for disease control and elimination. IgG antibodies play a critical role in combating infection through their ability to reduce parasitaemia and clinical symptoms. In particular, IgG subclasses have important roles in controlling malaria disease and may provide new insight into the development of malaria control strategies and understanding of malaria transmission. Through the use of excreted-secreted antigens from Plasmodium falciparum, were evaluated the responses of the four IgG subclasses in symptomatic and asymptomatic malarial infections. Results Higher levels of whole IgG were observed in asymptomatic carriers (P < 0.05). IgG3 and IgG1 were the most prevalent subclasses and did not show differences in their antibody levels in either type of carrier. All symptomatic carriers were positive for IgG4, and the presence of IgG3 and IgG2 were correlated with protection against parasitaemia. IgG2 showed lower prevalence and antibody titers in comparison to other subclasses. Conclusions This is the first study that characterizes the IgG subclass response in the Peruvian Amazon, and these results show that even in populations from regions with low malaria transmission, a certain degree of naturally acquired immunity can develop when the right antibody subclasses are produced. This provides important insight into the potential mechanisms regulating protective immunity. Electronic supplementary material The online version of this article (10.1186/s12936-018-2471-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rafael Saavedra-Langer
- Fundación para el Desarrollo Sostenible de la Amazonía Baja del Perú, Universidad Nacional de la Amazonía Peruana, Iquitos, Perú.,Laboratorio de Investigación de Productos Naturales Antiparasitarios de la Amazonía Peruana, Centro de Investigación de Recursos Naturales de la Amazonía, Universidad Nacional de la Amazonía Peruana, Iquitos, Perú
| | - Jorge Marapara
- Laboratorio de Investigación de Productos Naturales Antiparasitarios de la Amazonía Peruana, Centro de Investigación de Recursos Naturales de la Amazonía, Universidad Nacional de la Amazonía Peruana, Iquitos, Perú
| | - Andree Valle-Campos
- Fundación para el Desarrollo Sostenible de la Amazonía Baja del Perú, Universidad Nacional de la Amazonía Peruana, Iquitos, Perú
| | - Salomón Durand
- Centro de Investigación en Enfermedades Tropicales "Maxime Kuczynski", Instituto Nacional de Salud, Lima, Perú
| | - Maria E Vásquez-Chasnamote
- Fundación para el Desarrollo Sostenible de la Amazonía Baja del Perú, Universidad Nacional de la Amazonía Peruana, Iquitos, Perú.,Laboratorio de Investigación de Productos Naturales Antiparasitarios de la Amazonía Peruana, Centro de Investigación de Recursos Naturales de la Amazonía, Universidad Nacional de la Amazonía Peruana, Iquitos, Perú
| | - Hermann Silva
- Facultad de Medicina Humana, Universidad Nacional de la Amazonía Peruana, Iquitos, Perú
| | - Viviana Pinedo-Cancino
- Fundación para el Desarrollo Sostenible de la Amazonía Baja del Perú, Universidad Nacional de la Amazonía Peruana, Iquitos, Perú. .,Laboratorio de Investigación de Productos Naturales Antiparasitarios de la Amazonía Peruana, Centro de Investigación de Recursos Naturales de la Amazonía, Universidad Nacional de la Amazonía Peruana, Iquitos, Perú.
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11
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Song Y, Aguilar R, Guo J, Manaca MN, Nhabomba A, Berthoud TK, Khoo SK, Wiertsema S, Barbosa A, Quintó L, Laing IA, Mayor A, Guinovart C, Alonso PL, LeSouëf PN, Dobaño C, Zhang GB. Cord Blood IL-12 Confers Protection to Clinical Malaria in Early Childhood Life. Sci Rep 2018; 8:10860. [PMID: 30022038 PMCID: PMC6052074 DOI: 10.1038/s41598-018-29179-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 07/03/2018] [Indexed: 11/21/2022] Open
Abstract
Using a well-designed longitudinal cohort, we aimed to identify cytokines that were protective against malaria and to explore how they were influenced by genetic and immunological factors. 349 Mozambican pregnant women and their newborn babies were recruited and followed up for malaria outcomes until 24 months of age. Six Th1 cytokines in cord blood were screened for correlation with malaria incidence, of which IL-12 was selected for further analyses. We genotyped IL-12 polymorphisms in children/mothers and evaluated the genotype-phenotype associations and genetic effects on IL-12 levels. Maternal IL-12 concentrations were also investigated in relation to Plasmodium infections and cord blood IL-12 levels. Our data showed that high background IL-12 levels were prospectively associated with a low incidence of clinical malaria, while IL-12 production after parasite stimulation had the opposite effect on malaria incidence. IL-12 genotypes (IL-12b rs2288831/rs17860508) and the haplotype CGTTAGAG distribution were related to malaria susceptibility and background IL-12 levels. Maternal genotypes also exhibited an evident impact on host genotype-phenotype associations. Finally, a positive correlation in background IL-12 levels between maternal and cord blood was identified. Thus, cord blood background IL-12 concentrations are important for protecting children from clinical malaria, likely mediated by both genotypes (children&mothers) and maternal immunity.
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Affiliation(s)
- Yong Song
- School of Public Health, Curtin University, Perth, 6102, Western Australia, Australia.,Centre for Genetic Origins of Health and Disease, The University of Western Australia and Curtin University, Perth, 6009, Western Australia, Australia
| | - Ruth Aguilar
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, CP1929, Mozambique.,ISGlobal, Hospital Clínic of Barcelona, Universitat de Barcelona, Barcelona, Catalonia, 08036, Spain
| | - Jing Guo
- School of Public Health, Curtin University, Perth, 6102, Western Australia, Australia.,Centre for Genetic Origins of Health and Disease, The University of Western Australia and Curtin University, Perth, 6009, Western Australia, Australia
| | - Maria Nelia Manaca
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, CP1929, Mozambique
| | - Augusto Nhabomba
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, CP1929, Mozambique
| | - Tamara Katherine Berthoud
- ISGlobal, Hospital Clínic of Barcelona, Universitat de Barcelona, Barcelona, Catalonia, 08036, Spain
| | - Siew-Kim Khoo
- School of Paediatrics and Child Health, The University of Western Australia, Perth, 6009, Western Australia, Australia
| | - Selma Wiertsema
- School of Paediatrics and Child Health, The University of Western Australia, Perth, 6009, Western Australia, Australia
| | - Arnoldo Barbosa
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, CP1929, Mozambique
| | - Llorenç Quintó
- ISGlobal, Hospital Clínic of Barcelona, Universitat de Barcelona, Barcelona, Catalonia, 08036, Spain
| | - Ingrid A Laing
- School of Paediatrics and Child Health, The University of Western Australia, Perth, 6009, Western Australia, Australia
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic of Barcelona, Universitat de Barcelona, Barcelona, Catalonia, 08036, Spain
| | - Caterina Guinovart
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, CP1929, Mozambique.,ISGlobal, Hospital Clínic of Barcelona, Universitat de Barcelona, Barcelona, Catalonia, 08036, Spain
| | - Pedro L Alonso
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, CP1929, Mozambique.,ISGlobal, Hospital Clínic of Barcelona, Universitat de Barcelona, Barcelona, Catalonia, 08036, Spain
| | - Peter N LeSouëf
- School of Paediatrics and Child Health, The University of Western Australia, Perth, 6009, Western Australia, Australia
| | - Carlota Dobaño
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, CP1929, Mozambique. .,ISGlobal, Hospital Clínic of Barcelona, Universitat de Barcelona, Barcelona, Catalonia, 08036, Spain.
| | - Guicheng Brad Zhang
- School of Public Health, Curtin University, Perth, 6102, Western Australia, Australia. .,Centre for Genetic Origins of Health and Disease, The University of Western Australia and Curtin University, Perth, 6009, Western Australia, Australia. .,Curtin Health Innovation Research Institute, Curtin University, Perth, 6102, Western Australia, Australia.
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12
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Ubillos I, Campo JJ, Jiménez A, Dobaño C. Development of a high-throughput flexible quantitative suspension array assay for IgG against multiple Plasmodium falciparum antigens. Malar J 2018; 17:216. [PMID: 29843713 PMCID: PMC5975539 DOI: 10.1186/s12936-018-2365-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/22/2018] [Indexed: 11/28/2022] Open
Abstract
Background Antibody responses to Plasmodium falciparum play a critical role in disease control. Finding reliable IgG biomarkers of protection is complicated by a parasite proteome of over 5000 proteins, some with polymorphisms. Studies of anti-malarial naturally acquired and vaccine immunity would benefit from a standard high-throughput immunoassay to measure multiple antibodies. A multiplex quantitative suspension assay to measure antigen-specific IgGs was developed and its precision (reproducibility and repeatability), dynamic range, limits of detection and quantification, and non-specific binding to different P. falciparum proteins tested. A set of 288 human plasma samples from a malaria-endemic region were analysed twice by two different operators. Another set of samples from 9 malaria-naïve and 10 malaria-exposed individuals were repetitively assayed during 22 consecutive days. Positive controls, negative controls, blanks and microspheres coated with bovine serum albumin were included in all assays. Results The multiplex quantitative suspension assay demonstrated low non-specific signal and good estimates of precision and reproducibility between operators. The overall mean of non-specific binding measured in 288 plasma samples was 32.83 to ± 44.81 median fluorescence intensity (MFI). Repeatability was 7.66% ± 15.89 between triplicates for all antigens and samples, being lower in samples from malaria-exposed than malaria-naïve individuals. No evidence of significantly different variance across days in MFI or arbitrary units (AU)/mL was found, assuming homogeneity of variance between days of analysis. Intra-class correlation coefficient between 22 days of analysis was 0.98 (0.97–0.98) for MFI units and 0.9 (0.87–0.93) for AU/mL. Reproducibility between operators for all samples and antigens had an overall adjusted correlation of 0.929 for MFI and 0.836 for AU/mL. Conclusions This high-throughput multiplex immunoassay is simple and highly reproducible. This represents an asset for malaria vaccine studies involving CSP-specific antibodies and selected antigens for sero-epidemiological purposes. Measuring a multiplex antigen panel in a single reaction will help to assess not only vaccine immunogenicity but also potential malaria vaccine effects on naturally acquired immune responses. This will accelerate the identification of immune correlates of protection, down-selection of vaccine formulations, antigen discovery and guide second-generation vaccine design. Electronic supplementary material The online version of this article (10.1186/s12936-018-2365-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Itziar Ubillos
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - Joseph J Campo
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Catalonia, Spain.,Antigen Discovery, Inc, Irvine, CA, USA
| | - Alfons Jiménez
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Catalonia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Carlota Dobaño
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Catalonia, Spain.
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13
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Development of quantitative suspension array assays for six immunoglobulin isotypes and subclasses to multiple Plasmodium falciparum antigens. J Immunol Methods 2018; 455:41-54. [PMID: 29397157 DOI: 10.1016/j.jim.2018.01.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 01/19/2018] [Accepted: 01/24/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Quantitative suspension arrays are powerful immunoassays to measure antibodies against multiple antigens in large numbers of samples in a short time and using few microliters. To identify antigen targets of immunity for vaccine development against complex microbes like Plasmodium falciparum, such technology allows the characterization of the magnitude and antigenic specificity of Ig isotypes and subclasses that are important for functional responses. However, standardized assays are not widely available. METHODS We developed six quantitative suspension array assays to measure IgG1, IgG2, IgG3, IgG4, IgM and IgE specific to multiple P. falciparum antigens. Secondary and tertiary antibodies, as well as human purified antibodies for standard curves, were tested among several commercially available sources. Positive and negative controls included plasmas from malaria hyper-immune African adults and from malaria-naïve European adults, respectively. Reagents were selected and optimal antibody and test sample dilutions established according to sensitivity, specificity and performance of the standard curves. The variability between replicates and plates was assessed with 30 test samples and controls. RESULTS Assays were able to detect P. falciparum antigen-specific antibodies for all isotypes and subclasses in samples from malaria-exposed individuals, with low background signal in blank wells. Levels detected in malaria-naïve individuals were overall low except for IgM. For the IgG2 and IgE assays, a triple sandwich was required for sensitivity. Standard curves with 5-parameter logistic fit were successfully obtained in all assays. The coefficients of variation for measurements performed in different days were all <30%, and <5% when comparing duplicates from the same plate. CONCLUSION The isotype/subclass assays developed here were sensitive, specific, reproducible and of adequate quantification dynamic range. They allow performing detailed immuno-profiling to large panels of P. falciparum antigens to address naturally- and vaccine-induced Ig responses and elucidate correlates of malaria protection, and could also be applied to other antigenic panels.
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14
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Pratt-Riccio LR, De Souza Perce-Da-Silva D, Da Costa Lima-Junior J, Pratt Riccio EK, Ribeiro-Alves M, Santos F, Arruda M, Camus D, Druilhe P, Oliveira-Ferreira J, Daniel-Ribeiro CT, Banic DM. Synthetic Antigens Derived from Plasmodium falciparum Sporozoite, Liver, and Blood Stages: Naturally Acquired Immune Response and Human Leukocyte Antigen Associations in Individuals Living in a Brazilian Endemic Area. Am J Trop Med Hyg 2017; 97:1581-1592. [PMID: 29016339 DOI: 10.4269/ajtmh.17-0359] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Peptide vaccine strategies using Plasmodium-derived antigens have emerged as an attractive approach against malaria. However, relatively few studies have been conducted with malaria-exposed populations from non-African countries. Herein, the seroepidemiological profile against Plasmodium falciparum of naturally exposed individuals from a Brazilian malaria-endemic area against synthetic peptides derived from vaccine candidates circumsporozoite protein (CSP), liver stage antigen-1 (LSA-1), erythrocyte binding antigen-175 (EBA-175), and merozoite surface protein-3 (MSP-3) was investigated. Moreover, human leukocyte antigen (HLA)-DRB1* and HLA-DQB1* were evaluated to characterize genetic modulation of humoral responsiveness to these antigens. The study was performed using blood samples from 187 individuals living in rural malaria-endemic villages situated near Porto Velho, Rondônia State. Specific IgG and IgM antibodies and IgG subclasses were detected by enzyme-linked immunosorbent assay, and HLA-DRB1* and HLA-DQB1* low-resolution typing was performed by PCR-SSP. All four synthetic peptides were broadly recognized by naturally acquired antibodies. Regarding the IgG subclass profile, only CSP induced IgG1 and IgG3 antibodies, which is an important fact given that the acquisition of protective immunity appears to be associated with the cytophilicity of IgG1 and IgG3 antibodies. HLA-DRB1*11 and HLA-DQB1*7 had the lowest odds of responding to EBA-175. Our results showed that CSP, LSA-1, EBA, and MSP-3 are immunogenic in natural conditions of exposure and that anti-EBA antibody responses appear to be modulated by HLA class II antigens.
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Affiliation(s)
| | | | | | | | - Marcelo Ribeiro-Alves
- Laboratório de Pesquisa Clínica em DST/AIDS, Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil
| | - Fátima Santos
- Laboratório Central de Saúde Pública (LACEN), Rondônia, Brazil
| | - Mercia Arruda
- Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fiocruz, Recife, Brazil
| | - Daniel Camus
- Service de Parasitologie-Mycologie, Faculte de Médecine, Lille, France
| | | | | | | | - Dalma Maria Banic
- Laboratório de Imunologia Clínica, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
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15
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Galatas B, Guinovart C, Bassat Q, Aponte JJ, Nhamússua L, Macete E, Saúte F, Alonso P, Aide P. A prospective cohort study to assess the micro-epidemiology of Plasmodium falciparum clinical malaria in Ilha Josina Machel (Manhiça, Mozambique). Malar J 2016; 15:444. [PMID: 27577880 PMCID: PMC5006496 DOI: 10.1186/s12936-016-1496-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 08/16/2016] [Indexed: 12/03/2022] Open
Abstract
Background After the decrease in clinical malaria incidence observed in Mozambique until 2009, a steady resurgence of cases per year has been reported nationally, reaching alarming levels in 2014. However, little is known about the clinical profile of the cases presented, or the possible epidemiological factors contributing to the resurgence of cases. Methods An analysis of surveillance data collected between July 2003 and June 2013 in the high malaria-transmission area of Ilha Josina Machel (Southern Mozambique) through a paediatric outpatient morbidity surveillance system was conducted to calculate hospital-based clinical malaria rates, slide-positivity rates, and minimum community-based incidence rates (MCBIRs) and incidence rate ratios per malaria season in children younger than 15 years of age. Clinical malaria was defined as a fever ≥37.5 °C or a reported fever in the previous 24 h with a positive blood smear. Yearly mean age, geometric mean parasitaemia (GMP) and mean packed cell volume (PCV) were also described for all clinical malaria cases and compared between seasons using DID analysis or ANOVA tests. Results During the study period, the percentage of outpatient visits presenting with confirmed clinical malaria decreased from 51 % in the 2003–2004 season to 23 % in 2008–2009, followed by an increase back to 51 % in 2012–2013. The yearly mean age of cases significantly increased from 2.9 (95 % CI 2.8–3.0) in 2003–2004 to 5.7 (95 % CI 5.6–5.7) in 2012–2013, compared to non-malaria cases. An increase in mean PCV levels was also observed (p < 0.001), as well as in GMPs: from 5778 parasites/µL in 2002–2003 to 17,316 parasites/µL in 2012–2013 (p < 0.001) mainly driven by an increase in GMP in children older than 1 year of age. MCBIRs in infants decreased by 70 % (RR = 0.3, p < 0.001) between 2003–2004 and 2012–2013. Incidence diminished by a third among children 1- to 4-years between 2003 and 2007, although such drop was unsustained as observed in 2012–2013 (RR = 1.0, 95 % CI 0.9–1.0). Finally, the incidence among children 5–14 years was 3.8 (95 % CI 3.4–4.3) times higher in 2012–2013 compared to 2003–2004. Conclusion Since 2003, Ilha Josina Machel observed a significant reduction of clinical malaria cases which was followed by an upsurge, following the national trend. A shift in the age distribution towards older children was observed, indicating that the changes in the transmission intensity patterns resulted in a slower acquisition of the naturally acquired immunity to malaria in children.
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Affiliation(s)
- Beatriz Galatas
- Centro de Investigação em Saúde de Manhiça (CISM), Rua12, Bairro Cambeve, Vila de Manhiça, Maputo, Mozambique. .,ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
| | - Caterina Guinovart
- Centro de Investigação em Saúde de Manhiça (CISM), Rua12, Bairro Cambeve, Vila de Manhiça, Maputo, Mozambique.,ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Quique Bassat
- Centro de Investigação em Saúde de Manhiça (CISM), Rua12, Bairro Cambeve, Vila de Manhiça, Maputo, Mozambique.,ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - John J Aponte
- Centro de Investigação em Saúde de Manhiça (CISM), Rua12, Bairro Cambeve, Vila de Manhiça, Maputo, Mozambique.,ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Lídia Nhamússua
- Centro de Investigação em Saúde de Manhiça (CISM), Rua12, Bairro Cambeve, Vila de Manhiça, Maputo, Mozambique
| | - Eusebio Macete
- Centro de Investigação em Saúde de Manhiça (CISM), Rua12, Bairro Cambeve, Vila de Manhiça, Maputo, Mozambique
| | - Francisco Saúte
- Centro de Investigação em Saúde de Manhiça (CISM), Rua12, Bairro Cambeve, Vila de Manhiça, Maputo, Mozambique
| | - Pedro Alonso
- Centro de Investigação em Saúde de Manhiça (CISM), Rua12, Bairro Cambeve, Vila de Manhiça, Maputo, Mozambique.,Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Pedro Aide
- Centro de Investigação em Saúde de Manhiça (CISM), Rua12, Bairro Cambeve, Vila de Manhiça, Maputo, Mozambique.,National Institute of Health, Ministry of Health, Maputo, Mozambique
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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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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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18
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Perraut R, Richard V, Varela ML, Trape JF, Guillotte M, Tall A, Toure A, Sokhna C, Vigan-Womas I, Mercereau-Puijalon O. Comparative analysis of IgG responses to Plasmodium falciparum MSP1p19 and PF13-DBL1α1 using ELISA and a magnetic bead-based duplex assay (MAGPIX®-Luminex) in a Senegalese meso-endemic community. Malar J 2014; 13:410. [PMID: 25326042 PMCID: PMC4221706 DOI: 10.1186/1475-2875-13-410] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 10/09/2014] [Indexed: 01/16/2023] Open
Abstract
Background Numerous Plasmodium falciparum antigens elicit humoral responses in humans living in endemic areas. Use of multiplex assays is a convenient approach to monitor the antibody response against multiple antigens, but to integrate multiplex assay-derived data with datasets, generated previously using ELISA, comparative studies are needed. This work compares antibody responses to two P. falciparum antigens monitored using both technologies. Methods The IgG response against the merozoite surface protein-1 PfMSP1p19 and the PF13-DBL1α1 domain of the P. falciparum Erythrocyte Membrane Protein1, expressed by the rosette-forming parasite 3D7/PF13 (PF13), was investigated using ELISA and a MAGPIX®-Luminex duplex assay. Archived plasma samples collected before the rainy season from 217 villagers living in Ndiop, a Senegalese meso-endemic setting, were studied. ROC analysis was used to define the optimal antibody measure readout. Association of antibody levels with protection against clinical malaria was analysed using Poisson regression in a retrospective study from active case detection records performed during the 5.5-month transmission season that followed blood sampling. Results There was a strong positive correlation (P <10-3) between ELISA and MAGPIX®-Luminex-MFI (median fluorescence intensity) values for antibody to PfMSP1p19 (rho = 0.78) and PF13-DBL1α1 (rho = 0.89), with a similar degree of concordance in all age groups. Antibody levels to both antigens were high but displayed a different age-associated pattern. Independent age-adjusted Poisson regression analysis showed a significant association with protection only for IgG responses to MSP1p19 (P <0.01 RR = 0.71 [0.53-0.93]) measured by ELISA. Conclusion The individual ELISA and duplex-MAGPIX assays provide a concordant evaluation of age-associated antibody responses to MSP1p19 and PF13-DBL1α1, irrespective of the formulation of antibody levels (values, ratios or ROC-adjusted figures) but do diverge with regard to the association of antibody levels with clinical protection in age-adjusted models. This may reflect incomplete overlap of the epitopes presented in the two formats. Further development for multiplex assessment of antibody responses to a larger panel of antigens with the robust and cost effective MAGPIX®-Luminex technology is warranted. Electronic supplementary material The online version of this article (doi:10.1186/1475-2875-13-410) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ronald Perraut
- Institut Pasteur de Dakar, Unité d'Immunologie, Dakar, Sénégal.
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Plasmodium falciparum malaria in children aged 0-2 years: the role of foetal haemoglobin and maternal antibodies to two asexual malaria vaccine candidates (MSP3 and GLURP). PLoS One 2014; 9:e107965. [PMID: 25238160 PMCID: PMC4169582 DOI: 10.1371/journal.pone.0107965] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 08/07/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Children below six months are reported to be less susceptible to clinical malaria. Maternally derived antibodies and foetal haemoglobin are important putative protective factors. We examined antibodies to Plasmodium falciparum merozoite surface protein 3 (MSP3) and glutamate-rich protein (GLURP), in children in their first two years of life in Burkina Faso and their risk of malaria. METHODS A cohort of 140 infants aged between four and six weeks was recruited in a stable transmission area of south-western Burkina Faso and monitored for 24 months by active and passive surveillance. Malaria infections were detected by examining blood smears using light microscopy. Enzyme-linked immunosorbent assay was used to quantify total Immunoglobulin G to Plasmodium falciparum antigens MSP3 and two regions of GLURP (R0 and R2) on blood samples collected at baseline, three, six, nine, 12, 18 and 24 months. Foetal haemoglobin and variant haemoglobin fractions were measured at the baseline visit using high pressure liquid chromatography. RESULTS A total of 79.6% of children experienced one or more episodes of febrile malaria during monitoring. Antibody titres to MSP3 were prospectively associated with an increased risk of malaria while antibody responses to GLURP (R0 and R2) did not alter the risk. Antibody titres to MSP3 were higher among children in areas of high malaria risk. Foetal haemoglobin was associated with delayed first episode of febrile malaria and haemoglobin CC type was associated with reduced incidence of febrile malaria. CONCLUSIONS We did not find any evidence of association between titres of antibodies to MSP3, GLURP-R0 or GLURP-R2 as measured by enzyme-linked immunosorbent assay and early protection against malaria, although anti-MSP3 antibody titres may reflect increased exposure to malaria and therefore greater risk. Foetal haemoglobin was associated with protection against febrile malaria despite the study limitations and its role is therefore worthy further investigation.
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