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Protective Immunity against Severe Malaria in Children Is Associated with a Limited Repertoire of Antibodies to Conserved PfEMP1 Variants

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posted on 2019-11-13, 00:00 authored by S K Tessema, R Nakajima, A Jasinskas, S L Monk, L Lekieffre, E Lin, B Kiniboro, C Proietti, P Siba, P L Felgner, D L Doolan, I Mueller, Alyssa BarryAlyssa Barry
© 2019 Elsevier Inc. Extreme diversity of the major Plasmodium falciparum antigen, PfEMP1, poses a barrier to identifying targets of immunity to malaria. Here, we used protein microarrays containing hundreds of variants of the DBLα domain of PfEMP1 to cover the diversity of Papua New Guinean (PNG) parasites. Probing the plasma of a longitudinal cohort of malaria-exposed PNG children showed that group 2 DBLα antibodies were moderately associated with a lower risk of uncomplicated malaria, whereas individual variants were only weakly associated with clinical immunity. In contrast, antibodies to 85 individual group 1 and 2 DBLα variants were associated with a 70%–100% reduction in severe malaria. Of these, 17 variants were strong predictors of severe malaria. Analysis of full-length PfEMP1 sequences from PNG samples shows that these 17 variants are linked to pathogenic CIDR domains. This suggests that whereas immunity to uncomplicated malaria requires a broad repertoire of antibodies, immunity to severe malaria targets a subset of conserved variants. These findings provide insights into antimalarial immunity and potential antibody biomarkers for disease risk.

History

Journal

Cell Host and Microbe

Volume

26

Issue

5

Pagination

579 - 590.e5

Publisher

Science Direct

Location

New York, N.Y.

ISSN

1931-3128

eISSN

1934-6069

Language

eng.

Publication classification

C1 Refereed article in a scholarly journal