Abstract

BackgroundAcquisition of malaria immunity in low transmission areas usually occurs after relatively few exposures to the parasite. A recent Plasmodium vivax experimental challenge trial in malaria naïve and semi-immune volunteers from Colombia showed that all naïve individuals developed malaria symptoms, whereas semi-immune subjects were asymptomatic or displayed attenuated symptoms. Sera from these individuals were analyzed by protein microarray to identify antibodies associated with clinical protection.Methodology/Principal FindingsSerum samples from naïve (n = 7) and semi-immune (n = 9) volunteers exposed to P. vivax sporozoite-infected mosquito bites were probed against a custom protein microarray displaying 515 P. vivax antigens. The array revealed higher serological responses in semi-immune individuals before the challenge, although malaria naïve individuals also had pre-existing antibodies, which were higher in Colombians than US adults (control group). In both experimental groups the response to the P. vivax challenge peaked at day 45 and returned to near baseline at day 145. Additional analysis indicated that semi-immune volunteers without fever displayed a lower response to the challenge, but recognized new antigens afterwards.ConclusionClinical protection against experimental challenge in volunteers with previous P. vivax exposure was associated with elevated pre-existing antibodies, an attenuated serological response to the challenge and reactivity to new antigens.

Highlights

  • Malaria remains an important public health problem worldwide, affecting mainly developing countries in Africa, Asia and Latin America

  • A recent Plasmodium vivax experimental challenge trial in malaria naïve and semi-immune volunteers from Colombia showed that all naïve individuals developed malaria symptoms, whereas semi-immune subjects were asymptomatic or displayed attenuated symptoms

  • A high prevalence of uncomplicated and asymptomatic P. vivax and P. falciparum malaria infections are reported in both hyperendemic and unstable malaria transmission regions, indicating that a significant level of clinical immunity is induced by repeated exposure to the parasite [2, 6,7,8,9]

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Summary

Introduction

Malaria remains an important public health problem worldwide, affecting mainly developing countries in Africa, Asia and Latin America. In areas of high malaria transmission, individuals continuously exposed to Plasmodium develop partial protection against severe symptoms at an early age and a significant number of asymptomatic infections are recorded [2]. This clinical protection is mediated by both innate and acquired mechanisms that are not well understood [2,3,4]. A recent Plasmodium vivax experimental challenge trial in malaria naïve and semi-immune volunteers from Colombia showed that all naïve individuals developed malaria symptoms, whereas semi-immune subjects were asymptomatic or displayed attenuated symptoms Sera from these individuals were analyzed by protein microarray to identify antibodies associated with clinical protection

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