Abstract
Longitudinal cohort studies are important to describe the dynamics of naturally acquired antibody response profiles to defined Plasmodium falciparum malaria antigens relative to clinical malaria episodes. In children under 7 years of age in The Gambia, serum IgG responses were measured to P. falciparum merozoite antigens AMA1, EBA175, MSP119, MSP2 and crude schizont extract, over a 10-month period. Persistence of antibody responses was measured in 152 children during the dry season when there was virtually no malaria transmission, and 103 children were monitored for new episodes of clinical malaria during the subsequent wet season when transmission occurred. Children who experienced clinical malaria had lower antibody levels at the start of the study than those who remained free from malaria. Associations between dry season antibody persistence and subsequent wet season antibody levels suggested robust immunological memory responses. Mean antibody levels to all antigens were elevated by the end of the wet season in children who experienced clinical malaria; each of these children had a boosted antibody response to at least one antigen. In all children, antibody avidities were lower against MSP2 than other antigens, a difference that did not change throughout the study period or in relation to clinical malaria episodes.
Highlights
Plasmodium falciparum infection remains a significant cause of mortality among children in malaria endemic countries
Such persistent antibody production might be a marker of humoral immune memory capacity, but it is unknown whether this correlates with the ability to make rapid boosted antibody responses upon exposure to subsequent P. falciparum infections
There were no observed correlations between antibody avidity and presence of parasite infection, or occurrence of clinical malaria. In this cohort study in The Gambia, increases in serum IgG antibody levels to P. falciparum merozoite antigens were observed in many children during the wet season when malaria transmission occurred
Summary
Plasmodium falciparum infection remains a significant cause of mortality among children in malaria endemic countries. Antibody levels normally decline after an infection is resolved, the persistence of moderate antibody levels is seen in a substantial proportion of individuals, and this persistence has been shown to increase with age among young children [10]. Such persistent antibody production might be a marker of humoral immune memory capacity, but it is unknown whether this correlates with the ability to make rapid boosted antibody responses upon exposure to subsequent P. falciparum infections. Studies of serum antibodies prior to, during, and following clinical P. falciparum infections are important to investigate this
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