Abstract

Identifying the mechanism of naturally acquired immunity against Plasmodium falciparum malaria could contribute to the design of effective malaria vaccines. Using a recently developed multiplexed FluoroSpot assay, we assessed cross-sectional pre-existing memory B-cells (MBCs) and antibody responses against six well known P. falciparum antigens (MSP-119, MSP-2 (3D7), MSP-2 (FC27), MSP-3, AMA-1 and CSP) and measured their associations with previous infections and time to clinical malaria in the ensuing malaria season in Kenyan children. These children were under active weekly surveillance for malaria as part of a long-term longitudinal malaria immunology cohort study, where they are recruited from birth. After performing Cox regression analysis, we found that children with a breadth of three or more antigen-specific MBC or antibody responses at the baseline had a reduced risk for malaria in the ensuing P. falciparum transmission season. Specifically, MBC responses against AMA-1, MSP-2 (3D7) and MSP-3, as well as antibody responses to MSP-2 (3D7) and MSP-3 were prospectively associated with a reduced risk for malaria. The magnitude or breadth of MBC responses were however not correlated with the cumulative number of malaria episodes since birth. We conclude that increased breadth for merozoite antigen-specific MBC and antibody responses is associated with protection against malaria.

Highlights

  • Plasmodium falciparum malaria is a leading cause of death in Sub-Saharan Africa, especially in children

  • We assessed memory B-cells (MBCs) and antibody responses specific for six well characterized P. falciparum antigens with risk of malaria in children living in an endemic area in Kenya

  • Our results indicate that levels for some of the merozoite MBC and antibody specificities were associated with a reduced risk of malaria

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Summary

Introduction

Plasmodium falciparum malaria is a leading cause of death in Sub-Saharan Africa, especially in children. Children living in high endemic areas are at particular risk of life threatening malaria before gradually acquiring immunity, which requires repeated exposure [3]. Protection against the most severe forms of malaria is achieved more rapidly than against uncomplicated malaria, with immunity against uncomplicated malaria developing gradually after repeated parasite exposures in children living in endemic areas [6, 7]. This clinical immunity has been shown to decline in the absence of continuous exposure, resulting in a loss of protection against re-infections [8]

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