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Infection and Immunity, March 2003, p. 1242-1246, Vol. 71, No. 3
0019-9567/03/$08.00+0     DOI: 10.1128/IAI.71.3.1242-1246.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Congenital Exposure to Plasmodium falciparum Antigens: Prevalence and Antigenic Specificity of In Utero-Produced Antimalarial Immunoglobulin M Antibodies

Department of Biology, Georgetown University, Washington, DC 20054,¹ Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon,² AZ DataClinic, Inc., Rockville, Maryland 20850³

Received 5 August 2002/ Returned for modification 8 October 2002/ Accepted 13 December 2002

Congenital Plasmodium falciparum malaria in newborns is uncommon in sub-Saharan Africa. A significant number of infants, however, become infected or exposed to malarial antigens either in utero or at delivery and have the potential to produce antimalarial antibodies and memory cells before their first natural infection. In Yaounde, Cameroon, parasite-specific immunoglobulin M (IgM) was detected in 14% of cord blood samples. The IgM antibodies reacted with a wide range of asexual-stage antigens, with each newborn having its own unique pattern of IgM reactivity. PCR-based detection and genotyping of cord blood parasites found that the prevalence, total number of parasite genotypes, and complexity of infection were higher in newborns who had produced antimalarial IgM than those who had not. Maternal placental malaria and anemia were associated with the production of P. falciparum-specific IgM by the fetus. The effect of early immune priming on acquisition of immunity by infants is unknown and merits further investigation, since a significant proportion of Cameroonian newborns developed a humoral response to malaria before birth.

Editor: J. M. Mansfield

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