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Infection and Immunity, September 2002, p. 5328-5331, Vol. 70, No. 9
0019-9567/02/$04.00+0 DOI: 10.1128/IAI.70.9.5328-5331.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
The Human Immune Response to Plasmodium falciparum Includes Both Antibodies That Inhibit Merozoite Surface Protein 1 Secondary Processing and Blocking Antibodies
Roseangela I. Nwuba,1 Olugbemiro Sodeinde,2 Chiaka I. Anumudu,1 Yusuf O. Omosun,1 Alexander B. Odaibo,1 Anthony A. Holder,3* and Mark Nwagwu1
Cellular Parasitology Programme, Department of Zoology,1
Department of Paediatrics, University College Hospital, University of Ibadan, Ibadan, Nigeria,2
Division of Parasitology, National Institute for Medical Research, London NW7 1AA, United Kingdom3
Received 21 December 2001/
Returned for modification 12 March 2002/
Accepted 29 May 2002

ABSTRACT
Malaria merozoite surface protein 1 (MSP1) is cleaved in an
essential step during erythrocyte invasion. The responses of
children to natural malaria infection included antibodies that
inhibit this cleavage and others that block the binding of these
inhibitory antibodies. There was no correlation between the
titer of the antibody to the 19-kDa fragment of MSP1 and its
inhibitory activity. These findings have implications for the
design of MSP1-based vaccines.

TEXT
Malaria control is a major problem, and the need for the development
of new effective measures, including vaccines, is urgent. The
immune response to the parasite is complex, and various stages
of the parasite's life cycle are being explored as potential
targets for vaccine development (
15). The clinical disease is
associated with replication of the asexual blood stage parasite.
Merozoite surface protein 1 (MSP1) is an

200-kDa precursor that
is present on the surface of the merozoite as a multicomponent
complex derived by proteolytic processing (
12,
13). At the time
of erythrocyte invasion, the 42-kDa C-terminal component (MSP1
42)
is further cleaved to produce a soluble 33-kDa fragment (MSP1
33)
and a 19-kDa fragment (MSP1
19) that remains on the merozoite
surface during invasion (
2,
3). This so-called secondary processing
of MSP1 goes to completion during the successful invasion of
a red blood cell, suggesting that it is a necessary step. Monoclonal
antibodies (MAbs) that prevent invasion inhibit secondary processing
of MSP1, suggesting that this is their mechanism of action (
4).
Blocking antibodies (
10) are not inhibitory but interfere with
inhibitory antibody activity by competing for binding to the
merozoite surface. This suggests an immune evasion mechanism
to avoid the action of protective antibodies (
11). Here we present
evidence that natural infection may induce both antibodies that
inhibit MSP1 secondary processing and antibodies that block
this inhibition.
Prevalence of Plasmodium falciparum parasites.
This study was conducted at Igbo-Ora and Idere in southwestern Nigeria. After informed consent was obtained from their parents or guardians, children were recruited according to a protocol that was reviewed and approved by the Joint Ethical Committee of the College of Medicine and the University College Hospital, Ibadan, Nigeria. P. falciparum parasitemia was prevalent both at the end of the rainy season and in the middle of the dry season (Fig. 1), with no significant difference in the age distribution of the infected children between the two time points. Overall, the rate of parasitemia declined with age (data not shown).
Antibodies to MSP119 measured by ELISA.
Plasma samples from 708 donors were analyzed by enzyme-linked
immunosorbent assay (ELISA) for antibodies to recombinant MSP1
19 (
6). The samples were diluted at a 1:25 ratio and then in twofold
dilutions to 1:3,200; the reciprocal end point titer (the highest
dilution that gave an absorbance value above that of the negative
controls) was log transformed, and data were expressed as geometric
mean log reciprocal titers. There were no differences in the
geometric mean log reciprocal titers between those individuals
who had parasitemia (2.58) and those who did not (2.56) or between
sexes (
P > 0.05, data not shown). In both the dry and the
wet seasons, the mean log reciprocal titer for children under
12 months old (2.4) was the same as that for 12- to 60-month-old
children. When samples collected during the dry season were
compared, the antibody titers determined were higher for children
of

6 years than for those of

5 years of age (
P < 0.01); in
contrast, there was a decline with age in antibody titers for
the plasma samples collected during the rainy season, though
the difference between the two groups was not significant (
P > 0.05) (data not shown).
Antibody-mediated inhibition of MSP142 processing.
Plasma samples from 50 children, 1 month to 15 years of age, who were chosen randomly from the group of 343 children seen in the dry season were assayed for MSP1 processing-inhibitory activity. Merozoites were prepared according to the procedures of Blackman (1), and processing assays were performed essentially as described previously (4, 10). MSP142 and MSP133 were identified by enhanced chemiluminescence and exposure to autoradiographic film. The densities of the MSP142 and MSP133 bands were measured after a short exposure (2 to 5 s, in the linear density response range) with Scion (Frederick, Md.) image software. The relative proportion of MSP133 was calculated by use of the formula b/(a + b), where a is the amount of MSP142 remaining at the end of the assay and b is the amount of MSP133 produced. The percentage of MSP142 processing was calculated by the formula 100(X - B)/(A - B), where A, B, and X are the relative proportions of MSP133 produced, respectively, in the reaction buffer alone, in the zero-hour control (levels of MSP133 present at the start of the assay), and in the presence of MAb or the plasma sample being tested. Of the 50 plasma samples analyzed at random, the results for 20 are shown (Fig. 2). Three samples, BP89, BP100, and NW46 (from donors aged 13, 11 and 6 years, respectively), showed complete inhibition of secondary processing of MSP1. Three other samples, ID19, NW69, and NW48 (from donors aged 2 months and 6 and 7 years, respectively), showed significant inhibition of processing (64 to 83%). The remaining 44 samples did not show significant inhibition of MSP1 processing. Similar results were obtained with merozoites expressing either the Wellcome or MAD20 MSP1 types (data not shown). When the MSP119-specific antibody titers of these sera were examined, there was no significant correlation between specific antibody levels and processing-inhibitory activity (Fig. 2). Twenty-four of the samples (48%) appeared to show enhanced (up to threefold-higher) processing relative to that of the untreated positive control (data not shown). The biological significance of this is obscure, but it will be of interest to determine whether or not these antibodies contribute to the observed enhancement of parasite growth in vitro by human immunoglobulin G (5).
Antibodies that compete with inhibitory MAbs for binding to MSP1.
The ability of antibodies in the plasma samples to block the
binding of processing-inhibitory MAbs 12.8 and 12.10 to MSP1
19 was examined with a competition ELISA. Figure
3 shows the results
for the plasma samples assayed with MAb 12.8; similar results
were obtained with MAb 12.10 (data not shown). Of the six samples
that showed the most processing-inhibitory activity, only NW48
had antibodies that prevented the binding of MAb 12.8. The other
five samples, BP100, BP89, NW46, ID19, and NW69, did not have
antibodies that competed with the binding of MAb 12.8; thus,
these samples contain antibodies that define new binding sites
for MSP1 secondary-processing-inhibitory antibodies. Ten plasma
samples (20% of the 50 randomly chosen samples) had antibodies
that competed with MAbs 12.8 and 12.10 (Fig.
3 and data not
shown); in the absence of significant processing inhibition,
this implies that these samples contain largely blocking antibodies.
The remaining 34 samples did not show significant MSP1 processing-inhibitory
activity and did not compete with MAb 12.8 (or MAb 12.10) despite
the presence of MSP1
19-specific antibodies detected by ELISA.
The absence of either inhibitory or blocking activities is consistent
with these samples containing neutral antibodies (
11).
This is the first report of the induction of MSP1 processing-inhibitory
antibodies by natural infection with
P. falciparum. The natural
immune response to MSP1 also includes the production of blocking
antibodies, which may abolish these protective effects (
11),
providing an effective means for the malarial parasite to evade
a host immune defense. It is possible that, after natural infection
with
P. falciparum, individuals produce both processing-inhibitory
and blocking antibodies, with the outcome of exposure depending
on the kinetics of the appearance of these two classes of antibody,
their quantities, and their relative efficacies. Thus, the data
provide support for the idea of developing MSP1
19 as a malaria
vaccine and for the concept that an engineered protein may be
more effective than the natural protein as a vaccine (
17).
A major difficulty in the rational evaluation of malaria antigens for vaccine development has been the paucity of functional in vitro assays (14). Antibody-mediated inhibition of merozoite invasion has been used extensively as an in vitro test, for example, to examine the contribution of MSP119-specific antibodies in human sera (7, 9, 16). MSP119-specific MAbs that inhibited invasion also inhibited the processing of MSP142 (4), suggesting that this effect upon cleavage was the mechanism for inhibition of erythrocyte invasion. A second class of antibody may block the binding of these inhibitory antibodies, allowing processing and invasion to proceed in the presence of inhibitory antibodies (10). Despite the prevalence and level of MSP119-specific antibodies, only 12% of the 50 plasma samples analyzed had significant processing-inhibitory activity, suggesting that the fine specificity rather than the total level of specific antibody is important. This observation may explain why no evidence of association between antibody responses to MSP119 and clinical protection was found in a recent study (8). The contribution of passively acquired maternal antibody in young children and the importance of inhibitory antibodies for the clinical outcome of infection will need to be analyzed in a larger longitudinal study. Detailed evaluation of such assays for correlation with immune protection would be best achieved by using samples from MSP1 vaccine trials.

ACKNOWLEDGMENTS
We acknowledge with deep gratitude the cooperation and endurance
of the children who provided the blood samples for this study
while attending the immunization program at the Primary Health
Clinic at Idere and five nursery and primary schools at Igbo-Ora:
Nawarudeen Primary School, Baptist Primary and Secondary School,
His Grace Nursery and Primary School, Methodist Primary and
Secondary School, and Adegoke Nursery and Primary School. We
also thank the parents who gave permission for their children
to participate in the study. We are grateful to O. O. Osossanya,
A. A. Adeniran, and A. E. Echoga for their clinical assistance,
to E. O. Koyejo for enrolling the children, to A. O. Olagoke
for her cooperation in the use of the Idere Clinic, and to Muni
Grainger for parasite culture.
This work was supported by grants from the Multilateral Initiative on Malaria Africa Research Capability Strengthening of the UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases.

FOOTNOTES
* Corresponding author. Mailing address: Division of Parasitology, National Institute for Medical Research, The Ridgeway, Mill Hill, London NW7 1AA, United Kingdom. Phone: (44) 208-959-3666, ext. 2175. Fax: (44) 208-913-8593. E-mail:
aholder{at}nimr.mrc.ac.uk.

Editor: J. M. Mansfield

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Infection and Immunity, September 2002, p. 5328-5331, Vol. 70, No. 9
0019-9567/02/$04.00+0 DOI: 10.1128/IAI.70.9.5328-5331.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.
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