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Infection and Immunity, December 2008, p. 5721-5728, Vol. 76, No. 12
0019-9567/08/$08.00+0     doi:10.1128/IAI.00591-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Low Prevalence of Antibodies to Preerythrocytic but Not Blood-Stage Plasmodium falciparum Antigens in an Area of Unstable Malaria Transmission Compared to Prevalence in an Area of Stable Malaria Transmission{triangledown}

Gregory S. Noland,1 Brett Hendel-Paterson,1 Xinan M. Min,1 Ann M. Moormann,2 John M. Vulule,3 David L. Narum,4 David E. Lanar,5 James W. Kazura,2 and Chandy C. John1*

University of Minnesota, Minneapolis, Minnesota,1 Case Western Reserve University, Cleveland, Ohio,2 Kenya Medical Research Institute, Kisumu, Kenya,3 National Institutes of Health, Bethesda, Maryland,4 Walter Reed Army Institute for Research, Silver Spring, Maryland5

Received 13 May 2008/ Returned for modification 26 August 2008/ Accepted 12 September 2008

In areas where levels of transmission of Plasmodium falciparum are high and stable, the age-related acquisition of high-level immunoglobulin G (IgG) antibodies to preerythrocytic circumsporozoite protein (CSP) and liver-stage antigen 1 (LSA-1) has been associated with protection from clinical malaria. In contrast, age-related protection from malaria develops slowly or not at all in residents of epidemic-prone areas with unstable low levels of malaria transmission. We hypothesized that this suboptimal clinical and parasitological immunity may in part be due to reduced antibodies to CSP or LSA-1 and/or vaccine candidate blood-stage antigens. Frequencies and levels of IgG antibodies to CSP, LSA-1, thrombospondin-related adhesive protein (TRAP), apical membrane antigen 1 (AMA-1), erythrocyte binding antigen 175 (EBA-175), and merozoite surface protein 1 (MSP-1) were compared in 243 Kenyans living in a highland area of unstable transmission and 210 residents of a nearby lowland area of stable transmission. Levels of antibodies to CSP, LSA-1, TRAP, and AMA-1 in the oldest age group (>40 years) in the unstable transmission area were lower than or similar to those of children 2 to 6 years old in the stable transmission area. Only 3.3% of individuals in the unstable transmission area had high levels of IgG (>2 arbitrary units) to both CSP and LSA-1, compared to 43.3% of individuals in the stable transmission area. In contrast, antibody levels to and frequencies of MSP-1 and EBA-175 were similar in adults in areas of stable and unstable malaria transmission. Suboptimal immunity to malaria in areas of unstable malaria transmission may relate in part to infrequent high-level antibodies to preerythrocytic antigens and AMA-1.

* Corresponding author. Mailing address: University of Minnesota Department of Pediatrics, 717 Delaware St., SE, Room 363, MC1932, Minneapolis, MN 55455. Phone: (612) 625-8383. Fax: (612) 625-2920. E-mail: ccj{at}umn.edu

{triangledown} Published ahead of print on 22 September 2008.

Editor: W. A. Petri, Jr.

Infection and Immunity, December 2008, p. 5721-5728, Vol. 76, No. 12
0019-9567/08/$08.00+0     doi:10.1128/IAI.00591-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.





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