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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Antibodies to Plasmodium falciparum antigens predict a higher risk of malaria but protection from symptoms once parasitemic
Journal of Infectious Diseases, Volume 204, No. 1, Year 2011
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Description
Background. Associations between antibody responses to Plasmodium falciparum antigens and protection against symptomatic malaria have been difficult to ascertain, in part because antibodies are potential markers of both exposure to P. falciparum and protection against disease. Methods. We measured IgG responses to P. falciparum circumsporozoite protein, liver-stage antigen 1, apicalmembrane antigen 1 (AMA-1), and merozoite surface proteins (MSP) 1 and 3, in children in Kampala, Uganda, and measured incidence of malaria before and after antibody measurement. Results. Stronger responses to all 5 antigens were associated with an increased risk of clinical malaria (P < .01) because of confounding with prior exposure to P. falciparum. However, with use of another assessment, risk of clinical malaria once parasitemic, stronger responses to AMA-1, MSP-1, and MSP-3 were associated with protection (odds ratios, 0.34, 0.36, and 0.31, respectively, per 10-fold increase; P < .01). Analyses assessing antibodies in combination suggested that any protective effect of antibodies was overestimated by associations between individual responses and protection. Conclusions. Using the risk of symptomatic malaria once parasitemic as an outcome may improve detection of associations between immune responses and protection from disease. Immunoepidemiology studies designed to detect mechanisms of immune protection should integrate prior exposure into the analysis and evaluate multiple immune responses. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Greenhouse, Bryan R.
United States, San Francisco
Ucsf School of Medicine
Ho, Benjamin M.
United States, Minneapolis
University of Minnesota Twin Cities
Hubbard, Alan E.
United States, Berkeley
University of California, Berkeley
Njama-Meya, Denise
Uganda, Kampala
Makerere University
Narum, David L.
United States, Bethesda
National Institute of Allergy and Infectious Diseases Niaid
Lanar, David E.
United States, Silver Spring
Walter Reed Army Institute of Research
Dutta, Sheetij
United States, Silver Spring
Walter Reed Army Institute of Research
Rosenthal, Philip Jon
United States, San Francisco
Ucsf School of Medicine
Dorsey, Grant M.
United States, San Francisco
Ucsf School of Medicine
John, Chandy Chiramukhathu
United States, Minneapolis
University of Minnesota Twin Cities
Statistics
Citations: 98
Authors: 10
Affiliations: 6
Identifiers
Doi:
10.1093/infdis/jir223
ISSN:
00221899
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Locations
Uganda