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A threshold concentration of anti-merozoite antibodies is required for protection from clinical episodes of malaria

Abstract:
Antibodies to selected Plasmodium falciparum merozoite antigens are often reported to be associated with protection from malaria in one epidemiological cohort, but not in another. Here, we sought to understand this paradox by exploring the hypothesis that a threshold concentration of antibodies is necessary for protection. We analyzed data from two independent cohorts along the Kenyan coast, one in which antibodies to AMA1, MSP-2 and MSP-3 were associated with protection from malaria (Chonyi) and another in which this association was not observed (Junju). We used a malaria reference reagent to standardize antibody measurements across both cohorts, and applied statistical methods to derive the threshold concentration of antibodies against each antigen that best correlated with a reduced risk of malaria (the protective threshold), in the Chonyi cohort. We then tested whether antibodies in Junju reached the protective threshold concentrations observed in the Chonyi cohort. Except for children under 3 years, the age-matched proportions of children achieving protective threshold concentrations of antibodies against AMA1 and MSP-2 were significantly lower in Junju compared to Chonyi (Fishers exact test, P < 0.01). For MSP-3, this difference was significant only among 4-5 year olds. We conclude that although antibodies are commonly detected in malaria endemic populations, they may be present in concentrations that are insufficient for protection. Our results have implications for the analysis and interpretation of similar data from immuno-epidemiological studies. © 2013 The Authors.

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Publisher copy:
10.1016/j.vaccine.2013.06.042

Authors

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Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Jenner Institute
Role:
Author


Journal:
Vaccine More from this journal
Volume:
31
Issue:
37
Pages:
3936-3942
Publication date:
2013-08-20
DOI:
EISSN:
1873-2518
ISSN:
0264-410X


Language:
English
Keywords:
Pubs id:
pubs:419177
UUID:
uuid:19574b18-0a2b-49ec-bd31-43c79299e4c1
Local pid:
pubs:419177
Source identifiers:
419177
Deposit date:
2013-11-16
ARK identifier:

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