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Measuring Naturally Acquired Phagocytosis-Inducing Antibodies to Plasmodium falciparum Parasites by a Flow Cytometry-Based Assay
Published on: August 6, 2020
How is childhood development of immunity to Plasmodium falciparum enhanced by certain antimalarial interventions?
Colin J Sutherland1, Christopher J Drakeley, David Schellenberg
1Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. colin.sutherland@lshtm.ac.uk
Insights
Malaria prevention strategies like bed nets and vaccines may induce mild Plasmodium falciparum infections that act as a natural blood-stage vaccine. Sulfadoxine-pyrimethamine contributes to this sustained immunity in children.
Area of Science:
- Malariology
- Immunology
- Infectious Diseases
Background:
- Acquired immunity to Plasmodium falciparum is crucial for reducing malaria burden in African children.
- Current malaria prevention strategies include insecticide-treated nets, anti-sporozoite vaccines, and intermittent preventive therapy.
Purpose of the Study:
- To examine how current malaria prevention strategies influence the development of acquired immunity.
- To investigate the potential of attenuated blood-stage infections as a mechanism for sustained protection.
Main Methods:
- Review of evidence on insecticide-treated nets, anti-sporozoite vaccines, and intermittent preventive therapy.
- Analysis of the role of Plasmodium falciparum blood-stage infections in immunity development.
- Consideration of the pharmacological properties of sulphadoxine-pyrimethamine.
Main Results:
- Insecticide-treated nets, anti-sporozoite vaccines, and intermittent preventive therapy may lead to attenuated P. falciparum blood-stage infections.
- These attenuated infections can function as a 'blood-stage vaccine', promoting acquired immunity.
- Sulphadoxine-pyrimethamine's properties contribute to attenuated infections and sustained protection.
Conclusions:
- Attenuated blood-stage Plasmodium falciparum infections induced by prevention strategies can confer protective immunity.
- Intermittent preventive therapy with sulphadoxine-pyrimethamine plays a significant role in sustained malaria protection in high-transmission areas.
- Understanding these mechanisms can inform future malaria control and vaccine development efforts.
Abstract:
The development of acquired protective immunity to Plasmodium falciparum infection in young African children is considered in the context of three current strategies for malaria prevention: insecticide-impregnated bed nets or curtains, anti-sporozoite vaccines and intermittent preventive therapy. Evidence is presented that each of these measures may permit attenuated P. falciparum blood-stage infections, which do not cause clinical malaria but can act as an effective blood-stage "vaccine". It is proposed that the extended serum half-life, and rarely considered liver-stage prophylaxis provided by the anti-folate combination sulphadoxine-pyrimethamine frequently lead to such attenuated infections in high transmission areas, and thus contribute to the sustained protection from malaria observed among children receiving the combination as intermittent preventative therapy or for parasite clearance in vaccine trials.
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