IgE ANTIBODIES TO PLASMODIUM FALCIPARUM AND SEVERITY OF MALARIA IN CHILDREN OF ONE ETHNIC GROUP LIVING IN BURKINA FASO

CARLO CALISSANO Dipartimento di Scienze di Sanità Pubblica, Sezione di Parassitologia, World Health Organization Collaborating Centre for Malaria Epidemiology and Control, University of Rome La Sapienza, Rome, Italy; Dipartimento di Scienze di Sanità Publica, Sezione di Parassitologia; Istituto Pasteur Fondazione Cenci Bolognetti, University of Rome La Sapienza, Rome, Italy; Centre National de Recherche et Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Service de Pédiatrie, Centre Hospitalier National Yalgado Ouedraogo,Ouagadougou, Burkina Faso; Department of Immunology, Stockholm University, Stockholm, Sweden

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DAVID MODIANO Dipartimento di Scienze di Sanità Pubblica, Sezione di Parassitologia, World Health Organization Collaborating Centre for Malaria Epidemiology and Control, University of Rome La Sapienza, Rome, Italy; Dipartimento di Scienze di Sanità Publica, Sezione di Parassitologia; Istituto Pasteur Fondazione Cenci Bolognetti, University of Rome La Sapienza, Rome, Italy; Centre National de Recherche et Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Service de Pédiatrie, Centre Hospitalier National Yalgado Ouedraogo,Ouagadougou, Burkina Faso; Department of Immunology, Stockholm University, Stockholm, Sweden

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BIENVENU SODIOMON SIRIMA Dipartimento di Scienze di Sanità Pubblica, Sezione di Parassitologia, World Health Organization Collaborating Centre for Malaria Epidemiology and Control, University of Rome La Sapienza, Rome, Italy; Dipartimento di Scienze di Sanità Publica, Sezione di Parassitologia; Istituto Pasteur Fondazione Cenci Bolognetti, University of Rome La Sapienza, Rome, Italy; Centre National de Recherche et Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Service de Pédiatrie, Centre Hospitalier National Yalgado Ouedraogo,Ouagadougou, Burkina Faso; Department of Immunology, Stockholm University, Stockholm, Sweden

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AMADOU KONATE Dipartimento di Scienze di Sanità Pubblica, Sezione di Parassitologia, World Health Organization Collaborating Centre for Malaria Epidemiology and Control, University of Rome La Sapienza, Rome, Italy; Dipartimento di Scienze di Sanità Publica, Sezione di Parassitologia; Istituto Pasteur Fondazione Cenci Bolognetti, University of Rome La Sapienza, Rome, Italy; Centre National de Recherche et Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Service de Pédiatrie, Centre Hospitalier National Yalgado Ouedraogo,Ouagadougou, Burkina Faso; Department of Immunology, Stockholm University, Stockholm, Sweden

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ISSA SANOU Dipartimento di Scienze di Sanità Pubblica, Sezione di Parassitologia, World Health Organization Collaborating Centre for Malaria Epidemiology and Control, University of Rome La Sapienza, Rome, Italy; Dipartimento di Scienze di Sanità Publica, Sezione di Parassitologia; Istituto Pasteur Fondazione Cenci Bolognetti, University of Rome La Sapienza, Rome, Italy; Centre National de Recherche et Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Service de Pédiatrie, Centre Hospitalier National Yalgado Ouedraogo,Ouagadougou, Burkina Faso; Department of Immunology, Stockholm University, Stockholm, Sweden

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ALPHONSE SAWADOGO Dipartimento di Scienze di Sanità Pubblica, Sezione di Parassitologia, World Health Organization Collaborating Centre for Malaria Epidemiology and Control, University of Rome La Sapienza, Rome, Italy; Dipartimento di Scienze di Sanità Publica, Sezione di Parassitologia; Istituto Pasteur Fondazione Cenci Bolognetti, University of Rome La Sapienza, Rome, Italy; Centre National de Recherche et Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Service de Pédiatrie, Centre Hospitalier National Yalgado Ouedraogo,Ouagadougou, Burkina Faso; Department of Immunology, Stockholm University, Stockholm, Sweden

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HEDVIG PERLMANN Dipartimento di Scienze di Sanità Pubblica, Sezione di Parassitologia, World Health Organization Collaborating Centre for Malaria Epidemiology and Control, University of Rome La Sapienza, Rome, Italy; Dipartimento di Scienze di Sanità Publica, Sezione di Parassitologia; Istituto Pasteur Fondazione Cenci Bolognetti, University of Rome La Sapienza, Rome, Italy; Centre National de Recherche et Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Service de Pédiatrie, Centre Hospitalier National Yalgado Ouedraogo,Ouagadougou, Burkina Faso; Department of Immunology, Stockholm University, Stockholm, Sweden

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MARITA TROYE-BLOMBERG Dipartimento di Scienze di Sanità Pubblica, Sezione di Parassitologia, World Health Organization Collaborating Centre for Malaria Epidemiology and Control, University of Rome La Sapienza, Rome, Italy; Dipartimento di Scienze di Sanità Publica, Sezione di Parassitologia; Istituto Pasteur Fondazione Cenci Bolognetti, University of Rome La Sapienza, Rome, Italy; Centre National de Recherche et Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Service de Pédiatrie, Centre Hospitalier National Yalgado Ouedraogo,Ouagadougou, Burkina Faso; Department of Immunology, Stockholm University, Stockholm, Sweden

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PETER PERLMANN Dipartimento di Scienze di Sanità Pubblica, Sezione di Parassitologia, World Health Organization Collaborating Centre for Malaria Epidemiology and Control, University of Rome La Sapienza, Rome, Italy; Dipartimento di Scienze di Sanità Publica, Sezione di Parassitologia; Istituto Pasteur Fondazione Cenci Bolognetti, University of Rome La Sapienza, Rome, Italy; Centre National de Recherche et Formation sur le Paludisme, Ministère de la Santé, Ouagadougou, Burkina Faso; Service de Pédiatrie, Centre Hospitalier National Yalgado Ouedraogo,Ouagadougou, Burkina Faso; Department of Immunology, Stockholm University, Stockholm, Sweden

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Plasmodium falciparum malaria infection induces elevated blood levels of both total immunoglobulin and anti-plasmodial antibodies belonging to different isotypes. We have previously shown that donors living in areas of malaria transmission develop malaria-specific IgE antibodies that are present at highest concentrations in patients with severe disease, suggesting a role for this isotype in malaria pathogenesis. To establish the possible importance of IgE in the course and severity of this disease, we have analyzed a large and homogenous group of African children (age range = 6 months to 15 years) belonging to one ethnic group (Mossi) living in identical epidemiologic conditions in the same urban area (Ougadougo) of Burkina Faso. While IgG antibodies to P. falciparum increased to high concentrations in very young children and then remained at these levels in older patients, IgE antibodies increased with age, becoming most significantly elevated in children more than four years of age. In older children, those with severe malaria had significantly higher IgE antibody levels than those with non-severe disease. No significant differences between the patient groups were seen for IgG antibodies to P. falciparum. However, when the patients with severe malaria were divided into two groups distinguished by the presence of absence of coma, both IgG and IgE antibodies against malaria were lower in the comatous patients than in the non-comatous patients The results support the conclusion that IgE antibodies against malaria, regardless of their possible protectivity, also contribute to disease severity in this large and homogenous group of African children.

Author Notes

Reprint requests: Marita Troye-Blomberg, The Wenner-Gren Institute, Department of Immunology, Stockholm University, SE-10691 Stockholm, Sweden, Telephone: 46-8-164-164, Fax: 46-8-157-356, E-mail: marita@imun.su.se.
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