- INTRODUCTION
- MATERIALS AND METHODS
- RESULTS
- Negligible IgG antibody response to GPI in migrants at enrollment.
- Anti-GPI response after a single P. falciparum infection.
- Longitudinal anti-GPI IgG response to multiple P. falciparum infections in adults and children.
- Effect of age on generation of high anti-GPI IgG responses.
- Anti-GPI response and risk of symptoms in subsequent infection.
- DISCUSSION
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AGE-DEPENDENT IMPAIRMENT OF IgG RESPONSES TO GLYCOSYLPHOSPHATIDYLINOSITOL WITH EQUAL EXPOSURE TO PLASMODIUM FALCIPARUM AMONG JAVANESE MIGRANTS TO PAPUA, INDONESIA
Immune responses directed at glycosylphosphatidylinositol (GPI) anchors of Plasmodium falciparum may offer protection against symptomatic malaria. To independently explore the effect of age on generation of the anti-GPI IgG response, we measured serum anti-GPI IgGs in a longitudinal cohort of migrant Javanese children (6–12 years old) and adults (≥20 years old) with equivalent numbers of exposures to P. falciparum in Papua, Indonesia. While the peak response in adults was achieved after a single infection, comparable responses in children required ≥3–4 infections. Significantly fewer children (16%) than adults (41%) showed a high (optical density > 0.44) anti-GPI IgG response (odds ratio [OR] = 3.8, 95% confidence interval [CI] = 2.3–6.3, P < 0.0001), and adults were more likely to show a persistently high response (OR = 5.5, 95% CI = 1.0–56.8, P = 0.03). However, the minority of children showing a strong response were significantly less likely to experience symptoms with subsequent parasitemia compared with those with a weak response (OR = 4.0, 95% CI = 1.1–13.8, P = 0.02). This effect was not seen among high- and low-responding adults (OR = 1.2, 95% CI = 0.5–2.8, P = 0.60). Host age, independent of cumulative exposure, apparently represents a key determinant of the quantitative and qualitative nature of the IgG response to P. falciparum GPI.