VARIANT-SPECIFIC ANTIBODIES TO MEROZOITE SURFACE PROTEIN 2 AND CLINICAL EXPRESSION OF PLASMODIUM FALCIPARUM MALARIA IN RURAL AMAZONIANS

KÉZIA K. G. SCOPEL Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil; Laboratory of Protozoology, Institute of Tropical Medicine, and Department of Parasitology, Institute of Biomedical Sciences of São Paulo, São Paulo, Brazil

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MÔNICA DA SILVA-NUNES Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil; Laboratory of Protozoology, Institute of Tropical Medicine, and Department of Parasitology, Institute of Biomedical Sciences of São Paulo, São Paulo, Brazil

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ROSELY S. MALAFRONTE Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil; Laboratory of Protozoology, Institute of Tropical Medicine, and Department of Parasitology, Institute of Biomedical Sciences of São Paulo, São Paulo, Brazil

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ÉRIKA M. BRAGA Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil; Laboratory of Protozoology, Institute of Tropical Medicine, and Department of Parasitology, Institute of Biomedical Sciences of São Paulo, São Paulo, Brazil

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MARCELO U. FERREIRA Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil; Laboratory of Protozoology, Institute of Tropical Medicine, and Department of Parasitology, Institute of Biomedical Sciences of São Paulo, São Paulo, Brazil

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Naturally acquired antibodies to five variants of the merozoite surface protein 2 (MSP-2), a target of clinical immunity to Plasmodium falciparum malaria, were measured in a cohort of rural Amazonians. Local MSP-2 variants comprised both highly divergent families of alleles (FC27 and 3D7). Total IgG antibodies to two FC27-type antigens were found in 22–28% of subjects at baseline, with substantial cross-reactivity between variants and stable concentrations and specificities over time. The IgG antibodies to three 3D7-type antigens were less prevalent (6–7%), less cross-reactive, and short-lived; subsequent exposure to 3D7-type parasites rarely elicited homologous response. The clinical spectrum of 109 incident P. falciparum infections in our cohort ranged between asymptomatic infection and fully symptomatic but uncomplicated disease. Parasitemia at the time of diagnosis, rather than cumulative malaria exposure or acquired immunity (presence of variant-specific antibodies matching the MSP-2 type in infecting parasites), was a major predictor of perceived symptom severity.

Author Notes

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