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Plasmodium falciparum Infection during Suppressive Prophylaxis with Mefloquine Does Not Induce an Antibody Response to Merozoite Surface Protein-1(42)
A sensitive biomarker of malaria infection would obviate the need for placebo control arms in clinical trials of malaria prophylactic drugs. Antibodies to the 42-kDa fragment of merozoite surface protein-1 (MSP142) have been identified as a potential marker of malaria exposure in individuals receiving prophylaxis with mefloquine. We conducted an open-label trial to determine the sensitivity of seroconversion to MSP142, defined as a fourfold rise in enzyme-linked immunosorbant assay (ELISA) titer, among 23 malaria naïve volunteers receiving mefloquine prophylaxis and 6 controls after Plasmodium falciparum sporozoite challenge. All members of the control cohort but none of the mefloquine cohort developed patent parasitemia. Four of six controls but zero of the mefloquine cohort seroconverted to MSP142. We conclude that malaria infection during suppressive prophylaxis does not induce antibody response to the blood-stage antigen MSP142 in a malaria-naïve study population.
Author Notes
Financial support: This project was supported by the United States Army Medical Materiel Development Activity.
Authors' addresses: James E. Moon, Gregory A. Deye, Lori Miller, Susan Fracisco, R. Scott Miller, Donna Tosh, James F. Cummings, Colin Ohrt, and Alan J. Magill, Walter Reed Army Institute of Research, Silver Spring, MD, E-mails: james.e.moon@us.army.mil, gregory.deye@us.army.mil, robert.s.miller@us.army.mil, susan.fracisco@us.army.mil, robert.s.miller@us.army.mil, donna.tosh@amedd.army.mil, james.cummings@us.army.mil, colin.ohrt@amedd.army.mil, and alan.magill@us.army.mil.