The study aims at identifying protective immune response against severe malaria in young children. This study is based on our earlier studies of pregnancy malaria. Susceptibility to pregnancy malaria (PM) results from the unique binding phenotype of placental parasites that adhere to chondroitin sulfate A (CSA), a molecule that is expressed on the surface of the syncytiotrophoblast and appears throughout the intervillous spaces. Because CSA is not readily accessible for parasite adhesion in the nonpregnant host, women are nave to this parasite subpopulation before their first pregnancy, making first-time mothers most susceptible. Over successive pregnancies women develop specific humoral immunity to placental parasites in the form of anti-adhesion antibodies. Anti-adhesion antibodies are associated with improved pregnancy outcomes. Based on these findings, in the current study we survey the binding phenotype of parasites associated with discrete clinical syndromes collected from children participating in the immune-epi study at Ouelessebougou, Mali, and relate acquisition of anti-adhesion antibodies with protection from severe malaria. During the past fiscal year we completed enrolling pregnant women and their newborns into the immune-epi study in Mali. Also we have observed that 1. Anti-adhesion antibodies are associated with a reduction in parasite density in young children. 2. We completed the proteomic analysis of 30 parasite isolates collected from children. 3. Identified a subset of exported proteins commonly expressed by parasite isolates collected from children. 4. Developed a pipeline to identify PfEMP1 expressed by clinical isolates.
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