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 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 reduced prevalence of infection, reduced parasite densities, and improved pregnancy outcomes. Based on these findings, in the current study we survey the binding phenotype of IE 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. In addition to this activity, the Pregnancy Malaria Consortium identified several vaccine candidates, Recombinant forms of these candidates were used to immunize animals. The antibodies have been evaluated for their anti-adhesion activity of maternal parasites adapted to in-vitro culture. Currently we are evaluating the level of anti-adhesion activity using fresh isolate collected from pregnant women participating in the immune-epi studies at Ouelessebougou. These results will assist in the selection of pregnancy malaria vaccine targets.
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