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Identifying Immune Correlates of Protection Against Plasmodium falciparum Through a Novel Approach to Account for Heterogeneity in Malaria Exposure
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Background: A main criterion to identify malaria vaccine
candidates is the proof that acquired immunity against them is
associated with protection from disease. The age of the studied
individuals, heterogeneous malaria exposure, and assumption of
the maintenance of a baseline immune response can confound these
associations. Methods: Immunoglobulin G/immunoglobulin M (IgG/
IgM) levels were measured by Luminex(R) in Mozambican children
monitored for clinical malaria from birth until 3 years of age,
together with functional antibodies. Studied candidates were
pre-erythrocytic and erythrocytic antigens, including
EBAs/PfRhs, MSPs, DBLs, and novel antigens merely or not
previously studied in malaria-exposed populations. Cox
regression models were estimated at 9 and 24 months of age,
accounting for heterogeneous malaria exposure or limiting
follow-up according to the antibody's decay. Results:
Associations of antibody responses with higher clinical malaria
risk were avoided when accounting for heterogeneous malaria
exposure or when limiting the follow-up time in the analyses.
Associations with reduced risk of clinical malaria were found
only at 24 months old, but not younger children, for IgG breadth
and levels of IgG targeting EBA140III-V, CyRPA, DBL5epsilon and
DBL3x, together with C1q-fixation activity by antibodies
targeting MSP119. Conclusions: Malaria protection correlates
were identified, only in children aged 24 months old when
accounting for heterogeneous malaria exposure. These results
highlight the relevance of considering age and malaria exposure,
as well as the importance of not assuming the maintenance of a
baseline immune response throughout the follow-up. Results may
be misleading if these factors are not considered.
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VALMASEDA, Aida, MACETE, Eusebio víctor, NHABOMBA, Augusto j., GUINOVART, Caterina, AIDE, Pedro carlos paulino, BARDAJÍ, Azucena, BASSAT ORELLANA, Quique, NHAMPOSSA, Tacilta, MACULUVE, Sónia amós, CASELLAS, Aina, QUINTÓ, Llorenç, SANZ, Sergi, JIMÉNEZ, Alfons, FENG, Gaoqian, LANGER, Christine, REILING, Linda, REDDY, K. sony, PANDEY, Alok kumar, CHITNIS, Chetan e., CHAUHAN, Virander singh, AGUILAR, Ruth, APONTE, John j., DOBAÑO, Carlota, BEESON, James g., GAUR, Deepak, MENÉNDEZ, Clara, ALONSO, Pedro, MAYOR APARICIO, Alfredo gabriel. Identifying Immune Correlates of Protection Against Plasmodium
falciparum Through a Novel Approach to Account for Heterogeneity
in Malaria Exposure. _Clinical Infectious Diseases_. 2018. Vol. 66, núm. 4, pàgs. 586-593. [consulta: 14 de gener de 2026]. ISSN: 1058-4838. [Disponible a: https://hdl.handle.net/2445/121174]