Abstract
Background:
Acquired antibodies are important in human immunity to malaria, but key targets remain largely unknown. Plasmodium falciparum reticulocyte-binding-homologue-4 (PfRh4) is important for invasion of human erythrocytes and may therefore be a target of protective immunity.
Methods:
IgG and IgG subclass-specific responses against different regions of PfRh4 were determined in a longitudinal cohort of 206 children in Papua New Guinea (PNG). Human PfRh4 antibodies were tested for functional invasion-inhibitory activity, and expression of PfRh4 by P. falciparum isolates and sequence polymorphisms were determined.
Results:
Antibodies to PfRh4 were acquired by children exposed to P. falciparum malaria, were predominantly comprised of IgG1 and IgG3 subclasses, and were associated with increasing age and active parasitemia. High levels of antibodies, particularly IgG3, were strongly predictive of protection against clinical malaria and high-density parasitemia. Human affinity-purified antibodies to the binding region of PfRh4 effectively inhibited erythrocyte invasion by P. falciparum merozoites and antibody levels in protected children were at functionally-active concentrations. Although expression of PfRh4 can vary, PfRh4 protein was expressed by most isolates derived from the cohort and showed limited sequence polymorphism.
Conclusions:
Evidence suggests that PfRh4 is a target of antibodies that contribute to protective immunity to malaria by inhibiting erythrocyte invasion and preventing high density parasitemia. These findings advance our understanding of the targets and mechanisms of human immunity and evaluating the potential of PfRh4 as a component of candidate malaria vaccines.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Adolescent
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Animals
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Antibodies, Protozoan / biosynthesis
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Antibodies, Protozoan / immunology*
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Antibodies, Protozoan / pharmacology
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Antigens, Protozoan / genetics
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Antigens, Protozoan / immunology
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Child
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Child, Preschool
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Erythrocytes / drug effects
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Erythrocytes / immunology
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Erythrocytes / parasitology
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Female
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Gene Expression
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Humans
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Immunity, Humoral / drug effects
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Immunoglobulin G / biosynthesis
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Immunoglobulin G / immunology*
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Immunoglobulin G / pharmacology
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Malaria Vaccines / immunology
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Malaria, Falciparum / immunology
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Malaria, Falciparum / parasitology
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Malaria, Falciparum / prevention & control*
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Male
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Membrane Proteins / genetics
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Membrane Proteins / immunology*
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Merozoites / drug effects
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Merozoites / immunology
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Parasitemia / immunology
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Parasitemia / prevention & control*
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Plasmodium falciparum / drug effects
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Plasmodium falciparum / immunology*
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Polymorphism, Genetic
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Protein Binding
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Protozoan Proteins / genetics
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Protozoan Proteins / immunology*
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Recombinant Fusion Proteins / genetics
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Recombinant Fusion Proteins / immunology
Substances
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Antibodies, Protozoan
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Antigens, Protozoan
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Immunoglobulin G
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Malaria Vaccines
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Membrane Proteins
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Protozoan Proteins
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RH4 protein, Plasmodium falciparum
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Recombinant Fusion Proteins
Grants and funding
Funding was provided by the National Health and Medical Research Council of Australia (project grant and career development award to J. Beeson; program grant to J. Beeson, B. Crabb, A. Cowman; training award to F. Fowkes, postgraduate research fellowship to J. Richards, D. Wilson; project grant to A. Barry; Infrastructure for Research Institutes Support Scheme Grant); Australia-India Strategic Research Fund of the Department of Innovation Industry Science and Research, Australia; Australian Research Council (Future Fellowship to J. Beeson); Victorian State Government Operational Infrastructure Support grant; and International Nutrition Foundation/Ellison Medical Foundation Fellowship Program (W. Chokejindachai), Research Grant from Faculty of Tropical Medicine, Mahidol University (W. Chokejindachai) and the Office of the Higher Education Commission and Mahidol University under the National Research Universities Initiative (W. Chokejindachai). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.