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      Plasmodium malaria and antimalarial antibodies in the first year of life

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          SUMMARY

          Malaria is one of the most serious infectious diseases with most of the severe disease caused by Plasmodium falciparum (Pf). Naturally acquired immunity develops over time after repeated infections and the development of antimalarial antibodies is thought to play a crucial role. Neonates and young infants are relatively protected from symptomatic malaria through mechanisms that are poorly understood. The prevailing paradigm is that maternal antimalarial antibodies transferred to the fetus in the last trimester of pregnancy protect the infant from early infections. These antimalarial antibodies wane by approximately 6 months of age leaving the infant vulnerable to malaria, however direct evidence supporting this epidemiologically based paradigm is lacking. As infants are the target population for future malaria vaccines, understanding how they begin to develop immunity to malaria and the gaps in their responses is key. This review summarizes the antimalarial antibody responses detected in infants and how they change over time. We focus primarily on Pf antibody responses and will briefly mention Plasmodium vivax responses in infants.

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          Most cited references85

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          Gamma-globulin and acquired immunity to human malaria.

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            Vivax malaria: neglected and not benign.

            Plasmodium vivax threatens almost 40% of the world's population, resulting in 132-391 million clinical infections each year. Most of these cases originate from Southeast Asia and the Western Pacific, although a significant number also occurs in Africa and South America. Although often regarded as causing a benign and self-limiting infection, there is increasing evidence that the overall burden, economic impact, and severity of disease from P. vivax have been underestimated. Malaria control strategies have had limited success and are confounded by the lack of access to reliable diagnosis, emergence of multidrug resistant isolates, the parasite's ability to transmit early in the course of disease and relapse from dormant liver stages at varying time intervals after the initial infection. Progress in reducing the burden of disease will require improved access to reliable diagnosis and effective treatment of both blood-stage and latent parasites, and more detailed characterization of the epidemiology, morbidity, and economic impact of vivax malaria. Without these, vivax malaria will continue to be neglected by ministries of health, policy makers, researchers, and funding bodies.
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              Malaria in pregnancy: pathogenesis and immunity.

              Understanding of the biological basis for susceptibility to malaria in pregnancy was recently advanced by the discovery that erythrocytes infected with Plasmodium falciparum accumulate in the placenta through adhesion to molecules such as chondroitin sulphate A. Antibody recognition of placental infected erythrocytes is dependent on sex and gravidity, and could protect from malaria complications. Moreover, a conserved parasite gene-var2csa-has been associated with placental malaria, suggesting that its product might be an appropriate vaccine candidate. By contrast, our understanding of placental immunopathology and how this contributes to anaemia and low birthweight remains restricted, although inflammatory cytokines produced by T cells, macrophages, and other cells are clearly important. Studies that unravel the role of host response to malaria in pathology and protection in the placenta, and that dissect the relation between timing of infection and outcome, could allow improved targeting of preventive treatments and development of a vaccine for use in pregnant women.
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                Author and article information

                Journal
                Parasitology
                Parasitology
                PAR
                Parasitology
                Cambridge University Press (Cambridge, UK )
                0031-1820
                1469-8161
                February 2016
                08 January 2016
                : 143
                : 2 , Naturally Acquired Immunity to Malaria
                : 129-138
                Affiliations
                [1 ]Division of Pediatric Infectious Diseases, Department of Pediatrics, Rainbow Babies and Children's Hospital , Cleveland, OH, USA
                [2 ]Center for Global Health and Diseases, Case Western Reserve University , Cleveland, OH, USA
                Author notes
                [* ]Corresponding author. Center for Global Health and Diseases, Case Western Reserve University , Biomedical Research Building #430, 2109 Adelbert Road, Cleveland, OH 44106, USA. E-mail: arlene.dent@ 123456case.edu
                Article
                S0031182015001626 00162
                10.1017/S0031182015001626
                4825094
                26743626
                5b04648a-7643-41f1-9e07-eafb31489129
                © Cambridge University Press 2016

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 06 October 2015
                : 30 October 2015
                : 02 November 2015
                Page count
                Tables: 1, References: 120, Pages: 10
                Categories
                Special Issue Review

                Parasitology
                infant,malaria,antibodies,pregnancy-associated malaria
                Parasitology
                infant, malaria, antibodies, pregnancy-associated malaria

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