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A role for fetal hemoglobin and maternal immune IgG in infant resistance to Plasmodium falciparum malaria.

Publication ,  Journal Article
Amaratunga, C; Lopera-Mesa, TM; Brittain, NJ; Cholera, R; Arie, T; Fujioka, H; Keefer, JR; Fairhurst, RM
Published in: Plos One
April 12, 2011

BACKGROUND: In Africa, infant susceptibility to Plasmodium falciparum malaria increases substantially as fetal hemoglobin (HbF) and maternal immune IgG disappear from circulation. During the first few months of life, however, resistance to malaria is evidenced by extremely low parasitemias, the absence of fever, and the almost complete lack of severe disease. This resistance has previously been attributed in part to poor parasite growth in HbF-containing red blood cells (RBCs). A specific role for maternal immune IgG in infant resistance to malaria has been hypothesized but not yet identified. METHODS AND FINDINGS: We found that P. falciparum parasites invade and develop normally in fetal (cord blood, CB) RBCs, which contain up to 95% HbF. However, these parasitized CB RBCs are impaired in their binding to human microvascular endothelial cells (MVECs), monocytes, and nonparasitized RBCs--cytoadherence interactions that have been implicated in the development of high parasite densities and the symptoms of malaria. Abnormal display of the parasite's cytoadherence antigen P. falciparum erythrocyte membrane protein-1 (PfEMP-1) on CB RBCs accounts for these findings and is reminiscent of that on HbC and HbS RBCs. IgG purified from the plasma of immune Malian adults almost completely abolishes the adherence of parasitized CB RBCs to MVECs. CONCLUSIONS: Our data suggest a model of malaria protection in which HbF and maternal IgG act cooperatively to impair the cytoadherence of parasitized RBCs in the first few months of life. In highly malarious areas of Africa, an infant's contemporaneous expression of HbC or HbS and development of an immune IgG repertoire may effectively reconstitute the waning protective effects of HbF and maternal immune IgG, thereby extending the malaria resistance of infancy into early childhood.

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Published In

Plos One

DOI

EISSN

1932-6203

Publication Date

April 12, 2011

Volume

6

Issue

4

Start / End Page

e14798

Location

United States

Related Subject Headings

  • Plasmodium falciparum
  • Malaria, Falciparum
  • Infant, Newborn
  • Infant
  • Immunoglobulin G
  • Immunity, Maternally-Acquired
  • Humans
  • General Science & Technology
  • Fetal Hemoglobin
  • Female
 

Citation

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Amaratunga, C., Lopera-Mesa, T. M., Brittain, N. J., Cholera, R., Arie, T., Fujioka, H., … Fairhurst, R. M. (2011). A role for fetal hemoglobin and maternal immune IgG in infant resistance to Plasmodium falciparum malaria. Plos One, 6(4), e14798. https://doi.org/10.1371/journal.pone.0014798
Amaratunga, Chanaki, Tatiana M. Lopera-Mesa, Nathaniel J. Brittain, Rushina Cholera, Takayuki Arie, Hisashi Fujioka, Jeffrey R. Keefer, and Rick M. Fairhurst. “A role for fetal hemoglobin and maternal immune IgG in infant resistance to Plasmodium falciparum malaria.Plos One 6, no. 4 (April 12, 2011): e14798. https://doi.org/10.1371/journal.pone.0014798.
Amaratunga C, Lopera-Mesa TM, Brittain NJ, Cholera R, Arie T, Fujioka H, et al. A role for fetal hemoglobin and maternal immune IgG in infant resistance to Plasmodium falciparum malaria. Plos One. 2011 Apr 12;6(4):e14798.
Amaratunga, Chanaki, et al. “A role for fetal hemoglobin and maternal immune IgG in infant resistance to Plasmodium falciparum malaria.Plos One, vol. 6, no. 4, Apr. 2011, p. e14798. Pubmed, doi:10.1371/journal.pone.0014798.
Amaratunga C, Lopera-Mesa TM, Brittain NJ, Cholera R, Arie T, Fujioka H, Keefer JR, Fairhurst RM. A role for fetal hemoglobin and maternal immune IgG in infant resistance to Plasmodium falciparum malaria. Plos One. 2011 Apr 12;6(4):e14798.

Published In

Plos One

DOI

EISSN

1932-6203

Publication Date

April 12, 2011

Volume

6

Issue

4

Start / End Page

e14798

Location

United States

Related Subject Headings

  • Plasmodium falciparum
  • Malaria, Falciparum
  • Infant, Newborn
  • Infant
  • Immunoglobulin G
  • Immunity, Maternally-Acquired
  • Humans
  • General Science & Technology
  • Fetal Hemoglobin
  • Female