title: Effects of sex, parity, and sequence variation on seroreactivity to candidate pregnancy malaria vaccine antigens.
abstract: BACKGROUND
  Plasmodium falciparum-infected erythrocytes adhere to chondroitin sulfate A (CSA) to sequester in the human placenta, and pregnancy malaria (PM) is associated with the development of disease in and the death of both mother and child. A PM vaccine appears to be feasible, because women become protected as they develop antibodies against placental infected erythrocytes (IEs). Two IE surface molecules, VAR1CSA and VAR2CSA, bind CSA in vitro and are potential vaccine candidates.
  
  
  METHODS
  We expressed all domains of VAR1CSA and VAR2CSA as mammalian cell surface proteins, using a novel approach that allows rapid purification, immobilization, and quantification of target antigen. For serum samples from East Africa, we measured reactivity to all domains, and we examined the effects of host sex and parity, as well as the effects of parasite antigenic variation.
  
  
  RESULTS
  Serum samples obtained from multigravid women had a higher reactivity to all VAR2CSA domains than did those obtained from primigravid women or from men. Conversely, serum samples obtained from men had consistently higher reactivity to VAR1CSA domains than did those obtained from gravid women. Seroreactivity was strongly influenced by antigenic variation of VAR2CSA Duffy binding-like domains.
  
  
  CONCLUSIONS
  Women acquire antibodies to VAR2CSA over successive pregnancies, but they lose reactivity to VAR1CSA. Serum reactivity to VAR2CSA is variant specific, and future studies should examine the degree to which functional antibodies, such as binding-inhibition antibodies, are variant specific.
authors.affiliation: Seattle Biomedical Research Institute, Seattle, WA 98109, USA. andrew.oleinikov@sbri.org
authors.forename: Andrew V
authors.initials: AV
authors.lastname: Oleinikov
authors.forename: Eddie
authors.initials: E
authors.lastname: Rossnagle
authors.forename: Susan
authors.initials: S
authors.lastname: Francis
authors.forename: Theonest K
authors.initials: TK
authors.lastname: Mutabingwa
authors.forename: Michal
authors.initials: M
authors.lastname: Fried
authors.forename: Patrick E
authors.initials: PE
authors.lastname: Duffy
mesh_terms: D000293:Adolescent; D000328:Adult; D000595:Amino Acid Sequence; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood*; D000953:Antigens, Protozoan / Q000737:chemistry / Q000235:genetics / Q000276:immunology*; D005260:Female; D006801:Humans; D008288:Malaria / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D010298:Parity; D010963:Plasmodium falciparum / Q000235:genetics / Q000276:immunology*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic; D017434:Protein Structure, Tertiary; D016415:Sequence Alignment; D012727:Sex Characteristics
chemical_list: D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan; C521383:VAR1CSA protein, Plasmodium falciparum; C512601:VAR2CSA protein, Plasmodium falciparum