title: Plasmodium falciparum parasites causing cerebral malaria share variant surface antigens, but are they specific?
abstract: BACKGROUND
  Variant surface antigens (VSA) expressed on the surface of Plasmodium falciparum-infected red blood cells constitute a key for parasite sequestration and immune evasion. In distinct malaria pathologies, such as placental malaria, specific antibody response against VSA provides protection. This study investigated the antibody response specifically directed against VSA expressed by parasites isolated from individuals presenting a given type of clinical presentation.
  
  
  METHODS
  Plasma and isolates were obtained from four groups of Beninese subjects: healthy adults, patients presenting uncomplicated malaria (UM), cerebral malaria (CM), or pregnancy-associated malaria (PAM). The reactivity of plasma samples from each clinical group was measured by flow cytometry against parasites isolated from individuals from each clinical group.
  
  
  RESULTS
  Antibody responses against VSAUM were predominant in CM, UM and HA plasmas. When analysed according to age in all plasma groups, anti-VSACM and -VSAUM antibody levels were similar until six years of age. In older groups (6-18 and >19 years of age), VSAUM antibody levels were higher than VSACM antibody levels (P = .01, P = .0008, respectively). Mean MFI values, measured in all plasmas groups except the PAM plasmas, remained low for anti-VSAPAM antibodies and did not vary with age. One month after infection the level of anti-VSA antibodies able to recognize heterologous VSACM variants was increased in CM patients. In UM patients, antibody levels directed against heterologous VSAUM were similar, both during the infection and one month later.
  
  
  CONCLUSIONS
  In conclusion, this study suggests the existence of serologically distinct VSACM and VSAUM. CM isolates were shown to share common epitopes. Specific antibody response to VSAUM was predominant, suggesting a relative low diversity of VSAUM in the study area.
authors.affiliation: Institut de Recherche pour le Développement (IRD) UMR216, Mother and Child faced with tropical infections Unit, Paris, 75006, France.
authors.forename: Nabila
authors.initials: N
authors.lastname: Kheliouen
authors.forename: Firmine
authors.initials: F
authors.lastname: Viwami
authors.forename: Francis
authors.initials: F
authors.lastname: Lalya
authors.forename: Nicaise
authors.initials: N
authors.lastname: Tuikue-Ndam
authors.forename: Else C Eboumbou
authors.initials: EC
authors.lastname: Moukoko
authors.forename: Christophe
authors.initials: C
authors.lastname: Rogier
authors.forename: Philippe
authors.initials: P
authors.lastname: Deloron
authors.forename: Agnès
authors.initials: A
authors.lastname: Aubouy
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000913:Antibodies, Protozoan / Q000097:blood / Q000276:immunology; D000953:Antigens, Protozoan / Q000097:blood / Q000276:immunology*; D000954:Antigens, Surface / Q000276:immunology; D001541:Benin; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D000939:Epitopes / Q000276:immunology; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007223:Infant; D016779:Malaria, Cerebral / Q000276:immunology* / Q000469:parasitology; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010963:Plasmodium falciparum / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000276:immunology* / Q000469:parasitology; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan; D000954:Antigens, Surface; D000939:Epitopes; D007074:Immunoglobulin G