title: Protective immunity against malaria by 'natural immunization': a question of dose, parasite diversity, or both?
abstract: Plasmodium undergoes an obligate liver phase before the onset of malaria, which is caused exclusively by cyclic propagation of the parasite inside erythrocytes. The diagnostically inaccessible and clinically silent pre-erythrocytic expansion phase is a promising target for inducing sterilizing immunity against reinfections. Recent studies in rodent and human malaria models called attention to the induction of potent protective immunity by administration of anti-malarial drugs during sporozoite exposure. Here, we review the concept of drug-mediated pathogen arrest as a natural immunization strategy. This previously unrecognized immunological benefit might also open new opportunities for population-wide presumptive drug administration as an adjunct malaria control tool.
authors: Clinical Parasitology Unit, Heidelberg University School of Medicine, 69120 Heidelberg, Germany. sborrmann@kilifi.kemri-wellcome.org
authors: Steffen
authors: S
authors: Borrmann
authors: Kai
authors: K
authors: Matuschewski
mesh_terms: D000818:Animals; D000852:Anopheles / Q000469:parasitology; D000940:Antigenic Variation; D000953:Antigens, Protozoan / Q000235:genetics / Q000276:immunology; D000962:Antimalarials / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D002417:Cattle; D002418:Cattle Diseases / Q000276:immunology / Q000469:parasitology; D002648:Child; D002986:Clinical Trials as Topic; D004306:Dose-Response Relationship, Immunologic; D004334:Drug Administration Schedule; D006801:Humans; D032521:Immunity, Herd; D007113:Immunity, Innate; D007299:Insect Bites and Stings / Q000150:complications / Q000469:parasitology; D007303:Insect Vectors / Q000469:parasitology; D008099:Liver / Q000469:parasitology; D008288:Malaria / Q000469:parasitology; D017780:Malaria Vaccines / Q000276:immunology; D016778:Malaria, Falciparum / Q000209:etiology / Q000276:immunology / Q000517:prevention & control* / Q000635:transmission; D023421:Models, Animal; D010963:Plasmodium falciparum / Q000187:drug effects* / Q000235:genetics / Q000254:growth & development / Q000276:immunology; D012008:Recurrence; D012377:Rodentia; D013045:Species Specificity; D013801:Theileriasis / Q000276:immunology / Q000469:parasitology / Q000517:prevention & control; D014611:Vaccination
chemical_list: D000953:Antigens, Protozoan; D000962:Antimalarials; D017780:Malaria Vaccines