title: The Plasmodium falciparum erythrocyte invasion ligand Pfrh4 as a target of functional and protective human antibodies against malaria.
abstract: BACKGROUND
  Acquired antibodies are important in human immunity to malaria, but key targets remain largely unknown. Plasmodium falciparum reticulocyte-binding-homologue-4 (PfRh4) is important for invasion of human erythrocytes and may therefore be a target of protective immunity.
  
  
  METHODS
  IgG and IgG subclass-specific responses against different regions of PfRh4 were determined in a longitudinal cohort of 206 children in Papua New Guinea (PNG). Human PfRh4 antibodies were tested for functional invasion-inhibitory activity, and expression of PfRh4 by P. falciparum isolates and sequence polymorphisms were determined.
  
  
  RESULTS
  Antibodies to PfRh4 were acquired by children exposed to P. falciparum malaria, were predominantly comprised of IgG1 and IgG3 subclasses, and were associated with increasing age and active parasitemia. High levels of antibodies, particularly IgG3, were strongly predictive of protection against clinical malaria and high-density parasitemia. Human affinity-purified antibodies to the binding region of PfRh4 effectively inhibited erythrocyte invasion by P. falciparum merozoites and antibody levels in protected children were at functionally-active concentrations. Although expression of PfRh4 can vary, PfRh4 protein was expressed by most isolates derived from the cohort and showed limited sequence polymorphism.
  
  
  CONCLUSIONS
  Evidence suggests that PfRh4 is a target of antibodies that contribute to protective immunity to malaria by inhibiting erythrocyte invasion and preventing high density parasitemia. These findings advance our understanding of the targets and mechanisms of human immunity and evaluating the potential of PfRh4 as a component of candidate malaria vaccines.
authors.affiliation: Burnet Institute of Medical Research and Public Health, Victoria, Australia.
authors.forename: Linda
authors.initials: L
authors.lastname: Reiling
authors.forename: Jack S
authors.initials: JS
authors.lastname: Richards
authors.forename: Freya J I
authors.initials: FJ
authors.lastname: Fowkes
authors.forename: Danny W
authors.initials: DW
authors.lastname: Wilson
authors.forename: Watcharee
authors.initials: W
authors.lastname: Chokejindachai
authors.forename: Alyssa E
authors.initials: AE
authors.lastname: Barry
authors.forename: Wai-Hong
authors.initials: WH
authors.lastname: Tham
authors.forename: Janine
authors.initials: J
authors.lastname: Stubbs
authors.forename: Christine
authors.initials: C
authors.lastname: Langer
authors.forename: John
authors.initials: J
authors.lastname: Donelson
authors.forename: Pascal
authors.initials: P
authors.lastname: Michon
authors.forename: Livingstone
authors.initials: L
authors.lastname: Tavul
authors.forename: Brendan S
authors.initials: BS
authors.lastname: Crabb
authors.forename: Peter M
authors.initials: PM
authors.lastname: Siba
authors.forename: Alan F
authors.initials: AF
authors.lastname: Cowman
authors.forename: Ivo
authors.initials: I
authors.lastname: Mueller
authors.forename: James G
authors.initials: JG
authors.lastname: Beeson
mesh_terms: D000293:Adolescent; D000818:Animals; D000913:Antibodies, Protozoan / Q000096:biosynthesis / Q000276:immunology* / Q000494:pharmacology; D000953:Antigens, Protozoan / Q000235:genetics / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D004912:Erythrocytes / Q000187:drug effects / Q000276:immunology / Q000469:parasitology; D005260:Female; D015870:Gene Expression; D006801:Humans; D056724:Immunity, Humoral / Q000187:drug effects; D007074:Immunoglobulin G / Q000096:biosynthesis / Q000276:immunology* / Q000494:pharmacology; D017780:Malaria Vaccines / Q000276:immunology; D016778:Malaria, Falciparum / Q000276:immunology / Q000469:parasitology / Q000517:prevention & control*; D008297:Male; D008565:Membrane Proteins / Q000235:genetics / Q000276:immunology*; D052940:Merozoites / Q000187:drug effects / Q000276:immunology; D018512:Parasitemia / Q000276:immunology / Q000517:prevention & control*; D010963:Plasmodium falciparum / Q000187:drug effects / Q000276:immunology*; D011110:Polymorphism, Genetic; D011485:Protein Binding; D015800:Protozoan Proteins / Q000235:genetics / Q000276:immunology*; D011993:Recombinant Fusion Proteins / Q000235:genetics / Q000276:immunology
chemical_list: D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan; D007074:Immunoglobulin G; D017780:Malaria Vaccines; D008565:Membrane Proteins; D015800:Protozoan Proteins; C464927:RH4 protein, Plasmodium falciparum; D011993:Recombinant Fusion Proteins