title: Comparison of the specificity of antibodies to VAR2CSA in Cameroonian multigravidae with and without placental malaria: a retrospective case-control study.
abstract: BACKGROUND
  Antibodies (Ab) to VAR2CSA prevent Plasmodium falciparum-infected erythrocytes from sequestrating in the placenta, i.e., prevent placental malaria (PM). The specificity of Ab to VAR2CSA associated with absence of PM is unknown. Accordingly, differences in the specificity of Ab to VAR2CSA were compared between multigravidae with and without PM who had Ab to VAR2CSA.
  
  
  METHODS
  In a retrospective case-control study, plasma collected from Cameroonian multigravidae with (n = 96) and without (n = 324) PM were screened in 21 assays that measured antibody levels to full length VAR2CSA (FV2), individual VAR2CSA DBL domains, VAR2CSA domains from different genetic backgrounds (variants), as well as proportion of high avidity Ab to FV2.
  
  
  RESULTS
  Multigravidae with and without PM had similar levels of Ab to FV2, the six VAR2CSA DBL domains and different variants, while the proportion of high avidity Ab to FV2 was significantly higher in women without PM at delivery (p = 0.0030) compared to women with PM. In a logistic regression model adjusted for gravidity and age, the percentage of high avidity Ab to FV2 was associated with reduced likelihood of PM in multigravidae. A 5 % increase in proportion of high avidity Ab to FV2 was associated with a nearly 15 % lower likelihood of PM.
  
  
  CONCLUSIONS
  Ab avidity to FV2 may be an important indicator of immunity to PM.
authors.affiliation: Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at Manoa, 651 Ilalo Street, BSB 320, Honolulu, HI, 96813, USA. annab8@hawaii.edu.
authors.forename: Anna
authors.initials: A
authors.lastname: Babakhanyan
authors.affiliation: Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at Manoa, 651 Ilalo Street, BSB 320, Honolulu, HI, 96813, USA. fangr@hawaii.edu.
authors.forename: Rui
authors.initials: R
authors.lastname: Fang
authors.affiliation: Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at Manoa, 651 Ilalo Street, BSB 320, Honolulu, HI, 96813, USA. awey@hawaii.edu.
authors.forename: Andrew
authors.initials: A
authors.lastname: Wey
authors.affiliation: Department of Immunology and Microbiology, Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark. salanti@sund.ku.dk.
authors.forename: Ali
authors.initials: A
authors.lastname: Salanti
authors.affiliation: Faculty of Medicine and Biomedical Research, Biotechnology Centre, University of Yaounde 1, Yaounde, Cameroon. menyensg@yahoo.com.
authors.forename: Grace
authors.initials: G
authors.lastname: Sama
authors.affiliation: Faculty of Medicine and Biomedical Research, Biotechnology Centre, University of Yaounde 1, Yaounde, Cameroon. caniciaearthlink@yahoo.com.
authors.forename: Canisia
authors.initials: C
authors.lastname: Efundem
authors.affiliation: Faculty of Medicine and Biomedical Research, Biotechnology Centre, University of Yaounde 1, Yaounde, Cameroon. robertjleker@yahoo.fr.
authors.forename: Robert J I
authors.initials: RJ
authors.lastname: Leke
authors.affiliation: Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at Manoa, 651 Ilalo Street, BSB 320, Honolulu, HI, 96813, USA. jjchen@hawaii.edu.
authors.forename: John J
authors.initials: JJ
authors.lastname: Chen
authors.affiliation: Faculty of Medicine and Biomedical Research, Biotechnology Centre, University of Yaounde 1, Yaounde, Cameroon. roseleke@yahoo.com.
authors.forename: Rose G F
authors.initials: RG
authors.lastname: Leke
authors.affiliation: Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A Burns School of Medicine, University of Hawaii at Manoa, 651 Ilalo Street, BSB 320, Honolulu, HI, 96813, USA. dwtaylor@hawaii.edu.
authors.forename: Diane W
authors.initials: DW
authors.lastname: Taylor
mesh_terms: D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood*; D000915:Antibody Affinity; D000953:Antigens, Protozoan / Q000276:immunology*; D002163:Cameroon; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000276:immunology*; D008297:Male; D010922:Placenta Diseases / Q000276:immunology / Q000517:prevention & control; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan; C512601:VAR2CSA protein, Plasmodium falciparum