Immunological markers of Plasmodium vivaxexposure and immunity: a systematic review and meta-analysis

Abstract

BackgroundIdentifying Plasmodium vivax antigen-specific antibodies associated with P. vivax infection and protective immunity is key to the development of serosurveillance tools and vaccines for malaria. Antibody targets of P. vivax can be identified by seroepidemiological studies of individuals living in P. vivax-endemic areas, and is an important strategy given the limited ability to culture P. vivax in vitro. There have been numerous studies investigating the association between P. vivax antibody responses and P. vivax infection, but there has been no standardization of results to enable comparisons across populations.MethodsWe performed a systematic review with meta-analysis of population-based, cross-sectional, case–control, and cohort studies of individuals living in P. vivax-endemic areas. We searched 6 databases and identified 18 studies that met predefined inclusion and quality criteria, and examined the association between antibody responses to P. vivax antigens and P. vivax malaria.ResultsThe majority of studies were published in South America (all from Brazil) and the rest from geographically diverse areas in the Asia-Pacific region. Considerable heterogeneity in estimates was observed, but IgG responses to PvCSP, PvMSP-119, PvMSP-9RIRII, and PvAMA1 were associated with increased odds of P. vivax infection in geographically diverse populations. Potential sources of heterogeneity included study design, different transmission intensities and transmigrant populations. Protective associations were observed for antibodies to PvMSP-119, PvMSP-1NT, PvMSP-3α and PvMSP-9NT antigens, but only in single geographical locations.ConclusionsThis systematic review revealed several antigen-specific antibodies that were associated with active infection and protective immunity, which may be useful biomarkers. However, more studies are needed on additional antigens, particularly cohort studies to increase the body of evidence for protective immunity. More studies representing diverse geographical regions encompassing varying P. vivax endemicities are needed to validate the generalizability of the findings and to provide a solid evidence base for the use of P. vivax antigens in vaccines and serosurveillance tools.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-014-0150-1) contains supplementary material, which is available to authorized users.

Antibody responses within two leading Plasmodium vivax vaccine candidate antigens in three geographically diverse malaria-endemic regions of India

“…Limited studies were conducted in the Asia–Pacific region to identify immune response in a geographical diverse population with different P. vivax endemicity [64–68]. Basic understanding of antibody response against the vaccine antigens in different geographical areas is important to assess the effectiveness of malaria vaccine.…”

Immunological markers of Plasmodium vivax exposure and immunity: a systematic review and meta-analysis

“…IgG1 and IgG3 were the predominant subclasses to P. vivax antigens, and may function by opsonic phagocytosis [74], or by fixing complement. We found only one study that utilized a functional assay: King et al [35] showed that binding inhibitory antibodies to PvDBPII were associated with protection from P. vivax infection.…”

Recent insights into humoral immunity targeting Plasmodium falciparum and Plasmodium vivax malaria

“…For P. vivax, fewer studies have been done and the data in support of any given target of protective immunity needs strengthening (Cutts et al, 2014;Finney et al, 2014;Hostetler et al, 2015). Additional studies on P. vivax immunity were therefore timely, given the burden of disease particularly in central and southeastern Asia, and the more recent appreciation that infection with this species of Plasmodium can also result in severe clinical syndromes (Anstey et al, 2012).…”