The role of naturally acquired antimalarial antibodies in subclinicalPlasmodiumspp. infection

Abstract

Undetected subclinical Plasmodium spp. infections are a significant barrier to eliminating malaria. In malaria-endemic areas, naturally acquired antimalarial antibodies develop with repeated infection. These antibodies can confer protection against the clinical manifestations of Plasmodium spp. infection in highly exposed populations, and several distinct functional antibody mechanisms have been defined in the clearance of Plasmodium parasites. However, the role of antimalarial antibodies during subclinical infection is less well defined. In this review, we examine the development and maintenance of antibody responses and the functional mechanisms associated with clinical protection, highlighted by epidemiological studies investigating the association between human immunity and detection of subclinical infection across various malaria transmission intensities. Understanding the development and role of the antimalarial antibody response during subclinical Plasmodium spp. infection will be essential to furthering novel interventions including vaccines and immunological biomarkers that can be utilized for malaria surveillance and ultimately progress malaria elimination.

Can malaria parasites be spontaneously cleared?

“…As it is well established that antibodies and other adaptive immune responses are crucial in protection against clinical malaria, it seems likely that similar mechanisms are involved in the regulation of subclinical infections and spontaneous clearance events. These may involve both the innate and adaptive immune response, including antibody-mediated functional responses such as complement deposition and opsonic phagocytosis [40]. Needless to say, further research to elucidate the role of immunity in spontaneous clearance of submicroscopic P. falciparum parasites is warranted.…”