Avaliação da resposta de anticorpos IgG contra diferentes variantes alélicas do Antígeno 1 de Membrana Apical (AMA-1) de Plasmodium vivax em indivíduos de áreas endêmicas de malária / Evaluation of IgG antibody response against different variants of Plasmodium vivax apical membrane antigen 1 (AMA-1) in individuals from malaria endemic areas

O Plasmodium vivax é a espécie com maior distribuição geográfica no mundo e a que predomina nas Américas, incluindo o Brasil. Comparado ao Plasmodium falciparum, poucas vacinas contra o P. vivax encontram-se em fase de testes clínicos. Um dos antígenos de formas sanguíneas de P. vivax candidato a vacina é o Antígeno 1 de Membrana Apical (PvAMA-1). Entretanto, a diversidade antigênica do mesmo na natureza representa um grande desafio para seu uso no desenvolvimento de uma vacina de ampla cobertura. No presente estudo, avaliamos se os polimorfismos de sequências já descritos são capazes de influenciar na eficácia de uma vacina baseada em PvAMA-1. Para isso, geramos 9 proteínas recombinantes a partir da levedura Pichia pastoris, as quais são representativas de diferentes variantes alélicas do antígeno PvAMA-1, a saber: Belem, Chesson I, Sal-1, Indonesia XIX, SK0814, TC103, PNG_05_ESP, PNG_62_MU e PNG_68_MAS. Após expressão e purificação das proteínas selecionadas, avaliamos comparativamente por ELISA a resposta de anticorpos IgG naturalmente adquiridos em indivíduos expostos a malária, procedentes da Região Amazônica. Todas as proteínas foram obtidas com rendimento e pureza apropriados para os estudos propostos. A prevalência total de indivíduos expostos a malária com anticorpos contra PvAMA-1 Belem foi de 53,68%, em 611 amostras de soro testadas. Entre 100 das amostras sorologicamente positivas para PvAMA-1 Belem, os maiores valores de DO492 foram obtidos para as variantes Chesson I, SK0814 e Sal-1, sugerindo que epítopos comuns ou de reatividade cruzada estão sendo reconhecidos nessas variantes. Por outro lado, níveis mais baixos de DO492 foram obtidos para as variantes Indonesia XIX, TC103, PNG_05_ESP, PNG_62_MU e PNG_68_MAS, o que pode significar que essas variantes são menos prevalentes ou não circulam no Brasil. Soros policlonais de camundongos C57BL/6 previamente imunizados com PvAMA-1 Belem foram testados quanto ao reconhecimento das diferentes variantes por ELISA. Nossos resultados demonstraram que as variantes Chesson I, Indonesia XIX, SK0814, Sal-1 e a proteína homóloga foram predominantemente reconhecidas. Por fim, ensaios de competição baseados em ELISA revelaram que as proteínas Chesson I, Indonesia XIX, SK0814 e Sal-1, na fase solúvel, foram capazes de inibir a ligação de anticorpos à variante Belem aderida a placa, sugerindo a presença de epítopos comuns ou de reatividade cruzada entre as mesmas. Nossos dados sugerem que uma vacina baseada na variante PvAMA-1 Belem gera anticorpos variante-transcendentes. Entretanto, para gerar uma vacina universal baseada em PvAMA-1, uma formulação multi-alélica, incluindo variantes da Tailândia e Papua Nova Guiné, deverão ser testadas

Plasmodium vivax has the largest geographical distribution Plasmodium species in the world, and is predominant in the Americas, including Brazil. Fewer P. vivax vaccines than P. falciparum vaccines have successfully reached clinical trials. One of the candidate antigens for a blood-stage P. vivax vaccine is the apical membrane antigen 1 (PvAMA-1). However, the high natural variability found in this antigen presents a major challenge for its development into a wide-range vaccine. In the present study, we evaluated whether sequence polymorphisms would influence a vaccine based on PvAMA-1. To achieve this, we generated 9 recombinant proteins from the yeast Pichia pastoris, representative of different allelic variants of the PvAMA-1 antigen: Belem, Chesson I, Sal-1, Indonesia XIX, SK0814, TC103, PNG_05_ESP, PNG_62_MU, and PNG_68_MAS. After expression and purification of these proteins, we compared, by ELISA and IgG blocking, the natural acquired response from malaria-exposed individuals in the Amazon Region. All proteins selected had the appropriate yield and purity for the proposed studies. The total prevalence of malaria-exposed individuals with reactivity to PvAMA-1 Belem was 53,68%, from 611 serum samples tested. One hundred of these serologically positive samples were further tested against recombinant proteins representing the other allelic variants. The highest OD values resulted from Sal-1, Chesson I and SK0814 variants, suggesting that common epitopes or cross-reactivity exist across the variants. On the other hand, the lowest OD values resulted from the variants Indonesia XIX, TC103, PNG_05_ESP, PNG_62_MU, and PNG_68_MAS, which may mean these variants are less prevalent or do not circulate in Brazil. Polyclonal sera from C57BL/6 mice immunized with PvAMA-1 Belem were tested for recognition of different variants by ELISA. Our results showed that the variants Chesson I, Sal-1, Indonesia XIX, SK0814 and the homologous protein were predominantly recognized. Lastly, ELISA-based competition assays revealed that Chesson I, Sal-1, Indonesia XIX and SK0814 proteins were able to inhibit antibody binding to the Belem variant, suggesting the presence of common epitopes or cross-reactivity between these variants. Our data suggest that a vaccine based on the PvAMA-1 Belem variant displays strain-transcendent antibodies. However, to generate a universal vaccine based on PvAMA-1, a multiallelic formulation including variants from Thailand and Papua New Guinea must be tested

Oxidative Stress in Vivax Malaria

Malaria is still a leading cause of morbidity and mortality. The increase in lipid peroxidation reported in malaria infection and antioxidant status may be a useful marker of oxidative stress during malaria infection. The aim of this study was to investigate the role of antioxidant enzymes against toxic reactive oxygen species in patients infected with Plasmodium vivax and healthy controls. Malondialdehyde levels, superoxide dismutase, and glutathione peroxidase activities were determined in 91 P. vivax patients and compared with 52 controls. Malondialdehyde levels, superoxide dismutase, and glutathione peroxidase activities were 8.07+/-2.29 nM/ml, 2.69+/-0.33 U/ml, and 49.6+/-3.2 U/g Hb in the patient group and 2.72+/-0.50 nM/ml, 3.71+/-0.47 U/ml, and 62.3+/-4.3 U/g Hb in the control group, respectively. Malondialdehyde levels were found statistically significant in patients with vivax malaria higher than in healthy controls (P<0.001). On the other hand, superoxide dismutase and glutathione peroxidase activities were found to be significantly lower in vivax malaria patients than in controls (P<0.05). There was an increase in oxidative stress in vivax malaria. The results suggested that antioxidant defense mechanisms may play an important role in the pathogenesis of P. vivax.

Possible role of Granulocyte Macrophage Colony Stimulating Factor receptor (GM-CSF R) in malaria.

Malaria has been reportedly increasing in incidence on the globe. Evidence from clinical studies supports a role for cytokines in the pathogenesis of cerebral malaria. Given the stimulatory effect of the ligand GM-CSF on the synthesis and release of the pyrogenic cytokine TNF alpha, the present study has been undertaken to investigate a possible role of GMCSF receptor in the pathogenesis of both Plasmodium vivax and Plasmodium falciparum malaria. An enzyme immunoassay developed by us at our laboratory for the quantitation of GM-CSF receptor has been used. No changes in the concentration of the receptor have been indicated either at the time of diagnosis or after treatment. In addition, an intercomparison of the receptor concentration between the P. vivax and P. falciparum groups does not show any significant difference. The results suggest that GM-CSF receptor has no significant role in the pathogenesis of either type of malaria.