Antibody response against Plasmodium falciparum exoantigens and somatic antigens: a longitudinal survey in a rural community in Rondônia, western Brazilian Amazon.

Three clinical and sero-epidemiological cross-sectional surveys involving 50 subjects were performed at six-month intervals in Urupá, a rural community characterized by unstable malaria transmission, situated in Rondônia State, Western Brazilian Amazon. Between the surveys, a clinically and parasitologically passive surveillance was established in this community and 48 malaria attacks (28 due to Plasmodium falciparum and 20 due to Plasmodium vivax) were recorded in this cohort of 50 subjects. Serum samples were collected at each survey and tested by enzyme immunoassay (ELISA) for IgG, IgG subclass and IgM antibodies against P. falciparum exoantigens isolated from culture supernatants and detergent-soluble somatic antigens. As expected, both anti-malarial IgG and IgM antibody titres were shown to rise after a malaria outbreak observed during the follow-up period. Nevertheless, in marked contrast with the profile of anti-malarial IgG subclasses described for semi-immune Africans, in this Amazonian community IgG2 antibodies (that are non-cytophilic) against both antigens were shown to predominate over other IgG subclasses. Such overall predominance of IgG2 subclass titres was statistically significant concerning exoantigens, but was of borderline significance in relation to IgG1 antibodies against somatic antigens (p = 0.052). Moreover, highly variable patterns of boosting were observed in antibody responses against both antigens among the patients who suffered P. falciparum malaria attack during the study.

Detection of antigens in urine of patients with acute falciparum and vivax malaria infections.

Using an antigen-capture, dot-blot assay, antigens were detected in the urine of 50 patients infected with Plasmodium falciparum. Antigens were also detected in 12/15 patients who had no detectable parasitemias 1-2 weeks after chemotherapy. By Western blotting and immunoprecipitation, four predominant antigens were identified with the following molecular masses (Mr) and isoelectric points (pI): antigen 1, 200 kDa, pI 6.4-6.27; antigen 2, 180 kDa, pI 5.2-4.8; antigen 3, 150 kDa, pI 5.5; antigen 4, 96 kDa, pI 5.1-4.8. These antigens were heat stable to 100 degrees C for 5 min. Antigens were also detected in the urine of 35 patients with acute P. vivax infections by Western blotting and dot-blot analysis and 10/10 patients three weeks following chemotherapy. The antigens had Mr of 200, 170, and 130 kDa.