Acquired Immunity to Malaria

Queensland Institute of Medical Research, The Bancroft Centre, Post Office Royal Brisbane Hospital, Brisbane, Queensland 4029, Australia.
Clinical microbiology reviews (Impact Factor: 17.41). 02/2009; 22(1):13-36, Table of Contents. DOI: 10.1128/CMR.00025-08
Source: PubMed


Naturally acquired immunity to falciparum malaria protects millions of people routinely exposed to Plasmodium falciparum infection from severe disease and death. There is no clear concept about how this protection works. There is no general agreement about the rate of onset of acquired immunity or what constitutes the key determinants of protection; much less is there a consensus regarding the mechanism(s) of protection. This review summarizes what is understood about naturally acquired and experimentally induced immunity against malaria with the help of evolving insights provided by biotechnology and places these insights in the context of historical, clinical, and epidemiological observations. We advocate that naturally acquired immunity should be appreciated as being virtually 100% effective against severe disease and death among heavily exposed adults. Even the immunity that occurs in exposed infants may exceed 90% effectiveness. The induction of an adult-like immune status among high-risk infants in sub-Saharan Africa would greatly diminish disease and death caused by P. falciparum. The mechanism of naturally acquired immunity that occurs among adults living in areas of hyper- to holoendemicity should be understood with a view toward duplicating such protection in infants and young children in areas of endemicity.

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    • "The feasibility of a malaria vaccine is supported by two main findings. Firstly, people in endemic areas accumulate considerable protection against clinical disease [12]. Secondly, 90% of volunteers receiving a repeated series of irradiated sporozoites via infected mosquitoes demonstrate sterile protection to over several months [13]. "
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    Vaccine 08/2015; 33(40). DOI:10.1016/j.vaccine.2015.07.107 · 3.62 Impact Factor
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    • "Despite an urgent need for an effective vaccine against malaria, progress on vaccine development has been slow and disappointing (Salvador et al. 2012). Though naturally acquired immunity against Plasmodium falciparum can be gradually attained after years of multiple repeated infectious episodes in adults, it has been seen that it neither persists over long periods of time nor is seen in pregnant women or young children meaning that it is incomplete, nonsterilizing, and short-lived (Doolan et al. 2009) which underlines that the major obstacle for vaccine development is an incomplete understanding of the host immune response crucial for eradication of the malaria parasites. "
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    • "Human malaria infection can lead to a wide range of clinical symptoms that are influenced by epidemiological and immunological factors [1] along with the mechanisms of immune evasion of the parasite [2]. Protective humoral response against Plasmodium falciparum can be acquired after repeated infections of malaria; however, it does not persist over long periods of time and it is generally incomplete [1]. Despite concerted efforts worldwide, most advanced vaccines in development have shown moderate efficacy [3] maybe since they are based on parasite antigens, too polymorphic , and expressed only in brief periods of the parasite life cycle [4]. "
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