Abstract
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Malaria Journal |
| Vol/bind | 6 |
| Sider (fra-til) | 153 |
| ISSN | 1475-2875 |
| DOI | |
| Status | Udgivet - 2007 |
Bibliografisk note
Keywords: Amodiaquine; Animals; Antibodies, Protozoan; Child, Preschool; Drug Combinations; Drug Resistance; Female; Humans; Immunocompetence; Immunoglobulin G; Infant; Malaria, Falciparum; Male; Plasmodium falciparum; Polymerase Chain Reaction; Protozoan Proteins; Pyrimethamine; Sulfadoxine; Tanzania; Treatment OutcomeAdgang til dokumentet
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Potential impact of host immunity on malaria treatment outcome in Tanzanian children infected with Plasmodium falciparum. / Enevold, Anders; Nkya, Watoky M M M; Theisen, Michael; Vestergaard, Lasse S; Jensen, Anja Tr; Staalsoe, Trine; Theander, Thor G; Bygbjerg, Ib C; Alifrangis, Michael.
I: Malaria Journal, Bind 6, 2007, s. 153.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review
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TY - JOUR
T1 - Potential impact of host immunity on malaria treatment outcome in Tanzanian children infected with Plasmodium falciparum
AU - Enevold, Anders
AU - Nkya, Watoky M M M
AU - Theisen, Michael
AU - Vestergaard, Lasse S
AU - Jensen, Anja Tr
AU - Staalsoe, Trine
AU - Theander, Thor G
AU - Bygbjerg, Ib C
AU - Alifrangis, Michael
N1 - Keywords: Amodiaquine; Animals; Antibodies, Protozoan; Child, Preschool; Drug Combinations; Drug Resistance; Female; Humans; Immunocompetence; Immunoglobulin G; Infant; Malaria, Falciparum; Male; Plasmodium falciparum; Polymerase Chain Reaction; Protozoan Proteins; Pyrimethamine; Sulfadoxine; Tanzania; Treatment Outcome
PY - 2007
Y1 - 2007
N2 - BACKGROUND: In malaria endemic areas children may recover from malaria after chemotherapy in spite of harbouring genotypically drug-resistant Plasmodium falciparum. This phenomenon suggests that there is a synergy between drug treatment and acquired immunity. This hypothesis was examined in an area of moderately intense transmission of P. falciparum in Tanzania during a drug trail with sulphadoxine-pyrimethamine (SP) or amodiaquine (AQ). METHODS: One hundred children with uncomplicated malaria were treated with either SP or AQ and followed for 28 days. Mutations in parasite genes related to SP and AQ-resistance as well as human sickle cell trait and alpha-thalassaemia were determined using PCR and sequence-specific oligonucleotide probes and enzyme-linked immunosorbent assay (SSOP-ELISA), and IgG antibody responses to a panel of P. falciparum antigens were assessed and related to treatment outcome. RESULTS: Parasitological or clinical treatment failure (TF) was observed in 68% and 38% of children receiving SP or AQ, respectively. In those with adequate clinical and parasitological response (ACPR) compared to children with TF, and for both treatment regimens, prevalence and levels of anti-Glutamate-rich Protein (GLURP)-specific IgG antibodies were significantly higher (P < 0.001), while prevalence of parasite haplotypes associated with SP and AQ resistance was lower (P = 0.02 and P = 0.07, respectively). Interestingly, anti-GLURP-IgG antibodies were more strongly associated with treatment outcome than parasite resistant haplotypes, while the IgG responses to none of the other 11 malaria antigens were not significantly associated with ACPR. CONCLUSION: These findings suggest that GLURP-specific IgG antibodies in this setting contribute to clearance of drug-resistant infections and support the hypothesis that acquired immunity enhances the clinical efficacy of drug therapy. The results should be confirmed in larger scale with greater sample size and with variation in transmission intensity.
AB - BACKGROUND: In malaria endemic areas children may recover from malaria after chemotherapy in spite of harbouring genotypically drug-resistant Plasmodium falciparum. This phenomenon suggests that there is a synergy between drug treatment and acquired immunity. This hypothesis was examined in an area of moderately intense transmission of P. falciparum in Tanzania during a drug trail with sulphadoxine-pyrimethamine (SP) or amodiaquine (AQ). METHODS: One hundred children with uncomplicated malaria were treated with either SP or AQ and followed for 28 days. Mutations in parasite genes related to SP and AQ-resistance as well as human sickle cell trait and alpha-thalassaemia were determined using PCR and sequence-specific oligonucleotide probes and enzyme-linked immunosorbent assay (SSOP-ELISA), and IgG antibody responses to a panel of P. falciparum antigens were assessed and related to treatment outcome. RESULTS: Parasitological or clinical treatment failure (TF) was observed in 68% and 38% of children receiving SP or AQ, respectively. In those with adequate clinical and parasitological response (ACPR) compared to children with TF, and for both treatment regimens, prevalence and levels of anti-Glutamate-rich Protein (GLURP)-specific IgG antibodies were significantly higher (P < 0.001), while prevalence of parasite haplotypes associated with SP and AQ resistance was lower (P = 0.02 and P = 0.07, respectively). Interestingly, anti-GLURP-IgG antibodies were more strongly associated with treatment outcome than parasite resistant haplotypes, while the IgG responses to none of the other 11 malaria antigens were not significantly associated with ACPR. CONCLUSION: These findings suggest that GLURP-specific IgG antibodies in this setting contribute to clearance of drug-resistant infections and support the hypothesis that acquired immunity enhances the clinical efficacy of drug therapy. The results should be confirmed in larger scale with greater sample size and with variation in transmission intensity.
U2 - 10.1186/1475-2875-6-153
DO - 10.1186/1475-2875-6-153
M3 - Journal article
C2 - 18021388
VL - 6
SP - 153
JO - Malaria Journal
JF - Malaria Journal
SN - 1475-2875
ER -