Department of Medicine, University of Melbourne, Melbourne, VIC, Australia.
Lancet Infect Dis. 2010 Jan;10(1):51-9. doi: 10.1016/S1473-3099(09)70322-6.
Host immunity is an important but poorly understood determinant of antimalarial efficacy, influencing the outcome of prevention and treatment trials. Variations in host immunity might explain why factors such as host genetics, age, pregnancy, infection with HIV, parasite density, and malaria transmission intensity, can raise or lower apparent cure rates. Recently, attempts have been made to characterise immunological correlates of treatment outcome in Plasmodium falciparum malaria, but not yet for Plasmodium vivax. A better understanding of such correlates might improve trials of antimalarial drugs and provide leads for vaccine development. Greater understanding of the relation between host immunity and treatment outcome is crucial to making informed choices about the use of safe but partly effective drugs for malaria prevention in children and pregnant women. With increasing malaria control efforts worldwide, declining population immunity might alter drug response profiles. Improved methods for assessing antimalarial immunity will strengthen malaria control efforts.
宿主免疫力是抗疟疗效的一个重要但尚未被充分了解的决定因素，影响预防和治疗试验的结果。宿主免疫力的差异可能解释了为什么宿主遗传、年龄、妊娠、感染 HIV、寄生虫密度和疟疾传播强度等因素会提高或降低明显的治愈率。最近，人们试图描述恶性疟原虫疟疾治疗结果的免疫学相关性，但尚未针对间日疟原虫。更好地了解这些相关性可能会改善抗疟药物的临床试验，并为疫苗开发提供线索。更好地了解宿主免疫与治疗结果之间的关系，对于在儿童和孕妇中使用安全但部分有效的药物进行疟疾预防做出明智的选择至关重要。随着全球疟疾控制工作的加强，人群免疫力的下降可能会改变药物反应谱。改进评估抗疟免疫力的方法将加强疟疾控制工作。
