Unité Mixte de Recherche 145, Institut de Recherche pour le Développement and Université Montpellier 1, 911 avenue Agropolis, BP64501, 34394 Montpellier, France.
Malar J. 2010 Dec 17;9:363. doi: 10.1186/1475-2875-9-363.
BACKGROUND: Intermittent preventive treatment in children (IPTc) is a promising strategy to control malaria morbidity. A significant concern is whether IPTc increases children's susceptibility to subsequent malaria infection by altering their anti-Plasmodium acquired immunity. METHODS: To investigate this concern, IgG antibody (Ab) responses to Plasmodium falciparum schizont extract were measured in Senegalese children (6 months-5 years old) who had received three rounds of IPTc with artesunate + sulphadoxine-pyrimethamine (or placebo) at monthly intervals eight months earlier. Potential confounding factors, such as asexual malaria parasitaemia and nutritional status were also evaluated. RESULTS: Firstly, a bivariate analysis showed that children who had received IPTc had lower anti-Plasmodium IgG Ab levels than the non-treated controls. When epidemiological parameters were incorporated into a multivariate regression, gender, nutritional status and haemoglobin concentration did not have any significant influence. In contrast, parasitaemia, past malaria morbidity and increasing age were strongly associated with a higher specific IgG response. CONCLUSIONS: The intensity of the contacts with P. falciparum seems to represent the main factor influencing anti-schizont IgG responses. Previous IPTc does not seem to interfere with this parasite-dependent acquired humoral response eight months after the last drug administration.
背景:间歇性预防治疗(IPT)是控制疟疾发病率的一种很有前途的策略。一个值得关注的问题是,IPT 是否通过改变儿童对疟原虫的获得性免疫而增加其随后感染疟疾的易感性。
方法:为了研究这一担忧,我们测量了 8 个月前接受过三轮青蒿琥酯+磺胺多辛-乙胺嘧啶(或安慰剂)每月间隔 IPT 的塞内加尔儿童(6 个月至 5 岁)对恶性疟原虫裂殖体提取物的 IgG 抗体(Ab)反应。还评估了潜在的混杂因素,如无性疟原虫寄生虫血症和营养状况。
结果:首先,双变量分析显示,接受 IPT 的儿童的抗疟 IgG Ab 水平低于未治疗的对照组。当将流行病学参数纳入多元回归时,性别、营养状况和血红蛋白浓度没有任何显著影响。相比之下,寄生虫血症、过去的疟疾发病率和年龄增长与更高的特异性 IgG 反应强烈相关。
结论:与恶性疟原虫的接触强度似乎是影响抗裂殖体 IgG 反应的主要因素。在最后一次药物给药后 8 个月,先前的 IPT 似乎不会干扰这种依赖寄生虫的获得性体液反应。
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