Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia.
Department of Medical Biology, University of Melbourne, Melbourne, Victoria, Australia.
Nat Med. 2020 May;26(5):741-749. doi: 10.1038/s41591-020-0841-4. Epub 2020 May 11.
A major gap in the Plasmodium vivax elimination toolkit is the identification of individuals carrying clinically silent and undetectable liver-stage parasites, called hypnozoites. This study developed a panel of serological exposure markers capable of classifying individuals with recent P. vivax infections who have a high likelihood of harboring hypnozoites. We measured IgG antibody responses to 342 P. vivax proteins in longitudinal clinical cohorts conducted in Thailand and Brazil and identified candidate serological markers of exposure. Candidate markers were validated using samples from year-long observational cohorts conducted in Thailand, Brazil and the Solomon Islands and antibody responses to eight P. vivax proteins classified P. vivax infections in the previous 9 months with 80% sensitivity and specificity. Mathematical models demonstrate that a serological testing and treatment strategy could reduce P. vivax prevalence by 59-69%. These eight antibody responses can serve as a biomarker, identifying individuals who should be targeted with anti-hypnozoite therapy.
在消除间日疟原虫的工具包中存在一个主要的空白，那就是识别那些携带临床上无症状和无法检测到的肝脏期寄生虫（称为休眠子）的个体。本研究开发了一组血清学暴露标志物，能够对具有高携带休眠子可能性的近期间日疟原虫感染个体进行分类。我们在泰国和巴西进行的纵向临床队列研究中测量了对 342 种间日疟原虫蛋白的 IgG 抗体反应，并确定了暴露的候选血清学标志物。使用在泰国、巴西和所罗门群岛进行的为期一年的观察性队列研究中的样本对候选标志物进行了验证，对八种间日疟原虫蛋白的抗体反应可以以前 9 个月的间日疟原虫感染进行分类，敏感性和特异性分别为 80%。数学模型表明，血清学检测和治疗策略可以将间日疟原虫的流行率降低 59-69%。这八种抗体反应可以作为一种生物标志物，识别出需要接受抗休眠子治疗的个体。
