Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.
Malaria Research and Training Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
J Infect Dis. 2023 Jan 11;227(2):171-178. doi: 10.1093/infdis/jiac294.
The frequency and clinical presentation of malaria infections show marked heterogeneity in epidemiological studies. However, deeper understanding of this variability is hampered by the difficulty in quantifying all relevant factors. Here, we report the history of malaria infections in twins, who are exposed to the same in utero milieu, share genetic factors, and are similarly exposed to vectors.
Data were obtained from a Malian longitudinal birth cohort. Samples from 25 twin pairs were examined for malaria infection and antibody responses. Bayesian models were developed for the number of infections during follow-up.
In 16 of 25 pairs, both children were infected and often developed symptoms. In 8 of 25 pairs, only 1 twin was infected, but usually only once or twice. Statistical models suggest that this pattern is not inconsistent with twin siblings having the same underlying infection rate. In a pair with discordant hemoglobin genotype, parasite densities were consistently lower in the child with hemoglobin AS, but antibody levels were similar.
By using a novel design, we describe residual variation in malaria phenotypes in naturally matched children and confirm the important role of environmental factors, as suggested by the between-twin pair heterogeneity in malaria history.
疟疾感染的频率和临床表现在流行病学研究中存在明显的异质性。然而，由于难以量化所有相关因素，对这种变异性的深入了解受到了阻碍。在这里，我们报告了双胞胎中疟疾感染的历史，他们在子宫内环境中受到相同的暴露，具有遗传因素，并且同样受到媒介的暴露。
数据来自马里纵向出生队列。对 25 对双胞胎的样本进行了疟疾感染和抗体反应检测。为随访期间的感染次数开发了贝叶斯模型。
在 25 对双胞胎中，有 16 对双胞胎的两个孩子都被感染，并且经常出现症状。在 25 对双胞胎中，有 8 对双胞胎只有 1 个孩子被感染，但通常只有一次或两次。统计模型表明，这种模式与双胞胎兄弟姐妹具有相同的潜在感染率并不矛盾。在一对血红蛋白基因型不一致的双胞胎中，血红蛋白 AS 儿童的寄生虫密度始终较低，但抗体水平相似。
通过使用一种新颖的设计，我们描述了自然匹配的儿童中疟疾表型的剩余变异，并证实了环境因素的重要作用，这与疟疾史中的双胞胎间异质性一致。
