Differential regulation of IgG subclasses and IgE antimalarial antibody responses in complicated and uncomplicated Plasmodium falciparum malaria

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Abstract
The aim of this study was to assess the immunoglobulin (Ig)‐subclass distribution of antimalarial antibody responses in 110 and 169 Thai patients with complicated and uncomplicated Plasmodium falciparum malaria, respectively. Antimalarial plasma IgG subclasses and IgE antibody levels against a crude malaria blood stages, and antigen preparation were determined using enzyme‐linked immunosorbent assay (ELISA). On admission, the levels of anti‐P. falciparum IgG1, IgG2 and IgG3 were significantly lower in patients with complicated malaria than uncomplicated malaria (IgG1, P < 0·0001; IgG2, P < 0·0001; IgG3, P < 0·0001). The levels of antimalarial IgE were slightly lower, but not statistically significant (P = 0·389) in the complicated malaria. After adjusting all antibody levels and age, anti‐P. falciparum IgG3 levels remained significantly associated with complicated malaria. None of the other antibody concentrations showed statistically significant associations with complicated malaria. The anti‐P. falciparum IgG3 levels were related to the IgG1 as well as IgG2 levels. A correlation between anti‐P. falciparum IgG2 and IgE was observed in the complicated malaria group, and this may indicate their roles in the severity of disease. Our data suggest that anti‐P. falciparum IgG3 is associated with a reduced risk of complicated malaria and that antimalarial Ig‐subclasses are differently regulated in patients with complicated and uncomplicated malaria.

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