Antibodies to the 4-mer Repeat of the Ring-Infected Erythrocyte Surface Antigen (Pf155/RESA) Protect against Plasmodium falciparum Malaria

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Abstract
Astagneau P (INSERM Unite 13 and Institut de Medecine et d'Epidemiologie Africaines (IMEA), 190 Boulevard MacDonald, 75019 Paris, France), Chougnet C, Lepers J P, Andriamangatiana-Rason M D and Deloron P. Antibodies to the 4-mer repeat of the ring-infected erythrocyte surface antigen (Pf155/RESA) protect against Plasmodium falciparum malaria. International Journal of Epidemiology 1994; 23: 169–175. To investigate the protective role of antibodies to the ring-infected erythrocyte surface antigen (Pf155/RESA) epitopes against Plasmodium falciparum clinical malaria, a cohort study was conducted in a Malagasy village over 7 months. In the 304 individuals included, 127 experienced P. falciparum attacks of under 1500 parasites/μl with no clinical symptoms (protected individuals) and 177 experienced at least one clinical or preclinical P. falciparum attack requiring therapy (unprotected individuals). Antibodies to whole Pf155/RESA, to single epitopes of the 3′ terminus, (EENV) and EENVEHDA(EENV)2 had higher responses in protected than in unprotected individuals (P=0.006, P=0.005, P=0.05 respectively). Within the whole pattem of antibodies to the Pf155/RESA epitopes. only anti-R4 was related to protection independently of age and anti-wR. The Pf155/RESA 4-mer repeated epitope might be of interest for inclusion in a vaccine against the asexual blood stages of P. falciparum.

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