Title
A whole blood assay for antibody dependent phagocytosis of Plasmodium falciparum infected erythrocytes.
Author(s)
Rathnayake, Dilini
Hasang, Wina
Macpherson, Alexander
Ding, HongHua
Manning, Laurens
Laman, Moses
Ome-Kaius, Maria
Ter Kuile, Feiko
Madanitsa, Mwayi
Wines, Bruce
Hogarth, P Mark
Aitken, Elizabeth H
Rogerson, Stephen J
Abstract
Antibodies are used to protect against Plasmodium falciparum malaria. One antibody target, the variant surface antigens, is expressed on infected erythrocytes (IEs). Antibodies to these antigens can either block IE sequestration in the tissues, facilitate natural killer cell-mediated killing, or opsonise IEs for phagocytic clearance by neutrophils and monocytes.We developed a high-throughput assay to measure antibody-dependent neutrophil phagocytosis (ADNP) and antibody-dependent cellular phagocytosis (ADCP, by blood monocytes) in the same sample of fresh whole blood.Here we show that immune plasma mediates ADNP and ADCP in a concentration-dependent manner. Uptake is greater in the presence of complement proteins and is largely dependent on the expression of P. falciparum Erythrocyte Membrane Protein 1 located on the IE surface. Plasma from pregnant Papua New Guinean women with and without placental malaria shows that ADNP and ADCP are associated with protection from placental malaria. ADNP, but not ADCP, using IEs expressing IT4VAR19 (a PfEMP1 variant that binds to endothelial protein C receptor through a DC8 domain cassette) is higher at hospital presentation in children with uncomplicated malaria than in severe malaria. In pregnant women, ADNP and ADCP in whole blood are strongly correlated with one another (Spearman's rho = 0.90), but not with ADNP or ADCP using purified neutrophils and monocytes in the absence of complement proteins.The whole blood assay is a powerful new tool to assess functional antibodies that may protect against P. falciparum malaria. It allows simultaneous measurement of phagocytosis of opsonised IEs by monocytes and neutrophils.Malaria is a lethal disease spread by mosquitoes that are themselves infected with the malaria parasite Plasmodium falciparum. The immune system uses white blood cells to clear red blood cells that are infected with the malaria parasite. White blood cells clear the infected cells by eating them, and they do this better when the infected cells are coated with two proteins, antibody and complement. To better understand how infected cells are cleared, we developed an assay that measures the number of protein-coated infected cells eaten by white blood cells. When people had high levels of antibody protein, more white blood cells ate the parasites, and this was associated with a lower likelihood of malaria. Overall, this assay can help identify people who are susceptible to, or protected from, malaria, bringing us closer to understanding how the immune system works to eliminate malaria infection.
Publication information
Commun Med (Lond) . 2025 Jul 7;5(1):277. doi: 10.1038/s43856-025-00989-2.
Date Issued
2025-07-07
Type
Journal Article
Journal Title
Communications medicine
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