Iron Deficiency Is Associated With Reduced Levels of Plasmodium falciparum-specific Antibodies in African Children.
Africa
children
immunity
iron deficiency
malaria
Journal
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213
Informations de publication
Date de publication:
01 07 2021
01 07 2021
Historique:
received:
09
01
2020
accepted:
03
06
2020
pubmed:
9
6
2020
medline:
8
7
2021
entrez:
9
6
2020
Statut:
ppublish
Résumé
Iron deficiency (ID) and malaria are common causes of ill-health and disability among children living in sub-Saharan Africa. Although iron is critical for the acquisition of humoral immunity, little is known about the effects of ID on antibody responses to Plasmodium falciparum malaria. The study included 1794 Kenyan and Ugandan children aged 0-7 years. We measured biomarkers of iron and inflammation, and antibodies to P. falciparum antigens including apical merozoite antigen 1 (anti-AMA-1) and merozoite surface antigen 1 (anti-MSP-1) in cross-sectional and longitudinal studies. The overall prevalence of ID was 31%. ID was associated with lower anti-AMA-1 and anti-MSP-1 antibody levels in pooled analyses adjusted for age, sex, study site, inflammation, and P. falciparum parasitemia (adjusted mean difference on a log-transformed scale (β) -0.46; 95 confidence interval [CI], -.66, -.25 P < .0001; β -0.33; 95 CI, -.50, -.16 P < .0001, respectively). Additional covariates for malaria exposure index, previous malaria episodes, and time since last malaria episode were available for individual cohorts. Meta-analysis was used to allow for these adjustments giving β -0.34; -0.52, -0.16 for anti-AMA-1 antibodies and β -0.26; -0.41, -0.11 for anti-MSP-1 antibodies. Low transferrin saturation was similarly associated with reduced anti-AMA-1 antibody levels. Lower AMA-1 and MSP-1-specific antibody levels persisted over time in iron-deficient children. Reduced levels of P. falciparum-specific antibodies in iron-deficient children might reflect impaired acquisition of immunity to malaria and/or reduced malaria exposure. Strategies to prevent and treat ID may influence antibody responses to malaria for children living in sub-Saharan Africa.
Sections du résumé
BACKGROUND
Iron deficiency (ID) and malaria are common causes of ill-health and disability among children living in sub-Saharan Africa. Although iron is critical for the acquisition of humoral immunity, little is known about the effects of ID on antibody responses to Plasmodium falciparum malaria.
METHODS
The study included 1794 Kenyan and Ugandan children aged 0-7 years. We measured biomarkers of iron and inflammation, and antibodies to P. falciparum antigens including apical merozoite antigen 1 (anti-AMA-1) and merozoite surface antigen 1 (anti-MSP-1) in cross-sectional and longitudinal studies.
RESULTS
The overall prevalence of ID was 31%. ID was associated with lower anti-AMA-1 and anti-MSP-1 antibody levels in pooled analyses adjusted for age, sex, study site, inflammation, and P. falciparum parasitemia (adjusted mean difference on a log-transformed scale (β) -0.46; 95 confidence interval [CI], -.66, -.25 P < .0001; β -0.33; 95 CI, -.50, -.16 P < .0001, respectively). Additional covariates for malaria exposure index, previous malaria episodes, and time since last malaria episode were available for individual cohorts. Meta-analysis was used to allow for these adjustments giving β -0.34; -0.52, -0.16 for anti-AMA-1 antibodies and β -0.26; -0.41, -0.11 for anti-MSP-1 antibodies. Low transferrin saturation was similarly associated with reduced anti-AMA-1 antibody levels. Lower AMA-1 and MSP-1-specific antibody levels persisted over time in iron-deficient children.
CONCLUSIONS
Reduced levels of P. falciparum-specific antibodies in iron-deficient children might reflect impaired acquisition of immunity to malaria and/or reduced malaria exposure. Strategies to prevent and treat ID may influence antibody responses to malaria for children living in sub-Saharan Africa.
Identifiants
pubmed: 32507899
pii: 5854375
doi: 10.1093/cid/ciaa728
pmc: PMC8246895
mid: EMS127233
doi:
Substances chimiques
Antibodies, Protozoan
0
Antigens, Protozoan
0
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
43-49Subventions
Organisme : Wellcome Trust
ID : 110255
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 202800/Z/16/Z
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 10628
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 064693
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 203077
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00027/5
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 079110
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/R010161/1
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 107743
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 202800
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 095778
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 107769
Pays : United Kingdom
Informations de copyright
© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.
Références
PLoS Med. 2010 Jul 06;7(7):e1000304
pubmed: 20625549
Am J Clin Nutr. 2014 Sep;100(3):968-73
pubmed: 25080460
FEMS Microbiol Rev. 2016 May;40(3):343-72
pubmed: 26833236
Nutr Rev. 1994 Apr;52(4):137-40
pubmed: 8028819
J Nat Sci Biol Med. 2014 Jan;5(1):158-63
pubmed: 24678217
PLoS One. 2012;7(3):e32929
pubmed: 22479349
Nat Genet. 2016 Jan;48(1):74-8
pubmed: 26642240
Medicine (Baltimore). 2016 Nov;95(47):e5395
pubmed: 27893677
J Infect Dis. 2004 Aug 1;190(3):439-47
pubmed: 15243915
Clin Infect Dis. 2019 May 17;68(11):1807-1814
pubmed: 30219845
Blood. 2014 May 22;123(21):3221-9
pubmed: 24596418
Eur J Pediatr. 1993 Feb;152(2):120-4
pubmed: 8444218
Lancet. 2017 Sep 16;390(10100):1211-1259
pubmed: 28919117
Clin Chem. 2003 Jan;49(1):175-8
pubmed: 12507977
J Nutr. 1972 Apr;102(4):535-41
pubmed: 5012507
Clin Trials. 2007;4(1):42-57
pubmed: 17327245
Infect Immun. 2008 May;76(5):2240-8
pubmed: 18316390
BMC Med. 2014 Jul 01;12:108
pubmed: 24980799
N Engl J Med. 2008 Dec 11;359(24):2521-32
pubmed: 19064627
J Pediatr. 1975 Jun;86(6):899-902
pubmed: 1127529
Chin Med J (Engl). 1994 Nov;107(11):813-6
pubmed: 7867386
Indian J Hematol Blood Transfus. 2010 Jun;26(2):45-8
pubmed: 21629635
Nat Commun. 2019 Jul 3;10(1):2935
pubmed: 31270335
BMC Med. 2020 Feb 27;18(1):31
pubmed: 32102669
Wellcome Open Res. 2019 Mar 5;4:42
pubmed: 31168483
Malar J. 2018 Dec 11;17(1):464
pubmed: 30537973
J Leukoc Biol. 2017 Apr;101(4):913-925
pubmed: 27837017
Trop Med Int Health. 2015 May;20(5):665-672
pubmed: 25611008
EBioMedicine. 2015 Aug 08;2(10):1478-86
pubmed: 26629542
Am J Clin Nutr. 2001 Dec;74(6):767-75
pubmed: 11722958
Br Med J. 1980 May 24;280(6226):1249-51
pubmed: 7388490
J Pediatr. 1975 Jun;86(6):833-43
pubmed: 1127523
Blood. 2003 Nov 15;102(10):3711-8
pubmed: 12881306