Malarial antibodies and autoantibodies to heart and other tissues in the immigrant and indigenous peoples of uganda

Publisher Summary This chapter discusses the immunological aspects of malaria infection. The chapter is particularly concerned with specific acquired immunity to malaria and includes a discussion only of innate and nonspecific resistance. The chapter discusses immunity in malaria, an old subject that contains considerable current interest. New methods for the study of the relevant antibodies and a new appreciation for a role for cell-mediated immunity are responsible for this development. The very diverse contributions to this subject present unusual difficulties for a reviewer. However, a clear and interesting summary of the subject has emerged and is of considerable value as a reference for all immunologists. In adults, malaria sometimes occurs as epidemics but more often it is insidious in its effect; it reduces the vigor of communities and by its continued presence causes a retardation of social and economic growth. The effect of malaria on a community is accentuated by the occurrence of other endemic diseases such as schistosomiasis and hookworm. Suggestions are made in recent years to revise the nomenclature of malaria parasites and to institute several new genera.

Immunological aspects of malaria infection.

Following reports of associations between autoantibodies and living in the tropics, we have studied the seroprevalence and nature of anti-nuclear antibodies, anti-cardiolipin antibodies, antibodies to extractable nuclear antigens and anti-neutrophilic cytoplasmic antibodies in 351 West Africans with malaria, tuberculosis or hepatitis B, or in good health. Amongst healthy West Africans we found a seroprevalence of 7% for anti-nuclear antibodies with several staining patterns, and of 30.3% for anti-cardiolipin antibodies. Among patients with tuberculosis and malaria there was twice that frequency of anti-nuclear antibodies (predominantly speckled in pattern), and anti-neutrophil cytoplasmic antibodies (predominantly IgM) were demonstrated in a few cases. A possible association between IgG anti-cardiolipin antibodies and tuberculosis was observed (P < 0.05), but antibodies to double-stranded DNA were not elevated and no antibodies to extractable nuclear antigens were found in any of the patients or healthy individuals studied. Our findings suggest the need for caution in the interpretation of autoantibody tests in subjects from or living in the tropics, as well as in patients with tropical infections.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2249.1993.tb05950.x

Autoantibodies in malaria, tuberculosis and hepatitis B in a west African population

The influence of specific immunity upon the course of infection may vary considerably with different species of plasmodia and different mammalian hosts harbouring the same species of parasite. Certain infections, for example P. knowlesi in rhesus monkeys, lead to a rapidly progressive parasitaemia and almost inevitably to a fatal outcome so that the immune response is ineffective unless animals are protected initially by drug therapy. In other instances, including many examples of primate and avian malaria, infection is followed by clinical immunity associated with continuing low-grade infection, occasional parasitaemia and relapse after splenectomy. This 'non-sterilizing' response was analysed in detail by SERGENT (1963) and called "premunition". Finally, certain infections, such as P. berghei in the rat and P. cynomolgi bastianellii in man, produce a parasitaemia of comparatively short duration followed by long-lasting specific resistance during which no living organisms can be demonstrated by sub-inoculation or following splenectomy; after challenge of such immune individuals, parasites are rapidly killed--usually within about 2 days. This type of response has been referred to as 'sterilizing' immunity. The occurrence of these diverse responses to specific malarial infections implies that our present knowledge of the underlying immune mechanisms, which is restricted to a limited number of host-parasite combinations, is probably not applicable to all malarial infections.

Serum antibody in acquired malarial immunity.

IT WAS noted during collection of blood for transfusion in Rabaul, New Britain (an island in Melanesia) that a high proportion of whole blood specimens stored at 4\" C. showed erythrocyte agglutination. Examination of the donor population showed that the great majority of the specimens came from people of the Kuanua (Tolai) hguistic group. This finding was brought to our attention by Dr. A. Crezy of the Department of Public Health during a recent survey of the serum proteins of the peoples of New Guinea and New Britain (Curtain, Gajdusek, Kidson, Gorman, Champness and Rodrigue, 1964a). This paper describes some serological and chemical investigations of cold haemagglutinins in the sera of Tolai people and compares these with the distribution and properties of cold haemagglutinins in sera from several other population groups living in different regions of New Guinea and New Britain. In addition to a high incidence we found both heterogeneity and unusual specificity of cold haemagglutinins in these tropical populations.

Cold haemagglutinins: unusual incidence in melanesian populations.

804 hypergammaglobulinaemic sera from indigenous New Guineans were tested for auto-immune complement fixation with saline extracts of human liver and kidney. 30 sera gave titres exceeding 1 in 5 and 22 of these sera had gamma-globulin levels exceeding 1·50 g. per 100 ml. A possible reason for this finding may be the action of environmentally induced stresses leading to chronic tissue destruction (such as liver damage arising from malnutrition and malaria) and the heightened capacity for immune response which may result from the high antigenic load carried by tropical peoples.

D. Parkinson

Papers

Tropical hypergammaglobulinaemia and tissue antibodies.