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Broadly inhibitory antibodies against severe malaria virulence proteins.

bioRxiv : the preprint server for biology | 2024

Plasmodium falciparum pathology is driven by the accumulation of parasite-infected erythrocytes in microvessels. This process is mediated by the parasite's polymorphic erythrocyte membrane protein 1 (PfEMP1) adhesion proteins. A subset of PfEMP1 variants that bind human endothelial protein C receptor (EPCR) through their CIDRα1 domains is responsible for severe malaria pathogenesis. A longstanding question is whether individual antibodies can recognize the large repertoire of circulating PfEMP1 variants. Here, we describe two broadly reactive and binding-inhibitory human monoclonal antibodies against CIDRα1. The antibodies isolated from two different individuals exhibited a similar and consistent EPCR-binding inhibition of 34 CIDRα1 domains, representing five of the six subclasses of CIDRα1. Both antibodies inhibited EPCR binding of both recombinant full-length and native PfEMP1 proteins as well as parasite sequestration in bioengineered 3D brain microvessels under physiologically relevant flow conditions. Structural analyses of the two antibodies in complex with two different CIDRα1 antigen variants reveal similar binding mechanisms that depend on interactions with three highly conserved amino acid residues of the EPCR-binding site in CIDRα1. These broadly reactive antibodies likely represent a common mechanism of acquired immunity to severe malaria and offer novel insights for the design of a vaccine or treatment targeting severe malaria.

Pubmed ID: 38328068 RIS Download

Associated grants

  • Agency: NCATS NIH HHS, United States
    Id: TL1 TR002647
  • Agency: NIAID NIH HHS, United States
    Id: U19 AI089674
  • Agency: NIAID NIH HHS, United States
    Id: U01 AI150741
  • Agency: NIH HHS, United States
    Id: S10 OD030432
  • Agency: NIAID NIH HHS, United States
    Id: R01 AI093615
  • Agency: NCI NIH HHS, United States
    Id: P30 CA054174
  • Agency: Wellcome Trust, United Kingdom
  • Agency: NIAID NIH HHS, United States
    Id: F31 AI169993
  • Agency: NIAID NIH HHS, United States
    Id: R01 AI153425

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