1. Broadly inhibitory antibodies to severe malaria virulence proteins.
- Author
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Reyes RA, Raghavan SSR, Hurlburt NK, Introini V, Bol S, Kana IH, Jensen RW, Martinez-Scholze E, Gestal-Mato M, López-Gutiérrez B, Sanz S, Bancells C, Fernández-Quintero ML, Loeffler JR, Ferguson JA, Lee WH, Martin GM, Theander TG, Lusingu JPA, Minja DTR, Ssewanyana I, Feeney ME, Greenhouse B, Ward AB, Bernabeu M, Pancera M, Turner L, Bunnik EM, and Lavstsen T
- Subjects
- Animals, Humans, Antibodies, Monoclonal immunology, Binding Sites, Brain blood supply, Brain parasitology, Endothelial Protein C Receptor immunology, Endothelial Protein C Receptor metabolism, Erythrocytes parasitology, Erythrocytes immunology, Microvessels immunology, Microvessels parasitology, Models, Molecular, Protein Binding, Protein Domains, Malaria Vaccines immunology, Antibodies, Protozoan immunology, Malaria, Falciparum immunology, Malaria, Falciparum parasitology, Plasmodium falciparum immunology, Plasmodium falciparum pathogenicity, Protozoan Proteins immunology, Protozoan Proteins chemistry, Protozoan Proteins metabolism, Virulence, Virulence Factors chemistry, Virulence Factors immunology, Virulence Factors metabolism, Broadly Neutralizing Antibodies immunology
- Abstract
Malaria pathology is driven by the accumulation of Plasmodium falciparum-infected erythrocytes in microvessels
1 . This process is mediated by the polymorphic erythrocyte membrane protein 1 (PfEMP1) adhesion proteins of the parasite. A subset of PfEMP1 variants that bind to human endothelial protein C receptor (EPCR) through their CIDRα1 domains is responsible for severe malaria pathogenesis2 . A longstanding question is whether individual antibodies can recognize the large repertoire of circulating PfEMP1 variants. Here we describe two broadly reactive and inhibitory human monoclonal antibodies to CIDRα1. The antibodies isolated from two different individuals exhibited similar and consistent EPCR-binding inhibition of diverse 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 human brain microvessels under physiologically relevant flow conditions. Structural analyses of the two antibodies in complex with three 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 are likely to 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., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)- Published
- 2024
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