Natural antibody response to Plasmodium falciparum merozoite antigens MSP5, MSP9 and EBA175 is associated to clinical protection in the Brazilian Amazon
Antibodies have an essential role in the acquired immune response against blood stage P. falciparum infection. Although several antigens have been identified as important antibody targets, it is still elusive which antigens have to be recognized for clinical protection. Herein, we analyzed antibodie...
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description | Antibodies have an essential role in the acquired immune response against blood stage P. falciparum infection. Although several antigens have been identified as important antibody targets, it is still elusive which antigens have to be recognized for clinical protection. Herein, we analyzed antibodies from plasmas from symptomatic or asymptomatic individuals living in the same geographic area in the Western Amazon, measuring their recognition of multiple merozoite antigens.
Specific fragments of genes encoding merozoite proteins AMA1 and members of MSP and EBL families from circulating P. falciparum field isolates present in asymptomatic and symptomatic patients were amplified by PCR. After cloning and expression of different versions of the antigens as recombinant GST-fusion peptides, we tested the reactivity of patients' plasmas by ELISA and the presence of IgG subclasses in the most reactive plasmas.
11 out of 24 recombinant antigens were recognized by plasmas from either symptomatic or asymptomatic infections. Antibodies to MSP9 (X2(DF=1) = 9.26/p = 0.0047) and MSP5 (X2(DF=1) = 8.29/p = 0.0069) were more prevalent in asymptomatic individuals whereas the opposite was observed for MSP1 block 2-MAD20 (X2(DF=1) = 6.41/p = 0.0206, Fisher's exact test). Plasmas from asymptomatic individuals reacted more intensely against MSP4 (U = 210.5, p |
doi_str_mv | 10.1186/1471-2334-13-608 |
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Specific fragments of genes encoding merozoite proteins AMA1 and members of MSP and EBL families from circulating P. falciparum field isolates present in asymptomatic and symptomatic patients were amplified by PCR. After cloning and expression of different versions of the antigens as recombinant GST-fusion peptides, we tested the reactivity of patients' plasmas by ELISA and the presence of IgG subclasses in the most reactive plasmas.
11 out of 24 recombinant antigens were recognized by plasmas from either symptomatic or asymptomatic infections. Antibodies to MSP9 (X2(DF=1) = 9.26/p = 0.0047) and MSP5 (X2(DF=1) = 8.29/p = 0.0069) were more prevalent in asymptomatic individuals whereas the opposite was observed for MSP1 block 2-MAD20 (X2(DF=1) = 6.41/p = 0.0206, Fisher's exact test). Plasmas from asymptomatic individuals reacted more intensely against MSP4 (U = 210.5, p < 0.03), MSP5 (U = 212, p < 0.004), MSP9 (U = 189.5, p < 0.002) and EBA175 (U = 197, p < 0.014, Mann-Whitney's U test). IgG1 and IgG3 were predominant for all antigens, but some patients also presented with IgG2 and IgG4. The recognition of MSP5 (OR = 0.112, IC95% = 0.021-0.585) and MSP9 (OR = 0.125, IC95% = 0.030-0.529, cross tab analysis) predicted 8.9 and 8 times less chances, respectively, to present symptoms. Higher antibody levels against MSP5 and EBA175 were associated by odds ratios of 9.4 (IC95% = 1.29-69.25) and 5.7 (IC95% = 1.12-29.62, logistic regression), respectively, with an asymptomatic status.
Merozoite antigens were targets of cytophilic antibodies and antibodies against MSP5, MSP9 and EBA175 were independently associated with decreased symptoms.</description><identifier>ISSN: 1471-2334</identifier><identifier>EISSN: 1471-2334</identifier><identifier>DOI: 10.1186/1471-2334-13-608</identifier><identifier>PMID: 24373342</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Antibodies ; Antibodies, Protozoan - blood ; Antibodies, Protozoan - immunology ; Antigen-antibody reactions ; Antigens ; Antigens, Protozoan - blood ; Antigens, Protozoan - immunology ; Blood ; Brazil ; Care and treatment ; Cross Protection ; Enzyme-Linked Immunosorbent Assay ; Erythrocytes ; Female ; Health aspects ; Humans ; Immune response ; Immunoglobulin G ; Ligands ; Malaria ; Malaria, Falciparum - blood ; Malaria, Falciparum - immunology ; Malaria, Falciparum - parasitology ; Malaria, Falciparum - prevention & control ; Male ; Membrane Proteins - blood ; Membrane Proteins - immunology ; Middle Aged ; Mortality ; Parasites ; Plasmodium falciparum ; Plasmodium falciparum - genetics ; Plasmodium falciparum - immunology ; Plasmodium falciparum - isolation & purification ; Proteins ; Protozoan Proteins - blood ; Protozoan Proteins - immunology ; Risk factors ; Vaccines ; Viral antibodies</subject><ispartof>BMC infectious diseases, 2013-12, Vol.13 (1), p.608-608, Article 608</ispartof><rights>COPYRIGHT 2013 BioMed Central Ltd.</rights><rights>2013 Medeiros et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2013 Medeiros et al.; licensee BioMed Central Ltd. 2013 Medeiros et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b652t-a525f666228e2ba772d9d6a67ecd458df303b23ed0be87e8882e46a7ac0e9ed73</citedby><cites>FETCH-LOGICAL-b652t-a525f666228e2ba772d9d6a67ecd458df303b23ed0be87e8882e46a7ac0e9ed73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880555/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880555/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24373342$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Medeiros, Márcia M</creatorcontrib><creatorcontrib>Fotoran, Wesley L</creatorcontrib><creatorcontrib>dalla Martha, Rosimeire C</creatorcontrib><creatorcontrib>Katsuragawa, Tony H</creatorcontrib><creatorcontrib>Pereira da Silva, Luiz Hildebrando</creatorcontrib><creatorcontrib>Wunderlich, Gerhard</creatorcontrib><title>Natural antibody response to Plasmodium falciparum merozoite antigens MSP5, MSP9 and EBA175 is associated to clinical protection in the Brazilian Amazon</title><title>BMC infectious diseases</title><addtitle>BMC Infect Dis</addtitle><description>Antibodies have an essential role in the acquired immune response against blood stage P. falciparum infection. Although several antigens have been identified as important antibody targets, it is still elusive which antigens have to be recognized for clinical protection. Herein, we analyzed antibodies from plasmas from symptomatic or asymptomatic individuals living in the same geographic area in the Western Amazon, measuring their recognition of multiple merozoite antigens.
Specific fragments of genes encoding merozoite proteins AMA1 and members of MSP and EBL families from circulating P. falciparum field isolates present in asymptomatic and symptomatic patients were amplified by PCR. After cloning and expression of different versions of the antigens as recombinant GST-fusion peptides, we tested the reactivity of patients' plasmas by ELISA and the presence of IgG subclasses in the most reactive plasmas.
11 out of 24 recombinant antigens were recognized by plasmas from either symptomatic or asymptomatic infections. Antibodies to MSP9 (X2(DF=1) = 9.26/p = 0.0047) and MSP5 (X2(DF=1) = 8.29/p = 0.0069) were more prevalent in asymptomatic individuals whereas the opposite was observed for MSP1 block 2-MAD20 (X2(DF=1) = 6.41/p = 0.0206, Fisher's exact test). Plasmas from asymptomatic individuals reacted more intensely against MSP4 (U = 210.5, p < 0.03), MSP5 (U = 212, p < 0.004), MSP9 (U = 189.5, p < 0.002) and EBA175 (U = 197, p < 0.014, Mann-Whitney's U test). IgG1 and IgG3 were predominant for all antigens, but some patients also presented with IgG2 and IgG4. The recognition of MSP5 (OR = 0.112, IC95% = 0.021-0.585) and MSP9 (OR = 0.125, IC95% = 0.030-0.529, cross tab analysis) predicted 8.9 and 8 times less chances, respectively, to present symptoms. Higher antibody levels against MSP5 and EBA175 were associated by odds ratios of 9.4 (IC95% = 1.29-69.25) and 5.7 (IC95% = 1.12-29.62, logistic regression), respectively, with an asymptomatic status.
Merozoite antigens were targets of cytophilic antibodies and antibodies against MSP5, MSP9 and EBA175 were independently associated with decreased symptoms.</description><subject>Antibodies</subject><subject>Antibodies, Protozoan - blood</subject><subject>Antibodies, Protozoan - immunology</subject><subject>Antigen-antibody reactions</subject><subject>Antigens</subject><subject>Antigens, Protozoan - blood</subject><subject>Antigens, Protozoan - immunology</subject><subject>Blood</subject><subject>Brazil</subject><subject>Care and treatment</subject><subject>Cross Protection</subject><subject>Enzyme-Linked Immunosorbent Assay</subject><subject>Erythrocytes</subject><subject>Female</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Immune response</subject><subject>Immunoglobulin G</subject><subject>Ligands</subject><subject>Malaria</subject><subject>Malaria, Falciparum - blood</subject><subject>Malaria, Falciparum - immunology</subject><subject>Malaria, Falciparum - parasitology</subject><subject>Malaria, Falciparum - prevention & control</subject><subject>Male</subject><subject>Membrane Proteins - blood</subject><subject>Membrane Proteins - immunology</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Parasites</subject><subject>Plasmodium falciparum</subject><subject>Plasmodium falciparum - genetics</subject><subject>Plasmodium falciparum - immunology</subject><subject>Plasmodium falciparum - isolation & purification</subject><subject>Proteins</subject><subject>Protozoan Proteins - blood</subject><subject>Protozoan Proteins - immunology</subject><subject>Risk factors</subject><subject>Vaccines</subject><subject>Viral antibodies</subject><issn>1471-2334</issn><issn>1471-2334</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNk11rFDEUhgdRbK3eeyUBbxScmo-ZJHMjbJeqhWqLVW9DJnN2mzKTrElG7P4Sf64Zt9auVCiBJJw875uTc0hRPCV4nxDJX5NKkJIyVpWElRzLe8Xudej-jf1O8SjGC4yJkLR5WOzQiokcprvFz486jUH3SLtkW99dogBx5V0ElDw67XUcfGfHAS10b-xKh7wdIPi1twl-i5bgIvpwdlq_muYmxzp0eDAjokY2Ih2jN1Yn6CY_01tnTb5tFXwCk6x3yDqUzgEdBL22vdUOzQa99u5x8SBfGeHJ1bpXfHl7-Hn-vjw-eXc0nx2XLa9pKnVN6wXnnFIJtNVC0K7puOYCTFfVslswzFrKoMMtSAFSSgoV10IbDA10gu0Vbza-q7EdoDPgUi6HWgU76HCpvLZq-8TZc7X03xWTEtd1nQ3mG4PW-v8YbJ8YP6ipM2rqjCJM5cZllxdXaQT_bYSY1GCjgb7XDvwYs6Ch-ZE1FndBMW8Ekzyjz_9BL_wYXK7nlEFFMOeE_KWWugdl3cLnPM1kqmY1q3J6uJmo_VuoPDoYrPEOFjbHtwQvtwSZSfAjLfUYozo6-3R39uTrNos3rAk-xgCL61oTrKZvcVt1n91s8rXgzz9gvwBX4AZZ</recordid><startdate>20131228</startdate><enddate>20131228</enddate><creator>Medeiros, Márcia M</creator><creator>Fotoran, Wesley L</creator><creator>dalla Martha, Rosimeire C</creator><creator>Katsuragawa, Tony H</creator><creator>Pereira da Silva, Luiz Hildebrando</creator><creator>Wunderlich, Gerhard</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QL</scope><scope>7T2</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>F1W</scope><scope>H95</scope><scope>H97</scope><scope>L.G</scope><scope>5PM</scope></search><sort><creationdate>20131228</creationdate><title>Natural antibody response to Plasmodium falciparum merozoite antigens MSP5, MSP9 and EBA175 is associated to clinical protection in the Brazilian Amazon</title><author>Medeiros, Márcia M ; Fotoran, Wesley L ; dalla Martha, Rosimeire C ; Katsuragawa, Tony H ; Pereira da Silva, Luiz Hildebrando ; Wunderlich, Gerhard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b652t-a525f666228e2ba772d9d6a67ecd458df303b23ed0be87e8882e46a7ac0e9ed73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Antibodies</topic><topic>Antibodies, Protozoan - blood</topic><topic>Antibodies, Protozoan - immunology</topic><topic>Antigen-antibody reactions</topic><topic>Antigens</topic><topic>Antigens, Protozoan - blood</topic><topic>Antigens, Protozoan - immunology</topic><topic>Blood</topic><topic>Brazil</topic><topic>Care and treatment</topic><topic>Cross Protection</topic><topic>Enzyme-Linked Immunosorbent Assay</topic><topic>Erythrocytes</topic><topic>Female</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Immune response</topic><topic>Immunoglobulin G</topic><topic>Ligands</topic><topic>Malaria</topic><topic>Malaria, Falciparum - blood</topic><topic>Malaria, Falciparum - immunology</topic><topic>Malaria, Falciparum - parasitology</topic><topic>Malaria, Falciparum - prevention & control</topic><topic>Male</topic><topic>Membrane Proteins - blood</topic><topic>Membrane Proteins - immunology</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Parasites</topic><topic>Plasmodium falciparum</topic><topic>Plasmodium falciparum - genetics</topic><topic>Plasmodium falciparum - immunology</topic><topic>Plasmodium falciparum - isolation & purification</topic><topic>Proteins</topic><topic>Protozoan Proteins - blood</topic><topic>Protozoan Proteins - immunology</topic><topic>Risk factors</topic><topic>Vaccines</topic><topic>Viral antibodies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Medeiros, Márcia M</creatorcontrib><creatorcontrib>Fotoran, Wesley L</creatorcontrib><creatorcontrib>dalla Martha, Rosimeire C</creatorcontrib><creatorcontrib>Katsuragawa, Tony H</creatorcontrib><creatorcontrib>Pereira da Silva, Luiz Hildebrando</creatorcontrib><creatorcontrib>Wunderlich, Gerhard</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>ASFA: Aquatic Sciences and Fisheries Abstracts</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 1: Biological Sciences & Living Resources</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 3: Aquatic Pollution & Environmental Quality</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) Professional</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Medeiros, Márcia M</au><au>Fotoran, Wesley L</au><au>dalla Martha, Rosimeire C</au><au>Katsuragawa, Tony H</au><au>Pereira da Silva, Luiz Hildebrando</au><au>Wunderlich, Gerhard</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Natural antibody response to Plasmodium falciparum merozoite antigens MSP5, MSP9 and EBA175 is associated to clinical protection in the Brazilian Amazon</atitle><jtitle>BMC infectious diseases</jtitle><addtitle>BMC Infect Dis</addtitle><date>2013-12-28</date><risdate>2013</risdate><volume>13</volume><issue>1</issue><spage>608</spage><epage>608</epage><pages>608-608</pages><artnum>608</artnum><issn>1471-2334</issn><eissn>1471-2334</eissn><abstract>Antibodies have an essential role in the acquired immune response against blood stage P. falciparum infection. Although several antigens have been identified as important antibody targets, it is still elusive which antigens have to be recognized for clinical protection. Herein, we analyzed antibodies from plasmas from symptomatic or asymptomatic individuals living in the same geographic area in the Western Amazon, measuring their recognition of multiple merozoite antigens.
Specific fragments of genes encoding merozoite proteins AMA1 and members of MSP and EBL families from circulating P. falciparum field isolates present in asymptomatic and symptomatic patients were amplified by PCR. After cloning and expression of different versions of the antigens as recombinant GST-fusion peptides, we tested the reactivity of patients' plasmas by ELISA and the presence of IgG subclasses in the most reactive plasmas.
11 out of 24 recombinant antigens were recognized by plasmas from either symptomatic or asymptomatic infections. Antibodies to MSP9 (X2(DF=1) = 9.26/p = 0.0047) and MSP5 (X2(DF=1) = 8.29/p = 0.0069) were more prevalent in asymptomatic individuals whereas the opposite was observed for MSP1 block 2-MAD20 (X2(DF=1) = 6.41/p = 0.0206, Fisher's exact test). Plasmas from asymptomatic individuals reacted more intensely against MSP4 (U = 210.5, p < 0.03), MSP5 (U = 212, p < 0.004), MSP9 (U = 189.5, p < 0.002) and EBA175 (U = 197, p < 0.014, Mann-Whitney's U test). IgG1 and IgG3 were predominant for all antigens, but some patients also presented with IgG2 and IgG4. The recognition of MSP5 (OR = 0.112, IC95% = 0.021-0.585) and MSP9 (OR = 0.125, IC95% = 0.030-0.529, cross tab analysis) predicted 8.9 and 8 times less chances, respectively, to present symptoms. Higher antibody levels against MSP5 and EBA175 were associated by odds ratios of 9.4 (IC95% = 1.29-69.25) and 5.7 (IC95% = 1.12-29.62, logistic regression), respectively, with an asymptomatic status.
Merozoite antigens were targets of cytophilic antibodies and antibodies against MSP5, MSP9 and EBA175 were independently associated with decreased symptoms.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>24373342</pmid><doi>10.1186/1471-2334-13-608</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Antibodies Antibodies, Protozoan - blood Antibodies, Protozoan - immunology Antigen-antibody reactions Antigens Antigens, Protozoan - blood Antigens, Protozoan - immunology Blood Brazil Care and treatment Cross Protection Enzyme-Linked Immunosorbent Assay Erythrocytes Female Health aspects Humans Immune response Immunoglobulin G Ligands Malaria Malaria, Falciparum - blood Malaria, Falciparum - immunology Malaria, Falciparum - parasitology Malaria, Falciparum - prevention & control Male Membrane Proteins - blood Membrane Proteins - immunology Middle Aged Mortality Parasites Plasmodium falciparum Plasmodium falciparum - genetics Plasmodium falciparum - immunology Plasmodium falciparum - isolation & purification Proteins Protozoan Proteins - blood Protozoan Proteins - immunology Risk factors Vaccines Viral antibodies |
title | Natural antibody response to Plasmodium falciparum merozoite antigens MSP5, MSP9 and EBA175 is associated to clinical protection in the Brazilian Amazon |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-31T02%3A06%3A09IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Natural%20antibody%20response%20to%20Plasmodium%20falciparum%20merozoite%20antigens%20MSP5,%20MSP9%20and%20EBA175%20is%20associated%20to%20clinical%20protection%20in%20the%20Brazilian%20Amazon&rft.jtitle=BMC%20infectious%20diseases&rft.au=Medeiros,%20M%C3%A1rcia%20M&rft.date=2013-12-28&rft.volume=13&rft.issue=1&rft.spage=608&rft.epage=608&rft.pages=608-608&rft.artnum=608&rft.issn=1471-2334&rft.eissn=1471-2334&rft_id=info:doi/10.1186/1471-2334-13-608&rft_dat=%3Cgale_pubme%3EA534608091%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1474106611&rft_id=info:pmid/24373342&rft_galeid=A534608091&rfr_iscdi=true |