Loop-mediated isothermal amplification (LAMP), a novel nucleic acid amplification method, was developed for the clinical detection of four species of human malaria parasites: Plasmodium falciparum, P. vivax, P. malariae, and P. ovale. We evaluated the sensitivity and specificity of LAMP in comparison with the results of microscopic examination and nested PCR. LAMP showed a detection limit (analytical sensitivity) of 10 copies of the target 18S rRNA genes for P. malariae and P. ovale and 100 copies for the genus Plasmodium, P. falciparum, and P. vivax. LAMP detected malaria parasites in 67 of 68 microscopically positive blood samples (sensitivity, 98.5%) and 3 of 53 microscopically negative samples (specificity, 94.3%), in good agreement with the results of nested PCR. The LAMP reactions yielded results within about 26 min, on average, for detection of the genus Plasmodium, 32 min for P. falciparum, 31 min for P. vivax, 35 min for P. malariae, and 36 min for P. ovale. Accordingly, in comparison to the results obtained by microscopy, LAMP had a similar sensitivity and a greater specificity and LAMP yielded results similar to those of nested PCR in a shorter turnaround time. Because it can be performed with a simple technology, i.e., with heat-treated blood as the template, reaction in a water bath, and inspection of the results by the naked eye because of the use of a fluorescent dye, LAMP may provide a simple and reliable test for routine screening for malaria parasites in both clinical laboratories and malaria clinics in areas where malaria is endemic.

The development of effective malaria vaccines and immune biomarkers of malaria is a high priority for malaria control and elimination. Ags expressed by merozoites of Plasmodium falciparum are likely to be important targets of human immunity and are promising vaccine candidates, but very few Ags have been studied. We developed an approach to assess Ab responses to a comprehensive repertoire of merozoite proteins and investigate whether they are targets of protective Abs. We expressed 91 recombinant proteins, located on the merozoite surface or within invasion organelles, and screened them for quality and reactivity to human Abs. Subsequently, Abs to 46 proteins were studied in a longitudinal cohort of 206 Papua New Guinean children to define Ab acquisition and associations with protective immunity. Ab responses were higher among older children and those with active parasitemia. High-level Ab responses to rhoptry and microneme proteins that function in erythrocyte invasion were identified as being most strongly associated with protective immunity compared with other Ags. Additionally, Abs to new or understudied Ags were more strongly associated with protection than were Abs to current vaccine candidates that have progressed to phase 1 or 2 vaccine trials. Combinations of Ab responses were identified that were more strongly associated with protective immunity than responses to their single-Ag components. This study identifies Ags that are likely to be key targets of protective human immunity and facilitates the prioritization of Ags for further evaluation as vaccine candidates and/or for use as biomarkers of immunity in malaria surveillance and control.

One of the major bottlenecks in malaria research has been the difficulty in recombinant protein expression. Here, we report the application of the wheat germ cell-free system for the successful production of malaria proteins. For proof of principle, the Pfs25, PfCSP, and PfAMA1 proteins were chosen. These genes contain very high A/T sequences and are also difficult to express as recombinant proteins. In our wheat germ cell-free system, native and codon-optimized versions of the Pfs25 genes produced equal amounts of proteins. PfCSP and PfAMA1 genes without any codon optimization were also expressed. The products were soluble, with yields between 50 and 200 g/ml of the translation mixture, indicating that the cell-free system can be used to produce malaria proteins without any prior optimization of their biased codon usage. Biochemical and immunocytochemical analyses of antibodies raised in mice against each protein revealed that every antibody retained its high specificity to the parasite protein in question. The development of parasites in mosquitoes fed patient blood carrying Plasmodium falciparum gametocytes and supplemented with our mouse anti-Pfs25 sera was strongly inhibited, indicating that both Pfs25-3D7/WG and Pfs25-TBV/WG retained their immunogenicity. Lastly, we carried out a parallel expression assay of proteins of blood-stage P. falciparum. The PCR products of 124 P. falciparum genes chosen from the available database were used directly in a small-scale format of transcription and translation reactions. Autoradiogram testing revealed the production of 93 proteins. The application of this new cell-free system-based protocol for the discovery of malaria vaccine candidates will be discussed.Plasmodium falciparum is the protozoan responsible for the widespread return of malaria to tropical countries, particularly in Africa. This reemergence is generally credited to two causes: the development of multidrug-resistant parasites and the development of insecticide-resistant mosquitoes (10). Through decades of work, scientists have learned that vaccination could be a potent curative, but efforts to develop a successful vaccine have not yet succeeded (25). One of the bottlenecks in vaccine development is at the malaria protein production step and is mainly due to the lack of a methodology to enable preparation of quality proteins in an efficient manner. P. falciparum genes have a very high A/T content (average, 76% per gene), and a number of them encode repeated stretches of amino acid sequences (8); these features have been proposed as the major factors limiting P. falciparum protein expression in cell-based systems. Moreover, the presence of glycosylation machinery in eukaryotic cell-based systems can produce inappropriately glycosylated recombinant malaria proteins, resulting in incorrect immune responses (9,21,26). In fact, the three pioneering genome-wide studies on the production of P. falciparum proteins in cell-based systems faced serious problems. For instance, Aguiar et al. (1) were able to obtain exp...

Completed genome sequences and stage-specific transcriptomes of the intraerythrocytic developmental cycle of Plasmodium vivax offers the opportunity to profile immune responses against P. vivax infection using innovative screening approaches. To detect the immune responses to blood stage-specific proteins, we applied a protein array technology to screen the sera of vivax malaria patients. Herein, a set of genes from the P. vivax blood stage was cloned using the In-Fusion cloning method and expressed by a wheat germ cell-free system. A total of 94 open reading frames (ORFs) were cloned and 89 (95%, 89/94) proteins were expressed, which were screened with sera from P. vivax-infected patients and healthy individuals using protein arrays. A total of 18 (19.1%, 18/94) highly immunoreactive proteins were identified, including 7 well-characterized vivax vaccine candidates. The remaining 11 ORFs have not been previously described as immunologically reactive. These novel immunoproteomes of the vivax malaria blood stage will be further studied as potential vaccine candidates. In this first report, high-throughput screening assays have been applied to investigate blood stage-specific immunoproteomes from vivax malaria. These methods may be used to determine immunodominant candidate antigens from the P. vivax genome.

The major virulence determinant of the rodent malaria parasite, Plasmodium yoelii, has remained unresolved since the discovery of the lethal line in the 1970s. Because virulence in this parasite correlates with the ability to invade different types of erythrocytes, we evaluated the potential role of the parasite erythrocyte binding ligand, PyEBL. We found 1 amino acid substitution in a domain responsible for intracellular trafficking between the lethal and nonlethal parasite lines and, furthermore, that the intracellular localization of PyEBL was distinct between these lines. Genetic modification showed that this substitution was responsible not only for PyEBL localization but also the erythrocyte-type invasion preference of the parasite and subsequently its virulence in mice. This previously unrecognized mechanism for altering an invasion phenotype indicates that subtle alterations of a malaria parasite ligand can dramatically affect host-pathogen interactions and malaria virulence.dense granule ͉ invasion ͉ malaria ͉ microneme ͉ transfection T he rodent malaria parasite Plasmodium yoelii yoelii has been widely studied to understand the interactions between the malaria parasite and the host cell (1). The nonlethal 17X line mainly infects young erythrocytes (reticulocytes), whereas the lethal 17XL and YM lines infect a wide range of erythrocytes. These lines have previously been studied to identify the genetic determinants of virulence (2, 3). These differences in erythrocyte invasion preference suggest the possible involvement of a parasite ligand that recognizes erythrocyte surface receptors; however, the actual molecular basis of the observed invasion preference differences remains unclear.Erythrocyte invasion by the malaria merozoite is a multistep process, initiated by reversible binding to the erythrocyte surface, followed by the establishment of a tight junction between the apical end of the merozoite and erythrocyte surface and the subsequent movement of the merozoite into the nascent parasitophorous vacuole. Each step involves specific interactions between parasite ligands and erythrocyte receptors. Among the ligands of malaria parasites, the best characterized is a type I integral transmembrane protein encoded by the ebl (erythrocytebinding-like) gene family. Upon release from the micronemes, EBL proteins recognize erythrocyte receptors and initiate the formation of the tight junction. The importance of EBL in malaria virulence is exemplified in the human malaria parasite Plasmodium vivax, which uses an EBL orthologue, PvDBP, to recognize the Duffy antigen on the erythrocyte surface. Because the parasite is apparently unable to use an alternative invasion pathway, individuals in whom the Duffy antigen is not expressed on the erythrocyte surface are completely resistant to P. vivax (4,5). Because of this dramatic association between the disruption of a host-pathogen interaction and protection against a malaria parasite, PvDBP and the Plasmodium falciparum EBL orthologue, EBA-175, have been targeted for ...