Phage display of single-chain variable fragment (scFv) antibodies is a powerful tool for selecting important, useful, and specific human antibodies. We constructed a library from three patients infected with Plasmodium vivax. Panning on recombinant PvRII enriched a population of scFvs that recognized region II of the P. vivax Duffy binding protein (DBP). Three clones of scFvs that reacted with PvRII were selected, and their biological functions were analyzed. These scFvs inhibited erythrocyte binding to DBP. Clone SFDBII92 had the greatest affinity (dissociation constant ؍ 3.62 ؋ 10 ؊8 M) and the greatest inhibition activity (50% inhibitory concentration Ϸ 2.9 g/ml) to DBP. Thus, we demonstrated that human neutralizing antibody could be made from malaria patients using phage display and that these neutralizing scFvs should prove valuable for developing both passive and active immunization strategies based on DBP.Malaria caused by Plasmodium vivax is responsible for substantial morbidity in Asia and Central and South America (19). Merozoites of Plasmodium must attach to and invade red blood cells (RBCs) to begin asexual reproduction of the parasite, making this brief event a critical phase in the parasite life cycle. Invasion occurs quickly through a complex, multistep process that follows a distinct sequence of events involving numerous molecules expressed on the surface of the merozoite and in the apical organelles (1,4,6,7). This cascade of events represents potential targets for reducing or eliminating the blood stages of malarial parasites (21,25,31).The Duffy binding protein (DBP) of P. vivax interacts with Duffy antigen receptor for chemokines (DARC) on the RBC during junction formation between the merozoite and RBC (1, 2, 16, 34). The P. vivax DBP (PvDBP) is a 140-kDa protein that belongs to a family of erythrocyte-binding proteins characterized by a functionally conserved cysteine-rich region (1,6,12). This cysteine-rich region is in DBP region II (DBP II), which contains the binding motifs necessary for adhering to DARC on the erythrocyte surface (9, 10, 29). The critical binding motif has been mapped to a 170-amino-acid segment between cysteines 4 and 8 in the cysteine-rich region (26,28,29). Studies have shown that although the cysteine residues are conserved, other regions of DBP II are highly polymorphic (3, 32, 36). However, the hypervariable region of DBP II is located on the sites remote from the DARC-binding site and does not alter the capacity of the protein to bind DARC-positive erythrocytes (28, 33).Phage display antibodies offer a way to produce high-affinity single-chain variable fragment (scFv) derivatives of human antibodies of "natural host" origin (8). Our goal was to produce human monoclonal antibodies against the DARC-binding region of DBP II of P. vivax (PvRII). To do so, we constructed a combinatorial phage display library using peripheral blood mononuclear cells from three patients infected naturally with P. vivax. Subsequently, anti-PvRII human scFvs that had neutralizing activi...