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Pregnancy-associated malaria (PAM) is caused by Plasmodium falciparum-infected erythrocytes (IEs) that bind to chondroitin sulphate A (CSA) in the placenta by PAM-associated clonally variant surface antigens (VSA). Pregnancy-specific VSA (VSAPAM), which include the PfEMP1 variant VAR2CSA, are targets of IgG-mediated protective immunity to PAM. Here, we report an investigation of the specificity of naturally acquired immunity to PAM, using eight human monoclonal IgG1 antibodies that react exclusively with intact CSA-adhering IEs expressing VSAPAM. Four reacted in Western blotting with high-molecular-weight (> 200 kDa) proteins, while seven reacted with either the DBL3-X or the DBL5-ε domains of VAR2CSA expressed either as Baculovirus constructs or on the surface of transfected Jurkat cells. We used a panel of recombinant antigens representing DBL3-X domains from P. falciparum field isolates to evaluate B-cell epitope diversity among parasite isolates, and identified the binding site of one monoclonal antibody using a chimeric DBL3-X construct. Our findings show that there is a high-frequency memory response to VSAPAM, indicating that VAR2CSA is a primary target of naturally acquired PAM-specific protective immunity, and demonstrate the value of human monoclonal antibodies and conformationally intact recombinant antigens in VSA characterization. [ABSTRACT FROM AUTHOR]

The work of our laboratory has focused on the study of human memory B cells. Using an in vitro approach we dissected the triggering requirements of B cells and unveiled a distinct role for TLRs in the activation of naive versus memory B cells. Using an ex vivo approach we analyzed the dynamics of memory B cells and ASCs and the kinetics of serum antibodies during secondary immune responses and in steady state conditions and used these quantitative data to build up a model of serological memory. According to this model memory B cells behave as `stem cells' capable of generating plasma cells and antibodies in an antigen-dependent as well as in an antigen-independent fashion. Finally we developed an efficient method to interrogate human memory B cells and to isolate human monoclonal antibodies. This method can be exploited for the production of neutralizing antibodies for serotherapy and for “analytic vaccinology”. [ABSTRACT FROM AUTHOR]