The role of naturally acquired antimalarial antibodies in subclinical Plasmodium spp. infection

Undetected subclinical Plasmodium spp. infections are a significant barrier to eliminating malaria. In malaria-endemic areas, naturally acquired antimalarial antibodies develop with repeated infection. These antibodies can confer protection against the clinical manifestations of Plasmodium spp. infection in highly exposed populations, and several distinct functional antibody mechanisms have been defined in the clearance of Plasmodium parasites. However, the role of antimalarial antibodies during subclinical infection is less well defined. In this review, we examine the development and maintenance of antibody responses and the functional mechanisms associated with clinical protection, highlighted by epidemiological studies investigating the association between human immunity and detection of subclinical infection across various malaria transmission intensities. Understanding the development and role of the antimalarial antibody response during subclinical Plasmodium spp. infection will be essential to furthering novel interventions including vaccines and immunological biomarkers that can be utilized for malaria surveillance and ultimately progress malaria elimination.

Automated summary

Undetected subclinical Plasmodium spp. infections pose a significant obstacle to malaria elimination. Antimalarial antibodies acquired naturally in malaria-endemic regions have protective effects against clinical symptoms, but their role in subclinical infection is not well defined. Understanding the development and function of antimalarial antibody responses during subclinical Plasmodium spp. infection is crucial for the development of interventions such as vaccines and immunological biomarkers for malaria surveillance and elimination.