Interferon-gamma responses to Plasmodium falciparum liver-stage antigen-1 and merozoite-surface protein-1 increase with age in children in a malaria holoendemic area of western Kenya

BACKGROUND: In areas of high-level, year-round malaria transmission, morbidity and mortality due to malaria decrease after the first two to three years of life. This reduction may be related to the development of cellular immunity to specific antigens expressed in the different life-cycle stages of Plasmodium falciparum. METHODS: A cross sectional study was conducted to evaluate T cell cytokine responses to the P. falciparum pre-erythrocytic antigen liver-stage antigen-1 (LSA-1) and the blood-stage antigen merozoite-surface protein-1 (MSP-1) in children under five years of age residing in a malaria holoendemic region of western Kenya. Interferon-gamma (IFN-gamma) and interleukin-10 (IL-10) responses to the LSA-1 T3 peptide (aa 1813-1835) and the MSP-1 aa20-39 peptide were tested in 48 children. RESULTS: The proportion of children producing IFN-gamma to LSA-1 and to MSP-1 increased with age: in the 0-12, 13-24, 25-36 and 37-48 month age groups, zero, 11.1, 36.4 and 40% of children had IFN-gamma responses to LSA-1 (p = 0.019), and 10, 10, 27.7 and 40% of children had IFN-gamma responses to MSP-1 (p = 0.07), respectively. In contrast, the proportion of children producing IL-10 to LSA-1 and MSP-1 was similar in all age groups. CONCLUSION: The data suggest that development of IFN-gamma responses to LSA-1 and MSP-1 requires increased age and/or repeated exposure, whereas IL-10 responses to these antigens may occur at any age and with limited exposure. The data also demonstrate that by the age of 4 years, children in a malaria holoendemic area develop frequencies of IFN-gamma responses to LSA-1 and MSP-1 similar to those seen in adults in the area.