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Year : 2012  |  Volume : 1  |  Issue : 1  |  Page : 16-22

Blood group O protects against complicated Plasmodium falciparum malaria by the mechanism of inducing high levels of anti-malarial IgG antibodies

1 Department of Microbiology, College of Medicine and Medical Science, Taif University, Taif, Saudi Arabia; Faculty of Science and Technology, Al Neelain University, Khartoum, Sudan
2 Department of Haematology, Faculty of Medical Laboratory Science, University of Medical Science and Technology, Khartoum, Sudan
3 Department of ENT, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom
4 Department of Biochemistry, Faculty of Medicine, Malaria Research Centre (MalRC), University of Khartoum, Khartoum, Sudan; Department of Clinical Immunology, Faculty of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia

Correspondence Address:
Amre Nasr
Department of Microbiology, College of Medicine and Medical Science, Taif University, P.O. Box: 888, Taif, Saudi Arabia

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Source of Support: Ministry of Higher Education and Research, Sudan (MHER.SD. 2009.4771)., Conflict of Interest: None

DOI: 10.4103/2278-0521.94979

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In a prospective clinical study in North Kordofan (Western Sudan), the possible association between blood groups and anti-malarial antibody responses with clinical outcome of Plasmodium falciparum malaria among Sudanese patients was investigated. A total of 184 individuals were consecutively enrolled from an outpatient clinic. Sixty six (35.9%) patients were classified as complicated malaria (CM), 53 (28.8%) with uncomplicated malaria (UM) and 65 (35.3%) were malaria free controls (MFC). Phenotypes of ABO blood groups were typed using commercial anti-sera. The antibody responses to MSP2 malaria antigens were assessed by an enzyme-linked immunosorbent assay (ELISA). The frequency of O blood group was significantly lower in those with CM when compared with MFC and UM patients (P value < 0.001 and 0.002 respectively). The levels of IgG1, IgG2 and IgG3 antibodies were statistically significantly higher in UM and MFC compared with CM patients. Statistical analysis indicated that higher levels of total IgG, IgG1, IgG2, and IgG3 specific to the MSP2 (both antigen forms, 3D7 and FC27) were associated with a reduced risk of complicated CM in O blood type carriers than in non-O blood type carriers, P value <0.001. Taken together, the current study indicates that blood group O is associated with a reduction in the risk of developing complicated malaria in western Sudan. Our results also revealed that the natural acquisition of immunity against clinical malaria appeared to be more associated with IgG1 and IgG3 antibodies, signifying their roles in parasite-neutralizing immune mechanisms.

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