Discussion

Expression of the Plasmodium falciparum erythrocyte membrane protein 1(PfEMP1)on the surface of infected erythrocytes is associated with malarial pathology and immune evasion. PfEMP1 is encoded by the var gene family, which is diverse both within and between genomes. The protein is composed of a variable number of DBL and CIDR domains among which the DBLa domain is the most conserved. We investigated the development and maintenance of CD4+ T-cell responses to DBLa domain of PfEMP-1in children living in a malaria-endemic area in Kenya. Whereas antibody responses to PfEMP1 are largely variant-specific, our data suggest that at least some CD4⁺ T cells recognize semi-conserved regions of DBLa and thus may provide T cell help to a wide range of variant-specific B cells.