Malaria Blood Stage Suppression of Liver Stage Immunity by Dendritic Cells

Malaria starts with Plasmodium sporozoites infection of the host's liver, where development into blood stage parasites occurs. It is not clear why natural infections do not induce protection against the initial liver stage and generate low CD8⁺ T cell responses. Using a rodent malaria model, we show that Plasmodium blood stage infection suppresses CD8⁺ T cell immune responses that were induced against the initial liver stage. Blood stage Plasmodium affects dendritic cell (DC) functions, inhibiting maturation and the capacity to initiate immune responses and inverting the interleukin (IL)-12/IL-10 secretion pattern. The interaction of blood stage parasites with DCs induces the secretion of soluble factors that inhibit the activation of CD8⁺ T cells in vitro and the suppression of protective CD8⁺ T cell responses against the liver stage in vivo. We propose that blood stage infection induces DCs to suppress CD8⁺ T cell responses in natural malaria infections. This evasion mechanism leaves the host unprotected against reinfection by inhibiting the immune response against the initial liver stage of the disease.