14 Clonally variant surface antigens (VSA) of Plasmodium falciparum, inserted into the membranes of infected erythrocytes, have been recognized long ago and it was suggested that they constitute targets of antibody responses, enhanced with age and associated with protection from malaria: 55 a highly significant independent association was actually found between presence of HbAS and IgG anti-VSA responses, confirming that enhanced levels of cross-reactive anti-VSA responses in children with HbAS may be strongly associated with protection against malaria. 56 Other immunological factors may be relevant in CM pathogenesis, like pathogenic CD8 T cells.
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