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Binding Heterogeneity of Plasmodium falciparum to Engineered 3D Brain Microvessels Is Mediated by EPCR and ICAM-1. mBio 2019; 10:mBio.00420-19. [PMID: 31138740 PMCID: PMC6538777 DOI: 10.1128/mbio.00420-19] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Cerebral malaria research has been hindered by the inaccessibility of the brain. Here, we have developed an engineered 3D human brain microvessel model that mimics the blood flow rates and architecture of small blood vessels to study how P. falciparum-infected human erythrocytes attach to brain endothelial cells. By studying parasite lines with different adhesive properties, we show that the malaria parasite binding rate is heterogeneous and strongly influenced by physiological differences in flow and whether the endothelium has been previously activated by TNF-α, a proinflammatory cytokine that is linked to malaria disease severity. We also show the importance of human EPCR and ICAM-1 in parasite binding. Our model sheds new light on how P. falciparum binds within brain microvessels and provides a powerful method for future investigations of recruitment of human brain pathogens to the blood vessel lining of the brain. Cerebral malaria is a severe neurological complication associated with sequestration of Plasmodium falciparum-infected erythrocytes (IE) in the brain microvasculature, but the specific binding interactions remain under debate. Here, we have generated an engineered three-dimensional (3D) human brain endothelial microvessel model and studied P. falciparum binding under the large range of physiological flow velocities that occur in both health and disease. Perfusion assays on 3D microvessels reveal previously unappreciated phenotypic heterogeneity in parasite binding to tumor necrosis factor alpha (TNF-α)-activated brain endothelial cells. While clonal parasite lines expressing a group B P. falciparum erythrocyte membrane protein 1 (PfEMP1) present an increase in binding to activated 3D microvessels, P. falciparum-IE expressing DC8-PfEMP1 present a decrease in binding. The differential response to endothelium activation is mediated by surface expression changes of endothelial protein C receptor (EPCR) and intercellular adhesion molecule 1 (ICAM-1). These findings demonstrate heterogeneity in parasite binding and provide evidence for a parasite strategy to adapt to a changing microvascular environment during infection. The engineered 3D human brain microvessel model provides new mechanistic insight into parasite binding and opens opportunities for further studies on malaria pathogenesis and parasite-vessel interactions.
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Attaher O, Mahamar A, Swihart B, Barry A, Diarra BS, Kanoute MB, Dembele AB, Keita S, Gaoussou S, Issiaka D, Dicko A, Duffy PE, Fried M. Age-dependent increase in antibodies that inhibit Plasmodium falciparum adhesion to a subset of endothelial receptors. Malar J 2019; 18:128. [PMID: 30971252 PMCID: PMC6458601 DOI: 10.1186/s12936-019-2764-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 04/03/2019] [Indexed: 11/30/2022] Open
Abstract
Background Plasmodium falciparum-infected erythrocytes (IE) sequester in deep vascular beds where their adhesion is mediated by an array of endothelial surface receptors. Because parasite adhesion has been associated with disease, antibodies that block this activity may confer protective immunity. Here, levels of plasma anti-adhesion activity and surface reactivity against freshly collected IEs from malaria-infected children were measured in a Malian birth cohort and related to child age and malaria infection history. Methods Plasma samples from children enrolled at birth in a longitudinal cohort study of mother–infant pairs in Ouelessebougou, Mali were collected at multiple time points during follow-up visits. Anti-adhesion antibodies (i.e., inhibit IE binding to any of several endothelial receptors) and reactivity with surface IE proteins were measured using a binding inhibition assay and by flow cytometry, respectively. Results Levels of antibodies that inhibit the binding of children’s IE to the receptors ICAM-1, integrin α3β1 and laminin increased with age. The breadth of antibodies that inhibit ICAM-1 and laminin adhesion (defined as the proportion of IE isolates whose binding was reduced by ≥ 50%) also significantly increased with age. The number of malaria infections prior to plasma collection was associated with levels of plasma reactivity to IE surface proteins, but not levels of anti-adhesion activity. Conclusions Age is associated with increased levels of antibodies that reduce adhesion of children’s IE to three of the ten endothelial receptors evaluated here. These results suggest that anti-adhesion antibodies to some but not all endothelial receptors are acquired during the first few years of life. Electronic supplementary material The online version of this article (10.1186/s12936-019-2764-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Oumar Attaher
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences Techniques and Technologies of Bamako, P.O Box 1805, Bamako, Mali
| | - Almahamoudou Mahamar
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences Techniques and Technologies of Bamako, P.O Box 1805, Bamako, Mali
| | - Bruce Swihart
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, NIH, Rockville, MD, USA
| | - Amadou Barry
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences Techniques and Technologies of Bamako, P.O Box 1805, Bamako, Mali
| | - Bacary S Diarra
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences Techniques and Technologies of Bamako, P.O Box 1805, Bamako, Mali
| | - Moussa B Kanoute
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences Techniques and Technologies of Bamako, P.O Box 1805, Bamako, Mali
| | - Adama B Dembele
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences Techniques and Technologies of Bamako, P.O Box 1805, Bamako, Mali
| | - Sekouba Keita
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences Techniques and Technologies of Bamako, P.O Box 1805, Bamako, Mali
| | - Santara Gaoussou
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences Techniques and Technologies of Bamako, P.O Box 1805, Bamako, Mali
| | - Djibrilla Issiaka
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences Techniques and Technologies of Bamako, P.O Box 1805, Bamako, Mali
| | - Alassane Dicko
- Malaria Research & Training Center, Faculty of Medicine, Pharmacy and Dentistry, University of Sciences Techniques and Technologies of Bamako, P.O Box 1805, Bamako, Mali
| | - Patrick E Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, NIH, Rockville, MD, USA
| | - Michal Fried
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, NIH, Rockville, MD, USA.
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Bayes-optimal estimation of overlap between populations of fixed size. PLoS Comput Biol 2019; 15:e1006898. [PMID: 30925165 PMCID: PMC6440621 DOI: 10.1371/journal.pcbi.1006898] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 02/22/2019] [Indexed: 11/19/2022] Open
Abstract
Measuring the overlap between two populations is, in principle, straightforward. Upon fully sampling both populations, the number of shared objects—species, taxonomical units, or gene variants, depending on the context—can be directly counted. In practice, however, only a fraction of each population’s objects are likely to be sampled due to stochastic data collection or sequencing techniques. Although methods exists for quantifying population overlap under subsampled conditions, their bias is well documented and the uncertainty of their estimates cannot be quantified. Here we derive and validate a method to rigorously estimate the population overlap from incomplete samples when the total number of objects, species, or genes in each population is known, a special case of the more general β-diversity problem that is particularly relevant in the ecology and genomic epidemiology of malaria. By solving a Bayesian inference problem, this method takes into account the rates of subsampling and produces unbiased and Bayes-optimal estimates of overlap. In addition, it provides a natural framework for computing the uncertainty of its estimates, and can be used prospectively in study planning by quantifying the tradeoff between sampling effort and uncertainty. Understanding when two populations are composed of similar species is important for ecologists, epidemiologists, and population geneticists, and in principle it is easy: just sample the two populations, compare the sets of species identified in each, and count how many appear in both populations. In practice, however, this is difficult because sampling methods typically produce only a random subset of the total population, leaving current population overlap estimates biased. Knowing only the number of shared members between two of these partial population samples, this paper shows how we can nevertheless estimate the true overlap between the full populations, when those full populations’ sizes are known. Using Bayesian statistics, we can also compute credible intervals to produce error bars. We show that using this unbiased approach has a dramatic impact on the conclusions one might draw from previously published studies in the malaria literature, which used simple but biased methods. Because the method in this paper quantifies the tradeoff between sampling effort and uncertainty, we also show how to compute the number of samples required to ensure high-confidence results, which may be useful for planning future studies or budgeting lab reagents and time.
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Chan JA, Boyle MJ, Moore KA, Reiling L, Lin Z, Hasang W, Avril M, Manning L, Mueller I, Laman M, Davis T, Smith JD, Rogerson SJ, Simpson JA, Fowkes FJI, Beeson JG. Antibody Targets on the Surface of Plasmodium falciparum-Infected Erythrocytes That Are Associated With Immunity to Severe Malaria in Young Children. J Infect Dis 2019; 219:819-828. [PMID: 30365004 PMCID: PMC6376912 DOI: 10.1093/infdis/jiy580] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/15/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Sequestration of Plasmodium falciparum-infected erythrocytes (IEs) in the microvasculature contributes to pathogenesis of severe malaria in children. This mechanism is mediated by antigens expressed on the IE surface. However, knowledge of specific targets and functions of antibodies to IE surface antigens that protect against severe malaria is limited. METHODS Antibodies to IE surface antigens were examined in a case-control study of young children in Papua New Guinea presenting with severe or uncomplicated malaria (n = 448), using isolates with a virulent phenotype associated with severe malaria, and functional opsonic phagocytosis assays. We used genetically modified isolates and recombinant P. falciparum erythrocyte membrane protein 1 (PfEMP1) domains to quantify PfEMP1 as a target of antibodies associated with disease severity. RESULTS Antibodies to the IE surface and recombinant PfEMP1 domains were significantly higher in uncomplicated vs severe malaria and were boosted following infection. The use of genetically modified P. falciparum revealed that PfEMP1 was a major target of antibodies and that PfEMP1-specific antibodies were associated with reduced odds of severe malaria. Furthermore, antibodies promoting the opsonic phagocytosis of IEs by monocytes were lower in those with severe malaria. CONCLUSIONS Findings suggest that PfEMP1 is a dominant target of antibodies associated with reduced risk of severe malaria, and function in part by promoting opsonic phagocytosis.
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Affiliation(s)
- Jo-Anne Chan
- Burnet Institute for Medical Research and Public Health, Melbourne
| | - Michelle J Boyle
- Burnet Institute for Medical Research and Public Health, Melbourne
| | - Kerryn A Moore
- Burnet Institute for Medical Research and Public Health, Melbourne
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne
| | - Linda Reiling
- Burnet Institute for Medical Research and Public Health, Melbourne
| | - Zaw Lin
- Burnet Institute for Medical Research and Public Health, Melbourne
| | - Wina Hasang
- Department of Medicine, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Marion Avril
- Center for Infectious Diseases Research, Seattle, Washington
| | - Laurens Manning
- Papua New Guinea Institute of Medical Research, Madang
- University of Western Australia, Perth
| | - Ivo Mueller
- Walter and Eliza Hall Institute of Medical Research, Parkville
| | - Moses Laman
- Papua New Guinea Institute of Medical Research, Madang
| | | | - Joseph D Smith
- Center for Infectious Diseases Research, Seattle, Washington
| | - Stephen J Rogerson
- Department of Medicine, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Julie A Simpson
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville
| | - Freya J I Fowkes
- Burnet Institute for Medical Research and Public Health, Melbourne
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Infectious Diseases, Monash University, Melbourne, Victoria, Australia
| | - James G Beeson
- Burnet Institute for Medical Research and Public Health, Melbourne
- Department of Medicine, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Australia
- Department of Microbiology, Monash University, Melbourne, Victoria, Australia
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55
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Luzolo AL, Ngoyi DM. Cerebral malaria. Brain Res Bull 2019; 145:53-58. [DOI: 10.1016/j.brainresbull.2019.01.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 12/28/2018] [Accepted: 01/03/2019] [Indexed: 01/17/2023]
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56
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Barua P, Beeson JG, Maleta K, Ashorn P, Rogerson SJ. The impact of early life exposure to Plasmodium falciparum on the development of naturally acquired immunity to malaria in young Malawian children. Malar J 2019; 18:11. [PMID: 30658632 PMCID: PMC6339377 DOI: 10.1186/s12936-019-2647-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 01/12/2019] [Indexed: 11/23/2022] Open
Abstract
Background Antibodies targeting malaria blood-stage antigens are important targets of naturally acquired immunity, and may act as valuable biomarkers of malaria exposure. Methods Six-hundred and one young Malawian children from a randomized trial of prenatal nutrient supplementation with iron and folic acid or pre- and postnatal multiple micronutrients or lipid-based nutrient supplements were followed up weekly at home and febrile episodes were investigated for malaria from birth to 18 months of age. Antibodies were measured for 601 children against merozoite surface proteins (MSP1 19kD, MSP2), erythrocyte binding antigen 175 (EBA175), reticulocyte binding protein homologue 2 (Rh2A9), schizont extract and variant surface antigens expressed by Plasmodium falciparum-infected erythrocytes (IE) at 18 months of age. The antibody measurement data was related to concurrent malaria infection and to documented episodes of clinical malaria. Results At 18 months of age, antibodies were significantly higher among parasitaemic than aparasitaemic children. Antibody levels against MSP1 19kD, MSP2, schizont extract, and IE variant surface antigens were significantly higher in children who had documented episodes of malaria than in children who did not. Antibody levels did not differ between children with single or multiple malaria episodes before 18 months, nor between children who had malaria before 6 months of age or between 6 and 18 months. Conclusions Antibodies to merozoite and IE surface antigens increased following infection in early childhood, but neither age at first infection nor number of malaria episodes substantially affected antibody acquisition. These findings have implications for malaria surveillance during early childhood in the context of elimination. Trials registration Clinical Trials Registration: NCT01239693 (Date of registration: 11-10-2010). URL: http://www.ilins.org
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Affiliation(s)
- Priyanka Barua
- The Department of Medicine (RMH), Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC, 3000, Australia.,Department of Zoology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - James G Beeson
- The Department of Medicine (RMH), Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC, 3000, Australia.,Burnet Institute, Melbourne, VIC, 3004, Australia.,Department of Microbiology and Central Clinical School, Monash University, Melbourne, VIC, 3800, Australia
| | - Kenneth Maleta
- School of Public Health and Family Medicine, University of Malawi, Blantyre 3, Malawi
| | - Per Ashorn
- Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, 33100, Tampere, Finland.,Research and Development, Maternal, Newborn and Adolescent Health, World Health Organization, Geneva 27, 1211, Switzerland
| | - Stephen J Rogerson
- The Department of Medicine (RMH), Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC, 3000, Australia.
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57
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Tan J, Piccoli L, Lanzavecchia A. The Antibody Response to Plasmodium falciparum: Cues for Vaccine Design and the Discovery of Receptor-Based Antibodies. Annu Rev Immunol 2018; 37:225-246. [PMID: 30566366 DOI: 10.1146/annurev-immunol-042617-053301] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Plasmodium falciparum remains a serious public health problem and a continuous challenge for the immune system due to the complexity and diversity of the pathogen. Recent advances from several laboratories in the characterization of the antibody response to the parasite have led to the identification of critical targets for protection and revealed a new mechanism of diversification based on the insertion of host receptors into immunoglobulin genes, leading to the production of receptor-based antibodies. These advances have opened new possibilities for vaccine design and passive antibody therapies to provide sterilizing immunity and control blood-stage parasites.
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Affiliation(s)
- Joshua Tan
- Institute for Research in Biomedicine, Università della Svizzera italiana, 6500 Bellinzona, Switzerland; .,Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DU, United Kingdom.,Current affiliation: National Institute of Allergy and Infectious Diseases, Rockville, Maryland 20852, USA
| | - Luca Piccoli
- Institute for Research in Biomedicine, Università della Svizzera italiana, 6500 Bellinzona, Switzerland;
| | - Antonio Lanzavecchia
- Institute for Research in Biomedicine, Università della Svizzera italiana, 6500 Bellinzona, Switzerland; .,VIR Biotechnology, San Francisco, California 94158, USA
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58
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Ecklu-Mensah G, Olsen RW, Bengtsson A, Ofori MF, Hviid L, Jensen ATR, Adams Y. Blood outgrowth endothelial cells (BOECs) as a novel tool for studying adhesion of Plasmodium falciparum-infected erythrocytes. PLoS One 2018; 13:e0204177. [PMID: 30300360 PMCID: PMC6177148 DOI: 10.1371/journal.pone.0204177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 09/03/2018] [Indexed: 11/19/2022] Open
Abstract
The lack of suitable animal models for the study of cytoadhesion of P. falciparum-infected erythrocytes (IEs) has necessitated in vitro studies employing a range of cell lines of either human tumour origin (e.g., BeWo and C32 cells) or non-human origin (e.g., CHO cells). Of the human cells available, many were isolated from adults, or derived from a pool of donors (e.g., HBEC-5i). Here we demonstrate, for the first time, the successful isolation of blood outgrowth endothelial cells (BOECs) from frozen stabilates of peripheral blood mononuclear cells obtained from small-volume peripheral blood samples from paediatric malaria patients. BOECs are a sub-population of human endothelial cells, found within the peripheral blood. We demonstrate that these cells express receptors such as Intercellular Adhesion Molecule 1 (ICAM-1/CD54), Endothelial Protein C Receptor (EPCR/CD201), platelet/endothelial cell adhesion molecule 1 (PECAM-1/CD31), Thrombomodulin (CD141), and support adhesion of P. falciparum IEs.
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Affiliation(s)
- Gertrude Ecklu-Mensah
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- Centre for Medical Parasitology at Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rebecca W. Olsen
- Centre for Medical Parasitology at Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anja Bengtsson
- Centre for Medical Parasitology at Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael F. Ofori
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Lars Hviid
- Centre for Medical Parasitology at Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Anja T. R. Jensen
- Centre for Medical Parasitology at Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yvonne Adams
- Centre for Medical Parasitology at Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
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59
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Children with cerebral malaria or severe malarial anaemia lack immunity to distinct variant surface antigen subsets. Sci Rep 2018; 8:6281. [PMID: 29674705 PMCID: PMC5908851 DOI: 10.1038/s41598-018-24462-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 03/28/2018] [Indexed: 01/08/2023] Open
Abstract
Variant surface antigens (VSAs) play a critical role in severe malaria pathogenesis. Defining gaps, or “lacunae”, in immunity to these Plasmodium falciparum antigens in children with severe malaria would improve our understanding of vulnerability to severe malaria and how protective immunity develops. Using a protein microarray with 179 antigen variants from three VSA families as well as more than 300 variants of three other blood stage P. falciparum antigens, reactivity was measured in sera from Malian children with cerebral malaria or severe malarial anaemia and age-matched controls. Sera from children with severe malaria recognized fewer extracellular PfEMP1 fragments and were less reactive to specific fragments compared to controls. Following recovery from severe malaria, convalescent sera had increased reactivity to certain non-CD36 binding PfEMP1s, but not other malaria antigens. Sera from children with severe malarial anaemia reacted to fewer VSAs than did sera from children with cerebral malaria, and both of these groups had lacunae in their seroreactivity profiles in common with children who had both cerebral malaria and severe malarial anaemia. This microarray-based approach may identify a subset of VSAs that could inform the development of a vaccine to prevent severe disease or a diagnostic test to predict at-risk children.
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60
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Olsen RW, Ecklu-Mensah G, Bengtsson A, Ofori MF, Lusingu JPA, Castberg FC, Hviid L, Adams Y, Jensen ATR. Natural and Vaccine-Induced Acquisition of Cross-Reactive IgG-Inhibiting ICAM-1-Specific Binding of a Plasmodium falciparum PfEMP1 Subtype Associated Specifically with Cerebral Malaria. Infect Immun 2018; 86:e00622-17. [PMID: 29426042 PMCID: PMC5865037 DOI: 10.1128/iai.00622-17] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/25/2018] [Indexed: 12/17/2022] Open
Abstract
Cerebral malaria (CM) is a potentially deadly outcome of Plasmodium falciparum malaria that is precipitated by sequestration of infected erythrocytes (IEs) in the brain. The adhesion of IEs to brain endothelial cells is mediated by a subtype of parasite-encoded erythrocyte membrane protein 1 (PfEMP1) that facilitates dual binding to host intercellular adhesion molecule 1 (ICAM-1) and endothelial protein receptor C (EPCR). The PfEMP1 subtype is characterized by the presence of a particular motif (DBLβ_motif) in the constituent ICAM-1-binding DBLβ domain. The rate of natural acquisition of DBLβ_motif-specific IgG antibodies and the ability to induce such antibodies by vaccination are unknown, and the aim of this study was to provide such data. We used an enzyme-linked immunosorbent assay (ELISA) to measure DBLβ-specific IgG in plasma from Ghanaian children with malaria. The ability of human immune plasma and DBLβ-specific rat antisera to inhibit the interaction between ICAM-1 and DBLβ was assessed using ELISA and in vitro assays of IE adhesion under flow. The acquisition of DBLβ_motif-specific IgG coincided with age-specific susceptibility to CM. Broadly cross-reactive antibodies inhibiting the interaction between ICAM-1 and DBLβ_motif domains were detectable in immune plasma and in sera of rats immunized with specific DBLβ_motif antigens. Importantly, antibodies against the DBLβ_motif inhibited ICAM-1-specific in vitro adhesion of erythrocytes infected by four of five P. falciparum isolates from cerebral malaria patients. We conclude that natural exposure to P. falciparum as well as immunization with specific DBLβ_motif antigens can induce cross-reactive antibodies that inhibit the interaction between ICAM-1 and a broad range of DBLβ_motif domains. These findings raise hope that a vaccine designed specifically to prevent CM is feasible.
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MESH Headings
- Adolescent
- Amino Acid Motifs
- Antibodies, Neutralizing/immunology
- Antibodies, Protozoan/immunology
- Antigens, Protozoan/immunology
- Binding Sites
- Child
- Child, Preschool
- Cross Reactions/immunology
- Ghana
- Humans
- Immunoglobulin G/immunology
- Immunoglobulin G/metabolism
- Infant
- Intercellular Adhesion Molecule-1/metabolism
- Malaria Vaccines/immunology
- Malaria, Cerebral/immunology
- Malaria, Cerebral/metabolism
- Malaria, Cerebral/parasitology
- Malaria, Falciparum/immunology
- Malaria, Falciparum/metabolism
- Malaria, Falciparum/parasitology
- Plasmodium falciparum/immunology
- Protein Binding/immunology
- Protein Interaction Domains and Motifs
- Protozoan Proteins/chemistry
- Protozoan Proteins/immunology
- Protozoan Proteins/metabolism
- Tanzania
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Affiliation(s)
- Rebecca W Olsen
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gertrude Ecklu-Mensah
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Anja Bengtsson
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael F Ofori
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - John P A Lusingu
- National Institute for Medical Research, Tanga Centre, Tanga City, Tanzania
| | - Filip C Castberg
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Microbiology, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Lars Hviid
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Yvonne Adams
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anja T R Jensen
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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The Plasmodium falciparum transcriptome in severe malaria reveals altered expression of genes involved in important processes including surface antigen-encoding var genes. PLoS Biol 2018; 16:e2004328. [PMID: 29529020 PMCID: PMC5864071 DOI: 10.1371/journal.pbio.2004328] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/22/2018] [Accepted: 02/16/2018] [Indexed: 01/13/2023] Open
Abstract
Within the human host, the malaria parasite Plasmodium falciparum is exposed to multiple selection pressures. The host environment changes dramatically in severe malaria, but the extent to which the parasite responds to-or is selected by-this environment remains unclear. From previous studies, the parasites that cause severe malaria appear to increase expression of a restricted but poorly defined subset of the PfEMP1 variant, surface antigens. PfEMP1s are major targets of protective immunity. Here, we used RNA sequencing (RNAseq) to analyse gene expression in 44 parasite isolates that caused severe and uncomplicated malaria in Papuan patients. The transcriptomes of 19 parasite isolates associated with severe malaria indicated that these parasites had decreased glycolysis without activation of compensatory pathways; altered chromatin structure and probably transcriptional regulation through decreased histone methylation; reduced surface expression of PfEMP1; and down-regulated expression of multiple chaperone proteins. Our RNAseq also identified novel associations between disease severity and PfEMP1 transcripts, domains, and smaller sequence segments and also confirmed all previously reported associations between expressed PfEMP1 sequences and severe disease. These findings will inform efforts to identify vaccine targets for severe malaria and also indicate how parasites adapt to-or are selected by-the host environment in severe malaria.
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Infected erythrocytes expressing DC13 PfEMP1 differ from recombinant proteins in EPCR-binding function. Proc Natl Acad Sci U S A 2018; 115:1063-1068. [PMID: 29339517 PMCID: PMC5798336 DOI: 10.1073/pnas.1712879115] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Sequestration of Plasmodium falciparum-infected erythrocytes (IEs) in the brain microvasculature underlies the pathology of cerebral malaria. Parasites that express P. falciparum erythrocyte membrane protein 1 of domain cassette (DC) 8 and DC13 types bind to brain endothelial cells. Recent studies, largely based on recombinant proteins, have identified endothelial protein C receptor (EPCR) as the key receptor for endothelial cell binding. Using DC8- and DC13-expressing IEs, we show that binding of DC13 IEs to brain endothelial cells is not EPCR-dependent and that cytoadhesion of EPCR-binding DC8 IEs to brain endothelial cells is blocked by human serum. This study highlights differences between recombinant protein and native protein in EPCR-binding properties and suggests that other receptors are also required for sequestration in cerebral malaria. Recent advances have identified a new paradigm for cerebral malaria pathogenesis in which endothelial protein C receptor (EPCR) is a major host receptor for sequestration of Plasmodium falciparum-infected erythrocytes (IEs) in the brain and other vital organs. The parasite adhesins that bind EPCR are members of the IE variant surface antigen family Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) containing specific adhesion domains called domain cassette (DC) 8 and DC13. The binding interaction site between PfEMP1 and EPCR has been mapped by biophysical and crystallography studies using recombinant proteins. However, studies examining the interaction of native PfEMP1 on the IE surface with EPCR are few. We aimed to study binding to EPCR by IEs expressing DC8 and DC13 PfEMP1 variants whose recombinant proteins have been used in key prior functional and structural studies. IE binding to EPCR immobilized on plastic and on human brain endothelial cells was examined in static and flow adhesion assays. Unexpectedly, we found that IEs expressing the DC13 PfEMP1 variant HB3var03 or IT4var07 did not bind to EPCR on plastic and the binding of these variants to brain endothelial cells was not dependent on EPCR. IEs expressing the DC8 variant IT4var19 did bind to EPCR, but this interaction was inhibited if normal human serum or plasma was present, raising the possibility that IE–EPCR interaction may be prevented by plasma components under physiological conditions. These data highlight a discrepancy in EPCR-binding activity between PfEMP1 recombinant proteins and IEs, and indicate the critical need for further research to understand the pathophysiological significance of the PfEMP1–EPCR interaction.
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Towards an anti-disease malaria vaccine. Emerg Top Life Sci 2017; 1:539-545. [PMID: 33525843 PMCID: PMC7289038 DOI: 10.1042/etls20170091] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 11/01/2017] [Accepted: 11/03/2017] [Indexed: 11/24/2022]
Abstract
Human infective parasites, such as those that cause malaria, are highly adapted to evade clearance by the immune system. In situations where they must maintain prolonged interactions with molecules of their host, they often use parasite surface protein families. These families are highly diverse to prevent immune recognition, and yet, to promote parasite survival, their members must retain the ability to interact with specific human receptors. One of the best understood of the parasite surface protein families is the PfEMP1 proteins of Plasmodium falciparum. These molecules cause infected erythrocytes to adhere to human receptors found on blood vessel and tissue surfaces. This protects the parasite within from clearance by the spleen and also causes symptoms of severe malaria. The PfEMP1 are exposed to the immune system during infection and are therefore excellent vaccine candidates for use in an approach to prevent severe disease. A key question, however, is whether their extensive diversity precludes them from forming components of the malaria vaccines of the future?
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64
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Riggle BA, Miller LH, Pierce SK. Do we know enough to find an adjunctive therapy for cerebral malaria in African children? F1000Res 2017; 6:2039. [PMID: 29250318 PMCID: PMC5701444 DOI: 10.12688/f1000research.12401.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/23/2017] [Indexed: 01/27/2023] Open
Abstract
Cerebral malaria is the deadliest complication of malaria, a febrile infectious disease caused by Plasmodium parasite. Any of the five human Plasmodium species can cause disease, but, for unknown reasons, in approximately 2 million cases each year P. falciparum progresses to severe disease, ultimately resulting in half a million deaths. The majority of these deaths are in children under the age of five. Currently, there is no way to predict which child will progress to severe disease and there are no adjunctive therapies to halt the symptoms after onset. Herein, we discuss what is known about the disease mechanism of one form of severe malaria, cerebral malaria, and how we might exploit this understanding to rescue children in the throes of cerebral disease.
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Affiliation(s)
- Brittany A Riggle
- Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, USA
| | - Louis H Miller
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, USA
| | - Susan K Pierce
- Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, USA
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65
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Shabani E, Hanisch B, Opoka RO, Lavstsen T, John CC. Plasmodium falciparum EPCR-binding PfEMP1 expression increases with malaria disease severity and is elevated in retinopathy negative cerebral malaria. BMC Med 2017; 15:183. [PMID: 29025399 PMCID: PMC5639490 DOI: 10.1186/s12916-017-0945-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Accepted: 09/15/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Expression of group A and the A-like subset of group B Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) is associated with severe malaria (SM). The diversity of var sequences combined with the challenges of distinct classification of patient pathologies has made studying the role of distinct PfEMP1 variants on malaria disease severity challenging. The application of retinopathy in the recent years has provided a further method to clinically evaluate children with cerebral malaria (CM). The question of whether children with clinical CM but no retinopathy represent a completely different disease process or a subgroup within the spectrum of CM remains an important question in malaria. In the current study, we use newly designed primer sets with the best coverage to date in a large cohort of children with SM to determine the role of var genes in malaria disease severity and especially CM as discriminated by retinopathy. METHODS We performed qRT-PCR targeting the different subsets of these var genes on samples from Ugandan children with CM (n = 98, of whom 50 had malarial retinopathy [RP] and 47 did not [RN]), severe malarial anemia (SMA, n = 47), and asymptomatic parasitemia (AP, n = 14). The primers used in this study were designed based on var sequences from 226 Illumina whole genome sequenced P. falciparum field isolates. RESULTS Increasing severity of illness was associated with increasing levels of endothelial protein C receptor (EPCR)-binding PfEMP1. EPCR-binding PfEMP1 transcript levels were highest in children with combined CM and SMA and then decreased by level of disease severity: RP CM > RN CM > SMA > AP. CONCLUSIONS The study findings indicate that PfEMP1 binding to EPCR is important in the pathogenesis of SM, including RN CM, and suggest that increased expression of EPCR-binding PfEMP1 is associated with progressively more severe disease. Agents that block EPCR-binding of PfEMP1 could provide novel interventions to prevent or decrease disease severity in malaria.
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Affiliation(s)
- Estela Shabani
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University, 1044 W Walnut St R4 402D, Indianapolis, Indiana, USA.,Department of Pediatrics, Division of Global Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Robert O Opoka
- Department of Pediatrics and Child Health, Makerere University School of Medicine, Kampala, Uganda
| | - Thomas Lavstsen
- Centre for Medical Parasitology, Department of International Health, Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen, Denmark
| | - Chandy C John
- Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University, 1044 W Walnut St R4 402D, Indianapolis, Indiana, USA. .,Department of Pediatrics, Division of Global Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA.
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66
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Rougeron V, Tiedje KE, Chen DS, Rask TS, Gamboa D, Maestre A, Musset L, Legrand E, Noya O, Yalcindag E, Renaud F, Prugnolle F, Day KP. Evolutionary structure of Plasmodium falciparum major variant surface antigen genes in South America: Implications for epidemic transmission and surveillance. Ecol Evol 2017; 7:9376-9390. [PMID: 29187975 PMCID: PMC5696401 DOI: 10.1002/ece3.3425] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 07/07/2017] [Accepted: 08/19/2017] [Indexed: 11/11/2022] Open
Abstract
Strong founder effects resulting from human migration out of Africa have led to geographic variation in single nucleotide polymorphisms (SNPs) and microsatellites (MS) of the malaria parasite, Plasmodium falciparum. This is particularly striking in South America where two major founder populations of P. falciparum have been identified that are presumed to have arisen from the transatlantic slave trade. Given the importance of the major variant surface antigen of the blood stages of P. falciparum as both a virulence factor and target of immunity, we decided to investigate the population genetics of the genes encoding “Plasmodium falciparum Erythrocyte Membrane Protein 1” (PfEMP1) among several countries in South America, in order to evaluate the transmission patterns of malaria in this continent. Deep sequencing of the DBLα domain of var genes from 128 P. falciparum isolates from five locations in South America was completed using a 454 high throughput sequencing protocol. Striking geographic variation in var DBLα sequences, similar to that seen for SNPs and MS markers, was observed. Colombia and French Guiana had distinct var DBLα sequences, whereas Peru and Venezuela showed an admixture. The importance of such geographic variation to herd immunity and malaria vaccination is discussed.
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Affiliation(s)
- Virginie Rougeron
- Department of Microbiology Division of Parasitology New York University School of Medicine New York NY USA.,MIVEGEC (Laboratoire Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle), UMR CNRS 5290/IRD 224 Université Montpellier 1 Université Montpellier 2 Montpellier France
| | - Kathryn E Tiedje
- Department of Microbiology Division of Parasitology New York University School of Medicine New York NY USA.,School of BioSciences Bio21 Institute/University of Melbourne Parkville Vic. Australia
| | - Donald S Chen
- Department of Microbiology Division of Parasitology New York University School of Medicine New York NY USA
| | - Thomas S Rask
- Department of Microbiology Division of Parasitology New York University School of Medicine New York NY USA.,School of BioSciences Bio21 Institute/University of Melbourne Parkville Vic. Australia
| | - Dionicia Gamboa
- Instituto de Medicina Tropical Alexander Von Humboldt and Departamento de Ciencias Celulares y Moleculares Facultad de Ciencias y Filosofia Universidad Peruana Cayetano Heredia Lima Peru
| | - Amanda Maestre
- Grupo Salud y Comunidad Facultad de Medicina Universidad de Antioquía Medellín Colombia
| | - Lise Musset
- Parasitology UnitInstitut Pasteur de Guyane Cayenne Cedex French Guiana
| | - Eric Legrand
- Parasitology UnitInstitut Pasteur de Guyane Cayenne Cedex French Guiana.,Unit of Genetics and Genomics on Insect Vectors Institut Pasteur Paris France
| | - Oscar Noya
- Centro para Estudios Sobre Malaria Instituto de Altos Estudios en Salud "Dr. Arnoldo Gabaldón" Ministerio del Poder Popular para la Salud and Instituto de Medicina Tropical Universidad Central de Venezuela Caracas Venezuela
| | - Erhan Yalcindag
- MIVEGEC (Laboratoire Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle), UMR CNRS 5290/IRD 224 Université Montpellier 1 Université Montpellier 2 Montpellier France
| | - François Renaud
- MIVEGEC (Laboratoire Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle), UMR CNRS 5290/IRD 224 Université Montpellier 1 Université Montpellier 2 Montpellier France
| | - Franck Prugnolle
- MIVEGEC (Laboratoire Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle), UMR CNRS 5290/IRD 224 Université Montpellier 1 Université Montpellier 2 Montpellier France
| | - Karen P Day
- Department of Microbiology Division of Parasitology New York University School of Medicine New York NY USA.,School of BioSciences Bio21 Institute/University of Melbourne Parkville Vic. Australia
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67
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Githinji G, Bull PC. A re-assessment of gene-tag classification approaches for describing var gene expression patterns during human Plasmodium falciparum malaria parasite infections. Wellcome Open Res 2017; 2:86. [PMID: 29062916 PMCID: PMC5635463 DOI: 10.12688/wellcomeopenres.12053.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2017] [Indexed: 11/20/2022] Open
Abstract
PfEMP1 are variant parasite antigens that are inserted on the surface of Plasmodium falciparum infected erythrocytes (IE). Through interactions with various host molecules, PfEMP1 mediate IE sequestration in tissues and play a key role in the pathology of severe malaria. PfEMP1 is encoded by a diverse multi-gene family called var. Previous studies have shown that that expression of specific subsets of var genes are associated with low levels of host immunity and severe malaria. However, in most clinical studies to date, full-length var gene sequences were unavailable and various approaches have been used to make comparisons between var gene expression profiles in different parasite isolates using limited information. Several studies have relied on the classification of a 300 - 500 base-pair "DBLα tag" region in the DBLα domain located at the 5' end of most var genes. We assessed the relationship between various DBLα tag classification methods, and sequence features that are only fully assessable through full-length var gene sequences. We compared these different sequence features in full-length var gene from six fully sequenced laboratory isolates. These comparisons show that despite a long history of recombination, DBLα sequence tag classification can provide functional information on important features of full-length var genes. Notably, a specific subset of DBLα tags previously defined as "group A-like" is associated with CIDRα1 domains proposed to bind to endothelial protein C receptor. This analysis helps to bring together different sources of data that have been used to assess var gene expression in clinical parasite isolates.
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Affiliation(s)
- George Githinji
- Kenya Medical Research Institute (KEMRI)-Wellcome Trust Research Programme, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya
| | - Peter C Bull
- Department of Pathology, University of Cambridge, Cambridge, UK
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68
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Chan JA, Stanisic DI, Duffy MF, Robinson LJ, Lin E, Kazura JW, King CL, Siba PM, Fowkes FJ, Mueller I, Beeson JG. Patterns of protective associations differ for antibodies to P. falciparum-infected erythrocytes and merozoites in immunity against malaria in children. Eur J Immunol 2017; 47:2124-2136. [PMID: 28833064 DOI: 10.1002/eji.201747032] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 07/09/2017] [Accepted: 08/16/2017] [Indexed: 11/10/2022]
Abstract
Acquired antibodies play an important role in immunity to P. falciparum malaria and are typically directed towards surface antigens expressed by merozoites and infected erythrocytes (IEs). The importance of specific IE surface antigens as immune targets remains unclear. We evaluated antibodies and protective associations in two cohorts of children in Papua New Guinea. We used genetically-modified P. falciparum to evaluate the importance of PfEMP1 and a P. falciparum isolate with a virulent phenotype. Our findings suggested that PfEMP1 was the dominant target of antibodies to the IE surface, including functional antibodies that promoted opsonic phagocytosis by monocytes. Antibodies were associated with increasing age and concurrent parasitemia, and were higher among children exposed to a higher force-of-infection as determined using molecular detection. Antibodies to IE surface antigens were consistently associated with reduced risk of malaria in both younger and older children. However, protective associations for antibodies to merozoite surface antigens were only observed in older children. This suggests that antibodies to IE surface antigens, particularly PfEMP1, play an earlier role in acquired immunity to malaria, whereas greater exposure is required for protective antibodies to merozoite antigens. These findings have implications for vaccine design and serosurveillance of malaria transmission and immunity.
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Affiliation(s)
- Jo-Anne Chan
- Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Victoria, Australia.,Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.,Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
| | - Danielle I Stanisic
- Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.,Institute for Glycomics, Griffith University, Southport, Queensland, Australia
| | - Michael F Duffy
- Department of Medicine and Melbourne School of Public Health, University of Melbourne, Parkville, Victoria, Australia
| | - Leanne J Robinson
- Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Victoria, Australia.,Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.,Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Enmoore Lin
- Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - James W Kazura
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, USA
| | - Christopher L King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, USA
| | - Peter M Siba
- Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Freya Ji Fowkes
- Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Victoria, Australia.,Melbourne School of Public Health, University of Melbourne, Parkville, Victoria, Australia.,Department of Epidemiology and Preventive Medicine and Department of Infectious Diseases, Monash University, Melbourne, Victoria, Australia
| | - Ivo Mueller
- Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.,Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - James G Beeson
- Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Victoria, Australia.,Department of Medicine and Melbourne School of Public Health, University of Melbourne, Parkville, Victoria, Australia.,Department of Microbiology, Monash University, Melbourne, Victoria, Australia
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Lennartz F, Adams Y, Bengtsson A, Olsen RW, Turner L, Ndam NT, Ecklu-Mensah G, Moussiliou A, Ofori MF, Gamain B, Lusingu JP, Petersen JEV, Wang CW, Nunes-Silva S, Jespersen JS, Lau CKY, Theander TG, Lavstsen T, Hviid L, Higgins MK, Jensen ATR. Structure-Guided Identification of a Family of Dual Receptor-Binding PfEMP1 that Is Associated with Cerebral Malaria. Cell Host Microbe 2017; 21:403-414. [PMID: 28279348 PMCID: PMC5374107 DOI: 10.1016/j.chom.2017.02.009] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/20/2017] [Accepted: 02/10/2017] [Indexed: 11/09/2022]
Abstract
Cerebral malaria is a deadly outcome of infection by Plasmodium falciparum, occurring when parasite-infected erythrocytes accumulate in the brain. These erythrocytes display parasite proteins of the PfEMP1 family that bind various endothelial receptors. Despite the importance of cerebral malaria, a binding phenotype linked to its symptoms has not been identified. Here, we used structural biology to determine how a group of PfEMP1 proteins interacts with intercellular adhesion molecule 1 (ICAM-1), allowing us to predict binders from a specific sequence motif alone. Analysis of multiple Plasmodium falciparum genomes showed that ICAM-1-binding PfEMP1s also interact with endothelial protein C receptor (EPCR), allowing infected erythrocytes to synergistically bind both receptors. Expression of these PfEMP1s, predicted to bind both ICAM-1 and EPCR, is associated with increased risk of developing cerebral malaria. This study therefore reveals an important PfEMP1-binding phenotype that could be targeted as part of a strategy to prevent cerebral malaria. Structural basis for P. falciparum PfEMP1 binding to endothelial receptor ICAM-1defined A sequence motif derived from structure predicts group A PfEMP1 binding to ICAM-1 These ICAM-1-binding PfEMP1s also all bind to endothelial protein C receptor (EPCR) Expression of dual ICAM-1- and EPCR-binding PfEMP1 is associated with cerebral malaria
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Affiliation(s)
- Frank Lennartz
- Department of Biochemistry, University of Oxford, South Parks Road, OX1 3QU Oxford, UK
| | - Yvonne Adams
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Anja Bengtsson
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Rebecca W Olsen
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Louise Turner
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Nicaise T Ndam
- Faculté de Pharmacie, Institut de Recherche pour le Développement (IRD), COMUE Sorbonne Paris Cité, 75013 Paris, France; Faculté des Sciences de la Santé (FSS), Université d'Aboméy Calavi, 01 BP 526 Cotonou, Benin
| | - Gertrude Ecklu-Mensah
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark; Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Azizath Moussiliou
- Faculté des Sciences de la Santé (FSS), Université d'Aboméy Calavi, 01 BP 526 Cotonou, Benin
| | - Michael F Ofori
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Benoit Gamain
- UMR_S1134, Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence GR-Ex, 75013 Paris, France
| | - John P Lusingu
- National Institute for Medical Research, Tanga Centre, 11101 Dar es Salaam, Tanzania
| | - Jens E V Petersen
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Christian W Wang
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Sofia Nunes-Silva
- UMR_S1134, Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence GR-Ex, 75013 Paris, France
| | - Jakob S Jespersen
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Clinton K Y Lau
- Department of Biochemistry, University of Oxford, South Parks Road, OX1 3QU Oxford, UK
| | - Thor G Theander
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Thomas Lavstsen
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Lars Hviid
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Matthew K Higgins
- Department of Biochemistry, University of Oxford, South Parks Road, OX1 3QU Oxford, UK.
| | - Anja T R Jensen
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark.
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70
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Abdi AI, Hodgson SH, Muthui MK, Kivisi CA, Kamuyu G, Kimani D, Hoffman SL, Juma E, Ogutu B, Draper SJ, Osier F, Bejon P, Marsh K, Bull PC. Plasmodium falciparum malaria parasite var gene expression is modified by host antibodies: longitudinal evidence from controlled infections of Kenyan adults with varying natural exposure. BMC Infect Dis 2017; 17:585. [PMID: 28835215 PMCID: PMC5569527 DOI: 10.1186/s12879-017-2686-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 08/15/2017] [Indexed: 11/10/2022] Open
Abstract
Background The PfEMP1 family of Plasmodium falciparum antigens play a key role in pathogenesis of severe malaria through their insertion into the surface of parasite infected erythrocytes, and adhesion to host cells. Previous studies have suggested that parasites expressing PfEMP1 subclasses group A and DC8, associated with severe malaria, may have a growth advantage in immunologically naïve individuals. However, this idea has not been tested in longitudinal studies. Methods Here we assessed expression of the var genes encoding PfEMP1, in parasites sampled from volunteers with varying prior exposure to malaria, following experimental infection by sporozoites (PfSPZ). Using qPCR, we tested for associations between the expression of various var subgroups in surviving parasite populations from each volunteer and 1) the levels of participants’ antibodies to infected erythrocytes before challenge infection and 2) the apparent in vivo parasite multiplication rate. Results We show that 1) expression of var genes encoding for group A and DC8-like PfEMP1 were associated with low levels of antibodies to infected erythrocytes (αIE) before challenge, and 2) expression of a DC8-like CIDRα1.1 domain was associated with higher apparent parasite multiplication rate in a manner that was independent of levels of prior antibodies to infected erythrocytes. Conclusions This study provides insight into the role of antibodies to infected erythrocytes surface antigens in the development of naturally acquired immunity and may help explain why specific PfEMP1 variants may be associated with severe malaria. Trial registration Pan African Clinical Trial Registry: PACTR201211000433272. Date of registration: 10th October 2012.
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Affiliation(s)
- Abdirahman I Abdi
- KEMRI-Wellcome Trust Research Programme, CGMRC, P.O. Box 230-80108, Kilifi County, Kenya. .,Pwani University, P. O. Box 195-80108, Kilifi, Kenya.
| | | | - Michelle K Muthui
- KEMRI-Wellcome Trust Research Programme, CGMRC, P.O. Box 230-80108, Kilifi County, Kenya
| | - Cheryl A Kivisi
- KEMRI-Wellcome Trust Research Programme, CGMRC, P.O. Box 230-80108, Kilifi County, Kenya.,Pwani University, P. O. Box 195-80108, Kilifi, Kenya
| | - Gathoni Kamuyu
- KEMRI-Wellcome Trust Research Programme, CGMRC, P.O. Box 230-80108, Kilifi County, Kenya
| | - Domtila Kimani
- KEMRI-Wellcome Trust Research Programme, CGMRC, P.O. Box 230-80108, Kilifi County, Kenya
| | | | - Elizabeth Juma
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya.,Centre for Research in Therapeutic Sciences, Strathmore University, Nairobi, Kenya
| | - Bernhards Ogutu
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya.,Centre for Research in Therapeutic Sciences, Strathmore University, Nairobi, Kenya
| | | | - Faith Osier
- KEMRI-Wellcome Trust Research Programme, CGMRC, P.O. Box 230-80108, Kilifi County, Kenya
| | - Philip Bejon
- KEMRI-Wellcome Trust Research Programme, CGMRC, P.O. Box 230-80108, Kilifi County, Kenya
| | - Kevin Marsh
- KEMRI-Wellcome Trust Research Programme, CGMRC, P.O. Box 230-80108, Kilifi County, Kenya
| | - Peter C Bull
- Department of Pathology, University of Cambridge, 17 Tennis Court Road, Cambridge, CB2 1QP, UK.
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Abstract
Organisms with identical genome sequences can show substantial differences in their phenotypes owing to epigenetic changes that result in different use of their genes. Epigenetic regulation of gene expression plays a key role in the control of several fundamental processes in the biology of malaria parasites, including antigenic variation and sexual differentiation. Some of the histone modifications and chromatin-modifying enzymes that control the epigenetic states of malaria genes have been characterized, and their functions are beginning to be unraveled. The fundamental principles of epigenetic regulation of gene expression appear to be conserved between malaria parasites and model eukaryotes, but important peculiarities exist. Here, we review the current knowledge of malaria epigenetics and discuss how it can be exploited for the development of new molecular markers and new types of drugs that may contribute to malaria eradication efforts.
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Affiliation(s)
- Alfred Cortés
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Catalonia 08036, Spain.,ICREA, Barcelona, Catalonia 08010, Spain
| | - Kirk W Deitsch
- Department of Microbiology and Immunology, Weill Medical College of Cornell University, New York, New York 10065
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72
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Day KP, Artzy-Randrup Y, Tiedje KE, Rougeron V, Chen DS, Rask TS, Rorick MM, Migot-Nabias F, Deloron P, Luty AJF, Pascual M. Evidence of strain structure in Plasmodium falciparum var gene repertoires in children from Gabon, West Africa. Proc Natl Acad Sci U S A 2017; 114:E4103-E4111. [PMID: 28461509 PMCID: PMC5441825 DOI: 10.1073/pnas.1613018114] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Existing theory on competition for hosts between pathogen strains has proposed that immune selection can lead to the maintenance of strain structure consisting of discrete, weakly overlapping antigenic repertoires. This prediction of strain theory has conceptual overlap with fundamental ideas in ecology on niche partitioning and limiting similarity between coexisting species in an ecosystem, which oppose the hypothesis of neutral coexistence. For Plasmodium falciparum, strain theory has been specifically proposed in relation to the major surface antigen of the blood stage, known as PfEMP1 and encoded by the multicopy multigene family known as the var genes. Deep sampling of the DBLα domain of var genes in the local population of Bakoumba, West Africa, was completed to define whether patterns of repertoire overlap support a role of immune selection under the opposing force of high outcrossing, a characteristic of areas of intense malaria transmission. Using a 454 high-throughput sequencing protocol, we report extremely high diversity of the DBLα domain and a large parasite population with DBLα repertoires structured into nonrandom patterns of overlap. Such population structure, significant for the high diversity of var genes that compose it at a local level, supports the existence of "strains" characterized by distinct var gene repertoires. Nonneutral, frequency-dependent competition would be at play and could underlie these patterns. With a computational experiment that simulates an intervention similar to mass drug administration, we argue that the observed repertoire structure matters for the antigenic var diversity of the parasite population remaining after intervention.
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Affiliation(s)
- Karen P Day
- School of Biosciences, The University of Melbourne, Parkville, VIC 3052, Australia;
- Department of Microbiology, New York University, New York, NY 10016
| | - Yael Artzy-Randrup
- Theoretical Ecology Group, Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, 1090 GE Amsterdam, The Netherlands
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109
| | - Kathryn E Tiedje
- School of Biosciences, The University of Melbourne, Parkville, VIC 3052, Australia
- Department of Microbiology, New York University, New York, NY 10016
| | - Virginie Rougeron
- Department of Microbiology, New York University, New York, NY 10016
- Laboratoire Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle, UMR 224-5290 CNRS, Institut de Recherche pour le Développement-Université de Montpellier, Centre Institut de Recherche pour le Développement de Montpellier, 34394 Montpellier, France
| | - Donald S Chen
- Department of Microbiology, New York University, New York, NY 10016
- Department of Medicine, New York Medical College, Valhalla, NY 10595
| | - Thomas S Rask
- School of Biosciences, The University of Melbourne, Parkville, VIC 3052, Australia
- Department of Microbiology, New York University, New York, NY 10016
| | - Mary M Rorick
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109
- Department of Ecology and Evolution, University of Chicago, Chicago, IL 60637
| | - Florence Migot-Nabias
- Institut de Recherche pour le Développement, UMR 216 Mère et Enfant Face aux Infections Tropicales, 75006 Paris, France
- Communautés d'Universités et Établissements, Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, 75006 Paris, France
| | - Philippe Deloron
- Institut de Recherche pour le Développement, UMR 216 Mère et Enfant Face aux Infections Tropicales, 75006 Paris, France
- Communautés d'Universités et Établissements, Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, 75006 Paris, France
| | - Adrian J F Luty
- Institut de Recherche pour le Développement, UMR 216 Mère et Enfant Face aux Infections Tropicales, 75006 Paris, France
- Communautés d'Universités et Établissements, Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, 75006 Paris, France
| | - Mercedes Pascual
- Department of Ecology and Evolution, University of Chicago, Chicago, IL 60637
- Santa Fe Institute, Santa Fe, NM 87501
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73
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The Severity of Plasmodium falciparum Infection Is Associated with Transcript Levels of var Genes Encoding Endothelial Protein C Receptor-Binding P. falciparum Erythrocyte Membrane Protein 1. Infect Immun 2017; 85:IAI.00841-16. [PMID: 28138022 DOI: 10.1128/iai.00841-16] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/23/2017] [Indexed: 11/20/2022] Open
Abstract
By attaching infected erythrocytes to the vascular lining, Plasmodium falciparum parasites leave blood circulation and avoid splenic clearance. This sequestration is central to pathogenesis. Severe malaria is associated with parasites expressing an antigenically distinct P. falciparum erythrocyte membrane protein 1 (PfEMP1) subset mediating binding to endothelial receptors. Previous studies indicate that PfEMP1 adhesins with so-called CIDRα1 domains capable of binding endothelial protein C receptor (EPCR) constitute the PfEMP1 subset associated with severe pediatric malaria. To analyze the relative importance of different subtypes of CIDRα1 domains, we compared Pfemp1 transcript levels in children with severe malaria (including 9 fatal and 114 surviving cases), children hospitalized with uncomplicated malaria (n = 42), children with mild malaria not requiring hospitalization (n = 10), and children with parasitemia and no ongoing fever (n = 12). High levels of transcripts encoding EPCR-binding PfEMP1 were found in patients with symptomatic infections, and the abundance of these transcripts increased with disease severity. The compositions of CIDRα1 subtype transcripts varied markedly between patients, and none of the subtypes were dominant. Transcript-level analyses targeting other domain types indicated that subtypes of DBLβ or DBLζ domains might mediate binding phenomena that, in conjunction with EPCR binding, could contribute to pathogenesis. These observations strengthen the rationale for targeting the PfEMP1-EPCR interaction by vaccines and adjunctive therapies. Interventions should target EPCR binding of all CIDRα1 subtypes.
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74
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Antibody-independent mechanisms regulate the establishment of chronic Plasmodium infection. Nat Microbiol 2017; 2:16276. [PMID: 28165471 DOI: 10.1038/nmicrobiol.2016.276] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 12/22/2016] [Indexed: 01/15/2023]
Abstract
Malaria is caused by parasites of the genus Plasmodium. All human-infecting Plasmodium species can establish long-lasting chronic infections1-5, creating an infectious reservoir to sustain transmission1,6. It is widely accepted that the maintenance of chronic infection involves evasion of adaptive immunity by antigenic variation7. However, genes involved in this process have been identified in only two of five human-infecting species: Plasmodium falciparum and Plasmodium knowlesi. Furthermore, little is understood about the early events in the establishment of chronic infection in these species. Using a rodent model we demonstrate that from the infecting population, only a minority of parasites, expressing one of several clusters of virulence-associated pir genes, establishes a chronic infection. This process occurs in different species of parasites and in different hosts. Establishment of chronicity is independent of adaptive immunity and therefore different from the mechanism proposed for maintenance of chronic P. falciparum infections7-9. Furthermore, we show that the proportions of parasites expressing different types of pir genes regulate the time taken to establish a chronic infection. Because pir genes are common to most, if not all, species of Plasmodium10, this process may be a common way of regulating the establishment of chronic infections.
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75
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Nik Kamarudin NAA, Mohammed NA, Mustaffa KMF. Aptamer Technology: Adjunct Therapy for Malaria. Biomedicines 2017; 5:biomedicines5010001. [PMID: 28536344 PMCID: PMC5423489 DOI: 10.3390/biomedicines5010001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 12/08/2016] [Accepted: 12/16/2016] [Indexed: 02/07/2023] Open
Abstract
Malaria is a life-threatening parasitic infection occurring in the endemic areas, primarily in children under the age of five, pregnant women, and patients with human immunodeficiency virus and acquired immunodeficiency syndrome (HIV)/(AIDS) as well as non-immune individuals. The cytoadherence of infected erythrocytes (IEs) to the host endothelial surface receptor is a known factor that contributes to the increased prevalence of severe malaria cases due to the accumulation of IEs, mainly in the brain and other vital organs. Therefore, further study is needed to discover a new potential anti-adhesive drug to treat severe malaria thus reducing its mortality rate. In this review, we discuss how the aptamer technology could be applied in the development of a new adjunct therapy for current malaria treatment.
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Affiliation(s)
- Nik Abdul Aziz Nik Kamarudin
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Health Campus, Kubang Kerian, 16150 Kelantan, Malaysia.
| | - Nurul Adila Mohammed
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Health Campus, Kubang Kerian, 16150 Kelantan, Malaysia.
| | - Khairul Mohd Fadzli Mustaffa
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Health Campus, Kubang Kerian, 16150 Kelantan, Malaysia.
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76
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77
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Bernabeu M, Smith JD. EPCR and Malaria Severity: The Center of a Perfect Storm. Trends Parasitol 2016; 33:295-308. [PMID: 27939609 DOI: 10.1016/j.pt.2016.11.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 11/07/2016] [Accepted: 11/10/2016] [Indexed: 12/20/2022]
Abstract
Severe malaria due to Plasmodium falciparum infection causes nearly half a million deaths per year. The different symptomatology and disease manifestations among patients have hampered understanding of severe malaria pathology and complicated efforts to develop targeted disease interventions. Infected erythrocyte sequestration in the microvasculature plays a critical role in the development of severe disease, and there is increasing evidence that cytoadherent parasites interact with host factors to enhance the damage caused by the parasite. The recent discovery that parasite binding to endothelial protein C receptor (EPCR) is associated with severe disease has suggested new mechanisms of pathology and provided new avenues for severe malaria adjunctive therapy research.
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Affiliation(s)
- Maria Bernabeu
- Center for Infectious Disease Research, Seattle, WA 98109, USA
| | - Joseph D Smith
- Center for Infectious Disease Research, Seattle, WA 98109, USA; Department of Global Health, University of Washington, Seattle, WA 98195, USA.
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78
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Bruske EI, Dimonte S, Enderes C, Tschan S, Flötenmeyer M, Koch I, Berger J, Kremsner P, Frank M. In Vitro Variant Surface Antigen Expression in Plasmodium falciparum Parasites from a Semi-Immune Individual Is Not Correlated with Var Gene Transcription. PLoS One 2016; 11:e0166135. [PMID: 27907004 PMCID: PMC5132323 DOI: 10.1371/journal.pone.0166135] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 10/24/2016] [Indexed: 12/17/2022] Open
Abstract
Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) is considered to be the main variant surface antigen (VSA) of Plasmodium falciparum and is mainly localized on electron-dense knobs in the membrane of the infected erythrocyte. Switches in PfEMP1 expression provide the basis for antigenic variation and are thought to be critical for parasite persistence during chronic infections. Recently, strain transcending anti-PfEMP1 immunity has been shown to develop early in life, challenging the role of PfEMP1 in antigenic variation during chronic infections. In this work we investigate how P. falciparum achieves persistence during a chronic asymptomatic infection. The infected individual (MOA) was parasitemic for 42 days and multilocus var gene genotyping showed persistence of the same parasite population throughout the infection. Parasites from the beginning of the infection were adapted to tissue culture and cloned by limiting dilution. Flow cytometry using convalescent serum detected a variable surface recognition signal on isogenic clonal parasites. Quantitative real-time PCR with a field isolate specific var gene primer set showed that the surface recognition signal was not correlated with transcription of individual var genes. Strain transcending anti-PfEMP1 immunity of the convalescent serum was demonstrated with CD36 selected and PfEMP1 knock-down NF54 clones. In contrast, knock-down of PfEMP1 did not have an effect on the antibody recognition signal in MOA clones. Trypsinisation of the membrane surface proteins abolished the surface recognition signal and immune electron microscopy revealed that antibodies from the convalescent serum bound to membrane areas without knobs and with knobs. Together the data indicate that PfEMP1 is not the main variable surface antigen during a chronic infection and suggest a role for trypsin sensitive non-PfEMP1 VSAs for parasite persistence in chronic infections.
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Affiliation(s)
- Ellen Inga Bruske
- Institute of Tropical Medicine, University of Tuebingen, Tuebingen, Germany
| | - Sandra Dimonte
- Institute of Tropical Medicine, University of Tuebingen, Tuebingen, Germany
| | - Corinna Enderes
- Institute of Tropical Medicine, University of Tuebingen, Tuebingen, Germany
| | - Serena Tschan
- Institute of Tropical Medicine, University of Tuebingen, Tuebingen, Germany
| | | | - Iris Koch
- Max Planck Institute for Developmental Biology, Tuebingen, Germany
| | - Jürgen Berger
- Max Planck Institute for Developmental Biology, Tuebingen, Germany
| | - Peter Kremsner
- Institute of Tropical Medicine, University of Tuebingen, Tuebingen, Germany
- CERMEL (Centre de Recherche Médicale de Lambaréné), Lambaréné, Gabon
| | - Matthias Frank
- Institute of Tropical Medicine, University of Tuebingen, Tuebingen, Germany
- CERMEL (Centre de Recherche Médicale de Lambaréné), Lambaréné, Gabon
- * E-mail:
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79
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Cytoadhesion to gC1qR through Plasmodium falciparum Erythrocyte Membrane Protein 1 in Severe Malaria. PLoS Pathog 2016; 12:e1006011. [PMID: 27835682 PMCID: PMC5106025 DOI: 10.1371/journal.ppat.1006011] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 10/19/2016] [Indexed: 11/19/2022] Open
Abstract
Cytoadhesion of Plasmodium falciparum infected erythrocytes to gC1qR has been associated with severe malaria, but the parasite ligand involved is currently unknown. To assess if binding to gC1qR is mediated through the P. falciparum erythrocyte membrane protein 1 (PfEMP1) family, we analyzed by static binding assays and qPCR the cytoadhesion and var gene transcriptional profile of 86 P. falciparum isolates from Mozambican children with severe and uncomplicated malaria, as well as of a P. falciparum 3D7 line selected for binding to gC1qR (Pf3D7gC1qR). Transcript levels of DC8 correlated positively with cytoadhesion to gC1qR (rho = 0.287, P = 0.007), were higher in isolates from children with severe anemia than with uncomplicated malaria, as well as in isolates from Europeans presenting a first episode of malaria (n = 21) than Mozambican adults (n = 25), and were associated with an increased IgG recognition of infected erythrocytes by flow cytometry. Pf3D7gC1qR overexpressed the DC8 type PFD0020c (5.3-fold transcript levels relative to Seryl-tRNA-synthetase gene) compared to the unselected line (0.001-fold). DBLβ12 from PFD0020c bound to gC1qR in ELISA-based binding assays and polyclonal antibodies against this domain were able to inhibit binding to gC1qR of Pf3D7gC1qR and four Mozambican P. falciparum isolates by 50%. Our results show that DC8-type PfEMP1s mediate binding to gC1qR through conserved surface epitopes in DBLβ12 domain which can be inhibited by strain-transcending functional antibodies. This study supports a key role for gC1qR in malaria-associated endovascular pathogenesis and suggests the feasibility of designing interventions against severe malaria targeting this specific interaction. Plasmodium falciparum sequesters in vital organs. This phenomenon mediated by cytoadhesion of infected-erythrocytes to host receptors in the microvasculature, contributes to the development of severe malaria. Although cytoadhesion to Endothelial Protein-C Receptor has a central role in severe malaria, other host receptors are also likely to be involved. Our results generated by the analysis of P. falciparum isolates from Mozambican patients and laboratory parasite lines indicate that a specific domain (DBLβ12) from DC8-type PfEMP1s can bind to the human receptor gC1qR, previously associated with severe malaria. Our findings revealed that antibodies against PfEMP1 could provide strain-transcending inhibition of gC1qR-binding. Overall, these results support a key role for the adhesion to gC1qR in malaria-associated endovascular pathogenesis and the feasibility of new interventions targeting this specific interaction.
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80
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Carlos BC, Fotoran WL, Menezes MJ, Cabral FJ, Bastos MF, Costa FT, Sousa-Neto JA, Ribolla PE, Wunderlich G, Ferreira MU. Expressed var gene repertoire and variant surface antigen diversity in a shrinking Plasmodium falciparum population. Exp Parasitol 2016; 170:90-99. [DOI: 10.1016/j.exppara.2016.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 09/01/2016] [Accepted: 09/20/2016] [Indexed: 10/21/2022]
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81
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Davies HM, Thalassinos K, Osborne AR. Expansion of Lysine-rich Repeats in Plasmodium Proteins Generates Novel Localization Sequences That Target the Periphery of the Host Erythrocyte. J Biol Chem 2016; 291:26188-26207. [PMID: 27777305 PMCID: PMC5207086 DOI: 10.1074/jbc.m116.761213] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Indexed: 01/05/2023] Open
Abstract
Repetitive low complexity sequences, mostly assumed to have no function, are common in proteins that are exported by the malaria parasite into its host erythrocyte. We identify a group of exported proteins containing short lysine-rich tandemly repeated sequences that are sufficient to localize to the erythrocyte periphery, where key virulence-related modifications to the plasma membrane and the underlying cytoskeleton are known to occur. Efficiency of targeting is dependent on repeat number, indicating that novel targeting modules could evolve by expansion of short lysine-rich sequences. Indeed, analysis of fragments of GARP from different species shows that two novel targeting sequences have arisen via the process of repeat expansion in this protein. In the protein Hyp12, the targeting function of a lysine-rich sequence is masked by a neighboring repetitive acidic sequence, further highlighting the importance of repetitive low complexity sequences. We show that sequences capable of targeting the erythrocyte periphery are present in at least nine proteins from Plasmodium falciparum and one from Plasmodium knowlesi. We find these sequences in proteins known to be involved in erythrocyte rigidification and cytoadhesion as well as in previously uncharacterized exported proteins. Together, these data suggest that expansion and contraction of lysine-rich repeats could generate targeting sequences de novo as well as modulate protein targeting efficiency and function in response to selective pressure.
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Affiliation(s)
- Heledd M Davies
- From the Institute of Structural and Molecular Biology, Department of Biological Sciences, Birkbeck and University College London, London WC1E 6BT, United Kingdom
| | - Konstantinos Thalassinos
- From the Institute of Structural and Molecular Biology, Department of Biological Sciences, Birkbeck and University College London, London WC1E 6BT, United Kingdom
| | - Andrew R Osborne
- From the Institute of Structural and Molecular Biology, Department of Biological Sciences, Birkbeck and University College London, London WC1E 6BT, United Kingdom
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82
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Plasmodium falciparum proteins involved in cytoadherence of infected erythrocytes to chemokine CX3CL1. Sci Rep 2016; 6:33786. [PMID: 27653778 PMCID: PMC5031962 DOI: 10.1038/srep33786] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 09/02/2016] [Indexed: 12/19/2022] Open
Abstract
Malaria caused by Plasmodium falciparum is associated with cytoadherence of infected red blood cells (iRBC) to endothelial cells. Numerous host molecules have been involved in cytoadherence, including the adhesive chemokine CX3CL1. Most of the identified parasite ligands are from the multigenic and hypervariable Plasmodium falciparum Erythrocyte Membrane Protein 1 (PfEMP1) family which makes them poor targets for the development of a broadly protective vaccine. Using proteomics, we have identified two 25-kDa parasite proteins with adhesive properties for CX3CL1, called CBP for CX3CL1 Binding Proteins. CBPs are coded by single-copy genes with little polymorphic variation and no homology with other P. falciparum gene products. Specific antibodies raised against epitopes from the predicted extracellular domains of each CBP efficiently stain the surface of RBC infected with trophozoites or schizonts, which is a strong indication of CBP expression at the surface of iRBC. These anti-CBP antibodies partially neutralize iRBC adherence to CX3CL1. This adherence is similarly inhibited in the presence of peptides from the CBP extracellular domains, while irrelevant peptides had no such effect. CBP1 and CBP2 are new P. falciparum ligands for the human chemokine CX3CL1. The identification of this non-polymorphic P. falciparum factors provides a new avenue for innovative vaccination approaches.
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83
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Gallego-Delgado J, Basu-Roy U, Ty M, Alique M, Fernandez-Arias C, Movila A, Gomes P, Weinstock A, Xu W, Edagha I, Wassmer SC, Walther T, Ruiz-Ortega M, Rodriguez A. Angiotensin receptors and β-catenin regulate brain endothelial integrity in malaria. J Clin Invest 2016; 126:4016-4029. [PMID: 27643439 DOI: 10.1172/jci87306] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 07/12/2016] [Indexed: 12/17/2022] Open
Abstract
Cerebral malaria is characterized by cytoadhesion of Plasmodium falciparum-infected red blood cells (Pf-iRBCs) to endothelial cells in the brain, disruption of the blood-brain barrier, and cerebral microhemorrhages. No available antimalarial drugs specifically target the endothelial disruptions underlying this complication, which is responsible for the majority of malaria-associated deaths. Here, we have demonstrated that ruptured Pf-iRBCs induce activation of β-catenin, leading to disruption of inter-endothelial cell junctions in human brain microvascular endothelial cells (HBMECs). Inhibition of β-catenin-induced TCF/LEF transcription in the nucleus of HBMECs prevented the disruption of endothelial junctions, confirming that β-catenin is a key mediator of P. falciparum adverse effects on endothelial integrity. Blockade of the angiotensin II type 1 receptor (AT1) or stimulation of the type 2 receptor (AT2) abrogated Pf-iRBC-induced activation of β-catenin and prevented the disruption of HBMEC monolayers. In a mouse model of cerebral malaria, modulation of angiotensin II receptors produced similar effects, leading to protection against cerebral malaria, reduced cerebral hemorrhages, and increased survival. In contrast, AT2-deficient mice were more susceptible to cerebral malaria. The interrelation of the β-catenin and the angiotensin II signaling pathways opens immediate host-targeted therapeutic possibilities for cerebral malaria and other diseases in which brain endothelial integrity is compromised.
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MESH Headings
- Active Transport, Cell Nucleus
- Antimalarials/pharmacology
- Biphenyl Compounds/pharmacology
- Brain/blood supply
- Brain/parasitology
- Capillary Permeability
- Cell Adhesion
- Cells, Cultured
- Endothelial Cells/parasitology
- Endothelial Cells/physiology
- Endothelium, Vascular/parasitology
- Endothelium, Vascular/pathology
- Humans
- Intercellular Junctions/metabolism
- Irbesartan
- Malaria, Cerebral/metabolism
- Malaria, Cerebral/parasitology
- Malaria, Cerebral/pathology
- Malaria, Falciparum/metabolism
- Malaria, Falciparum/parasitology
- Malaria, Falciparum/pathology
- Microvessels/pathology
- Plasmodium falciparum
- Receptor, Angiotensin, Type 2/metabolism
- Tetrazoles/pharmacology
- beta Catenin/physiology
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84
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Hyalournan Role in Pathophysiology of Different Species of Plasmodium. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2016. [DOI: 10.1097/ipc.0000000000000412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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85
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Plasmodium Helical Interspersed Subtelomeric (PHIST) Proteins, at the Center of Host Cell Remodeling. Microbiol Mol Biol Rev 2016; 80:905-27. [PMID: 27582258 DOI: 10.1128/mmbr.00014-16] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
During the asexual cycle, Plasmodium falciparum extensively remodels the human erythrocyte to make it a suitable host cell. A large number of exported proteins facilitate this remodeling process, which causes erythrocytes to become more rigid, cytoadherent, and permeable for nutrients and metabolic products. Among the exported proteins, a family of 89 proteins, called the Plasmodium helical interspersed subtelomeric (PHIST) protein family, has been identified. While also found in other Plasmodium species, the PHIST family is greatly expanded in P. falciparum. Although a decade has passed since their first description, to date, most PHIST proteins remain uncharacterized and are of unknown function and localization within the host cell, and there are few data on their interactions with other host or parasite proteins. However, over the past few years, PHIST proteins have been mentioned in the literature at an increasing rate owing to their presence at various localizations within the infected erythrocyte. Expression of PHIST proteins has been implicated in molecular and cellular processes such as the surface display of PfEMP1, gametocytogenesis, changes in cell rigidity, and also cerebral and pregnancy-associated malaria. Thus, we conclude that PHIST proteins are central to host cell remodeling, but despite their obvious importance in pathology, PHIST proteins seem to be understudied. Here we review current knowledge, shed light on the definition of PHIST proteins, and discuss these proteins with respect to their localization and probable function. We take into consideration interaction studies, microarray analyses, or data from blood samples from naturally infected patients to combine all available information on this protein family.
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86
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Jespersen JS, Wang CW, Mkumbaye SI, Minja DT, Petersen B, Turner L, Petersen JE, Lusingu JP, Theander TG, Lavstsen T. Plasmodium falciparum var genes expressed in children with severe malaria encode CIDRα1 domains. EMBO Mol Med 2016; 8:839-50. [PMID: 27354391 PMCID: PMC4967939 DOI: 10.15252/emmm.201606188] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Most severe Plasmodium falciparum infections are experienced by young children. Severe symptoms are precipitated by vascular sequestration of parasites expressing a particular subset of the polymorphic P. falciparum erythrocyte membrane protein 1 (PfEMP1) adhesion molecules. Parasites binding human endothelial protein C receptor (EPCR) through the CIDRα1 domain of certain PfEMP1 were recently associated with severe malaria in children. However, it has remained unclear to which extend the EPCR‐binding CIDRα1 domains epitomize PfEMP1 expressed in severe malaria. Here, we characterized the near full‐length transcripts dominating the var transcriptome in children with severe malaria and found that the only common feature of the encoded PfEMP1 was CIDRα1 domains. Such genes were highly and dominantly expressed in both children with severe malarial anaemia and cerebral malaria. These observations support the hypothesis that the CIDRα1‐EPCR interaction is key to the pathogenesis of severe malaria and strengthen the rationale for pursuing a vaccine or adjunctive treatment aiming at inhibiting or reducing the damaging effects of this interaction.
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Affiliation(s)
- Jakob S Jespersen
- Centre for Medical Parasitology, Department of Immunology & Microbiology, University of Copenhagen, Copenhagen, Denmark Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Christian W Wang
- Centre for Medical Parasitology, Department of Immunology & Microbiology, University of Copenhagen, Copenhagen, Denmark Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Sixbert I Mkumbaye
- Kilimanjaro Christian Medical University College, Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Daniel Tr Minja
- National Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania
| | - Bent Petersen
- Centre for Biological Sequence Analysis, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Louise Turner
- Centre for Medical Parasitology, Department of Immunology & Microbiology, University of Copenhagen, Copenhagen, Denmark Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Jens Ev Petersen
- Centre for Medical Parasitology, Department of Immunology & Microbiology, University of Copenhagen, Copenhagen, Denmark Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - John Pa Lusingu
- Centre for Medical Parasitology, Department of Immunology & Microbiology, University of Copenhagen, Copenhagen, Denmark Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark National Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania
| | - Thor G Theander
- Centre for Medical Parasitology, Department of Immunology & Microbiology, University of Copenhagen, Copenhagen, Denmark Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Thomas Lavstsen
- Centre for Medical Parasitology, Department of Immunology & Microbiology, University of Copenhagen, Copenhagen, Denmark Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
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87
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Interaction between Endothelial Protein C Receptor and Intercellular Adhesion Molecule 1 to Mediate Binding of Plasmodium falciparum-Infected Erythrocytes to Endothelial Cells. mBio 2016; 7:mBio.00615-16. [PMID: 27406562 PMCID: PMC4958245 DOI: 10.1128/mbio.00615-16] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Intercellular adhesion molecule 1 (ICAM-1) and the endothelial protein C receptor (EPCR) are candidate receptors for the deadly complication cerebral malaria. However, it remains unclear if Plasmodium falciparum parasites with dual binding specificity are involved in cytoadhesion or different parasite subpopulations bind in brain microvessels. Here, we investigated this issue by studying different subtypes of ICAM-1-binding parasite lines. We show that two parasite lines expressing domain cassette 13 (DC13) of the P. falciparum erythrocyte membrane protein 1 (PfEMP1) family have dual binding specificity for EPCR and ICAM-1 and further mapped ICAM-1 binding to the first DBLβ domain following the PfEMP1 head structure in both proteins. As PfEMP1 head structures have diverged between group A (EPCR binders) and groups B and C (CD36 binders), we also investigated how ICAM-1-binding parasites with different coreceptor binding traits influence P. falciparum-infected erythrocyte binding to endothelial cells. Whereas levels of binding to tumor necrosis factor alpha (TNF-α)-stimulated endothelial cells from the lung and brain by all ICAM-1-binding parasite lines increased, group A (EPCR and ICAM-1) was less dependent than group B (CD36 and ICAM-1) on ICAM-1 upregulation. Furthermore, both group A DC13 parasite lines had higher binding levels to brain endothelial cells (a microvascular niche with limited CD36 expression). This study shows that ICAM-1 is a coreceptor for a subset of EPCR-binding parasites and provides the first evidence of how EPCR and ICAM-1 interact to mediate parasite binding to both resting and TNF-α-activated primary brain and lung endothelial cells. Cerebral malaria is a severe neurological complication of P. falciparum infection associated with infected erythrocyte (IE) binding in cerebral vessels. Yet little is known about the mechanisms by which parasites adhere in the brain or other microvascular sites. Here, we studied parasite lines expressing group A DC13-containing PfEMP1 variants, a subset that has previously been shown to have high brain cell- and other endothelial cell-binding activities. We show that DC13-containing PfEMP1 variants have dual EPCR- and ICAM-1-binding activities and that both receptors are involved in parasite adherence to lung and brain endothelial cells. As both EPCR and ICAM-1 are implicated in cerebral malaria, these findings suggest the possibility that parasites with dual binding activities are involved in parasite sequestration to microvascular beds with low CD36 expression, such as the brain, and we urge more research into the multiadhesive properties of PfEMP1 variants.
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88
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The endothelial protein C receptor rs867186-GG genotype is associated with increased soluble EPCR and could mediate protection against severe malaria. Sci Rep 2016; 6:27084. [PMID: 27255786 PMCID: PMC4891778 DOI: 10.1038/srep27084] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 04/29/2016] [Indexed: 11/23/2022] Open
Abstract
The endothelial protein C receptor (EPCR) appears to play an important role in Plasmodium falciparum endothelial cell binding in severe malaria (SM). Despite consistent findings of elevated soluble EPCR (sEPCR) in other infectious diseases, field studies to date have provided conflicting data about the role of EPCR in SM. To better define this role, we performed genotyping for the rs867186-G variant, associated with increased sEPCR levels, and measured sEPCR levels in two prospective studies of Ugandan children designed to understand immunologic and genetic factors associated with neurocognitive deficits in SM including 551 SM children, 71 uncomplicated malaria (UM) and 172 healthy community children (CC). The rs867186-GG genotype was more frequent in CC (4.1%) than SM (0.6%, P = 0.002). The rs867186-G variant was associated with increased sEPCR levels and sEPCR was lower in children with SM than CC (P < 0.001). Among SM children, those who had a second SM episode showed a trend toward lower plasma sEPCR both at initial admission and at 6-month follow-up compared to those without repeated SM (P = 0.06 for both). The study findings support a role for sEPCR in severe malaria pathogenesis and emphasize a distinct role of sEPCR in malaria as compared to other infectious diseases.
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89
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Bertin GI, Sabbagh A, Argy N, Salnot V, Ezinmegnon S, Agbota G, Ladipo Y, Alao JM, Sagbo G, Guillonneau F, Deloron P. Proteomic analysis of Plasmodium falciparum parasites from patients with cerebral and uncomplicated malaria. Sci Rep 2016; 6:26773. [PMID: 27245217 PMCID: PMC4887788 DOI: 10.1038/srep26773] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 05/05/2016] [Indexed: 01/31/2023] Open
Abstract
Plasmodium falciparum is responsible of severe malaria, including cerebral malaria (CM). During its intra-erythrocytic maturation, parasite-derived proteins are expressed, exported and presented at the infected erythrocyte membrane. To identify new CM-specific parasite membrane proteins, we conducted a mass spectrometry-based proteomic study and compared the protein expression profiles between 9 CM and 10 uncomplicated malaria (UM) samples. Among the 1097 Plasmodium proteins identified, we focused on the 499 membrane-associated and hypothetical proteins for comparative analysis. Filter-based feature selection methods combined with supervised data analysis identified a subset of 29 proteins distinguishing CM and UM samples with high classification accuracy. A hierarchical clustering analysis of these 29 proteins based on the similarity of their expression profiles revealed two clusters of 15 and 14 proteins, respectively under- and over-expressed in CM. Among the over-expressed proteins, the MESA protein is expressed at the erythrocyte membrane, involved in proteins trafficking and in the export of variant surface antigens (VSAs), but without antigenic function. Antigen 332 protein is exported at the erythrocyte, also involved in protein trafficking and in VSAs export, and exposed to the immune system. Our proteomics data demonstrate an association of selected proteins in the pathophysiology of CM.
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Affiliation(s)
- Gwladys I Bertin
- Institut de Recherche pour le Développement (IRD), UMR216 - MERIT, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie de Paris, Paris Descartes University, Paris 75006, France
| | - Audrey Sabbagh
- Institut de Recherche pour le Développement (IRD), UMR216 - MERIT, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie de Paris, Paris Descartes University, Paris 75006, France
| | - Nicolas Argy
- Institut de Recherche pour le Développement (IRD), UMR216 - MERIT, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie de Paris, Paris Descartes University, Paris 75006, France.,Parasitology laboratory, Bichat-Claude Bernard hospital, Paris 75018, France.,French national reference center of malaria laboratory, Bichat-Claude Bernard hospital, Paris 75018, France
| | - Virginie Salnot
- COMUE Sorbonne Paris Cité, Faculté de Pharmacie de Paris, Paris Descartes University, Paris 75006, France.,3P5 Proteomics facility, Université Paris Descartes, Paris, France
| | - Sem Ezinmegnon
- Centre d'Étude et de Recherche sur le Paludisme Associé à la Grossesse et l'Enfance (CERPAGE), Cotonou, Benin
| | - Gino Agbota
- Institut de Recherche pour le Développement (IRD), UMR216 - MERIT, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie de Paris, Paris Descartes University, Paris 75006, France.,Centre d'Étude et de Recherche sur le Paludisme Associé à la Grossesse et l'Enfance (CERPAGE), Cotonou, Benin
| | - Yélé Ladipo
- Paediatric Department, Mother and child hospital (HOMEL), Cotonou, Benin
| | - Jules M Alao
- Paediatric Department, Mother and child hospital (HOMEL), Cotonou, Benin
| | - Gratien Sagbo
- Paediatric Department, Centre National Hospitalo-Universitaire (CNHU), Cotonou, Benin
| | - François Guillonneau
- COMUE Sorbonne Paris Cité, Faculté de Pharmacie de Paris, Paris Descartes University, Paris 75006, France.,3P5 Proteomics facility, Université Paris Descartes, Paris, France
| | - Philippe Deloron
- Institut de Recherche pour le Développement (IRD), UMR216 - MERIT, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie de Paris, Paris Descartes University, Paris 75006, France
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90
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Duffy MF, Noviyanti R, Tsuboi T, Feng ZP, Trianty L, Sebayang BF, Takashima E, Sumardy F, Lampah DA, Turner L, Lavstsen T, Fowkes FJI, Siba P, Rogerson SJ, Theander TG, Marfurt J, Price RN, Anstey NM, Brown GV, Papenfuss AT. Differences in PfEMP1s recognized by antibodies from patients with uncomplicated or severe malaria. Malar J 2016; 15:258. [PMID: 27149991 PMCID: PMC4858840 DOI: 10.1186/s12936-016-1296-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 04/15/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) variants are encoded by var genes and mediate pathogenic cytoadhesion and antigenic variation in malaria. PfEMP1s can be broadly divided into three principal groups (A, B and C) and they contain conserved arrangements of functional domains called domain cassettes. Despite their tremendous diversity there is compelling evidence that a restricted subset of PfEMP1s is expressed in severe disease. In this study antibodies from patients with severe and uncomplicated malaria were compared for differences in reactivity with a range of PfEMP1s to determine whether antibodies to particular PfEMP1 domains were associated with severe or uncomplicated malaria. METHODS Parts of expressed var genes in a severe malaria patient were identified by RNAseq and several of these partial PfEMP1 domains were expressed together with others from laboratory isolates. Antibodies from Papuan patients to these parts of multiple PfEMP1 proteins were measured. RESULTS Patients with uncomplicated malaria were more likely to have antibodies that recognized PfEMP1 of Group C type and recognized a broader repertoire of group A and B PfEMP1s than patients with severe malaria. CONCLUSION These data suggest that exposure to a broad range of group A and B PfEMP1s is associated with protection from severe disease in Papua, Indonesia.
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Affiliation(s)
- Michael F. Duffy
- />Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria Australia
| | - Rintis Noviyanti
- />The Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Takafumi Tsuboi
- />Division of Malaria Research, Proteo-Science Center, Ehime University, Matsuyama, Ehime Japan
| | - Zhi-Ping Feng
- />Bioinformatics Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- />Department of Medical Biology, University of Melbourne, Parkville, Victoria Australia
| | - Leily Trianty
- />The Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Boni F. Sebayang
- />The Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Eizo Takashima
- />Division of Malaria Research, Proteo-Science Center, Ehime University, Matsuyama, Ehime Japan
| | - Fransisca Sumardy
- />Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria Australia
| | - Daniel A. Lampah
- />Timika Malaria Research Program, Papuan Health and Community Development Foundation, Timika, Papua Indonesia
| | - Louise Turner
- />Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Lavstsen
- />Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark
| | | | - Peter Siba
- />The Papua New Guinea Institute for Medical Research, Madang, Papua New Guinea
| | - Stephen J. Rogerson
- />Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria Australia
| | - Thor G. Theander
- />Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark
| | - Jutta Marfurt
- />Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT Australia
| | - Ric N. Price
- />Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT Australia
- />Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Nicholas M. Anstey
- />Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT Australia
| | - Graham V. Brown
- />The Nossal Institute for Global Health, The University of Melbourne, Parkville, Victoria Australia
| | - Anthony T. Papenfuss
- />Bioinformatics Division, The Walter & Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- />Department of Medical Biology, University of Melbourne, Parkville, Victoria Australia
- />Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
- />Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria Australia
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91
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Oberli A, Zurbrügg L, Rusch S, Brand F, Butler ME, Day JL, Cutts EE, Lavstsen T, Vakonakis I, Beck HP. Plasmodium falciparum Plasmodium helical interspersed subtelomeric proteins contribute to cytoadherence and anchor P. falciparum erythrocyte membrane protein 1 to the host cell cytoskeleton. Cell Microbiol 2016; 18:1415-28. [PMID: 26916885 PMCID: PMC5103180 DOI: 10.1111/cmi.12583] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 02/15/2016] [Accepted: 02/21/2016] [Indexed: 01/12/2023]
Abstract
Adherence of Plasmodium falciparum‐infected erythrocytes to host endothelium is conferred through the parasite‐derived virulence factor P. falciparum erythrocyte membrane protein 1 (PfEMP1), the major contributor to malaria severity. PfEMP1 located at knob structures on the erythrocyte surface is anchored to the cytoskeleton, and the Plasmodium helical interspersed subtelomeric (PHIST) gene family plays a role in many host cell modifications including binding the intracellular domain of PfEMP1. Here, we show that conditional reduction of the PHIST protein PFE1605w strongly reduces adhesion of infected erythrocytes to the endothelial receptor CD36. Adhesion to other endothelial receptors was less affected or even unaltered by PFE1605w depletion, suggesting that PHIST proteins might be optimized for subsets of PfEMP1 variants. PFE1605w does not play a role in PfEMP1 transport, but it directly interacts with both the intracellular segment of PfEMP1 and with cytoskeletal components. This is the first report of a PHIST protein interacting with key molecules of the cytoadherence complex and the host cytoskeleton, and this functional role seems to play an essential role in the pathology of P. falciparum.
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Affiliation(s)
- Alexander Oberli
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Laura Zurbrügg
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Sebastian Rusch
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Françoise Brand
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | - Jemma L Day
- Department of Biochemistry, University of Oxford, Oxford, UK
| | - Erin E Cutts
- Department of Biochemistry, University of Oxford, Oxford, UK
| | - Thomas Lavstsen
- Centre for Medical Parasitology, Department of International Health, Immunology, and Microbiology, University of Copenhagen, Copenhagen, Denmark.,Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | | | - Hans-Peter Beck
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
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92
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Soni R, Sharma D, Bhatt TK. Plasmodium falciparum Secretome in Erythrocyte and Beyond. Front Microbiol 2016; 7:194. [PMID: 26925057 PMCID: PMC4759260 DOI: 10.3389/fmicb.2016.00194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 02/05/2016] [Indexed: 01/19/2023] Open
Abstract
Plasmodium falciparum is the causative agent of deadly malaria disease. It is an intracellular eukaryote and completes its multi-stage life cycle spanning the two hosts viz, mosquito and human. In order to habituate within host environment, parasite conform several strategies to evade host immune responses such as surface antigen polymorphism or modulation of host immune system and it is mediated by secretion of proteins from parasite to the host erythrocyte and beyond, collectively known as, malaria secretome. In this review, we will discuss about the deployment of parasitic secretory protein in mechanism implicated for immune evasion, protein trafficking, providing virulence, changing permeability and cyto-adherence of infected erythrocyte. We will be covering the possibilities of developing malaria secretome as a drug/vaccine target. This gathered information will be worthwhile in depicting a well-organized picture for host-pathogen interplay during the malaria infection and may also provide some clues for the development of novel anti-malarial therapies.
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Affiliation(s)
- Rani Soni
- Department of Biotechnology, School of Life Sciences, Central University of Rajasthan Rajasthan, India
| | - Drista Sharma
- Department of Biotechnology, School of Life Sciences, Central University of Rajasthan Rajasthan, India
| | - Tarun K Bhatt
- Department of Biotechnology, School of Life Sciences, Central University of Rajasthan Rajasthan, India
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93
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Recombination and Diversification of the Variant Antigen Encoding Genes in the Malaria Parasite Plasmodium falciparum. Microbiol Spectr 2016; 2. [PMID: 26104446 DOI: 10.1128/microbiolspec.mdna3-0022-2014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The most severe form of human malaria is caused by the protozoan parasite Plasmodium falciparum. These parasites invade and replicate within the circulating red blood cells of infected individuals leading to numerous disease manifestations, including severe anemia, altered circulation, and tissue inflammation. Malaria parasites are also known for their ability to maintain a chronic infection through antigenic variation, the ability to systematically alter the antigens displayed on the surface of infected cells and thereby avoid clearance by the host's antibody response. The genome of P. falciparum includes several large, multicopy gene families that encode highly variable forms of the surface proteins that are the targets of host immunity. Alterations in expression of genes within these families are responsible for antigenic variation. This process requires the continuous generation of new antigenic variants within these gene families, and studies have shown that new variants arise through extensive recombination and gene conversion events between family members. Malaria parasites possess an unusual complement of DNA repair pathways, thus the study of recombination between variant antigen encoding genes provides a unique view into the evolution of mobile DNA in an organism distantly related to the more closely studied model eukaryotes.
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94
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Judice CC, Bourgard C, Kayano ACAV, Albrecht L, Costa FTM. MicroRNAs in the Host-Apicomplexan Parasites Interactions: A Review of Immunopathological Aspects. Front Cell Infect Microbiol 2016; 6:5. [PMID: 26870701 PMCID: PMC4735398 DOI: 10.3389/fcimb.2016.00005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 01/13/2016] [Indexed: 01/08/2023] Open
Abstract
MicroRNAs (miRNAs), a class of small non-coding regulatory RNAs, have been detected in a variety of organisms ranging from ancient unicellular eukaryotes to mammals. They have been associated with numerous molecular mechanisms involving developmental, physiological and pathological changes of cells and tissues. Despite the fact that miRNA-silencing mechanisms appear to be absent in some Apicomplexan species, an increasing number of studies have reported a role for miRNAs in host-parasite interactions. Host miRNA expression can change following parasite infection and the consequences can lead, for instance, to parasite clearance. In this context, the immune system signaling appears to have a crucial role.
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Affiliation(s)
- Carla C Judice
- Laboratory of Tropical Diseases, Department of Genetics, Evolution and Bioagents, University of Campinas UNICAMP, Campinas, Brazil
| | - Catarina Bourgard
- Laboratory of Tropical Diseases, Department of Genetics, Evolution and Bioagents, University of Campinas UNICAMP, Campinas, Brazil
| | - Ana C A V Kayano
- Laboratory of Tropical Diseases, Department of Genetics, Evolution and Bioagents, University of Campinas UNICAMP, Campinas, Brazil
| | | | - Fabio T M Costa
- Laboratory of Tropical Diseases, Department of Genetics, Evolution and Bioagents, University of Campinas UNICAMP, Campinas, Brazil
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95
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Langhorne J, Duffy PE. Expanding the antimalarial toolkit: Targeting host-parasite interactions. J Exp Med 2016; 213:143-53. [PMID: 26834158 PMCID: PMC4749928 DOI: 10.1084/jem.20151677] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 12/21/2015] [Indexed: 12/27/2022] Open
Abstract
Recent successes in malaria control are threatened by drug-resistant Plasmodium parasites and insecticide-resistant Anopheles mosquitoes, and first generation vaccines offer only partial protection. New research approaches have highlighted host as well as parasite molecules or pathways that could be targeted for interventions. In this study, we discuss host–parasite interactions at the different stages of the Plasmodium life cycle within the mammalian host and the potential for therapeutics that prevent parasite migration, invasion, intracellular growth, or egress from host cells, as well as parasite-induced pathology.
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Affiliation(s)
- Jean Langhorne
- Mill Hill Laboratory, The Francis Crick Institute, London NW7 1AA, England, UK
| | - Patrick E Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20852
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96
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Panackal AA, Williamson KC, van de Beek D, Boulware DR, Williamson PR. Fighting the Monster: Applying the Host Damage Framework to Human Central Nervous System Infections. mBio 2016; 7:e01906-15. [PMID: 26814182 PMCID: PMC4742705 DOI: 10.1128/mbio.01906-15] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The host damage-response framework states that microbial pathogenesis is a product of microbial virulence factors and collateral damage from host immune responses. Immune-mediated host damage is particularly important within the size-restricted central nervous system (CNS), where immune responses may exacerbate cerebral edema and neurological damage, leading to coma and death. In this review, we compare human host and therapeutic responses in representative nonviral generalized CNS infections that induce archetypal host damage responses: cryptococcal menigoencephalitis and tuberculous meningitis in HIV-infected and non-HIV-infected patients, pneumococcal meningitis, and cerebral malaria. Consideration of the underlying patterns of host responses provides critical insights into host damage and may suggest tailored adjunctive therapeutics to improve disease outcome.
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Affiliation(s)
- Anil A Panackal
- Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Kim C Williamson
- Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Diederik van de Beek
- Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - David R Boulware
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Peter R Williamson
- Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
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97
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Abstract
The Plasmodium falciparum erythrocyte membrane protein 1 antigens that are inserted onto the surface of P. falciparum infected erythrocytes play a key role both in the pathology of severe malaria and as targets of naturally acquired immunity. They might be considered unlikely vaccine targets because they are extremely diverse. However, several lines of evidence suggest that underneath this molecular diversity there are a restricted set of epitopes which may act as effective targets for a vaccine against severe malaria. Here we review some of the recent developments in this area of research, focusing on work that has assessed the potential of these molecules as possible vaccine targets.
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98
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Differential Plasmodium falciparum surface antigen expression among children with Malarial Retinopathy. Sci Rep 2015; 5:18034. [PMID: 26657042 PMCID: PMC4677286 DOI: 10.1038/srep18034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 11/10/2015] [Indexed: 11/08/2022] Open
Abstract
Retinopathy provides a window into the underlying pathology of life-threatening malarial coma ("cerebral malaria"), allowing differentiation between 1) coma caused by sequestration of Plasmodium falciparum-infected erythrocytes in the brain and 2) coma with other underlying causes. Parasite sequestration in the brain is mediated by PfEMP1; a diverse parasite antigen that is inserted into the surface of infected erythrocytes and adheres to various host receptors. PfEMP1 sub-groups called "DC8" and "DC13" have been proposed to cause brain pathology through interactions with endothelial protein C receptor. To test this we profiled PfEMP1 gene expression in parasites from children with clinically defined cerebral malaria, who either had or did not have accompanying retinopathy. We found no evidence for an elevation of DC8 or DC13 PfEMP1 expression in children with retinopathy. However, the proportional expression of a broad subgroup of PfEMP1 called "group A" was elevated in retinopathy patients suggesting that these variants may play a role in the pathology of cerebral malaria. Interventions targeting group A PfEMP1 may be effective at reducing brain pathology.
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99
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Deroost K, Pham TT, Opdenakker G, Van den Steen PE. The immunological balance between host and parasite in malaria. FEMS Microbiol Rev 2015; 40:208-57. [PMID: 26657789 DOI: 10.1093/femsre/fuv046] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2015] [Indexed: 12/16/2022] Open
Abstract
Coevolution of humans and malaria parasites has generated an intricate balance between the immune system of the host and virulence factors of the parasite, equilibrating maximal parasite transmission with limited host damage. Focusing on the blood stage of the disease, we discuss how the balance between anti-parasite immunity versus immunomodulatory and evasion mechanisms of the parasite may result in parasite clearance or chronic infection without major symptoms, whereas imbalances characterized by excessive parasite growth, exaggerated immune reactions or a combination of both cause severe pathology and death, which is detrimental for both parasite and host. A thorough understanding of the immunological balance of malaria and its relation to other physiological balances in the body is of crucial importance for developing effective interventions to reduce malaria-related morbidity and to diminish fatal outcomes due to severe complications. Therefore, we discuss in this review the detailed mechanisms of anti-malarial immunity, parasite virulence factors including immune evasion mechanisms and pathogenesis. Furthermore, we propose a comprehensive classification of malaria complications according to the different types of imbalances.
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Affiliation(s)
- Katrien Deroost
- Laboratory of Immunobiology, Rega Institute for Medical Research, KU Leuven - University of Leuven, 3000 Leuven, Belgium The Francis Crick Institute, Mill Hill Laboratory, London, NW71AA, UK
| | - Thao-Thy Pham
- Laboratory of Immunobiology, Rega Institute for Medical Research, KU Leuven - University of Leuven, 3000 Leuven, Belgium
| | - Ghislain Opdenakker
- Laboratory of Immunobiology, Rega Institute for Medical Research, KU Leuven - University of Leuven, 3000 Leuven, Belgium
| | - Philippe E Van den Steen
- Laboratory of Immunobiology, Rega Institute for Medical Research, KU Leuven - University of Leuven, 3000 Leuven, Belgium
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Nunes-Silva S, Dechavanne S, Moussiliou A, Pstrąg N, Semblat JP, Gangnard S, Tuikue-Ndam N, Deloron P, Chêne A, Gamain B. Beninese children with cerebral malaria do not develop humoral immunity against the IT4-VAR19-DC8 PfEMP1 variant linked to EPCR and brain endothelial binding. Malar J 2015; 14:493. [PMID: 26646943 PMCID: PMC4672576 DOI: 10.1186/s12936-015-1008-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 11/21/2015] [Indexed: 11/16/2022] Open
Abstract
Background Malaria is still one of the most prevalent infectious diseases in the world. Sequestration of infected erythrocytes (IEs) is the prime mediator of disease. Cytoadhesion of IEs is mediated by members of the highly diverse Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1). A restricted sub-set of var genes encoding for PfEMP1s possessing the domain cassettes DC8 and DC13 were found to bind to the endothelial protein C receptor (EPCR). These var genes were shown to be highly expressed by parasites from patients with severe malaria clinical outcomes compared to those from patients with uncomplicated symptoms. Methods In order to further study the molecular mechanisms underlying DC8/DC13 expressing IEs adhesion to EPCR, a method was developed to produce highly pure recombinant EPCR. The IT4 parasite strain was selected on either anti-IT4-VAR19 purified IgG, EPCR or human brain endothelial cell line and their var gene expression profiles as well as their binding phenotypes were compared. The N-terminal region of IT4-VAR19 comprising a full-length DC8 cassette as well as the single EPCR binding CIDRα1.1 domain were also produced, and their immune recognition (IgG) was assessed using plasma samples from Beninese children presenting acute mild malaria, severe malaria or cerebral malaria at the time of their admission to the clinic, and from convalescent-phase plasma collected 30 days after anti-malarial treatment. Results The multi-domain VAR19-NTS-DBLγ6 binds to EPCR with a greater affinity than the CIDRα1.1 domain alone and this study also demonstrates that VAR19-NTS-DBLγ6 binding to the EPCR-expressing endothelial cell line (HBEC5i) is more pronounced than that of the CIDRα1.1 domain alone. IT4-VAR19 represents the preferentially expressed-PfEMP1 when FCR3-IEs are selected based on their capability to bind EPCR. Notably, no significant difference in the levels of antibodies towards IT4-VAR19 antigens was observed within all clinical groups between plasma samples collected during the acute malaria phase compared to samples collected 30 days after anti-malaria treatment. Conclusions These data indicate that even being the preferentially selected IT4-EPCR-binding variant, the IT4-VAR19-DC8 region does not appear to be associated with the acquisition of antibodies during a single severe paediatric malaria episode in Benin. Electronic supplementary material The online version of this article (doi:10.1186/s12936-015-1008-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sofia Nunes-Silva
- Inserm UMR_1134, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, UMR_S1134, Paris, France. .,Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015, Paris, France. .,Laboratory of Excellence GR-Ex, Paris, France.
| | - Sébastien Dechavanne
- Inserm UMR_1134, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, UMR_S1134, Paris, France. .,Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015, Paris, France. .,Laboratory of Excellence GR-Ex, Paris, France.
| | - Azizath Moussiliou
- Laboratory of Excellence GR-Ex, Paris, France. .,Institut de Recherche pour le développement, UMR_216, Mère et enfant face aux infections tropicales, Paris, France. .,Faculté de pharmacie, PRES Sorbonne Paris Cité, Paris, France.
| | - Natalia Pstrąg
- Inserm UMR_1134, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, UMR_S1134, Paris, France. .,Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015, Paris, France. .,Laboratory of Excellence GR-Ex, Paris, France.
| | - Jean-Philippe Semblat
- Inserm UMR_1134, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, UMR_S1134, Paris, France. .,Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015, Paris, France. .,Laboratory of Excellence GR-Ex, Paris, France.
| | - Stéphane Gangnard
- Inserm UMR_1134, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, UMR_S1134, Paris, France. .,Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015, Paris, France. .,Laboratory of Excellence GR-Ex, Paris, France.
| | - Nicaise Tuikue-Ndam
- Laboratory of Excellence GR-Ex, Paris, France. .,Institut de Recherche pour le développement, UMR_216, Mère et enfant face aux infections tropicales, Paris, France. .,Faculté de pharmacie, PRES Sorbonne Paris Cité, Paris, France.
| | - Philippe Deloron
- Laboratory of Excellence GR-Ex, Paris, France. .,Institut de Recherche pour le développement, UMR_216, Mère et enfant face aux infections tropicales, Paris, France. .,Faculté de pharmacie, PRES Sorbonne Paris Cité, Paris, France.
| | - Arnaud Chêne
- Inserm UMR_1134, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, UMR_S1134, Paris, France. .,Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015, Paris, France. .,Laboratory of Excellence GR-Ex, Paris, France.
| | - Benoît Gamain
- Inserm UMR_1134, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, UMR_S1134, Paris, France. .,Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015, Paris, France. .,Laboratory of Excellence GR-Ex, Paris, France.
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