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Prah DA, Laryea-Akrong E. Asymptomatic Low-Density Plasmodium falciparum Infections: Parasites Under the Host's Immune Radar? J Infect Dis 2024; 229:1913-1918. [PMID: 38349649 PMCID: PMC11175676 DOI: 10.1093/infdis/jiad581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/18/2023] [Indexed: 06/15/2024] Open
Abstract
A large body of evidence suggests that low parasite carriage in Plasmodium falciparum asymptomatic infection is required for the maintenance of malaria immunity. However, the fact that treating such infections has little to no impact on subsequent clinical malaria is rarely noted. In this paper, we review data and argue that low-density parasite carriage in asymptomatic infection may not support host immune processes and that parasites are virtually under the host's immunological radar. We also discuss factors that may be constraining parasitemia in asymptomatic infections from reaching the threshold required to cause clinical symptoms. A thorough understanding of this infectious reservoir is essential for malaria control and eradication because asymptomatic infections contribute significantly to Plasmodium transmission.
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Affiliation(s)
- Diana Ahu Prah
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
- Faculty of Applied Sciences, Department of Science Laboratory Technology, Accra Technical University, Accra, Ghana
| | - Elizabeth Laryea-Akrong
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
- Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Legon, Ghana
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2
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Johnson AE, Upadhye A, Knight V, Gaskin EL, Turnbull LB, Ayuku D, Nyalumbe M, Abuonji E, John CC, McHenry MS, Tran TM, Ayodo G. Subclinical Inflammation in Asymptomatic Schoolchildren With Plasmodium falciparum Parasitemia Correlates With Impaired Cognition. J Pediatric Infect Dis Soc 2024; 13:288-296. [PMID: 38512283 DOI: 10.1093/jpids/piae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 03/19/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Subclinical inflammation and cognitive deficits have been separately associated with asymptomatic Plasmodium falciparum infections in schoolchildren. However, whether parasite-induced inflammation is associated with worse cognition has not been addressed. We conducted a cross-sectional pilot study to better assess the effect of asymptomatic P. falciparum parasitemia and inflammation on cognition in Kenyan schoolchildren. METHODS We enrolled 240 children aged 7-14 years residing in high malaria transmission in Western Kenya. Children performed five fluid cognition tests from a culturally adapted NIH toolbox and provided blood samples for blood smears and laboratory testing. Parasite densities and plasma concentrations of 14 cytokines were determined by quantitative PCR and multiplex immunoassay, respectively. Linear regression models were used to determine the effects of parasitemia and plasma cytokine concentrations on each of the cognitive scores as well as a composite cognitive score while controlling for age, gender, maternal education, and an interaction between age and P. falciparum infection status. RESULTS Plasma concentrations of TNF, IL-6, IL-8, and IL-10 negatively correlated with the composite score and at least one of the individual cognitive tests. Parasite density in parasitemic children negatively correlated with the composite score and measures of cognitive flexibility and attention. In the adjusted model, parasite density and TNF, but not P. falciparum infection status, independently predicted lower cognitive composite scores. By mediation analysis, TNF significantly mediated ~29% of the negative effect of parasitemia on cognition. CONCLUSIONS Among schoolchildren with PCR-confirmed asymptomatic P. falciparum infections, the negative effect of parasitemia on cognition could be mediated, in part, by subclinical inflammation. Additional studies are needed to validate our findings in settings of lower malaria transmission and address potential confounders that could affect both inflammation and cognitive performance.
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Affiliation(s)
- Alexander E Johnson
- Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Aditi Upadhye
- Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Veronicah Knight
- Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
| | - Erik L Gaskin
- Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lindsey B Turnbull
- Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - David Ayuku
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
- Department of Mental Health & Behavioral Sciences, Moi University School of Medicine, Eldoret, Kenya
| | - Mark Nyalumbe
- Department of Mental Health & Behavioral Sciences, Moi University School of Medicine, Eldoret, Kenya
| | - Emily Abuonji
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Chandy C John
- Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Megan S McHenry
- Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Tuan M Tran
- Division of Infectious Diseases, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - George Ayodo
- Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
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3
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Li J, Docile HJ, Fisher D, Pronyuk K, Zhao L. Current Status of Malaria Control and Elimination in Africa: Epidemiology, Diagnosis, Treatment, Progress and Challenges. J Epidemiol Glob Health 2024:10.1007/s44197-024-00228-2. [PMID: 38656731 DOI: 10.1007/s44197-024-00228-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024] Open
Abstract
The African continent carries the greatest malaria burden in the world. Falciparum malaria especially has long been the leading cause of death in Africa. Climate, economic factors, geographical location, human intervention and unstable security are factors influencing malaria transmission. Due to repeated infections and early interventions, the proportion of clinically atypical malaria or asymptomatic plasmodium carriers has increased significantly, which easily lead to misdiagnosis and missed diagnosis. African countries have made certain progress in malaria control and elimination, including rapid diagnosis of malaria, promotion of mosquito nets and insecticides, intermittent prophylactic treatment in high-risk groups, artemisinin based combination therapies, and the development of vaccines. Between 2000 and 2022, there has been a 40% decrease in malaria incidence and a 60% reduction in mortality rate in the WHO African Region. However, many challenges are emerging in the fight against malaria in Africa, such as climate change, poverty, substandard health services and coverage, increased outdoor transmission and the emergence of new vectors, and the growing threat of resistance to antimalarial drugs and insecticides. Joint prevention and treatment, identifying molecular determinants of resistance, new drug development, expanding seasonal malaria chemo-prevention intervention population, and promoting the vaccination of RTS, S/AS01 and R21/Matrix-M may help to solve the dilemma. China's experience in eliminating malaria is conducive to Africa's malaria prevention and control, and China-Africa cooperation needs to be constantly deepened and advanced. Our review aims to help the global public develop a comprehensive understanding of malaria in Africa, thereby contributing to malaria control and elimination.
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Affiliation(s)
- Jiahuan Li
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Haragakiza Jean Docile
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - David Fisher
- Department of Medical Biosciences, Faculty of Natural Sciences, University of The Western Cape, Cape Town, South Africa
| | - Khrystyna Pronyuk
- Department of Infectious Diseases, O. Bogomolets National Medical University, Kyiv, Ukraine
| | - Lei Zhao
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
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4
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Dunican C, Andradi-Brown C, Ebmeier S, Georgiadou A, Cunnington AJ. The malarial blood transcriptome: translational applications. Biochem Soc Trans 2024; 52:651-660. [PMID: 38421063 PMCID: PMC11088907 DOI: 10.1042/bst20230497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/02/2024]
Abstract
The blood transcriptome of malaria patients has been used extensively to elucidate the pathophysiological mechanisms and host immune responses to disease, identify candidate diagnostic and prognostic biomarkers, and reveal new therapeutic targets for drug discovery. This review gives a high-level overview of the three main translational applications of these studies (diagnostics, prognostics, and therapeutics) by summarising recent literature and outlining the main limitations and future directions of each application. It highlights the need for consistent and accurate definitions of disease states and subject groups and discusses how prognostic studies must distinguish clearly between analyses that attempt to predict future disease states and those which attempt to discriminate between current disease states (classification). Lastly it examines how many promising therapeutics fail due to the choice of imperfect animal models for pre-clinical testing and lack of appropriate validation studies in humans, and how future transcriptional studies may be utilised to overcome some of these limitations.
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Affiliation(s)
- Claire Dunican
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, U.K
- Centre for Paediatrics and Child Health, Imperial College London, London, U.K
| | - Clare Andradi-Brown
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, U.K
- Centre for Paediatrics and Child Health, Imperial College London, London, U.K
| | - Stefan Ebmeier
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, U.K
- Centre for Paediatrics and Child Health, Imperial College London, London, U.K
| | - Athina Georgiadou
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, U.K
- Centre for Paediatrics and Child Health, Imperial College London, London, U.K
| | - Aubrey J. Cunnington
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, U.K
- Centre for Paediatrics and Child Health, Imperial College London, London, U.K
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5
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Fontoura PS, Macedo EG, Calil PR, Corder RM, Rodrigues PT, Tonini J, Esquivel FD, Ladeia WA, Fernandes ARJ, Johansen IC, Silva MF, Fernandes AOS, Ladeia-Andrade S, Castro MC, Ferreira MU. Changing Clinical Epidemiology of Plasmodium vivax Malaria as Transmission Decreases: Population-Based Prospective Panel Survey in the Brazilian Amazon. J Infect Dis 2024; 229:947-958. [PMID: 38324758 PMCID: PMC11011196 DOI: 10.1093/infdis/jiad456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 10/16/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Malarial infections are often missed by microscopy, and most parasite carriers are asymptomatic in low-endemicity settings. Whether parasite detectability and its ability to elicit symptoms change as transmission declines remains unclear. METHODS We performed a prospective panel survey with repeated measurements on the same participants over 12 months to investigate whether Plasmodium vivax detectability by microscopy and risk of symptoms upon infection varied during a community-wide larviciding intervention in the Amazon basin of Brazil that markedly reduced vector density. We screened 1096 to 1400 residents in the intervention site for malaria by microscopy and quantitative TaqMan assays at baseline and twice during intervention. RESULTS We found that more P vivax infections than expected from their parasite densities measured by TaqMan assays were missed by microscopy as transmission decreased. At lower transmission, study participants appeared to tolerate higher P vivax loads without developing symptoms. We hypothesize that changes in the ratio between circulating parasites and those that accumulate in the bone marrow and spleen, by avoiding peripheral blood microscopy detection, account for decreased parasite detectability and lower risk of symptoms under low transmission. CONCLUSIONS P vivax infections are more likely to be subpatent and remain asymptomatic as malaria transmission decreases.
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Affiliation(s)
- Pablo S Fontoura
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo
- Secretary of Health Surveillance, Ministry of Health, Brasília, Brazil
| | - Evelyn G Macedo
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo
| | - Priscila R Calil
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo
| | - Rodrigo M Corder
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo
- Divisions of Epidemiology and Biostatistics, Berkeley School of Public Health, University of California
| | - Priscila T Rodrigues
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo
| | - Juliana Tonini
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo
| | - Fabiana D Esquivel
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo
| | - Winni A Ladeia
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo
| | | | - Igor C Johansen
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo
| | - Marcos F Silva
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo
| | - Amanda O S Fernandes
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo
| | | | - Marcia C Castro
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Marcelo U Ferreira
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, Nova University of Lisbon, Portugal
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6
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Florini F, Visone JE, Hadjimichael E, Malpotra S, Nötzel C, Kafsack BF, Deitsch KW. Transcriptional plasticity of virulence genes provides malaria parasites with greater adaptive capacity for avoiding host immunity. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.03.08.584127. [PMID: 38496509 PMCID: PMC10942408 DOI: 10.1101/2024.03.08.584127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Chronic, asymptomatic malaria infections contribute substantially to disease transmission and likely represent the most significant impediment preventing malaria elimination and eradication. Plasmodium falciparum parasites evade antibody recognition through transcriptional switching between members of the var gene family, which encodes the major virulence factor and surface antigen on infected red blood cells. This process can extend infections for up to a year; however, infections have been documented to last for over a decade, constituting an unseen reservoir of parasites that undermine eradication and control efforts. How parasites remain immunologically "invisible" for such lengthy periods is entirely unknown. Here we show that in addition to the accepted paradigm of mono-allelic var gene expression, individual parasites can simultaneously express multiple var genes or enter a state in which little or no var gene expression is detectable. This unappreciated flexibility provides parasites with greater adaptive capacity than previously understood and challenges the dogma of mutually exclusive var gene expression. It also provides an explanation for the antigenically "invisible" parasites observed in chronic asymptomatic infections.
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Affiliation(s)
| | | | - Evi Hadjimichael
- Department of Microbiology and Immunology, Weill Cornell Medical College, New York, New York, USA
| | - Shivali Malpotra
- Department of Microbiology and Immunology, Weill Cornell Medical College, New York, New York, USA
| | | | - Björn F.C. Kafsack
- Department of Microbiology and Immunology, Weill Cornell Medical College, New York, New York, USA
| | - Kirk W. Deitsch
- Department of Microbiology and Immunology, Weill Cornell Medical College, New York, New York, USA
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7
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Tebben K, Yirampo S, Coulibaly D, Koné AK, Laurens MB, Stucke EM, Dembélé A, Tolo Y, Traoré K, Niangaly A, Berry AA, Kouriba B, Plowe CV, Doumbo OK, Lyke KE, Takala-Harrison S, Thera MA, Travassos MA, Serre D. Gene expression analyses reveal differences in children's response to malaria according to their age. Nat Commun 2024; 15:2021. [PMID: 38448421 PMCID: PMC10918175 DOI: 10.1038/s41467-024-46416-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/26/2024] [Indexed: 03/08/2024] Open
Abstract
In Bandiagara, Mali, children experience on average two clinical malaria episodes per year. However, even in the same transmission area, the number of uncomplicated symptomatic infections, and their parasitemia, can vary dramatically among children. We simultaneously characterize host and parasite gene expression profiles from 136 Malian children with symptomatic falciparum malaria and examine differences in the relative proportion of immune cells and parasite stages, as well as in gene expression, associated with infection and or patient characteristics. Parasitemia explains much of the variation in host and parasite gene expression, and infections with higher parasitemia display proportionally more neutrophils and fewer T cells, suggesting parasitemia-dependent neutrophil recruitment and/or T cell extravasation to secondary lymphoid organs. The child's age also strongly correlates with variations in gene expression: Plasmodium falciparum genes associated with age suggest that older children carry more male gametocytes, while variations in host gene expression indicate a stronger innate response in younger children and stronger adaptive response in older children. These analyses highlight the variability in host responses and parasite regulation during P. falciparum symptomatic infections and emphasize the importance of considering the children's age when studying and treating malaria infections.
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Affiliation(s)
- Kieran Tebben
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Salif Yirampo
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Drissa Coulibaly
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Abdoulaye K Koné
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Matthew B Laurens
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Emily M Stucke
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ahmadou Dembélé
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Youssouf Tolo
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Karim Traoré
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Amadou Niangaly
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Andrea A Berry
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Bourema Kouriba
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Christopher V Plowe
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ogobara K Doumbo
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Kirsten E Lyke
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Shannon Takala-Harrison
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Mahamadou A Thera
- Malaria Research and Training Center, University of Sciences, Techniques and Technologies, Bamako, Mali
| | - Mark A Travassos
- Malaria Research Program, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - David Serre
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA.
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, USA.
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8
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Amwoma JG, Kituyi S, Wakoli DM, Ochora DO, Chemwor G, Maisiba R, Okore W, Opot B, Juma D, Muok EM, Garges EC, Egbo TE, Nyabuga FN, Andagalu B, Akala HM. Comparative analysis of peripheral whole blood transcriptome from asymptomatic carriers reveals upregulation of subsets of surface proteins implicated in Plasmodium falciparum phenotypic plasticity. Biochem Biophys Rep 2024; 37:101596. [PMID: 38146350 PMCID: PMC10749222 DOI: 10.1016/j.bbrep.2023.101596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/17/2023] [Accepted: 11/27/2023] [Indexed: 12/27/2023] Open
Abstract
The molecular mechanism underlying Plasmodium falciparum's persistence in the asymptomatic phase of infection remains largely unknown. However, large-scale shifts in the parasites' gene expression during asymptomatic infections may enhance phenotypic plasticity, maximizing their fitness and leading to the persistence of the asymptomatic infections. To uncover these mechanisms, we aimed to identify parasite genetic factors implicated in asymptomatic infections through whole transcriptome analysis. We analyzed publicly available transcriptome datasets containing asymptomatic malaria (ASM), uncomplicated malaria (SM), and malaria-naïve (NSM) samples from 35 subjects for differentially expressed genes (DEGs) and long noncoding RNAs. Our analysis identified 755 and 1773 DEGs in ASM vs SM and NSM, respectively. These DEGs revealed sets of genes coding for proteins of unknown functions (PUFs) upregulated in ASM vs SM and ASM, suggesting their role in underlying fundamental molecular mechanisms during asymptomatic infections. Upregulated genes in ASM vs SM revealed a subset of 24 clonal variant genes (CVGs) involved in host-parasite and symbiotic interactions and modulation of the symbiont of host erythrocyte aggregation pathways. Moreover, we identified 237 differentially expressed noncoding RNAs in ASM vs SM, of which 11 were found to interact with CVGs, suggesting their possible role in regulating the expression of CVGs. Our results suggest that P. falciparum utilizes phenotypic plasticity as an adaptive mechanism during asymptomatic infections by upregulating clonal variant genes, with long noncoding RNAs possibly playing a crucial role in their regulation. Thus, our study provides insights into the parasites' genetic factors that confer a fitness advantage during asymptomatic infections.
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Affiliation(s)
- Joseph G. Amwoma
- Department of Biological Sciences, University of Embu, Kenya
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Sarah Kituyi
- Department of Biological Sciences, University of Embu, Kenya
- Forgarty International Center of the National Institutes of Health, Bethesda, MD, USA
| | - Dancan M. Wakoli
- Department of Biochemistry and Molecular Biology, Egerton University, Kenya
| | - Douglas O. Ochora
- Department of Biological Sciences, School of Pure and Applied Sciences, Kisii University, Kenya
- DSI/NWU, Preclinical Drug Development Platform, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Gladys Chemwor
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Risper Maisiba
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Winnie Okore
- Department of Biomedical Sciences and Technology, Maseno University, Kenya
| | - Benjamin Opot
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Dennis Juma
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Eric M.O. Muok
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Eric C. Garges
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya
| | - Timothy E. Egbo
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya
| | | | - Ben Andagalu
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Hoseah M. Akala
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
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9
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Fraering J, Salnot V, Gautier EF, Ezinmegnon S, Argy N, Peoc'h K, Manceau H, Alao J, Guillonneau F, Migot-Nabias F, Bertin GI, Kamaliddin C. Infected erythrocytes and plasma proteomics reveal a specific protein signature of severe malaria. EMBO Mol Med 2024; 16:319-333. [PMID: 38297098 PMCID: PMC10897182 DOI: 10.1038/s44321-023-00010-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 11/18/2023] [Accepted: 11/22/2023] [Indexed: 02/02/2024] Open
Abstract
Cerebral malaria (CM), the most lethal complication of Plasmodium falciparum severe malaria (SM), remains fatal for 15-25% of affected children despite the availability of treatment. P. falciparum infects and multiplies in erythrocytes, contributing to anemia, parasite sequestration, and inflammation. An unbiased proteomic assessment of infected erythrocytes and plasma samples from 24 Beninese children was performed to study the complex mechanisms underlying CM. A significant down-regulation of proteins from the ubiquitin-proteasome pathway and an up-regulation of the erythroid precursor marker transferrin receptor protein 1 (TFRC) were associated with infected erythrocytes from CM patients. At the plasma level, the samples clustered according to clinical presentation. Significantly, increased levels of the 20S proteasome components were associated with SM. Targeted quantification assays confirmed these findings on a larger cohort (n = 340). These findings suggest that parasites causing CM preferentially infect reticulocytes or erythroblasts and alter their maturation. Importantly, the host plasma proteome serves as a specific signature of SM and presents a remarkable opportunity for developing innovative diagnostic and prognostic biomarkers.
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Affiliation(s)
- Jeremy Fraering
- UMR261 MERIT, Université Paris Cité, IRD, F-75006, Paris, France
- Plateforme Proteom'IC, Institut Cochin, Université Paris Cité, INSERM U-1016, CNRS UMR8104, Paris, France
| | - Virginie Salnot
- Plateforme Proteom'IC, Institut Cochin, Université Paris Cité, INSERM U-1016, CNRS UMR8104, Paris, France
| | - Emilie-Fleur Gautier
- Plateforme Proteom'IC, Institut Cochin, Université Paris Cité, INSERM U-1016, CNRS UMR8104, Paris, France
- Institut Imagine-INSERM U1163, Hôpital Necker, Université Paris Cité, F-75015, Paris, France
- Laboratoire d'Excellence GR-Ex, F-75015, Paris, France
| | - Sem Ezinmegnon
- Groupe de Recherche Action en Santé, Ouagadougou, Burkina Faso
| | - Nicolas Argy
- UMR261 MERIT, Université Paris Cité, IRD, F-75006, Paris, France
- Laboratoire de parasitologie, Hôpital Bichat-Claude Bernard, APHP, Paris, France
| | - Katell Peoc'h
- Laboratoire d'Excellence GR-Ex, F-75015, Paris, France
- Biochimie Métabolique et Cellulaire, Hôpital Bichat-Claude Bernard, APHP, Paris, France
- Centre de Recherche sur l'Inflammation, UFR de Médecine Xavier Bichat, Université Paris Cité, INSERM UMR1149, Paris, France
| | - Hana Manceau
- Laboratoire d'Excellence GR-Ex, F-75015, Paris, France
- Biochimie Métabolique et Cellulaire, Hôpital Bichat-Claude Bernard, APHP, Paris, France
- Département de Biochimie, Hôpital Universitaire Beaujon, APHP, Clichy, France
| | - Jules Alao
- Service de Pédiatrie, Centre Hospitalier Universitaire de la Mère et de l'Enfant-Lagune de Cotonou, Cotonou, Benin
| | - François Guillonneau
- Plateforme Proteom'IC, Institut Cochin, Université Paris Cité, INSERM U-1016, CNRS UMR8104, Paris, France
- Unité OncoProtéomique, Institut de Cancérologie de l'Ouest, F-49055, Angers, France
- Université d'Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Université, CRCI2NA, F-49000, Angers, France
| | | | - Gwladys I Bertin
- UMR261 MERIT, Université Paris Cité, IRD, F-75006, Paris, France.
| | - Claire Kamaliddin
- UMR261 MERIT, Université Paris Cité, IRD, F-75006, Paris, France.
- Cumming School of Medicine, The University of Calgary, Calgary, AB, Canada.
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10
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Kimenyi KM, Akinyi MY, Mwikali K, Gilmore T, Mwangi S, Omer E, Gichuki B, Wambua J, Njunge J, Obiero G, Bejon P, Langhorne J, Abdi A, Ochola-Oyier LI. Distinct transcriptomic signatures define febrile malaria depending on initial infective states, asymptomatic or uninfected. BMC Infect Dis 2024; 24:140. [PMID: 38287287 PMCID: PMC10823747 DOI: 10.1186/s12879-024-08973-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/01/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Cumulative malaria parasite exposure in endemic regions often results in the acquisition of partial immunity and asymptomatic infections. There is limited information on how host-parasite interactions mediate the maintenance of chronic symptomless infections that sustain malaria transmission. METHODS Here, we determined the gene expression profiles of the parasite population and the corresponding host peripheral blood mononuclear cells (PBMCs) from 21 children (< 15 years). We compared children who were defined as uninfected, asymptomatic and those with febrile malaria. RESULTS Children with asymptomatic infections had a parasite transcriptional profile characterized by a bias toward trophozoite stage (~ 12 h-post invasion) parasites and low parasite levels, while early ring stage parasites were characteristic of febrile malaria. The host response of asymptomatic children was characterized by downregulated transcription of genes associated with inflammatory responses, compared with children with febrile malaria,. Interestingly, the host responses during febrile infections that followed an asymptomatic infection featured stronger inflammatory responses, whereas the febrile host responses from previously uninfected children featured increased humoral immune responses. CONCLUSIONS The priming effect of prior asymptomatic infection may explain the blunted acquisition of antibody responses seen to malaria antigens following natural exposure or vaccination in malaria endemic areas.
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Affiliation(s)
- Kelvin M Kimenyi
- KEMRI‑Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Biochemistry, University of Nairobi, Nairobi, Kenya
| | | | - Kioko Mwikali
- KEMRI‑Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Shaban Mwangi
- KEMRI‑Wellcome Trust Research Programme, Kilifi, Kenya
| | - Elisha Omer
- KEMRI‑Wellcome Trust Research Programme, Kilifi, Kenya
| | | | | | - James Njunge
- KEMRI‑Wellcome Trust Research Programme, Kilifi, Kenya
| | - George Obiero
- Department of Biochemistry, University of Nairobi, Nairobi, Kenya
| | - Philip Bejon
- KEMRI‑Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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11
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Andradi-Brown C, Wichers-Misterek JS, von Thien H, Höppner YD, Scholz JAM, Hansson H, Filtenborg Hocke E, Gilberger TW, Duffy MF, Lavstsen T, Baum J, Otto TD, Cunnington AJ, Bachmann A. A novel computational pipeline for var gene expression augments the discovery of changes in the Plasmodium falciparum transcriptome during transition from in vivo to short-term in vitro culture. eLife 2024; 12:RP87726. [PMID: 38270586 PMCID: PMC10945709 DOI: 10.7554/elife.87726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024] Open
Abstract
The pathogenesis of severe Plasmodium falciparum malaria involves cytoadhesive microvascular sequestration of infected erythrocytes, mediated by P. falciparum erythrocyte membrane protein 1 (PfEMP1). PfEMP1 variants are encoded by the highly polymorphic family of var genes, the sequences of which are largely unknown in clinical samples. Previously, we published new approaches for var gene profiling and classification of predicted binding phenotypes in clinical P. falciparum isolates (Wichers et al., 2021), which represented a major technical advance. Building on this, we report here a novel method for var gene assembly and multidimensional quantification from RNA-sequencing that outperforms the earlier approach of Wichers et al., 2021, on both laboratory and clinical isolates across a combination of metrics. Importantly, the tool can interrogate the var transcriptome in context with the rest of the transcriptome and can be applied to enhance our understanding of the role of var genes in malaria pathogenesis. We applied this new method to investigate changes in var gene expression through early transition of parasite isolates to in vitro culture, using paired sets of ex vivo samples from our previous study, cultured for up to three generations. In parallel, changes in non-polymorphic core gene expression were investigated. Modest but unpredictable var gene switching and convergence towards var2csa were observed in culture, along with differential expression of 19% of the core transcriptome between paired ex vivo and generation 1 samples. Our results cast doubt on the validity of the common practice of using short-term cultured parasites to make inferences about in vivo phenotype and behaviour.
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Affiliation(s)
- Clare Andradi-Brown
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College LondonLondonUnited Kingdom
- Department of Life Sciences, Imperial College London, South KensingtonLondonUnited Kingdom
- Centre for Paediatrics and Child Health, Imperial College LondonLondonUnited Kingdom
| | - Jan Stephan Wichers-Misterek
- Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-StrasseHamburgGermany
- Centre for Structural Systems BiologyHamburgGermany
- Biology Department, University of HamburgHamburgGermany
| | - Heidrun von Thien
- Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-StrasseHamburgGermany
- Centre for Structural Systems BiologyHamburgGermany
- Biology Department, University of HamburgHamburgGermany
| | - Yannick D Höppner
- Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-StrasseHamburgGermany
- Centre for Structural Systems BiologyHamburgGermany
- Biology Department, University of HamburgHamburgGermany
| | - Judith AM Scholz
- Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-StrasseHamburgGermany
| | - Helle Hansson
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of CopenhagenCopenhagenDenmark
- Department of Infectious Diseases, Copenhagen University HospitalCopenhagenDenmark
| | - Emma Filtenborg Hocke
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of CopenhagenCopenhagenDenmark
- Department of Infectious Diseases, Copenhagen University HospitalCopenhagenDenmark
| | - Tim Wolf Gilberger
- Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-StrasseHamburgGermany
- Centre for Structural Systems BiologyHamburgGermany
- Biology Department, University of HamburgHamburgGermany
| | - Michael F Duffy
- Department of Microbiology and Immunology, University of MelbourneMelbourneAustralia
| | - Thomas Lavstsen
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of CopenhagenCopenhagenDenmark
- Department of Infectious Diseases, Copenhagen University HospitalCopenhagenDenmark
| | - Jake Baum
- Department of Life Sciences, Imperial College London, South KensingtonLondonUnited Kingdom
- School of Biomedical Sciences, Faculty of Medicine & Health, UNSW, KensingtonSydneyUnited Kingdom
| | - Thomas D Otto
- School of Infection & Immunity, MVLS, University of GlasgowGlasgowUnited Kingdom
| | - Aubrey J Cunnington
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College LondonLondonUnited Kingdom
- Centre for Paediatrics and Child Health, Imperial College LondonLondonUnited Kingdom
| | - Anna Bachmann
- Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-StrasseHamburgGermany
- Centre for Structural Systems BiologyHamburgGermany
- Biology Department, University of HamburgHamburgGermany
- German Center for Infection Research (DZIF), partner site Hamburg-Borstel-Lübeck-RiemsHamburgGermany
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12
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Reyes RA, Batugedara G, Dutta P, Reers AB, Garza R, Ssewanyana I, Jagannathan P, Feeney ME, Greenhouse B, Bol S, Ay F, Bunnik EM. Atypical B cells consist of subsets with distinct functional profiles. iScience 2023; 26:108496. [PMID: 38098745 PMCID: PMC10720271 DOI: 10.1016/j.isci.2023.108496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/30/2023] [Accepted: 11/16/2023] [Indexed: 12/17/2023] Open
Abstract
Atypical B cells are a population of activated B cells that are commonly enriched in individuals with chronic immune activation but are also part of a normal immune response to infection or vaccination. To better define the role of atypical B cells in the human adaptive immune response, we performed single-cell sequencing of transcriptomes, cell surface markers, and B cell receptors in individuals with chronic exposure to the malaria parasite Plasmodium falciparum, a condition known to lead to accumulation of circulating atypical B cells. We identified three previously uncharacterized populations of atypical B cells with distinct transcriptional and functional profiles and observed marked differences among these three subsets in their ability to produce immunoglobulin G upon T-cell-dependent activation. Our findings help explain the conflicting observations in prior studies regarding the function of atypical B cells and highlight their different roles in the adaptive immune response in chronic inflammatory conditions.
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Affiliation(s)
- Raphael A. Reyes
- Department of Microbiology, Immunology and Molecular Genetics, Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Gayani Batugedara
- Department of Microbiology, Immunology and Molecular Genetics, Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Paramita Dutta
- Centers for Cancer Immunotherapy and Autoimmunity, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Ashley B. Reers
- Department of Microbiology, Immunology and Molecular Genetics, Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Rolando Garza
- Department of Microbiology, Immunology and Molecular Genetics, Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Isaac Ssewanyana
- Infectious Disease Research Collaboration, Kampala, Uganda
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Prasanna Jagannathan
- Department of Medicine, Division of Infectious Diseases, Stanford University, Stanford, CA 94305, USA
- Department of Microbiology and Immunology, Stanford University, Stanford, CA 94305, USA
| | - Margaret E. Feeney
- Department of Medicine, University of California, San Francisco, San Francisco, CA 94110, USA
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA 94110, USA
| | - Bryan Greenhouse
- Department of Medicine, University of California, San Francisco, San Francisco, CA 94110, USA
| | - Sebastiaan Bol
- Department of Microbiology, Immunology and Molecular Genetics, Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Ferhat Ay
- Centers for Cancer Immunotherapy and Autoimmunity, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
- Department of Pediatrics, University of California San Diego, La Jolla, CA 92093, USA
| | - Evelien M. Bunnik
- Department of Microbiology, Immunology and Molecular Genetics, Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
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13
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Zupko RJ, Servadio JL, Nguyen TD, Tran TNA, Tran KT, Somé AF, Boni MF. Role of Seasonal Importation and Random Genetic Drift on Selection for Drug-Resistant Genotypes of Plasmodium falciparum in High Transmission Settings. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.20.563204. [PMID: 37961194 PMCID: PMC10634683 DOI: 10.1101/2023.10.20.563204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Historically Plasmodium falciparum has followed a pattern of drug resistance first appearing in low transmission settings before spreading to high transmission settings. Several features of low-transmission regions are hypothesized as explanations: higher chance of symptoms and treatment seeking, better treatment access, less within-host competition among clones, and lower rates of recombination. Here, we test whether importation of drug-resistant parasites is more likely to lead to successful emergence and establishment in low-transmission or high-transmission periods of the same epidemiological setting, using a spatial, individual-based stochastic model of malaria and drug-resistance evolution calibrated for Burkina Faso. Upon controlling for the timing of importation of drug-resistant genotypes and examination of key model variables, we found that drug-resistant genotypes imported during the low transmission season were, (1) more susceptible to stochastic extinction due to the action of random genetic drift, and (2) more likely to lead to establishment of drug resistance when parasites are able to survive early stochastic loss due to drift. This implies that rare importation events are more likely to lead to establishment if they occur during a high-transmission season, but that constant importation (e.g., neighboring countries with high levels of resistance) may produce a greater risk during low-transmission periods.
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Affiliation(s)
- Robert J. Zupko
- Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, USA
| | - Joseph L. Servadio
- Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, USA
| | - Tran Dang Nguyen
- Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, USA
| | - Thu Nguyen-Anh Tran
- Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, USA
| | - Kien Trung Tran
- Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, USA
| | - Anyirékun Fabrice Somé
- Institut de Recherche en Sciences de la Santé, Direction Régionale de l’Ouest, Bobo Dioulasso, Burkina Faso
| | - Maciej F. Boni
- Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, USA
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
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14
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Biruksew A, Demeke A, Birhanu Z, Golassa L, Getnet M, Yewhalaw D. Schoolchildren with asymptomatic malaria are potential hotspot for malaria reservoir in Ethiopia: implications for malaria control and elimination efforts. Malar J 2023; 22:311. [PMID: 37845680 PMCID: PMC10580533 DOI: 10.1186/s12936-023-04736-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/30/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Schoolchildren with asymptomatic malaria infections often go undiagnosed and untreated, serving as reservoirs for infection that hamper malaria control and elimination efforts. In this context, little is known about the magnitude of asymptomatic malaria infections in apparently healthy schoolchildren in Ethiopia. This study was aimed at determining the prevalence of asymptomatic malaria infection and its associated factors in apparently healthy schoolchildren in Ethiopia. METHODS From September 2021 to January 2022, a school-based cross-sectional study was conducted on 994 apparently healthy schoolchildren (aged 6-15 years) selected from 21 primary schools in the Gomma district, of Jimma zone, southwestern Oromia, Ethiopia. A multi-stage sampling technique was used to select schools and participants. After allocating the total sample proportionally to each school and then to each grade, participants were selected using the lottery method from a list of student records (rosters). Finger-pricked blood samples were collected for microscopy blood film preparation and malaria rapid diagnostic test (RDT) (SD Bioline Malaria Ag Pf/Pv). Moreover, dry blood spots (DBSs) were prepared onto filter papers for quantitative real time polymerase chain reaction (qPCR) analysis. RESULTS As determined by RDT and microscopy, the prevalence of asymptomatic malaria was 2.20% and 1.51%, respectively. Using qPCR, the overall prevalence was 5.03% (50/994). Of this, Plasmodium falciparum, Plasmodium vivax and mixed infections accounted for 90%, 6% and 4%, respectively. Submicroscopic asymptomatic malaria infection was also accounted for 70% (35/50) of the overall prevalence. Household head age, nighttime outdoor activities of household heads, family history of malaria, absence of insecticide-treated nets (ITN), and presence of stagnant water around the houses are all significantly associated with asymptomatic malaria infections among schoolchildren. CONCLUSIONS This study found that both RDT and microscopy underestimated the prevalence of asymptomatic malaria in schoolchildren. However, qPCR was able to detect even low levels of parasitaemia and revealed a higher prevalence of asymptomatic submicroscopic malaria infections. The findings imply that schoolchildren with asymptomatic malaria infection are potential hotspot for malaria reservoir that fuels ongoing transmission. Therefore, it is imperative to include schoolchildren and schools in malaria intervention package and equally important is the adoption of more advanced and sensitive diagnostic tools, which would be crucial for successful malaria control and elimination efforts. Targeted interventions for asymptomatic malaria-infected schoolchildren can provide invaluable support to the National Malaria Control Programme in controlling and eventually eliminating the disease.
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Affiliation(s)
- Abdissa Biruksew
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIRC), Jimma University, Jimma, Ethiopia
| | | | - Zewdie Birhanu
- Department of Health, Behavior, and Society, Faculty of Public Health, Institute of Health Jimma University, Jimma, Ethiopia
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Masrie Getnet
- Department of Biostatistics and Epidemiology, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Delenasaw Yewhalaw
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIRC), Jimma University, Jimma, Ethiopia
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15
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Lansink LIM, Skinner OP, Engel JA, Lee HJ, Soon MSF, Williams CG, SheelaNair A, Pernold CPS, Laohamonthonkul P, Akter J, Stoll T, Hill MM, Talman AM, Russell A, Lawniczak M, Jia X, Chua B, Anderson D, Creek DJ, Davenport MP, Khoury DS, Haque A. Systemic host inflammation induces stage-specific transcriptomic modification and slower maturation in malaria parasites. mBio 2023; 14:e0112923. [PMID: 37449844 PMCID: PMC10470790 DOI: 10.1128/mbio.01129-23] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 06/02/2023] [Indexed: 07/18/2023] Open
Abstract
Maturation rates of malaria parasites within red blood cells (RBCs) can be influenced by host nutrient status and circadian rhythm; whether host inflammatory responses can also influence maturation remains less clear. Here, we observed that systemic host inflammation induced in mice by an innate immune stimulus, lipopolysaccharide (LPS), or by ongoing acute Plasmodium infection, slowed the progression of a single cohort of parasites from one generation of RBC to the next. Importantly, plasma from LPS-conditioned or acutely infected mice directly inhibited parasite maturation during in vitro culture, which was not rescued by supplementation, suggesting the emergence of inhibitory factors in plasma. Metabolomic assessments confirmed substantial alterations to the plasma of LPS-conditioned and acutely infected mice, and identified a small number of candidate inhibitory metabolites. Finally, we confirmed rapid parasite responses to systemic host inflammation in vivo using parasite scRNA-seq, noting broad impairment in transcriptional activity and translational capacity specifically in trophozoites but not rings or schizonts. Thus, we provide evidence that systemic host inflammation rapidly triggered transcriptional alterations in circulating blood-stage Plasmodium trophozoites and predict candidate inhibitory metabolites in the plasma that may impair parasite maturation in vivo. IMPORTANCE Malaria parasites cyclically invade, multiply, and burst out of red blood cells. We found that a strong inflammatory response can cause changes to the composition of host plasma, which directly slows down parasite maturation. Thus, our work highlights a new mechanism that limits malaria parasite growth in the bloodstream.
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Affiliation(s)
- Lianne I. M. Lansink
- QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, Victoria, Australia
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- Department of Biology, University of York, Wentworth Way, York, Yorkshire, United Kingdom
| | - Oliver P. Skinner
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, Victoria, Australia
| | - Jessica A. Engel
- QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia
| | - Hyun Jae Lee
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, Victoria, Australia
| | - Megan S. F. Soon
- QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia
| | - Cameron G. Williams
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, Victoria, Australia
| | - Arya SheelaNair
- QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia
| | - Clara P. S. Pernold
- QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia
| | | | - Jasmin Akter
- QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia
| | - Thomas Stoll
- QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia
| | - Michelle M. Hill
- QIMR Berghofer Medical Research Institute, Herston, Brisbane, Queensland, Australia
| | - Arthur M. Talman
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridgeshire, United Kingdom
- MIVEGEC, University of Montpellier, IRD, CNRS, Montpellier, France
| | - Andrew Russell
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridgeshire, United Kingdom
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Mara Lawniczak
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridgeshire, United Kingdom
| | - Xiaoxiao Jia
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, Victoria, Australia
| | - Brendon Chua
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, Victoria, Australia
| | - Dovile Anderson
- Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Darren J. Creek
- Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Miles P. Davenport
- The Kirby Institute, University of New South Wales, Kensington, Sydney, New South Wales, Australia
| | - David S. Khoury
- The Kirby Institute, University of New South Wales, Kensington, Sydney, New South Wales, Australia
| | - Ashraful Haque
- Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, Victoria, Australia
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16
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Greischar MA, Childs LM. Extraordinary parasite multiplication rates in human malaria infections. Trends Parasitol 2023; 39:626-637. [PMID: 37336700 DOI: 10.1016/j.pt.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 06/21/2023]
Abstract
For pathogenic organisms, faster rates of multiplication promote transmission success, the potential to harm hosts, and the evolution of drug resistance. Parasite multiplication rates (PMRs) are often quantified in malaria infections, given the relative ease of sampling. Using modern and historical human infection data, we show that established methods return extraordinarily - and implausibly - large PMRs. We illustrate how inflated PMRs arise from two facets of malaria biology that are far from unique: (i) some developmental ages are easier to sample than others; (ii) the distribution of developmental ages changes over the course of infection. The difficulty of accurately quantifying PMRs demonstrates a need for robust methods and a subsequent re-evaluation of what is known even in the well-studied system of malaria.
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Affiliation(s)
- Megan A Greischar
- Department of Ecology & Evolutionary Biology, Cornell University, Ithaca, NY, USA.
| | - Lauren M Childs
- Department of Mathematics, Virginia Tech, Blacksburg, VA, USA
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17
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Nkemngo FN, W G Raissa L, Nebangwa DN, Nkeng AM, Kengne A, Mugenzi LMJ, Fotso-Toguem YG, Wondji MJ, Shey RA, Nguiffo-Nguete D, Fru-Cho J, Ndo C, Njiokou F, Webster JP, Wanji S, Wondji CS. Epidemiology of malaria, schistosomiasis, and geohelminthiasis amongst children 3-15 years of age during the dry season in Northern Cameroon. PLoS One 2023; 18:e0288560. [PMID: 37523402 PMCID: PMC10389741 DOI: 10.1371/journal.pone.0288560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 06/29/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND The double burden of malaria and helminthiasis in children poses an obvious public health challenge, particularly in terms of anemia morbidity. While both diseases frequently geographically overlap, most studies focus on mono-infection and general prevalence surveys without molecular analysis. The current study investigated the epidemiological determinants of malaria, schistosomiasis, and geohelminthiasis transmission among children in the North Region of Cameroon. METHODOLOGY School and pre-school children aged 3-15 year-of-age were enrolled from three communities in March 2021 using a community cross-sectional design. Capillary-blood samples were obtained, and each was examined for malaria parasites using rapid-diagnostic-test (RDT), microscopy, and PCR while hemoglobin level was measured using a hemoglobinometer. Stool samples were analyzed for Schistosoma mansoni, S. guineensis, and soil-transmitted-helminthiasis (STH) infections using the Kato Katz method, and urine samples were assessed for the presence of S. haematobium eggs (including hybrids) using the standard urine filtration technique. RESULT A malaria prevalence of 56% (277/495) was recorded by PCR as opposed to 31.5% (156/495) by microscopy and 37.8% (186/495) by RDT. Similarly, schistosomiasis was observed at prevalence levels of up to 13.3% (66/495) overall [S. haematobium (8.7%); S. mansoni (3.8%); mixed Sh/Sm (0.6%); mixed Sh/Sm/Sg (0.2%). Both infections were higher in males and the 3-9 year-of-age groups. A high frequency of PCR reported P. falciparum mono-infection of 81.9% (227/277) and mixed P. falciparum/P. malariae infection of 17.3% (48/277) was observed. Malaria-helminths co-infections were observed at 13.1% (65/495) with marked variation between P. falciparum/S. haematobium (50.8%, 33/65); P. falciparum/S. mansoni (16.9%, 11/65) and P. falciparum/Ascaris (9.2%, 6/65) (χ2 = 17.5, p = 0.00003). Anemia prevalence was 32.9% (163/495), categorically associated with P. falciparum (45.8%, 104/227), Pf/Sh (11.5%, 26/227), and Pf/Sm (3.9%, 9/227) polyparasitism. CONCLUSION Polyparasitism with malaria and helminth infections is common in school-aged children despite periodic long-lasting insecticide-treated nets (LLINs) distribution and regular school-based praziquantel (for schistosomiasis) and albendazole (for STH) campaigns. Co-existence of Plasmodium parasites and helminths infections notably Schistosoma species among children may concurrently lead to an increase in Plasmodium infection with an enhanced risk of anemia, highlighting the necessity of an integrated approach for disease control interventions.
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Affiliation(s)
- Francis N Nkemngo
- Centre for Research in Infectious Diseases (CRID), Yaoundé, Cameroon
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Lymen W G Raissa
- Centre for Research in Infectious Diseases (CRID), Yaoundé, Cameroon
| | - Derrick N Nebangwa
- Faculty of Life Science and Medicine, King's College London, New Hunt's House, London, United Kingdom
| | - Asongha M Nkeng
- Centre for Infection Biology and Translational Research (CIBiT), Forzi Institute, Buea, Cameroon
- Department of Sociology & Anthropology, Faculty of Social and Management Sciences, University of Buea, Buea, Cameroon
| | - Alvine Kengne
- Department of Animal Biology and Physiology, Parasitology and Ecology Laboratory, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
| | - Leon M J Mugenzi
- Centre for Research in Infectious Diseases (CRID), Yaoundé, Cameroon
| | | | - Murielle J Wondji
- Centre for Research in Infectious Diseases (CRID), Yaoundé, Cameroon
- Vector Biology Department, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Robert A Shey
- Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, Buea, Cameroon
| | | | - Jerome Fru-Cho
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and Environment (REFOTDE), Buea, Cameroon
| | - Cyrille Ndo
- Centre for Research in Infectious Diseases (CRID), Yaoundé, Cameroon
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - Flobert Njiokou
- Department of Animal Biology and Physiology, Parasitology and Ecology Laboratory, Faculty of Science, University of Yaoundé I, Yaoundé, Cameroon
| | - Joanne P Webster
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, Herts, United Kingdom
| | - Samuel Wanji
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and Environment (REFOTDE), Buea, Cameroon
| | - Charles S Wondji
- Centre for Research in Infectious Diseases (CRID), Yaoundé, Cameroon
- Vector Biology Department, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
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18
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Thompson TA, Chahine Z, Le Roch KG. The role of long noncoding RNAs in malaria parasites. Trends Parasitol 2023; 39:517-531. [PMID: 37121862 DOI: 10.1016/j.pt.2023.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/16/2023] [Accepted: 03/18/2023] [Indexed: 05/02/2023]
Abstract
The human malaria parasites, including Plasmodium falciparum, persist as a major cause of global morbidity and mortality. The recent stalling of progress toward malaria elimination substantiates a need for novel interventions. Controlled gene expression is central to the parasite's numerous life cycle transformations and adaptation. With few specific transcription factors (TFs) identified, crucial roles for chromatin states and epigenetics in parasite transcription have become evident. Although many chromatin-modifying enzymes are known, less is known about which factors mediate their impacts on transcriptional variation. Like those of higher eukaryotes, long noncoding RNAs (lncRNAs) have recently been shown to have integral roles in parasite gene regulation. This review aims to summarize recent developments and key findings on the role of lncRNAs in P. falciparum.
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Affiliation(s)
- Trevor A Thompson
- Department of Molecular, Cell and Systems Biology, University of California Riverside, CA, USA
| | - Zeinab Chahine
- Department of Molecular, Cell and Systems Biology, University of California Riverside, CA, USA
| | - Karine G Le Roch
- Department of Molecular, Cell and Systems Biology, University of California Riverside, CA, USA.
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19
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Andolina C, Ramjith J, Rek J, Lanke K, Okoth J, Grignard L, Arinaitwe E, Briggs J, Bailey J, Aydemir O, Kamya MR, Greenhouse B, Dorsey G, Staedke SG, Drakeley C, Jonker M, Bousema T. Plasmodium falciparum gametocyte carriage in longitudinally monitored incident infections is associated with duration of infection and human host factors. Sci Rep 2023; 13:7072. [PMID: 37127688 PMCID: PMC10150352 DOI: 10.1038/s41598-023-33657-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 04/17/2023] [Indexed: 05/03/2023] Open
Abstract
Malaria transmission depends on the presence of Plasmodium gametocytes that are the only parasite life stage that can infect mosquitoes. Gametocyte production varies between infections and over the course of infections. Infection duration is highly important for gametocyte production but poorly quantified. Between 2017 and 2019 an all-age cohort of individuals from Tororo, eastern Uganda was followed by continuous passive and routine assessments. We longitudinally monitored 104 incident infections from 98 individuals who were sampled once every 28 days and on any day of symptoms. Among infections that lasted ≥ 3 months, gametocyte appearance was near-universal with 96% of infections having detectable gametocytes prior to clearance. However, most infections were of much shorter duration; 55.7% of asymptomatic infections were detected only once. When considering all asymptomatic infections, regardless of their duration, only 36.3% had detectable gametocytes on at least one time-point prior to parasite clearance. Infections in individuals with sickle-cell trait (HbAS) were more likely to have gametocytes detected (Hazard Rate (HR) = 2.68, 95% CI 1.12, 6.38; p = 0.0231) and had gametocytes detected at higher densities (Density Ratio (DR) = 9.19, 95% CI 2.79, 30.23; p = 0.0002) compared to infections in wildtype (HbAA) individuals. Our findings suggest that a large proportion of incident infections is too short in duration and of too low density to contribute to onward transmission.
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Affiliation(s)
- Chiara Andolina
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Jordache Ramjith
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - John Rek
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Kjerstin Lanke
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Joseph Okoth
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Lynn Grignard
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Jessica Briggs
- Department of Medicine, San Francisco General Hospital, University of California, San Francisco, USA
| | - Jeffrey Bailey
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
| | - Ozkan Aydemir
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Moses R Kamya
- Infectious Diseases Research Collaboration, Kampala, Uganda
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Bryan Greenhouse
- Department of Medicine, San Francisco General Hospital, University of California, San Francisco, USA
| | - Grant Dorsey
- Department of Medicine, San Francisco General Hospital, University of California, San Francisco, USA
| | - Sarah G Staedke
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Drakeley
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - Marianne Jonker
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Teun Bousema
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK.
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20
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Ahmad A, Mohammed NI, Joof F, Affara M, Jawara M, Abubakar I, Okebe J, Ceesay S, Hamid-Adiamoh M, Bradley J, Amambua-Ngwa A, Nwakanma D, D'Alessandro U. Asymptomatic Plasmodium falciparum carriage and clinical disease: a 5-year community-based longitudinal study in The Gambia. Malar J 2023; 22:82. [PMID: 36882754 PMCID: PMC9993664 DOI: 10.1186/s12936-023-04519-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/28/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Carriers of persistent asymptomatic Plasmodium falciparum infections constitute an infectious reservoir that maintains malaria transmission. Understanding the extent of carriage and characteristics of carriers specific to endemic areas could guide use of interventions to reduce infectious reservoir. METHODS In eastern Gambia, an all-age cohort from four villages was followed up from 2012 to 2016. Each year, cross-sectional surveys were conducted at the end of the malaria transmission season (January) and just before the start of the next one (June) to determine asymptomatic P. falciparum carriage. Passive case detection was conducted during each transmission season (August to January) to determine incidence of clinical malaria. Association between carriage at the end of the season and at start of the next one and the risk factors for this were assessed. Effect of carriage before start of the season on risk of clinical malaria during the season was also examined. RESULTS A total of 1403 individuals-1154 from a semi-urban village and 249 from three rural villages were enrolled; median age was 12 years (interquartile range [IQR] 6, 30) and 12 years (IQR 7, 27) respectively. In adjusted analysis, asymptomatic P. falciparum carriage at the end of a transmission season and carriage just before start of the next one were strongly associated (adjusted odds ratio [aOR] = 19.99; 95% CI 12.57-31.77, p < 0.001). The odds of persistent carriage (i.e. infected both in January and in June) were higher in rural villages (aOR = 13.0; 95% CI 6.33-26.88, p < 0.001) and in children aged 5-15 years (aOR = 5.03; 95% CI 2.47-10.23, p = < 0.001). In the rural villages, carriage before start of the season was associated with a lower risk of clinical malaria during the season (incidence risk ratio [IRR] 0.48, 95% CI 0.27-0.81, p = 0.007). CONCLUSIONS Asymptomatic P. falciparum carriage at the end of a transmission season strongly predicted carriage just before start of the next one. Interventions that clear persistent asymptomatic infections when targeted at the subpopulation with high risk of carriage may reduce the infectious reservoir responsible for launching seasonal transmission.
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Affiliation(s)
- Abdullahi Ahmad
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O Box 273, Banjul, The Gambia.
- Global Health Institute, University of Antwerp, Gouverneur Kinsbergencentrum, Campus Drie Eiken, Doornstraat 331, 2610, Wilrijk, Belgium.
| | - Nuredin Ibrahim Mohammed
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O Box 273, Banjul, The Gambia
| | - Fatou Joof
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O Box 273, Banjul, The Gambia
| | - Muna Affara
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O Box 273, Banjul, The Gambia
| | - Musa Jawara
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O Box 273, Banjul, The Gambia
| | - Ismaela Abubakar
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O Box 273, Banjul, The Gambia
| | - Joseph Okebe
- International Public Health Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Serign Ceesay
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O Box 273, Banjul, The Gambia
| | - Majidah Hamid-Adiamoh
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O Box 273, Banjul, The Gambia
| | - John Bradley
- MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Alfred Amambua-Ngwa
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O Box 273, Banjul, The Gambia
| | - Davis Nwakanma
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O Box 273, Banjul, The Gambia.
| | - Umberto D'Alessandro
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O Box 273, Banjul, The Gambia
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21
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Stadler E, Cromer D, Ogunlade S, Ongoiba A, Doumbo S, Kayentao K, Traore B, Crompton PD, Portugal S, Davenport MP, Khoury DS. Evidence for exposure dependent carriage of malaria parasites across the dry season: modelling analysis of longitudinal data. Malar J 2023; 22:42. [PMID: 36737743 PMCID: PMC9898990 DOI: 10.1186/s12936-023-04461-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/17/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In malaria endemic regions, transmission of Plasmodium falciparum parasites is often seasonal with very low transmission during the dry season and high transmission in the wet season. Parasites survive the dry season within some individuals who experience prolonged carriage of parasites and are thought to 'seed' infection in the next transmission season. METHODS Dry season carriers and their role in the subsequent transmission season are characterized using a combination of mathematical simulations and data analysis of previously described data from a longitudinal study in Mali of individuals aged 3 months-12 years (n = 579). RESULTS Simulating the life-history of individuals experiencing repeated exposure to infection predicts that dry season carriage is more likely in the oldest, most exposed and most immune individuals. This hypothesis is supported by the data from Mali, which shows that carriers are significantly older, experience a higher biting rate at the beginning of the transmission season and develop clinical malaria later than non-carriers. Further, since the most exposed individuals in a community are most likely to be dry season carriers, this is predicted to enable a more than twofold faster spread of parasites into the mosquito population at the start of the subsequent wet season. CONCLUSIONS Carriage of malaria parasites over the months-long dry season in Mali is most likely in the older, more exposed and more immune children. These children may act as super-spreaders facilitating the fast spread of parasites at the beginning of the next transmission season.
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Affiliation(s)
- Eva Stadler
- grid.1005.40000 0004 4902 0432The Kirby Institute, UNSW Sydney, Sydney, NSW 2052 Australia
| | - Deborah Cromer
- grid.1005.40000 0004 4902 0432The Kirby Institute, UNSW Sydney, Sydney, NSW 2052 Australia
| | - Samson Ogunlade
- grid.1005.40000 0004 4902 0432The Kirby Institute, UNSW Sydney, Sydney, NSW 2052 Australia
| | - Aissata Ongoiba
- grid.461088.30000 0004 0567 336XMalaria Research and Training Centre, Department of Epidemiology of Parasitic Diseases, International Center of Excellence in Research, University of Sciences, Technique, and Technology of Bamako, 91094 Bamako, Mali
| | - Safiatou Doumbo
- grid.461088.30000 0004 0567 336XMalaria Research and Training Centre, Department of Epidemiology of Parasitic Diseases, International Center of Excellence in Research, University of Sciences, Technique, and Technology of Bamako, 91094 Bamako, Mali
| | - Kassoum Kayentao
- grid.461088.30000 0004 0567 336XMalaria Research and Training Centre, Department of Epidemiology of Parasitic Diseases, International Center of Excellence in Research, University of Sciences, Technique, and Technology of Bamako, 91094 Bamako, Mali
| | - Boubacar Traore
- grid.461088.30000 0004 0567 336XMalaria Research and Training Centre, Department of Epidemiology of Parasitic Diseases, International Center of Excellence in Research, University of Sciences, Technique, and Technology of Bamako, 91094 Bamako, Mali
| | - Peter D. Crompton
- grid.419681.30000 0001 2164 9667Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, USA
| | - Silvia Portugal
- grid.419681.30000 0001 2164 9667Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, USA
| | - Miles P. Davenport
- grid.1005.40000 0004 4902 0432The Kirby Institute, UNSW Sydney, Sydney, NSW 2052 Australia
| | - David S. Khoury
- grid.1005.40000 0004 4902 0432The Kirby Institute, UNSW Sydney, Sydney, NSW 2052 Australia
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22
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Merrick CJ. Histone lactylation: a new epigenetic axis for host-parasite signalling in malaria? Trends Parasitol 2023; 39:12-16. [PMID: 36357308 DOI: 10.1016/j.pt.2022.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/21/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022]
Abstract
Epigenetic modifications play important roles in the biology of malaria parasites. The new epigenetic mark histone lactylation, discovered only recently in humans, is also present in malaria parasites. It may have important functions as a key player in the epigenetic repertoire of Plasmodium.
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Affiliation(s)
- Catherine J Merrick
- Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QP, UK.
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23
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Genetic Diversity of Merozoite Surface Protein-1 and -2 Genes in Plasmodium falciparum Isolates among Asymptomatic Population in Boset and Badewacho Districts, Southern Ethiopia. J Parasitol Res 2022; 2022:7728975. [PMID: 36569519 PMCID: PMC9771644 DOI: 10.1155/2022/7728975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/13/2022] [Accepted: 11/26/2022] [Indexed: 12/15/2022] Open
Abstract
Background The genetic variation of Plasmodium falciparum has been studied to assess local malaria transmission genetic profile using evidence-based intervention measures. However, there are no known previous reports of P. falciparum polymorphism in Badewacho and Boset districts, Southern Ethiopia. The purpose of this study was to determine the genetic diversity of the merozoite surface protein-1 and -2 (msp-1 and msp-2) allelic families in P. falciparum isolates from an asymptomatic populations. Methods This study was conducted from finger-prick blood samples spotted on 3 mm Whatman filter paper collected during a community-based cross-sectional study. Nested polymerase chain reaction amplification was used to type the allelic variants of msp-1 and msp-2. Results From 669 asymptomatic study participants, a total of 50 samples positive for P. falciparum were included for molecular analysis. Of 50 positive samples, 43 P. falciparum isolates were successfully amplified for the msp-1 and msp-2 allelic families. A total of twelve different allele sizes (75-250 bp) were identified within the three allelic families of msp-1, whereas ten different allele sizes (250-500 bp) were detected within the two allelic families of msp-2. MAD20 had a higher allelic proportion, 65% among allelic families of msp-1, whereas the 3D7 allelic family 90.7% was higher in msp-2. A slightly higher frequency of polyclonal infection 53.5% was found in msp-2 allelic family, whereas a low proportion polyclonal infection 46.5% was found in msp-1 allelic family. The overall mean multiplicity of infection (MOI) for msp-1 and msp-2 was identical (MOI = 1.56). Correspondingly, the expected heterozygosity (He) value for msp-1 (He = 0.23) and msp-2 (He = 0.22) was almost similar. Conclusions The findings of this study revealed low genetic diversity of the msp-1 and msp-2 allelic families in P. falciparum isolates. However, continued monitoring status of the local genetic diversity profile in the P. falciparum population is required to support current malaria control and elimination strategies.
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24
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Zhang X, Deitsch KW. The mystery of persistent, asymptomatic Plasmodium falciparum infections. Curr Opin Microbiol 2022; 70:102231. [PMID: 36327690 PMCID: PMC10500611 DOI: 10.1016/j.mib.2022.102231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/31/2022] [Accepted: 10/12/2022] [Indexed: 01/25/2023]
Abstract
Plasmodium falciparum causes millions of malaria infections and hundreds of thousands of deaths annually. These parasites avoid the adaptive immune response by systematically cycling through a limited repertoire of variant surface antigens after which the number of circulating parasites drops to extremely low levels, coinciding with a loss of symptoms and eventual clearance of the infection. However, in regions with extended dry seasons or in individuals who no longer reside in endemic areas, asymptomatic infections have been observed to persist for many months or years, potentially serving as reservoirs for transmission. Recent work suggests the possibility that parasites can assume a state in which no variant surface antigens are expressed, thus rendering them virtually invisible to the immune system and enabling them to persist at low levels indefinitely.
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Affiliation(s)
- Xu Zhang
- Department of Microbiology and Immunology, Weill Cornell Medical College, New York, NY, USA
| | - Kirk W Deitsch
- Department of Microbiology and Immunology, Weill Cornell Medical College, New York, NY, USA.
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25
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CD36-A Host Receptor Necessary for Malaria Parasites to Establish and Maintain Infection. Microorganisms 2022; 10:microorganisms10122356. [PMID: 36557610 PMCID: PMC9785914 DOI: 10.3390/microorganisms10122356] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/21/2022] [Accepted: 11/27/2022] [Indexed: 11/30/2022] Open
Abstract
Plasmodium falciparum-infected erythrocytes (PfIEs) present P. falciparum erythrocyte membrane protein 1 proteins (PfEMP1s) on the cell surface, via which they cytoadhere to various endothelial cell receptors (ECRs) on the walls of human blood vessels. This prevents the parasite from passing through the spleen, which would lead to its elimination. Each P. falciparum isolate has about 60 different PfEMP1s acting as ligands, and at least 24 ECRs have been identified as interaction partners. Interestingly, in every parasite genome sequenced to date, at least 75% of the encoded PfEMP1s have a binding domain for the scavenger receptor CD36 widely distributed on host endothelial cells and many other cell types. Here, we discuss why the interaction between PfIEs and CD36 is optimal to maintain a finely regulated equilibrium that allows the parasite to multiply and spread while causing minimal harm to the host in most infections.
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26
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Kayentao K, Ongoiba A, Preston AC, Healy SA, Doumbo S, Doumtabe D, Traore A, Traore H, Djiguiba A, Li S, Peterson ME, Telscher S, Idris AH, Kisalu NK, Carlton K, Serebryannyy L, Narpala S, McDermott AB, Gaudinski M, Traore S, Cisse H, Keita M, Skinner J, Hu Z, Zéguimé A, Ouattara A, Doucoure M, Dolo A, Djimdé A, Traore B, Seder RA, Crompton PD. Safety and Efficacy of a Monoclonal Antibody against Malaria in Mali. N Engl J Med 2022; 387:1833-1842. [PMID: 36317783 PMCID: PMC9881676 DOI: 10.1056/nejmoa2206966] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND CIS43LS is a monoclonal antibody that was shown to protect against controlled Plasmodium falciparum infection in a phase 1 clinical trial. Whether a monoclonal antibody can prevent P. falciparum infection in a region in which the infection is endemic is unknown. METHODS We conducted a phase 2 trial to assess the safety and efficacy of a single intravenous infusion of CIS43LS against P. falciparum infection in healthy adults in Mali over a 6-month malaria season. In Part A, safety was assessed at three escalating dose levels. In Part B, participants were randomly assigned (in a 1:1:1 ratio) to receive 10 mg of CIS43LS per kilogram of body weight, 40 mg of CIS43LS per kilogram, or placebo. The primary efficacy end point, assessed in a time-to-event analysis, was the first P. falciparum infection detected on blood-smear examination, which was performed at least every 2 weeks for 24 weeks. At enrollment, all the participants received artemether-lumefantrine to clear possible P. falciparum infection. RESULTS In Part B, 330 adults underwent randomization; 110 were assigned to each trial group. The risk of moderate headache was 3.3 times as high with 40 mg of CIS43LS per kilogram as with placebo. P. falciparum infections were detected on blood-smear examination in 39 participants (35.5%) who received 10 mg of CIS43LS per kilogram, 20 (18.2%) who received 40 mg of CIS43LS per kilogram, and 86 (78.2%) who received placebo. At 6 months, the efficacy of 40 mg of CIS43LS per kilogram as compared with placebo was 88.2% (adjusted 95% confidence interval [CI], 79.3 to 93.3; P<0.001), and the efficacy of 10 mg of CIS43LS per kilogram as compared with placebo was 75.0% (adjusted 95% CI, 61.0 to 84.0; P<0.001). CONCLUSIONS CIS43LS was protective against P. falciparum infection over a 6-month malaria season in Mali without evident safety concerns. (Funded by the National Institute of Allergy and Infectious Diseases; ClinicalTrials.gov number, NCT04329104.).
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Affiliation(s)
- Kassoum Kayentao
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Aissata Ongoiba
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Anne C Preston
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Sara A Healy
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Safiatou Doumbo
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Didier Doumtabe
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Abdrahamane Traore
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Hamadi Traore
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Adama Djiguiba
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Shanping Li
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Mary E Peterson
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Shinyi Telscher
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Azza H Idris
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Neville K Kisalu
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Kevin Carlton
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Leonid Serebryannyy
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Sandeep Narpala
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Adrian B McDermott
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Martin Gaudinski
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Siriman Traore
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Hamidou Cisse
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Mamadou Keita
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Jeff Skinner
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Zonghui Hu
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Amatigué Zéguimé
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Adama Ouattara
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - M'Bouye Doucoure
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Amagana Dolo
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Abdoulaye Djimdé
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Boubacar Traore
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Robert A Seder
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
| | - Peter D Crompton
- From the Malaria Research and Training Center, Mali International Center for Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, H.C., M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); and the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., S.L., M.E.P., J.S., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, and the Vaccine Research Center, NIAID, NIH, Bethesda (S. Telscher, A.H.I., N.K.K., K.C., L.S., S.N., A.B.M., M.G., R.A.S.) - all in Maryland
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Matambisso G, Brokhattingen N, Maculuve S, Cisteró P, Mbeve H, Escoda A, Miguel J, Buetas E, de Jong I, Cuna B, Melembe C, Ndimande N, Porras G, Chen H, Tetteh KKA, Drakeley C, Gamain B, Chitnis C, Chauhan V, Quintó L, Galatas B, Macete E, Mayor A. Gravidity and malaria trends interact to modify P. falciparum densities and detectability in pregnancy: a 3-year prospective multi-site observational study. BMC Med 2022; 20:396. [PMID: 36376866 PMCID: PMC9664815 DOI: 10.1186/s12916-022-02597-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 10/06/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Low-density Plasmodium falciparum infections prevail in low transmission settings, where immunity is expected to be minimal, suggesting an immune-independent effect on parasite densities. We aimed to describe parasite densities in pregnancy, and determine how gravidity and antibody-mediated immunity affect these, during a period of declining malaria transmission in southern Mozambique. METHODS We documented P. falciparum infections at first antenatal care visits (n = 6471) between November 2016 and October 2019 in Ilha Josina (high-to-moderate transmission area), Manhiça (low transmission area), and Magude (pre-elimination area). Two-way interactions in mixed-effects regression models were used to assess gravidity-dependent differences in quantitative PCR-determined P. falciparum positivity rates (PfPRqPCR) and densities, in the relative proportion of detectable infections (pDi) with current diagnostic tests (≥ 100 parasites/μL) and in antimalarial antibodies. RESULTS PfPRqPCR declined from 28 to 13% in Ilha Josina and from 5-7 to 2% in Magude and Manhiça. In primigravidae, pDi was highest in Ilha Josina at the first study year (p = 0.048), which declined with falling PfPRqPCR (relative change/year: 0.41, 95% CI [0.08; 0.73], p = 0.029), with no differences in antibody levels. Higher parasite densities in primigravidae from Ilha Josina during the first year were accompanied by a larger reduction of maternal hemoglobin levels (- 1.60, 95% CI [- 2.49; - 0.72; p < 0.001), than in Magude (- 0.76, 95% CI [- 1.51; - 0.01]; p = 0.047) and Manhiça (- 0.44, 95% CI [- 0.99; 0.10; p = 0.112). In contrast, multigravidae during the transmission peak in Ilha Josina carried the lowest pDi (p = 0.049). As PfPRqPCR declined, geometric mean of parasite densities increased (4.63, 95% CI [1.28; 16.82], p = 0.020), and antibody levels declined among secundigravidae from Ilha Josina. CONCLUSIONS The proportion of detectable and clinically relevant infections is the highest in primigravid women from high-to-moderate transmission settings and decreases with declining malaria. In contrast, the falling malaria trends are accompanied by increased parasite densities and reduced humoral immunity among secundigravidae. Factors other than acquired immunity thus emerge as potentially important for producing less detectable infections among primigravidae during marked declines in malaria transmission.
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Affiliation(s)
- Glória Matambisso
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | | | - Sónia Maculuve
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Pau Cisteró
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Henriques Mbeve
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Anna Escoda
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Judice Miguel
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Elena Buetas
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Ianthe de Jong
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Boaventura Cuna
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Cardoso Melembe
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Nelo Ndimande
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Gemma Porras
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Haily Chen
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Kevin K A Tetteh
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Chris Drakeley
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Benoit Gamain
- Université de Paris, Biologie Intégrée du Globule Rouge, UMR_S1134, Inserm, 75015, Paris, France
| | - Chetan Chitnis
- Department of Parasites & Insect Vectors, Malaria Parasite Biology and Vaccines, Institut Pasteur, Paris, France
| | - Virander Chauhan
- Malaria Group, International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India
| | - Llorenç Quintó
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.,ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Beatriz Galatas
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.,ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Eusébio Macete
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.,National Directare of Health, Ministry of Health, Maputo, Mozambique
| | - Alfredo Mayor
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique. .,ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain. .,Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain. .,Department of Physiologic Sciences, Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique.
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28
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Faiman R, Yaro AS, Dao A, Sanogo ZL, Diallo M, Samake D, Yossi O, Veru LM, Graber LC, Conte AR, Kouam C, Krajacich BJ, Lehmann T. Isotopic evidence that aestivation allows malaria mosquitoes to persist through the dry season in the Sahel. Nat Ecol Evol 2022; 6:1687-1699. [PMID: 36216903 DOI: 10.1038/s41559-022-01886-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 08/11/2022] [Indexed: 11/09/2022]
Abstract
Data suggest that the malaria vector mosquito Anopheles coluzzii persists during the dry season in the Sahel through a dormancy mechanism known as aestivation; however, the contribution of aestivation compared with alternative strategies such as migration is unknown. Here we marked larval Anopheles mosquitoes in two Sahelian villages in Mali using deuterium (2H) to assess the contribution of aestivation to persistence of mosquitoes through the seven-month dry season. After an initial enrichment period, 33% of An. coluzzii mosquitoes were strongly marked. Seven months following enrichment, multiple analysis methods supported the ongoing presence of marked mosquitoes, compatible with the prediction that the fraction of marked mosquitoes should remain stable throughout the dry season if local aestivation is occurring. The results suggest that aestivation is a major persistence mechanism of An. coluzzii in the Sahel, contributing at least 20% of the adults at the onset of rains. This persistence strategy could influence mosquito control and malaria elimination campaigns.
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Affiliation(s)
- Roy Faiman
- Laboratory of Malaria and Vector Research, NIAID, NIH, Rockville, MD, USA.
| | - Alpha S Yaro
- Malaria Research and Training Center (MRTC)/Faculty of Medicine, Pharmacy and Odonto-stomatology, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Adama Dao
- Malaria Research and Training Center (MRTC)/Faculty of Medicine, Pharmacy and Odonto-stomatology, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Zana L Sanogo
- Malaria Research and Training Center (MRTC)/Faculty of Medicine, Pharmacy and Odonto-stomatology, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Moussa Diallo
- Malaria Research and Training Center (MRTC)/Faculty of Medicine, Pharmacy and Odonto-stomatology, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Djibril Samake
- Malaria Research and Training Center (MRTC)/Faculty of Medicine, Pharmacy and Odonto-stomatology, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Ousmane Yossi
- Malaria Research and Training Center (MRTC)/Faculty of Medicine, Pharmacy and Odonto-stomatology, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Laura M Veru
- Laboratory of Malaria and Vector Research, NIAID, NIH, Rockville, MD, USA
| | - Leland C Graber
- Laboratory of Malaria and Vector Research, NIAID, NIH, Rockville, MD, USA
| | - Abigail R Conte
- Laboratory of Malaria and Vector Research, NIAID, NIH, Rockville, MD, USA
| | - Cedric Kouam
- Laboratory of Malaria and Vector Research, NIAID, NIH, Rockville, MD, USA
| | | | - Tovi Lehmann
- Laboratory of Malaria and Vector Research, NIAID, NIH, Rockville, MD, USA
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Starkloff NC, Civitello DJ. Cascading impacts of host seasonal adaptation on parasitism. Trends Parasitol 2022; 38:942-949. [PMID: 36088213 PMCID: PMC9588794 DOI: 10.1016/j.pt.2022.08.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 01/13/2023]
Abstract
The persistence of parasite populations through harsh seasonal bouts is often critical to circannual disease outbreaks. Parasites have a diverse repertoire of phenotypes for persistence, ranging from transitioning to a different life stage better suited to within-host dormancy to utilizing weather-hardy structures external to hosts. While these adaptive traits allow parasite species to survive through harsh seasons, it is often at survival rates that threaten population persistence. We argue that these periods of parasite (and vector) population busts could be ideal targets for disease intervention. As climate change portends abbreviated host dormancy and extended transmission periods in many host-parasite systems, it is essential to identify novel pathways to shore up current disease-intervention strategies.
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30
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A member of the tryptophan-rich protein family is required for efficient sequestration of Plasmodium berghei schizonts. PLoS Pathog 2022; 18:e1010846. [PMID: 36126089 PMCID: PMC9524624 DOI: 10.1371/journal.ppat.1010846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/30/2022] [Accepted: 08/31/2022] [Indexed: 11/20/2022] Open
Abstract
Protein export and host membrane remodeling are crucial for multiple Plasmodium species to establish a niche in infected hosts. To better understand the contribution of these processes to successful parasite infection in vivo, we sought to find and characterize protein components of the intraerythrocytic Plasmodium berghei-induced membrane structures (IBIS) that form in the cytoplasm of infected erythrocytes. We identified proteins that immunoprecipitate with IBIS1, a signature member of the IBIS in P. berghei-infected erythrocytes. In parallel, we also report our data describing proteins that co-precipitate with the PTEX (Plasmodium translocon of exported proteins) component EXP2. To validate our findings, we examined the location of three candidate IBIS1-interactors that are conserved across multiple Plasmodium species, and we found they localized to IBIS in infected red blood cells and two further colocalized with IBIS1 in the liver-stage parasitophorous vacuole membrane. Successful gene deletion revealed that these two tryptophan-rich domain-containing proteins, termed here IPIS2 and IPIS3 (for intraerythrocytic Plasmodium-induced membrane structures), are required for efficient blood-stage growth. Erythrocytes infected with IPIS2-deficient schizonts in particular fail to bind CD36 as efficiently as wild-type P. berghei-infected cells and therefore fail to effectively sequester out of the circulating blood. Our findings support the idea that intra-erythrocytic membrane compartments are required across species for alterations of the host erythrocyte that facilitate interactions of infected cells with host tissues.
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31
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Declines in prevalence alter the optimal level of sexual investment for the malaria parasite Plasmodium falciparum. Proc Natl Acad Sci U S A 2022; 119:e2122165119. [PMID: 35867831 PMCID: PMC9335338 DOI: 10.1073/pnas.2122165119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Like most human pathogens, the malaria parasite Plasmodium falciparum experiences strong selection pressure from public health interventions such as drug treatment. While most commonly studied in the context of drug targets and related pathways, parasite adaptation to control measures likely extends to phenotypes beyond drug resistance. Here, we use modeling to explore how control measures can reduce levels of within-host competition between P. falciparum genotypes and favor higher rates of sexual investment. We validate these predictions with longitudinally sampled genomic data from French Guiana during a period of malaria decline and find that the most strongly selected genes are enriched for transcription factors involved in commitment to and development of the parasite’s sexual gametocyte form. Successful infectious disease interventions can result in large reductions in parasite prevalence. Such demographic change has fitness implications for individual parasites and may shift the parasite’s optimal life history strategy. Here, we explore whether declining infection rates can alter Plasmodium falciparum’s investment in sexual versus asexual growth. Using a multiscale mathematical model, we demonstrate how the proportion of polyclonal infections, which decreases as parasite prevalence declines, affects the optimal sexual development strategy: Within-host competition in multiclone infections favors a greater investment in asexual growth whereas single-clone infections benefit from higher conversion to sexual forms. At the same time, drug treatment also imposes selection pressure on sexual development by shortening infection length and reducing within-host competition. We assess these models using 148 P. falciparum parasite genomes sampled in French Guiana over an 18-y period of intensive intervention (1998 to 2015). During this time frame, multiple public health measures, including the introduction of new drugs and expanded rapid diagnostic testing, were implemented, reducing P. falciparum malaria cases by an order of magnitude. Consistent with this prevalence decline, we see an increase in the relatedness among parasites, but no single clonal background grew to dominate the population. Analyzing individual allele frequency trajectories, we identify genes that likely experienced selective sweeps. Supporting our model predictions, genes showing the strongest signatures of selection include transcription factors involved in the development of P. falciparum’s sexual gametocyte form. These results highlight how public health interventions impose wide-ranging selection pressures that affect basic parasite life history traits.
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32
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Mooney JP, DonVito SM, Jahateh M, Bittaye H, Bottomley C, D'Alessandro U, Riley EM. Dry season prevalence of Plasmodium falciparum in asymptomatic gambian children, with a comparative evaluation of diagnostic methods. Malar J 2022; 21:171. [PMID: 35672850 PMCID: PMC9172138 DOI: 10.1186/s12936-022-04184-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Subclinical infection with Plasmodium falciparum remains highly prevalent, yet diagnosing these often low-density infections remains a challenge. Infections can be subpatent, falling below the limit of detection for conventional thick-film microscopy and rapid diagnostic testing (RDT). In this study, the prevalence of subclinical P. falciparum infections in school-aged children was characterised at the start of the dry season in the Upper River Region of The Gambia in 2017/2018, with a goal to also compare the utility of different diagnostic tools. METHODS In a cross-sectional survey of children living in 29 villages on the south bank of the Gambia river (median age of 10 years), matched microscopy, rapid diagnostic test (RDT, detecting histidine-rich protein 2) and polymerase chain reaction (PCR, targeting either 18S rRNA or var gene acidic terminal sequence) were used to determine the prevalence of patent and subpatent infections and to compare the performance of the different diagnostic methods. RESULTS The prevalence of var gene acidic terminal sequence (varATS) qPCR-detectable infections was 10.2% (141/1381) with a median density of 3.12 parasites/µL. Malaria prevalence was highly heterogeneous across the region, ranging from < 1% to ~ 40% prevalence in different village clusters. Compared to varATS, 18S rRNA PCR detected fewer low-density infections, with an assay sensitivity of 50% and specificity of 98.8%. Parasite prevalence in the cohort was 2.9% by microscopy and 1.5% by RDT. Compared to varATS qPCR, microscopy and RDT had sensitivities of 11.5% and 9.2%, respectively, although both methods were highly specific (> 98%). Samples that were positive by all three tests (varATS qPCR, RDT and microscopy) had significantly higher parasite densities (median = 1705 parasites/µL) than samples that were positive by varATS qPCR only (median = 2.4 parasites/µL). CONCLUSIONS The majority of subclinical malaria infections in school-aged children were of extremely low parasite density and detectable only by ultra-sensitive PCR analysis. Understanding the duration of these low density infections, their physiological impact and their contribution to sustained parasite transmission is necessary to inform malaria elimination strategies.
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Affiliation(s)
- Jason P Mooney
- Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Ashworth Laboratories, Kings Buildings, Charlotte Auerbach Rd, Edinburgh, EH9 3FL, UK.
| | - Sophia M DonVito
- Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Ashworth Laboratories, Kings Buildings, Charlotte Auerbach Rd, Edinburgh, EH9 3FL, UK
| | - Maimuna Jahateh
- Medical Research Council Unit in The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Haddy Bittaye
- Medical Research Council Unit in The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Christian Bottomley
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Umberto D'Alessandro
- Medical Research Council Unit in The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Eleanor M Riley
- Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Ashworth Laboratories, Kings Buildings, Charlotte Auerbach Rd, Edinburgh, EH9 3FL, UK
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Oresegun DR, Thorpe P, Benavente ED, Campino S, Muh F, Moon RW, Clark TG, Cox-Singh J. De Novo Assembly of Plasmodium knowlesi Genomes From Clinical Samples Explains the Counterintuitive Intrachromosomal Organization of Variant SICAvar and kir Multiple Gene Family Members. Front Genet 2022; 13:855052. [PMID: 35677565 PMCID: PMC9169567 DOI: 10.3389/fgene.2022.855052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/15/2022] [Indexed: 12/31/2022] Open
Abstract
Plasmodium knowlesi, a malaria parasite of Old World macaque monkeys, is used extensively to model Plasmodium biology. Recently, P. knowlesi was found in the human population of Southeast Asia, particularly Malaysia. P. knowlesi causes uncomplicated to severe and fatal malaria in the human host with features in common with the more prevalent and virulent malaria caused by Plasmodium falciparum. As such, P. knowlesi presents a unique opportunity to develop experimental translational model systems for malaria pathophysiology informed by clinical data from same-species human infections. Experimental lines of P. knowlesi represent well-characterized genetically stable parasites, and to maximize their utility as a backdrop for understanding malaria pathophysiology, genetically diverse contemporary clinical isolates, essentially wild-type, require comparable characterization. The Oxford Nanopore PCR-free long-read sequencing platform was used to sequence and de novo assemble P. knowlesi genomes from frozen clinical samples. The sequencing platform and assembly pipelines were designed to facilitate capturing data and describing, for the first time, P. knowlesi schizont-infected cell agglutination (SICA) var and Knowlesi-Interspersed Repeats (kir) multiple gene families in parasites acquired from nature. The SICAvar gene family members code for antigenically variant proteins analogous to the virulence-associated P. falciparum erythrocyte membrane protein (PfEMP1) multiple var gene family. Evidence presented here suggests that the SICAvar family members have arisen through a process of gene duplication, selection pressure, and variation. Highly evolving genes including PfEMP1family members tend to be restricted to relatively unstable sub-telomeric regions that drive change with core genes protected in genetically stable intrachromosomal locations. The comparable SICAvar and kir gene family members are counter-intuitively located across chromosomes. Here, we demonstrate that, in contrast to conserved core genes, SICAvar and kir genes occupy otherwise gene-sparse chromosomal locations that accommodate rapid evolution and change. The novel methods presented here offer the malaria research community not only new tools to generate comprehensive genome sequence data from small clinical samples but also new insight into the complexity of clinically important real-world parasites.
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Affiliation(s)
- Damilola R. Oresegun
- Division of Infection and Global Health, School of Medicine, University of St Andrews, Scotland, United Kingdom
| | - Peter Thorpe
- Division of Infection and Global Health, School of Medicine, University of St Andrews, Scotland, United Kingdom
| | - Ernest Diez Benavente
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Susana Campino
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Fauzi Muh
- Division of Infection and Global Health, School of Medicine, University of St Andrews, Scotland, United Kingdom
| | - Robert William Moon
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Taane Gregory Clark
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Janet Cox-Singh
- Division of Infection and Global Health, School of Medicine, University of St Andrews, Scotland, United Kingdom
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Hopp CS, Skinner J, Anzick SL, Tipton CM, Peterson ME, Li S, Doumbo S, Kayentao K, Ongoiba A, Martens C, Traore B, Crompton PD. Atypical B cells up-regulate costimulatory molecules during malaria and secrete antibodies with T follicular helper cell support. Sci Immunol 2022; 7:eabn1250. [PMID: 35559666 PMCID: PMC11132112 DOI: 10.1126/sciimmunol.abn1250] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Several infectious and autoimmune diseases are associated with an expansion of CD21-CD27- atypical B cells (atBCs) that up-regulate inhibitory receptors and exhibit altered B cell receptor (BCR) signaling. The function of atBCs remains unclear, and few studies have investigated the biology of pathogen-specific atBCs during acute infection. Here, we performed longitudinal flow cytometry analyses and RNA sequencing of Plasmodium falciparum (Pf)-specific B cells isolated from study participants before and shortly after febrile malaria, with simultaneous analysis of influenza hemagglutinin (HA)-specific B cells as a comparator. At the healthy baseline before the malaria season, individuals had similar frequencies of Pf- and HA-specific atBCs that did not differ proportionally from atBCs within the total B cell population. BCR sequencing identified clonal relationships between Pf-specific atBCs, activated B cells (actBCs), and classical memory B cells (MBCs) and revealed comparable degrees of somatic hypermutation. At the healthy baseline, Pf-specific atBCs were transcriptionally distinct from Pf-specific actBCs and classical MBCs. In response to acute febrile malaria, Pf-specific atBCs and actBCs up-regulated similar intracellular signaling cascades. Pf-specific atBCs showed activation of pathways involved in differentiation into antibody-secreting cells and up-regulation of molecules that mediate B-T cell interactions, suggesting that atBCs respond to T follicular helper (TFH) cells. In the presence of TFH cells and staphylococcal enterotoxin B, atBCs of malaria-exposed individuals differentiated into CD38+ antibody-secreting cells in vitro, suggesting that atBCs may actively contribute to humoral immunity to infectious pathogens.
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Affiliation(s)
- Christine S. Hopp
- Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, USA
| | - Jeff Skinner
- Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, USA
| | - Sarah L. Anzick
- Rocky Mountain Laboratory Research Technologies Section, Genomics Unit, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, USA
| | - Christopher M. Tipton
- Lowance Center for Human Immunology, Division of Rheumatology, Department of Medicine, Emory University School of Medicine, Atlanta, USA
| | - Mary E. Peterson
- Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, USA
| | - Shanping Li
- Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, USA
| | - Safiatou Doumbo
- Malaria Research and Training Centre, Department of Epidemiology of Parasitic Diseases, International Center of Excellence in Research, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Kassoum Kayentao
- Malaria Research and Training Centre, Department of Epidemiology of Parasitic Diseases, International Center of Excellence in Research, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Aissata Ongoiba
- Malaria Research and Training Centre, Department of Epidemiology of Parasitic Diseases, International Center of Excellence in Research, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Craig Martens
- Rocky Mountain Laboratory Research Technologies Section, Genomics Unit, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, USA
| | - Boubacar Traore
- Malaria Research and Training Centre, Department of Epidemiology of Parasitic Diseases, International Center of Excellence in Research, University of Sciences, Techniques and Technologies of Bamako, Mali
| | - Peter D. Crompton
- Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, USA
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35
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Studniberg SI, Ioannidis LJ, Utami RAS, Trianty L, Liao Y, Abeysekera W, Li‐Wai‐Suen CSN, Pietrzak HM, Healer J, Puspitasari AM, Apriyanti D, Coutrier F, Poespoprodjo JR, Kenangalem E, Andries B, Prayoga P, Sariyanti N, Smyth GK, Cowman AF, Price RN, Noviyanti R, Shi W, Garnham AL, Hansen DS. Molecular profiling reveals features of clinical immunity and immunosuppression in asymptomatic P. falciparum malaria. Mol Syst Biol 2022; 18:e10824. [PMID: 35475529 PMCID: PMC9045086 DOI: 10.15252/msb.202110824] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 01/12/2023] Open
Abstract
Clinical immunity to P. falciparum malaria is non-sterilizing, with adults often experiencing asymptomatic infection. Historically, asymptomatic malaria has been viewed as beneficial and required to help maintain clinical immunity. Emerging views suggest that these infections are detrimental and constitute a parasite reservoir that perpetuates transmission. To define the impact of asymptomatic malaria, we pursued a systems approach integrating antibody responses, mass cytometry, and transcriptional profiling of individuals experiencing symptomatic and asymptomatic P. falciparum infection. Defined populations of classical and atypical memory B cells and a TH2 cell bias were associated with reduced risk of clinical malaria. Despite these protective responses, asymptomatic malaria featured an immunosuppressive transcriptional signature with upregulation of pathways involved in the inhibition of T-cell function, and CTLA-4 as a predicted regulator in these processes. As proof of concept, we demonstrated a role for CTLA-4 in the development of asymptomatic parasitemia in infection models. The results suggest that asymptomatic malaria is not innocuous and might not support the induction of immune processes to fully control parasitemia or efficiently respond to malaria vaccines.
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Affiliation(s)
- Stephanie I Studniberg
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleVic.Australia,Department of Medical BiologyThe University of MelbourneParkvilleVic.Australia
| | - Lisa J Ioannidis
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleVic.Australia,Department of Medical BiologyThe University of MelbourneParkvilleVic.Australia
| | - Retno A S Utami
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleVic.Australia,Department of Medical BiologyThe University of MelbourneParkvilleVic.Australia,Eijkman Institute for Molecular BiologyJakartaIndonesia
| | - Leily Trianty
- Eijkman Institute for Molecular BiologyJakartaIndonesia
| | - Yang Liao
- Olivia Newton‐John Cancer Research InstituteHeidelbergVic.Australia
| | - Waruni Abeysekera
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleVic.Australia,School of Mathematics and StatisticsThe University of MelbourneParkvilleVic.Australia
| | - Connie S N Li‐Wai‐Suen
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleVic.Australia,School of Mathematics and StatisticsThe University of MelbourneParkvilleVic.Australia
| | - Halina M Pietrzak
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleVic.Australia,Department of Medical BiologyThe University of MelbourneParkvilleVic.Australia
| | - Julie Healer
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleVic.Australia,Department of Medical BiologyThe University of MelbourneParkvilleVic.Australia
| | | | - Dwi Apriyanti
- Eijkman Institute for Molecular BiologyJakartaIndonesia
| | | | | | | | | | - Pak Prayoga
- Papuan Health and Community FoundationPapuaIndonesia
| | | | - Gordon K Smyth
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleVic.Australia,School of Mathematics and StatisticsThe University of MelbourneParkvilleVic.Australia
| | - Alan F Cowman
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleVic.Australia,Department of Medical BiologyThe University of MelbourneParkvilleVic.Australia
| | - Ric N Price
- Global and Tropical Health DivisionMenzies School of Health Research and Charles Darwin UniversityDarwinNTAustralia,Centre for Tropical Medicine and Global HealthNuffield Department of MedicineUniversity of OxfordOxfordUK,Mahidol‐Oxford Tropical Medicine Research UnitMahidol UniversityBangkokThailand
| | | | - Wei Shi
- Olivia Newton‐John Cancer Research InstituteHeidelbergVic.Australia
| | - Alexandra L Garnham
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleVic.Australia,School of Mathematics and StatisticsThe University of MelbourneParkvilleVic.Australia
| | - Diana S Hansen
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleVic.Australia,Department of Medical BiologyThe University of MelbourneParkvilleVic.Australia
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36
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Collins KA, Ceesay S, Drammeh S, Jaiteh FK, Guery MA, Lanke K, Grignard L, Stone W, Conway DJ, D'Alessandro U, Bousema T, Claessens A. A cohort study on the duration of Plasmodium falciparum infections during the dry season in The Gambia. J Infect Dis 2022; 226:128-137. [PMID: 35380684 PMCID: PMC9373158 DOI: 10.1093/infdis/jiac116] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/11/2022] [Indexed: 12/03/2022] Open
Abstract
Background In areas where Plasmodium falciparum malaria is seasonal, a dry season reservoir of blood-stage infection is essential for initiating transmission during the following wet season. Methods In The Gambia, a cohort of 42 individuals with quantitative polymerase chain reaction-positive P falciparum infections at the end of the transmission season (December) were followed monthly until the end of the dry season (May) to evaluate infection persistence. The influence of human host and parasitological factors was investigated. Results A large proportion of individuals infected at the end of the wet season had detectable infections until the end of the dry season (40.0%; 16 of 40). At the start of the dry season, the majority of these persistent infections (82%) had parasite densities >10 p/µL compared to only 5.9% of short-lived infections. Persistent infections (59%) were also more likely to be multiclonal than short-lived infections (5.9%) and were associated with individuals having higher levels of P falciparum-specific antibodies (P = .02). Conclusions Asymptomatic persistent infections were multiclonal with higher parasite densities at the beginning of the dry season. Screening and treating asymptomatic infections during the dry season may reduce the human reservoir of malaria responsible for initiating transmission in the wet season.
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Affiliation(s)
- Katharine A Collins
- Radboud university medical center, Radboud Institute for Health Sciences, Department of Medical Microbiology, Nijmegen, The Netherlands
| | - Sukai Ceesay
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Sainabou Drammeh
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Fatou K Jaiteh
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Marc-Antoine Guery
- LPHI, MIVEGEC, Université de Montpellier, CNRS, INSERM, Montpellier, France
| | - Kjerstin Lanke
- Radboud university medical center, Radboud Institute for Health Sciences, Department of Medical Microbiology, Nijmegen, The Netherlands
| | - Lynn Grignard
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - Will Stone
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - David J Conway
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - Umberto D'Alessandro
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Teun Bousema
- Radboud university medical center, Radboud Institute for Health Sciences, Department of Medical Microbiology, Nijmegen, The Netherlands.,Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, UK
| | - Antoine Claessens
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia.,LPHI, MIVEGEC, Université de Montpellier, CNRS, INSERM, Montpellier, France
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37
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Klaus S, Binder P, Kim J, Machado M, Funaya C, Schaaf V, Klaschka D, Kudulyte A, Cyrklaff M, Laketa V, Höfer T, Guizetti J, Becker NB, Frischknecht F, Schwarz US, Ganter M. Asynchronous nuclear cycles in multinucleated Plasmodium falciparum facilitate rapid proliferation. SCIENCE ADVANCES 2022; 8:eabj5362. [PMID: 35353560 PMCID: PMC8967237 DOI: 10.1126/sciadv.abj5362] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 02/10/2022] [Indexed: 05/20/2023]
Abstract
Malaria-causing parasites proliferate within erythrocytes through schizogony, forming multinucleated stages before cellularization. Nuclear multiplication does not follow a strict geometric 2n progression, and each proliferative cycle produces a variable number of progeny. Here, by tracking nuclei and DNA replication, we show that individual nuclei replicate their DNA at different times, despite residing in a shared cytoplasm. Extrapolating from experimental data using mathematical modeling, we provide strong indication that a limiting factor exists, which slows down the nuclear multiplication rate. Consistent with this prediction, our data show that temporally overlapping DNA replication events were significantly slower than partially overlapping or nonoverlapping events. Our findings suggest the existence of evolutionary pressure that selects for asynchronous DNA replication, balancing available resources with rapid pathogen proliferation.
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Affiliation(s)
- Severina Klaus
- Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Patrick Binder
- Institute for Theoretical Physics and BioQuant, Heidelberg University, Heidelberg, Germany
- Theoretical Systems Biology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Juyeop Kim
- Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Marta Machado
- Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
- Graduate Program in Areas of Basic and Applied Biology, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Charlotta Funaya
- Electron Microscopy Core Facility, Heidelberg University, Heidelberg, Germany
| | - Violetta Schaaf
- Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Darius Klaschka
- Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Aiste Kudulyte
- Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Marek Cyrklaff
- Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Vibor Laketa
- Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Höfer
- Theoretical Systems Biology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Julien Guizetti
- Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Nils B. Becker
- Theoretical Systems Biology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Ulrich S. Schwarz
- Institute for Theoretical Physics and BioQuant, Heidelberg University, Heidelberg, Germany
| | - Markus Ganter
- Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
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38
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Roe MS, O’Flaherty K, Fowkes FJ. Can malaria parasites be spontaneously cleared? Trends Parasitol 2022; 38:356-364. [DOI: 10.1016/j.pt.2022.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 12/25/2022]
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Amare A, Eshetu T, Lemma W. Dry-season transmission and determinants of Plasmodium infections in Jawi district, northwest Ethiopia. Malar J 2022; 21:45. [PMID: 35164768 PMCID: PMC8842575 DOI: 10.1186/s12936-022-04068-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/30/2022] [Indexed: 11/12/2022] Open
Abstract
Background Malaria remains a serious global public health problem, and continues to have a devastating impact on people’s health worldwide. Continuous monitoring and evaluation of current malaria transmission status in different seasons is a mainstay for the success of ongoing intervention strategies for malaria. The purpose of this study was to assess the dry-season transmission and determinants of malaria in Jawi district, northwest Ethiopia. Methods A community-based cross-sectional study was conducted from January 13 to February 11, 2020; among selected Kebeles in the Jawi district. A multistage sampling technique was used in this study. Random and systematic sampling techniques were carried out to select Kebeles and each household, respectively. Light microscopy and CareStart™ Malaria HRP2/pLDH (Pf/Pv) Combo RDT were implemented to determine the prevalence of malaria. Moreover, associated risk factors in the prevalence of malaria were assessed by using a bivariate and multivariate logistic regression model. Results A total of 219 study participants were enrolled in this study. Of the total enrolled individuals, malaria cases were found among 36 individuals with a positivity rate of 16.4% (95% CI 11.4–21.5). Plasmodium falciparum was the predominant species with an estimated prevalence of 87.0% in the study areas. Interrupted utilization of ITN (AOR = 4.411, 95% CI 1.401–13.880), using over 3 years older ITNs (AOR = 9.622, 95% CI 1.881–49.214), travel history (AOR = 12.703, 95% CI 2.441–66.114), living in a house with holes on the wall (AOR = 3.811, 95% CI 1.010–14.384), and living in a house with an eave (AOR = 4.23, 95% CI 1.065–16.801) significantly increased the probability of malaria positivity rate. Conclusion Malaria is still an important public health burden among individuals in the Jawi district. Interrupted utilization of ITNs, using over 3 years older ITNs, living in a house with holes on the wall, living in a house with an eave, and travel history were identified as the risk factors of malaria. Therefore, the District health office and Health extension workers should promote daily utilization of good ITNs and improve housing conditions to reduce malaria prevalence.
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40
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Dizon BLP, Pierce SK. The tangled web of autoreactive B cells in malaria immunity and autoimmune disease. Trends Parasitol 2022; 38:379-389. [PMID: 35120815 PMCID: PMC9012675 DOI: 10.1016/j.pt.2022.01.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 12/16/2022]
Abstract
Two seminal observations suggest that the African genome contains genes selected by malaria that protect against systemic lupus erythematosus (SLE) in individuals chronically exposed to malaria, but which in the absence of malaria, are risk factors for SLE. First, Brian Greenwood observed that SLE was rare in Africa and that malaria prevented SLE-like disease in susceptible mice. Second, African-Americans, as compared with individuals of European descent, are at higher risk of SLE. Understanding that antibodies play central roles in malaria immunity and SLE, we discuss how autoreactive B cells contribute to malaria immunity but promote SLE pathology in the absence of malaria. Testing this model may provide insights into the regulation of autoreactivity and identify new therapeutic targets for SLE.
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Affiliation(s)
- Brian L P Dizon
- Rheumatology Fellowship and Training Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA; Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA.
| | - Susan K Pierce
- Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA.
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41
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Mackenzie G, Jensen RW, Lavstsen T, Otto TD. Varia: a tool for prediction, analysis and visualisation of variable genes. BMC Bioinformatics 2022; 23:52. [PMID: 35073845 PMCID: PMC8785495 DOI: 10.1186/s12859-022-04573-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 01/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Parasites use polymorphic gene families to evade the immune system or interact with the host. Assessing the diversity and expression of such gene families in pathogens can inform on the repertoire or host interaction phenotypes of clinical relevance. However, obtaining the sequences and quantifying their expression is a challenge. In Plasmodium falciparum, the highly polymorphic var genes encode the major virulence protein, PfEMP1, which bind a range of human receptors through varying combinations of DBL and CIDR domains. Here we present a tool, Varia, to predict near full-length gene sequences and domain compositions of query genes from database genes sharing short sequence tags. Varia generates output through two complementary pipelines. Varia_VIP returns all putative gene sequences and domain compositions of the query gene from any partial sequence provided, thereby enabling experimental validation of specific genes of interest and detailed assessment of their putative domain structure. Varia_GEM accommodates rapid profiling of var gene expression in complex patient samples from DBLα expression sequence tags (EST), by computing a sample overall transcript profile stratified by PfEMP1 domain types. Results Varia_VIP was tested querying sequence tags from all DBL domain types using different search criteria. On average 92% of query tags had one or more 99% identical database hits, resulting in the full-length query gene sequence being identified (> 99% identical DNA > 80% of query gene) among the five most prominent database hits, for ~ 33% of the query genes. Optimized Varia_GEM settings allowed correct prediction of > 90% of domains placed among the four most N-terminal domains, including the DBLα domain, and > 70% of C-terminal domains. With this accuracy, N-terminal domains could be predicted for > 80% of queries, whereas prediction rates of C-terminal domains dropped with the distance from the DBLα from 70 to 40%. Conclusion Prediction of var sequence and domain composition is possible from short sequence tags. Varia can be used to guide experimental validation of PfEMP1 sequences of interest and conduct high-throughput analysis of var type expression in patient samples. Supplementary Information The online version contains supplementary material available at 10.1186/s12859-022-04573-6.
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42
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Bourgouin C, Puchot N, Paul R. [To stick or not to stick: A Plasmodium falciparum adaptive strategy to persist during the dry season]. Med Sci (Paris) 2022; 38:9-12. [PMID: 35060875 DOI: 10.1051/medsci/2021230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Catherine Bourgouin
- Unité de Génétique fonctionnelle des maladies infectieuses, Institut Pasteur, CNRS UMR 2000, 75015 Paris, France
| | - Nicolas Puchot
- Unité de Génétique fonctionnelle des maladies infectieuses, Institut Pasteur, CNRS UMR 2000, 75015 Paris, France
| | - Richard Paul
- Unité de Génétique fonctionnelle des maladies infectieuses, Institut Pasteur, CNRS UMR 2000, 75015 Paris, France
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43
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O'Flaherty K, Roe M, Fowkes FJ. The role of naturally acquired antimalarial antibodies in subclinical
Plasmodium
spp. infection. J Leukoc Biol 2022; 111:1097-1105. [PMID: 35060185 PMCID: PMC9303632 DOI: 10.1002/jlb.5mr1021-537r] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/09/2021] [Indexed: 12/17/2022] Open
Affiliation(s)
- Katherine O'Flaherty
- Disease Elimination Program Burnet Institute for Medical Research and Public Health Melbourne Australia
| | - Merryn Roe
- Disease Elimination Program Burnet Institute for Medical Research and Public Health Melbourne Australia
- School of Public Health and Preventive Medicine Monash University Melbourne Australia
| | - Freya J.I. Fowkes
- Disease Elimination Program Burnet Institute for Medical Research and Public Health Melbourne Australia
- School of Public Health and Preventive Medicine Monash University Melbourne Australia
- Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health, The University of Melbourne Melbourne Australia
- Department of Infectious Disease Monash University Melbourne Australia
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44
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Zhang X, Florini F, Visone JE, Lionardi I, Gross MR, Patel V, Deitsch KW. A coordinated transcriptional switching network mediates antigenic variation of human malaria parasites. eLife 2022; 11:83840. [PMID: 36515978 PMCID: PMC9833823 DOI: 10.7554/elife.83840] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
Malaria parasites avoid immune clearance through their ability to systematically alter antigens exposed on the surface of infected red blood cells. This is accomplished by tightly regulated transcriptional control of individual members of a large, multicopy gene family called var and is the key to both the virulence and chronic nature of malaria infections. Expression of var genes is mutually exclusive and controlled epigenetically, however how large populations of parasites coordinate var gene switching to avoid premature exposure of the antigenic repertoire is unknown. Here, we provide evidence for a transcriptional network anchored by a universally conserved gene called var2csa that coordinates the switching process. We describe a structured switching bias that shifts overtime and could shape the pattern of var expression over the course of a lengthy infection. Our results provide an explanation for a previously mysterious aspect of malaria infections and shed light on how parasites possessing a relatively small repertoire of variant antigen-encoding genes can coordinate switching events to limit antigen exposure, thereby maintaining chronic infections.
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Affiliation(s)
- Xu Zhang
- Department of Microbiology and Immunology, Weill Cornell Medical CollegeNew YorkUnited States
| | - Francesca Florini
- Department of Microbiology and Immunology, Weill Cornell Medical CollegeNew YorkUnited States
| | - Joseph E Visone
- Department of Microbiology and Immunology, Weill Cornell Medical CollegeNew YorkUnited States
| | - Irina Lionardi
- Jill Roberts Center for Inflammatory Bowel Disease, Weill Cornell Medical CollegeNew YorkUnited States
| | - Mackensie R Gross
- Department of Microbiology and Immunology, Weill Cornell Medical CollegeNew YorkUnited States
| | - Valay Patel
- Department of Microbiology and Immunology, Weill Cornell Medical CollegeNew YorkUnited States
| | - Kirk W Deitsch
- Department of Microbiology and Immunology, Weill Cornell Medical CollegeNew YorkUnited States
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Mooney JP, DonVito SM, Jahateh M, Bittaye H, Keith M, Galloway LJ, Ndow M, Cunnington AJ, D'Alessandro U, Bottomley C, Riley EM. 'Bouncing Back' From Subclinical Malaria: Inflammation and Erythrocytosis After Resolution of P. falciparum Infection in Gambian Children. Front Immunol 2022; 13:780525. [PMID: 35154104 PMCID: PMC8831762 DOI: 10.3389/fimmu.2022.780525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
Recent malaria is associated with an increased risk of systemic bacterial infection. The aetiology of this association is unclear but malaria-related haemolysis may be one contributory factor. To characterise the physiological consequences of persistent and recently resolved malaria infections and associated haemolysis, 1650 healthy Gambian children aged 8-15 years were screened for P. falciparum infection (by 18sRNA PCR) and/or anaemia (by haematocrit) at the end of the annual malaria transmission season (t1). P. falciparum-infected children and children with moderate or severe anaemia (haemoglobin concentration < 11g/dl) were age matched to healthy, uninfected, non-anaemic controls and screened again 2 months later (t2). Persistently infected children (PCR positive at t1 and t2) had stable parasite burdens and did not differ significantly haematologically or in terms of proinflammatory markers from healthy, uninfected children. However, among persistently infected children, IL-10 concentrations were positively correlated with parasite density suggesting a tolerogenic response to persistent infection. By contrast, children who naturally resolved their infections (positive at t1 and negative at t2) exhibited mild erythrocytosis and concentrations of pro-inflammatory markers were raised compared to other groups of children. These findings shed light on a 'resetting' and potential overshoot of the homeostatic haematological response following resolution of malaria infection. Interestingly, the majority of parameters tested were highly heterogeneous in uninfected children, suggesting that some may be harbouring cryptic malaria or other infections.
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Affiliation(s)
- Jason P Mooney
- Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Sophia M DonVito
- Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Maimuna Jahateh
- Medical Research Council Unit in The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, Gambia
| | - Haddy Bittaye
- Medical Research Council Unit in The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, Gambia
| | - Marianne Keith
- Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Lauren J Galloway
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - Mortala Ndow
- Medical Research Council Unit in The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, Gambia
| | - Aubrey J Cunnington
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Umberto D'Alessandro
- Medical Research Council Unit in The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, Gambia
| | - Christian Bottomley
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Eleanor M Riley
- Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
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Chahine Z, Le Roch KG. Decrypting the complexity of the human malaria parasite biology through systems biology approaches. FRONTIERS IN SYSTEMS BIOLOGY 2022; 2:940321. [PMID: 37200864 PMCID: PMC10191146 DOI: 10.3389/fsysb.2022.940321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The human malaria parasite, Plasmodium falciparum, is a unicellular protozoan responsible for over half a million deaths annually. With a complex life cycle alternating between human and invertebrate hosts, this apicomplexan is notoriously adept at evading host immune responses and developing resistance to all clinically administered treatments. Advances in omics-based technologies, increased sensitivity of sequencing platforms and enhanced CRISPR based gene editing tools, have given researchers access to more in-depth and untapped information about this enigmatic micro-organism, a feat thought to be infeasible in the past decade. Here we discuss some of the most important scientific achievements made over the past few years with a focus on novel technologies and platforms that set the stage for subsequent discoveries. We also describe some of the systems-based methods applied to uncover gaps of knowledge left through single-omics applications with the hope that we will soon be able to overcome the spread of this life-threatening disease.
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47
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Nguyen HHT, Azizan S, Yeoh LM, Tang J, Duffy MF. RNAseq of Infected Erythrocyte Surface Antigen-Encoding Genes. Methods Mol Biol 2022; 2470:185-209. [PMID: 35881347 DOI: 10.1007/978-1-0716-2189-9_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Massive parallel sequencing technology has greatly increased the breadth and depth of transcriptomic data that can be captured from P. falciparum samples. This has revolutionized in vitro studies but uptake has been slower in the analysis of clinical samples. The principal barriers are the removal of contaminating white blood cells in a malaria endemic setting and preservation of the RNA. We provide here detailed methods for the collection of purified infected erythrocytes and the preservation and extraction of RNA. We also provide methods for assessing and addressing contaminating RNA from erythroid cells, and a protocol for RNAseq library preparation optimized to maximize yield from low amounts of parasite mRNA. Finally, we provide some examples of RNAseq library characteristics that may fail quality control for other species but are in fact satisfactory for P. falciparum RNAseq.
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Affiliation(s)
- Hanh Hong Thi Nguyen
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
- Peter Doherty Institute, Melbourne, VIC, Australia
- Bio21 Institute, Parkville, VIC, Australia
| | - Suffian Azizan
- Bio21 Institute, Parkville, VIC, Australia
- School of BioSciences, The University of Melbourne, Parkville, VIC, Australia
| | - Lee Ming Yeoh
- Peter Doherty Institute, Melbourne, VIC, Australia
- Bio21 Institute, Parkville, VIC, Australia
- Department of Microbiology and Immunology, School of Biomedical Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Jingyi Tang
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, VIC, Australia
| | - Michael F Duffy
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia.
- Peter Doherty Institute, Melbourne, VIC, Australia.
- Bio21 Institute, Parkville, VIC, Australia.
- Department of Microbiology and Immunology, School of Biomedical Sciences, The University of Melbourne, Parkville, VIC, Australia.
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48
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Guillochon E, Fraering J, Joste V, Kamaliddin C, Vianou B, Houzé L, Baudrin LG, Faucher JF, Aubouy A, Houzé S, Cot M, Argy N, Taboureau O, Bertin GI. OUP accepted manuscript. J Infect Dis 2022; 225:2187-2196. [PMID: 35255125 PMCID: PMC9200161 DOI: 10.1093/infdis/jiac086] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
Cerebral malaria (CM) is the severest form of Plasmodium falciparum infection. Children under 5 years old are those most vulnerable to CM, and they consequently have the highest risk of malaria-related death. Parasite-associated factors leading to CM are not yet fully elucidated. We therefore sought to characterize the gene expression profile associated with CM, using RNA sequencing data from 15 CM and 15 uncomplicated malaria isolates from Benin. Cerebral malaria parasites displayed reduced circulation times, possibly related to higher cytoadherence capacity. Consistent with the latter, we detected increased var genes abundance in CM isolates. Differential expression analyses showed that distinct transcriptome profiles are signatures of malaria severity. Genes involved in adhesion, excluding variant surface antigens, were dysregulated, supporting the idea of increased cytoadhesion capacity of CM parasites. Finally, we found dysregulated expression of genes in the entry into host pathway that may reflect greater erythrocyte invasion capacity of CM parasites.
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Affiliation(s)
- E Guillochon
- Université Paris Cité, MERIT, IRD, Paris, France
- Université Paris Cité, INSERM U1133, CNRS UMR 8251, Paris, France
| | - J Fraering
- Université Paris Cité, MERIT, IRD, Paris, France
| | - V Joste
- Université Paris Cité, MERIT, IRD, Paris, France
- Parasitology Laboratory, Hôpital Bichat - Claude-Bernard, APHP, Paris, France
- French Malaria Reference Center, Hôpital Bichat, APHP, Paris, France
| | - C Kamaliddin
- Cumming School of Medicine, The University of Calgary, Calgary, Alberta, Canada
| | - B Vianou
- Université Paris Cité, MERIT, IRD, Paris, France
- Institut de Recherche Clinique du Bénin, Cotonou, Bénin
| | - L Houzé
- Université Paris Cité, MERIT, IRD, Paris, France
| | - L G Baudrin
- Institut Curie Genomics of Excellence Platform, PSL Research University, Research Center, Institut Curie, Paris, France
| | - J F Faucher
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - A Aubouy
- Université de Toulouse, PHARMADEV, IRD, UPS, Toulouse, France
| | - S Houzé
- Université Paris Cité, MERIT, IRD, Paris, France
- Parasitology Laboratory, Hôpital Bichat - Claude-Bernard, APHP, Paris, France
- French Malaria Reference Center, Hôpital Bichat, APHP, Paris, France
| | - M Cot
- Université Paris Cité, MERIT, IRD, Paris, France
| | - N Argy
- Université Paris Cité, MERIT, IRD, Paris, France
- Parasitology Laboratory, Hôpital Bichat - Claude-Bernard, APHP, Paris, France
- French Malaria Reference Center, Hôpital Bichat, APHP, Paris, France
| | - O Taboureau
- Université Paris Cité, INSERM U1133, CNRS UMR 8251, Paris, France
| | - G I Bertin
- Correspondence: Gwladys I. Bertin, PhD, Université Paris Cité, MERIT, IRD, 4 avenue de l’Observatoire, 75006 Paris, France ()
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49
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Zupko RJ, Nguyen TD, Somé AF, Tran TNA, Gerardin J, Dudas P, Giang DDH, Tran KT, Wesolowski A, Ouédraogo JB, Boni MF. Long-term effects of increased adoption of artemisinin combination therapies in Burkina Faso. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000111. [PMID: 36962300 PMCID: PMC10021447 DOI: 10.1371/journal.pgph.0000111] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/09/2022] [Indexed: 11/18/2022]
Abstract
Artemisinin combination therapies (ACTs) are the WHO-recommended first-line therapies for uncomplicated Plasmodium falciparum malaria. The emergence and spread of artemisinin-resistant genotypes is a major global public health concern due to the increased rate of treatment failures that result. This is particularly germane for WHO designated 'high burden to high impact' (HBHI) countries, such as Burkina Faso, where there is increased emphasis on improving guidance, strategy, and coordination of local malaria response in an effort to reduce the prevalence of P. falciparum malaria. To explore how the increased adoption of ACTs may affect the HBHI malaria setting of Burkina Faso, we added spatial structure to a validated individual-based stochastic model of P. falciparum transmission and evaluated the long-term effects of increased ACT use. We explored how de novo emergence of artemisinin-resistant genotypes, such as pfkelch13 580Y, may occur under scenarios in which private-market drugs are eliminated or multiple first-line therapies (MFT) are deployed. We found that elimination of private market drugs would result in lower treatment failures rates (between 11.98% and 12.90%) when compared to the status quo (13.11%). However, scenarios incorporating MFT with equal deployment of artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DHA-PPQ) may accelerate near-term drug resistance (580Y frequency ranging between 0.62 to 0.84 in model year 2038) and treatment failure rates (26.69% to 34.00% in 2038), due to early failure and substantially reduced treatment efficacy resulting from piperaquine-resistant genotypes. A rebalanced MFT approach (90% AL, 10% DHA-PPQ) results in approximately equal long-term outcomes to using AL alone but may be difficult to implement in practice.
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Affiliation(s)
- Robert J Zupko
- Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, United States of America
| | - Tran Dang Nguyen
- Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, United States of America
| | - Anyirékun Fabrice Somé
- Institut de Recherche en Sciences de la Santé, Direction Régionale de l'Ouest, Bobo Dioulasso, Burkina Faso
| | - Thu Nguyen-Anh Tran
- Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, United States of America
| | - Jaline Gerardin
- Department of Preventive Medicine and Institute for Global Health, Northwestern University, Chicago, IL, United States of America
| | - Patrick Dudas
- Institute for Computational and Data Sciences, Pennsylvania State University, University Park, PA, United States of America
| | - Dang Duy Hoang Giang
- Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Kien Trung Tran
- Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, United States of America
| | - Amy Wesolowski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | | | - Maciej F Boni
- Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, University Park, PA, United States of America
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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50
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Fu R, Du W, Jin X, Wang R, Lin X, Su Y, Yang H, Shan X, Lv W, Zheng Z, Huang G. Microfluidic Biosensor for Rapid Nucleic Acid Quantitation Based on Hyperspectral Interferometric Amplicon-Complex Analysis. ACS Sens 2021; 6:4057-4066. [PMID: 34694791 DOI: 10.1021/acssensors.1c01491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Nucleic acid detection plays a vital role in both biomedical research and clinical medicine. The temperature circulation changes of the widely used polymerase chain reaction technique are time-consuming and technically challenging for system development. Recombinase polymerase amplification (RPA) is an isothermal method for rapid nucleic acid detection. However, current RPA amplicon detection methods are complicated and expensive and easily generate false positives, restricting the promotion of RPA techniques. In this work, a hyperspectral interferometric amplicon-complex quantitation method is presented, combined with asymmetric dipole complex strategy optical scattering analysis. GelRed dye was utilized to form amplicon-complex particles, and the Fourier domain spectrum computation contributed to complex scattering quantitation. With this method, a supporting microfluidic chip and automatic system were developed to achieve integrated, rapid, quantitative, and miniscule nucleic acid detection. The Plasmodium falciparum dhfr gene was utilized as an example for targeted nucleic acid quantitation and single nucleotide polymorphism detection. The total reaction time was decreased to merely 20 min, and the limit of detection was only 3.17 ng/μL. The minimum measurable concentration of target was 1.68 copies/μL, 31.67 times more sensitive than turbidity detection, and the single reaction chamber was only 9.33 μL. No scattering increase occurred for template-free control, and thus, false positives caused by primer dimers and nonspecific products could be avoided. The experimental results prove that the provided method and system can detect single-base mutations in the dhfr gene and is a reasonable technique for rapid, automatic, and low-cost nucleic acid detection.
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Affiliation(s)
- Rongxin Fu
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Wenli Du
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Xiangyu Jin
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Ruliang Wang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Xue Lin
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Ya Su
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Han Yang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Xiaohui Shan
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Wenqi Lv
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Zhi Zheng
- Department of Biochemistry and Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing 100730, China
| | - Guoliang Huang
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
- National Engineering Research Center for Beijing Biochip Technology, Beijing 102206, China
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