1
|
Stucke EM, Lawton JG, Travassos MA. ApoE: A new piece to the severe malaria puzzle. Pediatr Res 2024; 96:12-14. [PMID: 38388820 DOI: 10.1038/s41390-024-03096-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024]
Affiliation(s)
- Emily M Stucke
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jonathan G Lawton
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Mark A Travassos
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, USA.
| |
Collapse
|
2
|
Ndila CM, Nyirongo V, Macharia AW, Jeffreys AE, Rowlands K, Hubbart C, Busby GBJ, Band G, Harding RM, Rockett KA, Williams TN. Haplotype heterogeneity and low linkage disequilibrium reduce reliable prediction of genotypes for the ‑α 3.7I form of α-thalassaemia using genome-wide microarray data. Wellcome Open Res 2021; 5:287. [PMID: 34632085 PMCID: PMC8474104 DOI: 10.12688/wellcomeopenres.16320.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2021] [Indexed: 12/26/2022] Open
Abstract
Background: The -α
3.7I-thalassaemia deletion is very common throughout Africa because it protects against malaria. When undertaking studies to investigate human genetic adaptations to malaria or other diseases, it is important to account for any confounding effects of α-thalassaemia to rule out spurious associations. Methods: In this study, we have used direct α-thalassaemia genotyping to understand why GWAS data from a large malaria association study in Kilifi Kenya did not identify the α-thalassaemia signal. We then explored the potential use of a number of new approaches to using GWAS data for imputing α-thalassaemia as an alternative to direct genotyping by PCR. Results: We found very low linkage-disequilibrium of the directly typed data with the GWAS SNP markers around α-thalassaemia and across the haemoglobin-alpha (
HBA) gene region, which along with a complex haplotype structure, could explain the lack of an association signal from the GWAS SNP data. Some indirect typing methods gave results that were in broad agreement with those derived from direct genotyping and could identify an association signal, but none were sufficiently accurate to allow correct interpretation compared with direct typing, leading to confusing or erroneous results. Conclusions: We conclude that going forwards, direct typing methods such as PCR will still be required to account for α-thalassaemia in GWAS studies.
Collapse
Affiliation(s)
- Carolyne M Ndila
- Department of Epidemiology and Demography, KEMRI-Wellcome Trust Research Programme, Kilifi, PO BOX 230-80108, Kenya
| | - Vysaul Nyirongo
- United Nation Statistics Division, United Nations, New York, New York, 10017, USA
| | - Alexander W Macharia
- Department of Epidemiology and Demography, KEMRI-Wellcome Trust Research Programme, Kilifi, PO BOX 230-80108, Kenya
| | - Anna E Jeffreys
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, Oxfordshire, OX3 7BN, UK
| | - Kate Rowlands
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, Oxfordshire, OX3 7BN, UK
| | - Christina Hubbart
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, Oxfordshire, OX3 7BN, UK
| | - George B J Busby
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, Oxfordshire, OX3 7BN, UK.,Centre for Genomics and Global Health, Big Data Institute, University of Oxford, Oxford, Oxfordshire, OX3 7LF, UK
| | - Gavin Band
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, Oxfordshire, OX3 7BN, UK.,Parasites and Microbes Programme, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridgeshire, CB10 1SA, UK
| | - Rosalind M Harding
- Departments of Zoology and Statistics, University of Oxford, Oxford, Oxfordshire, OX1 3SZ, UK
| | - Kirk A Rockett
- Wellcome Centre for Human Genetics, University of Oxford, Oxford, Oxfordshire, OX3 7BN, UK.,Parasites and Microbes Programme, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridgeshire, CB10 1SA, UK
| | - Thomas N Williams
- Department of Epidemiology and Demography, KEMRI-Wellcome Trust Research Programme, Kilifi, PO BOX 230-80108, Kenya.,Department of Infectious Diseases, Imperial College Faculty of Medicine, London, W2 1NY, UK
| | | |
Collapse
|
3
|
Ndila CM, Nyirongo V, Macharia AW, Jeffreys AE, Rowlands K, Hubbart C, Busby GBJ, Band G, Harding RM, Rockett KA, Williams TN. Haplotype heterogeneity and low linkage disequilibrium reduce reliable prediction of genotypes for the ‑α3.7I form of α-thalassaemia using genome-wide microarray data. Wellcome Open Res 2020; 5:287. [DOI: 10.12688/wellcomeopenres.16320.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2020] [Indexed: 11/20/2022] Open
Abstract
Background: The -α3.7I-thalassaemia deletion is very common throughout Africa because it protects against malaria. When undertaking studies to investigate human genetic adaptations to malaria or other diseases, it is important to account for any confounding effects of α-thalassaemia to rule out spurious associations. Methods: In this study we have used direct α-thalassaemia genotyping to understand why GWAS data from a large malaria association study in Kilifi Kenya did not identify the α-thalassaemia signal. We then explored the potential use of a number of new approaches to using GWAS data for imputing α-thalassaemia as an alternative to direct genotyping by PCR. Results: We found very low linkage-disequilibrium of the directly typed data with the GWAS SNP markers around α-thalassaemia and across the haemoglobin-alpha (HBA) gene region, which along with a complex haplotype structure, could explain the lack of an association signal from the GWAS SNP data. Some indirect typing methods gave results that were in broad agreement with those derived from direct genotyping and could identify an association signal, but none were sufficiently accurate to allow correct interpretation compared with direct typing, leading to confusing or erroneous results. Conclusions: We conclude that going forwards, direct typing methods such as PCR will still be required to account for α-thalassaemia in GWAS studies.
Collapse
|
4
|
Lwanira CN, Kironde F, Swedberg G. Haptoglobin gene diversity and incidence of uncomplicated malaria among children in Iganga, Uganda. Malar J 2020; 19:435. [PMID: 33243242 PMCID: PMC7690179 DOI: 10.1186/s12936-020-03515-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/19/2020] [Indexed: 11/15/2022] Open
Abstract
Background Haptoglobin (Hp) is an acute phase protein that takes part in systemic regulation of haem during Plasmodium falciparum infections. Numerous genotypes of haptoglobin have been reported in malaria endemic populations. In this study, the relationship between haptoglobin genotypes and incidence of uncomplicated malaria in a cohort of children living in a malaria-endemic area of Uganda was determined. Methods This is an extension of a longitudinal study comprising of 423 children aged between six months and nine years, who were actively followed up for one year. Malaria episodes occurring in the cohort children were detected and the affected children treated with national policy drug regimen. Haptoglobin genotypes were determined by an allele-specific PCR method and their frequencies were calculated. A multivariate negative binomial regression model was used to estimate the impact of haptoglobin genotypes on incidence of uncomplicated malaria in the children’s cohort. In all statistical tests, a P–value of < 0.05 was considered as significant. Results The prevalence of the Hp 1–1, Hp 2–1 and Hp 2–2 genotypes in the children’s cohort was 41%, 36.2% and 22.9%, respectively. The overall frequency for the Hp 1 allele was 59%, while Hp 2 allele occurred at a frequency of 41%. After adjustment of incidence rates for age, insecticide treated bed net (ITN) use and malaria history, the incidence of uncomplicated malaria for children carrying the Hp 2–2 genotype and those with the Hp 2–1 genotype was statistically similar (P = 0.41). Also, no difference in the incidence of uncomplicated malaria was observed between children carrying the Hp 1–1 genotype and those having the Hp 2–1 genotype (P = 0.84) or between Hp 2–2 Vs Hp 1–1 genotypes (P = 0.50). Conclusions This study showed that the Hp 1–1 and Hp 2–1 genotypes each occur in nearly 4 in 10 children and the Hp 2–2 genotype occurs in 2 of every 10 children. No association with incidence of uncomplicated malaria was found. Additional studies of influence of haptoglobin genotypes on P. falciparum malaria severity are needed to understand the role of these genotypes in malarial protection.
Collapse
Affiliation(s)
- Catherine N Lwanira
- School of Biomedical Sciences, College of Health Sciences, Makerere University, PO Box 7072, Kampala, Uganda. .,Department of Biochemistry, Uganda Christian University School of Medicine, PO BOX 4, Mukono, Uganda.
| | - Fred Kironde
- School of Biomedical Sciences, College of Health Sciences, Makerere University, PO Box 7072, Kampala, Uganda.,Habib Medical School, Faculty of Health Sciences, Islamic University in Uganda (IUIU), Kampala Campus, Uganda
| | - Göte Swedberg
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| |
Collapse
|
5
|
Nairz M, Weiss G. Iron in infection and immunity. Mol Aspects Med 2020; 75:100864. [PMID: 32461004 DOI: 10.1016/j.mam.2020.100864] [Citation(s) in RCA: 163] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/25/2020] [Accepted: 05/05/2020] [Indexed: 12/12/2022]
Abstract
Iron is an essential micronutrient for virtually all living cells. In infectious diseases, both invading pathogens and mammalian cells including those of the immune system require iron to sustain their function, metabolism and proliferation. On the one hand, microbial iron uptake is linked to the virulence of most human pathogens. On the other hand, the sequestration of iron from bacteria and other microorganisms is an efficient strategy of host defense in line with the principles of 'nutritional immunity'. In an acute infection, host-driven iron withdrawal inhibits the growth of pathogens. Chronic immune activation due to persistent infection, autoimmune disease or malignancy however, sequesters iron not only from infectious agents, autoreactive lymphocytes and neoplastic cells but also from erythroid progenitors. This is one of the key mechanisms which collectively result in the anemia of chronic inflammation. In this review, we highlight the most important interconnections between iron metabolism and immunity, focusing on host defense against relevant infections and on the clinical consequences of anemia of inflammation.
Collapse
Affiliation(s)
- Manfred Nairz
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck, Austria; Christian Doppler Laboratory for Iron Metabolism and Anemia Research, Medical University of Innsbruck, Austria.
| |
Collapse
|
6
|
di Masi A, De Simone G, Ciaccio C, D'Orso S, Coletta M, Ascenzi P. Haptoglobin: From hemoglobin scavenging to human health. Mol Aspects Med 2020; 73:100851. [PMID: 32660714 DOI: 10.1016/j.mam.2020.100851] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 02/07/2023]
Abstract
Haptoglobin (Hp) belongs to the family of acute-phase plasma proteins and represents the most important plasma detoxifier of hemoglobin (Hb). The basic Hp molecule is a tetrameric protein built by two α/β dimers. Each Hp α/β dimer is encoded by a single gene and is synthesized as a single polypeptide. Following post-translational protease-dependent cleavage of the Hp polypeptide, the α and β chains are linked by disulfide bridge(s) to generate the mature Hp protein. As human Hp gene is characterized by two common Hp1 and Hp2 alleles, three major genotypes can result (i.e., Hp1-1, Hp2-1, and Hp2-2). Hp regulates Hb clearance from circulation by the macrophage-specific receptor CD163, thus preventing Hb-mediated severe consequences for health. Indeed, the antioxidant and Hb binding properties of Hp as well as its ability to stimulate cells of the monocyte/macrophage lineage and to modulate the helper T-cell type 1 and type 2 balance significantly associate with a variety of pathogenic disorders (e.g., infectious diseases, diabetes, cardiovascular diseases, and cancer). Alternative functions of the variants Hp1 and Hp2 have been reported, particularly in the susceptibility and protection against infectious (e.g., pulmonary tuberculosis, HIV, and malaria) and non-infectious (e.g., diabetes, cardiovascular diseases and obesity) diseases. Both high and low levels of Hp are indicative of clinical conditions: Hp plasma levels increase during infections, inflammation, and various malignant diseases, and decrease during malnutrition, hemolysis, hepatic disease, allergic reactions, and seizure disorders. Of note, the Hp:Hb complexes display heme-based reactivity; in fact, they bind several ferrous and ferric ligands, including O2, CO, and NO, and display (pseudo-)enzymatic properties (e.g., NO and peroxynitrite detoxification). Here, genetic, biochemical, biomedical, and biotechnological aspects of Hp are reviewed.
Collapse
Affiliation(s)
- Alessandra di Masi
- Department of Sciences, Roma Tre University, Viale Guglielmo Marconi 446, I-00146 Roma, Italy
| | - Giovanna De Simone
- Department of Sciences, Roma Tre University, Viale Guglielmo Marconi 446, I-00146 Roma, Italy
| | - Chiara Ciaccio
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata", Via Montpellier 1, I-00133, Roma, Italy; Interuniversity Consortium for the Research on the Chemistry of Metals in Biological Systems, Via Celso Ulpiani 27, I-70126, Bari, Italy
| | - Silvia D'Orso
- Department of Sciences, Roma Tre University, Viale Guglielmo Marconi 446, I-00146 Roma, Italy
| | - Massimo Coletta
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata", Via Montpellier 1, I-00133, Roma, Italy; Interuniversity Consortium for the Research on the Chemistry of Metals in Biological Systems, Via Celso Ulpiani 27, I-70126, Bari, Italy
| | - Paolo Ascenzi
- Interdepartmental Laboratory for Electron Microscopy, Roma Tre University, Via della Vasca Navale 79, I-00146, Roma, Italy.
| |
Collapse
|
7
|
Damena D, Denis A, Golassa L, Chimusa ER. Genome-wide association studies of severe P. falciparum malaria susceptibility: progress, pitfalls and prospects. BMC Med Genomics 2019; 12:120. [PMID: 31409341 PMCID: PMC6693204 DOI: 10.1186/s12920-019-0564-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 07/29/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND P. falciparum malaria has been recognized as one of the prominent evolutionary selective forces of human genome that led to the emergence of multiple host protective alleles. A comprehensive understanding of the genetic bases of severe malaria susceptibility and resistance can potentially pave ways to the development of new therapeutics and vaccines. Genome-wide association studies (GWASs) have recently been implemented in malaria endemic areas and identified a number of novel association genetic variants. However, there are several open questions around heritability, epistatic interactions, genetic correlations and associated molecular pathways among others. Here, we assess the progress and pitfalls of severe malaria susceptibility GWASs and discuss the biology of the novel variants. RESULTS We obtained all severe malaria susceptibility GWASs published thus far and accessed GWAS dataset of Gambian populations from European Phenome Genome Archive (EGA) through the MalariaGen consortium standard data access protocols. We noticed that, while some of the well-known variants including HbS and ABO blood group were replicated across endemic populations, only few novel variants were convincingly identified and their biological functions remain to be understood. We estimated SNP-heritability of severe malaria at 20.1% in Gambian populations and showed how advanced statistical genetic analytic methods can potentially be implemented in malaria susceptibility studies to provide useful functional insights. CONCLUSIONS The ultimate goal of malaria susceptibility study is to discover a novel causal biological pathway that provide protections against severe malaria; a fundamental step towards translational medicine such as development of vaccine and new therapeutics. Beyond singe locus analysis, the future direction of malaria susceptibility requires a paradigm shift from single -omics to multi-stage and multi-dimensional integrative functional studies that combines multiple data types from the human host, the parasite, the mosquitoes and the environment. The current biotechnological and statistical advances may eventually lead to the feasibility of systems biology studies and revolutionize malaria research.
Collapse
Affiliation(s)
- Delesa Damena
- Division of Human Genetics, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Private Bag, Rondebosch, Cape Town, 7700 South Africa
| | - Awany Denis
- Division of Human Genetics, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Private Bag, Rondebosch, Cape Town, 7700 South Africa
| | - Lemu Golassa
- Aklilu Lema Institute of Pathobiology, Addis Ababa University, PO box 1176, Addis Ababa, Ethiopia
| | - Emile R. Chimusa
- Division of Human Genetics, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Private Bag, Rondebosch, Cape Town, 7700 South Africa
| |
Collapse
|
8
|
Abah SE, Burté F, Marquet S, Brown BJ, Akinkunmi F, Oyinloye G, Afolabi NK, Omokhodion S, Lagunju I, Shokunbi WA, Wahlgren M, Dessein H, Argiro L, Dessein AJ, Noyvert B, Hunt L, Elgar G, Sodeinde O, Holder AA, Fernandez-Reyes D. Low plasma haptoglobin is a risk factor for life-threatening childhood severe malarial anemia and not an exclusive consequence of hemolysis. Sci Rep 2018; 8:17527. [PMID: 30510258 PMCID: PMC6277387 DOI: 10.1038/s41598-018-35944-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 09/21/2018] [Indexed: 12/21/2022] Open
Abstract
Severe Malarial Anemia (SMA), a life-threatening childhood Plasmodium falciparum malaria syndrome requiring urgent blood transfusion, exhibits inflammatory and hemolytic pathology. Differentiating between hypo-haptoglobinemia due to hemolysis or that of genetic origin is key to understand SMA pathogenesis. We hypothesized that while malaria-induced hypo-haptoglobinemia should reverse at recovery, that of genetic etiology should not. We carried-out a case-control study of children living under hyper-endemic holoendemic malaria burden in the sub-Saharan metropolis of Ibadan, Nigeria. We show that hypo-haptoglobinemia is a risk factor for childhood SMA and not solely due to intravascular hemolysis from underlying schizogony. In children presenting with SMA, hypo-haptoglobinemia remains through convalescence to recovery suggesting a genetic cause. We identified a haptoglobin gene variant, rs12162087 (g.-1203G > A, frequency = 0.67), to be associated with plasma haptoglobin levels (p = 8.5 × 10-6). The Homo-Var:(AA) is associated with high plasma haptoglobin while the reference Homo-Ref:(GG) is associated with hypo-haptoglobinemia (p = 2.3 × 10-6). The variant is associated with SMA, with the most support for a risk effect for Homo-Ref genotype. Our insights on regulatory haptoglobin genotypes and hypo-haptoglobinemia suggest that haptoglobin screening could be part of risk-assessment algorithms to prevent rapid disease progression towards SMA in regions with no-access to urgent blood transfusion where SMA accounts for high childhood mortality rates.
Collapse
Affiliation(s)
- Samuel Eneọjọ Abah
- Francis Crick Institute, 1 Midland Road, London, NW1 1AT, United Kingdom
| | - Florence Burté
- Francis Crick Institute, 1 Midland Road, London, NW1 1AT, United Kingdom
| | - Sandrine Marquet
- Aix-Marseille University, Inserm GIMP, Labex ParaFrap, Marseille, 13385, France.,Aix-Marseille University, Inserm Laboratoire TAGC/U1090, Marseille, 13288, France
| | - Biobele J Brown
- Department of Paediatrics, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria.,Childhood Malaria Research Group, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
| | - Francis Akinkunmi
- Department of Paediatrics, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
| | - Gbeminiyi Oyinloye
- Department of Paediatrics, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria.,Childhood Malaria Research Group, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
| | - Nathaniel K Afolabi
- Department of Paediatrics, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria.,Childhood Malaria Research Group, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
| | - Samuel Omokhodion
- Department of Paediatrics, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria.,Childhood Malaria Research Group, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
| | - Ikeoluwa Lagunju
- Department of Paediatrics, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria.,Childhood Malaria Research Group, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
| | - Wuraola A Shokunbi
- Childhood Malaria Research Group, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria.,Department of Haematology, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
| | - Mats Wahlgren
- Department of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Hélia Dessein
- Aix-Marseille University, Inserm GIMP, Labex ParaFrap, Marseille, 13385, France
| | - Laurent Argiro
- Aix-Marseille University, Inserm GIMP, Labex ParaFrap, Marseille, 13385, France
| | - Alain J Dessein
- Aix-Marseille University, Inserm GIMP, Labex ParaFrap, Marseille, 13385, France
| | - Boris Noyvert
- Francis Crick Institute, 1 Midland Road, London, NW1 1AT, United Kingdom
| | - Lilian Hunt
- Francis Crick Institute, 1 Midland Road, London, NW1 1AT, United Kingdom
| | - Greg Elgar
- Francis Crick Institute, 1 Midland Road, London, NW1 1AT, United Kingdom
| | - Olugbemiro Sodeinde
- Department of Paediatrics, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria.,Childhood Malaria Research Group, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria.,Department of Computer Science, Faculty of Engineering, University College London, Gower Street, London, WC1E 6BT, United Kingdom
| | - Anthony A Holder
- Francis Crick Institute, 1 Midland Road, London, NW1 1AT, United Kingdom
| | - Delmiro Fernandez-Reyes
- Department of Paediatrics, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria. .,Childhood Malaria Research Group, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria. .,Department of Computer Science, Faculty of Engineering, University College London, Gower Street, London, WC1E 6BT, United Kingdom.
| |
Collapse
|
9
|
Ndila CM, Uyoga S, Macharia AW, Nyutu G, Peshu N, Ojal J, Shebe M, Awuondo KO, Mturi N, Tsofa B, Sepúlveda N, Clark TG, Band G, Clarke G, Rowlands K, Hubbart C, Jeffreys A, Kariuki S, Marsh K, Mackinnon M, Maitland K, Kwiatkowski DP, Rockett KA, Williams TN, Abathina A, Abubakar I, Achidi E, Agbenyega T, Aiyegbo M, Akoto A, Allen A, Allen S, Amenga-Etego L, Amodu F, Amodu O, Anchang-Kimbi J, Ansah N, Ansah P, Ansong D, Antwi S, Anyorigiya T, Apinjoh T, Asafo-Agyei E, Asoala V, Atuguba F, Auburn S, Bah A, Bamba K, Bancone G, Band G, Barnwell D, Barry A, Bauni E, Besingi R, Bojang K, Bougouma E, Bull S, Busby G, Camara A, Camara L, Campino S, Carter R, Carucci D, Casals-Pascual C, Ceesay N, Ceesay P, Chau T, Chuong L, Clark T, Clarke G, Cole-Ceesay R, Conway D, Cook K, Cook O, Cornelius V, Corran P, Correa S, Cox S, Craik R, Danso B, Davis T, Day N, Deloukas P, Dembele A, deVries J, Dewasurendra R, Diakite M, Diarra E, Dibba Y, Diss A, Djimdé A, Dolo A, Doumbo O, Doyle A, Drakeley C, Drury E, Duffy P, Dunstan S, Ebonyi A, Elhassan A, Elhassan I, Elzein A, Enimil A, Esangbedo P, Evans J, Evans J, Farrar J, Fernando D, Fitzpatrick K, Fullah J, Garcia J, Ghansah A, Gottleib M, Green A, Hart L, Hennsman M, Hien T, Hieu N, Hilton E, Hodgson A, Horstmann R, Hubbart C, Hughes C, Hussein A, Hutton R, Ibrahim M, Ishengoma D, Jaiteh J, Jallow M, Jallow M, Jammeh K, Jasseh M, Jeffreys A, Jobarteh A, Johnson K, Joseph S, Jyothi D, Kachala D, Kamuya D, Kanyi H, Karunajeewa H, Karunaweera N, Keita M, Kerasidou A, Khan A, Kivinen K, Kokwaro G, Konate A, Konate S, Koram K, Kwiatkowski D, Laman M, Le S, Leffler E, Lemnge M, Lin E, Ly A, Macharia A, MacInnis B, Mai N, Makani J, Malangone C, Mangano V, Manjurano A, Manneh L, Manning L, Manske M, Marsh K, Marsh V, Maslen G, Maxwell C, Mbunwe E, McCreight M, Mead D, Mendy A, Mendy A, Mensah N, Michon P, Miles A, Miotto O, Modiano D, Mohamed H, Molloy S, Molyneux M, Molyneux S, Moore M, Moyes C, Mtei F, Mtove G, Mueller I, Mugri R, Munthali A, Mutabingwa T, Nadjm B, Ndi A, Ndila C, Newton C, Niangaly A, Njie H, Njie J, Njie M, Njie M, Njie S, Njiragoma L, Nkrumah F, Ntunthama N, Nyika A, Nyirongo V, O'Brien J, Obu H, Oduro A, Ofori A, Olaniyan S, Olaosebikan R, Oluoch T, Omotade O, Oni O, Onykwelu E, Opi D, Orimadegun A, O'Riordan S, Ouedraogo I, Oyola S, Parker M, Pearson R, Pensulo P, Peshu N, Phiri A, Phu N, Pinder M, Pirinen M, Plowe C, Potter C, Poudiougou B, Puijalon O, Quyen N, Ragoussis I, Ragoussis J, Rasheed O, Reeder J, Reyburn H, Riley E, Risley P, Rockett K, Rodford J, Rogers J, Rogers W, Rowlands K, Ruano-Rubio V, Sabally-Ceesay K, Sadiq A, Saidy-Khan M, Saine H, Sakuntabhai A, Sall A, Sambian D, Sambou I, SanJoaquin M, Sepúlveda N, Shah S, Shelton J, Siba P, Silva N, Simmons C, Simpore J, Singhasivanon P, Sinh D, Sirima S, Sirugo G, Sisay-Joof F, Sissoko S, Small K, Somaskantharajah E, Spencer C, Stalker J, Stevens M, Suriyaphol P, Sylverken J, Taal B, Tall A, Taylor T, Teo Y, Thai C, Thera M, Titanji V, Toure O, Troye-Blomberg M, Usen S, Uyoga S, Vanderwal A, Wangai H, Watson R, Williams T, Wilson M, Wrigley R, Yafi C, Yamoah L. Human candidate gene polymorphisms and risk of severe malaria in children in Kilifi, Kenya: a case-control association study. Lancet Haematol 2018; 5:e333-e345. [PMID: 30033078 PMCID: PMC6069675 DOI: 10.1016/s2352-3026(18)30107-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Human genetic factors are important determinants of malaria risk. We investigated associations between multiple candidate polymorphisms-many related to the structure or function of red blood cells-and risk for severe Plasmodium falciparum malaria and its specific phenotypes, including cerebral malaria, severe malaria anaemia, and respiratory distress. METHODS We did a case-control study in Kilifi County, Kenya. We recruited as cases children presenting with severe malaria to the high-dependency ward of Kilifi County Hospital. We included as controls infants born in the local community between Aug 1, 2006, and Sept 30, 2010, who were part of a genetics study. We tested for associations between a range of candidate malaria-protective genes and risk for severe malaria and its specific phenotypes. We used a permutation approach to account for multiple comparisons between polymorphisms and severe malaria. We judged p values less than 0·005 significant for the primary analysis of the association between candidate genes and severe malaria. FINDINGS Between June 11, 1995, and June 12, 2008, 2244 children with severe malaria were recruited to the study, and 3949 infants were included as controls. Overall, 263 (12%) of 2244 children with severe malaria died in hospital, including 196 (16%) of 1233 with cerebral malaria. We investigated 121 polymorphisms in 70 candidate severe malaria-associated genes. We found significant associations between risk for severe malaria overall and polymorphisms in 15 genes or locations, of which most were related to red blood cells: ABO, ATP2B4, ARL14, CD40LG, FREM3, INPP4B, G6PD, HBA (both HBA1 and HBA2), HBB, IL10, LPHN2 (also known as ADGRL2), LOC727982, RPS6KL1, CAND1, and GNAS. Combined, these genetic associations accounted for 5·2% of the variance in risk for developing severe malaria among individuals in the general population. We confirmed established associations between severe malaria and sickle-cell trait (odds ratio [OR] 0·15, 95% CI 0·11-0·20; p=2·61 × 10-58), blood group O (0·74, 0·66-0·82; p=6·26 × 10-8), and -α3·7-thalassaemia (0·83, 0·76-0·90; p=2·06 × 10-6). We also found strong associations between overall risk of severe malaria and polymorphisms in both ATP2B4 (OR 0·76, 95% CI 0·63-0·92; p=0·001) and FREM3 (0·64, 0·53-0·79; p=3·18 × 10-14). The association with FREM3 could be accounted for by linkage disequilibrium with a complex structural mutation within the glycophorin gene region (comprising GYPA, GYPB, and GYPE) that encodes for the rare Dantu blood group antigen. Heterozygosity for Dantu was associated with risk for severe malaria (OR 0·57, 95% CI 0·49-0·68; p=3·22 × 10-11), as was homozygosity (0·26, 0·11-0·62; p=0·002). INTERPRETATION Both ATP2B4 and the Dantu blood group antigen are associated with the structure and function of red blood cells. ATP2B4 codes for plasma membrane calcium-transporting ATPase 4 (the major calcium pump on red blood cells) and the glycophorins are ligands for parasites to invade red blood cells. Future work should aim at uncovering the mechanisms by which these polymorphisms can result in severe malaria protection and investigate the implications of these associations for wider health. FUNDING Wellcome Trust, UK Medical Research Council, European Union, and Foundation for the National Institutes of Health as part of the Bill & Melinda Gates Grand Challenges in Global Health Initiative.
Collapse
|
10
|
Opi DH, Swann O, Macharia A, Uyoga S, Band G, Ndila CM, Harrison EM, Thera MA, Kone AK, Diallo DA, Doumbo OK, Lyke KE, Plowe CV, Moulds JM, Shebbe M, Mturi N, Peshu N, Maitland K, Raza A, Kwiatkowski DP, Rockett KA, Williams TN, Rowe JA. Two complement receptor one alleles have opposing associations with cerebral malaria and interact with α +thalassaemia. eLife 2018; 7:e31579. [PMID: 29690995 PMCID: PMC5953541 DOI: 10.7554/elife.31579] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 04/01/2018] [Indexed: 12/13/2022] Open
Abstract
Malaria has been a major driving force in the evolution of the human genome. In sub-Saharan African populations, two neighbouring polymorphisms in the Complement Receptor One (CR1) gene, named Sl2 and McCb, occur at high frequencies, consistent with selection by malaria. Previous studies have been inconclusive. Using a large case-control study of severe malaria in Kenyan children and statistical models adjusted for confounders, we estimate the relationship between Sl2 and McCb and malaria phenotypes, and find they have opposing associations. The Sl2 polymorphism is associated with markedly reduced odds of cerebral malaria and death, while the McCb polymorphism is associated with increased odds of cerebral malaria. We also identify an apparent interaction between Sl2 and α+thalassaemia, with the protective association of Sl2 greatest in children with normal α-globin. The complex relationship between these three mutations may explain previous conflicting findings, highlighting the importance of considering genetic interactions in disease-association studies.
Collapse
Affiliation(s)
- D Herbert Opi
- Kenya Medical Research Institute-Wellcome Trust Research ProgrammeKilifiKenya
- Centre for Immunity, Infection and Evolution, Institute of Immunology and Infection Research, School of Biological SciencesUniversity of EdinburghEdinburghUnited Kingdom
| | - Olivia Swann
- Centre for Immunity, Infection and Evolution, Institute of Immunology and Infection Research, School of Biological SciencesUniversity of EdinburghEdinburghUnited Kingdom
| | - Alexander Macharia
- Kenya Medical Research Institute-Wellcome Trust Research ProgrammeKilifiKenya
| | - Sophie Uyoga
- Kenya Medical Research Institute-Wellcome Trust Research ProgrammeKilifiKenya
| | - Gavin Band
- Wellcome Trust Centre for Human GeneticsUniversity of OxfordOxfordUnited Kingdom
| | - Carolyne M Ndila
- Kenya Medical Research Institute-Wellcome Trust Research ProgrammeKilifiKenya
| | - Ewen M Harrison
- Centre for Medical InfomaticsUsher Insitute of Population Health Sciences and Informatics, University of EdinburghEdinburghUnited Kingdom
| | - Mahamadou A Thera
- Malaria Research and Training Centre, Faculty of Medicine, Pharmacy, and DentistryUniversity of BamakoBamakoMali
| | - Abdoulaye K Kone
- Malaria Research and Training Centre, Faculty of Medicine, Pharmacy, and DentistryUniversity of BamakoBamakoMali
| | - Dapa A Diallo
- Malaria Research and Training Centre, Faculty of Medicine, Pharmacy, and DentistryUniversity of BamakoBamakoMali
| | - Ogobara K Doumbo
- Malaria Research and Training Centre, Faculty of Medicine, Pharmacy, and DentistryUniversity of BamakoBamakoMali
| | - Kirsten E Lyke
- Division of Malaria Research, Institute for Global HealthUniversity of Maryland School of MedicineBaltimoreUnited States
| | - Christopher V Plowe
- Division of Malaria Research, Institute for Global HealthUniversity of Maryland School of MedicineBaltimoreUnited States
| | | | - Mohammed Shebbe
- Kenya Medical Research Institute-Wellcome Trust Research ProgrammeKilifiKenya
| | - Neema Mturi
- Kenya Medical Research Institute-Wellcome Trust Research ProgrammeKilifiKenya
| | - Norbert Peshu
- Kenya Medical Research Institute-Wellcome Trust Research ProgrammeKilifiKenya
| | - Kathryn Maitland
- Kenya Medical Research Institute-Wellcome Trust Research ProgrammeKilifiKenya
- Department of MedicineImperial CollegeLondonUnited Kingdom
| | - Ahmed Raza
- Centre for Immunity, Infection and Evolution, Institute of Immunology and Infection Research, School of Biological SciencesUniversity of EdinburghEdinburghUnited Kingdom
| | - Dominic P Kwiatkowski
- Wellcome Trust Centre for Human GeneticsUniversity of OxfordOxfordUnited Kingdom
- Wellcome Trust Sanger InstituteCambridgeUnited Kingdom
| | - Kirk A Rockett
- Wellcome Trust Centre for Human GeneticsUniversity of OxfordOxfordUnited Kingdom
| | - Thomas N Williams
- Kenya Medical Research Institute-Wellcome Trust Research ProgrammeKilifiKenya
- Department of MedicineImperial CollegeLondonUnited Kingdom
| | - J Alexandra Rowe
- Centre for Immunity, Infection and Evolution, Institute of Immunology and Infection Research, School of Biological SciencesUniversity of EdinburghEdinburghUnited Kingdom
| |
Collapse
|
11
|
Chapin J, Giardina PJ. Thalassemia Syndromes. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00040-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
|
12
|
Awasthi G, Tyagi S, Kumar V, Patel SK, Rojh D, Sakrappanavar V, Kochar SK, Talukdar A, Samanta B, Das A, Srivastava S, Patankar S. A Proteogenomic Analysis of Haptoglobin in Malaria. Proteomics Clin Appl 2017; 12:e1700077. [PMID: 28960920 DOI: 10.1002/prca.201700077] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 08/08/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Gauri Awasthi
- Molecular Parasitology Lab; Department of Biosciences and Bioengineering; IIT Bombay; Mumbai Maharashtra India
| | - Suchi Tyagi
- National Institute of Malaria Research; Field Unit, Civil Hospital; Nadiad Gujarat India
| | - Vipin Kumar
- Proteomics Lab; Department of Biosciences and Bioengineering; IIT Bombay; Mumbai Maharashtra India
| | - Sandip Kumar Patel
- Proteomics Lab; Department of Biosciences and Bioengineering; IIT Bombay; Mumbai Maharashtra India
| | | | - Vijeth Sakrappanavar
- Department of Medicine; Basaveshwara Medical College and Hospital; Chitradurga Karnataka India
| | | | - Arunansu Talukdar
- Medicine Department; Medical College Hospital Kolkata; Kolkata West Bengal India
| | - Biaus Samanta
- Medicine Department; Medical College Hospital Kolkata; Kolkata West Bengal India
| | - Aparup Das
- ICMR-National Institute for research in Tribal Health; Jabalpur Madhya Pradesh India
| | - Sanjeeva Srivastava
- Proteomics Lab; Department of Biosciences and Bioengineering; IIT Bombay; Mumbai Maharashtra India
| | - Swati Patankar
- Molecular Parasitology Lab; Department of Biosciences and Bioengineering; IIT Bombay; Mumbai Maharashtra India
| |
Collapse
|
13
|
Marquet S. Overview of human genetic susceptibility to malaria: From parasitemia control to severe disease. INFECTION GENETICS AND EVOLUTION 2017; 66:399-409. [PMID: 28579526 DOI: 10.1016/j.meegid.2017.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 05/31/2017] [Accepted: 06/01/2017] [Indexed: 10/19/2022]
Abstract
Malaria is a life-threatening blood disease caused by the protozoan Plasmodium. Infection may lead to several different patterns of symptoms in the host: asymptomatic state, uncomplicated disease or severe disease. Severe malaria occurs mostly in young children and is a major cause of death. Disease is thought to result from the sequestration of parasites in the small blood vessels of the brain and the deregulation of key immune system elements. The cellular and molecular regulatory mechanisms underlying the pathogenesis of disease are however not fully understood. What is known it is that the genetic determinants of the host play an important role in the severity of the disease and the outcome of infection. Here we review the most convincing results obtained through genetic epidemiology studies concerning the genetic control of malaria in human caused by Plasmodium falciparum infection. The identification of genes conferring susceptibility or resistance to malaria might improve diagnosis and treatment.
Collapse
Affiliation(s)
- Sandrine Marquet
- Aix-Marseille University, INSERM, GIMP, Labex ParaFrap, Marseille, France.
| |
Collapse
|
14
|
Zhang J, He J, Mao X, Zeng X, Chen H, Su J, Zhu B. Haematological and electrophoretic characterisation of β-thalassaemia in Yunnan province of Southwestern China. BMJ Open 2017; 7:e013367. [PMID: 28143837 PMCID: PMC5293871 DOI: 10.1136/bmjopen-2016-013367] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES β-Thalassaemia is widely found in Southwestern China. Characterisation of β-thalassaemia can improve screening and prenatal diagnosis for at-risk populations. DESIGN A retrospective study. METHODS In this study, the levels of haemoglobin alpha 2 (HbA2) and haemoglobin alpha (HbA) were analysed by gender for a total of 15 067 subjects screened by capillary electrophoresis. The cut-off value with the highest accuracy was established to identify β-thalassaemia in 723 patients suspected to have this disease. Haematological and electrophoretic characterisation of eight common types of β-thalassaemia were analysed in 486 β-thalassaemia subjects. RESULTS HbA levels were significantly higher in men than in women, but there was no significant difference on HbA2 levels. A new cut-off value for the diagnosis of β-thalassaemia (HbA2≥4.0%) with the highest accuracy was proposed for the studied populations. Haemoglobin (Hb) was significantly higher in men compared with women (p<0.05), whereas no statistically significant differences were found for mean cell volume (MCV), mean cell haemoglobin (MCH), HbA and HbA2. The haemoglobin E (HbE) group showed comparatively higher values for haematological indices (Hb, MCV and MCH) than the other genotypes in heterozygous β-thalassaemia groups (p<0.05), and -28 (A>G) (HBB (β-globin):c.-78A>C) had significantly higher HbA2 values compared with other β-thalassaemia. CONCLUSIONS Ethnic groups have diversified β-globin gene mutations and considerable haematological variations. Our study will lay the foundation for screening programmes and clinical management of thalassaemia in Southwestern China.
Collapse
Affiliation(s)
- Jie Zhang
- Yunnan Provincial Key Laboratory For Birth Defects and Genetic Diseases, Genetic Diagnosis Center, the First People's Hospital of Yunnan Province, Kunming, China
- Genetics Department, Kunming University of Science and Technology
| | - Jing He
- Yunnan Provincial Key Laboratory For Birth Defects and Genetic Diseases, Genetic Diagnosis Center, the First People's Hospital of Yunnan Province, Kunming, China
- Genetics Department, Kunming University of Science and Technology
| | - Xiaoqin Mao
- Department of Clinical Laboratory, The First People's Hospital of Yunnan Province, Kunming, China
| | - Xiaohong Zeng
- Yunnan Provincial Key Laboratory For Birth Defects and Genetic Diseases, Genetic Diagnosis Center, the First People's Hospital of Yunnan Province, Kunming, China
- Genetics Department, Kunming University of Science and Technology
| | - Hong Chen
- Yunnan Provincial Key Laboratory For Birth Defects and Genetic Diseases, Genetic Diagnosis Center, the First People's Hospital of Yunnan Province, Kunming, China
- Genetics Department, Kunming University of Science and Technology
| | - Jie Su
- Yunnan Provincial Key Laboratory For Birth Defects and Genetic Diseases, Genetic Diagnosis Center, the First People's Hospital of Yunnan Province, Kunming, China
- Genetics Department, Kunming University of Science and Technology
| | - Baosheng Zhu
- Yunnan Provincial Key Laboratory For Birth Defects and Genetic Diseases, Genetic Diagnosis Center, the First People's Hospital of Yunnan Province, Kunming, China
- Genetics Department, Kunming University of Science and Technology
| |
Collapse
|
15
|
Immunological properties of oxygen-transport proteins: hemoglobin, hemocyanin and hemerythrin. Cell Mol Life Sci 2016; 74:293-317. [PMID: 27518203 PMCID: PMC5219038 DOI: 10.1007/s00018-016-2326-7] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 07/17/2016] [Accepted: 08/03/2016] [Indexed: 01/22/2023]
Abstract
It is now well documented that peptides with enhanced or alternative functionality (termed cryptides) can be liberated from larger, and sometimes inactive, proteins. A primary example of this phenomenon is the oxygen-transport protein hemoglobin. Aside from respiration, hemoglobin and hemoglobin-derived peptides have been associated with immune modulation, hematopoiesis, signal transduction and microbicidal activities in metazoans. Likewise, the functional equivalents to hemoglobin in invertebrates, namely hemocyanin and hemerythrin, act as potent immune effectors under certain physiological conditions. The purpose of this review is to evaluate the true extent of oxygen-transport protein dynamics in innate immunity, and to impress upon the reader the multi-functionality of these ancient proteins on the basis of their structures. In this context, erythrocyte-pathogen antibiosis and the immune competences of various erythroid cells are compared across diverse taxa.
Collapse
|
16
|
Mmbando BP, Mgaya J, Cox SE, Mtatiro SN, Soka D, Rwezaula S, Meda E, Msaki E, Snow RW, Jeffries N, Geller NL, Makani J. Negative Epistasis between Sickle and Foetal Haemoglobin Suggests a Reduction in Protection against Malaria. PLoS One 2015; 10:e0125929. [PMID: 25965586 PMCID: PMC4428884 DOI: 10.1371/journal.pone.0125929] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 03/26/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Haemoglobin variants, Sickle (HbS) and foetal (HbF) have been associated with malaria protection. This study explores epistatic interactions between HbS and HbF on malaria infection. METHODS The study was conducted between March 2004 and December 2013 within the sickle cell disease (SCD) programme at Muhimbili National Hospital, Tanzania. SCD status was categorized into HbAA, HbAS and HbSS using hemoglobin electrophoresis and High Performance Liquid Chromatography (HPLC). HbF levels were determined by HPLC. Malaria was diagnosed using rapid diagnostic test and/or blood film. Logistic regression and generalized estimating equations models were used to evaluate associations between SCD status, HbF and malaria. FINDINGS 2,049 individuals with age range 0-70 years, HbAA 311(15.2%), HbAS 241(11.8%) and HbSS 1,497(73.1%) were analysed. At enrolment, malaria prevalence was significantly higher in HbAA 13.2% compared to HbAS 1.24% and HbSS 1.34% (p<0.001). Mean HbF was lower in those with malaria compared to those without malaria in HbAA (0.43% vs 0.82%) but was the reverse in HbSS (8.10% vs 5.59%). An increase in HbF was associated with a decrease in risk of malaria OR=0.50 (95%CI: 0.28, 0.90; p=0.021) in HbAA, whereas for HbSS the risk of malaria increased OR=2.94 (1.44, 5.98; p=0.003). A similar pattern was seen during multiple visits; HbAA OR=0.52 (0.34, 0.80; p=0.003) vs HbSS OR=2.01 (1.27, 3.23; p=0.003). CONCLUSION Higher prevalence of malaria in HbAA compared to HbAS and HbSS confirmed the protective effect of HbS. Lower prevalence of malaria in HbAA with high HbF supports a protective effect of HbF. However, in HbSS, the higher prevalence of malaria with high levels of HbF suggests loss of malaria protection. This is the first epidemiological study to suggest a negative epistasis between HbF and HbS on malaria.
Collapse
Affiliation(s)
- Bruno P. Mmbando
- Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
- National Institute for Medical Research, Tanga, Tanzania
- * E-mail:
| | - Josephine Mgaya
- Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - Sharon E. Cox
- Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Siana N. Mtatiro
- Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - Deogratias Soka
- Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | | | - Elineema Meda
- Muhimbili National Hospital, Dar-es-Salaam, Tanzania
| | - Evarist Msaki
- Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - Robert W. Snow
- KEMRI-Wellcome Trust Programme, Nairobi, Kenya
- University of Oxford, Oxford, United Kingdom
| | - Neal Jeffries
- National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, Maryland, United States of America
| | - Nancy L. Geller
- National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), Bethesda, Maryland, United States of America
| | - Julie Makani
- Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
- University of Oxford, Oxford, United Kingdom
| |
Collapse
|
17
|
Reappraisal of known malaria resistance loci in a large multicenter study. Nat Genet 2014; 46:1197-204. [PMID: 25261933 PMCID: PMC4617542 DOI: 10.1038/ng.3107] [Citation(s) in RCA: 161] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 09/04/2014] [Indexed: 02/08/2023]
Abstract
Many human genetic associations with resistance to malaria have been reported, but few have been reliably replicated. We collected data on 11,890 cases of severe malaria due to Plasmodium falciparum and 17,441 controls from 12 locations in Africa, Asia and Oceania. We tested 55 SNPs in 27 loci previously reported to associate with severe malaria. There was evidence of association at P < 1 × 10(-4) with the HBB, ABO, ATP2B4, G6PD and CD40LG loci, but previously reported associations at 22 other loci did not replicate in the multicenter analysis. The large sample size made it possible to identify authentic genetic effects that are heterogeneous across populations or phenotypes, with a striking example being the main African form of G6PD deficiency, which reduced the risk of cerebral malaria but increased the risk of severe malarial anemia. The finding that G6PD deficiency has opposing effects on different fatal complications of P. falciparum infection indicates that the evolutionary origins of this common human genetic disorder are more complex than previously supposed.
Collapse
|
18
|
Mangano VD, Modiano D. An evolutionary perspective of how infection drives human genome diversity: the case of malaria. Curr Opin Immunol 2014; 30:39-47. [PMID: 24996199 DOI: 10.1016/j.coi.2014.06.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Revised: 05/31/2014] [Accepted: 06/04/2014] [Indexed: 11/26/2022]
Abstract
Infection with malaria parasites has imposed a strong selective pressure on the human genome, promoting the convergent evolution of a diverse range of genetic adaptations, many of which are harboured by the red blood cell, which hosts the pathogenic stage of the Plasmodium life cycle. Recent genome-wide and multi-centre association studies of severe malaria have consistently identified ATP2B4, encoding the major Ca(2+) pump of erythrocytes, as a novel resistance locus. Evidence is also accumulating that interaction occurs among resistance loci, the most recent example being negative epistasis among alpha-thalassemia and haptoglobin type 2. Finally, studies on the effect of haemoglobin S and C on parasite transmission to mosquitoes have suggested that protective variants could increase in frequency enhancing parasite fitness.
Collapse
Affiliation(s)
- Valentina D Mangano
- Department of Public Health and Infectious Diseases, University of Rome 'La Sapienza', Rome, Italy; Istituto Pasteur, Fondazione Cenci Bolognetti, University of Rome 'La Sapienza', Rome, Italy.
| | - David Modiano
- Department of Public Health and Infectious Diseases, University of Rome 'La Sapienza', Rome, Italy; Istituto Pasteur, Fondazione Cenci Bolognetti, University of Rome 'La Sapienza', Rome, Italy.
| |
Collapse
|