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Kotepui KU, Mahittikorn A, Masangkay FR, Kotepui M. Association between ovalocytosis and Plasmodium infection: a systematic review and meta-analysis. Sci Rep 2023; 13:7164. [PMID: 37137935 PMCID: PMC10156661 DOI: 10.1038/s41598-023-34170-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 04/25/2023] [Indexed: 05/05/2023] Open
Abstract
Reports of an association between ovalocytosis and protection against Plasmodium infection are inconsistent. Therefore, we aimed to synthesise the overall evidence of the association between ovalocytosis and malaria infection using a meta-analysis approach. The systematic review protocol was registered with PROSPERO (CRD42023393778). A systematic literature search of the MEDLINE, Embase, Scopus, PubMed, Ovid, and ProQuest databases, from inception to 30 December 2022, was performed to retrieve studies documenting the association between ovalocytosis and Plasmodium infection. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. Data synthesis included a narrative synthesis and a meta-analysis to calculate the pooled effect estimate (log odds ratios [ORs]) and 95% confidence intervals (CIs) using the random-effects model. Our database search retrieved 905 articles, 16 of which were included for data synthesis. Qualitative synthesis revealed that over half of the studies showed no association between ovalocytosis and malaria infections or severity. Furthermore, our meta-analysis demonstrated no association between ovalocytosis and Plasmodium infection (P = 0.81, log OR = 0.06, 95% CI - 0.44 to 0.19, I2: 86.20%; 11 studies). In conclusion, the meta-analysis results demonstrated no association between ovalocytosis and Plasmodium infection. Hence, the role of ovalocytosis in relation to protection against Plasmodium infection or disease severity should be further investigated in larger prospective studies.
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Affiliation(s)
- Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Aongart Mahittikorn
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | | | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
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2
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Opi DH, Boyle MJ, McLean ARD, Reiling L, Chan JA, Stanisic DI, Ura A, Mueller I, Fowkes FJI, Rogerson SJ, Beeson JG. Reduced risk of placental parasitemia associated with complement fixation on Plasmodium falciparum by antibodies among pregnant women. BMC Med 2021; 19:201. [PMID: 34425801 PMCID: PMC8383393 DOI: 10.1186/s12916-021-02061-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/13/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The pathogenesis of malaria in pregnancy (MiP) involves accumulation of P. falciparum-infected red blood cells (pRBCs) in the placenta, contributing to poor pregnancy outcomes. Parasite accumulation is primarily mediated by P. falciparum erythrocyte membrane protein 1 (PfEMP1). Magnitude of IgG to pRBCs has been associated with reduced risk of MiP in some studies, but associations have been inconsistent. Further, antibody effector mechanisms are poorly understood, and the role of antibody complement interactions is unknown. METHODS Studying a longitudinal cohort of pregnant women (n=302) from a malaria-endemic province in Papua New Guinea (PNG), we measured the ability of antibodies to fix and activate complement using placental binding pRBCs and PfEMP1 recombinant domains. We determined antibody-mediated complement inhibition of pRBC binding to the placental receptor, chondroitin sulfate A (CSA), and associations with protection against placental parasitemia. RESULTS Some women acquired antibodies that effectively promoted complement fixation on placental-binding pRBCs. Complement fixation correlated with IgG1 and IgG3 antibodies, which dominated the response. There was, however, limited evidence for membrane attack complex activity or pRBC lysis or killing. Importantly, a higher magnitude of complement fixing antibodies was prospectively associated with reduced odds of placental infection at delivery. Using genetically modified P. falciparum and recombinant PfEMP1 domains, we found that complement-fixing antibodies primarily targeted a specific variant of PfEMP1 (known as VAR2CSA). Furthermore, complement enhanced the ability of antibodies to inhibit pRBC binding to CSA, which was primarily mediated by complement C1q protein. CONCLUSIONS These findings provide new insights into mechanisms mediating immunity to MiP and reveal potential new strategies for developing malaria vaccines that harness antibody-complement interactions.
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Affiliation(s)
- D Herbert Opi
- Burnet Institute, 85 Commercial Road, Melbourne, Victoria, 3004, Australia. .,Department of Immunology, Monash University, Melbourne, Australia. .,Department of Medicine at the Doherty Institute, University of Melbourne, Melbourne, Australia.
| | - Michelle J Boyle
- Burnet Institute, 85 Commercial Road, Melbourne, Victoria, 3004, Australia.,Human Malaria Immunology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - Linda Reiling
- Burnet Institute, 85 Commercial Road, Melbourne, Victoria, 3004, Australia
| | - Jo-Anne Chan
- Burnet Institute, 85 Commercial Road, Melbourne, Victoria, 3004, Australia.,Department of Immunology, Monash University, Melbourne, Australia.,Department of Medicine at the Doherty Institute, University of Melbourne, Melbourne, Australia
| | - Danielle I Stanisic
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.,Institute for Glycomics, Griffith University, Southport, Queensland, Australia
| | - Alice Ura
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Ivo Mueller
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.,Department of Medical Biology, University of Melbourne, Melbourne, Australia.,Institute Pasteur, Paris, France
| | - Freya J I Fowkes
- Burnet Institute, 85 Commercial Road, Melbourne, Victoria, 3004, Australia.,Department of Infectious Diseases, Monash University, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Australia.,Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Stephen J Rogerson
- Department of Medicine at the Doherty Institute, University of Melbourne, Melbourne, Australia
| | - James G Beeson
- Burnet Institute, 85 Commercial Road, Melbourne, Victoria, 3004, Australia. .,Department of Immunology, Monash University, Melbourne, Australia. .,Department of Medicine at the Doherty Institute, University of Melbourne, Melbourne, Australia. .,Department of Microbiology, Monash University, Clayton, Australia.
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3
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Penman BS, Gandon S. Adaptive immunity selects against malaria infection blocking mutations. PLoS Comput Biol 2020; 16:e1008181. [PMID: 33031369 PMCID: PMC7544067 DOI: 10.1371/journal.pcbi.1008181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/22/2020] [Indexed: 11/18/2022] Open
Abstract
The mutation responsible for Duffy negativity, which impedes Plasmodium vivax infection, has reached high frequencies in certain human populations. Conversely, mutations capable of blocking the more lethal P. falciparum have not succeeded in malarious zones. Here we present an evolutionary-epidemiological model of malaria which demonstrates that if adaptive immunity against the most virulent effects of malaria is gained rapidly by the host, mutations which prevent infection per se are unlikely to succeed. Our results (i) explain the rarity of strain-transcending P. falciparum infection blocking adaptations in humans; (ii) make the surprising prediction that mutations which block P. falciparum infection are most likely to be found in populations experiencing low or infrequent malaria transmission, and (iii) predict that immunity against some of the virulent effects of P. vivax malaria may be built up over the course of many infections.
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Affiliation(s)
- Bridget S. Penman
- Zeeman Institute and School of Life Sciences, University of Warwick, Coventry, United Kingdom
| | - Sylvain Gandon
- CEFE, CNRS, University of Montpellier, Paul Valéry University of Montpellier, EPHE, IRD, Montpellier, France
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4
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Flatt JF, Stevens-Hernandez CJ, Cogan NM, Eggleston DJ, Haines NM, Heesom KJ, Picard V, Thomas C, Bruce LJ. Expression of South East Asian Ovalocytic Band 3 Disrupts Erythroblast Cytokinesis and Reticulocyte Maturation. Front Physiol 2020; 11:357. [PMID: 32411010 PMCID: PMC7199003 DOI: 10.3389/fphys.2020.00357] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/27/2020] [Indexed: 12/17/2022] Open
Abstract
Southeast Asian Ovalocytosis results from a heterozygous deletion of 9 amino acids in the erythrocyte anion exchange protein AE1 (band 3). The report of the first successful birth of an individual homozygous for this mutation showed an association with severe dyserythropoietic anemia. Imaging of the proband’s erythrocytes revealed the presence of band 3 at their surface, a reduction in Wr(b) antigen expression, and increases in glycophorin C, CD44, and CD147 immunoreactivity. Immunoblotting of membranes from heterozygous Southeast Asian Ovalocytosis red cells showed a quantitative increase in CD44, CD147, and calreticulin suggesting a defect in reticulocyte maturation, as well as an increase in phosphorylation at residue Tyr359 of band 3, and peroxiredoxin-2 at the membrane, suggesting altered band 3 trafficking and oxidative stress, respectively. In vitro culture of homozygous and heterozygous Southeast Asian Ovalocytosis erythroid progenitor cells produced bi- and multi-nucleated cells. Enucleation was severely impaired in the homozygous cells and reduced in the heterozygous cells. Large internal vesicular accumulations of band 3 formed, which co-localized with other plasma membrane proteins and with the autophagosome marker, LC3, but not with ER, Golgi or recycling endosome markers. Immunoprecipitation of band 3 from erythroblast cell lysates at the orthochromatic stage showed increased interaction of the mutant band 3 with heat shock proteins, ubiquitin and cytoskeleton proteins, ankyrin, spectrin and actin. We also found that the mutant band 3 forms a strong interaction with non-muscle myosins IIA and IIB, while this interaction could not be detected in wild type erythroblasts. Consistent with this, the localization of non-muscle myosin IIA and actin was perturbed in some Southeast Asian Ovalocytosis erythroblasts. These findings provide new insights toward understanding in vivo dyserythropoiesis caused by the expression of mutant membrane proteins.
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Affiliation(s)
- Joanna F Flatt
- Bristol Institute for Transfusion Sciences, National Health Service (NHS) Blood and Transplant, Bristol, United Kingdom
| | - Christian J Stevens-Hernandez
- Bristol Institute for Transfusion Sciences, National Health Service (NHS) Blood and Transplant, Bristol, United Kingdom.,School of Biochemistry, University of Bristol, Bristol, United Kingdom
| | - Nicola M Cogan
- Bristol Institute for Transfusion Sciences, National Health Service (NHS) Blood and Transplant, Bristol, United Kingdom
| | - Daniel J Eggleston
- Bristol Institute for Transfusion Sciences, National Health Service (NHS) Blood and Transplant, Bristol, United Kingdom
| | - Nicole M Haines
- Bristol Institute for Transfusion Sciences, National Health Service (NHS) Blood and Transplant, Bristol, United Kingdom
| | - Kate J Heesom
- School of Biochemistry, University of Bristol, Bristol, United Kingdom
| | - Veronique Picard
- Assistance Publique-Hôpitaux de Paris, Service d'Hématologie Biologique, Hôpital Bicêtre, Paris, France.,Faculté de Pharmacie, Université Paris-Saclay, Chatenay Malabry, France
| | - Caroline Thomas
- Hématologie et Immunologie Pédiatrique, Hôpital Mère Enfants, Nantes, France
| | - Lesley J Bruce
- Bristol Institute for Transfusion Sciences, National Health Service (NHS) Blood and Transplant, Bristol, United Kingdom
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Antibody responses to Plasmodium vivax Duffy binding and Erythrocyte binding proteins predict risk of infection and are associated with protection from clinical Malaria. PLoS Negl Trop Dis 2019; 13:e0006987. [PMID: 30768655 PMCID: PMC6400399 DOI: 10.1371/journal.pntd.0006987] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 03/05/2019] [Accepted: 11/12/2018] [Indexed: 01/05/2023] Open
Abstract
Background The Plasmodium vivax Duffy Binding Protein (PvDBP) is a key target of naturally acquired immunity. However, region II of PvDBP, which contains the receptor-binding site, is highly polymorphic. The natural acquisition of antibodies to different variants of PvDBP region II (PvDBPII), including the AH, O, P and Sal1 alleles, the central region III-V (PvDBPIII-V), and P. vivax Erythrocyte Binding Protein region II (PvEBPII) and their associations with risk of clinical P. vivax malaria are not well understood. Methodology Total IgG and IgG subclasses 1, 2, and 3 that recognize four alleles of PvDBPII (AH, O, P, and Sal1), PvDBPIII-V and PvEBPII were measured in samples collected from a cohort of 1 to 3 year old Papua New Guinean (PNG) children living in a highly endemic area of PNG. The levels of binding inhibitory antibodies (BIAbs) to PvDBPII (AH, O, and Sal1) were also tested in a subset of children. The association of presence of IgG with age, cumulative exposure (measured as the product of age and malaria infections during follow-up) and prospective risk of clinical malaria were evaluated. Results The increase in antigen-specific total IgG, IgG1, and IgG3 with age and cumulative exposure was only observed for PvDBPII AH and PvEBPII. High levels of total IgG and predominant subclass IgG3 specific for PvDBPII AH were associated with decreased incidence of clinical P. vivax episodes (aIRR = 0.56–0.68, P≤0.001–0.021). High levels of total IgG and IgG1 to PvEBPII correlated strongly with protection against clinical vivax malaria compared with IgGs against all PvDBPII variants (aIRR = 0.38, P<0.001). Antibodies to PvDBPII AH and PvEBPII showed evidence of an additive effect, with a joint protective association of 70%. Conclusion Antibodies to the key parasite invasion ligands PvDBPII and PvEBPII are good correlates of protection against P. vivax malaria in PNG. This further strengthens the rationale for inclusion of PvDBPII in a recombinant subunit vaccine for P. vivax malaria and highlights the need for further functional studies to determine the potential of PvEBPII as a component of a subunit vaccine for P. vivax malaria. Plasmodium vivax is responsible for most malaria infections outside Africa, with 13.8 million vivax malaria cases reported annually worldwide. Antibodies are a key component of the host response to P. vivax infection, and their study can assist in identifying suitable vaccine candidates and serological biomarkers for malaria surveillance. The binding of P. vivax Duffy binding protein region II (PvDBPII) to the Duffy Antigen Receptor for Chemokines (DARC) is critical for P. vivax invasion of reticulocytes. Although the binding residues for DARC are highly conserved across PvDBPII, the parasite displays high sequence diversity in non-binding residues of PvDBPII. Other regions such as PvDBPIII-V are relatively conserved. Recently, sequencing of P. vivax field isolates, identified a homologous erythrocyte-binding protein (PvEBP), which harbors a domain, region II (PvEBPII), that is homologous to PvDBPII. To date, there has been limited investigation into the naturally acquired immunity to both PvDBPIII-V and PvEBPII in human populations. Using a longitudinal cohort study, we have characterized the serological response to PvDBPII, PvDBPIII-V, and PvEBPII among 1–3 years old PNG children and investigated associations with protection against clinical malaria. This study shows that both total IgG and IgG3 to the predominant PvDBPII AH allele in PNG, and total IgG and IgG1 to PvEBPII were associated with protection from P. vivax malaria.
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Associations between erythrocyte polymorphisms and risks of uncomplicated and severe malaria in Ugandan children: A case control study. PLoS One 2018; 13:e0203229. [PMID: 30222732 PMCID: PMC6141089 DOI: 10.1371/journal.pone.0203229] [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: 06/22/2018] [Accepted: 08/16/2018] [Indexed: 12/20/2022] Open
Abstract
Background Evidence for association between sickle cell and alpha thalassemia trait and severe malaria is compelling. However, for these polymorphisms associations with uncomplicated malaria, and for G6PD deficiency associations with uncomplicated and severe malaria, findings have been inconsistent. We studied samples from a three-arm case-control study with the objective of determining associations between common host erythrocyte polymorphisms and both uncomplicated and severe malaria, including different severe malaria phenotypes. Method We assessed hemoglobin abnormalities, α-thalassemia, and G6PD deficiency by molecular methods in 325 children with severe malaria age-matched to 325 children with uncomplicated malaria and 325 healthy community controls. Conditional logistic regression was used to measure associations between specified genotypes and malaria outcomes. Results No tested polymorphisms offered significant protection against uncomplicated malaria. α-thalassemia homozygotes (_α/_α) had increased risk of uncomplicated malaria (OR 2.40; 95%CI 1.15, 5.03, p = 0.020). HbAS and α-thalassemia heterozygous (_α/αα) genotypes protected against severe malaria compared to uncomplicated malaria (HbAS OR 0.46; 0.23, 0.95, p = 0.036; _α/αα OR 0.51; 0.24, 0.77; p = 0.001) or community (HbAS OR 0.23; 0.11, 0.50; p<0.001; _α/αα; OR 0.49; 0.32, 0.76; p = 0.002) controls. The α-thalassemia homozygous (_α/_α) genotype protected against severe malaria when compared to uncomplicated malaria controls (OR 0.34; 95%CI 0.156, 0.73, p = 0.005), but not community controls (OR 1.03; 0.46, 2.27, p = 0.935). Stratifying by the severe malaria phenotype, compared to community controls, the protective effect of HbAS was limited to children with severe anemia (OR 0.17; 95%CI 0.04, 0.65; p = 0.009) and that of _α/αα to those with altered consciousness (OR 0.24; 0.09, 0.59; p = 0.002). A negative epistatic effect was seen between HbAS and _α/αα; protection compared to uncomplicated malaria controls was not seen in individuals with both polymorphisms (OR 0.45; 0.11, 1.84; p = 0.269). G6PD deficiency was not protective against severe malaria. Conclusion Associations were complex, with HbAS principally protective against severe anemia, _α/αα against altered consciousness, and negative epistasis between the two polymorphisms.
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7
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França CT, Li Wai Suen CSN, Carmagnac A, Lin E, Kiniboro B, Siba P, Schofield L, Mueller I. IgG antibodies to synthetic GPI are biomarkers of immune-status to both Plasmodium falciparum and Plasmodium vivax malaria in young children. Malar J 2017; 16:386. [PMID: 28946883 PMCID: PMC5613389 DOI: 10.1186/s12936-017-2042-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 09/21/2017] [Indexed: 11/14/2022] Open
Abstract
Background Further reduction in malaria prevalence and its eventual elimination would be greatly facilitated by the development of biomarkers of exposure and/or acquired immunity to malaria, as well as the deployment of effective vaccines against Plasmodium falciparum and Plasmodium vivax. A better understanding of the acquisition of immunity in naturally-exposed populations is essential for the identification of antigens useful as biomarkers, as well as to inform rational vaccine development. Methods ELISA was used to measure total IgG to a synthetic form of glycosylphosphatidylinositol from P. falciparum (PfGPI) in a cohort of 1–3 years old Papua New Guinea children with well-characterized individual differences in exposure to P. falciparum and P. vivax blood-stage infections. The relationship between IgG levels to PfGPI and measures of recent and past exposure to P. falciparum and P. vivax infections was investigated, as well as the association between antibody levels and prospective risk of clinical malaria over 16 months of follow-up. Results Total IgG levels to PfGPI were low in the young children tested. Antibody levels were higher in the presence of P. falciparum or P. vivax infections, but short-lived. High IgG levels were associated with higher risk of P. falciparum malaria (IRR 1.33–1.66, P = 0.008–0.027), suggesting that they are biomarkers of increased exposure to P. falciparum infections. Given the cross-reactive nature of antibodies to PfGPI, high IgG levels were also associated with reduced risk of P. vivax malaria (IRR 0.65–0.67, P = 0.039–0.044), indicating that these antibodies are also markers of acquired immunity to P. vivax. Conclusions This study highlights that in young children, IgG to PfGPI might be a useful marker of immune-status to both P. falciparum and P. vivax infections, and potentially useful to help malaria control programs to identify populations at-risk. Further functional studies are necessary to confirm the potential of PfGPI as a target for vaccine development. Electronic supplementary material The online version of this article (doi:10.1186/s12936-017-2042-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Camila T França
- Population Health and Immunity Division, Walter and Eliza Hall Institute, Parkville, VIC, Australia. .,Department of Medical Biology, University of Melbourne, Melbourne, VIC, Australia.
| | - Connie S N Li Wai Suen
- Population Health and Immunity Division, Walter and Eliza Hall Institute, Parkville, VIC, Australia.,Department of Medical Biology, University of Melbourne, Melbourne, VIC, Australia
| | - Amandine Carmagnac
- Infection and Immunity Division, Walter and Eliza Hall Institute, Parkville, VIC, Australia
| | - Enmoore Lin
- Malaria Immuno-Epidemiology Unit, PNG Institute of Medical Research, Madang, Madang Province, Papua New Guinea
| | - Benson Kiniboro
- Malaria Immuno-Epidemiology Unit, PNG Institute of Medical Research, Madang, Madang Province, Papua New Guinea
| | - Peter Siba
- Malaria Immuno-Epidemiology Unit, PNG Institute of Medical Research, Madang, Madang Province, Papua New Guinea
| | - Louis Schofield
- Population Health and Immunity Division, Walter and Eliza Hall Institute, Parkville, VIC, Australia.,Department of Medical Biology, University of Melbourne, Melbourne, VIC, Australia.,Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD, Australia
| | - Ivo Mueller
- Population Health and Immunity Division, Walter and Eliza Hall Institute, Parkville, VIC, Australia.,Department of Medical Biology, University of Melbourne, Melbourne, VIC, Australia.,Malaria Parasites & Hosts Unit, Department of Parasites & Insect Vectors, Institut Pasteur, Paris, France.,Barcelona Institute of Global Health (ISGLOBAL), Barcelona, Spain
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8
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Laman M, Aipit S, Bona C, Siba PM, Robinson LJ, Manning L, Davis TME. Ultrasonographic assessment of splenic volume at presentation and after anti-malarial therapy in children with malarial anaemia. Malar J 2015; 14:219. [PMID: 26017395 PMCID: PMC4448319 DOI: 10.1186/s12936-015-0741-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 05/20/2015] [Indexed: 11/20/2022] Open
Abstract
Background Splenic enlargement is a component of the host response to malaria and may also influence the genesis and progression of malarial anaemia. Few cross-sectional and no longitudinal studies have assessed the relationship between splenic volume measured ultrasonographically and haemoglobin concentrations in children with malaria. Methods Fifteen Papua New Guinean children with severe malarial anaemia (SMA; haemoglobin <50 g/L) and ten with moderate malarial anaemia (MMA; 51–99 g/L) were recruited. The SMA patients were given intramuscular artemether followed by oral artemisinin combination therapy (ACT), and were transfused one unit of packed cells 0.3-4.0 days post-admission. The MMA patients were treated with ACT. Splenic enlargement (Hackett’s grade, subcostal distance and ultrasonographically determined volume) and haemoglobin concentrations were measured on days 0, 1, 2, 3, 7, 14, 28, and 42. Results Associations between Hackett’s grade, subcostal distance and splenic volume were modest (rs ≤ 0.62, P <0.001). Baseline splenic volume was not associated with age or haemoglobin (P ≥0.90). Mean splenic volume had fallen by approximately 50 % at day 14 in children with MMA (P ≤0.011 vs days 0, 1 and 2), but there was no change in the SMA group (P ≥0.30). There was no change in haemoglobin in the MMA group during follow-up but a rise in the SMA group to day 7 (P ≤0.05 vs days 0, 1, 2, and 3) which paralleled the packed cell volume transfused. Conclusions Clinical assessment of splenomegaly is imprecise compared with ultrasonography. Serial splenic volumes and haemoglobin concentrations suggest that the spleen does not influence post-treatment haemoglobin, including after transfusion.
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Affiliation(s)
- Moses Laman
- School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, PO Box 480, Fremantle, 6959, WA, Australia. .,Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea.
| | - Susan Aipit
- Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea.
| | - Cathy Bona
- Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea.
| | - Peter M Siba
- Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea. .,Department of Microbiology, Division of Veterinary and Biomedical Sciences, James Cook University, Townsville, Australia.
| | - Leanne J Robinson
- Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea. .,Infection and Immunity Division, Walter and Eliza Hall Institute, Parkville, VIC, Australia. .,Department of Medical Biology, University of Melbourne, Melbourne, VIC, Australia.
| | - Laurens Manning
- School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, PO Box 480, Fremantle, 6959, WA, Australia.
| | - Timothy M E Davis
- School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, PO Box 480, Fremantle, 6959, WA, Australia.
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Schmidt CQ, Kennedy AT, Tham WH. More than just immune evasion: Hijacking complement by Plasmodium falciparum. Mol Immunol 2015; 67:71-84. [PMID: 25816986 DOI: 10.1016/j.molimm.2015.03.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 03/04/2015] [Accepted: 03/04/2015] [Indexed: 12/24/2022]
Abstract
Malaria remains one of the world's deadliest diseases. Plasmodium falciparum is responsible for the most severe and lethal form of human malaria. P. falciparum's life cycle involves two obligate hosts: human and mosquito. From initial entry into these hosts, malaria parasites face the onslaught of the first line of host defence, the complement system. In this review, we discuss the complex interaction between complement and malaria infection in terms of hosts immune responses, parasite survival and pathogenesis of severe forms of malaria. We will focus on the role of complement receptor 1 and its associated polymorphisms in malaria immune complex clearance, as a mediator of parasite rosetting and as an entry receptor for P. falciparum invasion. Complement evasion strategies of P. falciparum parasites will also be highlighted. The sexual forms of the malaria parasites recruit the soluble human complement regulator Factor H to evade complement-mediated killing within the mosquito host. A novel evasion strategy is the deployment of parasite organelles to divert complement attack from infective blood stage parasites. Finally we outline the future challenge to understand the implications of these exploitation mechanisms in the interplay between successful infection of the host and pathogenesis observed in severe malaria.
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Affiliation(s)
- Christoph Q Schmidt
- Institute of Pharmacology of Natural Products and Clinical Pharmacology, Ulm University, Helmholtzstraße 20, Ulm, Germany.
| | - Alexander T Kennedy
- Department of Medical Biology, University of Melbourne and Division of Infection and Immunity, The Walter and Eliza Hall Institute, Parkville, Victoria 3052, Australia
| | - Wai-Hong Tham
- Department of Medical Biology, University of Melbourne and Division of Infection and Immunity, The Walter and Eliza Hall Institute, Parkville, Victoria 3052, Australia.
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10
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Stanisic DI, Moore KA, Baiwog F, Ura A, Clapham C, King CL, Siba PM, Beeson JG, Mueller I, Fowkes FJ, Rogerson SJ. Risk factors for malaria and adverse birth outcomes in a prospective cohort of pregnant women resident in a high malaria transmission area of Papua New Guinea. Trans R Soc Trop Med Hyg 2015; 109:313-24. [PMID: 25758854 DOI: 10.1093/trstmh/trv019] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 02/13/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Low birth weight (LBW), anaemia and malaria are common in Papua New Guinean women. METHODS To identify risk factors for LBW, anaemia and preterm delivery (PTD), pregnant women recruited into a cohort study in Madang, Papua New Guinea, were followed to delivery. RESULTS Of 470 women enrolled, delivery data were available for 328 (69.7%). By microscopy, 34.4% (113/328) of women had malaria parasitaemia at enrolment and 12.5% (41/328) at delivery; at each time point, PCR detected sub-microscopic parasitaemia in substantially more. Most infections were with Plasmodium falciparum; the remainder being predominantly P. vivax. Anaemia and smoking were associated with lower birth weight, and LBW (16.7%; 51/305) and PTD (21.8%; 63/290) were common. Histopathologically diagnosed chronic placental malaria was associated with LBW (adjusted odds ratio [aOR] 3.3; p=0.048) and PTD (aOR 4.2; p=0.01). Lack of maternal education predisposed to PTD. Sub-microscopic parasitaemia at delivery appeared to increase the risk of LBW. Of the genetic polymorphisms, Southeast Asian ovalocytosis, α(+)-thalassaemia and complement receptor 1 (CR1) deficiency, a CR1 heterozygous genotype was associated with decreased risk of anaemia and substantial but non-significant effects were noted in other comparisons. CONCLUSIONS In coastal Papua New Guinea, malaria and anaemia are important causes of adverse pregnancy outcomes.
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Affiliation(s)
- Danielle I Stanisic
- Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3050, Australia Institute of Glycomics, Griffith University, Southport, Queensland 4215, Australia
| | - Kerryn A Moore
- Burnet Institute, Melbourne, Victoria, Australia Centre for Epidemiology and Biostatistics, University of Melbourne, Parkville, Victoria, Australia
| | - Francesca Baiwog
- Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Alice Ura
- Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - Caroline Clapham
- Department of Medicine (RMH), The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Christopher L King
- Case Western Reserve University, Cleveland Ohio, USA Veterans Affairs Medical Center, Cleveland, Ohio, USA
| | - Peter M Siba
- Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea
| | - James G Beeson
- Burnet Institute, Melbourne, Victoria, Australia Department of Medicine (RMH), The University of Melbourne, Parkville, Victoria 3010, Australia Department of Microbiology, Monash University, Victoria, Australia
| | - Ivo Mueller
- Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3050, Australia CRESIB, University of Barcelona, Barcelona, Spain
| | - Freya J Fowkes
- Burnet Institute, Melbourne, Victoria, Australia Department of Epidemiology and Preventive Medicine and Department of Infectious Diseases, Monash University, Melbourne, Victoria, Australia
| | - Stephen J Rogerson
- Department of Medicine (RMH), The University of Melbourne, Parkville, Victoria 3010, Australia
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Rosanas-Urgell A, Senn N, Rarau P, Aponte JJ, Reeder JC, Siba PM, Michon P, Mueller I. Lack of associations of α(+)-thalassemia with the risk of Plasmodium falciparum and Plasmodium vivax infection and disease in a cohort of children aged 3-21 months from Papua New Guinea. Int J Parasitol 2012; 42:1107-13. [PMID: 23085147 DOI: 10.1016/j.ijpara.2012.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 10/01/2012] [Accepted: 10/01/2012] [Indexed: 10/27/2022]
Abstract
Despite consistent evidence of a protective effect of α(+)-thalassemia against severe Plasmodium falciparum disease, the mechanisms underlying this protection remain unknown. An increase in risk of Plasmodium vivax malaria in early childhood resulting in a cross-species protection against severe P. falciparum malaria has been proposed as a possible mechanism in Melanesian children. The association of α(+)-thalassemia genotypes with a risk of P. falciparum and P. vivax infection and uncomplicated illness was reassessed in a cohort of 1,112 Papua New Guinean children, followed from 3 to 21 months of age. Three hundred and eighty-nine (35.0%) children were homozygous for α(+)-thalassemia (-α/-α), 506 (45.5%) heterozygous (αα/-α) and 217 (19.5%) homozygous for the wild-type allele. No significant differences in the incidence of P. falciparum (Pf) or P. vivax (Pv) malaria were observed between α(+)-thalassemia homozygote (Pf: incidence rate ratio (IRR)=1.13, CI(95) (0.82, 1.56), P=0.45, Pv: IRR=1.15, CI(95) (0.88, 1.50), P=0.31), heterozygote (Pf: IRR=0.98, CI(95) (0.71, 1.34), P=0.93, Pv: IRR=1.14, CI(95) (0.88, 1.48), P=0.33) and wild-type children. The prevalence of infection with either species did not differ between α(+)-thalassemia genotypes, although densities of P. vivax (but not of P. falciparum) infections were significantly higher in α(+)-thalassemia homozygote and heterozygote children. An excessive risk of moderate-to-severe anemia (Hb<8 g/dl) was observed in α(+)-thalassemia homozygote children (IRR=1.54, CI(95) (1.12, 2.11), P=0.008). This study therefore failed to confirm an increased risk of P. vivax or P. falciparum malaria in very young, α(+)-thalassemic children without significant levels of acquired immunity. This confirms the lack of protection by α(+)-thalassemia against uncomplicated P. falciparum and challenges the hypothesis of immunological cross-protection between P. falciparum and P. vivax as a mechanism underlying α(+)-thalassemia protection against severe P. falciparum disease in Melanesian children.
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The Plasmodium falciparum erythrocyte invasion ligand Pfrh4 as a target of functional and protective human antibodies against malaria. PLoS One 2012; 7:e45253. [PMID: 23028883 PMCID: PMC3447948 DOI: 10.1371/journal.pone.0045253] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 08/17/2012] [Indexed: 11/19/2022] Open
Abstract
Background Acquired antibodies are important in human immunity to malaria, but key targets remain largely unknown. Plasmodium falciparum reticulocyte-binding-homologue-4 (PfRh4) is important for invasion of human erythrocytes and may therefore be a target of protective immunity. Methods IgG and IgG subclass-specific responses against different regions of PfRh4 were determined in a longitudinal cohort of 206 children in Papua New Guinea (PNG). Human PfRh4 antibodies were tested for functional invasion-inhibitory activity, and expression of PfRh4 by P. falciparum isolates and sequence polymorphisms were determined. Results Antibodies to PfRh4 were acquired by children exposed to P. falciparum malaria, were predominantly comprised of IgG1 and IgG3 subclasses, and were associated with increasing age and active parasitemia. High levels of antibodies, particularly IgG3, were strongly predictive of protection against clinical malaria and high-density parasitemia. Human affinity-purified antibodies to the binding region of PfRh4 effectively inhibited erythrocyte invasion by P. falciparum merozoites and antibody levels in protected children were at functionally-active concentrations. Although expression of PfRh4 can vary, PfRh4 protein was expressed by most isolates derived from the cohort and showed limited sequence polymorphism. Conclusions Evidence suggests that PfRh4 is a target of antibodies that contribute to protective immunity to malaria by inhibiting erythrocyte invasion and preventing high density parasitemia. These findings advance our understanding of the targets and mechanisms of human immunity and evaluating the potential of PfRh4 as a component of candidate malaria vaccines.
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Williams TN, Weatherall DJ. World distribution, population genetics, and health burden of the hemoglobinopathies. Cold Spring Harb Perspect Med 2012; 2:a011692. [PMID: 22951448 PMCID: PMC3426822 DOI: 10.1101/cshperspect.a011692] [Citation(s) in RCA: 249] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although information about the precise world distribution and frequency of the inherited hemoglobin disorders is still limited, there is no doubt that they are going to pose an increasing burden on global health resources in the future. Their high frequency is a reflection of natural selection combined with a high frequency of consanguineous marriages in many countries, together with an epidemiological transition; whereby, as public health measures improve in the poorer countries of the world, more babies with these disorders are surviving to present for treatment.
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Affiliation(s)
- Thomas N Williams
- Kenya Medical Research Institute/Wellcome Trust Programme, Centre for Geographical Research, Kilifi District Hospital, PO Box 230, Kilifi, Kenya.
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14
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John E, Christiansen FT, Mueller I, Schofield L, Senitzer D, Siba P, Witt CS. Distinct distribution of killer-cell immunoglobulin-like receptor genes in the Mugil and Ilaita areas of Papua New Guinea. TISSUE ANTIGENS 2012; 79:263-71. [PMID: 22320834 DOI: 10.1111/j.1399-0039.2012.01848.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The frequency of the killer-cell immunoglobulin-like receptor (KIR) genes and transmembrane alleles of KIR2DL4 were studied in coastal (Mugil community) and inland (Ilaita community) communities in Papua New Guinea. Linkage disequilibria between KIR genes and between alleles of KIR2DL4 and the KIR genes were similar to those found in other populations suggesting conservation of the usual gene order in Papua New Guinean haplotypes. Significant differences in the frequency of KIR genes were found between the two populations despite being separated by only 300 km. Examples of individuals who lacked the KIR2DL4 gene and others whose KIR2DL4 allele appeared to have 11 adenines in the polyadenine tract in exon 6 were identified. A relatively low frequency of the KIR A haplotype was found in both populations and particularly in the inland community. The KIR gene frequencies were consistent with the inland Ilaita community being closely related to Australian Aborigines and southern Indians, whereas the KIR gene frequencies of the coastal Mugil community appeared to have been influenced either by recent or ancient admixture from populations with a higher frequency of the KIR A haplotype.
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Affiliation(s)
- E John
- Department of Clinical Immunology, PathWest, Royal Perth Hospital, Perth, WA, Australia
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15
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Taylor SM, Parobek CM, Fairhurst RM. Haemoglobinopathies and the clinical epidemiology of malaria: a systematic review and meta-analysis. THE LANCET. INFECTIOUS DISEASES 2012; 12:457-68. [PMID: 22445352 DOI: 10.1016/s1473-3099(12)70055-5] [Citation(s) in RCA: 212] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Haemoglobinopathies can reduce the risk of malaria syndromes. We aimed to quantify the relation between different haemoglobin mutations and malaria protection to strengthen the foundation for translational studies of malaria pathogenesis and immunity. METHODS We systematically searched the Medline and Embase databases for studies that estimated the risk of malaria in patients with and without haemoglobinopathies up to Sept 9, 2011, and identified additional studies from reference lists. We included studies that enrolled mainly children or pregnant women and had the following outcomes: Plasmodium falciparum severe malaria, uncomplicated malaria, asymptomatic parasitaemia, or pregnancy-associated malaria, and Plasmodium vivax malaria. Two reviewers identified studies independently, assessed quality of the studies, and extracted data. We produced odds ratios (ORs; 95% CIs) for case-control studies and incidence rate ratios (IRRs; 95% CIs) for prospective studies. We did the meta-analysis with a random-effects model when equivalent outcomes were reported in more than one study. FINDINGS Of 62 identified studies, 44 reported data for haemoglobin AS, 19 for haemoglobin AC and CC, and 18 for α-thalassaemia. Meta-analysis of case-control studies showed a decreased risk of severe P. falciparum malaria in individuals with haemoglobin AS (OR 0·09, 95% CI 0·06-0·12), haemoglobin CC (0·27, 0·11-0·63), haemoglobin AC (0·83, 0·67-0·96), homozygous α-thalassaemia (0·63, 0·48-0·83), and heterozygous α-thalassaemia (0·83, 0·74-0·92). In meta-analysis of prospective trials only haemoglobin AS was consistently associated with protection from uncomplicated malaria (IRR 0·69, 95% CI 0·61-0·79); no haemoglobinopathies led to consistent protection from asymptomatic parasitaemia. Few clinical studies have investigated β-thalassaemia, haemoglobin E, P. vivax malaria, or pregnancy-associated malaria. INTERPRETATION Haemoglobin AS, CC, and AC genotypes and homozygous and heterozygous α-thalassaemia provide significant protection from severe malaria syndromes, but these haemoglobinopathies differ substantially in the degree of protection provided and confer mild or no protection against uncomplicated malaria and asymptomatic parasitaemia. Through attenuation of severity of malaria, haemoglobinopathies could serve as a model for investigation of the mechanisms of malaria pathogenesis and immunity. FUNDING US National Institute of Allergy and Infectious Diseases.
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Affiliation(s)
- Steve M Taylor
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA.
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Kazura JW, Siba PM, Betuela I, Mueller I. Research challenges and gaps in malaria knowledge in Papua New Guinea. Acta Trop 2012; 121:274-80. [PMID: 21896268 DOI: 10.1016/j.actatropica.2011.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 08/04/2011] [Accepted: 08/07/2011] [Indexed: 10/17/2022]
Abstract
Taking into consideration the relative number of people living in Papua New Guinea the burden of malaria in this country is among the highest in Asia and the Pacific region. This article summarizes the research questions and challenges being undertaken by the Southwest Pacific International Center of Excellence for Malaria Research in the context of the epidemiology, transmission and pathogenesis of Plasmodium falciparum and P. vivax at the present time and the recent past. It is hoped that the research accomplished and local infrastructure strengthened by this effort will help inform regional and national policy with regard to the control and ultimately elimination of malaria in this region of the world.
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17
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Rosanas-Urgell A, Lin E, Manning L, Rarau P, Laman M, Senn N, Grimberg BT, Tavul L, Stanisic DI, Robinson LJ, Aponte JJ, Dabod E, Reeder JC, Siba P, Zimmerman PA, Davis TME, King CL, Michon P, Mueller I. Reduced risk of Plasmodium vivax malaria in Papua New Guinean children with Southeast Asian ovalocytosis in two cohorts and a case-control study. PLoS Med 2012; 9:e1001305. [PMID: 22973182 PMCID: PMC3433408 DOI: 10.1371/journal.pmed.1001305] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 07/23/2012] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The erythrocyte polymorphism, Southeast Asian ovalocytosis (SAO) (which results from a 27-base pair deletion in the erythrocyte band 3 gene, SLC4A1Δ27) protects against cerebral malaria caused by Plasmodium falciparum; however, it is unknown whether this polymorphism also protects against P. vivax infection and disease. METHODS AND FINDINGS The association between SAO and P. vivax infection was examined through genotyping of 1,975 children enrolled in three independent epidemiological studies conducted in the Madang area of Papua New Guinea. SAO was associated with a statistically significant 46% reduction in the incidence of clinical P. vivax episodes (adjusted incidence rate ratio [IRR] = 0.54, 95% CI 0.40-0.72, p<0.0001) in a cohort of infants aged 3-21 months and a significant 52% reduction in P. vivax (blood-stage) reinfection diagnosed by PCR (95% CI 22-71, p = 0.003) and 55% by light microscopy (95% CI 13-77, p = 0.014), respectively, in a cohort of children aged 5-14 years. SAO was also associated with a reduction in risk of P. vivax parasitaemia in children 3-21 months (1,111/µl versus 636/µl, p = 0.011) and prevalence of P. vivax infections in children 15-21 months (odds ratio [OR] = 0.39, 95% CI 0.23-0.67, p = 0.001). In a case-control study of children aged 0.5-10 years, no child with SAO was found among 27 cases with severe P. vivax or mixed P. falciparum/P. vivax malaria (OR = 0, 95% CI 0-1.56, p = 0.11). SAO was associated with protection against severe P. falciparum malaria (OR = 0.38, 95% CI 0.15-0.87, p = 0.014) but no effect was seen on either the risk of acquiring blood-stage infections or uncomplicated episodes with P. falciparum. Although Duffy antigen receptor expression and function were not affected on SAO erythrocytes compared to non-SAO children, high level (>90% binding inhibition) P. vivax Duffy binding protein-specific binding inhibitory antibodies were observed significantly more often in sera from SAO than non-SAO children (SAO, 22.2%; non-SAO, 6.7%; p = 0.008). CONCLUSIONS In three independent studies, we observed strong associations between SAO and protection against P. vivax malaria by a mechanism that is independent of the Duffy antigen. P. vivax malaria may have contributed to shaping the unique host genetic adaptations to malaria in Asian and Oceanic populations. Please see later in the article for the Editors' Summary.
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Affiliation(s)
| | - Enmoore Lin
- PNG Institute of Medical Research, Madang, Papua New Guinea
| | - Laurens Manning
- Department of Medicine & Pharmacology, University of Western Australia, Perth, Australia
| | - Patricia Rarau
- PNG Institute of Medical Research, Madang, Papua New Guinea
| | - Moses Laman
- PNG Institute of Medical Research, Madang, Papua New Guinea
| | - Nicolas Senn
- PNG Institute of Medical Research, Madang, Papua New Guinea
- Swiss Tropical & Public Health Institute, Basel, Switzerland
| | - Brian T. Grimberg
- Center of Global Health & Diseases (CGHD), Case Western Reserve University, Cleveland, Ohio, United States of America
| | | | - Danielle I. Stanisic
- PNG Institute of Medical Research, Madang, Papua New Guinea
- Infection & Immunity Division, Walter+Eliza Hall Institute, Parkville, Victoria, Australia
| | - Leanne J. Robinson
- PNG Institute of Medical Research, Madang, Papua New Guinea
- Infection & Immunity Division, Walter+Eliza Hall Institute, Parkville, Victoria, Australia
| | - John J. Aponte
- Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain
| | - Elijah Dabod
- PNG Institute of Medical Research, Madang, Papua New Guinea
| | | | - Peter Siba
- PNG Institute of Medical Research, Madang, Papua New Guinea
| | - Peter A. Zimmerman
- Center of Global Health & Diseases (CGHD), Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Timothy M. E. Davis
- Department of Medicine & Pharmacology, University of Western Australia, Perth, Australia
| | - Christopher L. King
- Center of Global Health & Diseases (CGHD), Case Western Reserve University, Cleveland, Ohio, United States of America
- Veterans Affairs Medical Center, Cleveland, Ohio, United States of America
| | - Pascal Michon
- PNG Institute of Medical Research, Madang, Papua New Guinea
- Faculty of Health Sciences, Divine Word University, Madang, Papua New Guinea
| | - Ivo Mueller
- PNG Institute of Medical Research, Madang, Papua New Guinea
- Infection & Immunity Division, Walter+Eliza Hall Institute, Parkville, Victoria, Australia
- Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain
- * E-mail:
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Wilson DW, Fowkes FJI, Gilson PR, Elliott SR, Tavul L, Michon P, Dabod E, Siba PM, Mueller I, Crabb BS, Beeson JG. Quantifying the importance of MSP1-19 as a target of growth-inhibitory and protective antibodies against Plasmodium falciparum in humans. PLoS One 2011; 6:e27705. [PMID: 22110733 PMCID: PMC3217002 DOI: 10.1371/journal.pone.0027705] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 10/23/2011] [Indexed: 12/13/2022] Open
Abstract
Background Antibodies targeting blood stage antigens are important in protection against malaria, but the key targets and mechanisms of immunity are not well understood. Merozoite surface protein 1 (MSP1) is an abundant and essential protein. The C-terminal 19 kDa region (MSP1-19) is regarded as a promising vaccine candidate and may also be an important target of immunity. Methodology/Findings Growth inhibitory antibodies against asexual-stage parasites and IgG to recombinant MSP1-19 were measured in plasma samples from a longitudinal cohort of 206 children in Papua New Guinea. Differential inhibition by samples of mutant P. falciparum lines that expressed either the P. falciparum or P. chabaudi form of MSP1-19 were used to quantify MSP1-19 specific growth-inhibitory antibodies. The great majority of children had detectable IgG to MSP1-19, and high levels of IgG were significantly associated with a reduced risk of symptomatic P. falciparum malaria during the 6-month follow-up period. However, there was little evidence of PfMSP1-19 specific growth inhibition by plasma samples from children. Similar results were found when testing non-dialysed or dialysed plasma, or purified antibodies, or when measuring growth inhibition in flow cytometry or microscopy-based assays. Rabbit antisera generated by immunization with recombinant MSP1-19 demonstrated strong MSP1-19 specific growth-inhibitory activity, which appeared to be due to much higher antibody levels than human samples; antibody avidity was similar between rabbit antisera and human plasma. Conclusions/Significance These data suggest that MSP1-19 is not a major target of growth inhibitory antibodies and that the protective effects of antibodies to MSP1-19 are not due to growth inhibitory activity, but may instead be mediated by other mechanisms. Alternatively, antibodies to MSP1-19 may act as a marker of protective immunity.
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Affiliation(s)
- Danny W. Wilson
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
- University of Melbourne, Melbourne, Australia
| | - Freya J. I. Fowkes
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
- Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Australia
| | - Paul R. Gilson
- Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Australia
- Monash University, Clayton, Australia
| | - Salenna R. Elliott
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
- Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Australia
| | - Livingstone Tavul
- Papua New Guinea Institute of Medical Research (PNGIMR), Goroka, Papua New Guinea
| | - Pascal Michon
- Papua New Guinea Institute of Medical Research (PNGIMR), Goroka, Papua New Guinea
- Faculty of Health Sciences, Divine Word University, Madang, Papua New Guinea
| | - Elija Dabod
- Papua New Guinea Institute of Medical Research (PNGIMR), Goroka, Papua New Guinea
| | - Peter M. Siba
- Papua New Guinea Institute of Medical Research (PNGIMR), Goroka, Papua New Guinea
| | - Ivo Mueller
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
- Papua New Guinea Institute of Medical Research (PNGIMR), Goroka, Papua New Guinea
- Barcelona Centre for International Health Research (CRESIB), Barcelona, Spain
| | - Brendan S. Crabb
- University of Melbourne, Melbourne, Australia
- Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Australia
| | - James G. Beeson
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
- Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Australia
- * E-mail:
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Mirchev R, Lam A, Golan DE. Membrane compartmentalization in Southeast Asian ovalocytosis red blood cells. Br J Haematol 2011; 155:111-21. [PMID: 21793815 DOI: 10.1111/j.1365-2141.2011.08805.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Red blood cells (RBCs) from individuals with Southeast Asian ovalocytosis (SAO) contain a mutant band 3 protein that causes the formation of unique linear oligomers in the RBC membrane. We used single-particle tracking to measure the lateral diffusion of individual glycophorin C (GPC), band 3, and CD58 proteins in membranes of intact SAO RBCs and normal RBCs (nRBCs). GPC, an integral protein that binds with high affinity to the RBC membrane skeleton, showed oscillatory motion within confinement areas that were smaller in SAO RBCs than in nRBCs. The additional confinement in SAO RBCs could be due to membrane stiffening associated with the SAO phenotype. Band 3 in both SAO RBCs and nRBCs also showed confined motion over short times (ms) and distances (nm), and the area of confinement was smaller in SAO RBCs than in nRBCs. These data presumably reflect the constraints imposed by band 3 oligomerization. Similarly, the glycosylphosphatidylinositol-linked protein CD58 showed loosely confined diffusion in nRBCs and a substantially higher degree of confinement in SAO RBCs. Restricted protein mobility could contribute to the altered adherence of parasite-infected RBCs to vascular endothelium that is thought to protect individuals with SAO from severe manifestations of malaria.
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Affiliation(s)
- Rossen Mirchev
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, 250 Longwood Avenue, Boston, MA 02115, USA
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