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Mondeilh A, Yovo E, Accrombessi M, Hounkonnou C, Agbota G, Atade W, Ladikpo OT, Mehoba M, Degbe A, Vianou B, Sossou D, Ndam NT, Massougbodji A, McGready R, Fievet N, Rijken MJ, Cottrell G, Briand V. Malaria Infections and Placental Blood Flow: A Doppler Ultrasound Study From a Preconception Cohort in Benin. Open Forum Infect Dis 2023; 10:ofad376. [PMID: 37577115 PMCID: PMC10414806 DOI: 10.1093/ofid/ofad376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Indexed: 08/15/2023] Open
Abstract
Background Malaria in pregnancy (MiP) has been associated with fetal growth restriction, the underlying pathogenic mechanisms of which remain poorly understood. Malaria in pregnancy is suspected to induce abnormalities in placental vascularization, leading to impaired placental development. Our study evaluated MIP's effect on uterine artery (UtA) and umbilical artery (UA) blood flow. Methods The analysis included 253 Beninese women followed throughout pregnancy and screened monthly for submicroscopic and microscopic malaria. Uterine artery Doppler measurement was performed once between 21 and 25 weeks' gestation (wg), and UA Doppler measurement was performed 1-3 times from 28 wg. Linear and logistic regression models were used to assess the effect of malaria infections on UtA Doppler indicators (pulsatility index and presence of a notch), whereas a logistic mixed model was used to assess the association between malaria infections and abnormal UA Doppler (defined as Z-score ≥2 standard deviation or absent/reversed UA end-diastolic flow). Results Primigravidae represented 7.5% of the study population; 42.3% of women had at least 1 microscopic infection during pregnancy, and 29.6% had at least 1 submicroscopic infection (and no microscopic infection). Both microscopic and submicroscopic infections before Doppler measurement were associated with the presence of a notch (adjusted odds ratio [aOR] 4.5, 95% confidence interval [CI] = 1.2-16.3 and aOR 3.3, 95% CI = .9-11.9, respectively). No associations were found between malaria before the Doppler measurement and abnormal UA Doppler. Conclusions Malaria infections in the first half of pregnancy impair placental blood flow. This highlights the need to prevent malaria from the very beginning of pregnancy.
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Affiliation(s)
- Aude Mondeilh
- Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, National Institute for Health and Medical Research (INSERM) UMR 1219, University of Bordeaux, Bordeaux, France
| | - Emmanuel Yovo
- Institut de Recherche Clinique du Bénin (IRCB), Abomey-Calavi, Benin
- Montpellier Interdisciplinary Center on Sustainable Agri-food Systems (MoISA), Université de Montpellier, Montpellier, France
| | - Manfred Accrombessi
- Institut de Recherche Clinique du Bénin (IRCB), Abomey-Calavi, Benin
- Faculty of Infectious and Tropical Diseases, Disease Control Department, London School of Hygiene and Tropical MedicineLondon, United Kingdom
| | - Cornelia Hounkonnou
- Centre d'investigation clinique, module épidémiologie clinique (CIC-EC 1425), Université Paris Cité and Université Sorbonne Paris Nord, Paris, France
- Département d’Épidémiologie, Biostatistique et Recherche Clinique, AP-HP, Hôpital BichatParis, France
| | - Gino Agbota
- Institut de Recherche Clinique du Bénin (IRCB), Abomey-Calavi, Benin
| | - William Atade
- Institut de Recherche Clinique du Bénin (IRCB), Abomey-Calavi, Benin
| | | | - Murielle Mehoba
- Institut de Recherche Clinique du Bénin (IRCB), Abomey-Calavi, Benin
| | - Auguste Degbe
- Institut de Recherche Clinique du Bénin (IRCB), Abomey-Calavi, Benin
| | - Bertin Vianou
- Institut de Recherche Clinique du Bénin (IRCB), Abomey-Calavi, Benin
| | - Dariou Sossou
- Institut de Recherche Clinique du Bénin (IRCB), Abomey-Calavi, Benin
| | - Nicaise Tuikue Ndam
- Research Institute for Sustainable Development (IRD), UMR 261 MERIT, Université Paris Cité, Paris, France
| | | | - Rose McGready
- Shoklo Malaria Research Unit, Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Nadine Fievet
- Research Institute for Sustainable Development (IRD), UMR 261 MERIT, Université Paris Cité, Paris, France
| | - Marcus J Rijken
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Gilles Cottrell
- Research Institute for Sustainable Development (IRD), UMR 261 MERIT, Université Paris Cité, Paris, France
| | - Valérie Briand
- Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, National Institute for Health and Medical Research (INSERM) UMR 1219, University of Bordeaux, Bordeaux, France
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2
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Eboumbou Moukoko CE, Kojom Foko LP, Ayina A, Tornyigah B, Epote AR, Penda IC, Epee Eboumbou P, Ebong SB, Texier G, Nsango SE, Ayong L, Tuikue Ndam N, Same Ekobo A. Effectiveness of Intermittent Preventive Treatment with Sulfadoxine-Pyrimethamine in Pregnancy: Low Coverage and High Prevalence of Plasmodium falciparum dhfr-dhps Quintuple Mutants as Major Challenges in Douala, an Urban Setting in Cameroon. Pathogens 2023; 12:844. [PMID: 37375534 DOI: 10.3390/pathogens12060844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/02/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023] Open
Abstract
Intermittent preventive treatment in pregnancy with sulfadoxine and pyrimethamine (IPTp-SP) is a key component in the malaria control strategy implemented in Africa. The aim of this study was to determine IPTp-SP adherence and coverage, and the impact on maternal infection and birth outcomes in the context of widespread SP resistance in the city of Douala, Cameroon. Clinical and demographic information were documented among 888 pregnant women attending 3 health facilities, from the antenatal care visit to delivery. Positive samples were genotyped for P. falciparum gene (dhfr, dhps, and k13) mutations. The overall IPTp-SP coverage (≥three doses) was 17.5%, and 5.1% received no dose. P. falciparum prevalence was 16%, with a predominance of submicroscopic infections (89.3%). Malaria infection was significantly associated with locality and history of malaria, and it was reduced among women using indoor residual spraying. Optimal doses of IPTp-SP were significantly associated with reduced infection among newborns and women (secundiparous and multiparous), but there was no impact of IPTp-SP on the newborn bodyweight. Pfdhfr-Pfdhps quintuple mutants were over-represented (IRNI-FGKAA, IRNI-AGKAA), and sextuple mutants (IRNI-AGKAS, IRNI-FGEAA, IRNI-AGKGS) were also reported. The Pfk13 gene mutations associated with artemisinin resistance were not detected. This study highlights the role of ANC in achieving optimal SP coverage in pregnant women, the mitigated impact of IPTp-SP on malaria outcomes, and the high prevalence of multiple SP-resistant P. falciparum parasites in the city of Douala that could compromise the efficacy of IPTp-SP.
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Affiliation(s)
- Carole Else Eboumbou Moukoko
- Malaria Research Unit, Centre Pasteur Cameroon, Yaoundé P.O. Box 1274, Cameroon
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, Douala P.O. Box 24157, Cameroon
- Laboratory of Parasitology, Mycology and Virology, Postgraduate Training Unit for Health Sciences, Postgraduate School for Pure and Applied Sciences, The University of Douala, Douala P.O. Box 24157, Cameroon
| | | | - Angèle Ayina
- Malaria Research Unit, Centre Pasteur Cameroon, Yaoundé P.O. Box 1274, Cameroon
- Pharmaceutical Sciences Department, Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, Douala P.O. Box 24157, Cameroon
| | - Bernard Tornyigah
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra P.O. Box 1181, Ghana
- UMR 261 MERIT, Institut de Recherche pour le Développement (IRD), Université de Paris, 75006 Paris, France
| | - Annie Rachel Epote
- Haematology Laboratory, Centre Pasteur Cameroon, Yaoundé P.O. Box 1274, Cameroon
| | - Ida Calixte Penda
- Clinical Sciences Department, Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, Douala P.O. Box 24157, Cameroon
| | - Patricia Epee Eboumbou
- Clinical Sciences Department, Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, Douala P.O. Box 24157, Cameroon
- Pediatric Wards, Bonassama Hospital, Douala P.O. Box 9023, Cameroon
| | - Serge Bruno Ebong
- Animal Organisms Biology and Physiology Department, Faculty of Sciences, The University of Douala, Douala P.O. Box 24157, Cameroon
| | - Gaetan Texier
- UMR 257-Vecteurs, Infections Tropicales et Méditerranéennes-VITROME-IRD/SSA/AP-HM, Aix-Marseille University, 13005 Marseille, France
| | - Sandrine Eveline Nsango
- Malaria Research Unit, Centre Pasteur Cameroon, Yaoundé P.O. Box 1274, Cameroon
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, Douala P.O. Box 24157, Cameroon
| | - Lawrence Ayong
- Malaria Research Unit, Centre Pasteur Cameroon, Yaoundé P.O. Box 1274, Cameroon
| | - Nicaise Tuikue Ndam
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra P.O. Box 1181, Ghana
- UMR 261 MERIT, Institut de Recherche pour le Développement (IRD), Université de Paris, 75006 Paris, France
| | - Albert Same Ekobo
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, Douala P.O. Box 24157, Cameroon
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3
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Blankson SO, Rietmeyer L, Tettey P, Dikroh L, Tornyigah B, Adamou R, Moussiliou A, Padounou C, Amoussou A, Mensah BA, Alao MJ, Awandare G, Ndam NT, Roussilhon C, Tahar R. High Plasma Levels of Neopterin Are Associated with Increased Mortality among Children with Severe Malaria in Benin. Diagnostics (Basel) 2023; 13:diagnostics13030528. [PMID: 36766633 PMCID: PMC9914932 DOI: 10.3390/diagnostics13030528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 02/04/2023] Open
Abstract
Among the barriers to accessing adequate treatment and high-level monitoring for malaria febrile patients is the lack of effective prognostic markers. Neopterin, which is a marker of monocyte/macrophage activation, was found have increased during severe malaria. In this study, we used quantitative ELISA in order to assess the levels of plasma soluble neopterin in 151 patients from a cohort of Beninese children with severe malaria. We evaluated the prognostic accuracy of this molecule in order to predict the outcome of the disease. Our results show that neopterin levels were not significantly different between patients with different forms of severe malaria, including severe non-cerebral malaria (SNCM) and cerebral malaria (CM). However, the levels of this molecule were found to be higher in patients with severe malarial anemia (SMA) among both CM and SNCM cases (p-value = 0.02). Additionally, the levels of this molecule were found to be higher in patients who died from these pathologies compared to those who survived among the two clinical groups (p-value < 0.0001) and within the same group (p-value < 0.0001 for the CM group, p-value = 0.0046 for the SNCM group). The AUC-ROC for fatality among all the severe cases was 0.77 with a 95%CI of (0.69-0.85). These results suggest that plasma neopterin levels constitute a potential biomarker for predicting fatality among severe falciparum malaria patients.
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Affiliation(s)
- Samuel Odarkwei Blankson
- MERIT, IRD, Université de Paris Cité, 75006 Paris, France
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra LG 54, Ghana
| | | | - Patrick Tettey
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra LG 54, Ghana
| | - Liliane Dikroh
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra LG 54, Ghana
| | - Bernard Tornyigah
- MERIT, IRD, Université de Paris Cité, 75006 Paris, France
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra LG 54, Ghana
| | - Rafiou Adamou
- Institut de Recherche Clinique du Benin (IRCB), Calavi, Benin
| | | | | | - Annick Amoussou
- Service de Pédiatrie, Centre Hospitalo-Universitaire, Suruléré (CHU-Suruléré), Cotonou, Benin
| | - Benedicta Ayiedu Mensah
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra LG 54, Ghana
| | - Maroufou J. Alao
- Département de Pédiatrie, Hôpital Mère-Enfant la Lagune (CHUMEL), Cotonou, Benin
| | - Gordon Awandare
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra LG 54, Ghana
| | - Nicaise Tuikue Ndam
- MERIT, IRD, Université de Paris Cité, 75006 Paris, France
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra LG 54, Ghana
| | | | - Rachida Tahar
- MERIT, IRD, Université de Paris Cité, 75006 Paris, France
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra LG 54, Ghana
- Correspondence: ; Tel.: +331-70-64-94-33
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4
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Blankson SO, Dikroh L, Tettey P, Tornyigah B, Adamou R, Moussiliou A, Alao MJ, Amoussou A, Padounou C, Milet J, Mensah BA, Aniweh Y, Ndam NT, Roussilhon C, Tahar R. Association of Endothelial Protein C Receptor (EPCR) rs867186 Gene Polymorphism With Increased Levels of Soluble EPCR and High Risk of Severe Malaria and Fatality in Beninese Children. J Infect Dis 2023; 227:179-182. [PMID: 36416015 DOI: 10.1093/infdis/jiac461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 11/24/2022] Open
Abstract
The endothelial protein C receptor (EPCR)-rs867186 G allele has been linked to high plasma levels of soluble EPCR (sEPCR) and controversially associated with either susceptibility or resistance to severe and cerebral malaria. In this study, quantitative enzyme-linked immunosorbent assay and sequencing were used to assess sEPCR levels and EPCR-rs867186 polymorphism in blood samples from Beninese children with different clinical presentations of malaria. Our findings show that sEPCR levels were higher at hospital admission than during convalescence and that EPCR-rs867186 G allele was associated with increased sEPCR plasma levels, malaria severity, and mortality rate (P < .001, P = .03, and P = .04, respectively), suggesting a role of sEPCR in the pathogenesis of severe malaria.
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Affiliation(s)
- Samuel Odarkwei Blankson
- Université de Paris Cité, MERIT, IRD, Paris, France.,West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Liliane Dikroh
- Department of Immunology and Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Patrick Tettey
- Department of Immunology and Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Bernard Tornyigah
- Université de Paris Cité, MERIT, IRD, Paris, France.,Department of Immunology and Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Rafiou Adamou
- Université de Paris Cité, MERIT, IRD, Paris, France.,Institut de Recherche Clinique du Benin, Calavi, Benin
| | - Azizath Moussiliou
- Université de Paris Cité, MERIT, IRD, Paris, France.,Institut de Recherche Clinique du Benin, Calavi, Benin
| | - Maroufou J Alao
- Département de Pédiatrie, Centre Hospitalier Universitaire de La Mère et De L'Enfant Lagune, Cotonou, Benin
| | - Annick Amoussou
- Service de Pédiatrie, Centre Hospitalo-Universitaire, Suruléré, Cotonou, Benin
| | - Caroline Padounou
- Centre Hospitalier Universitaire de l'Oueme/Plateau, Porto-Novo, Benin
| | | | - Benedicta Ayiedu Mensah
- Department of Immunology and Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Yaw Aniweh
- West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | - Nicaise Tuikue Ndam
- Université de Paris Cité, MERIT, IRD, Paris, France.,West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | | | - Rachida Tahar
- Université de Paris Cité, MERIT, IRD, Paris, France.,West African Centre for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
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5
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Mensah BA, Ndong IC, Quashie PK, Guichet E, Abuaku B, Effah-Baafi Y, Tapela K, Asiedu K, Appiedu-Addo SNA, Obbeng LB, Amponsah JA, Kusi KA, Ofori M, Ayouba A, Courtin D, Tahar R, Delaporte E, Awandare G, Ndam NT. Population-based sero-epidemiological investigation of the dynamics of SARS-CoV-2 infections in the Greater Accra Region of Ghana. Sci Rep 2022; 12:21582. [PMID: 36517505 PMCID: PMC9748398 DOI: 10.1038/s41598-022-25598-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic devastated countries worldwide, and resulted in a global shutdown. Not all infections are symptomatic and hence the extent of SARS-CoV-2 infection in the community is unknown. The paper presents the dynamics of the SARS-CoV-2 epidemic in the Greater Accra Metropolis, describing the evolution of seroprevalence through time and by age group. Three repeated independent population-based surveys at 6-week intervals were conducted in from November 2020 to July 2021. The global and by age-groups weighted seroprevalences were estimated and the risk factors for SARS-CoV-2 antibody seropositivity were assessed using logistic regression. The overall age-standardized SARS-CoV-2 antibody seroprevalence for both spike and nucleocapsid increased from 13.8% (95% CI 11.9, 16.1) in November 2020 to 39.6% (95% CI 34.8, 44.6) in July 2021. After controlling for gender, marital status, education level, and occupation, the older age group over 40 years had a higher odds of seropositivity than the younger age group (OR 3.0 [95% CI 1.1-8.5]) in the final survey. Pupils or students had 3.3-fold increased odds of seropositivity (OR 3.2 [95% CI 1.1-8.5]) compared to the unemployed. This study reinforces that, SARS-CoV-2 infections have been significantly higher than reported.
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Affiliation(s)
| | - Ignatius Cheng Ndong
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- Department of Biochemistry, Catholic University of Cameroon, Bamenda, Cameroon
| | - Peter Kojo Quashie
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
| | - Emilande Guichet
- TransVIHMI, University of Montpellier, IRD and Institut National de La Santé Et de La Recherche Médicale (INSERM), Montpellier, France
| | - Benjamin Abuaku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Yaw Effah-Baafi
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Kesego Tapela
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
| | - Kwame Asiedu
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
| | | | - Louisa Baaba Obbeng
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
| | - Jones Amo Amponsah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Kwadwo Asamoah Kusi
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Michael Ofori
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Ahidjo Ayouba
- TransVIHMI, University of Montpellier, IRD and Institut National de La Santé Et de La Recherche Médicale (INSERM), Montpellier, France
| | - David Courtin
- MERIT, IRD, Université de Paris, 75006, Paris, France
| | - Rachida Tahar
- MERIT, IRD, Université de Paris, 75006, Paris, France
| | - Eric Delaporte
- TransVIHMI, University of Montpellier, IRD and Institut National de La Santé Et de La Recherche Médicale (INSERM), Montpellier, France
| | - Gordon Awandare
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
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6
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Tapela K, Oyawoye FO, Olwal CO, Opurum PC, Amponsah JA, Segbedzi KAL, Tetteh B, Kumi-Ansah F, Mutungi JK, Obodai E, Amoako E, Agyemang S, Ndam NT, Ampofo WK, Rayner JC, Awandare GA, Paemka L, Bediako Y, Quashie PK. Probing SARS-CoV-2-positive plasma to identify potential factors correlating with mild COVID-19 in Ghana, West Africa. BMC Med 2022; 20:370. [PMID: 36184636 PMCID: PMC9527094 DOI: 10.1186/s12916-022-02571-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/20/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND West Africa has recorded a relatively higher proportion of asymptomatic coronavirus disease 2019 (COVID-19) cases than the rest of the world, and West Africa-specific host factors could play a role in this discrepancy. Here, we assessed the association between COVID-19 severity among Ghanaians with their immune profiles and ABO blood groups. METHODS Plasma samples were obtained from Ghanaians PCR-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive individuals. The participants were categorized into symptomatic and asymptomatic cases. Cytokine profiling and antibody quantification were performed using Luminex™ multiplex assay whereas antigen-driven agglutination assay was used to assess the ABO blood groups. Immune profile levels between symptomatic and asymptomatic groups were compared using the two-tailed Mann-Whitney U test. Multiple comparisons of cytokine levels among and between days were tested using Kruskal-Wallis with Dunn's post hoc test. Correlations within ABO blood grouping (O's and non-O's) and between cytokines were determined using Spearman correlations. Logistic regression analysis was performed to assess the association of various cytokines with asymptomatic phenotype. RESULTS There was a trend linking blood group O to reduced disease severity, but this association was not statistically significant. Generally, symptomatic patients displayed significantly (p < 0.05) higher cytokine levels compared to asymptomatic cases with exception of Eotaxin, which was positively associated with asymptomatic cases. There were also significant (p < 0.05) associations between other immune markers (IL-6, IL-8 and IL-1Ra) and disease severity. Cytokines' clustering patterns differ between symptomatic and asymptomatic cases. We observed a steady decrease in the concentration of most cytokines over time, while anti-SARS-CoV-2 antibody levels were stable for at least a month, regardless of the COVID-19 status. CONCLUSIONS The findings suggest that genetic background and pre-existing immune response patterns may in part shape the nature of the symptomatic response against COVID-19 in a West African population. This study offers clear directions to be explored further in larger studies.
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Affiliation(s)
- Kesego Tapela
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana.,Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Fatima O Oyawoye
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana.,Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Charles Ochieng' Olwal
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana.,Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Precious C Opurum
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Jones Amo Amponsah
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Kekeli Aku Lumor Segbedzi
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana.,Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Becky Tetteh
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | | | - Joe K Mutungi
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana
| | - Evangeline Obodai
- Virology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Emmanuella Amoako
- Department of Pediatrics, Cape Coast Teaching Hospital, Cape Coast, Ghana.,Yemaachi Biotech Inc., 222 Swaniker St, Accra, Ghana
| | - Seth Agyemang
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana.,Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Nicaise Tuikue Ndam
- UMR261 MERIT and Head of IRD Branch in Benin-Nigeria-Togo-Ghana, Accra, Ghana
| | - William Kwabena Ampofo
- Virology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Julian C Rayner
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana.,Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Lily Paemka
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana.,Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana.,Yemaachi Biotech Inc., 222 Swaniker St, Accra, Ghana
| | - Yaw Bediako
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana.,Yemaachi Biotech Inc., 222 Swaniker St, Accra, Ghana.,The Francis Crick Institute, 1 Midland Rd, London, NW1 1AT, UK
| | - Peter Kojo Quashie
- West African Centre for Cell Biology of Infectious Pathogens, College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana. .,The Francis Crick Institute, 1 Midland Rd, London, NW1 1AT, UK.
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Blankson SO, Dadjé DS, Traikia N, Alao MJ, Ayivi S, Amoussou A, Deloron P, Ndam NT, Milet J, Basco LK, Aniweh Y, Tahar R. ICAM-1 Kilifi variant is not associated with cerebral and severe malaria pathogenesis in Beninese children. Malar J 2022; 21:115. [PMID: 35379236 PMCID: PMC8978164 DOI: 10.1186/s12936-022-04139-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cytoadhesion and sequestration of Plasmodium falciparum infected red blood cells (iRBC) in the microvasculature of vital organs are a major cause of malaria pathology. Several studies have provided evidence on the implication of the human host intercellular adhesion molecule-1 (ICAM-1) as a major receptor for iRBCs binding to P. falciparum erythrocyte membrane protein 1 (PfEMP1) in the development of severe and cerebral malaria. The genetic polymorphism K29M in the immunoglobulin-like domain of ICAM-1, known as ICAM-1Kilifi, has been associated with either increased or decreased risk of developing cerebral malaria.
Methods
To provide more conclusive results, the genetic polymorphism of ICAM-1Kilifi was assessed by PCR and sequencing in blood samples from 215 Beninese children who presented with either mild or severe malaria including cerebral malaria.
Results and conclusions
The results showed that in this cohort of Beninese children, the ICAM-1kilifi variant is present at the frequencies of 0.27, similar to the frequency observed in other African countries. This ICAM-1kilifi variant was not associated with disease severity in agreement with other findings from the Gambia, Tanzania, Malawi, Gabon, and Thailand, suggesting no evidence of a direct link between this polymorphism and the pathogenesis of severe and cerebral malaria.
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Mama A, Ahiabor C, Tornyigah B, Frempong NA, Kusi KA, Adu B, Courtin D, Houzé S, Deloron P, Ofori MF, Anang AK, Ariey F, Ndam NT. Intermittent preventive treatment in pregnancy with sulfadoxine–pyrimethamine and parasite resistance: cross-sectional surveys from antenatal care visit and delivery in rural Ghana. Malar J 2022; 21:107. [PMID: 35346205 PMCID: PMC8962208 DOI: 10.1186/s12936-022-04124-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 03/13/2022] [Indexed: 11/28/2022] Open
Abstract
Background Despite decades of prevention efforts, the burden of malaria in pregnancy (MiP) remains a great public health concern. Sulfadoxine-pyrimethamine (SP), used as intermittent preventive treatment in pregnancy (IPTp-SP) is an important component of the malaria prevention strategy implemented in Africa. However, IPTp-SP is under constant threat from parasite resistance, thus requires regular evaluation to inform decision-making bodies. Methods In two malaria endemic communities in the Volta region (Adidome and Battor), a cross-sectional hospital-based study was conducted in pregnant women recruited at their first antenatal care (ANC) visit and at delivery. Basic clinical and demographic information were documented and their antenatal records were reviewed to confirm IPTp-SP adherence. Peripheral and placental blood were assayed for the presence of Plasmodium falciparum parasites by quantitative polymerase chain reaction (qPCR). One hundred and twenty (120) positive samples were genotyped for mutations associated with SP resistance. Results At first ANC visit, P. falciparum prevalence was 28.8% in Adidome and 18.2% in Battor. At delivery, this decreased to 14.2% and 8.2%, respectively. At delivery, 66.2% of the women had taken at least the recommended 3 or more doses of IPTp-SP and there was no difference between the two communities. Taking at least 3 IPTp-SP doses was associated with an average birth weight increase of more than 360 g at both study sites compared to women who did not take treatment (p = 0.003). The Pfdhfr/Pfdhps quintuple mutant IRNI-A/FGKAA was the most prevalent (46.7%) haplotype found and the nonsynonymous Pfdhps mutation at codon A581G was higher at delivery among post-SP treatment isolates (40.6%) compared to those of first ANC (10.22%). There was also an increase in the A581G mutation in isolates from women who took 3 or more IPTp-SP. Conclusions This study confirms a positive impact following the implementation of the new IPTp-SP policy in Ghana in increasing the birth weight of newborns. However, the selection pressure exerted by the recommended 3 or more doses of IPTp-SP results in the emergence of parasites carrying the non-synonymous mutation on codon A581G. This constant selective pressure calls into question the time remaining for the clinical utility of IPTp-SP treatment during pregnancy in Africa.
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9
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Lopez-Perez M, Viwami F, Doritchamou J, Ndam NT, Hviid L. Natural Acquired Immunity to Malaria Antigens among Pregnant Women with Hemoglobin C Trait. Am J Trop Med Hyg 2022; 106:853-856. [PMID: 35026728 PMCID: PMC8922521 DOI: 10.4269/ajtmh.21-1039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/17/2021] [Indexed: 11/07/2022] Open
Abstract
Hemoglobin C is the second most common structural hemoglobinopathy in Africa, and carriers have a reduced risk of severe malaria. However, the effect of HbAC on the antibody response to malaria antigens in pregnancy has not been studied. Here, we measured PfEMP1-specific antibodies in plasma samples from 74 Beninese pregnant women with either HbAA or HbAC. IgG-mediated inhibition of VAR2CSA+ infected erythrocytes adhesion to chondroitin sulfate A (CSA) was also tested. PfEMP1-specific IgG levels to VAR2CSA were significantly lower in HbAC women, suggesting less exposure to VAR2CSA. In contrast, the percentage of VAR2CSA+-infected erythrocytes adhesion to CSA was not different between HbAA and HbAC women. Moreover, IgG levels to PfEMP1 variants associated with severe malaria were not significantly different between groups. The findings indicate similar exposure to Plasmodium falciparum parasites expressing PfEMP1 variants causing severe malaria, and justify more comprehensive studies of hemoglobinopathy-related qualitative and quantitative differences in PfEMP1-specific antibody responses.
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Affiliation(s)
- Mary Lopez-Perez
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;,Address correspondence to Mary Lopez-Perez, Panum Institute 07-11-38, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark. E-mail:
| | - Firmine Viwami
- UMR 261 MERIT, Université de Paris, Institut de Recherche pour le Développement (IRD), Paris, France;,Institut de Recherche Clinique du Benin, Abomey Calavi, Benin
| | | | - Nicaise Tuikue Ndam
- UMR 261 MERIT, Université de Paris, Institut de Recherche pour le Développement (IRD), Paris, France;,Institut de Recherche Clinique du Benin, Abomey Calavi, Benin;,Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Lars Hviid
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;,Centre for Medical Parasitology, Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
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10
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Tornyigah B, Blankson SO, Adamou R, Moussiliou A, Rietmeyer L, Tettey P, Dikroh L, Addo B, Lamptey H, Alao MJ, Amoussou A, Padounou C, Roussilhon C, Pons S, Mensah BA, Ndam NT, Tahar R. Specific Combinations of Inflammatory, Angiogenesis and Vascular Integrity Biomarkers Are Associated with Clinical Severity, Coma and Mortality in Beninese Children with Plasmodium Falciparum Malaria. Diagnostics (Basel) 2022; 12:diagnostics12020524. [PMID: 35204613 PMCID: PMC8871337 DOI: 10.3390/diagnostics12020524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/07/2022] [Accepted: 02/15/2022] [Indexed: 12/16/2022] Open
Abstract
Malaria-related deaths could be prevented if powerful diagnostic and reliable prognostic biomarkers were available to allow rapid prediction of the clinical severity allowing adequate treatment. Using quantitative ELISA, we assessed the plasma concentrations of Procalcitonin, Pentraxine-3, Ang-2, sTie-2, suPAR, sEPCR and sICAM-1 in a cohort of Beninese children with malaria to investigate their potential association with clinical manifestations of malaria. We found that all molecules showed higher levels in children with severe or cerebral malaria compared to those with uncomplicated malaria (p-value < 0.005). Plasma concentrations of Pentraxine-3, Procalcitonin, Ang-2 and the soluble receptors were significantly higher in children with coma as defined by a Blantyre Coma Score < 3 (p < 0.001 for Pentraxine-3, suPAR, and sTie-2, p = 0.004 for PCT, p = 0.005 for sICAM-1, p = 0.04 for Ang-2). Moreover, except for the PCT level, the concentrations of Pentraxine-3, suPAR, sEPCR, sICAM-1, sTie-2 and Ang-2 were higher among children who died from severe malaria compared to those who survived (p = 0.037, p = 0.035, p < 0.0001, p= 0.0008, p = 0.01 and p = 0.02, respectively). These findings indicate the ability of these molecules to accurately discriminate among clinical manifestations of malaria, thus, they might be potentially useful for the early prognostic of severe and fatal malaria, and to improve management of severe cases.
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Affiliation(s)
- Bernard Tornyigah
- Université de Paris, MERIT, IRD, 75006 Paris, France; (B.T.); (S.O.B.); (L.R.); (N.T.N.)
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana; (P.T.); (L.D.); (B.A.); (H.L.); (B.A.M.)
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana
| | - Samuel Odarkwei Blankson
- Université de Paris, MERIT, IRD, 75006 Paris, France; (B.T.); (S.O.B.); (L.R.); (N.T.N.)
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana; (P.T.); (L.D.); (B.A.); (H.L.); (B.A.M.)
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana
| | - Rafiou Adamou
- Institut de Recherche Clinique du Benin (IRCB), Calavi, Benin; (R.A.); (A.M.)
| | - Azizath Moussiliou
- Institut de Recherche Clinique du Benin (IRCB), Calavi, Benin; (R.A.); (A.M.)
| | - Lauriane Rietmeyer
- Université de Paris, MERIT, IRD, 75006 Paris, France; (B.T.); (S.O.B.); (L.R.); (N.T.N.)
| | - Patrick Tettey
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana; (P.T.); (L.D.); (B.A.); (H.L.); (B.A.M.)
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana
| | - Liliane Dikroh
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana; (P.T.); (L.D.); (B.A.); (H.L.); (B.A.M.)
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana
| | - Bernard Addo
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana; (P.T.); (L.D.); (B.A.); (H.L.); (B.A.M.)
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana
| | - Helena Lamptey
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana; (P.T.); (L.D.); (B.A.); (H.L.); (B.A.M.)
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana
| | - Maroufou J. Alao
- Département de Pédiatrie, Hôpital Mère-Enfant la Lagune (CHUMEL), Cotonou, Benin;
| | - Annick Amoussou
- Service de Pédiatrie, Centre Hospitalo-Universitaire, Suruléré (CHU-Suruléré), Cotonou, Benin;
| | - Caroline Padounou
- Centre Hospitalier Universitaire de l’Oueme/Plateau, Porto-Novo, Benin;
| | - Christian Roussilhon
- Unité de Génétique Fonctionnelle des Maladies Infectieuses, Département Génomes et Génétique, Institut Pasteur, 28 Rue du Docteur Roux, 75015 Paris, France;
| | - Sylvie Pons
- Laboratoire Commun de Recherche Hospices Civils de Lyon-BioMérieux, Centre Hospitalier Lyon-Sud, Bâtiment 3F, 165 chemin du Grand Revoyet, 69310 Pierre-Bénite, France;
| | - Benedicta Ayiedu Mensah
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana; (P.T.); (L.D.); (B.A.); (H.L.); (B.A.M.)
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana
| | - Nicaise Tuikue Ndam
- Université de Paris, MERIT, IRD, 75006 Paris, France; (B.T.); (S.O.B.); (L.R.); (N.T.N.)
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana; (P.T.); (L.D.); (B.A.); (H.L.); (B.A.M.)
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana
| | - Rachida Tahar
- Université de Paris, MERIT, IRD, 75006 Paris, France; (B.T.); (S.O.B.); (L.R.); (N.T.N.)
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana; (P.T.); (L.D.); (B.A.); (H.L.); (B.A.M.)
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra P.O. Box LG 581, Ghana
- Correspondence: ; Tel.: +33-153-739-933
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Coppée R, Mama A, Sarrasin V, Kamaliddin C, Adoux L, Palazzo L, Ndam NT, Letourneur F, Ariey F, Houzé S, Clain J. 5WBF: a low-cost and straightforward whole blood filtration method suitable for whole-genome sequencing of Plasmodium falciparum clinical isolates. Malar J 2022; 21:51. [PMID: 35172825 PMCID: PMC8848818 DOI: 10.1186/s12936-022-04073-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/31/2022] [Indexed: 11/21/2022] Open
Abstract
Background Whole-genome sequencing (WGS) is becoming increasingly helpful to assist malaria control programmes. A major drawback of this approach is the large amount of human DNA compared to parasite DNA extracted from unprocessed whole blood. As red blood cells (RBCs) have a diameter of about 7–8 µm and exhibit some deformability, it was hypothesized that cheap and commercially available 5 µm filters might retain leukocytes but much less of Plasmodium falciparum-infected RBCs. This study aimed to test the hypothesis that such a filtration method, named 5WBF (for 5 µm Whole Blood Filtration), may provide highly enriched parasite material suitable for P. falciparum WGS. Methods Whole blood was collected from five patients experiencing a P. falciparum malaria episode (ring-stage parasitaemia range: 0.04–5.5%) and from mock samples obtained by mixing synchronized, ring-stage cultured P. falciparum 3D7 parasites with uninfected human whole blood (final parasitaemia range: 0.02–1.1%). These whole blood samples (50 to 400 µL) were diluted in RPMI 1640 medium or PBS 1× buffer and filtered with a syringe connected to a 5 µm commercial filter. DNA was extracted from 5WBF-treated and unfiltered counterpart blood samples using a commercial kit. The 5WBF method was evaluated on the ratios of parasite:human DNA assessed by qPCR and by sequencing depth and percentages of coverage from WGS data (Illumina NextSeq 500). As a comparison, the popular selective whole-genome amplification (sWGA) method, which does not rely on blood filtration, was applied to the unfiltered counterpart blood samples. Results After applying 5WBF, qPCR indicated an average of twofold loss in the amount of parasite template DNA (Pf ARN18S gene) and from 4096- to 65,536-fold loss of human template DNA (human β actin gene). WGS analyses revealed that > 95% of the parasite nuclear and organellar genomes were all covered at ≥ 10× depth for all samples tested. In sWGA counterparts, the organellar genomes were poorly covered and from 47.7 to 82.1% of the nuclear genome was covered at ≥ 10× depth depending on parasitaemia. Sequence reads were homogeneously distributed across gene sequences for 5WBF-treated samples (n = 5460 genes; mean coverage: 91×; median coverage: 93×; 5th percentile: 70×; 95th percentile: 103×), allowing the identification of gene copy number variations such as for gch1. This later analysis was not possible for sWGA-treated samples, as a much more heterogeneous distribution of reads across gene sequences was observed (mean coverage: 80×; median coverage: 51×; 5th percentile: 7×; 95th percentile: 245×). Conclusions The novel 5WBF leucodepletion method is simple to implement and based on commercially available, standardized 5 µm filters which cost from 1.0 to 1.7€ per unit depending on suppliers. 5WBF permits extensive genome-wide analysis of P. falciparum ring-stage isolates from minute amounts of whole blood even with parasitaemias as low as 0.02%. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04073-1.
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Affiliation(s)
- Romain Coppée
- Université de Paris, IRD, MERIT, 75006, Paris, France. .,Université de Paris, Infection Modelisation Antimicrobial Evolution (IAME), Inserm UMR1137, 75018, Paris, France.
| | - Atikatou Mama
- Université de Paris, IRD, MERIT, 75006, Paris, France
| | - Véronique Sarrasin
- Université de Paris, IRD, MERIT, 75006, Paris, France.,Centre National de Référence du Paludisme, AP-HP, Hôpital Bichat - Claude-Bernard, 75018, Paris, France
| | - Claire Kamaliddin
- Centre National de Référence du Paludisme, AP-HP, Hôpital Bichat - Claude-Bernard, 75018, Paris, France.,Cumming School of Medicine, Pathology and Laboratory Medicine, The University of Calgary, Calgary, AB, Canada
| | - Lucie Adoux
- Cochin Institute, INSERM U1016, UMR CNRS 8104, Genomic Platform, 75014, Paris, France
| | | | | | - Franck Letourneur
- Cochin Institute, INSERM U1016, UMR CNRS 8104, Genomic Platform, 75014, Paris, France
| | - Frédéric Ariey
- Université de Paris, INSERM 1016, Service de Parasitologie-Mycologie Hôpital Cochin, 75014, Paris, France
| | - Sandrine Houzé
- Université de Paris, IRD, MERIT, 75006, Paris, France.,Centre National de Référence du Paludisme, AP-HP, Hôpital Bichat - Claude-Bernard, 75018, Paris, France
| | - Jérôme Clain
- Université de Paris, IRD, MERIT, 75006, Paris, France. .,Centre National de Référence du Paludisme, AP-HP, Hôpital Bichat - Claude-Bernard, 75018, Paris, France.
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12
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Tornyigah B, Ndam NT. Preservation of Parasite RNA in the Field. Methods Mol Biol 2022; 2470:19-25. [PMID: 35881335 DOI: 10.1007/978-1-0716-2189-9_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The pathogenesis of malaria is largely attributable to the parasite's ability to modulate its cytoadhesion phenotype. This relates to the multigenic families comprising dozens to hundreds of members, whose expression, often mutually exclusive, allows the parasite to vary its adhesive properties and antigenic appearance. This phenomenon is mainly described for the variant surface antigens that the parasite expresses on the infected erythrocyte. In order to decipher these gene expression spectra and identify potential antigenic candidates and/or targets of therapeutic interest, the analysis of the transcriptomes of the parasites directly isolated from patients with well-defined clinical presentation is important. RNA stabilization is an absolute prerequisite for a precise and accurate transcriptome profiling. Immediate stabilization of RNA of biological samples is therefore necessary to prevent degradation by ribonucleases (RNase) or cellular changes. This chapter described methodology for preserving parasite RNA samples from malaria patients in the field for transcriptome studies.
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Affiliation(s)
- Bernard Tornyigah
- Université de Paris, MERIT, IRD, Paris, France
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
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13
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Lopez-Perez M, Viwami F, Seidu Z, Jensen ATR, Doritchamou J, Ndam NT, Hviid L. PfEMP1-Specific Immunoglobulin G Reactivity Among Beninese Pregnant Women With Sickle Cell Trait. Open Forum Infect Dis 2021; 8:ofab527. [PMID: 34909438 PMCID: PMC8664683 DOI: 10.1093/ofid/ofab527] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/14/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Sickle cell trait (HbAS) protects against severe Plasmodium falciparum malaria but not against placental malaria (PM). In this study, P falciparum erythrocyte membrane protein (PfEMP1)-specific antibodies were measured in HbAA and HbAS Beninese pregnant women as a proxy of exposure to specific PfEMP1 variants. METHODS Plasma samples collected at delivery from 338 HbAA and 63 HbAS women were used to measure immunoglobulin (Ig)G levels to 6 recombinant PfEMP1 proteins and 3 corresponding native proteins expressed on the infected erythrocyte (IE) surface. Immunoglobulin G-mediated inhibition of VAR2CSA+ IEs adhesion to chondroitin sulfate A (CSA) was also tested. RESULTS Levels of PfEMP1-specific IgG were similar in the 2 groups, except for native IT4VAR09 on IEs, where IgG levels were significantly higher in HbAS women. Adjusted odds ratios for women with positive IgG to HB3VAR06 and PFD1235w suggest a lower risk of infection with these virulent variants among HbAS individuals. The percentage of IEs binding to CSA did not differ between HbAA and HbAS women, but it correlated positively with levels of anti-VAR2CSA and parity. Women with PM had lower levels of anti-VAR2CSA-specific IgG and lower IgG-mediated inhibition of IE adhesion to CSA. CONCLUSIONS The findings support similar malaria exposure in HbAA and HbAS women and a lack of HbAS-dependent protection against placental infection among pregnant women.
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Affiliation(s)
- Mary Lopez-Perez
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Firmine Viwami
- UMR 261 MERIT, Université de Paris, Institut de Recherche pour le Développement, Paris, France
- Institut de Recherche Clinique du Benin, Abomey Calavi, Benin
| | - Zakaria Seidu
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West Africa Centre for Cell Biology of Infectious Pathogens (WACCBIP), Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Anja T R Jensen
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Nicaise Tuikue Ndam
- UMR 261 MERIT, Université de Paris, Institut de Recherche pour le Développement, Paris, France
- Institut de Recherche Clinique du Benin, Abomey Calavi, Benin
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Lars Hviid
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Centre for Medical Parasitology, Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
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14
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Larsen MD, Lopez-Perez M, Dickson EK, Ampomah P, Tuikue Ndam N, Nouta J, Koeleman CAM, Ederveen ALH, Mordmüller B, Salanti A, Nielsen MA, Massougbodji A, van der Schoot CE, Ofori MF, Wuhrer M, Hviid L, Vidarsson G. Afucosylated Plasmodium falciparum-specific IgG is induced by infection but not by subunit vaccination. Nat Commun 2021. [PMID: 34611164 DOI: 10.1101/2021.04.23.441082v1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) family members mediate receptor- and tissue-specific sequestration of infected erythrocytes (IEs) in malaria. Antibody responses are a central component of naturally acquired malaria immunity. PfEMP1-specific IgG likely protects by inhibiting IE sequestration and through IgG-Fc Receptor (FcγR) mediated phagocytosis and killing of antibody-opsonized IEs. The affinity of afucosylated IgG to FcγRIIIa is up to 40-fold higher than fucosylated IgG, resulting in enhanced antibody-dependent cellular cytotoxicity. Most IgG in plasma is fully fucosylated, but afucosylated IgG is elicited in response to enveloped viruses and to paternal alloantigens during pregnancy. Here we show that naturally acquired PfEMP1-specific IgG is strongly afucosylated in a stable and exposure-dependent manner, and efficiently induces FcγRIIIa-dependent natural killer (NK) cell degranulation. In contrast, immunization with a subunit PfEMP1 (VAR2CSA) vaccine results in fully fucosylated specific IgG. These results have implications for understanding protective natural- and vaccine-induced immunity to malaria.
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Affiliation(s)
- Mads Delbo Larsen
- Department of Experimental Immunohematology, Sanquin Research, Amsterdam, The Netherlands.,Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mary Lopez-Perez
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Emmanuel Kakra Dickson
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Paulina Ampomah
- Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Jan Nouta
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | - Carolien A M Koeleman
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Benjamin Mordmüller
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands.,Institut für Tropenmedizin, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Ali Salanti
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Morten Agertoug Nielsen
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Achille Massougbodji
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Godomey, Benin
| | - C Ellen van der Schoot
- Department of Experimental Immunohematology, Sanquin Research, Amsterdam, The Netherlands.,Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Michael F Ofori
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Manfred Wuhrer
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, The Netherlands
| | - Lars Hviid
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,Centre for Medical Parasitology, Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
| | - Gestur Vidarsson
- Department of Experimental Immunohematology, Sanquin Research, Amsterdam, The Netherlands. .,Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
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15
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Jafari-Guemouri S, Courtois L, Mama A, Rouas B, Neto Braga G, Accrombessi M, Massougbodji A, Ding XC, Tuikue Ndam N, Fievet N, Briand V. A Genotyping Study in Benin Comparing the Carriage of Plasmodium falciparum Infections Before Pregnancy and in Early Pregnancy: Story of a Persistent Infection. Clin Infect Dis 2021; 73:e355-e361. [PMID: 32569359 PMCID: PMC8282262 DOI: 10.1093/cid/ciaa841] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/17/2020] [Indexed: 12/16/2022] Open
Abstract
Background Malaria infections in the first trimester of pregnancy are frequent and deleterious for both mother and child health. To investigate if these early infections are newly acquired or already present in the host, we assessed whether parasites detected before pregnancy and those detected in early pregnancy are the same infection. Methods We used data from the preconceptional “RECIPAL” study (Benin, 2014–2017). Sixty-three pregnant women of 411 included who had a malaria infection detected by quantitative polymerase chain reaction both before pregnancy and at the first antenatal care (ANC) visit were selected for this study. Two highly polymorphic markers, msp-2 and glurp, and a fragment-analysis method were used to enumerate the Plasmodium falciparum genotypes and to quantify their proportions within isolates. An infection was considered as persistent when identical msp-2 and glurp genotypes were found in the corresponding prepregnancy and early-pregnancy samples. Results The median time between the 2 malaria screenings was 3 months. The median gestational age at the first ANC visit was 6.4 weeks. Most infections before pregnancy were submicroscopic infections. Based on both msp-2 and glurp genotyping, the infection was similar before and in early pregnancy in 46% (29/63) of cases. Conclusions Almost half of P. falciparum infections detected in the first trimester originate before pregnancy. Protecting young women from malaria infection before pregnancy might reduce the prevalence of malaria in early pregnancy and its related poor maternal and birth outcomes.
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Affiliation(s)
- Sayeh Jafari-Guemouri
- Université de Paris, UMR261-MERIT, Institut de Recherche pour le Développement, Paris, France
| | - Laura Courtois
- Université de Paris, UMR261-MERIT, Institut de Recherche pour le Développement, Paris, France
| | - Atika Mama
- Clinical Research Institute of Benin (IRCB), Abomey-Calavi, Benin
| | - Baptiste Rouas
- Université de Paris, UMR261-MERIT, Institut de Recherche pour le Développement, Paris, France
| | - Gabriel Neto Braga
- Université de Paris, UMR261-MERIT, Institut de Recherche pour le Développement, Paris, France
| | - Manfred Accrombessi
- Clinical Research Institute of Benin (IRCB), Abomey-Calavi, Benin.,Faculty of Infectious and Tropical Diseases, Disease Control Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - Nicaise Tuikue Ndam
- Université de Paris, UMR261-MERIT, Institut de Recherche pour le Développement, Paris, France
| | - Nadine Fievet
- Université de Paris, UMR261-MERIT, Institut de Recherche pour le Développement, Paris, France
| | - Valérie Briand
- Université de Paris, UMR261-MERIT, Institut de Recherche pour le Développement, Paris, France.,University of Bordeaux, Inserm, Institut de Recherche pour le Développement, Inserm, University of Bordeaux, UMR, Bordeaux, France
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16
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Badaut C, Visitdesotrakul P, Chabry A, Bigey P, Tornyigah B, Roman J, Maroufou JA, Amoussou A, Ayivi BS, Sagbo G, Ndam NT, Oleinikov AV, Tahar R. Author Correction: IgG acquisition against PfEMP1 PF11_0521 domain cassette DC13, DBLβ3_D4 domain, and peptides located within these constructs in children with cerebral malaria. Sci Rep 2021; 11:9619. [PMID: 33927330 PMCID: PMC8085146 DOI: 10.1038/s41598-021-89079-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Cyril Badaut
- Institut de Recherche Biomédicale des Armées, National Reference Laboratory for Arboviruses, Marseille, France
| | | | | | - Pascal Bigey
- Université de Paris, UMR 8151 CNRS - INSERM U1022 - ENSCP, 75006, Paris, France
| | | | | | - Jules Alao Maroufou
- Département de Pédiatrie, Hôpital Mère-Enfant La Lagune (CHUMEL) Cotonou, Cotonou, Benin
| | - Annick Amoussou
- Service de Pédiatrie, Centre Hospitalo-Universitaire, Suruléré (CHU-Suruléré, Cotonou, Benin
| | - Blaise Serge Ayivi
- Service de Pédiatrie, Centre National Hospitalo-Universitaire (CNHU), Cotonou, Benin
| | - Gratien Sagbo
- Service de Pédiatrie, Centre National Hospitalo-Universitaire (CNHU), Cotonou, Benin
| | | | - Andrew V Oleinikov
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33428, USA
| | - Rachida Tahar
- Université de Paris, MERIT, IRD, 75006, Paris, France. .,Institut de Recherche Pour le Développement (IRD), UMR 261 Mère et Enfant Face Aux Infections Tropicales, Université Paris-Descartes, 4, Avenue de l'observatoire, 75270, Paris, France.
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17
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Tornyigah B, d'Almeida T, Escriou G, Viwami F, Fievet N, Luty AJF, Massougbodji A, Nielsen MA, Deloron P, Tuikue Ndam N. Plasmodium falciparum VAR2CSA-Specific IgG Subclass Responses Reflect Protection Against Low Birth Weight and Pregnancy-Associated Malaria. Front Immunol 2021; 12:610305. [PMID: 33968015 PMCID: PMC8099026 DOI: 10.3389/fimmu.2021.610305] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/31/2021] [Indexed: 11/13/2022] Open
Abstract
Sequestration of Plasmodium falciparum-infected erythrocytes expressing the VAR2CSA antigen in the placenta results in poor pregnancy outcomes, including low birth weight and maternal anemia. Antigen-specific antibody-mediated immunity is acquired during successive pregnancies. Thus, evaluating VAR2CSA-specific IgG profiles among pregnant women will increase knowledge on the immunological mechanisms associated with protection, and help in the development of VAR2CSA-based placental malaria vaccines. Using the PAMVAC candidate vaccine antigen, we assessed anti-VAR2CSA IgG subclass responses of a cohort of pregnant Beninese, and analyzed their relationships with pregnancy outcomes. Cytophilic IgG1 and IgG3 responses were the most frequent, with prevalences ranging from 28% (IgG3) up to 50% (IgG1). Elevated levels of VAR2CSA-specific total IgG and cytophilic IgG3 during pregnancy were consistently associated with higher birth weights, whilst high levels of IgG4 were associated with a reduced risk of placental infections. This suggests that protective anti-VAR2CSA IgG responses are coordinated between both cytophilic and non-cytophilic antibodies.
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Affiliation(s)
- Bernard Tornyigah
- Université de Paris, MERIT, IRD, Paris, France.,Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Tania d'Almeida
- Université de Paris, MERIT, IRD, Paris, France.,Université Pierre et Marie Curie, Ecole doctorale 393 Pierre Louis de Santé publique, Paris, France
| | | | - Firmine Viwami
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance, Cotonou, Benin
| | - Nadine Fievet
- Université de Paris, MERIT, IRD, Paris, France.,Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance, Cotonou, Benin
| | - Adrian J F Luty
- Université de Paris, MERIT, IRD, Paris, France.,Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance, Cotonou, Benin
| | - Achille Massougbodji
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance, Cotonou, Benin
| | - Morten A Nielsen
- Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark
| | | | - Nicaise Tuikue Ndam
- Université de Paris, MERIT, IRD, Paris, France.,Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
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18
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Hounkonnou CPA, Briand V, Fievet N, Accrombessi M, Yovo E, Mama A, Sossou D, Vianou B, Massougbodji A, Ndam NT, Cot M, Cottrell G. Dynamics of Submicroscopic Plasmodium falciparum Infections Throughout Pregnancy: A Preconception Cohort Study in Benin. Clin Infect Dis 2021; 71:166-174. [PMID: 32215629 PMCID: PMC7312237 DOI: 10.1093/cid/ciz748] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 08/05/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In the context of global malaria elimination efforts, special attention is being paid to submicroscopic Plasmodium falciparum infections. In pregnant, sub-Saharan African women, such infections are more prevalent than microscopic infections, and are thought to have adverse effects on both mothers' and newborns' health. However, no study has studied the dynamics and determinants of these infections throughout pregnancy. Retard de Croissance Intra-uterin et Paludisme (RECIPAL), a preconception cohort study carried out in Benin between 2014 and 2017, represented a unique opportunity to assess this issue. METHODS We used data from 273 pregnant Beninese women who were followed-up from preconception to delivery. We studied the dynamics of and factors influencing submicroscopic (and microscopic) P. falciparum infections during the 3 trimesters of pregnancy, using an ordinal logistic mixed model. RESULTS The incidence rate of submicroscopic P. falciparum infections during pregnancy was 12.7 per 100 person-months (95% confidence interval [CI] 10.8-14.9), compared to 6.7 per 100 person-months (95% CI 5.5-8.1) for microscopic infections. The prevalences were highest in the first trimester for both submicroscopic and microscopic infections. After adjustment for potential confounding factors, we found that those of young age and those with a submicroscopic P. falciparum infection prior to pregnancy were at significantly higher risks of submicroscopic and microscopic infections throughout pregnancy, with a more pronounced effect in the first trimester of pregnancy. CONCLUSIONS The first trimester of pregnancy is a particularly high-risk period for P. falciparum infection during pregnancy, especially for the youngest women. Malaria prevention tools covering the preconception period and early pregnancy are urgently needed to better protect pregnant women and their newborns.
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Affiliation(s)
- Cornélia P A Hounkonnou
- Université de Paris, Mère et enfant en milieu tropical: pathogènes, système de santé et transition épidémiologique, Institut de Recherche pour le Développement, Paris, France.,Sorbonne Université, Université Pierre et Marie-Curie, Paris, France
| | - Valérie Briand
- Université de Paris, Mère et enfant en milieu tropical: pathogènes, système de santé et transition épidémiologique, Institut de Recherche pour le Développement, Paris, France
| | - Nadine Fievet
- Université de Paris, Mère et enfant en milieu tropical: pathogènes, système de santé et transition épidémiologique, Institut de Recherche pour le Développement, Paris, France
| | | | - Emmanuel Yovo
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Bénin
| | - Atikatou Mama
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Bénin
| | - Darius Sossou
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Bénin
| | - Bertin Vianou
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Bénin
| | - Achille Massougbodji
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Bénin
| | - Nicaise Tuikue Ndam
- Université de Paris, Mère et enfant en milieu tropical: pathogènes, système de santé et transition épidémiologique, Institut de Recherche pour le Développement, Paris, France
| | - Michel Cot
- Université de Paris, Mère et enfant en milieu tropical: pathogènes, système de santé et transition épidémiologique, Institut de Recherche pour le Développement, Paris, France
| | - Gilles Cottrell
- Université de Paris, Mère et enfant en milieu tropical: pathogènes, système de santé et transition épidémiologique, Institut de Recherche pour le Développement, Paris, France.,Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Cotonou, Bénin
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19
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Gamain B, Chêne A, Viebig NK, Tuikue Ndam N, Nielsen MA. Progress and Insights Toward an Effective Placental Malaria Vaccine. Front Immunol 2021; 12:634508. [PMID: 33717176 PMCID: PMC7947914 DOI: 10.3389/fimmu.2021.634508] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/06/2021] [Indexed: 12/03/2022] Open
Abstract
In areas where Plasmodium falciparum transmission is endemic, clinical immunity against malaria is progressively acquired during childhood and adults are usually protected against the severe clinical consequences of the disease. Nevertheless, pregnant women, notably during their first pregnancies, are susceptible to placental malaria and the associated serious clinical outcomes. Placental malaria is characterized by the massive accumulation of P. falciparum infected erythrocytes and monocytes in the placental intervillous spaces leading to maternal anaemia, hypertension, stillbirth and low birth weight due to premature delivery, and foetal growth retardation. Remarkably, the prevalence of placental malaria sharply decreases with successive pregnancies. This protection is associated with the development of antibodies directed towards the surface of P. falciparum-infected erythrocytes from placental origin. Placental sequestration is mediated by the interaction between VAR2CSA, a member of the P. falciparum erythrocyte membrane protein 1 family expressed on the infected erythrocytes surface, and the placental receptor chondroitin sulfate A. VAR2CSA stands today as the leading candidate for a placental malaria vaccine. We recently reported the safety and immunogenicity of two VAR2CSA-derived placental malaria vaccines (PRIMVAC and PAMVAC), spanning the chondroitin sulfate A-binding region of VAR2CSA, in both malaria-naïve and P. falciparum-exposed non-pregnant women in two distinct Phase I clinical trials (ClinicalTrials.gov, NCT02658253 and NCT02647489). This review discusses recent advances in placental malaria vaccine development, with a focus on the recent clinical data, and discusses the next clinical steps to undertake in order to better comprehend vaccine-induced immunity and accelerate vaccine development.
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Affiliation(s)
- Benoît Gamain
- Université de Paris, Inserm, Biologie Intégrée du Globule Rouge, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France
| | - Arnaud Chêne
- Université de Paris, Inserm, Biologie Intégrée du Globule Rouge, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France
| | - Nicola K Viebig
- European Vaccine Initiative, UniversitätsKlinikum Heidelberg, Heidelberg, Germany
| | | | - Morten A Nielsen
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
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20
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Badaut C, Visitdesotrakul P, Chabry A, Bigey P, Tornyigah B, Roman J, Maroufou JA, Amoussou A, Ayivi BS, Sagbo G, Ndam NT, Oleinikov AV, Tahar R. IgG acquisition against PfEMP1 PF11_0521 domain cassette DC13, DBLβ3_D4 domain, and peptides located within these constructs in children with cerebral malaria. Sci Rep 2021; 11:3680. [PMID: 33574457 PMCID: PMC7878510 DOI: 10.1038/s41598-021-82444-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/30/2020] [Indexed: 11/09/2022] Open
Abstract
The Plasmodium falciparum erythrocyte-membrane-protein-1 (PF3D7_1150400/PF11_0521) contains both domain cassette DC13 and DBLβ3 domain binding to EPCR and ICAM-1 receptors, respectively. This type of PfEMP1 proteins with dual binding specificity mediate specific interactions with brain micro-vessels endothelium leading to the development of cerebral malaria (CM). Using plasma collected from children at time of hospital admission and after 30 days, we study an acquisition of IgG response to PF3D7_1150400/PF11_0521 DC13 and DBLβ3_D4 recombinant constructs, and five peptides located within these constructs, specifically in DBLα1.7_D2 and DBLβ3_D4 domains. We found significant IgG responses against the entire DC13, PF11_0521_DBLβ3_D4 domain, and peptides. The responses varied against different peptides and depended on the clinical status of children. The response was stronger at day 30, and mostly did not differ between CM and uncomplicated malaria (UM) groups. Specifically, the DBLβ3 B3-34 peptide that contains essential residues involved in the interaction between PF11_0521 DBLβ3_D4 domain and ICAM-1 receptor demonstrated significant increase in reactivity to IgG1 and IgG3 antibodies at convalescence. Further, IgG reactivity in CM group at time of admission against functionally active (ICAM-1-binding) PF11_0521 DBLβ3_D4 domain was associated with protection against severe anemia. These results support development of vaccine based on the PF3D7_1150400/PF11_0521 structures to prevent CM.
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Affiliation(s)
- Cyril Badaut
- Institut de Recherche Biomédicale des Armées, National Reference Laboratory for Arboviruses, Marseille, France
| | | | | | - Pascal Bigey
- Université de Paris, UMR 8151 CNRS - INSERM U1022 - ENSCP, 75006, Paris, France
| | | | | | - Jules Alao Maroufou
- Département de Pédiatrie, Hôpital Mère-Enfant La Lagune (CHUMEL) Cotonou, Cotonou, Benin
| | - Annick Amoussou
- Service de Pédiatrie, Centre Hospitalo-Universitaire, Suruléré (CHU-Suruléré, Cotonou, Benin
| | - Blaise Serge Ayivi
- Service de Pédiatrie, Centre National Hospitalo-Universitaire (CNHU), Cotonou, Benin
| | - Gratien Sagbo
- Service de Pédiatrie, Centre National Hospitalo-Universitaire (CNHU), Cotonou, Benin
| | | | - Andrew V Oleinikov
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33428, USA
| | - Rachida Tahar
- Université de Paris, MERIT, IRD, 75006, Paris, France. .,Institut de Recherche Pour le Développement (IRD), UMR 261 Mère et Enfant Face Aux Infections Tropicales, Université Paris-Descartes, 4, Avenue de l'observatoire, 75270, Paris, France.
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21
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Abstract
Introduction: Several malaria vaccines are under various phases of development with some promising results. In placental malaria (PM) a deliberately anti-disease approach is considered as many studies have underlined the key role of VAR2CSA protein, which therefore represents the leading vaccine candidate. However, evidence indicates that VAR2CSA antigenic polymorphism remains an obstacle to overcome.Areas covered: This review analyzes the progress made thus far in developing a VAR2CSA-based vaccine, and addresses the current issues and challenges that must be overcome to develop an effective PM vaccine.Expert opinion: Phase I trials of PAMVAC and PRIMVAC VAR2CSA vaccines have shown more or less satisfactory results with regards to safety and immunogenicity. The second generation of VAR2CSA-based vaccines could benefit from optimization approaches to broaden the activity spectrum against various placenta-binding isolates through continued advances in the structural understanding of the interaction with CSA.
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Affiliation(s)
- Justin Yai Alamou Doritchamou
- Laboratory of Malaria Immunology & Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Jennifer Suurbaar
- Université de Paris, MERIT, IRD, F-75006 Paris, France.,Noguchi Memorial Institute for Medical Research, Department of Immunology, University of Ghana, Accra, Ghana
| | - Nicaise Tuikue Ndam
- Université de Paris, MERIT, IRD, F-75006 Paris, France.,Noguchi Memorial Institute for Medical Research, Department of Immunology, University of Ghana, Accra, Ghana
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22
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Briand V, Cottrell G, Tuikue Ndam N, Martiáñez–Vendrell X, Vianou B, Mama A, Kouwaye B, Houzé S, Bailly J, Gbaguidi E, Sossou D, Massougbodji A, Accrombessi M, Mayor A, Ding XC, Fievet N. Correction to: Prevalence and clinical impact of malaria infections detected with a highly sensitive HRP2 rapid diagnostic test in Beninese pregnant women. Malar J 2020; 19:328. [PMID: 32894149 PMCID: PMC7487944 DOI: 10.1186/s12936-020-03400-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
An amendment to this paper has been published and can be accessed via the original article.
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23
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Huijben S, Macete E, Mombo-Ngoma G, Ramharter M, Kariuki S, Desai M, Shi YP, Mwangoka G, Massougbodji A, Cot M, Ndam NT, Uberegui E, Gupta H, Cisteró P, Aponte JJ, González R, Menéndez C, Mayor A. Counter-Selection of Antimalarial Resistance Polymorphisms by Intermittent Preventive Treatment in Pregnancy. J Infect Dis 2020; 221:293-303. [PMID: 31677349 DOI: 10.1093/infdis/jiz451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 09/19/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Innovative approaches are needed to limit antimalarial resistance evolution. Understanding the role of intermittent preventive treatment in pregnancy (IPTp) on the selection for resistance and the impact such selection has on pregnancy outcomes can guide future interventions. METHODS Plasmodium falciparum isolates (n = 914) from 2 randomized clinical trials were screened for pfmdr1 copy number variation and pfcrt, pfmdr1, pfdhfr, and pfdhps resistance markers. The trials were conducted between 2010 and 2013 in Benin, Gabon, Kenya, and Mozambique to establish the efficacy of IPTp-mefloquine (MQ) compared with IPTp-sulphadoxine-pyrimethamine (SP) in human immunodeficiency virus (HIV)-uninfected and to IPTp-placebo in HIV-infected women. RESULTS In HIV-uninfected women, the prevalence of pfcrt mutants, pfdhfr/pfdhps quintuple mutants, and pfmdr1 copy number was similar between women receiving IPT-SP and IPTp-MQ. However, prevalence of pfmdr1 polymorphism 86Y was lower in the IPTp-MQ group than in the IPTp-SP group, and within the IPTp-MQ group it was lower at delivery compared with recruitment. No effect of IPTp-MQ on resistance markers was observed among HIV-infected women. The carriage of resistance markers was not associated with pregnancy outcomes. CONCLUSIONS Selection of wild-type pfmdr1 polymorphism N86 by IPTp-MQ highlights the strong selective pressure IPTp can exert and the opportunity for using negative cross-resistance in drug choice for clinical treatment and IPTp.
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Affiliation(s)
- Silvie Huijben
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Center for Evolution and Medicine, School of Life Sciences, Arizona State University, Tempe, Arizona, USA
| | - Eusebio Macete
- Centro de Investigação em Saúde da Manhiça, Manhiça, Mozambique
| | - Ghyslain Mombo-Ngoma
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.,Institut für Tropenmedizin, Universität Tübingen, und Deutsches Zentrum für Infektionsforschung, Tübingen, Germany.,Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine and Department of Medicine I, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Ramharter
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon.,Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine and Department of Medicine I, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simon Kariuki
- Kenya Medical Research Institute/Centre for Global Health Research, Kisumu, Kenya
| | - Meghna Desai
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ya Ping Shi
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Achille Massougbodji
- Unité d'Enseignement et de Recherche de Parasitologie Mycologie, Faculté des Sciences de la Santé, Cotonou, Bénin
| | - Michel Cot
- Université de Paris, MERIT, IRD, Paris, France
| | | | | | - Himanshu Gupta
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Pau Cisteró
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - John J Aponte
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde da Manhiça, Manhiça, Mozambique
| | - Raquel González
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde da Manhiça, Manhiça, Mozambique
| | - Clara Menéndez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde da Manhiça, Manhiça, Mozambique
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde da Manhiça, Manhiça, Mozambique
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24
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Hounkonnou CPA, Ndam NT, Fievet N, Accrombessi M, Yovo E, Mama A, Sossou D, Vianou B, Massougbodji A, Briand V, Cot M, Cottrell G. Sub-optimal Intermittent Preventive Treatment in pregnancy (IPTp) is associated with an increased risk of submicroscopic P. falciparum infection in pregnant women: a prospective cohort study in Benin. Clin Infect Dis 2020; 73:e3759-e3767. [PMID: 32901806 PMCID: PMC8662796 DOI: 10.1093/cid/ciaa1355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Indexed: 01/07/2023] Open
Abstract
Background Harmful maternal and neonatal health outcomes result from malaria in pregnancy, the prevention of which primarily relies on intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP). The World Health Organization recommends IPTp-SP in sub-Saharan Africa, but implementation is highly heterogeneous and often suboptimal in terms of the number of doses and their timing. In this study, we assessed the impact of this heterogeneity on malaria in pregnancy, mainly with respect to submicroscopic Plasmodium falciparum infections. Methods We used data from 273 Beninese women followed throughout pregnancy. Screening for P. falciparum infections, using both microscopy-based and polymerase chain reaction (PCR)–based methods, was performed monthly, and information on IPTp-SP doses was collected. Gestational age was estimated by repeated ultrasound scans. Using a negative binomial model, we investigated the effect of IPTp-SP doses and timing after 17 weeks of gestation on the number of P. falciparum infections, focusing on submicroscopic infections detectable only by PCR. Results At least 2 IPTp-SP doses were taken by 77.3% of the women. The median gestational age at the first IPTp-SP dose was 22 weeks. A late first IPTp-SP dose (>21.2 weeks) was marginally associated with an increased number of P. falciparum infections (adjusted incidence rate ratio [aIRR] = 1.3; P = .098). The number of IPTp-SP doses was not associated with the number of submicroscopic infections (aIRR = 1.2, P = .543). Conclusions A late first IPTp-SP dose failed to provide optimal protection against P. falciparum, especially submicroscopic infections. This highlights the need for a new antimalarial drug for IPTp that could be taken early in pregnancy.
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Affiliation(s)
- Cornélia P A Hounkonnou
- Université de Paris, MERIT, IRD, Paris, France.,Sorbonne Université, Université Pierre et Marie-Curie, Paris, France
| | | | | | - Manfred Accrombessi
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Bénin.,Faculty of Infectious and Tropical Diseases, Disease Control Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Emmanuel Yovo
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Bénin
| | - Atikatou Mama
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Bénin
| | - Darius Sossou
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Bénin
| | - Bertin Vianou
- Institut de Recherche Clinique du Bénin, Abomey-Calavi, Bénin
| | | | - Valérie Briand
- IRD, Inserm, Université de Bordeaux, IDLIC team, UMR, Bordeaux, France
| | - Michel Cot
- Université de Paris, MERIT, IRD, Paris, France
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25
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Fonseca AM, González R, Bardají A, Jairoce C, Rupérez M, Jiménez A, Quintó L, Cisteró P, Vala A, Sacoor C, Gupta H, Hegewisch-Taylor J, Brew J, Ndam NT, Kariuki S, López M, Dobaño C, Chitnis CE, Ouma P, Ramharter M, Abdulla S, Aponte JJ, Massougbodji A, Briand V, Mombo-Ngoma G, Desai M, Cot M, Nhacolo A, Sevene E, Macete E, Menéndez C, Mayor A. VAR2CSA Serology to Detect Plasmodium falciparum Transmission Patterns in Pregnancy. Emerg Infect Dis 2020; 25:1851-1860. [PMID: 31538557 PMCID: PMC6759269 DOI: 10.3201/eid2510.181177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Pregnant women constitute a promising sentinel group for continuous monitoring of malaria transmission. To identify antibody signatures of recent Plasmodium falciparum exposure during pregnancy, we dissected IgG responses against VAR2CSA, the parasite antigen that mediates placental sequestration. We used a multiplex peptide-based suspension array in 2,354 samples from pregnant women from Mozambique, Benin, Kenya, Gabon, Tanzania, and Spain. Two VAR2CSA peptides of limited polymorphism were immunogenic and targeted by IgG responses readily boosted during infection and with estimated half-lives of <2 years. Seroprevalence against these peptides reflected declines and rebounds of transmission in southern Mozambique during 2004–2012, reduced exposure associated with use of preventive measures during pregnancy, and local clusters of transmission that were missed by detection of P. falciparum infections. These data suggest that VAR2CSA serology can provide a useful adjunct for the fine-scale estimation of the malaria burden among pregnant women over time and space.
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MESH Headings
- Adult
- Antibodies, Protozoan/immunology
- Antigens, Protozoan/blood
- Antigens, Protozoan/immunology
- Benin/epidemiology
- Female
- Gabon/epidemiology
- Humans
- Immunoglobulin G/immunology
- Kenya/epidemiology
- Malaria, Falciparum/complications
- Malaria, Falciparum/diagnosis
- Malaria, Falciparum/epidemiology
- Malaria, Falciparum/transmission
- Mozambique/epidemiology
- Plasmodium falciparum/immunology
- Pregnancy
- Pregnancy Complications, Parasitic/blood
- Pregnancy Complications, Parasitic/diagnosis
- Pregnancy Complications, Parasitic/epidemiology
- Serologic Tests/methods
- Spain/epidemiology
- Tanzania/epidemiology
- Young Adult
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26
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Quakyi I, Tornyigah B, Houze P, Kusi KA, Coleman N, Escriou G, Laar A, Cot M, Fobil J, Asare GQ, Deloron P, Anang AK, Cottrell G, Ofori MF, Ndam NT. High uptake of Intermittent Preventive Treatment of malaria in pregnancy is associated with improved birth weight among pregnant women in Ghana. Sci Rep 2019; 9:19034. [PMID: 31836735 PMCID: PMC6911095 DOI: 10.1038/s41598-019-55046-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 11/20/2019] [Indexed: 11/09/2022] Open
Abstract
Despite the clinically proven advantages of intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP), utilisation has been low in many African countries. To increase uptake and achieve the desired effect, the World Health Organization revised the policy to a monthly administration. Assessing the coverage and impact of the revised policy on pregnancy and neonatal outcomes is, therefore, a necessity. A 2-parallel cross-sectional hospital-based study was carried out among pregnant women attending first antenatal care (ANC) and delivery. Maternal and cord blood samples were assayed for malaria parasites by quantitative PCR targeting both the 18S rDNA and the acidic terminal segment of Plasmodium falciparum var genes, and plasma SP levels were measured by liquid chromatography coupled to tandem mass spectrometry. Parasite prevalence was similar between the two study sites but decreased significantly between the first ANC (9% or 43%) and delivery (4% or 11%) based on the qPCR target. At delivery, 64.5% of women received ≥3 IPTp-SP dose, 15.5% received 2 doses and 6% had 1 dose. Taking ≥3 IPTp-SP doses was associated with an average birth weight increase of more than 0.165 kg. IPTp-SP uptake was associated with plasma SP level at delivery (OR = 32.3, p ≤ 0.005, 95% CI (13.3;78.4) for those that reported ≥3 IPTp-SP doses) while the same trend of improved birth weight was observed with high plasma SP levels. The new IPTp policy is well implemented and well utilised by women in the sites considered in this study and translates to the improved birth weight observed. This study confirms the interest and the clinical benefit expected from this policy change.
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Affiliation(s)
- Isabella Quakyi
- Université de Paris, MERIT, IRD, F-75006, Paris, France.,Department of Biological Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Bernard Tornyigah
- Université de Paris, MERIT, IRD, F-75006, Paris, France.,Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, Legon, Ghana
| | - Pascal Houze
- Service de biochimie générale, Hôpital universitaire Necker-Enfants Malades, AP-HP, 149 rue de Sèvres, 75015, Paris, France.,Unité de Technologies Biologiques et Chimiques pour la Santé (UTCBS), Paris 5-CNRS UMR8258 Inserm U1022, Faculté de Pharmacie, Université Paris Descartes, Paris, France.,Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Kwadwo A Kusi
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, Legon, Ghana
| | - Nathaniel Coleman
- Department of Biological Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
| | | | - Amos Laar
- Department of Biological Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Michel Cot
- Université de Paris, MERIT, IRD, F-75006, Paris, France
| | - Julius Fobil
- Department of Biological Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Gloria Quansah Asare
- Department of Biological Environmental and Occupational Health Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
| | | | - Abraham K Anang
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | | | - Michael F Ofori
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, Legon, Ghana
| | - Nicaise Tuikue Ndam
- Université de Paris, MERIT, IRD, F-75006, Paris, France. .,Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, Legon, Ghana.
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27
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Gnidehou S, Mitran CJ, Arango E, Banman S, Mena A, Medawar E, Lima BAS, Doritchamou J, Rajwani J, Jin A, Gavina K, Ntumngia F, Duffy P, Narum D, Ndam NT, Nielsen MA, Salanti A, Kano FS, Carvalho LH, Adams JH, Maestre A, Good MF, Yanow SK. Cross-Species Immune Recognition Between Plasmodium vivax Duffy Binding Protein Antibodies and the Plasmodium falciparum Surface Antigen VAR2CSA. J Infect Dis 2019; 219:110-120. [PMID: 30534974 DOI: 10.1093/infdis/jiy467] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 07/24/2018] [Indexed: 01/23/2023] Open
Abstract
Background In pregnancy, Plasmodium falciparum parasites express the surface antigen VAR2CSA, which mediates adherence of red blood cells to chondroitin sulfate A (CSA) in the placenta. VAR2CSA antibodies are generally acquired during infection in pregnancy and are associated with protection from placental malaria. We observed previously that men and children in Colombia also had antibodies to VAR2CSA, but the origin of these antibodies was unknown. Here, we tested whether infection with Plasmodium vivax is an alternative mechanism of acquisition of VAR2CSA antibodies. Methods We analyzed sera from nonpregnant Colombians and Brazilians exposed to P. vivax and monoclonal antibodies raised against P. vivax Duffy binding protein (PvDBP). Cross-reactivity to VAR2CSA was characterized by enzyme-linked immunosorbent assay, immunofluorescence assay, and flow cytometry, and antibodies were tested for inhibition of parasite binding to CSA. Results Over 50% of individuals had antibodies that recognized VAR2CSA. Affinity-purified PvDBP human antibodies and a PvDBP monoclonal antibody recognized VAR2CSA, showing that PvDBP can give rise to cross-reactive antibodies. Importantly, the monoclonal antibody inhibited parasite binding to CSA, which is the primary in vitro correlate of protection from placental malaria. Conclusions These data suggest that PvDBP induces antibodies that functionally recognize VAR2CSA, revealing a novel mechanism of cross-species immune recognition to falciparum malaria.
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Affiliation(s)
- Sédami Gnidehou
- Department of Biology, Campus Saint-Jean, University of Alberta, Edmonton, Canada
| | | | - Eliana Arango
- Grupo Salud y Comunidad, Facultad de Medicina, Medellín, Colombia
| | - Shanna Banman
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Angie Mena
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Evelyn Medawar
- School of Public Health, University of Alberta, Edmonton, Canada
| | | | - Justin Doritchamou
- National Institute of Allergy and Infectious Diseases, Rockville, Maryland
| | - Jahanara Rajwani
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Albert Jin
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Kenneth Gavina
- Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Canada
| | | | - Patrick Duffy
- National Institute of Allergy and Infectious Diseases, Rockville, Maryland
| | - David Narum
- National Institute of Allergy and Infectious Diseases, Rockville, Maryland
| | | | - Morten A Nielsen
- Department of Immunology and Microbiology, Center for Medical Parasitology, University of Copenhagen, Denmark
| | - Ali Salanti
- Department of Immunology and Microbiology, Center for Medical Parasitology, University of Copenhagen, Denmark
| | | | | | | | - Amanda Maestre
- Grupo Salud y Comunidad, Facultad de Medicina, Medellín, Colombia
| | - Michael F Good
- Institute for Glycomics, Griffith University, Gold Coast, Australia
| | - Stephanie K Yanow
- School of Public Health, University of Alberta, Edmonton, Canada.,Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Canada
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28
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Tuikue Ndam N, Tornyigah B, Dossou AY, Escriou G, Nielsen MA, Salanti A, Issifou S, Massougbodji A, Chippaux JP, Deloron P. Persistent Plasmodium falciparum Infection in Women With an Intent to Become Pregnant as a Risk Factor for Pregnancy-associated Malaria. Clin Infect Dis 2019; 67:1890-1896. [PMID: 29733338 DOI: 10.1093/cid/ciy380] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/03/2018] [Indexed: 02/04/2023] Open
Abstract
Background Pregnant women are more susceptible to Plasmodium falciparum than before pregnancy, and infection has consequences for both mother and offspring. The World Health Organization recommends that pregnant woman in areas of transmission receive intermittent preventive treatment (IPTp) starting in the second trimester. Consequently, women are not protected during the first trimester, although P. falciparum infections are both frequent and harmful. Methods A cohort of nulligravid women was followed up during subsequent pregnancy. Malaria was diagnosed by means of microscopy and polymerase chain reaction. Parasites were genotyped at polymorphic loci. Results Among 275 nulligravidae enrolled, 68 women became pregnant and were followed up during pregnancy. Before pregnancy, P. falciparum prevalence rates were 15% by microscopy and 66% by polymerase chain reaction. Microscopic infection rates increased to 29% until IPTp administration, and their density increased by 20-fold. Conversely, submicroscopic infection rates decreased. After IPTp administration, all types of infections decreased, but they increased again late in pregnancy. The risk of infection during pregnancy was higher in women with a microscopic (odds ratio, 6.5; P = .047) or submicroscopic (3.06; P = .05) infection before pregnancy and was not related to the season of occurrence. Most infections during pregnancy were persistent infections acquired before pregnancy. Conclusions Microscopic and submicroscopic malaria infections were frequent in nulligravid women from south Benin. During the first trimester of pregnancy, microscopic infections were more frequent, with a higher parasite density, and mainly derived from parasites infecting the woman before conception. Preventive strategies targeting nonpregnant women with a desire for conception need to be designed.
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Affiliation(s)
- Nicaise Tuikue Ndam
- Mère et Enfant face aux Infections Tropicales, Institut de Recherche pour le Développement, Université Paris 5, Sorbonne Paris Cité, France.,Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon
| | - Bernard Tornyigah
- Mère et Enfant face aux Infections Tropicales, Institut de Recherche pour le Développement, Université Paris 5, Sorbonne Paris Cité, France.,Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon
| | | | - Guillaume Escriou
- Mère et Enfant face aux Infections Tropicales, Institut de Recherche pour le Développement, Université Paris 5, Sorbonne Paris Cité, France
| | - Morten A Nielsen
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Science, University of Copenhagen.,Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Denmark
| | - Ali Salanti
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Science, University of Copenhagen.,Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Denmark
| | - Saadou Issifou
- Centre de Recherche sur le Paludisme Associé à la Grossesse et l'Enfance, Cotonou, Benin
| | - Achille Massougbodji
- Centre de Recherche sur le Paludisme Associé à la Grossesse et l'Enfance, Cotonou, Benin
| | - Jean-Philippe Chippaux
- Mère et Enfant face aux Infections Tropicales, Institut de Recherche pour le Développement, Université Paris 5, Sorbonne Paris Cité, France.,Centre de Recherche sur le Paludisme Associé à la Grossesse et l'Enfance, Cotonou, Benin
| | - Philippe Deloron
- Mère et Enfant face aux Infections Tropicales, Institut de Recherche pour le Développement, Université Paris 5, Sorbonne Paris Cité, France
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29
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Chauvet M, Tétard M, Cottrell G, Aussenac F, Brossier E, Denoyel L, Hanny M, Lohezic M, Milet J, Ndam NT, Pineau D, Roman J, Luty AJF, Gamain B, Migot-Nabias F, Merckx A. Impact of Hemoglobin S Trait on Cell Surface Antibody Recognition of Plasmodium falciparum-Infected Erythrocytes in Pregnancy-Associated Malaria. Open Forum Infect Dis 2019; 6:ofz156. [PMID: 31041352 PMCID: PMC6483131 DOI: 10.1093/ofid/ofz156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 03/21/2019] [Indexed: 11/24/2022] Open
Abstract
Background Sickle cell trait (HbAS) confers partial protection against malaria by reducing the adhesion of Plasmodium falciparum-infected erythrocytes to host receptors, but little is known about its potential protection against placental malaria. Methods Using flow cytometry, we assessed the recognition of HbAA and HbAS VAR2CSA-expressing infected erythrocytes, by plasma from 159 Beninese pregnant women with either HbAA (normal) or HbAS. Using multivariate linear models adjusted for gravidity, parasite infection at delivery, glucose-6-phosphate dehydrogenase deficiency, and α-thalassemia carriage, we observed significantly reduced cell surface antibody binding of HbAS-infected erythrocytes by plasma from HbAS compared with HbAA women (P < 10–3). Results The difference in cell surface antibody binding was only observed when infected erythrocytes and plasma were associated according to the same hemoglobin genotype. Similar levels of VAR2CSA-specific antibody were measured by enzyme-linked immunosorbent assay in the 2 groups, suggesting that the altered interaction between VAR2CSA and HbAS women’s antibodies could reflect abnormal display of VAR2CSA on HbAS erythrocytes. Conclusions Our data stress the need for assessments of erythrocyte disorders such as the sickle cell trait in a population group when studying immunological responses to P falciparum.
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Affiliation(s)
- Margaux Chauvet
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France.,Laboratoire d'Excellence GR-Ex, Paris, France
| | - Marilou Tétard
- UMR_S1134, Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence GR-Ex, Paris, France
| | - Gilles Cottrell
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France.,Centre d'Etude et de Recherche pour le Paludisme Associé à la Grossesse et à l'Enfance, Cotonou, Benin
| | - Florentin Aussenac
- Centre d'Etude et de Recherche pour le Paludisme Associé à la Grossesse et à l'Enfance, Cotonou, Benin
| | - Emeline Brossier
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - Luc Denoyel
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - Marion Hanny
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - Murielle Lohezic
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France.,Laboratoire d'Excellence GR-Ex, Paris, France
| | - Jacqueline Milet
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - Nicaise Tuikue Ndam
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France.,Laboratoire d'Excellence GR-Ex, Paris, France.,Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon
| | - Damien Pineau
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - Jocelyne Roman
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France
| | - Adrian J F Luty
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France.,Laboratoire d'Excellence GR-Ex, Paris, France.,Centre d'Etude et de Recherche pour le Paludisme Associé à la Grossesse et à l'Enfance, Cotonou, Benin
| | - Benoît Gamain
- UMR_S1134, Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence GR-Ex, Paris, France
| | - Florence Migot-Nabias
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France.,Laboratoire d'Excellence GR-Ex, Paris, France
| | - Anaïs Merckx
- MERIT, Institut de Recherche pour le Développement (IRD), Université Sorbonne Paris Cité, Université Paris Descartes, France.,Laboratoire d'Excellence GR-Ex, Paris, France
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30
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Waltmann A, Patel JC, Thwai KL, Hathaway NJ, Parobek CM, Massougbodji A, Fievet N, Bailey JA, Deloron P, Juliano JJ, Ndam NT, Meshnick SR. Matched Placental and Circulating Plasmodium falciparum Parasites are Genetically Homologous at the var2csa ID1-DBL2X Locus by Deep Sequencing. Am J Trop Med Hyg 2018; 98:77-82. [PMID: 29342401 DOI: 10.4269/ajtmh.17-0529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
In pregnancy-associated malaria, infected erythrocytes accumulate in the placenta. It is unclear if in polyclonal infections this results in distinct peripheral and placental parasite populations. We used long amplicon deep sequencing of Plasmodium falciparum var2csa ID1-DBL2X from 15 matched peripheral and placental samples collected at delivery from a high transmission area to determine genetic homology. Despite substantial sequence variation and detecting 23 haplotypes, the matched pairs mostly contained the same genetic variants, with 11 pairs sharing 100% of their variants, whereas others showed some heterogeneity. Thus, at delivery, peripheral and placental parasites appear to intermix and placental genotypes can be inferred through peripheral sampling.
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Affiliation(s)
- Andreea Waltmann
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Jaymin C Patel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Kyaw L Thwai
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Nicholas J Hathaway
- Program in Bioinformatics and Integrative Biology, University of Massachusetts, Worcester, Massachusetts
| | - Christian M Parobek
- Curriculum in Genetics and Molecular Biology, University of North Carolina, Chapel Hill, North Carolina
| | - Achille Massougbodji
- Centre d'Etude et de Recherche sur le paludisme associé à la Grossesse et à l'Enfance, Université d'Abomey-Calavi, Cotonou, Benin
| | - Nadine Fievet
- UMR216 - MERIT, Institut de Recherche pour le Développement, COMUE Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - Jeffery A Bailey
- Division of Transfusion Medicine, Department of Medicine, University of Massachusetts, Worcester, Massachusetts.,Program in Bioinformatics and Integrative Biology, University of Massachusetts, Worcester, Massachusetts
| | - Philippe Deloron
- UMR216 - MERIT, Institut de Recherche pour le Développement, COMUE Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - Jonathan J Juliano
- Curriculum in Genetics and Molecular Biology, University of North Carolina, Chapel Hill, North Carolina.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Nicaise Tuikue Ndam
- UMR216 - MERIT, Institut de Recherche pour le Développement, COMUE Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - Steven R Meshnick
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
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31
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Gavina K, Gnidehou S, Arango E, Hamel-Martineau C, Mitran C, Agudelo O, Lopez C, Karidio A, Banman S, Carmona-Fonseca J, Salanti A, Tuikue Ndam N, Hawkes M, Maestre A, Yanow SK. Clinical Outcomes of Submicroscopic Infections and Correlates of Protection of VAR2CSA Antibodies in a Longitudinal Study of Pregnant Women in Colombia. Infect Immun 2018; 86:e00797-17. [PMID: 29378797 PMCID: PMC5865023 DOI: 10.1128/iai.00797-17] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 01/22/2018] [Indexed: 11/20/2022] Open
Abstract
Malaria in pregnancy can cause serious adverse outcomes for the mother and the fetus. However, little is known about the effects of submicroscopic infections (SMIs) in pregnancy, particularly in areas where Plasmodium falciparum and Plasmodium vivax cocirculate. A cohort of 187 pregnant women living in Puerto Libertador in northwest Colombia was followed longitudinally from recruitment to delivery. Malaria was diagnosed by microscopy, reverse transcription-quantitative PCR (RT-qPCR), and placental histopathology. Gestational age, hemoglobin concentration, VAR2CSA-specific IgG levels, and adhesion-blocking antibodies were measured during pregnancy. Statistical analyses were performed to evaluate the impact of SMIs on birth weight and other delivery outcomes. Twenty-five percent of women (45/180) were positive for SMIs during pregnancy. Forty-seven percent of infections (21/45) were caused by P. falciparum, 33% were caused by P. vivax, and 20% were caused by mixed Plasmodium spp. Mixed infections of P. falciparum and P. vivax were associated with lower gestational age at delivery (P = 0.0033), while other outcomes were normal. Over 60% of women had antibodies to VAR2CSA, and there was no difference in antibody levels between those with and without SMIs. The anti-adhesion function of these antibodies was associated with protection from SMI-related anemia at delivery (P = 0.0086). SMIs occur frequently during pregnancy, and while mixed infections of both P. falciparum and P. vivax were not associated with a decrease in birth weight, they were associated with significant risk of preterm birth. We propose that the lack of adverse delivery outcomes is due to functional VAR2CSA antibodies that can protect pregnant women from SMI-related anemia.
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Affiliation(s)
- Kenneth Gavina
- Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Sedami Gnidehou
- Department of Biology, Campus Saint-Jean, University of Alberta, Edmonton, Alberta, Canada
| | - Eliana Arango
- Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Chloe Hamel-Martineau
- Department of Biology, Campus Saint-Jean, University of Alberta, Edmonton, Alberta, Canada
| | - Catherine Mitran
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Olga Agudelo
- Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Carolina Lopez
- Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Aisha Karidio
- Department of Biology, Campus Saint-Jean, University of Alberta, Edmonton, Alberta, Canada
| | - Shanna Banman
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jaime Carmona-Fonseca
- Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Ali Salanti
- Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Michael Hawkes
- Department of Pediatrics, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Amanda Maestre
- Grupo Salud y Comunidad, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Stephanie K Yanow
- Department of Medical Microbiology and Immunology, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Tuikue Ndam N, Moussiliou A, Lavstsen T, Kamaliddin C, Jensen ATR, Mama A, Tahar R, Wang CW, Jespersen JS, Alao JM, Gamain B, Theander TG, Deloron P. Parasites Causing Cerebral Falciparum Malaria Bind Multiple Endothelial Receptors and Express EPCR and ICAM-1-Binding PfEMP1. J Infect Dis 2017; 215:1918-1925. [PMID: 28863469 DOI: 10.1093/infdis/jix230] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 05/10/2017] [Indexed: 11/12/2022] Open
Abstract
Background Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) mediates the binding and accumulation of infected erythrocytes (IE) to blood vessels and tissues. Specific interactions have been described between PfEMP1 and human endothelial proteins CD36, intercellular adhesion molecule-1 (ICAM-1), and endothelial protein C receptor (EPCR); however, cytoadhesion patterns typical for pediatric malaria syndromes and the associated PfEMP1 members are still undefined. Methods In a cohort of 94 hospitalized children with malaria, we characterized the binding properties of IE collected on admission, and var gene transcription using quantitative polymerase chain reaction. Results IE from patients with cerebral malaria were more likely to bind EPCR and ICAM-1 than IE from children with uncomplicated malaria (P = .007). The level of transcripts encoding CIDRα1.4 and CIDRα1.5 domain subclasses was higher in patients with severe disease (P < .05). IE populations exhibiting binding to all 3 receptors had higher levels of transcripts encoding PfEMP1 with CIDRα1.4 and Duffy binding-like (DBL)-β3 domains than parasites, which only bound CD36. Conclusions These results underpin the significance of EPCR binding in pediatric malaria patients that require hospital admission, and support the notion that complementary receptor interactions of EPCR binding PfEMP1with ICAM-1 amplifies development of severe malaria symptoms.
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Affiliation(s)
- Nicaise Tuikue Ndam
- UMR 216, Mère et enfant face aux infections tropicales, Institut de Recherche pour le développement, COMUE Sorbonne Paris Cité, Faculté de pharmacie, Laboratoire d'Excellence GR-Ex, DHU Risques et Grossesse, France
| | - Azizath Moussiliou
- UMR 216, Mère et enfant face aux infections tropicales, Institut de Recherche pour le développement, COMUE Sorbonne Paris Cité, Faculté de pharmacie, Laboratoire d'Excellence GR-Ex, DHU Risques et Grossesse, France
| | - Thomas Lavstsen
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital, Denmark
| | - Claire Kamaliddin
- UMR 216, Mère et enfant face aux infections tropicales, Institut de Recherche pour le développement, COMUE Sorbonne Paris Cité, Faculté de pharmacie, Laboratoire d'Excellence GR-Ex, DHU Risques et Grossesse, France
| | - Anja T R Jensen
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital, Denmark
| | - Atikatou Mama
- Centre d'Etude et de Recherche sur le paludisme associé à la Grossesse et à l'Enfance, Université d'Abomey-Calavi
| | - Rachida Tahar
- UMR 216, Mère et enfant face aux infections tropicales, Institut de Recherche pour le développement, COMUE Sorbonne Paris Cité, Faculté de pharmacie, Laboratoire d'Excellence GR-Ex, DHU Risques et Grossesse, France
| | - Christian W Wang
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital, Denmark
| | - Jakob S Jespersen
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital, Denmark
| | - Jules M Alao
- Département de pédiatrie, Hôpital Mère-enfant de la lagune, Cotonou, Bénin
| | - Benoit Gamain
- Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence GR-Ex, France
| | - Thor G Theander
- Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital, Denmark
| | - Philippe Deloron
- UMR 216, Mère et enfant face aux infections tropicales, Institut de Recherche pour le développement, COMUE Sorbonne Paris Cité, Faculté de pharmacie, Laboratoire d'Excellence GR-Ex, DHU Risques et Grossesse, France
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Patel JC, Hathaway NJ, Parobek CM, Thwai KL, Madanitsa M, Khairallah C, Kalilani-Phiri L, Mwapasa V, Massougbodji A, Fievet N, Bailey JA, Ter Kuile FO, Deloron P, Engel SM, Taylor SM, Juliano JJ, Tuikue Ndam N, Meshnick SR. Increased risk of low birth weight in women with placental malaria associated with P. falciparum VAR2CSA clade. Sci Rep 2017; 7:7768. [PMID: 28801627 PMCID: PMC5554196 DOI: 10.1038/s41598-017-04737-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 05/30/2017] [Indexed: 11/17/2022] Open
Abstract
Pregnancy associated malaria (PAM) causes adverse pregnancy and birth outcomes owing to Plasmodium falciparum accumulation in the placenta. Placental accumulation is mediated by P. falciparum protein VAR2CSA, a leading PAM-specific vaccine target. The extent of its antigen diversity and impact on clinical outcomes remain poorly understood. Through amplicon deep-sequencing placental malaria samples from women in Malawi and Benin, we assessed sequence diversity of VAR2CSA’s ID1-DBL2x region, containing putative vaccine targets and estimated associations of specific clades with adverse birth outcomes. Overall, var2csa diversity was high and haplotypes subdivided into five clades, the largest two defined by homology to parasites strains, 3D7 or FCR3. Across both cohorts, compared to women infected with only FCR3-like variants, women infected with only 3D7-like variants delivered infants with lower birthweight (difference: −267.99 g; 95% Confidence Interval [CI]: −466.43 g,−69.55 g) and higher odds of low birthweight (<2500 g) (Odds Ratio [OR] 5.41; 95% CI:0.99,29.52) and small-for-gestational-age (OR: 3.65; 95% CI: 1.01,13.38). In two distinct malaria-endemic African settings, parasites harboring 3D7-like variants of VAR2CSA were associated with worse birth outcomes, supporting differential effects of infection with specific parasite strains. The immense diversity coupled with differential clinical effects of this diversity suggest that an effective VAR2CSA-based vaccine may require multivalent activity.
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Affiliation(s)
- Jaymin C Patel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA.
| | - Nicholas J Hathaway
- Program in Bioinformatics and Integrative Biology, University of Massachusetts, Worcester, MA, USA
| | - Christian M Parobek
- Curriculum in Genetics and Molecular Biology, University of North Carolina, Chapel Hill, USA
| | - Kyaw L Thwai
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Mwayiwawo Madanitsa
- College of Medicine, University of Malawi, Blantyre, Malawi.,Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Carole Khairallah
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | - Victor Mwapasa
- College of Medicine, University of Malawi, Blantyre, Malawi
| | - Achille Massougbodji
- Centre d'Etude et de Recherche sur le paludisme associé à la Grossesse et à l'Enfance, Université d'Abomey-Calavi, Cotonou, Benin
| | - Nadine Fievet
- COMUE Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,UMR216 - MERIT, Institut de Recherche pour le Développement, Paris, France
| | - Jeffery A Bailey
- Program in Bioinformatics and Integrative Biology, University of Massachusetts, Worcester, MA, USA.,Division of Transfusion Medicine, Department of Medicine, University of Massachusetts, Worcester, MA, USA
| | - Feiko O Ter Kuile
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Philippe Deloron
- COMUE Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,UMR216 - MERIT, Institut de Recherche pour le Développement, Paris, France
| | - Stephanie M Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Steve M Taylor
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA.,Division of Infectious Diseases, Duke University Medical Center and Duke Global Health Institute, Durham, NC, USA
| | - Jonathan J Juliano
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA.,Curriculum in Genetics and Molecular Biology, University of North Carolina, Chapel Hill, USA.,Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Nicaise Tuikue Ndam
- COMUE Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,UMR216 - MERIT, Institut de Recherche pour le Développement, Paris, France
| | - Steven R Meshnick
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
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34
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Ndam NT, Mbuba E, González R, Cisteró P, Kariuki S, Sevene E, Rupérez M, Fonseca AM, Vala A, Maculuve S, Jiménez A, Quintó L, Ouma P, Ramharter M, Aponte JJ, Nhacolo A, Massougbodji A, Briand V, Kremsner PG, Mombo-Ngoma G, Desai M, Macete E, Cot M, Menéndez C, Mayor A. Resisting and tolerating P. falciparum in pregnancy under different malaria transmission intensities. BMC Med 2017; 15:130. [PMID: 28712360 PMCID: PMC5513247 DOI: 10.1186/s12916-017-0893-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 06/15/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Resistance and tolerance to Plasmodium falciparum can determine the progression of malaria disease. However, quantitative evidence of tolerance is still limited. We investigated variations in the adverse impact of P. falciparum infections among African pregnant women under different intensities of malaria transmission. METHODS P. falciparum at delivery was assessed by microscopy, quantitative PCR (qPCR) and placental histology in 946 HIV-uninfected and 768 HIV-infected pregnant women from Benin, Gabon, Kenya and Mozambique. Resistance was defined by the proportion of submicroscopic infections and the levels of anti-parasite antibodies quantified by Luminex, and tolerance by the relationship of pregnancy outcomes with parasite densities at delivery. RESULTS P. falciparum prevalence by qPCR in peripheral and/or placental blood of HIV-uninfected Mozambican, Gabonese and Beninese women at delivery was 6% (21/340), 11% (28/257) and 41% (143/349), respectively. The proportion of peripheral submicroscopic infections was higher in Benin (83%) than in Mozambique (60%) and Gabon (55%; P = 0.033). Past or chronic placental P. falciparum infection was associated with an increased risk of preterm birth in Mozambican newborns (OR = 7.05, 95% CI 1.79 to 27.82). Microscopic infections were associated with reductions in haemoglobin levels at delivery among Mozambican women (-1.17 g/dL, 95% CI -2.09 to -0.24) as well as with larger drops in haemoglobin levels from recruitment to delivery in Mozambican (-1.66 g/dL, 95% CI -2.68 to -0.64) and Gabonese (-0.91 g/dL, 95% CI -1.79 to -0.02) women. Doubling qPCR-peripheral parasite densities in Mozambican women were associated with decreases in haemoglobin levels at delivery (-0.16 g/dL, 95% CI -0.29 to -0.02) and increases in the drop of haemoglobin levels (-0.29 g/dL, 95% CI -0.44 to -0.14). Beninese women had higher anti-parasite IgGs than Mozambican women (P < 0.001). No difference was found in the proportion of submicroscopic infections nor in the adverse impact of P. falciparum infections in HIV-infected women from Kenya (P. falciparum prevalence by qPCR: 9%, 32/351) and Mozambique (4%, 15/417). CONCLUSIONS The lowest levels of resistance and tolerance in pregnant women from areas of low malaria transmission were accompanied by the largest adverse impact of P. falciparum infections. Exposure-dependent mechanisms developed by pregnant women to resist the infection and minimise pathology can reduce malaria-related adverse outcomes. Distinguishing both types of defences is important to understand how reductions in transmission can affect malaria disease. TRIAL REGISTRATION ClinicalTrials.gov NCT00811421 . Registered 18 December 2008.
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Affiliation(s)
- Nicaise Tuikue Ndam
- Institut de Recherche pour le Développement (IRD), Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie, Paris, France.,Faculté des Sciences de la Santé (FSS), Université d'Aboméy Calavi, Cotonou, Benin
| | - Emmanuel Mbuba
- Ifakara Health Institute (IHI), Bagamoyo Research and Training Centre (BRTC), Bagamoyo, Tanzania
| | - Raquel González
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
| | - Pau Cisteró
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Simon Kariuki
- Kenya Medical Research Institute (KEMRI)/Centre for Global Health Research, Kisumu, Kenya
| | - Esperança Sevene
- Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique.,Universidade Eduardo Mondlane, Maputo, Mozambique
| | - María Rupérez
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
| | - Ana Maria Fonseca
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Graduate Program in Areas of Basic and Applied Biology, Universidade do Porto, Porto, Portugal
| | - Anifa Vala
- Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
| | - Sonia Maculuve
- Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
| | - Alfons Jiménez
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Llorenç Quintó
- Faculté des Sciences de la Santé (FSS), Université d'Aboméy Calavi, Cotonou, Benin
| | - Peter Ouma
- Kenya Medical Research Institute (KEMRI)/Centre for Global Health Research, Kisumu, Kenya
| | - Michael Ramharter
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria.,Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
| | - John J Aponte
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
| | - Arsenio Nhacolo
- Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
| | - Achille Massougbodji
- Faculté des Sciences de la Santé (FSS), Université d'Aboméy Calavi, Cotonou, Benin
| | - Valerie Briand
- Institut de Recherche pour le Développement (IRD), Paris, France
| | - Peter G Kremsner
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
| | - Ghyslain Mombo-Ngoma
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.,Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
| | - Meghna Desai
- Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Eusebio Macete
- Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
| | - Michel Cot
- Institut de Recherche pour le Développement (IRD), Paris, France
| | - Clara Menéndez
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique
| | - Alfredo Mayor
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain. .,Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique.
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Ndam NT, Basco LK, Ngane VF, Ayouba A, Ngolle EM, Deloron P, Peeters M, Tahar R. Reemergence of chloroquine-sensitive pfcrt K76 Plasmodium falciparum genotype in southeastern Cameroon. Malar J 2017; 16:130. [PMID: 28347314 PMCID: PMC5368939 DOI: 10.1186/s12936-017-1783-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 03/17/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chloroquine had been used extensively during the last five decades in Cameroon. Its decreasing clinical effectiveness, supported by high proportions of clinical isolates carrying the mutant pfcrt haplotype (CVIET), led the health authorities to resort to amodiaquine monotherapy in 2002 and artemisinin-based combination therapy (ACT) in 2004 (artesunate-amodiaquine, with artemether-lumefantrine as an alternative since 2006) as the first-line treatment of uncomplicated malaria. The aim of the present study was to investigate whether the withdrawal of chloroquine was associated with a reduction in pfcrt mutant parasite population and reemergence of chloroquine-sensitive parasites in southeastern Cameroon between 2003 and 2012. METHODS The frequency of pfcrt haplotypes at positions 72-76 in Plasmodium falciparum isolates collected from individuals in 2003 and 2012 in southeastern Cameroon was determined by sequence specific oligonucleotide probes-enzyme linked immunosorbent assay (SSOP-ELISA). RESULTS The proportions of parasites carrying the mutant haplotype CVIET and the wild-type CVMNK were 53.0 and 28.0% in 2003, respectively. The proportion of the mutant haplotype in samples collected 9 years later decreased to 25.3% whereas the proportion of parasites carrying the wild-type CVMNK haplotype was 53.7%. CONCLUSIONS Even though the proportion of chloroquine-sensitive parasites seems to be increasing in southeastern Cameroon, a reintroduction of chloroquine cannot be recommended at present in Cameroon. The current national anti-malarial drug policy should be implemented and reinforced to combat drug-resistant malaria.
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Affiliation(s)
- Nicaise Tuikue Ndam
- UMR 216 Mère et Enfant Face aux Infections Tropicales, Institut de Recherche pour le Développement (IRD), 4, Avenue de l'Observatoire, 75270, Paris, France. .,PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, 75270, Paris, France. .,Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Accra, Ghana.
| | - Leonardo K Basco
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), CNRS 7278, IRD 198, INSERM 1095, AP-HM, Aix-Marseille Université, Institut Hospitalo-Universitaire (IHU)-Méditerranée Infection, 13385, Marseille, France
| | - Vincent Foumane Ngane
- Laboratoire de Recherche sur le Paludisme, Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC), B. P. 288, Yaoundé, Cameroon
| | - Ahidjo Ayouba
- Unité IRD 233 Recherches Translationnelles sur le VIH et les maladies infectieuses, Montpellier, France
| | - Eitel Mpoudi Ngolle
- Prévention du Sida au Cameroun, Institut de Recherches Médicales et d'Études des Plantes Médicinales, Yaoundé, Cameroon
| | - Philippe Deloron
- UMR 216 Mère et Enfant Face aux Infections Tropicales, Institut de Recherche pour le Développement (IRD), 4, Avenue de l'Observatoire, 75270, Paris, France.,PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, 75270, Paris, France
| | - Martine Peeters
- Unité IRD 233 Recherches Translationnelles sur le VIH et les maladies infectieuses, Montpellier, France
| | - Rachida Tahar
- UMR 216 Mère et Enfant Face aux Infections Tropicales, Institut de Recherche pour le Développement (IRD), 4, Avenue de l'Observatoire, 75270, Paris, France.,PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, 75270, Paris, France
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36
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Gbédandé K, Cottrell G, Vianou B, Ibitokou S, Fernando A, Troye-Blomberg M, Salanti A, Moutairou K, Massougbodji A, Ndam NT, Deloron P, Luty AJF, Fievet N. Infections with Plasmodium falciparum during pregnancy affect VAR2CSA DBL-5 domain-specific T cell cytokine responses. Malar J 2016; 15:485. [PMID: 27653505 PMCID: PMC5031276 DOI: 10.1186/s12936-016-1525-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 09/06/2016] [Indexed: 01/15/2023] Open
Abstract
Background Current knowledge of human immunological responses to pregnancy-associated malaria-specific Plasmodium falciparum protein VAR2CSA concerns almost exclusively B cell-driven
antibody-mediated activity. Knowledge of VAR2CSA-specific T cell-mediated activity is minimal by comparison, with only a single published report of a study investigating VAR2CSA-derived peptide-specific T cell responses. The study described here represents an attempt to redress this balance. Methods Within the framework of a cohort study of 1037 pregnant Beninese, sub-groups were selected on the basis of the documented presence/absence of infection with P. falciparum and conducted detailed immunological assessments both at inclusion into the study and at delivery. Peripheral blood mononuclear cells were isolated, stimulated in vitro, and VAR2CSA DBL-5 domain-specific, IFN-γ-secreting T-cell frequencies and cytokine responses were quantified using flow cytometric techniques. Multivariate analyses were used to determine primarily whether the T cell-mediated DBL5-specific activity measured was associated with infection by P. falciparum adjusted for gravidity, anaemia and other cofactors. Results Infections with P. falciparum detected at inclusion were associated with enhanced non-specific TNF responses, whilst diminished non-specific and DBL-5-specific IL-10 responses were associated with infections detected at delivery. Infections during pregnancy led to enhanced non-specific and DBL-5-specific IFN-γ responses detectable at delivery but to concomitantly lower DBL-5-specific CD8+ IFN-γ responses. Prospective assessments indicated that non-specific pro-inflammatory responses detectable at inclusion in the study were associated with the occurrence of infections subsequently during pregnancy. Conclusions The findings represent a first step in elucidating the quantity and quality of cellular immunological responses to VAR2CSA, which will help in the development of the primary vaccine candidate for prevention of pregnancy-associated malaria. Electronic supplementary material The online version of this article (doi:10.1186/s12936-016-1525-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Komi Gbédandé
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, Benin.,Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d'Abomey-Calavi, Cotonou, Benin.,Institut de Recherche pour le Développement, MERIT UMR D216 Mère et enfant face aux infections tropicales, Paris, France
| | - Gilles Cottrell
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, Benin.,Institut de Recherche pour le Développement, MERIT UMR D216 Mère et enfant face aux infections tropicales, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes, Paris, France
| | - Bertin Vianou
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, Benin
| | - Samad Ibitokou
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, Benin
| | - Aurax Fernando
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, Benin
| | - Marita Troye-Blomberg
- Department of Molecular Biosciences, the Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Ali Salanti
- Department of International Health, Institute of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Kabirou Moutairou
- Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d'Abomey-Calavi, Cotonou, Benin
| | - Achille Massougbodji
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, Benin
| | - Nicaise Tuikue Ndam
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, Benin.,Institut de Recherche pour le Développement, MERIT UMR D216 Mère et enfant face aux infections tropicales, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes, Paris, France
| | - Philippe Deloron
- Institut de Recherche pour le Développement, MERIT UMR D216 Mère et enfant face aux infections tropicales, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes, Paris, France
| | - Adrian J F Luty
- Institut de Recherche pour le Développement, MERIT UMR D216 Mère et enfant face aux infections tropicales, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes, Paris, France
| | - Nadine Fievet
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et à l'Enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, Benin. .,Institut de Recherche pour le Développement, MERIT UMR D216 Mère et enfant face aux infections tropicales, Paris, France. .,COMUE Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes, Paris, France.
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Ndam NT, Denoeud-Ndam L, Doritchamou J, Viwami F, Salanti A, Nielsen MA, Fievet N, Massougbodji A, Luty AJF, Deloron P. Protective Antibodies against Placental Malaria and Poor Outcomes during Pregnancy, Benin. Emerg Infect Dis 2016; 21:813-23. [PMID: 25898123 PMCID: PMC4412227 DOI: 10.3201/eid2105.141626] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Immunity requires a vaccine that inhibits binding of infected erythrocytes to chondroitin sulfate. Placental malaria is caused by Plasmodium falciparum–infected erythrocytes that bind to placental tissue. Binding is mediated by VAR2CSA, a parasite antigen coded by the var gene, which interacts with chondroitin sulfate A (CSA). Consequences include maternal anemia and fetal growth retardation. Antibody-mediated immunity to placental malaria is acquired during successive pregnancies, but the target of VAR2CSA-specific protective antibodies is unclear. We assessed VAR2CSA-specific antibodies in pregnant women and analyzed their relationships with protection against placental infection, preterm birth, and low birthweight. Antibody responses to the N-terminal region of VAR2CSA during early pregnancy were associated with reduced risks for infections and low birthweight. Among women infected during pregnancy, an increase in CSA binding inhibition was associated with reduced risks for placental infection, preterm birth, and low birthweight. These data suggest that antibodies against VAR2CSA N-terminal region mediate immunity to placental malaria and associated outcomes. Our results validate current vaccine development efforts with VAR2CSA N-terminal constructs.
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MESH Headings
- Adult
- Antibodies, Protozoan/blood
- Antibodies, Protozoan/immunology
- Antibody Specificity/immunology
- Antigens, Protozoan/immunology
- Benin/epidemiology
- Erythrocytes/immunology
- Erythrocytes/parasitology
- Female
- Follow-Up Studies
- Humans
- Immunoglobulin G/blood
- Immunoglobulin G/immunology
- Infant
- Infant, Newborn
- Malaria/epidemiology
- Malaria/immunology
- Malaria/parasitology
- Malaria, Falciparum/epidemiology
- Malaria, Falciparum/immunology
- Malaria, Falciparum/parasitology
- Patient Outcome Assessment
- Placenta/parasitology
- Plasmodium falciparum/immunology
- Pregnancy
- Pregnancy Complications, Parasitic/epidemiology
- Pregnancy Complications, Parasitic/immunology
- Pregnancy Complications, Parasitic/parasitology
- Pregnancy Outcome
- Protein Binding
- Risk Factors
- Young Adult
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Doritchamou J, Sabbagh A, Jespersen JS, Renard E, Salanti A, Nielsen MA, Deloron P, Tuikue Ndam N. Identification of a Major Dimorphic Region in the Functionally Critical N-Terminal ID1 Domain of VAR2CSA. PLoS One 2015; 10:e0137695. [PMID: 26393516 PMCID: PMC4579133 DOI: 10.1371/journal.pone.0137695] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 08/19/2015] [Indexed: 01/18/2023] Open
Abstract
The VAR2CSA protein of Plasmodium falciparum is transported to and expressed on the infected erythrocyte surface where it plays a key role in placental malaria (PM). It is the current leading candidate for a vaccine to prevent PM. However, the antigenic polymorphism integral to VAR2CSA poses a challenge for vaccine development. Based on detailed analysis of polymorphisms in the sequence of its ligand-binding N-terminal region, currently the main focus for vaccine development, we assessed var2csa from parasite isolates infecting pregnant women. The results reveal for the first time the presence of a major dimorphic region in the functionally critical N-terminal ID1 domain. Parasite isolates expressing VAR2CSA with particular motifs present within this domain are associated with gravidity- and parasite density-related effects. These observations are of particular interest in guiding efforts with respect to optimization of the VAR2CSA-based vaccines currently under development.
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Affiliation(s)
- Justin Doritchamou
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France; UMR216 - MERIT, Institut de Recherche pour le Développement, Paris, France
| | - Audrey Sabbagh
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - Jakob S Jespersen
- Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark
| | | | - Ali Salanti
- Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark
| | - Morten A Nielsen
- Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark
| | - Philippe Deloron
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France; UMR216 - MERIT, Institut de Recherche pour le Développement, Paris, France
| | - Nicaise Tuikue Ndam
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France; UMR216 - MERIT, Institut de Recherche pour le Développement, Paris, France
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Nielsen MA, Resende M, de Jongh WA, Ditlev SB, Mordmüller B, Houard S, Ndam NT, Agerbæk MØ, Hamborg M, Massougbodji A, Issifou S, Strøbæk A, Poulsen L, Leroy O, Kremsner PG, Chippaux JP, Luty AJF, Deloron P, Theander TG, Dyring C, Salanti A. The Influence of Sub-Unit Composition and Expression System on the Functional Antibody Response in the Development of a VAR2CSA Based Plasmodium falciparum Placental Malaria Vaccine. PLoS One 2015; 10:e0135406. [PMID: 26327283 PMCID: PMC4556615 DOI: 10.1371/journal.pone.0135406] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 07/21/2015] [Indexed: 11/19/2022] Open
Abstract
The disease caused by Plasmodium falciparum (Pf) involves different clinical manifestations that, cumulatively, kill hundreds of thousands every year. Placental malaria (PM) is one such manifestation in which Pf infected erythrocytes (IE) bind to chondroitin sulphate A (CSA) through expression of VAR2CSA, a parasite-derived antigen. Protection against PM is mediated by antibodies that inhibit binding of IE in the placental intervillous space. VAR2CSA is a large antigen incompatible with large scale recombinant protein expression. Vaccines based on sub-units encompassing the functionally constrained receptor-binding domains may, theoretically, circumvent polymorphisms, reduce the risk of escape-mutants and induce cross-reactive antibodies. However, the sub-unit composition and small differences in the borders, may lead to exposure of novel immuno-dominant antibody epitopes that lead to non-functional antibodies, and furthermore influence the folding, stability and yield of expression. Candidate antigens from the pre-clinical development expressed in High-Five insect cells using the baculovirus expression vector system were transitioned into the Drosophila Schneider-2 cell (S2) expression-system compliant with clinical development. The functional capacity of antibodies against antigens expressed in High-Five cells or in S2 cells was equivalent. This enabled an extensive down-selection of S2 insect cell-expressed antigens primarily encompassing the minimal CSA-binding region of VAR2CSA. In general, we found differential potency of inhibitory antibodies against antigens with the same borders but of different var2csa sequences. Likewise, we found that subtle size differences in antigens of the same sequence gave varying levels of inhibitory antibodies. The study shows that induction of a functional response against recombinant subunits of the VAR2CSA antigen is unpredictable, demonstrating the need for large-scale screening in order to identify antigens that induce a broadly strain-transcending antibody response.
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Affiliation(s)
- Morten A. Nielsen
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Science, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
- * E-mail:
| | - Mafalda Resende
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Science, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | | | - Sisse B. Ditlev
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Science, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Benjamin Mordmüller
- Eberhard Karls Universität Tübingen, Institut für Tropenmedizin, Tübingen, Germany, and Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Sophie Houard
- European Vaccine Initiative, Universitäts Klinikum Heidelberg, Heidelberg, Germany
| | - Nicaise Tuikue Ndam
- Institut de Recherche pour le Développement, UMR216 Mère et enfant face aux infections tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - Mette Ø. Agerbæk
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Science, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Mette Hamborg
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Science, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Achille Massougbodji
- Faculté des Sciences de la Santé de l’Université d’Abomey-Calavi, Centre d’étude et de recherche sur le paludisme associé à la grossesse et à l’enfance, Cotonou, Bénin
| | - Saddou Issifou
- Faculté des Sciences de la Santé de l’Université d’Abomey-Calavi, Centre d’étude et de recherche sur le paludisme associé à la grossesse et à l’enfance, Cotonou, Bénin
| | - Anette Strøbæk
- ExpreSion Biotechnologies, SCION-DTU Science Park, Hørsholm, Denmark
| | - Lars Poulsen
- ExpreSion Biotechnologies, SCION-DTU Science Park, Hørsholm, Denmark
| | - Odile Leroy
- European Vaccine Initiative, Universitäts Klinikum Heidelberg, Heidelberg, Germany
| | - Peter G. Kremsner
- Eberhard Karls Universität Tübingen, Institut für Tropenmedizin, Tübingen, Germany, and Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Jean-Philippe Chippaux
- Institut de Recherche pour le Développement, UMR216 Mère et enfant face aux infections tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
- Faculté des Sciences de la Santé de l’Université d’Abomey-Calavi, Centre d’étude et de recherche sur le paludisme associé à la grossesse et à l’enfance, Cotonou, Bénin
| | - Adrian J. F. Luty
- Institut de Recherche pour le Développement, UMR216 Mère et enfant face aux infections tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
- Faculté des Sciences de la Santé de l’Université d’Abomey-Calavi, Centre d’étude et de recherche sur le paludisme associé à la grossesse et à l’enfance, Cotonou, Bénin
| | - Philippe Deloron
- Institut de Recherche pour le Développement, UMR216 Mère et enfant face aux infections tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - Thor G. Theander
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Science, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Charlotte Dyring
- ExpreSion Biotechnologies, SCION-DTU Science Park, Hørsholm, Denmark
| | - Ali Salanti
- Centre for Medical Parasitology at Department of Immunology and Microbiology, Faculty of Health and Medical Science, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
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Ibitokou SA, Denoeud-Ndam L, Ezinmegnon S, Ladékpo R, Zannou DM, Massougbodji A, Girard PM, Cot M, Luty AJF, Ndam NT. Insights Into Circulating Cytokine Dynamics During Pregnancy in HIV-Infected Beninese Exposed to Plasmodium falciparum Malaria. Am J Trop Med Hyg 2015; 93:287-92. [PMID: 26101276 DOI: 10.4269/ajtmh.14-0653] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 01/20/2015] [Indexed: 11/07/2022] Open
Abstract
We investigated the circulating plasma levels of Th1- (Interleukin-2 [IL-2], tumor necrosis factor-α [TNF-α], interferon-gamma [IFN-γ]) and Th2-type (IL-4, IL-5, IL-10) cytokines in human immunodeficiency virus (HIV)-infected pregnant women living in a malaria-endemic area. We analyzed samples from 200 pregnant women included in the prevention of pregnancy-associated malaria in HIV-infected women: cotrimoxazole prophylaxis versus mefloquine (PACOME) clinical trial who were followed until delivery. Cytokine concentrations were measured by flow cytometry-based multiplex bead array. Significantly elevated levels of IL-10 and lower levels of TNF-α were observed at delivery compared with inclusion (P = 0.005). At inclusion, the presence of circulating IFN-γ, a higher CD4(+) T cell count and having initiated intermittent preventive treatment of malaria with sulfadoxine pyrimethamine (SP-IPTp) were all associated with a lower likelihood of Plasmodium falciparum infection. At delivery, the inverse relationship between the presence of infection and circulating IFN-γ persisted, although there was a positive association between the likelihood of infection and the presence of circulating TNF-α. Initiation of antiretroviral therapy was associated with elevated IL-5 production. Consistent with our own and others' observations in HIV seronegative subjects, this study shows circulating IL-10 to be a marker of infection with P. falciparum during pregnancy even in HIV-infected women, although plasma IFN-γ may be a marker of anti-malarial protection in such women.
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Affiliation(s)
- Samad A Ibitokou
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Lise Denoeud-Ndam
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Sèm Ezinmegnon
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Rodolphe Ladékpo
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Djimon-Marcel Zannou
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Achille Massougbodji
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Pierre-Marie Girard
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Michel Cot
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Adrian J F Luty
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
| | - Nicaise Tuikue Ndam
- Centre d'étude et de Recherche sur le Paludisme Associé à la Grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Benin; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux Infections Tropicales, Paris, France; Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France
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Cottrell G, Moussiliou A, Luty AJF, Cot M, Fievet N, Massougbodji A, Deloron P, Tuikue Ndam N. Submicroscopic Plasmodium falciparum Infections Are Associated With Maternal Anemia, Premature Births, and Low Birth Weight. Clin Infect Dis 2015; 60:1481-8. [PMID: 25694651 DOI: 10.1093/cid/civ122] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 02/02/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Molecular, as opposed to microscopic, detection measures the real prevalence of Plasmodium falciparum infections. Such occult infections are common during pregnancy but their impact on pregnancy outcomes is unclear. We performed a longitudinal study to describe that impact. METHODS In a cohort of 1037 Beninese pregnant women, we used ultrasound to accurately estimate gestational ages. Infection with P. falciparum, hemoglobin concentration, use of intermittent preventive treatment during pregnancy (IPTp) for malaria, and other parameters were recorded during pregnancy. Using multivariate analyses, we evaluated the impact of submicroscopic infections on maternal anemia, premature birth, and low birth weight. RESULTS At inclusion, polymerase chain reaction (PCR) and microscopy detected infection in 40% and 16% of women, respectively. The proportion infected declined markedly after 2 doses of IPTp but rebounded to 34% (by PCR) at delivery. Submicroscopic infections during pregnancy were associated with lower mean hemoglobin irrespective of gravidity, and with increased anemia risk in primigravidae (odds ratio [OR], 2.23; 95% confidence interval [CI], .98-5.07). Prospectively, submicroscopic infections at inclusion were associated with significantly increased risks of low birth weight in primigravidae (OR, 6.09; 95% CI, 1.16-31.95) and premature births in multigravidae (OR, 2.25; 95% CI, 1.13-4.46). CONCLUSIONS In this detailed longitudinal study, we document the deleterious impact of submicroscopic P. falciparum parasitemia during pregnancy on multiple pregnancy outcomes. Parasitemia occurs frequently during pregnancy, but routine microscopic and rapid diagnostic tests fail to detect the vast majority of episodes. Our findings imply caution in any revision of the current strategies for prevention of pregnancy-associated malaria.
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Affiliation(s)
- Gilles Cottrell
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes Institut de Recherche pour le Développement, UMR216-MERIT
| | - Azizath Moussiliou
- Institut de Recherche pour le Développement, UMR216-MERIT Université Pierre et Marie Curie, Paris, France
| | - Adrian J F Luty
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes Institut de Recherche pour le Développement, UMR216-MERIT
| | - Michel Cot
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes Institut de Recherche pour le Développement, UMR216-MERIT
| | - Nadine Fievet
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes Institut de Recherche pour le Développement, UMR216-MERIT
| | - Achille Massougbodji
- Centre d'Etude et de Recherche sur le paludisme associé à la Grossesse et à l'Enfance, Université d'Abomey-Calavi, Cotonou, Benin
| | - Philippe Deloron
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes Institut de Recherche pour le Développement, UMR216-MERIT
| | - Nicaise Tuikue Ndam
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes Institut de Recherche pour le Développement, UMR216-MERIT
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Almelli T, Nuel G, Bischoff E, Aubouy A, Elati M, Wang CW, Dillies MA, Coppée JY, Ayissi GN, Basco LK, Rogier C, Ndam NT, Deloron P, Tahar R. Differences in gene transcriptomic pattern of Plasmodium falciparum in children with cerebral malaria and asymptomatic carriers. PLoS One 2014; 9:e114401. [PMID: 25479608 PMCID: PMC4257676 DOI: 10.1371/journal.pone.0114401] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 11/10/2014] [Indexed: 11/24/2022] Open
Abstract
The mechanisms underlying the heterogeneity of clinical malaria remain largely unknown. We hypothesized that differential gene expression contributes to phenotypic variation of parasites which results in a specific interaction with the host, leading to different clinical features of malaria. In this study, we analyzed the transcriptomes of isolates obtained from asymptomatic carriers and patients with uncomplicated or cerebral malaria. We also investigated the transcriptomes of 3D7 clone and 3D7-Lib that expresses severe malaria associated-variant surface antigen. Our findings revealed a specific up-regulation of genes involved in pathogenesis, adhesion to host cell, and erythrocyte aggregation in parasites from patients with cerebral malaria and 3D7-Lib, compared to parasites from asymptomatic carriers and 3D7, respectively. However, we did not find any significant difference between the transcriptomes of parasites from cerebral malaria and uncomplicated malaria, suggesting similar transcriptomic pattern in these two parasite populations. The difference between isolates from asymptomatic children and cerebral malaria concerned genes coding for exported proteins, Maurer's cleft proteins, transcriptional factor proteins, proteins implicated in protein transport, as well as Plasmodium conserved and hypothetical proteins. Interestingly, UPs A1, A2, A3 and UPs B1 of var genes were predominantly found in cerebral malaria-associated isolates and those containing architectural domains of DC4, DC5, DC13 and their neighboring rif genes in 3D7-lib. Therefore, more investigations are needed to analyze the effective role of these genes during malaria infection to provide with new knowledge on malaria pathology. In addition, concomitant regulation of genes within the chromosomal neighborhood suggests a common mechanism of gene regulation in P. falciparum.
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Affiliation(s)
- Talleh Almelli
- Institut de Recherche pour le Développement (IRD), UMR 216 Mère et Enfant Face aux Infections Tropicales, Université Paris-Descartes, Près Sorbonne Paris-Cité, Paris, France
- PRES Sorbone Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Grégory Nuel
- PRES Sorbone Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Emmanuel Bischoff
- Institut Pasteur, Unit of Molecular Immunology of Parasites, Unit of Insect Vector Genetics and Genomics, Department of Parasitology and Mycology, Paris, France
- Centre National de la Recherche Scientifique (CNRS), URA 3012, Paris, France
| | - Agnès Aubouy
- Institut de Recherche pour le Développement (IRD), UMR 152 Pharmacochimie et pharmacologie pour le développement - (PHARMA-DEV), Université Paul Sabatier, Toulouse, France
| | - Mohamed Elati
- Institute of Systems and Synthetic Biology, CNRS, University of Evry, Genopole, Evry, France
| | - Christian William Wang
- Centre for Medical Parasitology at Department of International Health, Immunology, and Microbiology, University of Copenhagen and at Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Marie-Agnès Dillies
- Plate-forme Transcriptome et Epigénome, Departement Génomes et Génétique, Institut Pasteur, Paris, France
| | - Jean-Yves Coppée
- Plate-forme Transcriptome et Epigénome, Departement Génomes et Génétique, Institut Pasteur, Paris, France
| | | | - Leonardo Kishi Basco
- Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC), Laboratoire de Recherche sur le Paludisme, B. P. 288, Yaoundé, Cameroon
- Institut de Recherche pour le Développement (IRD), UMR 198 Unité de Recherche des Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine La Timone, Aix-Marseille Université, Marseille, France
| | - Christophe Rogier
- Institut Pasteur de Madagascar, B.P. 1274, Ambatofotsikely, Antananarivo, Madagascar
| | - Nicaise Tuikue Ndam
- Institut de Recherche pour le Développement (IRD), UMR 216 Mère et Enfant Face aux Infections Tropicales, Université Paris-Descartes, Près Sorbonne Paris-Cité, Paris, France
- PRES Sorbone Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Philippe Deloron
- Institut de Recherche pour le Développement (IRD), UMR 216 Mère et Enfant Face aux Infections Tropicales, Université Paris-Descartes, Près Sorbonne Paris-Cité, Paris, France
- PRES Sorbone Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Rachida Tahar
- Institut de Recherche pour le Développement (IRD), UMR 216 Mère et Enfant Face aux Infections Tropicales, Université Paris-Descartes, Près Sorbonne Paris-Cité, Paris, France
- PRES Sorbone Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
- Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC), Laboratoire de Recherche sur le Paludisme, B. P. 288, Yaoundé, Cameroon
- * E-mail:
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Moussiliou A, Alao MJ, Denoeud-Ndam L, Tahar R, Ezimegnon S, Sagbo G, Amoussou A, Luty AJF, Deloron P, Tuikue Ndam N. High plasma levels of soluble endothelial protein C receptor are associated with increased mortality among children with cerebral malaria in Benin. J Infect Dis 2014; 211:1484-8. [PMID: 25425698 DOI: 10.1093/infdis/jiu661] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 11/20/2014] [Indexed: 11/14/2022] Open
Abstract
Loss of endothelial protein C receptor (EPCR) occurs at the sites of Plasmodium falciparum-infected erythrocyte sequestration in patients with or who died from cerebral malaria. In children presenting with different clinical syndromes of malaria, we assessed the relationships between endogenous plasma soluble EPCR (sEPCR) levels and clinical presentation or mortality. After adjustment for age, for treatment before admission, and for a known genetic factor, sEPCR level at admission was positively associated with cerebral malaria (P = .011) and with malaria-related mortality (P = .0003). Measuring sEPCR levels at admission could provide an early biological marker of the outcome of cerebral malaria.
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Affiliation(s)
- Azizath Moussiliou
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes Institut de Recherche pour le Développement, UMR216-MERIT Université Pierre et Marie Curie, Paris, France
| | | | - Lise Denoeud-Ndam
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes Institut de Recherche pour le Développement, UMR216-MERIT
| | - Rachida Tahar
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes Institut de Recherche pour le Développement, UMR216-MERIT
| | - Sem Ezimegnon
- Centre d'Etude et de Recherche sur le paludisme associé à la Grossesse et à l'Enfance, Université d'Abomey-Calavi
| | - Gratien Sagbo
- Service de pédiatrie, Centre National Hospitalo-Universitaire
| | - Annick Amoussou
- Service de pédiatrie, Hôpital de zone de Suru-Léré, Cotonou, Bénin
| | - Adrian J F Luty
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes Institut de Recherche pour le Développement, UMR216-MERIT
| | - Philippe Deloron
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes Institut de Recherche pour le Développement, UMR216-MERIT
| | - Nicaise Tuikue Ndam
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes Institut de Recherche pour le Développement, UMR216-MERIT
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Doritchamou J, Sossou-tchatcha S, Cottrell G, Moussiliou A, Hounton Houngbeme C, Massougbodji A, Deloron P, Ndam NT. Dynamics in the cytoadherence phenotypes of Plasmodium falciparum infected erythrocytes isolated during pregnancy. PLoS One 2014; 9:e98577. [PMID: 24905223 PMCID: PMC4048182 DOI: 10.1371/journal.pone.0098577] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 05/05/2014] [Indexed: 11/19/2022] Open
Abstract
Pregnant women become susceptible to malaria infection despite their acquired immunity to this disease from childhood. The placental sequestration of Plasmodium falciparum infected erythrocytes (IE) is the major feature of malaria during pregnancy, due to ability of these parasites to bind chondroitin sulfate A (CSA) in the placenta through the VAR2CSA protein that parasites express on the surface of IE. We collected parasites at different times of pregnancy and investigated the adhesion pattern of freshly collected isolates on the three well described host receptors (CSPG, CD36 and ICAM-1). Var genes transcription profile and VAR2CSA surface-expression were assessed in these isolates. Although adhesion of IE to CD36 and ICAM-1 was observed in some isolates, CSA-adhesion was the predominant binding feature in all isolates analyzed. Co-existence in the peripheral blood of several adhesion phenotypes in early pregnancy isolates was observed, a diversity that gradually tightens with gestational age in favour of the CSA-adhesion phenotype. Infections occurring in primigravidae were often by parasites that adhered more to CSA than those from multigravidae. Data from this study further emphasize the specificity of CSA adhesion and VAR2CSA expression by parasites responsible for pregnancy malaria, while drawing attention to the phenotypic complexity of infections occurring early in pregnancy as well as in multigravidae.
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Affiliation(s)
- Justin Doritchamou
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes, Paris, France
- UMR216 Mère et enfant face aux infections tropicales, Institut de Recherche pour le Développement, Paris, France
- Centre d'Etude et de Recherche sur le paludisme associé à la Grossesse et à l'Enfance, Université d'Abomey-Calavi, Cotonou, Benin
| | - Sylvain Sossou-tchatcha
- Centre d'Etude et de Recherche sur le paludisme associé à la Grossesse et à l'Enfance, Université d'Abomey-Calavi, Cotonou, Benin
| | - Gilles Cottrell
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes, Paris, France
- UMR216 Mère et enfant face aux infections tropicales, Institut de Recherche pour le Développement, Paris, France
| | - Azizath Moussiliou
- UMR216 Mère et enfant face aux infections tropicales, Institut de Recherche pour le Développement, Paris, France
- ED Physiologie Physiopathologie et thérapeutique Sorbone Université, Université Pierre Marie Curie, Paris, France
| | | | - Achille Massougbodji
- Centre d'Etude et de Recherche sur le paludisme associé à la Grossesse et à l'Enfance, Université d'Abomey-Calavi, Cotonou, Benin
| | - Philippe Deloron
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes, Paris, France
- UMR216 Mère et enfant face aux infections tropicales, Institut de Recherche pour le Développement, Paris, France
| | - Nicaise Tuikue Ndam
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes, Paris, France
- UMR216 Mère et enfant face aux infections tropicales, Institut de Recherche pour le Développement, Paris, France
- Centre d'Etude et de Recherche sur le paludisme associé à la Grossesse et à l'Enfance, Université d'Abomey-Calavi, Cotonou, Benin
- * E-mail:
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Ogouyèmi-Hounto A, Ndam NT, Fadégnon G, Azagnandji C, Bello M, Moussiliou A, Chippaux JP, Kinde Gazard D, Massougbodji A. Low prevalence of the molecular markers of Plasmodium falciparum resistance to chloroquine and sulphadoxine/pyrimethamine in asymptomatic children in Northern Benin. Malar J 2013; 12:413. [PMID: 24225351 PMCID: PMC3834525 DOI: 10.1186/1475-2875-12-413] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 11/10/2013] [Indexed: 12/18/2022] Open
Abstract
Background In Benin, very few studies have been done on the genetics of Plasmodium falciparum and the resistance markers of anti-malarial drugs, while malaria treatment policy changed in 2004. Chloroquine (CQ) and sulphadoxine pyrimethamine (SP) have been removed and replaced by artemisinin-combination therapy (ACT). The objective of this study was to determine the genetic diversity of P. falciparum and the prevalence of P. falciparum molecular markers that are associated with resistance to CQ and SP in northern Benin seven years after the new policy was instituted. Methods The study was conducted in northern Benin, a region characterized by a seasonal malaria transmission. Blood samples were collected in 2012 from children presenting with asymptomatic P. falciparum infections. Samples collected in filter paper were genotyped by primary and nested PCR in block 2 of msp-1 and block 3 of msp-2 to analyse the diversity of P. falciparum. The prevalence of critical point mutations in the genes of Pfcrt (codon 76), Pfmdr1 (codon 86), Pfdhfr (codons, 51, 59 and 108) and Pfdhps (codons 437, 540) was examined in parasite isolates by mutation-specific restriction enzyme digestion. Results Genotyping of 195 isolates from asymptomatic children showed 34 msp-1 and 38 msp-2 genotypes. The multiplicity of infection was 4.51 ± 0.35 for msp-1 and 4.84 ± 0.30 for msp-2. Only the codon 51 of Pfdhfr and codon 437 of Pfdhps showed a high mutation rate: I51: 64.4% (57.3; 71.2); G437: 47.4% (40.2; 54.7), respectively. The prevalence of Pfdhfr triple mutant IRN (I51, R59 and N108) was 1.5% (0.3; 3.9), and Pfdhfr/Pfdhps quadruple mutant IRNG (PfdhfrI51, R59, N108, and PfdhpsG437): 0. 5% (0; 2.5). No mutation was found with codon 540 of Pfdhps. Analysis of mutation according to age (younger or older than ten years) showed similar frequencies in each category without significant difference between the two groups. Conclusions This study showed a high diversity of P. falciparum in northern Benin with a very low prevalence of resistance markers to CQ and SP that dramatically contrasted with the pattern observed in southern Benin. No influence of age on genetic diversity of P. falciparum and on distribution of the mutations was observed.
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Affiliation(s)
- Aurore Ogouyèmi-Hounto
- Unité d'Enseignement et de Recherche en Parasitologie Mycologie de la Faculté des Sciences de la Santé 01 BP188, Bénin.
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Doritchamou J, Bigey P, Nielsen MA, Gnidehou S, Ezinmegnon S, Burgain A, Massougbodji A, Deloron P, Salanti A, Ndam NT. Differential adhesion-inhibitory patterns of antibodies raised against two major variants of the NTS-DBL2X region of VAR2CSA. Vaccine 2013; 31:4516-22. [PMID: 23933341 DOI: 10.1016/j.vaccine.2013.07.072] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 07/19/2013] [Accepted: 07/29/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND VAR2CSA is a large polymorphic Plasmodium falciparum protein expressed on infected erythrocytes (IE) that allows their binding in the placenta, thus precipitating placental malaria (PM). The N-terminal part of VAR2CSA that contains the binding site to placental chondroitin sulfate A (CSA) is currently recognized as the most attractive region for vaccine development. An ultimate challenge is to define epitopes in this region that induce a broad cross-reactive adhesion inhibitory antibody response. METHODS Based on phylogenetic data that identified a dimorphic sequence motif in the VAR2CSA DBL2X, we raised antibodies against the NTS-DBL2X constructs containing one sequence or the other (3D7 and FCR3) and tested their functional properties on P. falciparum isolates from pregnant women and on laboratory-adapted strains. RESULTS The CSA binding inhibitory capacity of the antibodies induced varied from one parasite isolate to another (range, 10%–100%), but the combined analysis of individual activity highlighted a broader functionality that increased the total number of isolates inhibited. Interestingly, the differential inhibitory effect of the antibodies observed on field isolates resulted in significant inhibition of all field isolates tested, suggesting that optimal inhibitory spectrum on field isolates from pregnant women might be achieved with antibodies targeting limited variants of the N-terminal VAR2CSA. CONCLUSIONS Our findings indicate that the NTS-DBL2X region of VAR2CSA can elicit strain-transcending anti-adhesion antibodies and suggest that the combination of the two major variants used here could represent the basis for an effective bivalent VAR2CSA-based vaccine.
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Affiliation(s)
- Justin Doritchamou
- PRES Sorbonne Paris Cité, Faculté de Pharmacie, Université Paris Descartes, France; Institut de Recherche pour le Développement, UMR216 Mère et enfant face aux infections tropicales, Paris, France; Centre d'Etude et de Recherche sur le paludisme associé à la Grossesse et à l'Enfance, Université d'Abomey-Calavi, Cotonou, Benin
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Bertin GI, Lavstsen T, Guillonneau F, Doritchamou J, Wang CW, Jespersen JS, Ezimegnon S, Fievet N, Alao MJ, Lalya F, Massougbodji A, Ndam NT, Theander TG, Deloron P. Expression of the domain cassette 8 Plasmodium falciparum erythrocyte membrane protein 1 is associated with cerebral malaria in Benin. PLoS One 2013; 8:e68368. [PMID: 23922654 PMCID: PMC3726661 DOI: 10.1371/journal.pone.0068368] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 05/29/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Plasmodium falciparum erythrocyte membrane protein-1 (PfEMP-1) is a highly polymorphic adherence receptor expressed on the surface of infected erythrocytes. Based on sequence homology PfEMP-1 variants have been grouped into three major groups A-C, the highly conserved VAR2CSA variants, and semi-conserved types defined by tandem runs of specific domains ("domain cassettes" (DC)). The PfEMP-1 type expressed determines the adherence phenotype, and is associated with clinical outcome of infection. METHODS Parasite isolates from Beninese children or women presenting with, respectively, CM or PAM were collected along with samples from patients with uncomplicated malaria (UM). We assessed the transcript level of var genes by RT-qPCR and the expression of PfEMP-1 proteins by LC-MS/MS. RESULTS Var genes encoding DC8 and Group A PfEMP-1 were transcribed more often and at higher levels in cerebral malaria vs. uncomplicated malaria patients. LC-MS/MS identified peptides from group A, DC8 PfEMP-1 more frequently in cerebral malaria than in uncomplicated malaria and pregnancy-associated malaria samples. CONCLUSION This is the first study to show association between PfEMP-1 subtype and disease outcome by direct analysis of parasites proteome. The results corroborate that group A and specifically the PfEMP-1 types DC8 are universally associated with cerebral malaria. This is a crucial observation for promoting studies on malaria pathogenesis.
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MESH Headings
- Adolescent
- Adult
- Benin
- Child
- Child, Preschool
- Chromatography, Liquid
- Female
- Gene Expression Regulation
- Genes, Protozoan
- Humans
- Malaria, Cerebral/genetics
- Malaria, Cerebral/parasitology
- Mass Spectrometry
- Plasmodium falciparum/genetics
- Plasmodium falciparum/physiology
- Pregnancy
- Pregnancy Complications, Parasitic/genetics
- Pregnancy Complications, Parasitic/parasitology
- Protein Structure, Tertiary
- Proteomics
- Protozoan Proteins/chemistry
- Protozoan Proteins/genetics
- Protozoan Proteins/metabolism
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
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Affiliation(s)
- Gwladys I. Bertin
- Institut de Recherche pour le Développement (IRD), UMR216-Mère et enfant face aux infections tropicales, Paris, France
- PRES Paris Sorbonne Cité, Université Paris Descartes, Paris, France
| | - Thomas Lavstsen
- Centre for Medical Parasitology at Department of International Health, Immunology and Microbiology, University of Copenhagen and at Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - François Guillonneau
- PRES Paris Sorbonne Cité, Université Paris Descartes, Paris, France
- 3P5 proteomics facility, Université Paris Descartes, Paris, France
| | - Justin Doritchamou
- Institut de Recherche pour le Développement (IRD), UMR216-Mère et enfant face aux infections tropicales, Paris, France
- PRES Paris Sorbonne Cité, Université Paris Descartes, Paris, France
- Centre d’Étude et de Recherche sur le Paludisme Associé à la Grossesse et l′Enfance (CERPAGE), Cotonou, Bénin
| | - Christian W. Wang
- Centre for Medical Parasitology at Department of International Health, Immunology and Microbiology, University of Copenhagen and at Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Jakob S. Jespersen
- Centre for Medical Parasitology at Department of International Health, Immunology and Microbiology, University of Copenhagen and at Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Sem Ezimegnon
- Centre d’Étude et de Recherche sur le Paludisme Associé à la Grossesse et l′Enfance (CERPAGE), Cotonou, Bénin
| | - Nadine Fievet
- Institut de Recherche pour le Développement (IRD), UMR216-Mère et enfant face aux infections tropicales, Paris, France
- PRES Paris Sorbonne Cité, Université Paris Descartes, Paris, France
- Centre d’Étude et de Recherche sur le Paludisme Associé à la Grossesse et l′Enfance (CERPAGE), Cotonou, Bénin
| | - Maroufou J. Alao
- Paediatric Department, Mother and child hospital (HOMEL), Cotonou, Bénin
| | - Francis Lalya
- Paediatric Department, Centre National Hospitalo-Universitaire (CNHU), Cotonou, Bénin
| | - Achille Massougbodji
- Centre d’Étude et de Recherche sur le Paludisme Associé à la Grossesse et l′Enfance (CERPAGE), Cotonou, Bénin
| | - Nicaise Tuikue Ndam
- Institut de Recherche pour le Développement (IRD), UMR216-Mère et enfant face aux infections tropicales, Paris, France
- PRES Paris Sorbonne Cité, Université Paris Descartes, Paris, France
- Centre d’Étude et de Recherche sur le Paludisme Associé à la Grossesse et l′Enfance (CERPAGE), Cotonou, Bénin
| | - Thor G. Theander
- Centre for Medical Parasitology at Department of International Health, Immunology and Microbiology, University of Copenhagen and at Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Philippe Deloron
- Institut de Recherche pour le Développement (IRD), UMR216-Mère et enfant face aux infections tropicales, Paris, France
- PRES Paris Sorbonne Cité, Université Paris Descartes, Paris, France
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Moussiliou A, De Tove YSS, Doritchamou J, Luty AJF, Massougbodji A, Alifrangis M, Deloron P, Ndam NT. High rates of parasite recrudescence following intermittent preventive treatment with sulphadoxine-pyrimethamine during pregnancy in Benin. Malar J 2013; 12:195. [PMID: 23758883 PMCID: PMC3686599 DOI: 10.1186/1475-2875-12-195] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 06/04/2013] [Indexed: 11/10/2022] Open
Abstract
Background Despite widespread parasite resistance to sulphadoxine-pyrimethamine (SP) its use for intermittent preventative treatment during pregnancy remains the policy in Benin and throughout most of sub-Saharan Africa. Methods In a prospective study, 982 pregnant women were recruited in Benin and followed until delivery. The prevalence of point mutations in the pfdhfr and pfdhps genes associated with Plasmodium falciparum resistance to SP during consecutive antenatal visits was determined. Parasites clearance among women infected at SP intake was assessed by microscopy and PCR. Association between the persistence of parasites and malaria consequences, were investigated. Recurrent parasites were genotyped to identify recrudescences from re-infections. Results The prevalence of pfdhfr/pfdhps quadruple mutants (triple pfdhfr + single pfdhps) was consistently above 80% while quintuple and sextuple mutants remained low. Importantly the higly mutated parasites apparently never included the two key mutations, pfdhfr 164 L or pfdhps 540E. Based on PCR results, SP failed to clear existing parasitaemia in half (48%) of the women who were infected at IPTp schedule. The frequency of recrudescence reached 76% after the second dose. Women with persistent parasitaemia had an increased prevalence of anaemia (P = 0.03). Conclusion The data presented here, highlight the inability of SP to ensure optimal antiplasmodial protection in late pregnancy, and invite urgent consideration of an alternative drug or strategy.
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Alout H, Ndam NT, Sandeu MM, Djégbe I, Chandre F, Dabiré RK, Djogbénou LS, Corbel V, Cohuet A. Insecticide resistance alleles affect vector competence of Anopheles gambiae s.s. for Plasmodium falciparum field isolates. PLoS One 2013; 8:e63849. [PMID: 23704944 PMCID: PMC3660590 DOI: 10.1371/journal.pone.0063849] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 04/06/2013] [Indexed: 11/19/2022] Open
Abstract
The widespread insecticide resistance raises concerns for vector control implementation and sustainability particularly for the control of the main vector of human malaria, Anopheles gambiae sensu stricto. However, the extent to which insecticide resistance mechanisms interfere with the development of the malignant malaria parasite in its vector and their impact on overall malaria transmission remains unknown. We explore the impact of insecticide resistance on the outcome of Plasmodium falciparum infection in its natural vector using three An. gambiae strains sharing a common genetic background, one susceptible to insecticides and two resistant, one homozygous for the ace-1(R) mutation and one for the kdr mutation. Experimental infections of the three strains were conducted in parallel with field isolates of P. falciparum from Burkina Faso (West Africa) by direct membrane feeding assays. Both insecticide resistant mutations influence the outcome of malaria infection by increasing the prevalence of infection. In contrast, the kdr resistant allele is associated with reduced parasite burden in infected individuals at the oocyst stage, when compared to the susceptible strain, while the ace-1 (R) resistant allele showing no such association. Thus insecticide resistance, which is particularly problematic for malaria control efforts, impacts vector competence towards P. falciparum and probably parasite transmission through increased sporozoite prevalence in kdr resistant mosquitoes. These results are of great concern for the epidemiology of malaria considering the widespread pyrethroid resistance currently observed in Sub-Saharan Africa and the efforts deployed to control the disease.
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Affiliation(s)
- Haoues Alout
- Institut de recherche pour le développement (IRD), Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), UM1-UM2-CNRS 5290 IRD 224, Montpellier, France
- Institut de Recherche en Sciences de la Santé (IRSS), 01 BP 545 Bobo-Dioulasso 01, Burkina Faso
| | - Nicaise Tuikue Ndam
- Institut des Sciences Biomédicale et Appliquées, Cotonou, Bénin
- IRD, UMR 216, Mère et Enfant face aux Infections Tropicales, Université Paris Descartes, Paris, France
| | - Marcel Maurice Sandeu
- IRD, UMR 216, Mère et Enfant face aux Infections Tropicales, Université Paris Descartes, Paris, France
- Centre de Recherche Entomologique de Cotonou, Cotonou, Bénin
| | - Innocent Djégbe
- Centre de Recherche Entomologique de Cotonou, Cotonou, Bénin
| | - Fabrice Chandre
- Institut de recherche pour le développement (IRD), Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), UM1-UM2-CNRS 5290 IRD 224, Montpellier, France
| | - Roch Kounbobr Dabiré
- Institut de Recherche en Sciences de la Santé (IRSS), 01 BP 545 Bobo-Dioulasso 01, Burkina Faso
| | | | - Vincent Corbel
- Institut de recherche pour le développement (IRD), Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), UM1-UM2-CNRS 5290 IRD 224, Montpellier, France
- Department of Entomology, Faculty of Agriculture, Kasetsart University, Bangkok, Thailand
| | - Anna Cohuet
- Institut de recherche pour le développement (IRD), Maladies Infectieuses et Vecteurs, Ecologie, Génétique, Evolution et Contrôle (MIVEGEC), UM1-UM2-CNRS 5290 IRD 224, Montpellier, France
- Institut de Recherche en Sciences de la Santé (IRSS), 01 BP 545 Bobo-Dioulasso 01, Burkina Faso
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Ogouyèmi-Hounto A, Ndam NT, Kinde Gazard D, d'Almeida S, Koussihoude L, Ollo E, Azagnandji C, Bello M, Chippaux JP, Massougbodji A. Prevalence of the molecular marker of Plasmodium falciparum resistance to chloroquine and sulphadoxine/pyrimethamine in Benin seven years after the change of malaria treatment policy. Malar J 2013; 12:147. [PMID: 23634705 PMCID: PMC3651273 DOI: 10.1186/1475-2875-12-147] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 04/28/2013] [Indexed: 12/03/2022] Open
Abstract
Background In Benin, the National Malaria Control Programme (NMCP) changed the policy of malaria treatment in 2004 following increasing of failure rate of treatment with chloroquine (CQ) and sulphadoxine-pyrimethamine (SP). The objective of this study was to determinate the prevalence of Plasmodium falciparum molecular markers that are associated with resistance to CQ and SP in Benin seven years after the new policy was instituted. Methods The study was conducted in southern Benin, a region characterized by a perennial malaria transmission. Blood samples were collected in 2011 from children presenting with symptomatic and asymptomatic P. falciparum infections and living in the same area. The prevalence of critical point mutations in the genes of pfcrt (codon 76), pfmdr1 (codon 86), pfdhfr (codons, 51, 59 and 108) and pfdhps (codons 437, 540) was examined in parasite isolates by mutation-specific restriction enzyme digestion of nested PCR products. Results A high prevalence of parasites carrying point mutations in all studied targets was found: T76: 93.9% [89.8; 96.7], I51: 96.2% [92.7; 98.4], R59: 93, 9% [89.7; 96.7], N108: 97.6% [94.6; 99.2] and G437: 71.4% [64.8; 77.4]. No mutation was found at codon 540 of the pfdhps gene. The proportion of parasite isolates carrying triple mutation in the pfdhfr gene IRN (I51, R59 andN108) and quadruple mutation on the combination of pfdhfr/pfdhps IRNG (I51, R59, N108 and G437) was 91.5% [86.9; 94.9] and 65.7% [58.9; 72.1], respectively. Analysis of mutation in relation to the clinical status (symptomatic or asymptomatic) and according to age (younger or older than 10 years) showed similar very high frequencies in each category without significant difference between two groups. Conclusions These results suggest a persistence level of resistance of P. falciparum to CQ and SP, seven years after the recommendation of the change of malaria treatment policy in Benin. The distribution of mutations studied was neither related to age nor to clinical status.
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Affiliation(s)
- Aurore Ogouyèmi-Hounto
- Faculté des Sciences de la Santé, Laboratoire du centre de lutte intégrée contre le paludisme, Cotonou 01 BP188, Benin.
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