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Raballah E, Wilding K, Anyona SB, Munde EO, Hurwitz I, Onyango CO, Ayieko C, Lambert CG, Schneider KA, Seidenberg PD, Ouma C, McMahon BH, Cheng Q, Perkins DJ. Nonsynonymous amino acid changes in the α-chain of complement component 5 influence longitudinal susceptibility to Plasmodium falciparum infections and severe malarial anemia in kenyan children. Front Genet 2022; 13:977810. [PMID: 36186473 PMCID: PMC9515573 DOI: 10.3389/fgene.2022.977810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Severe malarial anemia (SMA; Hb < 5.0 g/dl) is a leading cause of childhood morbidity and mortality in holoendemic Plasmodium falciparum transmission regions such as western Kenya. Methods: We investigated the relationship between two novel complement component 5 (C5) missense mutations [rs17216529:C>T, p(Val145Ile) and rs17610:C>T, p(Ser1310Asn)] and longitudinal outcomes of malaria in a cohort of Kenyan children (under 60 mos, n = 1,546). Molecular modeling was used to investigate the impact of the amino acid transitions on the C5 protein structure. Results: Prediction of the wild-type and mutant C5 protein structures did not reveal major changes to the overall structure. However, based on the position of the variants, subtle differences could impact on the stability of C5b. The influence of the C5 genotypes/haplotypes on the number of malaria and SMA episodes over 36 months was determined by Poisson regression modeling. Genotypic analyses revealed that inheritance of the homozygous mutant (TT) for rs17216529:C>T enhanced the risk for both malaria (incidence rate ratio, IRR = 1.144, 95%CI: 1.059–1.236, p = 0.001) and SMA (IRR = 1.627, 95%CI: 1.201–2.204, p = 0.002). In the haplotypic model, carriers of TC had increased risk of malaria (IRR = 1.068, 95%CI: 1.017–1.122, p = 0.009), while carriers of both wild-type alleles (CC) were protected against SMA (IRR = 0.679, 95%CI: 0.542–0.850, p = 0.001). Conclusion: Collectively, these findings show that the selected C5 missense mutations influence the longitudinal risk of malaria and SMA in immune-naïve children exposed to holoendemic P. falciparum transmission through a mechanism that remains to be defined.
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Affiliation(s)
- Evans Raballah
- University of New Mexico-Kenya Global Health Programs, Kisumu, Kenya
- Department of Medical Laboratory Sciences, School of Public Health Biomedical Sciences and Technology, Masinde Muliro University of Science and Technology, Kakamega, Kenya
- *Correspondence: Evans Raballah,
| | - Kristen Wilding
- Theoretical Biology and Biophysics Group, Theoretical Division, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Samuel B. Anyona
- University of New Mexico-Kenya Global Health Programs, Kisumu, Kenya
- Department of Medical Biochemistry, School of Medicine, Maseno University, Maseno, Kenya
| | - Elly O. Munde
- University of New Mexico-Kenya Global Health Programs, Kisumu, Kenya
- Department of Clinical Medicine, School of Health Sciences, Kirinyaga University, Kerugoya, Kenya
| | - Ivy Hurwitz
- University of New Mexico, Center for Global Health, Department of Internal Medicine, Albuquerque, NM, United States
| | - Clinton O. Onyango
- University of New Mexico-Kenya Global Health Programs, Kisumu, Kenya
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno, Kenya
| | - Cyrus Ayieko
- Department of Zoology, Maseno University, Maseno, Kenya
| | - Christophe G. Lambert
- University of New Mexico, Center for Global Health, Department of Internal Medicine, Albuquerque, NM, United States
| | - Kristan A. Schneider
- Department of Applied Computer and Biosciences, University of Applied Sciences Mittweida, Mittweida, Germany
| | - Philip D. Seidenberg
- University of New Mexico, Department of Emergency Medicine, Albuquerque, NM, United States
| | - Collins Ouma
- University of New Mexico-Kenya Global Health Programs, Kisumu, Kenya
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno, Kenya
| | - Benjamin H. McMahon
- Theoretical Biology and Biophysics Group, Theoretical Division, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Qiuying Cheng
- University of New Mexico, Center for Global Health, Department of Internal Medicine, Albuquerque, NM, United States
| | - Douglas J. Perkins
- University of New Mexico-Kenya Global Health Programs, Kisumu, Kenya
- University of New Mexico, Center for Global Health, Department of Internal Medicine, Albuquerque, NM, United States
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Raballah E, Anyona SB, Cheng Q, Munde EO, Hurwitz IF, Onyango C, Ndege C, Hengartner NW, Pacheco MA, Escalante AA, Lambert CG, Ouma C, Obama HCJT, Scheider KA, Seidenberg PD, McMahon BH, Perkins DJ. Complement component 3 mutations alter the longitudinal risk of pediatric malaria and severe malarial anemia. Exp Biol Med (Maywood) 2021; 247:672-682. [PMID: 34842470 DOI: 10.1177/15353702211056272] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Severe malarial anemia (SMA) is a leading cause of childhood morbidity and mortality in holoendemic Plasmodium falciparum transmission regions. To gain enhanced understanding of predisposing factors for SMA, we explored the relationship between complement component 3 (C3) missense mutations [rs2230199 (2307C>G, Arg>Gly102) and rs11569534 (34420G>A, Gly>Asp1224)], malaria, and SMA in a cohort of children (n = 1617 children) over 36 months of follow-up. Variants were selected based on their ability to impart amino acid substitutions that can alter the structure and function of C3. The 2307C>G mutation results in a basic to a polar residue change (Arg to Gly) at position 102 (β-chain) in the macroglobulin-1 (MG1) domain, while 34420G>A elicits a polar to acidic residue change (Gly to Asp) at position 1224 (α-chain) in the thioester-containing domain. After adjusting for multiple comparisons, longitudinal analyses revealed that inheritance of the homozygous mutant (GG) at 2307 enhanced the risk of SMA (RR = 2.142, 95%CI: 1.229-3.735, P = 0.007). The haplotype containing both wild-type alleles (CG) decreased the incident risk ratio of both malaria (RR = 0.897, 95%CI: 0.828-0.972, P = 0.008) and SMA (RR = 0.617, 95%CI: 0.448-0.848, P = 0.003). Malaria incident risk ratio was also reduced in carriers of the GG (Gly102Gly1224) haplotype (RR = 0.941, 95%CI: 0.888-0.997, P = 0.040). Collectively, inheritance of the missense mutations in MG1 and thioester-containing domain influence the longitudinal risk of malaria and SMA in children exposed to intense Plasmodium falciparum transmission.
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Affiliation(s)
- Evans Raballah
- 1104University of New Mexico-Kenya Global Health Programs, Kisumu and Siaya 40100, Kenya.,Department of Medical Laboratory Sciences, 118970School of Public Health Biomedical Sciences and Technology, Masinde Muliro University of Science and Technology, 50100 Kakamega, Kenya
| | - Samuel B Anyona
- 1104University of New Mexico-Kenya Global Health Programs, Kisumu and Siaya 40100, Kenya.,Department of Medical Biochemistry, 118971School of Medicine, Maseno University, 40105 Maseno, Kenya
| | - Qiuying Cheng
- Center for Global Health, Department of Internal Medicine, 1104University of New Mexico, Albuquerque, 87131 NM, USA
| | - Elly O Munde
- 1104University of New Mexico-Kenya Global Health Programs, Kisumu and Siaya 40100, Kenya.,Department of Clinical Medicine, Kirinyaga University School of Health Sciences, Kerugoya 10300, Kenya
| | - Ivy-Foo Hurwitz
- Center for Global Health, Department of Internal Medicine, 1104University of New Mexico, Albuquerque, 87131 NM, USA
| | - Clinton Onyango
- 1104University of New Mexico-Kenya Global Health Programs, Kisumu and Siaya 40100, Kenya
| | - Caroline Ndege
- 1104University of New Mexico-Kenya Global Health Programs, Kisumu and Siaya 40100, Kenya
| | - Nicolas W Hengartner
- Theoretical Division, Theoretical Biology and Biophysics Group, Los Alamos National Laboratory, Los Alamos, 87544 NM, USA
| | - Maria Andreína Pacheco
- Biology Department/Institute of Genomics and Evolutionary Medicine (iGEM), Temple University, Philadelphia, PA 19122, USA
| | - Ananias A Escalante
- Biology Department/Institute of Genomics and Evolutionary Medicine (iGEM), Temple University, Philadelphia, PA 19122, USA
| | - Christophe G Lambert
- Center for Global Health, Department of Internal Medicine, 1104University of New Mexico, Albuquerque, 87131 NM, USA
| | - Collins Ouma
- 1104University of New Mexico-Kenya Global Health Programs, Kisumu and Siaya 40100, Kenya.,Department of Biomedical Sciences and Technology, 118971School of Public Health and Community Development, Maseno University, 40105 Maseno, Kenya
| | - Henri C Jr T Obama
- Department of Applied Computer and Biosciences, University of Applied Sciences Mittweida, Technikumplatz, Mittweida 09648, Germany
| | - Kristan A Scheider
- Department of Applied Computer and Biosciences, University of Applied Sciences Mittweida, Technikumplatz, Mittweida 09648, Germany
| | - Philip D Seidenberg
- Department of Emergency Medicine, 1104University of New Mexico, Albuquerque, NM 87131, USA
| | - Benjamin H McMahon
- Theoretical Division, Theoretical Biology and Biophysics Group, Los Alamos National Laboratory, Los Alamos, 87544 NM, USA
| | - Douglas J Perkins
- 1104University of New Mexico-Kenya Global Health Programs, Kisumu and Siaya 40100, Kenya.,Center for Global Health, Department of Internal Medicine, 1104University of New Mexico, Albuquerque, 87131 NM, USA
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Anyona SB, Raballah E, Cheng Q, Hurwitz I, Ndege C, Munde E, Otieno W, Seidenberg PD, Schneider KA, Lambert CG, McMahon BH, Ouma C, Perkins DJ. Differential Gene Expression in Host Ubiquitination Processes in Childhood Malarial Anemia. Front Genet 2021; 12:764759. [PMID: 34880904 PMCID: PMC8646022 DOI: 10.3389/fgene.2021.764759] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Malaria remains one of the leading global causes of childhood morbidity and mortality. In holoendemic Plasmodium falciparum transmission regions, such as western Kenya, severe malarial anemia [SMA, hemoglobin (Hb) < 6.0 g/dl] is the primary form of severe disease. Ubiquitination is essential for regulating intracellular processes involved in innate and adaptive immunity. Although dysregulation in ubiquitin molecular processes is central to the pathogenesis of multiple human diseases, the expression patterns of ubiquitination genes in SMA remain unexplored. Methods: To examine the role of the ubiquitination processes in pathogenesis of SMA, differential gene expression profiles were determined in Kenyan children (n = 44, aged <48 mos) with either mild malarial anemia (MlMA; Hb ≥9.0 g/dl; n = 23) or SMA (Hb <6.0 g/dl; n = 21) using the Qiagen Human Ubiquitination Pathway RT2 Profiler PCR Array containing a set of 84 human ubiquitination genes. Results: In children with SMA, 10 genes were down-regulated (BRCC3, FBXO3, MARCH5, RFWD2, SMURF2, UBA6, UBE2A, UBE2D1, UBE2L3, UBR1), and five genes were up-regulated (MDM2, PARK2, STUB1, UBE2E3, UBE2M). Enrichment analyses revealed Ubiquitin-Proteasomal Proteolysis as the top disrupted process, along with altered sub-networks involved in proteasomal, protein, and ubiquitin-dependent catabolic processes. Conclusion: Collectively, these novel results show that protein coding genes of the ubiquitination processes are involved in the pathogenesis of SMA.
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Affiliation(s)
- Samuel B. Anyona
- Department of Medical Biochemistry, School of Medicine, Maseno University, Maseno, Kenya,University of New Mexico-Kenya Global Health Programs, Kisumu and Siaya, Kenya,*Correspondence: Samuel B. Anyona,
| | - Evans Raballah
- University of New Mexico-Kenya Global Health Programs, Kisumu and Siaya, Kenya,Department of Medical Laboratory Sciences, School of Public Health Biomedical Sciences and Technology, Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | - Qiuying Cheng
- Center for Global Health, University of New Mexico, Albuquerque, NM, United States
| | - Ivy Hurwitz
- Center for Global Health, University of New Mexico, Albuquerque, NM, United States
| | - Caroline Ndege
- University of New Mexico-Kenya Global Health Programs, Kisumu and Siaya, Kenya
| | - Elly Munde
- University of New Mexico-Kenya Global Health Programs, Kisumu and Siaya, Kenya,Department of Clinical Medicine, School of Health Science, Kirinyaga University, Kerugoya, Kenya
| | - Walter Otieno
- Department of Pediatrics and Child Health, School of Medicine, Maseno University, Maseno, Kenya
| | - Philip D. Seidenberg
- Department of Emergency Medicine, University of New Mexico, Albuquerque, NM, United States
| | - Kristan A. Schneider
- Department Applied Computer and Bio-Sciences, University of Applied Sciences Mittweida, Mittweida, Germany
| | | | - Benjamin H. McMahon
- Theoretical Biology and Biophysics Group, Theoretical Division, Los Alamos National Laboratory, Los Alamos, NM, United States
| | - Collins Ouma
- University of New Mexico-Kenya Global Health Programs, Kisumu and Siaya, Kenya,Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno, Kenya
| | - Douglas J. Perkins
- University of New Mexico-Kenya Global Health Programs, Kisumu and Siaya, Kenya,Center for Global Health, University of New Mexico, Albuquerque, NM, United States
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Seidenberg PD, Hamer DH, Iyer H, Pilingana P, Siazeele K, Hamainza B, MacLeod WB, Yeboah-Antwi K. Impact of integrated community case management on health-seeking behavior in rural Zambia. Am J Trop Med Hyg 2015; 87:105-110. [PMID: 23136285 PMCID: PMC3748509 DOI: 10.4269/ajtmh.2012.11-0799] [Citation(s) in RCA: 42] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Provision of integrated community case management (iCCM) for common childhood illnesses by community health workers (CHWs) represents an increasingly common strategy for reducing childhood morbidity and mortality. We sought to assess how iCCM availability influenced care-seeking behavior. In areas where two different iCCM approaches were implemented, we conducted baseline and post-study household surveys on healthcare-seeking practices among women who were caring for children ≤ 5 years in their homes. For children presenting with fever, there was an increase in care sought from CHWs and a decrease in care sought at formal health centers between baseline and post-study periods. For children with fast/difficulty breathing, an increase in care sought from CHWs was only noted in areas where CHWs were trained and supplied with amoxicillin to treat non-severe pneumonia. These findings suggest that iCCM access influences local care-seeking practices and reduces workload at primary health centers.
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Affiliation(s)
| | - Davidson H. Hamer
- *Address correspondence to Davidson H. Hamer, Center for Global Health and Development, Crosstown 3rd Floor, 801 Massachusetts Avenue, Boston, MA 02118. E-mail:
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