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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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Brisset J, Angendu Baki K, Watier L, Kinkpé E, Bailly J, Ayédadjou L, Alao MJ, Dossou-Dagba I, Bertin GI, Cot M, Boumédiène F, Ajzenberg D, Aubouy A, Houzé S, Faucher JF, Affolabi D, Argy N, Biokou B, Degbelo JE, Calavi, Benin, Deloron P, Dramane L, Fraering J, Guillochon E, Jafari-Guemouri S, Houzé L, Joste V, Kamaliddin C, Labrunie A, Ladipo Y, Lathiere T, Massougbodji A, Mowendabeka A, Papin J, Pipy B, Preux PM, Raymondeau M, Royo J, Sossou D, Techer B, Vianou B. Non-traumatic coma in young children in Benin: are viral and bacterial infections gaining ground on cerebral malaria? Infect Dis Poverty 2022; 11:29. [PMID: 35287726 PMCID: PMC8919613 DOI: 10.1186/s40249-022-00956-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/01/2022] [Indexed: 11/24/2022] Open
Abstract
Background While malaria morbidity and mortality have declined since 2000, viral central nervous system infections appear to be an important, underestimated cause of coma in malaria-endemic Eastern Africa. We aimed to describe the etiology of non-traumatic comas in young children in Benin, as well as their management and early outcomes, and to identify factors associated with death. Methods From March to November 2018, we enrolled all HIV-negative children aged between 2 and 6 years, with a Blantyre Coma Score ≤ 2, in this prospective observational study. Children were screened for malaria severity signs and assessed using a systematic diagnostic protocol, including blood cultures, malaria diagnostics, and cerebrospinal fluid analysis using multiplex PCR. To determine factors associated with death, univariate and multivariate analyses were performed. Results From 3244 admissions, 84 children were included: malaria was diagnosed in 78, eight of whom had a viral or bacterial co-infection. Six children had a non-malarial infection or no identified cause. The mortality rate was 29.8% (25/84), with 20 children dying in the first 24 h. Co-infected children appeared to have a poorer prognosis. Of the 76 children who consulted a healthcare professional before admission, only 5 were prescribed adequate antimalarial oral therapy. Predictors of early death were jaundice or increased bilirubin [odd ratio (OR)= 8.6; 95% confidential interval (CI): 2.03–36.1] and lactate > 5 mmol/L (OR = 5.1; 95% CI: 1.49–17.30). Antibiotic use before admission (OR = 0.1; 95% CI: 0.02–0.85) and vaccination against yellow fever (OR = 0.2, 95% CI: 0.05–0.79) protected against mortality. Conclusions Infections were found in all children who died, and cerebral malaria was by far the most common cause of non-traumatic coma. Missed opportunities to receive early effective antimalarial treatment were common. Other central nervous system infections must be considered in their management. Some factors that proved to be protective against early death were unexpected. Supplementary Information The online version contains supplementary material available at 10.1186/s40249-022-00956-2.
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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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Moussiliou A, Turner L, Cottrell G, Doritchamou J, Gbédandé K, Fievet N, Luty AJF, Massougbodji A, Theander TG, Deloron P, Lavstsen T, Tuikue Ndam N. Dynamics of PfEMP1 Antibody Profile From Birth to 12 Months of Age in Beninese Infants. J Infect Dis 2021; 221:2010-2017. [PMID: 32002541 DOI: 10.1093/infdis/jiaa043] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/24/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Plasmodium falciparum-infected erythrocytes bind to specific endothelial cell receptors via members of the PfEMP1 family exported onto the erythrocyte surface. These interactions are mediated by different types of cysteine-rich interdomain region (CIDR) domains found in the N-terminal region of all PfEMP1. CIDRα1 domains bind endothelial protein C receptor (EPCR), CIDRα2-6 domains bind CD36, whereas the receptor specificity of CIDRβ/γ/δ domains is unknown. METHODS In this study, we investigated the level of immunoglobulin (Ig)G targeting the different types of PfEMP1 CIDR during the first year of life. We used plasma collected longitudinally from children of pregnant women who had been followed closely through pregnancy. RESULTS Antibodies to CIDRα1 domains were more frequent in cord blood compared with antibodies to CIDRα2-6 domains. Higher IgG levels to EPCR-binding CIDRα1 variants positively correlated with the timing of first infections. Antibodies to all PfEMP1 types declined at similar rates to the point of disappearance over the first 6 months of life. At 12 months, children had acquired antibody to all types of CIDR domains, mostly in children with documented P falciparum infections. CONCLUSIONS These observations agree with the notion that the timing and phenotype of first P falciparum infections in life are influenced by the immune status of the mother.
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Affiliation(s)
| | - L Turner
- Centre for Medical Parasitology at Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - G Cottrell
- Université de Paris, MERIT, IRD, Paris, France
| | - J Doritchamou
- Institut de Recherche Clinique du Bénin, Université d'Abomey-Calavi, Cotonou, Bénin
| | - K Gbédandé
- Institut de Recherche Clinique du Bénin, Université d'Abomey-Calavi, Cotonou, Bénin
| | - N Fievet
- Université de Paris, MERIT, IRD, Paris, France
| | - A J F Luty
- Université de Paris, MERIT, IRD, Paris, France
| | - A Massougbodji
- Institut de Recherche Clinique du Bénin, Université d'Abomey-Calavi, Cotonou, Bénin
| | - T G Theander
- Centre for Medical Parasitology at Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - P Deloron
- Université de Paris, MERIT, IRD, Paris, France
| | - T Lavstsen
- Centre for Medical Parasitology at Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
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Kamaliddin C, Guillochon E, Salnot V, Rombaut D, Huguet S, Guillonneau F, Houzé S, Cot M, Deloron P, Argy N, Bertin GI. Comprehensive Analysis of Transcript and Protein Relative Abundance During Blood Stages of Plasmodium falciparum Infection. J Proteome Res 2021; 20:1206-1216. [PMID: 33475364 DOI: 10.1021/acs.jproteome.0c00496] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Plasmodium falciparum is the main causative agent of human malaria. During the intraerythrocytic development cycle, the P. falciparum morphology changes dramatically from circulating young rings to sequestered mature trophozoites and schizonts. Sequestered forms contribute to the pathophysiology of severe malaria as the infected erythrocytes obstruct the microvascular flow in deep organs and induce local inflammation. However, the sequestration mechanism limits the access to the corresponding parasitic form in the clinical samples from patients infected with P. falciparum. To complement this deficiency, we aimed to evaluate the relevance of mRNA study as a proxy of protein expression in sequestered parasites. To do so, we conducted a proteotranscriptomic analysis using five independent P. falciparum laboratory strain samples. RNA sequencing was performed, and the mRNA expression level was assessed on circulating ring-stage parasites. The level of protein expression were measured by LC-MS/MS on the corresponding sequestered mature forms after 18-24 h of maturation. Overall, our results showed a strong transcriptome/transcriptome and a very strong proteome/proteome correlation between samples. Moreover, positive correlations of mRNA and protein expression levels were found between ring-stage transcriptomes and mature form proteomes. However, twice more transcripts were identified at the ring stage than proteins at the mature trophozoite stage. A high level of transcript expression did not guarantee the detection of the corresponding protein. Finally, we pointed out discrepancies at the individual gene level. Taken together, our results show that transcript and protein expressions are overall correlated. However, mRNA abundance is not a perfect proxy of protein expression at the individual level. Importantly, our study shows limitations of the "blind" use of RNA-seq and the importance of multiomics approaches for P. falciparum blood stage study in clinical samples.
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Affiliation(s)
- Claire Kamaliddin
- Université de Paris UMR261-MERIT Faculté de Pharmacie, 4 Ave. de l'observatoire, Île-de-France, FR 75006 Paris, France
| | - Emilie Guillochon
- Université de Paris UMR261-MERIT Faculté de Pharmacie, 4 Ave. de l'observatoire, Île-de-France, FR 75006 Paris, France
| | - Virginie Salnot
- Université de Paris, 3p5-Proteom'IC Platform Institut Cochin, INSERM, U1016, CNRS, UMR8104, Île-de-France, FR 75006 Paris, France
| | - David Rombaut
- Université de Paris, 3p5-Proteom'IC Platform Institut Cochin, INSERM, U1016, CNRS, UMR8104, Île-de-France, FR 75006 Paris, France
| | - Stéphanie Huguet
- Université Paris-Saclay, CNRS, INRAE, Université Evry, Institute of Plant Sciences Paris-Saclay (IPS2), 91405 Orsay, France.,Université de Paris, CNRS, INRAE, Institute of Plant Sciences Paris-Saclay (IPS2), 91405 Orsay, France
| | - François Guillonneau
- Université de Paris, 3p5-Proteom'IC Platform Institut Cochin, INSERM, U1016, CNRS, UMR8104, Île-de-France, FR 75006 Paris, France
| | - Sandrine Houzé
- Université de Paris UMR261-MERIT Faculté de Pharmacie, 4 Ave. de l'observatoire, Île-de-France, FR 75006 Paris, France.,Centre National de Référence pour le Paludisme, Bichat-Claude Bernard Hospital, 75018 Paris, France.,Parasitology Laboratory, Bichat-Claude Bernard Hospital, 75018 Paris, France
| | - Michel Cot
- Université de Paris UMR261-MERIT Faculté de Pharmacie, 4 Ave. de l'observatoire, Île-de-France, FR 75006 Paris, France
| | - Philippe Deloron
- Université de Paris UMR261-MERIT Faculté de Pharmacie, 4 Ave. de l'observatoire, Île-de-France, FR 75006 Paris, France
| | - Nicolas Argy
- Université de Paris UMR261-MERIT Faculté de Pharmacie, 4 Ave. de l'observatoire, Île-de-France, FR 75006 Paris, France.,Centre National de Référence pour le Paludisme, Bichat-Claude Bernard Hospital, 75018 Paris, France.,Parasitology Laboratory, Bichat-Claude Bernard Hospital, 75018 Paris, France
| | - Gwladys I Bertin
- Université de Paris UMR261-MERIT Faculté de Pharmacie, 4 Ave. de l'observatoire, Île-de-France, FR 75006 Paris, France
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7
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Mordmüller B, Sulyok M, Egger-Adam D, Resende M, de Jongh WA, Jensen MH, Smedegaard HH, Ditlev SB, Soegaard M, Poulsen L, Dyring C, Calle CL, Knoblich A, Ibáñez J, Esen M, Deloron P, Ndam N, Issifou S, Houard S, Howard RF, Reed SG, Leroy O, Luty AJF, Theander TG, Kremsner PG, Salanti A, Nielsen MA. First-in-human, Randomized, Double-blind Clinical Trial of Differentially Adjuvanted PAMVAC, A Vaccine Candidate to Prevent Pregnancy-associated Malaria. Clin Infect Dis 2020; 69:1509-1516. [PMID: 30629148 PMCID: PMC6792113 DOI: 10.1093/cid/ciy1140] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [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: 08/17/2018] [Accepted: 01/03/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Malaria in pregnancy has major impacts on mother and child health. To complement existing interventions, such as intermittent preventive treatment and use of impregnated bed nets, we developed a malaria vaccine candidate with the aim of reducing sequestration of asexual "blood-stage" parasites in the placenta, the major virulence mechanism. METHODS The vaccine candidate PAMVAC is based on a recombinant fragment of VAR2CSA, the Plasmodium falciparum protein responsible for binding to the placenta via chondroitin sulfate A (CSA). Healthy, adult malaria-naive volunteers were immunized with 3 intramuscular injections of 20 μg (n = 9) or 50 μg (n = 27) PAMVAC, adjuvanted with Alhydrogel or glucopyranosyl lipid adjuvant in stable emulsion (GLA-SE) or in a liposomal formulation with QS21 (GLA-LSQ). Allocation was random and double blind. The vaccine was given every 4 weeks. Volunteers were observed for 6 months following last immunization. RESULTS All PAMVAC formulations were safe and well tolerated. A total of 262 adverse events (AEs) occurred, 94 (10 grade 2 and 2 grade 3) at least possibly related to the vaccine. No serious AEs occurred. Distribution and severity of AEs were similar in all arms. PAMVAC was immunogenic in all participants. PAMVAC-specific antibody levels were highest with PAMVAC-GLA-SE. The antibodies inhibited binding of VAR2CSA expressing P. falciparum-infected erythrocytes to CSA in a standardized functional assay. CONCLUSIONS PAMVAC formulated with Alhydrogel or GLA-based adjuvants was safe, well tolerated, and induced functionally active antibodies. Next, PAMVAC will be assessed in women before first pregnancies in an endemic area. CLINICAL TRIALS REGISTRATION EudraCT 2015-001827-21; ClinicalTrials.gov NCT02647489.
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Affiliation(s)
- Benjamin Mordmüller
- Institut für Tropenmedizin, Universitätsklinikum Tübingen and Deutsches Zentrum für Infektionsforschung, Germany.,Centre de Recherches Médicales de Lambaréné, Gabon
| | - Mihály Sulyok
- Institut für Tropenmedizin, Universitätsklinikum Tübingen and Deutsches Zentrum für Infektionsforschung, Germany
| | - Diane Egger-Adam
- Institut für Tropenmedizin, Universitätsklinikum Tübingen and Deutsches Zentrum für Infektionsforschung, Germany
| | - Mafalda Resende
- Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital
| | | | - Mette H Jensen
- Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital
| | - Helle Holm Smedegaard
- Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital
| | - Sisse B Ditlev
- Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital
| | | | | | | | - Carlos Lamsfus Calle
- Institut für Tropenmedizin, Universitätsklinikum Tübingen and Deutsches Zentrum für Infektionsforschung, Germany
| | - Annette Knoblich
- Institut für Tropenmedizin, Universitätsklinikum Tübingen and Deutsches Zentrum für Infektionsforschung, Germany
| | - Javier Ibáñez
- Institut für Tropenmedizin, Universitätsklinikum Tübingen and Deutsches Zentrum für Infektionsforschung, Germany
| | - Meral Esen
- Institut für Tropenmedizin, Universitätsklinikum Tübingen and Deutsches Zentrum für Infektionsforschung, Germany.,Centre de Recherches Médicales de Lambaréné, Gabon
| | - Philippe Deloron
- Mère et Enfant face aux Infections Tropicales, Institut de Recherche pour le Développement, Université Paris 5, Sorbonne Paris Cité, France
| | - Nicaise Ndam
- Mère et Enfant face aux Infections Tropicales, Institut de Recherche pour le Développement, Université Paris 5, Sorbonne Paris Cité, France
| | - Saadou Issifou
- Fondation pour la Recherche Scientifique and Institut de Recherche Clinique du Bénin, Cotonou
| | | | | | - Steven G Reed
- Infectious Disease Research Institute, Seattle, Washington
| | - Odile Leroy
- European Vaccine Initiative, Heidelberg, Germany
| | - Adrian J F Luty
- Mère et Enfant face aux Infections Tropicales, Institut de Recherche pour le Développement, Université Paris 5, Sorbonne Paris Cité, France
| | - Thor G Theander
- Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital
| | - Peter G Kremsner
- Institut für Tropenmedizin, Universitätsklinikum Tübingen and Deutsches Zentrum für Infektionsforschung, Germany.,Centre de Recherches Médicales de Lambaréné, Gabon
| | - Ali Salanti
- Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital
| | - Morten A Nielsen
- Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital
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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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9
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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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10
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Kamaliddin C, Rombaut D, Guillochon E, Royo J, Ezinmegnon S, Agbota G, Huguet S, Guemouri S, Peirera C, Coppée R, Broussard C, Alao JM, Aubouy A, Guillonneau F, Deloron P, Bertin GI. From genomic to LC-MS/MS evidence: Analysis of PfEMP1 in Benin malaria cases. PLoS One 2019; 14:e0218012. [PMID: 31251748 PMCID: PMC6599223 DOI: 10.1371/journal.pone.0218012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 05/23/2019] [Indexed: 11/18/2022] Open
Abstract
Background PfEMP1 is the major protein from parasitic origin involved in the pathophysiology of severe malaria, and PfEMP1 domain subtypes are associated with the infection outcome. In addition, PfEMP1 variability is endless and current publicly available protein repositories do not reflect the high diversity of the sequences of PfEMP1 proteins. The identification of PfEMP1 protein sequences expressed with samples remains challenging. The aim of our study is to identify the different PfEMP1 proteins variants expressed within patient samples, and therefore identify PfEMP1 proteins domains expressed by patients presenting uncomplicated malaria or severe malaria in malaria endemic setting in Cotonou, Benin. Methods We performed a multi-omic approach to decipher PfEMP1 expression at the patient’s level in different clinical settings. Using a combination of whole genome sequencing approach and RNA sequencing, we were able to identify new PfEMP1 sequences and created a new custom protein database. This database was used for protein identification in mass spectrometry analysis. Results The differential expression analysis of RNAsequencing data shows an increased expression of the var domains transcripts DBLα1.7, DBLα1.1, DBLα2 and DBLβ12 in samples from patients suffering from Cerebral Malaria compared to Uncomplicated Malaria. Our approach allowed us to attribute PfEMP1 sequences to each sample and identify new peptides associated to PfEMP1 proteins in mass spectrometry. Conclusion We highlighted the diversity of the PfEMP1 sequences from field sample compared to reference sequences repositories and confirmed the validity of our approach. These findings should contribute to further vaccine development strategies based on PfEMP1 proteins.
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Affiliation(s)
| | - David Rombaut
- 3p5 Proteomic Facility, Université de Paris, Paris, France
| | | | - Jade Royo
- UMR 152 – PHARMADEV, IRD, Paul Sabatier Toulouse III University, Toulouse, France
| | - Sem Ezinmegnon
- UMR 261 – MERIT, IRD, Université de Paris, Paris, France
- Centre pour la Recherche et l’Etude du paludisme associé à la grossesse et à l’enfance, Cotonou, Bénin
| | - Gino Agbota
- UMR 261 – MERIT, IRD, Université de Paris, Paris, France
- Centre pour la Recherche et l’Etude du paludisme associé à la grossesse et à l’enfance, Cotonou, Bénin
| | - Stéphanie Huguet
- Institute of Plant Sciences Paris-Saclay (IPS2), CNRS, INRA, Université Paris-Sud, Université d’Evry, Université Paris-Saclay, Gif sur Yvette, France
- Institute of Plant Sciences Paris-Saclay (IPS2), CNRS, INRA Université Paris-Diderot, Sorbonne Paris-Cité, Gif sur Yvette, France
| | - Sayeh Guemouri
- UMR 261 – MERIT, IRD, Université de Paris, Paris, France
| | - Céline Peirera
- UMR 261 – MERIT, IRD, Université de Paris, Paris, France
| | - Romain Coppée
- UMR 261 – MERIT, IRD, Université de Paris, Paris, France
| | | | | | - Agnès Aubouy
- UMR 152 – PHARMADEV, IRD, Paul Sabatier Toulouse III University, Toulouse, France
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11
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Mowendabeka A, Ayedadjou L, Kinkpé E, Bailly J, Alao J, Deloron P, Houzé S, Faucher J. Caractérisation des liquides cérébro-spinaux dans les comas pédiatriques non-traumatiques en zone d’endémie palustre. Med Mal Infect 2019. [DOI: 10.1016/j.medmal.2019.04.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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12
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Joste V, Maurice L, Bertin GI, Aubouy A, Boumédiène F, Houzé S, Ajzenberg D, Argy N, Massougbodji A, Dossou-Dagba I, Alao MJ, Cot M, Deloron P, Faucher JF. Identification of Plasmodium falciparum and host factors associated with cerebral malaria: description of the protocol for a prospective, case-control study in Benin (NeuroCM). BMJ Open 2019; 9:e027378. [PMID: 31142528 PMCID: PMC6549734 DOI: 10.1136/bmjopen-2018-027378] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION In 2016, an estimated 216 million cases and 445 000 deaths of malaria occurred worldwide, in 91 countries. In Benin, malaria causes 26.8% of consultation and hospitalisation motif in the general population and 20.9% in children under 5 years old.The goal of the NeuroCM project is to identify the causative factors of neuroinflammation in the context of cerebral malaria. There are currently very few systematic data from West Africa on the aetiologies and management of non-malarial non-traumatic coma in small children, and NeuroCM will help to fill this gap. We postulate that an accurate understanding of molecular and cellular mechanisms involved in neuroinflammation may help to define efficient strategies to prevent and manage cerebral malaria. METHODS AND ANALYSIS This is a prospective, case-control study comparing cerebral malaria to uncomplicated malaria and non-malarial non-traumatic coma. This study takes place in Benin, precisely in Cotonou for children with coma and in Sô-Ava district for children with uncomplicated malaria. We aim to include 300 children aged between 24 and 71 months and divided in three different clinical groups during 12 months (from December 2017 to November 2018) with a 21 to 28 days follow-up for coma. Study data, including clinical, biological and research results will be collected and managed using CSOnline-Ennov Clinical. ETHICS AND DISSEMINATION Ethics approval for the NeuroCM study has been obtained from Comité National d'Ethique pour la Recherche en santé of Benin (n°67/MS/DC/SGM/DRFMT/CNERS/SA; 10/17/2017). NeuroCM study has also been approved by Comité consultatif de déontologie et d'éthique of Institut de Recherche pour le Développement (IRD; 10/24/2017). The study results will be disseminated through the direct consultations with the WHO's Multilateral Initiative on Malaria (TDR-MIM) and Roll Back Malaria programme, through scientific meetings and peer-reviewed publications in scientific or medical journals, and through guidelines and booklets.
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Affiliation(s)
| | - Laurine Maurice
- MERIT, Sorbonne Paris Cité, IRD, 75006, Paris, France
- PHARMADEV, Université de Toulouse, IRD, UPS, France, Toulouse, France
| | | | - Agnès Aubouy
- PHARMADEV, Université de Toulouse, IRD, UPS, France, Toulouse, France
| | | | - Sandrine Houzé
- MERIT, Sorbonne Paris Cité, IRD, 75006, Paris, France
- Parasitology Laboratory, Hopital Bichat - Claude-Bernard, Paris, France
| | | | - Nicolas Argy
- MERIT, Sorbonne Paris Cité, IRD, 75006, Paris, France
- Parasitology Laboratory, Hopital Bichat - Claude-Bernard, Paris, France
| | | | | | - Maroufou Jules Alao
- Paediatric Department, Mother and Child University and Hospital Center (CHU-MEL), Cotonou, Benin
| | - Michel Cot
- MERIT, Sorbonne Paris Cité, IRD, 75006, Paris, France
| | | | - Jean-François Faucher
- Tropical Neuroepidemiology, INSERM UMR 1094, Limoges, France
- Infectious diseases and tropical medicine department, Limoges University Hospital, Limoges, France
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13
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Schmiegelow C, Matondo S, Minja DTR, Resende M, Pehrson C, Nielsen BB, Olomi R, Nielsen MA, Deloron P, Salanti A, Lusingu J, Theander TG. Plasmodium falciparum Infection Early in Pregnancy has Profound Consequences for Fetal Growth. J Infect Dis 2019; 216:1601-1610. [PMID: 29029247 DOI: 10.1093/infdis/jix530] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 08/17/2017] [Accepted: 09/27/2017] [Indexed: 11/14/2022] Open
Abstract
Malaria during pregnancy constitutes a large health problem in areas of endemicity. The World Health Organization recommends that interventions are initiated at the first antenatal visit, and these improve pregnancy outcomes. This study evaluated fetal growth by ultrasonography and birth outcomes in women who were infected prior to the first antenatal visit (gestational age, <120 days) and not later in pregnancy. Compared with uninfected controls, women with early Plasmodium falciparum exposure had retarded intrauterine growth between gestational ages of 212 and 253 days (difference between means, 107 g [95% confidence interval {CI}, 26-188]; P = .0099) and a shorter pregnancy duration (difference between means, 6.6 days [95% CI, 1.0-112.5]; P = .0087). The birth weight (difference between means, 221 g [95% CI, 6-436]; P = .044) and the placental weight (difference between means, 84 g [95% CI, 18-150]; P = .013) at term were also reduced. The study suggests that early exposure to P. falciparum, which is not targeted for prevention by current control strategies, has a profound impact on fetal growth, pregnancy duration, and placental weight at term.
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Affiliation(s)
- Christentze Schmiegelow
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital, Denmark
| | - Sungwa Matondo
- Kilimanjaro Christian Medical University College, Moshi, Tanzania.,Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Daniel T R Minja
- National Institute for Medical Research, Tanga Medical Research Center, Tanzania
| | - Mafalda Resende
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital, Denmark
| | - Caroline Pehrson
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital, Denmark
| | | | - Raimos Olomi
- Kilimanjaro Christian Medical University College, Moshi, Tanzania.,Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Morten A Nielsen
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital, Denmark
| | - Philippe Deloron
- Institut de Recherche pour le Développement, UMR 216, MERIT, Sorbonne Paris Cité, Faculté de pharmacie, Paris, France
| | - Ali Salanti
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital, Denmark
| | - John Lusingu
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital, Denmark.,National Institute for Medical Research, Tanga Medical Research Center, Tanzania
| | - Thor G Theander
- Center for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital, Denmark
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14
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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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15
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Brembilla A, Faucher JF, Garcia A, Koura KG, Deloron P, Parmentier AL, Pierrat C, Cottrell G, Mauny F. Determinants of primary healthcare seeking behaviours for children during the first 18 months of life in Benin. Int Health 2018; 10:237-245. [PMID: 29659852 DOI: 10.1093/inthealth/ihy020] [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] [Received: 10/27/2017] [Accepted: 02/21/2018] [Indexed: 11/13/2022] Open
Abstract
Background Primary healthcare is a key element of management of childhood illness in Africa. The objectives were to identify primary care seeking determinants among infants and young children up to 18 mo in a birth cohort from Benin. Methods From 2007 to 2009 in Benin, a birth cohort was followed until the age of 18 mo in three health centres. Multilevel Poisson regression models were fitted to identify the factors related to the monthly number of consultations. Maternal and newborn characteristics and infant general health parameters were considered. Results A total of 566 children were followed. On average, 0.46 consultations per month per child were recorded. The number of consultations was significantly lower after the first 6 mo of life (p<0.001). A distance >1000 m was associated with fewer consultations (p=0.01). Primiparity was significantly associated with higher care seeking (relative risk 1.17 [95% CI 1.05 to 1.30], p<0.01). No child characteristics at birth were significantly associated with the number of consultations (all p>0.16). Conclusions Development of health structures and improvement of access remain important goals for strengthening of the primary care health system. Studying factors of care seeking behaviour, like parity, can help to identify women more prone to seek care for their child during the first year of life.
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Affiliation(s)
- A Brembilla
- Laboratoire Chrono-Environnement UMR CNRS 6249, Université Bourgogne Franche-Comté, 16 Route de Gray, Besançon, France.,Centre de Méthodologie Clinique, Centre Hospitalier Universitaire de Besançon, 2 Place Saint-Jacques, Besançon Cedex, France
| | - J-F Faucher
- MERIT IRD, Université Paris 5, Sorbonne Paris Cité, Faculté de pharmacie, 4 Avenue de l'Observatoire, Paris, France.,Service des maladies infectieuses et tropicales, Centre Hospitalier Universitaire de Limoges, Hôpital Dupuytren, 2 Avenue Martin Luther King, Limoges Cedex, France
| | - A Garcia
- MERIT IRD, Université Paris 5, Sorbonne Paris Cité, Faculté de pharmacie, 4 Avenue de l'Observatoire, Paris, France
| | - K G Koura
- MERIT IRD, Université Paris 5, Sorbonne Paris Cité, Faculté de pharmacie, 4 Avenue de l'Observatoire, Paris, France.,Union Internationale Contre la Tuberculose et les Maladies Respiratoires, 68 Boulevard Saint Michel, Paris, France
| | - P Deloron
- MERIT IRD, Université Paris 5, Sorbonne Paris Cité, Faculté de pharmacie, 4 Avenue de l'Observatoire, Paris, France
| | - A-L Parmentier
- Laboratoire Chrono-Environnement UMR CNRS 6249, Université Bourgogne Franche-Comté, 16 Route de Gray, Besançon, France.,Centre de Méthodologie Clinique, Centre Hospitalier Universitaire de Besançon, 2 Place Saint-Jacques, Besançon Cedex, France
| | - C Pierrat
- MERIT IRD, Université Paris 5, Sorbonne Paris Cité, Faculté de pharmacie, 4 Avenue de l'Observatoire, Paris, France
| | - G Cottrell
- MERIT IRD, Université Paris 5, Sorbonne Paris Cité, Faculté de pharmacie, 4 Avenue de l'Observatoire, Paris, France
| | - F Mauny
- Laboratoire Chrono-Environnement UMR CNRS 6249, Université Bourgogne Franche-Comté, 16 Route de Gray, Besançon, France.,Centre de Méthodologie Clinique, Centre Hospitalier Universitaire de Besançon, 2 Place Saint-Jacques, Besançon Cedex, France
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16
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Kloprogge F, Workman L, Borrmann S, Tékété M, Lefèvre G, Hamed K, Piola P, Ursing J, Kofoed PE, Mårtensson A, Ngasala B, Björkman A, Ashton M, Friberg Hietala S, Aweeka F, Parikh S, Mwai L, Davis TME, Karunajeewa H, Salman S, Checchi F, Fogg C, Newton PN, Mayxay M, Deloron P, Faucher JF, Nosten F, Ashley EA, McGready R, van Vugt M, Proux S, Price RN, Karbwang J, Ezzet F, Bakshi R, Stepniewska K, White NJ, Guerin PJ, Barnes KI, Tarning J. Artemether-lumefantrine dosing for malaria treatment in young children and pregnant women: A pharmacokinetic-pharmacodynamic meta-analysis. PLoS Med 2018; 15:e1002579. [PMID: 29894518 PMCID: PMC5997317 DOI: 10.1371/journal.pmed.1002579] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 05/04/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The fixed dose combination of artemether-lumefantrine (AL) is the most widely used treatment for uncomplicated Plasmodium falciparum malaria. Relatively lower cure rates and lumefantrine levels have been reported in young children and in pregnant women during their second and third trimester. The aim of this study was to investigate the pharmacokinetic and pharmacodynamic properties of lumefantrine and the pharmacokinetic properties of its metabolite, desbutyl-lumefantrine, in order to inform optimal dosing regimens in all patient populations. METHODS AND FINDINGS A search in PubMed, Embase, ClinicalTrials.gov, Google Scholar, conference proceedings, and the WorldWide Antimalarial Resistance Network (WWARN) pharmacology database identified 31 relevant clinical studies published between 1 January 1990 and 31 December 2012, with 4,546 patients in whom lumefantrine concentrations were measured. Under the auspices of WWARN, relevant individual concentration-time data, clinical covariates, and outcome data from 4,122 patients were made available and pooled for the meta-analysis. The developed lumefantrine population pharmacokinetic model was used for dose optimisation through in silico simulations. Venous plasma lumefantrine concentrations 7 days after starting standard AL treatment were 24.2% and 13.4% lower in children weighing <15 kg and 15-25 kg, respectively, and 20.2% lower in pregnant women compared with non-pregnant adults. Lumefantrine exposure decreased with increasing pre-treatment parasitaemia, and the dose limitation on absorption of lumefantrine was substantial. Simulations using the lumefantrine pharmacokinetic model suggest that, in young children and pregnant women beyond the first trimester, lengthening the dose regimen (twice daily for 5 days) and, to a lesser extent, intensifying the frequency of dosing (3 times daily for 3 days) would be more efficacious than using higher individual doses in the current standard treatment regimen (twice daily for 3 days). The model was developed using venous plasma data from patients receiving intact tablets with fat, and evaluations of alternative dosing regimens were consequently only representative for venous plasma after administration of intact tablets with fat. The absence of artemether-dihydroartemisinin data limited the prediction of parasite killing rates and recrudescent infections. Thus, the suggested optimised dosing schedule was based on the pharmacokinetic endpoint of lumefantrine plasma exposure at day 7. CONCLUSIONS Our findings suggest that revised AL dosing regimens for young children and pregnant women would improve drug exposure but would require longer or more complex schedules. These dosing regimens should be evaluated in prospective clinical studies to determine whether they would improve cure rates, demonstrate adequate safety, and thereby prolong the useful therapeutic life of this valuable antimalarial treatment.
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Affiliation(s)
- Frank Kloprogge
- WorldWide Antimalarial Resistance Network, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- Institute for Global Health, University College London, London, United Kingdom
| | - Lesley Workman
- WorldWide Antimalarial Resistance Network, Cape Town, South Africa
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Steffen Borrmann
- Kenya Medical Research Institute–Wellcome Trust Research Programme, Kilifi, Kenya
- Institute for Tropical Medicine, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Mamadou Tékété
- Institute for Tropical Medicine, Eberhard Karls University of Tübingen, Tübingen, Germany
- Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, University of Science, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Kamal Hamed
- Novartis Pharmaceuticals, East Hanover, New Jersey, United States of America
| | | | - Johan Ursing
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, Danderyds Hospital, Stockholm, Sweden
- Bandim Health Project, Bissau, Guinea-Bissau
| | - Poul Erik Kofoed
- Bandim Health Project, Bissau, Guinea-Bissau
- Department of Paediatrics, Kolding Hospital, Kolding, Denmark
| | - Andreas Mårtensson
- Department of Women’s and Children’s Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
| | - Billy Ngasala
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Michael Ashton
- Department of Pharmacology, University of Gothenburg, Gothenburg, Sweden
| | - Sofia Friberg Hietala
- Department of Pharmacology, University of Gothenburg, Gothenburg, Sweden
- Pharmetheus, Uppsala, Sweden
| | - Francesca Aweeka
- UCSF School of Pharmacy, San Francisco, California, United States of America
| | - Sunil Parikh
- Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Leah Mwai
- Kenya Medical Research Institute–Wellcome Trust Research Programme, Kilifi, Kenya
- Institute for Tropical Medicine and Joanna Briggs Institute Affiliate Centre for Evidence Based Health Care Evidence Synthesis and Translation Unit, Afya Research Africa, Nairobi, Kenya
- International Development Research Centre, Ottawa, Ontario, Canada
| | - Timothy M. E. Davis
- Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Harin Karunajeewa
- Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Sam Salman
- Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Francesco Checchi
- Epicentre, Paris, France
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Carole Fogg
- Epicentre, Paris, France
- Faculty of Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Paul N. Newton
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- Lao–Oxford–Mahosot Hospital–Wellcome Trust Research Unit, Vientiane, Laos
| | - Mayfong Mayxay
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- Lao–Oxford–Mahosot Hospital–Wellcome Trust Research Unit, Vientiane, Laos
- Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Laos
| | - Philippe Deloron
- UMR216 Institut de Recherche pour le Développement, Faculté de Pharmacie, Université Paris Descartes, Paris, France
| | | | - François Nosten
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- Shoklo Malaria Research Unit, Mae Sot, Thailand
| | - Elizabeth A. Ashley
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- Myanmar Oxford Clinical Research Unit, Yangon, Myanmar
| | - Rose McGready
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- Shoklo Malaria Research Unit, Mae Sot, Thailand
| | - Michele van Vugt
- Shoklo Malaria Research Unit, Mae Sot, Thailand
- Amsterdam Medical Centre, Amsterdam, The Netherlands
| | - Stephane Proux
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- Shoklo Malaria Research Unit, Mae Sot, Thailand
| | - Ric N. Price
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- WorldWide Antimalarial Resistance Network, Darwin, Northern Territory, Australia
- Global and Tropical Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
- Charles Darwin University, Darwin, Northern Territory, Australia
| | - Juntra Karbwang
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Farkad Ezzet
- Novartis Pharmaceuticals, East Hanover, New Jersey, United States of America
| | | | - Kasia Stepniewska
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- WorldWide Antimalarial Resistance Network, Oxford, United Kingdom
| | - Nicholas J. White
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Philippe J. Guerin
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- WorldWide Antimalarial Resistance Network, Oxford, United Kingdom
| | - Karen I. Barnes
- WorldWide Antimalarial Resistance Network, Cape Town, South Africa
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Joel Tarning
- WorldWide Antimalarial Resistance Network, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
- Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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17
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Doritchamou JYA, Akuffo RA, Moussiliou A, Luty AJF, Massougbodji A, Deloron P, Tuikue Ndam NG. Submicroscopic placental infection by non-falciparum Plasmodium spp. PLoS Negl Trop Dis 2018; 12:e0006279. [PMID: 29432484 PMCID: PMC5825172 DOI: 10.1371/journal.pntd.0006279] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 02/23/2018] [Accepted: 01/29/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Among the Plasmodium species that infect humans, adverse effects of P. falciparum and P. vivax have been extensively studied and reported with respect to poor outcomes particularly in first time mothers and in pregnant women living in areas with unstable malaria transmission. Although, other non-falciparum malaria infections during pregnancy have sometimes been reported, little is known about the dynamics of these infections during pregnancy. METHODS AND FINDINGS Using a quantitative PCR approach, blood samples collected from Beninese pregnant women during the first antenatal visit (ANV) and at delivery including placental blood were screened for Plasmodium spp. Risk factors associated with Plasmodium spp. infection during pregnancy were assessed as well as the relationships with pregnancy outcomes. P. falciparum was the most prevalent Plasmodium species detected during pregnancy, irrespective either of parity, of age or of season during which the infection occurred. Although no P. vivax infections were detected in this cohort, P. malariae (9.2%) and P. ovale (5.8%) infections were observed in samples collected during the first ANV. These non-falciparum infections were also detected in maternal peripheral blood (1.3% for P. malariae and 1.2% for P. ovale) at delivery. Importantly, higher prevalence of P. malariae (5.5%) was observed in placental than peripheral blood while that of P. ovale was similar (1.8% in placental blood). Among the non-falciparum infected pregnant women with paired peripheral and placental samples, P. malariae infections in the placental blood was significantly higher than in the peripheral blood, suggesting a possible affinity of P. malariae for the placenta. However, no assoctiation of non-falciparum infections and the pregnancy outcomes was observed. CONCLUSIONS Overall this study provided insights into the molecular epidemiology of Plasmodium spp. infection during pregnancy, indicating placental infection by non-falciparum Plasmodium and the lack of association of these infections with adverse pregnancy outcomes.
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Affiliation(s)
- Justin Y. A. Doritchamou
- MERIT, Intitut de Recherche pour le Developpement—Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- 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
| | - Richard A. Akuffo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Azizath Moussiliou
- MERIT, Intitut de Recherche pour le Developpement—Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- 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
| | - Adrian J. F. Luty
- MERIT, Intitut de Recherche pour le Developpement—Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- 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
| | - 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
| | - Philippe Deloron
- MERIT, Intitut de Recherche pour le Developpement—Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Nicaise G. Tuikue Ndam
- MERIT, Intitut de Recherche pour le Developpement—Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- 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
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- * E-mail:
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18
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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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19
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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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20
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Gbédandé K, Fievet N, Viwami F, Ezinmegnon S, Issifou S, Chippaux JP, Dossou Y, Moutairou K, Massougbodji A, Ndam N, de Jongh WA, Søgaard TMM, Salanti A, Nielsen MA, Esen M, Mordmüller B, Deloron P, Luty AJF. Clinical development of a VAR2CSA-based placental malaria vaccine PAMVAC: Quantifying vaccine antigen-specific memory B & T cell activity in Beninese primigravidae. Vaccine 2017; 35:3474-3481. [PMID: 28527688 DOI: 10.1016/j.vaccine.2017.05.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 04/06/2017] [Revised: 05/04/2017] [Accepted: 05/06/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND The antigen VAR2CSA plays a pivotal role in the pathophysiology of pregnancy-associated malaria (PAM) caused by Plasmodium falciparum. A VAR2CSA-based vaccine candidate, PAMVAC, is under development by an EU-funded multi-country consortium (PlacMalVac project). As part of PAMVAC's clinical development, we quantified naturally acquired vaccine antigen-specific memory B and T cell responses in Beninese primigravidae recruited at the beginning of pregnancy and followed up to delivery and beyond. METHODS Clinical and parasitological histories were compiled from monthly clinic visits. On 4 occasions (first and fifth month of pregnancy, delivery, 6months post-delivery) peripheral blood mononuclear cells were isolated for in vitro assays. PAMVAC-specific memory B cells as well as those specific for a PAM unrelated P. falciparum antigen (PfEMP1-CIDR1a) and for tetanus toxoid were quantified by ELISpot. Memory T cell responses were assessed by quantifying cytokines (IL-5, IL-6, IL-10, IL-13, IFN-γ, TNF-α) in supernatants of cells stimulated in vitro either with PAMVAC, or mitogen (PHA). RESULTS Both tetanus toxoid- and PAMVAC-specific memory B cell frequencies increased to reach peak levels in the 5th month and at delivery, respectively and persisted post-delivery. The frequency of CIDR1a-specific memory B cells was stable during pregnancy, but declined post-delivery. The cumulated prevalence of infection with P. falciparum during pregnancy was 61% by microscopy. In women with a history of such infections, a significantly higher frequency of PAMVAC-specific memory B cells was observed at delivery. PAMVAC-specific pro-inflammatory (IFN-γ, TNF) responses tended to be higher at delivery in those with a history of infection. Mitogen-induced IL-5/IL-13 responses were significantly enhanced in the same women. CONCLUSIONS PAMVAC-specific memory B cells are induced during first pregnancies and are maintained post-delivery. Women with a T helper cell profile biased towards production of Th2-type cytokines have a greater risk of infection with P. falciparum.
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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, Benin; Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d'Abomey-Calavi, Benin; MERIT UMR D216, Institut de Recherche pour le Développement, Université Paris Descartes, COMUE Sorbonne Paris Cité, 75006 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, Benin; MERIT UMR D216, Institut de Recherche pour le Développement, Université Paris Descartes, COMUE Sorbonne Paris Cité, 75006 Paris, France.
| | - Firmine Viwami
- 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, Benin.
| | - Sem Ezinmegnon
- 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, Benin.
| | - Saadou Issifou
- 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, Benin.
| | - Jean-Philippe Chippaux
- 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, Benin; MERIT UMR D216, Institut de Recherche pour le Développement, Université Paris Descartes, COMUE Sorbonne Paris Cité, 75006 Paris, France.
| | - Yannelle Dossou
- 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, Benin.
| | - Kabirou Moutairou
- Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d'Abomey-Calavi, 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, Benin.
| | - Nicaise Ndam
- MERIT UMR D216, Institut de Recherche pour le Développement, Université Paris Descartes, COMUE Sorbonne Paris Cité, 75006 Paris, France.
| | | | - T Max M Søgaard
- ExpreS(2)ion Biotechnologies SCION-DTU Science Park DK-2970, Hoersholm, Denmark.
| | - Ali Salanti
- Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.
| | - Morten A Nielsen
- Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark.
| | - Meral Esen
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany.
| | - Benjamin Mordmüller
- Institut für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany.
| | - Philippe Deloron
- MERIT UMR D216, Institut de Recherche pour le Développement, Université Paris Descartes, COMUE Sorbonne Paris Cité, 75006 Paris, France.
| | - Adrian J F Luty
- 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, Benin; MERIT UMR D216, Institut de Recherche pour le Développement, Université Paris Descartes, COMUE Sorbonne Paris Cité, 75006 Paris, France.
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21
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Day KP, Artzy-Randrup Y, Tiedje KE, Rougeron V, Chen DS, Rask TS, Rorick MM, Migot-Nabias F, Deloron P, Luty AJF, Pascual M. Evidence of strain structure in Plasmodium falciparum var gene repertoires in children from Gabon, West Africa. Proc Natl Acad Sci U S A 2017; 114:E4103-E4111. [PMID: 28461509 PMCID: PMC5441825 DOI: 10.1073/pnas.1613018114] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Existing theory on competition for hosts between pathogen strains has proposed that immune selection can lead to the maintenance of strain structure consisting of discrete, weakly overlapping antigenic repertoires. This prediction of strain theory has conceptual overlap with fundamental ideas in ecology on niche partitioning and limiting similarity between coexisting species in an ecosystem, which oppose the hypothesis of neutral coexistence. For Plasmodium falciparum, strain theory has been specifically proposed in relation to the major surface antigen of the blood stage, known as PfEMP1 and encoded by the multicopy multigene family known as the var genes. Deep sampling of the DBLα domain of var genes in the local population of Bakoumba, West Africa, was completed to define whether patterns of repertoire overlap support a role of immune selection under the opposing force of high outcrossing, a characteristic of areas of intense malaria transmission. Using a 454 high-throughput sequencing protocol, we report extremely high diversity of the DBLα domain and a large parasite population with DBLα repertoires structured into nonrandom patterns of overlap. Such population structure, significant for the high diversity of var genes that compose it at a local level, supports the existence of "strains" characterized by distinct var gene repertoires. Nonneutral, frequency-dependent competition would be at play and could underlie these patterns. With a computational experiment that simulates an intervention similar to mass drug administration, we argue that the observed repertoire structure matters for the antigenic var diversity of the parasite population remaining after intervention.
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Affiliation(s)
- Karen P Day
- School of Biosciences, The University of Melbourne, Parkville, VIC 3052, Australia;
- Department of Microbiology, New York University, New York, NY 10016
| | - Yael Artzy-Randrup
- Theoretical Ecology Group, Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, 1090 GE Amsterdam, The Netherlands
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109
| | - Kathryn E Tiedje
- School of Biosciences, The University of Melbourne, Parkville, VIC 3052, Australia
- Department of Microbiology, New York University, New York, NY 10016
| | - Virginie Rougeron
- Department of Microbiology, New York University, New York, NY 10016
- Laboratoire Maladies Infectieuses et Vecteurs: Ecologie, Génétique, Evolution et Contrôle, UMR 224-5290 CNRS, Institut de Recherche pour le Développement-Université de Montpellier, Centre Institut de Recherche pour le Développement de Montpellier, 34394 Montpellier, France
| | - Donald S Chen
- Department of Microbiology, New York University, New York, NY 10016
- Department of Medicine, New York Medical College, Valhalla, NY 10595
| | - Thomas S Rask
- School of Biosciences, The University of Melbourne, Parkville, VIC 3052, Australia
- Department of Microbiology, New York University, New York, NY 10016
| | - Mary M Rorick
- Department of Ecology and Evolutionary Biology, University of Michigan, Ann Arbor, MI 48109
- Department of Ecology and Evolution, University of Chicago, Chicago, IL 60637
| | - Florence Migot-Nabias
- Institut de Recherche pour le Développement, UMR 216 Mère et Enfant Face aux Infections Tropicales, 75006 Paris, France
- Communautés d'Universités et Établissements, Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, 75006 Paris, France
| | - Philippe Deloron
- Institut de Recherche pour le Développement, UMR 216 Mère et Enfant Face aux Infections Tropicales, 75006 Paris, France
- Communautés d'Universités et Établissements, Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, 75006 Paris, France
| | - Adrian J F Luty
- Institut de Recherche pour le Développement, UMR 216 Mère et Enfant Face aux Infections Tropicales, 75006 Paris, France
- Communautés d'Universités et Établissements, Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, 75006 Paris, France
| | - Mercedes Pascual
- Department of Ecology and Evolution, University of Chicago, Chicago, IL 60637
- Santa Fe Institute, Santa Fe, NM 87501
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22
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Tétard M, Milet J, Dechavanne S, Fievet N, Dorin-Semblat D, Elion J, Fairhurst RM, Deloron P, Tuikue-Ndam N, Gamain B. Heterozygous HbAC but not HbAS is associated with higher newborn birthweight among women with pregnancy-associated malaria. Sci Rep 2017; 7:1414. [PMID: 28469130 PMCID: PMC5431107 DOI: 10.1038/s41598-017-01495-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 01/16/2017] [Accepted: 03/28/2017] [Indexed: 12/21/2022] Open
Abstract
Pregnancy-associated malaria (PAM) is associated with poor pregnancy outcomes. Hemoglobin S (HbS) and hemoglobin C (HbC) mutations are frequently encountered in malaria-endemic areas of Africa, where they protect children from severe and uncomplicated Plasmodium falciparum malaria. However, scant epidemiological data exist on the impact of these Hb variants on PAM. A prospective cohort of 635 Beninese pregnant women was recruited before 24 weeks of gestational age and followed until the end of pregnancy. HbAA, HbAC, and HbAS genotypes were determined and tested for association with pregnancy outcomes and PAM indicators using linear and logistic multivariate models. Newborns from HbAC mothers had higher birthweights than those from HbAA mothers among women infected at any time during pregnancy (mean difference 182.9 g, p = 0.08), or during the first half of pregnancy (654.3 g, p = 0.0006). No such birthweight differences were observed between newborns from HbAS and HbAA mothers. HbAC and HbAS were not associated with other pregnancy outcomes or PAM indicators. In conclusion, HbAC but not HbAS is associated with an improved birth outcome in pregnant women with documented PAM. Higher-birthweight newborns from HbAC mothers may have a survival advantage that contributes to the natural selection of HbC in malaria-endemic areas.
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Affiliation(s)
- Marilou Tétard
- Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence GR-Ex, Paris, France
| | - Jacqueline Milet
- Institut de Recherche pour le Développement, UMR 216, Mère et Enfant face aux Infections Tropicales, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie, Paris, France
| | - Sébastien Dechavanne
- Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence GR-Ex, Paris, France
| | - Nadine Fievet
- Institut de Recherche pour le Développement, UMR 216, Mère et Enfant face aux Infections Tropicales, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie, Paris, France
| | - Dominique Dorin-Semblat
- Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence GR-Ex, Paris, France
| | - Jacques Elion
- Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence GR-Ex, Paris, France
| | - Rick M Fairhurst
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Philippe Deloron
- Institut de Recherche pour le Développement, UMR 216, Mère et Enfant face aux Infections Tropicales, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie, Paris, France
| | - Nicaise Tuikue-Ndam
- Institut de Recherche pour le Développement, UMR 216, Mère et Enfant face aux Infections Tropicales, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie, Paris, France
| | - Benoît Gamain
- Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence GR-Ex, Paris, France.
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23
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Argy N, Kendjo E, Augé-Courtoi C, Cojean S, Clain J, Houzé P, Thellier M, Hubert V, Deloron P, Houzé S. Influence of host factors and parasite biomass on the severity of imported Plasmodium falciparum malaria. PLoS One 2017; 12:e0175328. [PMID: 28410415 PMCID: PMC5391917 DOI: 10.1371/journal.pone.0175328] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/23/2017] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Imported malaria in France is characterized by various clinical manifestations observed in a heterogeneous population of patients such as travelers/expatriates and African migrants. In this population, host factors and parasite biomass associated with severe imported malaria are poorly known. METHODS From data collected by the Centre National de Référence du Paludisme, we identified epidemiological, demographic and biological features including parasite biomass and anti-plasmodial antibody levels (negative, positive and strongly positive serology) associated with different disease severity groups (very severe, moderately severe, and uncomplicated malaria) in 3 epidemiological groups (travelers/expatriates, first- and second-generation migrants). RESULTS Age, ethnicity, absence of prior infection with P. falciparum, antibody levels, plasma PfHRP2 levels, total and circulating parasite biomass were related to severe malaria onset. Sequestered parasite biomass tended to be increased in very severe malaria, and was strongly correlated to the antibody level of the host. CONCLUSIONS Prior exposure to P. falciparum is associated with high anti-plasmodial antibody levels which influence clinical presentation of imported malaria and its correlated circulating and sequestered parasite burden.
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Affiliation(s)
- Nicolas Argy
- Laboratoire de parasitologie, hôpital Bichat-Claude Bernard, APHP, Paris, France
- Centre National de Référence du Paludisme, hôpital Bichat-Claude Bernard, APHP, Paris, France
- Faculté de Pharmacie, Université Paris Descartes, COMUE Sorbonne Paris Cité, Paris, France
- UMR MERIT 216, Institut de recherche pour le développement, Paris, France
| | - Eric Kendjo
- Centre National de Référence du Paludisme, hôpital Bichat-Claude Bernard, APHP, Paris, France
| | - Claire Augé-Courtoi
- Faculté de Pharmacie, Université Paris Descartes, COMUE Sorbonne Paris Cité, Paris, France
- UMR MERIT 216, Institut de recherche pour le développement, Paris, France
| | - Sandrine Cojean
- Centre National de Référence du Paludisme, hôpital Bichat-Claude Bernard, APHP, Paris, France
| | - Jérôme Clain
- Centre National de Référence du Paludisme, hôpital Bichat-Claude Bernard, APHP, Paris, France
- Faculté de Pharmacie, Université Paris Descartes, COMUE Sorbonne Paris Cité, Paris, France
- UMR MERIT 216, Institut de recherche pour le développement, Paris, France
| | - Pascal Houzé
- Faculté de Pharmacie, Université Paris Descartes, COMUE Sorbonne Paris Cité, Paris, France
- Laboratoire de pharmacologie, hôpital Saint-Louis, APHP, Paris, France
| | - Marc Thellier
- Laboratoire de parasitologie, hôpital Pitié-Salpêtrière, APHP, Paris, France
- Faculté de Médecine, Université Pierre et Marie Curie, COMUE Sorbonne Paris Cité, Paris, France
| | - Veronique Hubert
- Centre National de Référence du Paludisme, hôpital Bichat-Claude Bernard, APHP, Paris, France
| | - Philippe Deloron
- Faculté de Pharmacie, Université Paris Descartes, COMUE Sorbonne Paris Cité, Paris, France
- UMR MERIT 216, Institut de recherche pour le développement, Paris, France
| | - Sandrine Houzé
- Laboratoire de parasitologie, hôpital Bichat-Claude Bernard, APHP, Paris, France
- Centre National de Référence du Paludisme, hôpital Bichat-Claude Bernard, APHP, Paris, France
- Faculté de Pharmacie, Université Paris Descartes, COMUE Sorbonne Paris Cité, Paris, France
- UMR MERIT 216, Institut de recherche pour le développement, Paris, France
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24
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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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25
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Argy N, Bertin G, Milet J, Hubert V, Clain J, Cojean S, Houzé P, Tuikue-Ndam N, Kendjo E, Deloron P, Houzé S, Matheron S, Casalino E, Wolff M, Delaval A, Agnamey P, Durand R, Pilo J, Rapp C, Faucher J, Cuisenier B, Poilane I, Bemba D, Roide A, Debourgogne A, Thibault M, Toubas D, Patoz P, De Gentile L, Pons D, Hurst J, Lohmann C, Bigel M, Godineau N, Thouvenin M, Dunand J, Ait-Ammar N, Angoulvant A, Dahane N, Lefevre M, Murat J, Garnaud C, Dannaoui E, Botterel F, Dutoit E, Dardé M, Ichou H, Branger C, Penn P, Angebault C, Morio F, Bret L, Thellier M, Mouri O, Cateau E, Siriez J, Fenneteau O, Revest M, Belaz S, Belkadi G, Hamane S, Bretagne S, Aboubacar A, Leloup G, Develoux M, Lapillonne H, Eloy O, Nevez G, Raffenot D, Buret B, Desoubeaux G, Goepp A. Preferential expression of domain cassettes 4, 8 and 13 of Plasmodium falciparum erythrocyte membrane protein 1 in severe malaria imported in France. Clin Microbiol Infect 2017; 23:211.e1-211.e4. [DOI: 10.1016/j.cmi.2016.10.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 10/06/2016] [Accepted: 10/12/2016] [Indexed: 11/25/2022]
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26
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Gueneuc A, Deloron P, Bertin GI. Usefulness of a biomarker to identify placental dysfunction in the context of malaria. Malar J 2017; 16:11. [PMID: 28049536 PMCID: PMC5209802 DOI: 10.1186/s12936-016-1664-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 08/11/2016] [Accepted: 12/21/2016] [Indexed: 11/25/2022] Open
Abstract
In most tropical areas, pregnant women are at increased risk of malaria, as a consequence of the massive sequestration of parasitized red blood cells in the placenta. The placenta plays a key role in embryonic and fetal development as well as in maternal-fetal exchanges, and pregnancy-associated malaria may alter selected placenta functions that lead to stillbirth and low birth weight. Although there are several tools (blood smear examination, RDT, PCR) to diagnose malaria infection during pregnancy, there is currently no test to assess placenta dysfunction in the framework of pregnancy-associated malaria. Pregnancy-associated malaria shares many features with preeclampsia, an extensively studied disease. Various biomarkers associated with placental dysfunction have been identified as associated with preeclampsia. Several of these are inflammatory markers that lack of specificity. A few seem more specific of placenta dysfunction, including s-endoglin and sFlt1, increased in the peripheral blood during preeclampsia. The predictive value of these biomarkers should be studied in the context of pregnancy-associated malaria to evaluate their usefulness in identifying placental dysfunction during malaria. These biomarkers should be considered to improve the diagnosis of placental dysfunction during malaria and pregnant women monitoring.
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Affiliation(s)
- Alexandra Gueneuc
- Institute of Research for Development (IRD), UMR216-MERIT, Paris, France.,ComUE Sorbonne Paris Cité, Paris, France.,Obstetrics and Fetal Medicine Department, Necker-Enfants-Malades Hospital, Paris, France
| | - Philippe Deloron
- Institute of Research for Development (IRD), UMR216-MERIT, Paris, France.,ComUE Sorbonne Paris Cité, Paris, France.,DHU Risks in Pregnancy, Paris, France
| | - Gwladys I Bertin
- Institute of Research for Development (IRD), UMR216-MERIT, Paris, France. .,ComUE Sorbonne Paris Cité, Paris, France. .,DHU Risks in Pregnancy, Paris, France.
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27
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Nunes-Silva S, Dechavanne S, Moussiliou A, Pstrąg N, Semblat JP, Gangnard S, Tuikue-Ndam N, Deloron P, Chêne A, Gamain B. Erratum to: Beninese children with cerebral malaria do not develop humoral immunity against the IT4-VAR19-DC8 PfEMP1 variant linked to EPCR and brain endothelial binding. Malar J 2016; 15:22. [PMID: 26755189 PMCID: PMC4710028 DOI: 10.1186/s12936-015-1061-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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28
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Cot M, Le Hesran JY, Miailhes P, Roisin A, Fievet N, Barro D, Etya'Ale D, Deloron P, Carnevale P, Breart G. Effect of chloroquine prophylaxis during pregnancy on maternal haematocrit. Annals of Tropical Medicine & Parasitology 2016. [DOI: 10.1080/00034983.1998.11813259] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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29
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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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30
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Bertin GI, Sabbagh A, Argy N, Salnot V, Ezinmegnon S, Agbota G, Ladipo Y, Alao JM, Sagbo G, Guillonneau F, Deloron P. Proteomic analysis of Plasmodium falciparum parasites from patients with cerebral and uncomplicated malaria. Sci Rep 2016; 6:26773. [PMID: 27245217 PMCID: PMC4887788 DOI: 10.1038/srep26773] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 01/13/2016] [Accepted: 05/05/2016] [Indexed: 01/31/2023] Open
Abstract
Plasmodium falciparum is responsible of severe malaria, including cerebral malaria (CM). During its intra-erythrocytic maturation, parasite-derived proteins are expressed, exported and presented at the infected erythrocyte membrane. To identify new CM-specific parasite membrane proteins, we conducted a mass spectrometry-based proteomic study and compared the protein expression profiles between 9 CM and 10 uncomplicated malaria (UM) samples. Among the 1097 Plasmodium proteins identified, we focused on the 499 membrane-associated and hypothetical proteins for comparative analysis. Filter-based feature selection methods combined with supervised data analysis identified a subset of 29 proteins distinguishing CM and UM samples with high classification accuracy. A hierarchical clustering analysis of these 29 proteins based on the similarity of their expression profiles revealed two clusters of 15 and 14 proteins, respectively under- and over-expressed in CM. Among the over-expressed proteins, the MESA protein is expressed at the erythrocyte membrane, involved in proteins trafficking and in the export of variant surface antigens (VSAs), but without antigenic function. Antigen 332 protein is exported at the erythrocyte, also involved in protein trafficking and in VSAs export, and exposed to the immune system. Our proteomics data demonstrate an association of selected proteins in the pathophysiology of CM.
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Affiliation(s)
- Gwladys I Bertin
- Institut de Recherche pour le Développement (IRD), UMR216 - MERIT, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie de Paris, Paris Descartes University, Paris 75006, France
| | - Audrey Sabbagh
- Institut de Recherche pour le Développement (IRD), UMR216 - MERIT, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie de Paris, Paris Descartes University, Paris 75006, France
| | - Nicolas Argy
- Institut de Recherche pour le Développement (IRD), UMR216 - MERIT, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie de Paris, Paris Descartes University, Paris 75006, France.,Parasitology laboratory, Bichat-Claude Bernard hospital, Paris 75018, France.,French national reference center of malaria laboratory, Bichat-Claude Bernard hospital, Paris 75018, France
| | - Virginie Salnot
- COMUE Sorbonne Paris Cité, Faculté de Pharmacie de Paris, Paris Descartes University, Paris 75006, France.,3P5 Proteomics facility, Université Paris Descartes, Paris, France
| | - Sem Ezinmegnon
- Centre d'Étude et de Recherche sur le Paludisme Associé à la Grossesse et l'Enfance (CERPAGE), Cotonou, Benin
| | - Gino Agbota
- Institut de Recherche pour le Développement (IRD), UMR216 - MERIT, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie de Paris, Paris Descartes University, Paris 75006, France.,Centre d'Étude et de Recherche sur le Paludisme Associé à la Grossesse et l'Enfance (CERPAGE), Cotonou, Benin
| | - Yélé Ladipo
- Paediatric Department, Mother and child hospital (HOMEL), Cotonou, Benin
| | - Jules M Alao
- Paediatric Department, Mother and child hospital (HOMEL), Cotonou, Benin
| | - Gratien Sagbo
- Paediatric Department, Centre National Hospitalo-Universitaire (CNHU), Cotonou, Benin
| | - François Guillonneau
- COMUE Sorbonne Paris Cité, Faculté de Pharmacie de Paris, Paris Descartes University, Paris 75006, France.,3P5 Proteomics facility, Université Paris Descartes, Paris, France
| | - Philippe Deloron
- Institut de Recherche pour le Développement (IRD), UMR216 - MERIT, Paris, France.,COMUE Sorbonne Paris Cité, Faculté de Pharmacie de Paris, Paris Descartes University, Paris 75006, France
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31
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Briand V, Saal J, Ghafari C, Huynh BT, Fievet N, Schmiegelow C, Massougbodji A, Deloron P, Zeitlin J, Cot M. Fetal Growth Restriction Is Associated With Malaria in Pregnancy: A Prospective Longitudinal Study in Benin. J Infect Dis 2016; 214:417-25. [DOI: 10.1093/infdis/jiw158] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 04/13/2016] [Indexed: 11/14/2022] Open
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32
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Brembilla A, Mauny F, Garcia A, Koura KG, Deloron P, Faucher JF. Antibiotics usage in infants during the first 18 months of life in Benin: a population-based cohort study. Eur J Clin Microbiol Infect Dis 2016; 35:681-9. [PMID: 26864042 DOI: 10.1007/s10096-016-2587-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 01/14/2016] [Indexed: 01/21/2023]
Abstract
Data centered on antibiotics usage and their determinants in African pediatric populations are limited. In order to define the determinants of antibiotics prescriptions (ABPr), we analyzed the data of a birth cohort in Benin. From 2007 to 2009, 538 infants were followed from birth to 18 months in three different health centers. The following determinants were assessed: infants' clinical findings at consultations, mothers' and children's characteristics at birth, and health parameters recorded at scheduled follow-up of general health parameters. Multilevel logistic models were performed for analysis. Among the 4394 consultations, fever represented 53.7 % of consultations, 64.1 % of which were non-malarial fevers. Antibiotics were prescribed during 44.2 % of the consultations and the proportion of ABPr differed significantly among health centers (p < 10(-3)). Nearly 40 % of ABPr were related to children without fever. During the first semester of life, the percentage of ABPr was twice lower than after (27.4 vs. 54.7, p < 10(-3)). Respiratory and enteric symptoms were positively associated with ABPr (p < 10(-3)). Malaria was significantly associated with a lower ABPr after the first semester [odds ratio (OR) = 0.55, 95 % confidence interval (CI) = 0.44-0.67, p < 10(-3)]. No maternal and child at-birth characteristics were associated with ABPr. ABPr was positively associated with a low breastfeeding score (p < 10(-3)). Studies on the rational use of antibiotics in this population should give priority to children more than 6 months of age, without malaria, and with respiratory and/or enteric symptoms. Our data also advocate for studies specifically designed to assess and improve healthcare providers' compliance to guidelines on antibiotics usage.
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Affiliation(s)
- A Brembilla
- Laboratoire Chrono-Environnement UMR CNRS 6249, Université Bourgogne Franche-Comté, 25000, Besançon, France. .,Centre de Méthodologie Clinique, Centre Hospitalier Régional Universitaire de Besançon, 2 Place Saint-Jacques, 25000, Besançon, France.
| | - F Mauny
- Laboratoire Chrono-Environnement UMR CNRS 6249, Université Bourgogne Franche-Comté, 25000, Besançon, France.,Centre de Méthodologie Clinique, Centre Hospitalier Régional Universitaire de Besançon, 2 Place Saint-Jacques, 25000, Besançon, France
| | - A Garcia
- UMR 216 MERIT IRD, Paris, France.,PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - K G Koura
- Union Internationale Contre la Tuberculose et les Maladies Respiratoires, Paris, France
| | - P Deloron
- UMR 216 MERIT IRD, Paris, France.,PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - J-F Faucher
- UMR 216 MERIT IRD, Paris, France.,PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
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33
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Lecarpentier E, Bhatt M, Bertin GI, Deloison B, Salomon LJ, Deloron P, Fournier T, Barakat AI, Tsatsaris V. Computational Fluid Dynamic Simulations of Maternal Circulation: Wall Shear Stress in the Human Placenta and Its Biological Implications. PLoS One 2016; 11:e0147262. [PMID: 26815115 PMCID: PMC4729471 DOI: 10.1371/journal.pone.0147262] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [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: 07/15/2015] [Accepted: 01/02/2016] [Indexed: 11/20/2022] Open
Abstract
Introduction In the human placenta the maternal blood circulates in the intervillous space (IVS). The syncytiotrophoblast (STB) is in direct contact with maternal blood. The wall shear stress (WSS) exerted by the maternal blood flow on the STB has not been evaluated. Our objective was to determine the physiological WSS exerted on the surface of the STB during the third trimester of pregnancy. Material and Methods To gain insight into the shear stress levels that the STB is expected to experience in vivo, we have formulated three different computational models of varying levels of complexity that reflect different physical representations of the IVS. Computations of the flow fields in all models were performed using the CFD module of the finite element code COMSOL Multiphysics 4.4. The mean velocity of maternal blood in the IVS during the third trimester was measured in vivo with dynamic MRI (0.94±0.14 mm.s-1). To investigate if the in silico results are consistent with physiological observations, we studied the cytoadhesion of human parasitized (Plasmodium falciparum) erythrocytes to primary human STB cultures, in flow conditions with different WSS values. Results The WSS applied to the STB is highly heterogeneous in the IVS. The estimated average values are relatively low (0.5±0.2 to 2.3±1.1 dyn.cm-2). The increase of WSS from 0.15 to 5 dyn.cm-2 was associated with a significant decrease of infected erythrocyte cytoadhesion. No cytoadhesion of infected erythrocytes was observed above 5 dyn.cm-2 applied for one hour. Conclusion Our study provides for the first time a WSS estimation in the maternal placental circulation. In spite of high maternal blood flow rates, the average WSS applied at the surface of the chorionic villi is low (<5 dyn.cm-2). These results provide the basis for future physiologically-relevant in vitro studies of the biological effects of WSS on the STB.
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Affiliation(s)
- E. Lecarpentier
- INSERM, UMR-S 1139, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
- Port Royal Maternity, Department of Gynecology Obstetrics I, Centre Hospitalier Universitaire Cochin Broca Hôtel Dieu, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpital de Paris, Paris, France
- DHU Risques et grossesse, Paris, France
- PremUP Foundation, Paris, France
- * E-mail:
| | - M. Bhatt
- Laboratoire d'Hydrodynamique (LadHyX), CNRS, École Polytechnique, 91128, Palaiseau, France
| | - G. I. Bertin
- Institut de Recherche pour le Développement (IRD), MERIT - UMR216, Paris, France
| | - B. Deloison
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
- INSERM U970, Paris Cardiovascular Research Center-PARCC, Paris, France
- EA FETUS 7328, Paris, France
- Department of Obstetrics and Fetal Medicine, Paris Descartes University, Hôpital Necker-Enfants-Malades, Assistance Publique-Hôpital de Paris, Paris, France
| | - L. J. Salomon
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
- INSERM U970, Paris Cardiovascular Research Center-PARCC, Paris, France
- EA FETUS 7328, Paris, France
- Department of Obstetrics and Fetal Medicine, Paris Descartes University, Hôpital Necker-Enfants-Malades, Assistance Publique-Hôpital de Paris, Paris, France
| | - P. Deloron
- Institut de Recherche pour le Développement (IRD), MERIT - UMR216, Paris, France
| | - T. Fournier
- INSERM, UMR-S 1139, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
- DHU Risques et grossesse, Paris, France
- PremUP Foundation, Paris, France
| | - A. I. Barakat
- Laboratoire d'Hydrodynamique (LadHyX), CNRS, École Polytechnique, 91128, Palaiseau, France
| | - V. Tsatsaris
- INSERM, UMR-S 1139, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Paris, France
- Port Royal Maternity, Department of Gynecology Obstetrics I, Centre Hospitalier Universitaire Cochin Broca Hôtel Dieu, Groupe Hospitalier Universitaire Ouest, Assistance Publique-Hôpital de Paris, Paris, France
- DHU Risques et grossesse, Paris, France
- PremUP Foundation, Paris, France
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34
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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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Nunes-Silva S, Dechavanne S, Moussiliou A, Pstrąg N, Semblat JP, Gangnard S, Tuikue-Ndam N, Deloron P, Chêne A, Gamain B. Beninese children with cerebral malaria do not develop humoral immunity against the IT4-VAR19-DC8 PfEMP1 variant linked to EPCR and brain endothelial binding. Malar J 2015; 14:493. [PMID: 26646943 PMCID: PMC4672576 DOI: 10.1186/s12936-015-1008-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 07/08/2015] [Accepted: 11/21/2015] [Indexed: 11/16/2022] Open
Abstract
Background Malaria is still one of the most prevalent infectious diseases in the world. Sequestration of infected erythrocytes (IEs) is the prime mediator of disease. Cytoadhesion of IEs is mediated by members of the highly diverse Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1). A restricted sub-set of var genes encoding for PfEMP1s possessing the domain cassettes DC8 and DC13 were found to bind to the endothelial protein C receptor (EPCR). These var genes were shown to be highly expressed by parasites from patients with severe malaria clinical outcomes compared to those from patients with uncomplicated symptoms. Methods In order to further study the molecular mechanisms underlying DC8/DC13 expressing IEs adhesion to EPCR, a method was developed to produce highly pure recombinant EPCR. The IT4 parasite strain was selected on either anti-IT4-VAR19 purified IgG, EPCR or human brain endothelial cell line and their var gene expression profiles as well as their binding phenotypes were compared. The N-terminal region of IT4-VAR19 comprising a full-length DC8 cassette as well as the single EPCR binding CIDRα1.1 domain were also produced, and their immune recognition (IgG) was assessed using plasma samples from Beninese children presenting acute mild malaria, severe malaria or cerebral malaria at the time of their admission to the clinic, and from convalescent-phase plasma collected 30 days after anti-malarial treatment. Results The multi-domain VAR19-NTS-DBLγ6 binds to EPCR with a greater affinity than the CIDRα1.1 domain alone and this study also demonstrates that VAR19-NTS-DBLγ6 binding to the EPCR-expressing endothelial cell line (HBEC5i) is more pronounced than that of the CIDRα1.1 domain alone. IT4-VAR19 represents the preferentially expressed-PfEMP1 when FCR3-IEs are selected based on their capability to bind EPCR. Notably, no significant difference in the levels of antibodies towards IT4-VAR19 antigens was observed within all clinical groups between plasma samples collected during the acute malaria phase compared to samples collected 30 days after anti-malaria treatment. Conclusions These data indicate that even being the preferentially selected IT4-EPCR-binding variant, the IT4-VAR19-DC8 region does not appear to be associated with the acquisition of antibodies during a single severe paediatric malaria episode in Benin. Electronic supplementary material The online version of this article (doi:10.1186/s12936-015-1008-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sofia Nunes-Silva
- Inserm UMR_1134, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, UMR_S1134, Paris, France. .,Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015, Paris, France. .,Laboratory of Excellence GR-Ex, Paris, France.
| | - Sébastien Dechavanne
- Inserm UMR_1134, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, UMR_S1134, Paris, France. .,Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015, Paris, France. .,Laboratory of Excellence GR-Ex, Paris, France.
| | - Azizath Moussiliou
- Laboratory of Excellence GR-Ex, Paris, France. .,Institut de Recherche pour le développement, UMR_216, Mère et enfant face aux infections tropicales, Paris, France. .,Faculté de pharmacie, PRES Sorbonne Paris Cité, Paris, France.
| | - Natalia Pstrąg
- Inserm UMR_1134, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, UMR_S1134, Paris, France. .,Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015, Paris, France. .,Laboratory of Excellence GR-Ex, Paris, France.
| | - Jean-Philippe Semblat
- Inserm UMR_1134, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, UMR_S1134, Paris, France. .,Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015, Paris, France. .,Laboratory of Excellence GR-Ex, Paris, France.
| | - Stéphane Gangnard
- Inserm UMR_1134, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, UMR_S1134, Paris, France. .,Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015, Paris, France. .,Laboratory of Excellence GR-Ex, Paris, France.
| | - Nicaise Tuikue-Ndam
- Laboratory of Excellence GR-Ex, Paris, France. .,Institut de Recherche pour le développement, UMR_216, Mère et enfant face aux infections tropicales, Paris, France. .,Faculté de pharmacie, PRES Sorbonne Paris Cité, Paris, France.
| | - Philippe Deloron
- Laboratory of Excellence GR-Ex, Paris, France. .,Institut de Recherche pour le développement, UMR_216, Mère et enfant face aux infections tropicales, Paris, France. .,Faculté de pharmacie, PRES Sorbonne Paris Cité, Paris, France.
| | - Arnaud Chêne
- Inserm UMR_1134, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, UMR_S1134, Paris, France. .,Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015, Paris, France. .,Laboratory of Excellence GR-Ex, Paris, France.
| | - Benoît Gamain
- Inserm UMR_1134, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, UMR_S1134, Paris, France. .,Institut National de la Transfusion Sanguine, 6 rue Alexandre Cabanel, 75015, Paris, France. .,Laboratory of Excellence GR-Ex, Paris, France.
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36
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Nouatin O, Gbédandé K, Ibitokou S, Vianou B, Houngbegnon P, Ezinmegnon S, Borgella S, Akplogan C, Cottrell G, Varani S, Massougbodji A, Moutairou K, Troye-Blomberg M, Deloron P, Luty AJF, Fievet N. Infants' Peripheral Blood Lymphocyte Composition Reflects Both Maternal and Post-Natal Infection with Plasmodium falciparum. PLoS One 2015; 10:e0139606. [PMID: 26580401 PMCID: PMC4651557 DOI: 10.1371/journal.pone.0139606] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 04/22/2015] [Accepted: 09/14/2015] [Indexed: 11/19/2022] Open
Abstract
Maternal parasitoses modulate fetal immune development, manifesting as altered cellular immunological activity in cord blood that may be linked to enhanced susceptibility to infections in early life. Plasmodium falciparum typifies such infections, with distinct placental infection-related changes in cord blood exemplified by expanded populations of parasite antigen-specific regulatory T cells. Here we addressed whether such early-onset cellular immunological alterations persist through infancy. Specifically, in order to assess the potential impacts of P. falciparum infections either during pregnancy or during infancy, we quantified lymphocyte subsets in cord blood and in infants' peripheral blood during the first year of life. The principal age-related changes observed, independent of infection status, concerned decreases in the frequencies of CD4+, NKdim and NKT cells, whilst CD8+, Treg and Teff cells' frequencies increased from birth to 12 months of age. P. falciparum infections present at delivery, but not those earlier in gestation, were associated with increased frequencies of Treg and CD8+ T cells but fewer CD4+ and NKT cells during infancy, thus accentuating the observed age-related patterns. Overall, P. falciparum infections arising during infancy were associated with a reversal of the trends associated with maternal infection i.e. with more CD4+ cells, with fewer Treg and CD8+ cells. We conclude that maternal P. falciparum infection at delivery has significant and, in some cases, year-long effects on the composition of infants' peripheral blood lymphocyte populations. Those effects are superimposed on separate and independent age- as well as infant infection-related alterations that, respectively, either match or run counter to them.
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MESH Headings
- Adult
- Antigens, Protozoan/genetics
- Antigens, Protozoan/immunology
- Benin
- CD8-Positive T-Lymphocytes/immunology
- CD8-Positive T-Lymphocytes/pathology
- Female
- Fetal Blood/immunology
- Fetal Blood/parasitology
- Humans
- Immunophenotyping
- Infant
- Killer Cells, Natural/immunology
- Killer Cells, Natural/pathology
- Lymphocyte Count
- Malaria, Falciparum/immunology
- Malaria, Falciparum/parasitology
- Malaria, Falciparum/pathology
- Natural Killer T-Cells/immunology
- Natural Killer T-Cells/pathology
- Placenta/immunology
- Placenta/parasitology
- Placenta/pathology
- Plasmodium falciparum/immunology
- Pregnancy
- Pregnancy Complications, Parasitic/immunology
- Pregnancy Complications, Parasitic/parasitology
- Pregnancy Complications, Parasitic/pathology
- Retrospective Studies
- T-Lymphocyte Subsets/immunology
- T-Lymphocyte Subsets/pathology
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Affiliation(s)
- Odilon Nouatin
- 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, Bénin
| | - 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, Bénin
| | - 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
- Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d’Abomey-Calavi, Cotonou, Bénin
| | - 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
- Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d’Abomey-Calavi, Cotonou, Bénin
| | - Parfait Houngbegnon
- 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, Bénin
| | - Sem Ezinmegnon
- 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, Bénin
| | - Sophie Borgella
- 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
| | - Carine Akplogan
- 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, Bénin
| | - 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
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Stefania Varani
- Unit of Microbiology, Department of Diagnostic, Experimental and Specialty Medicine, University of Bologna, Bologna, Italy
| | - 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
| | - Kabirou Moutairou
- Département de Biochimie et de Biologie Cellulaire, Faculté des Sciences et Techniques, Université d’Abomey-Calavi, Cotonou, Bénin
| | - Marita Troye-Blomberg
- Department of Molecular Biosciences, the Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Philippe Deloron
- Institut de Recherche pour le Développement, MERIT UMR D216 Mère et enfant face aux infections tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Adrian J. F. Luty
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - 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
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
- * E-mail:
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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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Aubouy A, Olagnier D, Bertin G, Ezinmegnon S, Majorel C, Mimar S, Massougbodji A, Deloron P, Pipy B, Coste A. Nrf2-driven CD36 and HO-1 gene expression in circulating monocytes correlates with favourable clinical outcome in pregnancy-associated malaria. Malar J 2015; 14:358. [PMID: 26385579 PMCID: PMC4575452 DOI: 10.1186/s12936-015-0888-8] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 09/03/2015] [Indexed: 12/21/2022] Open
Abstract
Background Pregnancy-associated malaria (PAM) constitutes one of the most severe forms of malaria infection leading to fetal growth restriction and high risk of infant death. The severity of the pathology is largely attributed to the recruitment of monocytes and macrophages in the placenta which is evidenced by dysregulated inflammation found in placental blood. Importantly, CD36+ monocytes/macrophages are also thought to participate in the tight control of the pro- and anti-inflammatory responses following Plasmodium detection through elimination of apoptotic cells and malaria-infected erythrocytes, internalization and recycling of oxidized forms of low-density lipoprotein and collaboration with TLR2 in pro-inflammatory response. Interestingly, previous work demonstrated that CD36 expression was upregulated on inflammatory macrophages following stimulation of the Nrf2 transcription factor, whilst the PPARγ pathway was inhibited and non-functional in the same inflammatory conditions. This current study examined the possible role of Nrf2-driven gene expression, CD36 and Haem-Oxygenase-1 (HO-1), in PAM clinical outcomes. Methods Clinical data and biological samples including peripheral blood mononuclear cells were collected from 27 women presenting PAM. Polychromatic flow cytometry was used to characterize innate immune cell subpopulations and quantify CD36 protein expression level on monocytes. mRNA levels of CD36, PPARγ, Nrf2 and HO-1 were determined by qPCR and related to clinical outcomes. Finally, the capacity of monocytes to modulate CD36 expression upon rosiglitazone or sulforaphane treatment, two respective PPARγ or Nrf2 activators, was also investigated. Results The CD36 receptor, mostly expressed by CD14+ circulating monocytes, statistically correlated with increased infant birth weights. Interestingly, mRNA levels of the transcription factor Nrf2 and the enzyme HO-1 also correlated with lower parasitaemia and increased infant birth weight, while PPARγ mRNA levels did not. Finally, monocytes isolated from low infant birth weight pregnant women were capable of up-regulating CD36 via the Nrf2 pathway ex vivo. Conclusions Altogether these results suggest that Nrf2-driven CD36 and HO-1 expression on innate immune cells could contribute to a protective and detoxifying mechanism during PAM. More powered and mechanistical studies are however needed to strengthen the conclusions of this study. Electronic supplementary material The online version of this article (doi:10.1186/s12936-015-0888-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Agnès Aubouy
- Institut de Recherche pour le Développement (IRD), Université Paul Sabatier Toulouse III, UMR 152 Pharma-Dev, CHU Rangueil, Bâtiment L1, 1 Avenue du Pr Jean Poulhès, 31059, Toulouse, France.
| | - David Olagnier
- Institut de Recherche pour le Développement (IRD), Université Paul Sabatier Toulouse III, UMR 152 Pharma-Dev, CHU Rangueil, Bâtiment L1, 1 Avenue du Pr Jean Poulhès, 31059, Toulouse, France. .,Lady Davis Institute-Jewish General Hospital, McGill University, Montreal, Canada.
| | - Gwladys Bertin
- Institut de Recherche pour le Développement (IRD), PRES Sorbonne Paris Cité, Université Paris Descartes, UMR 216 Mère et enfant face aux infections tropicales, Paris, France.
| | - Sem Ezinmegnon
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et l'Enfance (CERPAGE), Cotonou, Benin.
| | - Clarisse Majorel
- Institut de Recherche pour le Développement (IRD), Université Paul Sabatier Toulouse III, UMR 152 Pharma-Dev, CHU Rangueil, Bâtiment L1, 1 Avenue du Pr Jean Poulhès, 31059, Toulouse, France. .,Laboratoire Insulaire du Vivant et de l'Environnement (LIVE-EA 4243), Université de la Nouvelle-Caledonie (UNC), Nouméa, New Caledonia.
| | - Saliha Mimar
- Institut de Recherche pour le Développement (IRD), Université Paul Sabatier Toulouse III, UMR 152 Pharma-Dev, CHU Rangueil, Bâtiment L1, 1 Avenue du Pr Jean Poulhès, 31059, Toulouse, France.
| | - Achille Massougbodji
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et l'Enfance (CERPAGE), Cotonou, Benin.
| | - Philippe Deloron
- Institut de Recherche pour le Développement (IRD), PRES Sorbonne Paris Cité, Université Paris Descartes, UMR 216 Mère et enfant face aux infections tropicales, Paris, France.
| | - Bernard Pipy
- Institut de Recherche pour le Développement (IRD), Université Paul Sabatier Toulouse III, UMR 152 Pharma-Dev, CHU Rangueil, Bâtiment L1, 1 Avenue du Pr Jean Poulhès, 31059, Toulouse, France.
| | - Agnès Coste
- Institut de Recherche pour le Développement (IRD), Université Paul Sabatier Toulouse III, UMR 152 Pharma-Dev, CHU Rangueil, Bâtiment L1, 1 Avenue du Pr Jean Poulhès, 31059, Toulouse, 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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Badaut C, Guyonnet L, Milet J, Renard E, Durand R, Viwami F, Sagbo G, Layla F, Deloron P, Bonnefoy S, Migot-Nabias F. Immunoglobulin response to Plasmodium falciparum RESA proteins in uncomplicated and severe malaria. Malar J 2015; 14:278. [PMID: 26178656 PMCID: PMC4502540 DOI: 10.1186/s12936-015-0799-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 03/25/2015] [Accepted: 07/07/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The three members of the ring-infected erythrocyte surface antigen (RESA) proteins family share high sequence homologies, which impair the detection and assignment to one or another protein of some pathogenic processes inherent to Plasmodium falciparum malaria. The present study was intended to determine if the antibody and inflammatory responses of children living in a malaria-endemic area varied depending on the RESA-1, RESA-2 or RESA-3 proteins and the severity of the disease, two groups of severe and uncomplicated malaria cases being considered. METHODS Two synthetic peptides representing predicted B cell epitopes were designed per RESA protein, all located outside of the 3' and 5' repetition blocks, in order to allow an antibody detection specific of each member of the family. Recombinant rRESA-1B and rRESA-3B proteins were also engineered. Two groups of Beninese children admitted to hospital in 2009 for either uncomplicated or severe malaria were compared for their plasma levels of IgG specifically recognizing each recombinant RESA protein or synthetic peptide, and for their plasma inflammatory cytokine levels (IFN-γ, TNF-α and IL-10), taking into account host and parasite genetic factors. RESULTS The absence of IgG cross-reactivity between rRESA proteins and their protein carrier as well as between each RESA peptide and a non-epitopic RESA control peptide validated the use of the engineered recombinant proteins and peptides for the measurement of plasma IgG. Taking into account age, fever duration and parasitaemia, a multiple logistic regression performed on children clustered according to their antibody responses' profiles concluded to an increased risk of severe malaria for P2 (representative of RESA-1) responders (P = 0.007). Increased IL-10 plasma levels were found in children harbouring multiclonal P. falciparum infections on the basis of the T1526G resa2 gene polymorphism (P = 0.004). CONCLUSIONS This study provided novel tools to dissect the seroreactivity against the three members of the RESA protein family and to describe its relation to protection against malaria. It suggested the measurement of plasma antibodies raised against specific peptides to serve as predictive immunologic markers for disease severity. Lastly, it reinforced previous observations linking the T1526G resa2 gene mutation to severe malaria.
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Affiliation(s)
- Cyril Badaut
- Equipe résidente de recherche en infectiologie tropicale, Institut de Recherche Biomédicale des Armées (IRBA), Brétigny sur Orge, France.
| | - Léa Guyonnet
- Institut de Recherche pour le Développement, UMR 216 Mère et enfant face aux infections tropicales, Paris, France. .,COMUE Sorbonne Paris Cité, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Paris, France. .,Paris Cardiovascular Centre (PARCC), Institut National de la Santé et de la Recherche Médicale (INSERM) U970, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
| | - Jacqueline Milet
- Institut de Recherche pour le Développement, UMR 216 Mère et enfant face aux infections tropicales, Paris, France. .,COMUE Sorbonne Paris Cité, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Paris, France.
| | - Emmanuelle Renard
- Institut de Recherche pour le Développement, UMR 216 Mère et enfant face aux infections tropicales, Paris, France. .,COMUE Sorbonne Paris Cité, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Paris, France.
| | - Rémy Durand
- Institut de Recherche pour le Développement, UMR 216 Mère et enfant face aux infections tropicales, Paris, France. .,COMUE Sorbonne Paris Cité, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Paris, France. .,Laboratoire de Parasitologie-Mycologie, Hôpital Avicenne, AP-HP, Bobigny, France.
| | - Firmine Viwami
- Centre d'Étude et de Recherche sur le Paludisme Associé à la Grossesse et l'Enfance (CERPAGE), Cotonou, Benin.
| | - Gratien Sagbo
- Service de Pédiatrie, Centre National Hospitalier et Universitaire Hubert K. Maga, Cotonou, Benin.
| | - Francis Layla
- Service de Pédiatrie, Centre National Hospitalier et Universitaire Hubert K. Maga, Cotonou, Benin.
| | - Philippe Deloron
- Institut de Recherche pour le Développement, UMR 216 Mère et enfant face aux infections tropicales, Paris, France. .,COMUE Sorbonne Paris Cité, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Paris, France.
| | - Serge Bonnefoy
- Unité de Biologie Cellulaire des Trypanosomes, Institut Pasteur, INSERM U1201, Paris, France.
| | - Florence Migot-Nabias
- Institut de Recherche pour le Développement, UMR 216 Mère et enfant face aux infections tropicales, Paris, France. .,COMUE Sorbonne Paris Cité, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Paris, France. .,Faculté de Pharmacie, IRD UMR216, 4 avenue de l'Observatoire, 75006, Paris, France.
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Adjuik MA, Allan R, Anvikar AR, Ashley EA, Ba MS, Barennes H, Barnes KI, Bassat Q, Baudin E, Björkman A, Bompart F, Bonnet M, Borrmann S, Brasseur P, Bukirwa H, Checchi F, Cot M, Dahal P, D'Alessandro U, Deloron P, Desai M, Diap G, Djimde AA, Dorsey G, Doumbo OK, Espié E, Etard JF, Fanello CI, Faucher JF, Faye B, Flegg JA, Gaye O, Gething PW, González R, Grandesso F, Guerin PJ, Guthmann JP, Hamour S, Hasugian AR, Hay SI, Humphreys GS, Jullien V, Juma E, Kamya MR, Karema C, Kiechel JR, Kremsner PG, Krishna S, Lameyre V, Ibrahim LM, Lee SJ, Lell B, Mårtensson A, Massougbodji A, Menan H, Ménard D, Menéndez C, Meremikwu M, Moreira C, Nabasumba C, Nambozi M, Ndiaye JL, Nikiema F, Nsanzabana C, Ntoumi F, Ogutu BR, Olliaro P, Osorio L, Ouédraogo JB, Penali LK, Pene M, Pinoges L, Piola P, Price RN, Roper C, Rosenthal PJ, Rwagacondo CE, Same-Ekobo A, Schramm B, Seck A, Sharma B, Sibley CH, Sinou V, Sirima SB, Smith JJ, Smithuis F, Somé FA, Sow D, Staedke SG, Stepniewska K, Swarthout TD, Sylla K, Talisuna AO, Tarning J, Taylor WRJ, Temu EA, Thwing JI, Tjitra E, Tine RCK, Tinto H, Vaillant MT, Valecha N, Van den Broek I, White NJ, Yeka A, Zongo I. The effect of dosing strategies on the therapeutic efficacy of artesunate-amodiaquine for uncomplicated malaria: a meta-analysis of individual patient data. BMC Med 2015; 13:66. [PMID: 25888957 PMCID: PMC4411752 DOI: 10.1186/s12916-015-0301-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 02/20/2015] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Artesunate-amodiaquine (AS-AQ) is one of the most widely used artemisinin-based combination therapies (ACTs) to treat uncomplicated Plasmodium falciparum malaria in Africa. We investigated the impact of different dosing strategies on the efficacy of this combination for the treatment of falciparum malaria. METHODS Individual patient data from AS-AQ clinical trials were pooled using the WorldWide Antimalarial Resistance Network (WWARN) standardised methodology. Risk factors for treatment failure were identified using a Cox regression model with shared frailty across study sites. RESULTS Forty-three studies representing 9,106 treatments from 1999-2012 were included in the analysis; 4,138 (45.4%) treatments were with a fixed dose combination with an AQ target dose of 30 mg/kg (FDC), 1,293 (14.2%) with a non-fixed dose combination with an AQ target dose of 25 mg/kg (loose NFDC-25), 2,418 (26.6%) with a non-fixed dose combination with an AQ target dose of 30 mg/kg (loose NFDC-30), and the remaining 1,257 (13.8%) with a co-blistered non-fixed dose combination with an AQ target dose of 30 mg/kg (co-blistered NFDC). The median dose of AQ administered was 32.1 mg/kg [IQR: 25.9-38.2], the highest dose being administered to patients treated with co-blistered NFDC (median = 35.3 mg/kg [IQR: 30.6-43.7]) and the lowest to those treated with loose NFDC-25 (median = 25.0 mg/kg [IQR: 22.7-25.0]). Patients treated with FDC received a median dose of 32.4 mg/kg [IQR: 27-39.0]. After adjusting for reinfections, the corrected antimalarial efficacy on day 28 after treatment was similar for co-blistered NFDC (97.9% [95% confidence interval (CI): 97.0-98.8%]) and FDC (98.1% [95% CI: 97.6%-98.5%]; P = 0.799), but significantly lower for the loose NFDC-25 (93.4% [95% CI: 91.9%-94.9%]), and loose NFDC-30 (95.0% [95% CI: 94.1%-95.9%]) (P < 0.001 for all comparisons). After controlling for age, AQ dose, baseline parasitemia and region; treatment with loose NFDC-25 was associated with a 3.5-fold greater risk of recrudescence by day 28 (adjusted hazard ratio, AHR = 3.51 [95% CI: 2.02-6.12], P < 0.001) compared to FDC, and treatment with loose NFDC-30 was associated with a higher risk of recrudescence at only three sites. CONCLUSIONS There was substantial variation in the total dose of amodiaquine administered in different AS-AQ combination regimens. Fixed dose AS-AQ combinations ensure optimal dosing and provide higher antimalarial treatment efficacy than the loose individual tablets in all age categories.
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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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Almelli T, Ndam NT, Ezimegnon S, Alao MJ, Ahouansou C, Sagbo G, Amoussou A, Deloron P, Tahar R. Cytoadherence phenotype of Plasmodium falciparum-infected erythrocytes is associated with specific pfemp-1 expression in parasites from children with cerebral malaria. Malar J 2014; 13:333. [PMID: 25156105 PMCID: PMC4150962 DOI: 10.1186/1475-2875-13-333] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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: 05/29/2014] [Accepted: 07/29/2014] [Indexed: 11/25/2022] Open
Abstract
Background Cytoadherence of Plasmodium falciparum-infected erythrocytes (IEs) in deep microvasculature endothelia plays a major role in the pathogenesis of cerebral malaria (CM). This biological process is thought to be mediated by P. falciparum erythrocyte membrane protein-1 (PfEMP-1) and human receptors such as CD36 and ICAM-1. The relationship between the expression of PfEMP-1 variants and cytoadherence phenotype in the pathology of malaria is not well established. Methods Cytoadherence phenotypes of IEs to CD36, ICAM-1, CSPG and the transcription patterns of A, B, var2csa, var3, var gene groups and domain cassettes DC8 and DC13 were assessed in parasites from children with CM and uncomplicated malaria (UM) to determine if cytoadherence is related to a specific transcription profile of pfemp-1 variants. Results Parasites from CM patients bind significantly more to CD36 than those from UM patients, but no difference was observed in their binding ability to ICAM-1 and CSPG. CM isolates highly transcribed groups A, B, var2csa, var3, DC8 and DC13 compared to UM parasites. The high transcription levels of var genes belonging to group B positively correlated with increased binding level to CD36. Conclusion CM isolates bind significantly more to CD36 than to ICAM-1, which was correlated with high transcription level of group B var genes, supporting their implication in malaria pathogenesis.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Rachida Tahar
- Institut de Recherche pour le Développement (IRD), UMR 216 Mère et Enfant Face aux Infections Tropicales, 4, avenue de l'Observatoire, Paris 75270, France.
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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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Abstract
Plasmodium vivax is a major cause of illness in areas with low transmission of malaria in Latin America, Asia, and the Horn of Africa. However, pregnancy-associated malaria remains poorly characterized in such areas. Using a hospital-based survey of women giving birth and an antenatal survey, we assessed the prevalence rates of Plasmodium spp. infections in pregnant women in Bolivia, and evaluated the consequences of malaria during pregnancy on the health of mothers and newborns. P. vivax infection was detected in 7.9% of pregnant women attending antenatal visits, and placental infection occurred in 2.8% of deliveries; these rates did not vary with parity. Forty-two percent of all P. vivax malaria episodes were symptomatic. P. vivax-infected pregnant women were frequently anemic (6.5%) and delivered babies of reduced birthweight. P. vivax infections during pregnancy are clearly associated with serious adverse outcomes and should be considered in prevention strategies of pregnancy-associated malaria.
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Borgella S, Fievet N, Huynh BT, Ibitokou S, Hounguevou G, Affedjou J, Sagbo JC, Houngbegnon P, Guezo-Mévo B, Massougbodji A, Luty AJF, Cot M, Deloron P. Impact of pregnancy-associated malaria on infant malaria infection in southern Benin. PLoS One 2013; 8:e80624. [PMID: 24236190 PMCID: PMC3827421 DOI: 10.1371/journal.pone.0080624] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 10/04/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Infants of mothers with placental Plasmodium falciparum infections at delivery are themselves more susceptible to malaria attacks or to infection in early life. METHODOLOGY/ PRINCIPAL FINDINGS To assess the impact of either the timing or the number of pregnancy-associated malaria (PAM) infections on the incidence of parasitemia or malaria attacks in infancy, we followed 218 mothers through pregnancy (monthly visits) up to delivery and their infants from birth to 12 months of age (fortnightly visits), collecting detailed clinical and parasitological data. After adjustment on location, mother's age, birth season, bed net use, and placental malaria, infants born to a mother with PAM during the third trimester of pregnancy had a significantly increased risk of infection (OR [95% CI]: 4.2 [1.6; 10.5], p = 0.003) or of malaria attack (4.6 [1.7; 12.5], p = 0.003). PAM during the first and second trimesters had no such impact. Similarly significant results were found for the effect of the overall number of PAM episodes on the time to first parasitemia and first malaria attack (HR [95% CI]: 2.95 [1.58; 5.50], p = 0.001 and 3.19 [1.59; 6.38], p = 0.001) respectively. CONCLUSIONS/ SIGNIFICANCE This study highlights the importance of protecting newborns by preventing repeated episodes of PAM in their mothers.
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Affiliation(s)
- Sophie Borgella
- 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, Cotonou, Benin
- Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux infections tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Nadine Fievet
- 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, Cotonou, Benin
- Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux infections tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
- * E-mail:
| | - Bich-Tram Huynh
- Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux infections tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Samad Ibitokou
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Gbetognon Hounguevou
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Jacqueline Affedjou
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Jean-Claude Sagbo
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Parfait Houngbegnon
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Blaise Guezo-Mévo
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Achille Massougbodji
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Adrian J. F. Luty
- Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux infections tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Michel Cot
- Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux infections tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
| | - Philippe Deloron
- Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux infections tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France
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Rougeron V, Woods CM, Tiedje KE, Bodeau-Livinec F, Migot-Nabias F, Deloron P, Luty AJF, Fowkes FJI, Day KP. Epistatic Interactions between apolipoprotein E and hemoglobin S Genes in regulation of malaria parasitemia. PLoS One 2013; 8:e76924. [PMID: 24116184 PMCID: PMC3792892 DOI: 10.1371/journal.pone.0076924] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 09/04/2013] [Indexed: 11/18/2022] Open
Abstract
Apolipoprotein E is a monomeric protein secreted by the liver and responsible for the transport of plasma cholesterol and triglycerides. The APOE gene encodes 3 isoforms Ɛ4, Ɛ3 and Ɛ2 with APOE Ɛ4 associated with higher plasma cholesterol levels and increased pathogenesis in several infectious diseases (HIV, HSV). Given that cholesterol is an important nutrient for malaria parasites, we examined whether APOE Ɛ4 was a risk factor for Plasmodium infection, in terms of prevalence or parasite density. A cross sectional survey was performed in 508 children aged 1 to 12 years in Gabon during the wet season. Children were screened for Plasmodium spp. infection, APOE and hemoglobin S (HbS) polymorphisms. Median parasite densities were significantly higher in APOE Ɛ4 children for Plasmodium spp. densities compared to non-APOE Ɛ4 children. When stratified for HbS polymorphisms, median Plasmodium spp. densities were significantly higher in HbAA children if they had an APOE Ɛ4 allele compared to those without an APOE Ɛ4 allele. When considering non-APOE Ɛ4 children, there was no quantitative reduction of Plasmodium spp. parasite densities for HbAS compared to HbAA phenotypes. No influence of APOE Ɛ4 on successful Plasmodium liver cell invasion was detected by multiplicity of infection. These results show that the APOE Ɛ4 allele is associated with higher median malaria parasite densities in children likely due to the importance of cholesterol availability to parasite growth and replication. Results suggest an epistatic interaction between APOE and HbS genes such that sickle cell trait only had an effect on parasite density in APOE Ɛ4 children. This suggests a linked pathway of regulation of parasite density involving expression of these genes. These findings have significance for understanding host determinants of regulation of malaria parasite density, the design of clinical trials as well as studies of co-infection with Plasmodium and other pathogens.
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Affiliation(s)
- Virginie Rougeron
- Department of Microbiology, Division of Medical Parasitology, New York University School of Medicine, New York, New York, United States of America
| | - Caira M. Woods
- Department of Microbiology, Division of Medical Parasitology, New York University School of Medicine, New York, New York, United States of America
| | - Kathryn E. Tiedje
- Department of Microbiology, Division of Medical Parasitology, New York University School of Medicine, New York, New York, United States of America
| | - Florence Bodeau-Livinec
- Department of Microbiology, Division of Medical Parasitology, New York University School of Medicine, New York, New York, United States of America
- UMR216, Institut de Recherche pour le Développement, Paris, France
| | | | - Philippe Deloron
- UMR216, Institut de Recherche pour le Développement, Paris, France
- PRES, Paris Sorbonne Cité, Université Paris Descartes, Paris, France
| | | | - Freya J. I. Fowkes
- Department of Microbiology, Division of Medical Parasitology, New York University School of Medicine, New York, New York, United States of America
- Centre for Population Health, Macfarlane Burnet Institute of Medical Research and Public Health, Melbourne, Victoria, Australia
| | - Karen P. Day
- Department of Microbiology, Division of Medical Parasitology, New York University School of Medicine, New York, New York, United States of America
- * E-mail:
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50
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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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