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Lennartz F, Adams Y, Bengtsson A, Olsen RW, Turner L, Ndam NT, Ecklu-Mensah G, Moussiliou A, Ofori MF, Gamain B, Lusingu JP, Petersen JEV, Wang CW, Nunes-Silva S, Jespersen JS, Lau CKY, Theander TG, Lavstsen T, Hviid L, Higgins MK, Jensen ATR. Structure-Guided Identification of a Family of Dual Receptor-Binding PfEMP1 that Is Associated with Cerebral Malaria. Cell Host Microbe 2017; 21:403-414. [PMID: 28279348 PMCID: PMC5374107 DOI: 10.1016/j.chom.2017.02.009] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [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: 10/04/2016] [Revised: 01/20/2017] [Accepted: 02/10/2017] [Indexed: 11/09/2022]
Abstract
Cerebral malaria is a deadly outcome of infection by Plasmodium falciparum, occurring when parasite-infected erythrocytes accumulate in the brain. These erythrocytes display parasite proteins of the PfEMP1 family that bind various endothelial receptors. Despite the importance of cerebral malaria, a binding phenotype linked to its symptoms has not been identified. Here, we used structural biology to determine how a group of PfEMP1 proteins interacts with intercellular adhesion molecule 1 (ICAM-1), allowing us to predict binders from a specific sequence motif alone. Analysis of multiple Plasmodium falciparum genomes showed that ICAM-1-binding PfEMP1s also interact with endothelial protein C receptor (EPCR), allowing infected erythrocytes to synergistically bind both receptors. Expression of these PfEMP1s, predicted to bind both ICAM-1 and EPCR, is associated with increased risk of developing cerebral malaria. This study therefore reveals an important PfEMP1-binding phenotype that could be targeted as part of a strategy to prevent cerebral malaria. Structural basis for P. falciparum PfEMP1 binding to endothelial receptor ICAM-1defined A sequence motif derived from structure predicts group A PfEMP1 binding to ICAM-1 These ICAM-1-binding PfEMP1s also all bind to endothelial protein C receptor (EPCR) Expression of dual ICAM-1- and EPCR-binding PfEMP1 is associated with cerebral malaria
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Affiliation(s)
- Frank Lennartz
- Department of Biochemistry, University of Oxford, South Parks Road, OX1 3QU Oxford, UK
| | - Yvonne Adams
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Anja Bengtsson
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Rebecca W Olsen
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Louise Turner
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Nicaise T Ndam
- Faculté de Pharmacie, Institut de Recherche pour le Développement (IRD), COMUE Sorbonne Paris Cité, 75013 Paris, France; Faculté des Sciences de la Santé (FSS), Université d'Aboméy Calavi, 01 BP 526 Cotonou, Benin
| | - Gertrude Ecklu-Mensah
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark; Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Azizath Moussiliou
- Faculté des Sciences de la Santé (FSS), Université d'Aboméy Calavi, 01 BP 526 Cotonou, Benin
| | - Michael F Ofori
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Benoit Gamain
- UMR_S1134, Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence GR-Ex, 75013 Paris, France
| | - John P Lusingu
- National Institute for Medical Research, Tanga Centre, 11101 Dar es Salaam, Tanzania
| | - Jens E V Petersen
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Christian W Wang
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Sofia Nunes-Silva
- UMR_S1134, Université Sorbonne Paris Cité, Université Paris Diderot, Inserm, INTS, Unité Biologie Intégrée du Globule Rouge, Laboratoire d'Excellence GR-Ex, 75013 Paris, France
| | - Jakob S Jespersen
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Clinton K Y Lau
- Department of Biochemistry, University of Oxford, South Parks Road, OX1 3QU Oxford, UK
| | - Thor G Theander
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Thomas Lavstsen
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Lars Hviid
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark
| | - Matthew K Higgins
- Department of Biochemistry, University of Oxford, South Parks Road, OX1 3QU Oxford, UK.
| | - Anja T R Jensen
- Centre for Medical Parasitology, Department of Immunology and Microbiology (ISIM), Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital (Rigshospitalet), 2100 Copenhagen, Denmark.
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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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