1. Common virulence gene expression in adult first-time infected malaria patients and severe cases
- Author
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Louise Turner, Tim W. Gilberger, Thomas D. Otto, Anna Schöllhorn, Egbert Tannich, Jan Strauss, Rolf Fendel, Iris Bruchhaus, J. Stephan Wichers, Ralf Krumkamp, Judith Am Scholz, Helle Smedegaard Hansson, Freia-Raphaella Lorenz, Gerry Tonkin-Hill, Thorsten Thye, Benno Kreuels, Michael F. Duffy, Anna Bachmann, Rasmus Weisel Jensen, Thomas Lavstsen, and Heidrun von Thien
- Subjects
CD36 Antigens ,Male ,Protozoan Proteins ,Cohort Studies ,Pathogenesis ,transcriptomics ,0302 clinical medicine ,Biology (General) ,Malaria, Falciparum ,Microbiology and Infectious Disease ,0303 health sciences ,Endothelial protein C receptor ,biology ,General Neuroscience ,Endothelial Protein C Receptor ,General Medicine ,Chromosomes and Gene Expression ,3. Good health ,Medicine ,Female ,variant surface antigens ,Antibody ,Research Article ,Protein Binding ,Adult ,QH301-705.5 ,Science ,Plasmodium falciparum ,Virulence ,P. falciparum ,General Biochemistry, Genetics and Molecular Biology ,Young Adult ,03 medical and health sciences ,Antigen ,parasitic diseases ,medicine ,Humans ,Gene ,030304 developmental biology ,General Immunology and Microbiology ,biology.organism_classification ,medicine.disease ,Virology ,PfEMP1 ,virulence ,biology.protein ,RNA-seq ,030217 neurology & neurosurgery ,Malaria - Abstract
Sequestration of Plasmodium falciparum(P. falciparum)-infected erythrocytes to host endothelium through the parasite-derived P. falciparum erythrocyte membrane protein 1 (PfEMP1) adhesion proteins is central to the development of malaria pathogenesis. PfEMP1 proteins have diversified and expanded to encompass many sequence variants, conferring each parasite a similar array of human endothelial receptor-binding phenotypes. Here, we analyzed RNA-seq profiles of parasites isolated from 32 P. falciparum-infected adult travellers returning to Germany. Patients were categorized into either malaria naive (n = 15) or pre-exposed (n = 17), and into severe (n = 8) or non-severe (n = 24) cases. For differential expression analysis, PfEMP1-encoding var gene transcripts were de novo assembled from RNA-seq data and, in parallel, var-expressed sequence tags were analyzed and used to predict the encoded domain composition of the transcripts. Both approaches showed in concordance that severe malaria was associated with PfEMP1 containing the endothelial protein C receptor (EPCR)-binding CIDRα1 domain, whereas CD36-binding PfEMP1 was linked to non-severe malaria outcomes. First-time infected adults were more likely to develop severe symptoms and tended to be infected for a longer period. Thus, parasites with more pathogenic PfEMP1 variants are more common in patients with a naive immune status, and/or adverse inflammatory host responses to first infections favor the growth of EPCR-binding parasites.
- Published
- 2021
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