1. A systematic analysis of the human immune response to Plasmodium vivax
- Author
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Bach, Florian A., Sandoval, Diana Munoz, Mazurczyk, Michalina, Themistocleous, Yrene, Rawlinson, Thomas A., Harding, Adam C., Kemp, Alison, Silk, Sarah E., Barrett, Jordan R., Edwards, Nick J., Ivens, Alasdair, Rayner, Julian C., Minassian, Angela M., Napolitani, Giorgio, Draper, Simon J., and Spence, Philip J.
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Interferon -- Comparative analysis -- Health aspects ,Medical research -- Comparative analysis -- Health aspects ,Medicine, Experimental -- Comparative analysis -- Health aspects ,T cells -- Comparative analysis -- Health aspects ,RNA sequencing -- Health aspects -- Comparative analysis ,Immune response -- Health aspects -- Comparative analysis ,Biological response modifiers -- Comparative analysis -- Health aspects ,Infection -- Comparative analysis -- Health aspects ,Malaria -- Health aspects -- Comparative analysis ,RNA -- Health aspects -- Comparative analysis ,Cell differentiation -- Comparative analysis -- Health aspects ,Plasmodium falciparum -- Comparative analysis -- Health aspects ,Health care industry ,Wellcome Trust - Abstract
BACKGROUND. The biology of Plasmodium vivax is markedly different from that of P. falciparum; how this shapes the immune response to infection remains unclear. To address this shortfall, we inoculated human volunteers with a clonal field isolate of P. vivax and tracked their response through infection and convalescence. METHODS. Participants were injected intravenously with blood-stage parasites and infection dynamics were tracked in real time by quantitative PCR. Whole blood samples were used for high dimensional protein analysis, RNA sequencing, and cytometry by time of flight, and temporal changes in the host response to P. vivax were quantified by linear regression. Comparative analyses with P. falciparum were then undertaken using analogous data sets derived from prior controlled human malaria infection studies. RESULTS. P. vivax rapidly induced a type I inflammatory response that coincided with hallmark features of clinical malaria. This acute-phase response shared remarkable overlap with that induced by P. falciparum but was significantly elevated (at RNA and protein levels), leading to an increased incidence of pyrexia. In contrast, T cell activation and terminal differentiation were significantly increased in volunteers infected with P. falciparum. Heterogeneous [CD4.sup.+] T cells were found to dominate this adaptive response and phenotypic analysis revealed unexpected features normally associated with cytotoxicity and autoinflammatory disease. CONCLUSION. P. vivax triggers increased systemic interferon signaling (cf P. falciparum), which likely explains its reduced pyrogenic threshold. In contrast, P. falciparum drives T cell activation far in excess of P. vivax, which may partially explain why falciparum malaria more frequently causes severe disease. TRIAL REGISTRATION. ClinicalTrials.gov NCT03797989. FUNDING. The European Union's Horizon 2020 Research and Innovation programme, the Wellcome Trust, and the Royal Society., Introduction Plasmodium vivax causes more than half of all malaria cases in the Americas and Southeast Asia (1) and its distinct biology (cf P falciparum) presents unique challenges for control [...]
- Published
- 2023
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