Common virulence gene expression in adult first-time infected malaria patients and severe cases

Publikation: Bidrag til tidsskriftTidsskriftartikelfagfællebedømt

  • Jan Stephan Wichers
  • Gerry Tonkin-Hill
  • Thorsten Thye
  • Ralf Krumkamp
  • Benno Kreuels
  • Jan Strauss
  • Heidrun von Thien
  • Judith Anna Marie Scholz
  • Rasmus Weisel Jensen
  • Freia-Raphaella Lorenz
  • Anna Schöllhorn
  • Iris Bruchhaus
  • Egbert Tannich
  • Rolf Fendel
  • Thomas D Otto
  • Tim Wolf Gilberger
  • Michael Duffy
  • Anna Bachmann

Sequestration of Plasmodium falciparum-infected erythrocytes to host endothelium through the parasite-derived 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 travelers returning to Germany. Patients were categorized into either malaria naïve (n=15) or pre-exposed (n=17), and into severe (n=8) or non-severe (n=24) cases. For differential expression analysis of 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 naïve immune status and/or adverse inflammatory host responses to first infections favors growth of EPCR-binding parasites.

OriginalsprogEngelsk
Artikelnummere69040
TidsskrifteLife
Vol/bind10
ISSN2050-084X
DOI
StatusUdgivet - 2021

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