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Malaria Journal Jun 2024Malaria, a severe health threat, significantly affects total antioxidant status (TAS) levels, leading to considerable oxidative stress. This systematic review and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Malaria, a severe health threat, significantly affects total antioxidant status (TAS) levels, leading to considerable oxidative stress. This systematic review and meta-analysis aimed to delineate differences in TAS levels between malaria patients and healthy controls, and assess correlations between disease severity and parasite density.
METHODS
The systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42023448761. A comprehensive literature search was conducted in databases such as Embase, MEDLINE, Journals@Ovid, PubMed, Scopus, ProQuest, and Google Scholar to identify studies reporting data on TAS levels in malaria patients. Data from the included studies were analysed both qualitatively and quantitatively. Differences in TAS levels between malaria patients and controls were pooled using a random effects model, with Hedges' g as the effect size measure.
RESULTS
Of 1796 identified records, 20 studies met the inclusion criteria. The qualitative synthesis of these studies revealed a marked decrease in TAS levels in patients with malaria compared to non-malaria cases. The meta-analysis results showed a significant decrease in TAS levels in patients with malaria compared to non-malaria cases (P < 0.01, Hedges' g: - 2.75, 95% CI - 3.72 to -1.78, I: 98.16%, 13 studies), suggesting elevated oxidative stress in these patients. Subgroup analyses revealed that TAS level variations were significantly influenced by geographical region, age group, Plasmodium species, and method for measuring TAS. Notably, TAS levels were significantly lower in severe malaria cases and those with high parasite density, indicating a potential relationship between oxidative stress and disease severity.
CONCLUSION
This study highlights the potential utility of TAS as a biomarker for disease risk and severity in malaria. The significant decrease in TAS levels in malaria patients compared to controls implies increased oxidative stress. Further well-designed, large-scale studies are warranted to validate these findings and elucidate the intricate mechanisms linking TAS and malaria.
Topics: Malaria; Antioxidants; Humans; Oxidative Stress
PubMed: 38926807
DOI: 10.1186/s12936-024-05003-z -
The Journal of Biological Chemistry Jun 2024Emerging Artemisinin (ART) resistance in Plasmodium falciparum (Pf) poses challenges for discovery of novel drugs to tackle ART resistant parasites. Concentrated efforts...
Emerging Artemisinin (ART) resistance in Plasmodium falciparum (Pf) poses challenges for discovery of novel drugs to tackle ART resistant parasites. Concentrated efforts towards ART resistance mechanism indicated a strong molecular link of ART resistance with up-regulated expression of unfolded protein response pathways involving Prefoldins (PFDs). However, a complete characterization of PFDs as molecular players taking part in ART resistance mechanism, and discovery of small molecule inhibitors to block this process have not been identified to date. Here, we functionally characterized all Pf Prefoldin subunits (PFD1-6), and established a causative role played by PFDs in ART resistance by demonstrating their expression in intra-erythrocytic parasites along with their interactions with Kelch13 protein through immunoprecipitation coupled MS/MS analysis. Systematic biophysical interaction analysis between all subunits of PFDs revealed their potential to form a complex. The role of PFDs in ART resistance was confirmed in orthologous yeast PFD6 mutants, where PfPFD6 expression in yeast mutants reverted phenotype to ART resistance. We identified an FDA approved drug 'Biperiden' that restricts the formation of Prefoldin complex and inhibits its interaction with its key parasite protein substrates, MSP-1 and α-tubulin-I. Moreover, Biperiden treatment inhibits the parasite growth in ART sensitive Pf3D7 and resistant Pf3D7k13 strains. Ring survival assays that are clinically relevant to analyse ART resistance in Pf3D7k13 parasites demonstrate the potency of BPD to inhibit growth of survivor parasites. Overall, our study provides first evidence towards the role of PfPFDs in ART resistance mechanism, and opens new avenues for the management of resistant parasite.
PubMed: 38925325
DOI: 10.1016/j.jbc.2024.107496 -
Biotechnology and Applied Biochemistry Jun 2024In spite of 150 years of studying malaria, the unique features of the malarial parasite, Plasmodium, still perplex researchers. One of the methods by which the parasite...
In spite of 150 years of studying malaria, the unique features of the malarial parasite, Plasmodium, still perplex researchers. One of the methods by which the parasite manages its gene expression is epigenetic regulation, the champion of which is PfGCN5, an essential enzyme responsible for acetylating histone proteins. PfGCN5 is a ∼170 kDa chromatin-remodeling enzyme that harbors the conserved bromodomain and acetyltransferase domain situated in its C-terminus domain. Although the PfGCN5 proteolytic processing is essential for its activity, the specific protease involved in this process still remains elusive. Identification of PfGCN5 interacting proteins through immunoprecipitation (IP) followed by LC-tandem mass spectrometry analysis revealed the presence of food vacuolar proteins, such as the cysteine protease Falcipain 3 (FP3), in addition to the typical members of the PfGCN5 complex. The direct interaction between FP3 and PfGCN5 was further validated by in vitro pull-down assay as well as IP assay. Subsequently, use of cysteine protease inhibitor E64d led to the inhibition of protease-specific processing of PfGCN5 with concomitant enrichment and co-localization of PfGCN5 and FP3 around the food vacuole as evidenced by confocal microscopy as well as electron microscopy. Remarkably, the proteolytic cleavage of the nuclear protein PfGCN5 by food vacuolar protease FP3 is exceptional and atypical in eukaryotic organisms. Targeting the proteolytic processing of GCN5 and the associated protease FP3 could provide a novel approach for drug development aimed at addressing the growing resistance of parasites to current antimalarial drugs.
PubMed: 38924147
DOI: 10.1002/bab.2630 -
Chembiochem : a European Journal of... Jun 2024The human malaria parasite Plasmodium falciparum (P. falciparum) continues to pose a significant public health challenge, leading to millions of fatalities globally....
The human malaria parasite Plasmodium falciparum (P. falciparum) continues to pose a significant public health challenge, leading to millions of fatalities globally. Halofuginone (HF) has shown a significant anti-P. falciparum effect, suggesting its potential as a therapeutic agent for malaria treatment. In this study, we synthesized a photoaffinity labeling probe of HF to identify its direct target in P. falciparum. Our results reveal that ubiquitin carboxyl-terminal hydrolase 3 (PfUCHL3) acts as a crucial target protein of HF, which modulates parasite growth in the intraerythrocytic cycle. In particular, we discovered that HF potentially forms hydrogen bonds with the Leu10, Glu11, and Arg217 sites of PfUCHL3, thereby inducing an allosteric effect by promoting the embedding of the helix 6' region on the protein surface. Furthermore, HF disrupts the expression of multiple functional proteins mediated by PfUCHL3, specifically those that play crucial roles in amino acid biosynthesis and metabolism in P. falciparum. Taken together, this study highlights PfUCHL3 as a previously undisclosed druggable target of HF, which contributes to the development of novel anti-malarial agents in the future.
PubMed: 38923255
DOI: 10.1002/cbic.202400269 -
Journal of Vector Borne Diseases Apr 2024Plasmodium knowlesi, a simian malaria species, is now known to infect humans. Due to disadvantages in the current diagnosis methods, many efforts have been placed into...
Detection of Plasmodium knowlesi in whole blood samples with sandwich enzyme-linked immunosorbent assay (ELISA) using rhoptry-associated protein 1 specific polyclonal antibodies.
BACKGROUND OBJECTIVES
Plasmodium knowlesi, a simian malaria species, is now known to infect humans. Due to disadvantages in the current diagnosis methods, many efforts have been placed into developing new methods to diagnose the disease. This study assessed the ability of the PkRAP-1 sandwich enzyme-linked immunosorbent (ELISA) to detect P knowlesi antigens in whole blood specimens.
METHODS
Western blot assay was conducted to evaluate the ability of raised mouse and rabbit anti-PkRAP-1 polyclonal antibodies to bind to the native proteins in P. knowlesi lysate. The polyclonal antibodies were then used in sandwich ELISA to detect P. knowlesi. In the sandwich ELISA, mouse and rabbit polyclonal antibodies were used as the capture and detection antibodies, respectively. The limit of detection (LOD) of the assay was determined using P. knowlesi A1H1 culture and purified recombinant PkRAP-1.
RESULTS
Western blot results showed positive reactions towards the proteins in P. knowlesi lysate. The LOD of the assay from three technical replicates was 0.068% parasitaemia. The assay performance in detecting P. knowlesi was 83% sensitivity and 70% specificity with positive and negative predictive values of 74% and 80%, respectively. The anti-PkRAP-1 polyclonal antibodies did not cross-react with P. falciparum and healthy samples, but P. vivax by detecting all 12 samples.
INTERPRETATION CONCLUSION
PkRAP-1 has the potential as a biomarker for the development of a new diagnostic tool for P. knowlesi detection. Further studies need to be conducted to establish the full potential of the usage of anti-PkRAP-1 antibodies for P. knowlesi detection.
Topics: Plasmodium knowlesi; Enzyme-Linked Immunosorbent Assay; Animals; Malaria; Antibodies, Protozoan; Rabbits; Sensitivity and Specificity; Mice; Protozoan Proteins; Humans; Antigens, Protozoan; Blotting, Western; Limit of Detection
PubMed: 38922654
DOI: 10.4103/jvbd.jvbd_55_23 -
Journal of Vector Borne Diseases Apr 2024Following World Health Organization (WHO) plans for thirty-five malaria-endemic countries, Indonesia will eliminate malaria by 2030. As one of the Indonesian provinces,...
BACKGROUND OBJECTIVES
Following World Health Organization (WHO) plans for thirty-five malaria-endemic countries, Indonesia will eliminate malaria by 2030. As one of the Indonesian provinces, West Java targeted subnational malaria elimination in 2022. This article aims to describe malaria surveillance data and elimination programs, including weaknesses in sustaining the program.
METHODS
This study used secondary data from malaria surveillance information system regencies/cities' case reports for 2019-2022 and achievement data of sub-national malaria elimination certification from each regency/city from 2014-2022. The data was confirmed from the evaluation study document, analysis of reported cases, and interviews.
RESULTS
Most cases were confirmed by microscopic examination (84.1% in 2021 and 94.4% in 2022) and rapid diagnostic tests (57% in 2019 and 58.1% in 2020). Malaria is more prevalent among men (93% in 2019, 95% in 2020, 96% in 2021, and 95.9% in 2022) and productive ages of 15-64 years (98.8% in 2019, 100% in 2020, 99.2% in 2021, and 98.8% in 2022), frequently occurs in the military (56.3% in 2019, 75.7% in 2020, 45.2% in 2021) and police (40.5% in 2022), often uses passive case detection for identifying cases (97.9% in 2019 and 2020, 95.2% in 2021, and 97.6% in 2022), and the majority undergo inpatient treatment (86.4% in 2019, 81.7% in 2021, and 82.6% in 2022). Most positive cases originated from imported cases, and last indigenous cases were still found in 2019. Plasmodium vivax dominated malaria cases and and relapses were high (55.0% in 2020, and 47.3% in 2022).
INTERPRETATION CONCLUSION
All regencies/cities have obtained sub-national malaria elimination certification in 2022. West Java has the potential to be verified for Java-Bali sub-national malaria elimination targeted in 2023, albeit cases of imported malaria still occur. It is imperative to address the issue of imported cases transitioning into locally transmitted cases (introduced) by effective coordination across all regencies/cities and inter-provincial efforts.
Topics: Indonesia; Humans; Adolescent; Adult; Male; Middle Aged; Young Adult; Disease Eradication; Female; Child; Child, Preschool; Malaria; Infant; Malaria, Vivax; Prevalence; Aged; Infant, Newborn
PubMed: 38922652
DOI: 10.4103/jvbd.jvbd_113_23 -
JMIR Public Health and Surveillance Jun 2024A challenge in achieving the malaria-elimination target in the Greater Mekong Subregion, including Thailand, is the predominance of Plasmodium vivax malaria, which has... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
A challenge in achieving the malaria-elimination target in the Greater Mekong Subregion, including Thailand, is the predominance of Plasmodium vivax malaria, which has shown extreme resilience to control measures.
OBJECTIVE
This proof-of-concept study aimed to provide evidence for implementing primaquine mass drug administration (pMDA) as a strategy for P. vivax elimination in low-endemicity settings.
METHODS
The study employed a mixed-methods trial to thoroughly evaluate the effectiveness, safety, acceptability, and community engagement of pMDA. The quantitative part was designed as a 2-period cluster-crossover randomized controlled trial. The intervention was pMDA augmented to the national prevention and control standards with directly observed treatment (DOT) by village health volunteers. The qualitative part employed in-depth interviews and brainstorming discussions. The study involved 7 clusters in 2 districts of 2 southern provinces in Thailand with persistently low P. vivax transmission. In the quantitative part, 5 cross-sectional blood surveys were conducted in both the pMDA and control groups before and 3 months after pMDA. The effectiveness of pMDA was determined by comparing the proportions of P. vivax infections per 1000 population between the 2 groups, with a multilevel zero-inflated negative binomial model adjusted for cluster and time as covariates and the interaction. The safety data comprised adverse events after drug administration. Thematic content analysis was used to assess the acceptability and engagement of stakeholders.
RESULTS
In the pre-pMDA period, the proportions of P. vivax infections in the pMDA (n=1536) and control (n=1577) groups were 13.0 (95% CI 8.2-20.4) and 12.0 (95% CI 7.5-19.1), respectively. At month 3 post-pMDA, these proportions in the pMDA (n=1430) and control (n=1420) groups were 8.4 (95% CI 4.6-15.1) and 5.6 (95% CI 2.6-11.5), respectively. No statistically significant differences were found between the groups. The number of malaria cases reduced in all clusters in both groups, and thus, the impact of pMDA was inconclusive. There were no major safety concerns. Acceptance among the study participants and public health care providers at local and national levels was high, and they believed that pMDA had boosted awareness in the community.
CONCLUSIONS
pMDA was associated with high adherence, safety, and tolerability, but it may not significantly impact P. vivax transmission. As this was a proof-of-concept study, we decided not to scale up the intervention with larger clusters and samples. An alternative approach involving a targeted primaquine treatment strategy with primaquine and DOT is currently being implemented. We experienced success regarding effective health care workforces at point-of-care centers, effective collaborations in the community, and commitment from authorities at local and national levels. Our efforts boosted the acceptability of the malaria-elimination initiative. Community engagement is recommended to achieve elimination targets.
TRIAL REGISTRATION
Thai Clinical Trials Registry TCTR20190806004; https://www.thaiclinicaltrials.org/show/TCTR20190806004.
Topics: Humans; Primaquine; Thailand; Mass Drug Administration; Male; Female; Adult; Adolescent; Malaria, Vivax; Antimalarials; Middle Aged; Young Adult; Proof of Concept Study; Child; Cross-Over Studies; Cross-Sectional Studies; Patient Acceptance of Health Care
PubMed: 38922648
DOI: 10.2196/51993 -
Parasitology Research Jun 2024Avian haemosporidians of the genera Plasmodium and Haemoproteus are a group of widely distributed blood parasites that can negatively affect the fitness of their hosts....
Avian haemosporidians of the genera Plasmodium and Haemoproteus are a group of widely distributed blood parasites that can negatively affect the fitness of their hosts. Colombia contains the greatest diversity of birds on the planet, but knowledge about the associations between haemosporidian and its avifauna is scarce and fragmented. We collected blood samples from 255 birds (203 residents and 52 neotropical migrants) belonging to 27 families and 108 species. The study was conducted in six localities in the inter-Andean valleys of the Cauca and Magdalena rivers. Parasites of the genera Plasmodium and Haemoproteus were identified in the samples by morphological and molecular analysis of a fragment of the mitochondrial gene cyt b. Among the samples, 9.3% (n = 24) were positive for Plasmodium or Haemoproteus. Co-infection with Plasmodium and Haemoproteus was found in Red-eyed Vireo. Seventeen haemosporidian lineages were identified, five of which were reported for the first time in resident birds (Common Ground Dove, Checker-throated Stipplethroat, Tropical Kingbird, Pale-breasted Thrush, and Ruddy-breasted Seedeater) and one in the Summer Tanager (neotropical migrant). The research results confirm the wide diversity of haemosporidian present in tropical lowlands and the possible role of neotropical migratory birds in dissemination on haemosporidian along their migratory routes.
Topics: Animals; Colombia; Haemosporida; Birds; Bird Diseases; Plasmodium; Protozoan Infections, Animal; Cytochromes b; Animal Migration; Phylogeny; Coinfection
PubMed: 38922536
DOI: 10.1007/s00436-024-08260-8 -
Memorias Do Instituto Oswaldo Cruz 2024The coinfection between malaria (ML) and arboviral diseases represents a major global public health problem, particularly in tropical and subtropical countries. Despite...
The coinfection between malaria (ML) and arboviral diseases represents a major global public health problem, particularly in tropical and subtropical countries. Despite its relevance, this topic is still insufficiently discussed in the current literature. Here, we aimed to investigate the worldwide distribution, symptoms, and diagnosis during coinfection between ML and arboviral diseases. We conducted a systematic review following the Preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement and assessed the selection and eligibility criteria, created and diagrammed maps, and analysed major symptoms with 95% confidence intervals (CI) using prevalence ratio and effect size, also performing latent class analysis. A total of 85,485 studies were retrieved, of which 56 were included: 57.14% in Asia, 25% in Africa, 14.30% in South America, and 3.56% in Europe. A total of 746 individuals were reported to be coinfected with Plasmodium and arbovirus. Concurrent ML, Dengue (DEN), Chikungunya (CHIK), and Zika (ZIK) patients are more likely to present headache and skin rash. Regarding diagnosis, 58,253 were made, of which 38,176 were positive (ML and at least one arboviral disease). The magnitude of these pathogens' coexistence points out the pressing need for improvements in public health policies towards diagnosis and prevention of both diseases, especially in endemic areas.
Topics: Humans; Coinfection; Malaria; Arbovirus Infections; Global Health; Prevalence
PubMed: 38922217
DOI: 10.1590/0074-02760240015 -
ELife Jun 2024While often undetected and untreated, persistent seasonal asymptomatic malaria infections remain a global public health problem. Despite the presence of parasites in the...
While often undetected and untreated, persistent seasonal asymptomatic malaria infections remain a global public health problem. Despite the presence of parasites in the peripheral blood, no symptoms develop. Disease severity is correlated with the levels of infected red blood cells (iRBCs) adhering within blood vessels. Changes in iRBC adhesion capacity have been linked to seasonal asymptomatic malaria infections, however how this is occurring is still unknown. Here, we present evidence that RNA polymerase III (RNA Pol III) transcription in is downregulated in field isolates obtained from asymptomatic individuals during the dry season. Through experiments with in vitro cultured parasites, we have uncovered an RNA Pol III-dependent mechanism that controls pathogen proliferation and expression of a major virulence factor in response to external stimuli. Our findings establish a connection between cytoadhesion and a non-coding RNA family transcribed by Pol III. Additionally, we have identified Maf1 as a pivotal regulator of Pol III transcription, both for maintaining cellular homeostasis and for responding adaptively to external signals. These results introduce a novel perspective that contributes to our understanding of virulence. Furthermore, they establish a connection between this regulatory process and the occurrence of seasonal asymptomatic malaria infections.
Topics: Plasmodium falciparum; Virulence; RNA Polymerase III; Humans; Malaria, Falciparum; Erythrocytes; Protozoan Proteins; Virulence Factors; Cell Adhesion; Gene Expression Regulation
PubMed: 38921824
DOI: 10.7554/eLife.95879