Host Cell Phosphatidylcholine Is a Key Mediator of Malaria Parasite Survival during Liver Stage Infection

During invasion, Plasmodium, the causative agent of malaria, wraps itself in a parasitophorous vacuole membrane (PVM), which constitutes a critical interface between the parasite and its host cell. Within hepatocytes, each Plasmodium sporozoite generates thousands of new parasites, creating high demand for lipids to support this replication and enlarge the PVM. Here, a global analysis of the total lipid repertoire of Plasmodium-infected hepatocytes reveals an enrichment of neutral lipids and the major membrane phospholipid, phosphatidylcholine (PC). While infection is unaffected in mice deficient in key enzymes involved in neutral lipid synthesis and lipolysis, ablation of rate-limiting enzymes in hepatic PC biosynthetic pathways significantly decreases parasite numbers. Host PC is taken up by both P. berghei and P. falciparum and is necessary for correct localization of parasite proteins to the PVM, which is essential for parasite survival. Thus, Plasmodium relies on the abundance of these lipids within hepatocytes to support infection.Seventh Framework Programme (European Commission) (Grant Agreement 311502)Fundacao para a Ciencia e a Tecnologia (Grant EXCL/IMI-MIC/0056/2012)Fundacao para a Ciencia e a Tecnologia (Grant PTDC/IMI-MIC/1568/2012

Identificación y caracterización funcional de la molécula de membrana CD38 en células hepáticas estrelladas

[spa] Las células hepáticas estrelladas (CHE) representan entre 5-8% del total de las células hepáticas y un 13% del total de las células sinusoidales. Se encuentran situadas en el espacio de Disse (espacio virtual entre las células endoteliales y el parénquima). En el hígado normal, presentan un fenotipo quiescente, morfológicamente se caracterizan por la presencia de vacuolas intracitoplasmaticas que contienen vitamina A. En el hígado normal funcionalmente están implicadas en: la regulación del recambio de la matriz extracelular, secreción de una variedad de citoquinas y factores de crecimiento, control del diámetro de los sinusoides y almacenamiento de vitamina A. En situaciones de lesión celular las CHE sufren un proceso de activación y se transforman en un fenotipo tipo miofibroblasto, adquiriendo características propias de este linaje: una elevada capacidad proliferativa, sintética y contráctil. En este estado de activación las CHE están implicadas en procesos de fibrogenesis, al ser las principales productoras de matriz extracelular, en procesos inflamatorios, debido a su capacidad de secretar al medio mediadores solubles de la inflamación (ej. quimioquinas, factores de crecimiento hematopoyetico, etc.) y en procesos de contracción, las CHE son capaces de contraerse o relajarse en respuesta a diferentes sustancias vasoactivas. Nuestro objetivo fue identificar nuevas moléculas expresadas en la superficie CHE y posteriormente estudiar su posible papel funcional en procesos fisopatologicos como la inflamación, fibrogenesis y contracción. Para alcanzar tal objetivo la estrategia que seguimos fue la producción de anticuerpos monoclonales que reconociesen proteínas de la membrana expresadas principalmente en CHE. Los resultados obtenidos fueron los siguientes: 1.1. Producción de anticuerpos monoclonales: Obtuvimos una panel de 13 anticuerpos monoclonales contra la CHE. El estudio lo centramos en los anticuerpos 5.520, 8.9 y 14.27, ya que por datos preliminares de citometría de flujo e inmunohistoquimica, fueron los mas específicos. 1.2. Identificación de proteínas; Purificamos la proteína reconocida por el anticuerpo 14.27 y por espectrometría de masas (MALDI-TOF), pudimos identificar que proteína estaba reconociendo, se trato del CD38. 1.3. Clonaje del CD38 de rata y transfección en células COS: Para acabar de confirmar que el anticuerpo 14.27 estaba reconociendo la molécula CD38. El CD38 de rata fue clonado a partir del mRNA procedente de un cultivo primario de CHEs. Posteriormente se subclono en un vector de expresión y se transfectaron células COS. Los experimentos demostraron que el anticuerpo reconocía el CD38 expresado en células COS. 1.4. Caracterización bioquímica del anticuerpo anti-CD38 (14.27): A partir de lisados de cultivos primarios de CHE, el anticuerpo 14.27 inmunoprecipitó la molécula CD38. El anticuerpo también pudo detectar el CD38 mediante Western-Blott. 1.5. Estudio de la expresión del CD38: mediante un esudio inmunohistoquimico realizados con secciones de hígado procedente de ratas sanas, pre-tratadas con LPS y cirróticas, se determinó la distribución del CD38 en el hígado. Su localización fue mayoritariamente sinusoidal. Estudios "in Vitro" y "in vivo" demostraron que la expresión del CD38 en CHE aumentaba tras su activación. 1.6. Estudios funcionales demostraron que el anticuerpo anti-CD38 (14.27): 1.6.1. Funciona como un anticuerpo agonista al inducir la movilización de calcio en CHE. 1.6.2. Induce la secreción de IL-6 tanto en CHEs activadas como en CHEs quiescentes (independiente estado de activación) 1.6.3. Induce la expresión de las moléculas de adhesión I-CAM, V-CAM y N-CAM en CHE activadas pero no en CHE quiescente (dependiente estado de activación) 1.6.4. Produce un aumento de la presión portal en ratas. 1.6.5. Induce la contracción de CHE en cultivo, la fosforilación de la cadena ligera de la miosina y la reorganización de citoesqueleto. (datos pre-liminares). 1.6.6. Media la regulación del colageno I, metaloproteinasa II (MMP-2) y del inhibidor de metaloproteinasas I (TIMP-I) (datos pre-liminares). Estos resultados indican el posible papel del CD38 en la inflamación, contracción y fibrogenesis

In Vitro Culture, Drug Sensitivity, and Transcriptome of Plasmodium Vivax Hypnozoites

The unique relapsing nature of Plasmodium vivax infection is a major barrier to malaria eradication. Upon infection, dormant liver-stage forms, hypnozoites, linger for weeks to months and then relapse to cause recurrent blood-stage infection. Very little is known about hypnozoite biology; definitive biomarkers are lacking and in vitro platforms that support phenotypic studies are needed. Here, we recapitulate the entire liver stage of P. vivax in vitro, using a multiwell format that incorporates micropatterned primary human hepatocyte co-cultures (MPCCs). MPCCs feature key aspects of P. vivax biology, including establishment of persistent small forms and growing schizonts, merosome release, and subsequent infection of reticulocytes. We find that the small forms exhibit previously described hallmarks of hypnozoites, and we pilot MPCCs as a tool for testing candidate anti-hypnozoite drugs. Finally, we employ a hybrid capture strategy and RNA sequencing to describe the hypnozoite transcriptome and gain insight into its biology. Plasmodium vivax hypnozoites are difficult to study due to the lack of human liver platforms. Gural et al. recapitulated the entire liver stage of P. vivax in vitro, including formation and reactivation of hypnozoites and release of merosomes. Hybrid capture followed by RNA-seq revealed a first look into the hypnozoite transcriptome. Keywords: malaria; plasmodium vivax; liver stage; hypnozoite; RNA-seq; transcriptome; RNA capture; micropatterning; primary human hepatocytes; radical cureBill & Melinda Gates Foundation (Grant OPP1023607)National Cancer Institute (U.S.) (Grant P30-CA14051

A human monoclonal antibody prevents malaria infection by targeting a new site of vulnerability on the parasite

Development of a highly effective vaccine or antibodies for the prevention and ultimately elimination of malaria is urgently needed. Here we report the isolation of a number of human monoclonal antibodies directed against the Plasmodium falciparum (Pf) circumsporozoite protein (PfCSP) from several subjects immunized with an attenuated Pf whole-sporozoite (SPZ) vaccine (Sanaria PfSPZ Vaccine). Passive transfer of one of these antibodies, monoclonal antibody CIS43, conferred high-level, sterile protection in two different mouse models of malaria infection. The affinity and stoichiometry of CIS43 binding to PfCSP indicate that there are two sequential multivalent binding events encompassing the repeat domain. The first binding event is to a unique 'junctional' epitope positioned between the N terminus and the central repeat domain of PfCSP. Moreover, CIS43 prevented proteolytic cleavage of PfCSP on PfSPZ. Analysis of crystal structures of the CIS43 antigen-binding fragment in complex with the junctional epitope determined the molecular interactions of binding, revealed the epitope's conformational flexibility and defined Asn-Pro-Asn (NPN) as the structural repeat motif. The demonstration that CIS43 is highly effective for passive prevention of malaria has potential application for use in travelers, military personnel and elimination campaigns and identifies a new and conserved site of vulnerability on PfCSP for next-generation rational vaccine design

Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010

Background Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorporating a systematic reassessment of disease and injury-specific epidemiology has been done since the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and 2010 with methods to enable meaningful comparisons over time. Methods We calculated DALYs as the sum of years of life lost (YLLs) and years lived with disability (YLDs). DALYs were calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional and global estimates of disease burden for three points in time with strictly comparable definitions and methods. YLLs were calculated from age-sex-country-time-specific estimates of mortality by cause, with death by standardised lost life expectancy at each age. YLDs were calculated as prevalence of 1160 disabling sequelae, by age, sex, and cause, and weighted by new disability weights for each health state. Neither YLLs nor YLDs were age-weighted or discounted. Uncertainty around cause-specific DALYs was calculated incorporating uncertainty in levels of all-cause mortality, cause-specific mortality, prevalence, and disability weights. Findings Global DALYs remained stable from 1990 (2.503 billion) to 2010 (2.490 billion). Crude DALYs per 1000 decreased by 23% (472 per 1000 to 361 per 1000). An important shift has occurred in DALY composition with the contribution of deaths and disability among children (younger than 5 years of age) declining from 41% of global DALYs in 1990 to 25% in 2010. YLLs typically account for about half of disease burden in more developed regions (high-income Asia Pacific, western Europe, high-income North America, and Australasia), rising to over 80% of DALYs in sub-Saharan Africa. In 1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% from non-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively. Ischaemic heart disease was the leading cause of DALYs worldwide in 2010 (up from fourth rank in 1990, increasing by 29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs), stroke (fifth in 1990; 19% increase), diarrhoeal diseases (second in 1990; 51% decrease), and HIV/AIDS (33rd in 1990; 351% increase). Major depressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34% increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions. Interpretation Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results

Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010:a systematic analysis for the Global Burden of Disease Study 2010

BACKGROUND: Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and regional level. Neither effort quantified uncertainty in prevalence or years lived with disability (YLDs).METHODS: Of the 291 diseases and injuries in the GBD cause list, 289 cause disability. For 1160 sequelae of the 289 diseases and injuries, we undertook a systematic analysis of prevalence, incidence, remission, duration, and excess mortality. Sources included published studies, case notification, population-based cancer registries, other disease registries, antenatal clinic serosurveillance, hospital discharge data, ambulatory care data, household surveys, other surveys, and cohort studies. For most sequelae, we used a Bayesian meta-regression method, DisMod-MR, designed to address key limitations in descriptive epidemiological data, including missing data, inconsistency, and large methodological variation between data sources. For some disorders, we used natural history models, geospatial models, back-calculation models (models calculating incidence from population mortality rates and case fatality), or registration completeness models (models adjusting for incomplete registration with health-system access and other covariates). Disability weights for 220 unique health states were used to capture the severity of health loss. YLDs by cause at age, sex, country, and year levels were adjusted for comorbidity with simulation methods. We included uncertainty estimates at all stages of the analysis.FINDINGS: Global prevalence for all ages combined in 2010 across the 1160 sequelae ranged from fewer than one case per 1 million people to 350,000 cases per 1 million people. Prevalence and severity of health loss were weakly correlated (correlation coefficient -0·37). In 2010, there were 777 million YLDs from all causes, up from 583 million in 1990. The main contributors to global YLDs were mental and behavioural disorders, musculoskeletal disorders, and diabetes or endocrine diseases. The leading specific causes of YLDs were much the same in 2010 as they were in 1990: low back pain, major depressive disorder, iron-deficiency anaemia, neck pain, chronic obstructive pulmonary disease, anxiety disorders, migraine, diabetes, and falls. Age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010. Regional patterns of the leading causes of YLDs were more similar compared with years of life lost due to premature mortality. Neglected tropical diseases, HIV/AIDS, tuberculosis, malaria, and anaemia were important causes of YLDs in sub-Saharan Africa.INTERPRETATION: Rates of YLDs per 100,000 people have remained largely constant over time but rise steadily with age. Population growth and ageing have increased YLD numbers and crude rates over the past two decades. Prevalences of the most common causes of YLDs, such as mental and behavioural disorders and musculoskeletal disorders, have not decreased. Health systems will need to address the needs of the rising numbers of individuals with a range of disorders that largely cause disability but not mortality. Quantification of the burden of non-fatal health outcomes will be crucial to understand how well health systems are responding to these challenges. Effective and affordable strategies to deal with this rising burden are an urgent priority for health systems in most parts of the world.FUNDING: Bill &amp; Melinda Gates Foundation.</p