Apicoplasts - malaria Flashcards
Malaria immune evasion
Evade recognition
Evade innate immunity
Modulating adaptive immunity
Malaria - evading recognition
Intracellular location Antigenic variation Tandem repeats High polymorphism Functional redundancy Reduced immunogenicity
Malaria pathogenesis
Know the asexual cycle
Basic symptoms and causes
Syndromes
Placental malaria
Malaria pathogenesis - asexual cycle
Invasion by merozoites, digestion of Hb, morphological changes, asexual replication and rupture of RBC.
Malaria pathogenesis, asexual cycle, morphological changes.
More spherical, formation of knobs.
400 proteins exported by parasite.
pfEMP1 cluster under membrane knobs.
Basic malaria symptoms
Fever, headache, nausea, vomiting, general malaise.
Cause of fevers in malaria.
Rupture –> release of toxins (GPI lipid tethering + hemozoin) –> production of inflammatory mediators and cytokines (C5a, TNF, IL-1B, IL-8) –> effect on hypothalamus –> natural synchronisation.
Severe malaria syndromes
Importance of sequestration
Cerebral malaria
Severe malarial anaemia
Metabolic acidosis.
Severe malaria syndromes - importance of sequestration.
Disappear from peripheral circulation, avoid splenic clearance and immune attack.
Need for ntigenic variation.
Mechanism of transport of proteins not fully understood
Cerebral malaria
Importance
Causes
Causes of severe cerebral malaria
Cytoadherence Inflammatory response Damage to the BBB Role of NO Localisation to brain
Causes of severe malarial anemia
Destruction of RBCs
Decreased productions of RBCs
Co-infections
Causes of metabolic acidosis
The shock model
End products of parasite metabolism
Decreased elimination through impaired hepatic blood flow.
Cerebral malaria importance
Paediatric cerebral malaria: particularly bad and common in children under 5 in sub-Saharan Africa.Mostly P. falciparum.
Modelling cerebral malaria
Difficult to model. Observation in humans depends on post-mortem findings and malarial retinopathy. Animal models have limitations. 3 main contributing factors? Vascular probably important due to correlation between vascular changes in retinopathy and severity of CM.
Cytoadherence in malaria - cause.
PfEMP1 on surface – rosetting, endothelial cytoadhesion.
Cytoadhesion in malaria - effects.
Endothelial activation leading to increased vasoconstriction
Endothelial activation in cytoadherence
Due to upregulation of proinflammatory response and release of cytokines such as TNF-a and IL-1B which act on endothelial cells.
Inflammatory response cerebral malaria
TNFa
The mouse model
Effects
The inflammatory response TNF-a
Cerebral malaria.
TNF-a associated with disease severity.
The inflammatory response observed in the mouse model. Cerebral malaria.
Hyper-inflammation observed in mouse model, and TNF-a and IFNy known to be important.
Dysregulation of TNF-a commonly associated (although in murine models, injection of TNF-a does not mimic CM).
Cerebral malariaThe inflammatory response - effects
Angiopoitin 2
Upregulation of CAMs
Inflammation important in loss of BBB integrity.
Damage to the BBB cerebral malaria
Loss of tight junctions
Effect of inflammation.
Damage to the BBB cerebral malaria - inflammation
Due to inflammation, activation of endothelium and occlusion of microvasculature –> apoptosis of cells of BBB –> haemorrhagic lesions into parenchyma. Edema. –> myelin loss, axonal damage
Cerebral malaria. The inflammatory response - upregulation of CAMs
Inflammation (TNF-a) leads to upregulation of CAMs, which increase sequestration. Especially in cerebellum, may explain motor coordination deficits in children post-CM.
Cerebral malaria. The inflammatory response - angiopoietin 2.
Angipoietin 2 sensitises endothelium to inflammation, and is dysregulated in many cases severe malaria. Increasing Ang2/Ang1 ratio is associated with CM, can predict severity.
Receptors important for pfEMP1.
ICAM-1 for initial rolling and CD31, CD36, CSA, E-selecting, TSP and VCAM-1, among others for cytoadherence.
Cerebral malaria - loss of tight junctions.
Focal loss of tight junctions appear to occur at points of sequestration
Role of NO in cerebral malaria - highly controversial.
Associated both with pathogenesis and protection.
Differing levels are important.
In mice, treatment with NO decreased endothelial activation and reduced sequestration.
Role of NO in cerebral malaria - differing levels
o High levels alter neurotransmission, cause vasodilation
o Low levels lead to endothelial dysfunction.
o Generally low in disease, possibly due to scavenging effects of free haemoglobin.
Cerebral malaria - brain localisation.
- pfEMP1 receptors that are more common in brain – some found, but not yet associated with disease severity.
- Importance of BBB
Cerebral malaria - potential modulators.
NO - successful in mice.
Possibly cerebrovasculature modulators could be important for adjunctive therapies e.g. PPARy agonists, calcium channel blockers, erythropoietin etc.
Metabolic acidosis - the shock model
The shock model: Reduced circulating blood volume and reduced oxygen carrying capacity (hypovolemic shock) –> anaerobic metabolism –> lactate and keto acid production and impaired metabolism –> acidosis
Placental malaria
Pathogenesis
Immunity
Placental malaria pathogenesis
Var2csa bind chondroitin sulphate A and hyaluronic acid. Little role for rosette formation.
Accumulation of infected erythrocytes in intervillous space.
Intervillous infiltrates of monocytes.
Hemozoin deposits in fibrin.
Placental malaria immunity
Can develop, so placental malaria mostly a problem in primagravidae.
Changes in cellular immunity in pregnancy could be important.
Malaria - evading recognition, antigenic variation.
Altering expression
Generating diversity
Malaria - antigenic variation, altering expression.
Basics
Silencing of all except one var gene.
Switching of active genes.
Malaria - antigenic variation, altering expression, BASICS.
60 var genes, monallelic expression. Frequent switching. Strain specific anti-pfEMP1 Abs can only block cytoadherence when pfEMP1 is the same.
Malaria - antigenic variation, altering expression, SILENCING
Location near telomeres
Reversible histone modifications
Upstream of histone modifications.
Malaria - pfEMP1 silencing, location.
Most are located near telomeres (also VSG in T. brucei)
Some are in chromosome central positions.
All are tethered to nuclear periphery.
Malaria - pfEMP1 silencing, tethering to periphery.
This tethering occurs via a var intron region that interacts with nuclear proteins.
Malaria - pfEMP1 silencing, HISTONE MODIFICATIONS
Very key. Histone deacetylases Histone methyltransferases Histone lysine demethylases. Recruited by telomere binding proteins.
Malaria - pfEMP1 silencing, histone deacetylases
Different ones act on different variant gene families.
Deacetylation probably leads to establishment of histone 3 lysine 9 trimethylation by pfSETvs. This overall recrutes heterochromatin protein 1 to silent genes.
Sir2A and Sir2B
Sir2A and Sir2B have complementary actions repressing different var genes
H3K9me3
histone 3 lysine 9 trimethylation
pfSETvs knockout
transcription of almost all var genes.
Knockout of histone methyltransferases in falciparum.
transcription of almost all var genes.
Malaria pfEMP1 silencing - UPSTREAM of HISTONES.
var intron may act as silencing element. If paired with var promoter, latter is silent, but if a promoter is unpaired it will be expressed, even if it is integrated into a silent var gene cluster.
Malaria - antigenic variation, altering expression.
Switching of active genes.
Basics
Mechanism
Altering rate of switching.
Malaria - switching of active genes.
BASICS
A single gene is selectively activated in the early phase of blood stage development. A var gene which is activated is not expressed in the late blood stage, but is ‘poised’ for re-expression in the next cycle .
Adjacent var genes on this telomere are not transcribed due to boundary elements.
Malaria - switching of active genes.
MECHANISM
Not fully understood.
Limiting activation factor hypothesis
Active area hypothesis
Enhancer element hypothesis.
Malaria. Mechanism for switching of active var genes.
Limiting activation factor hypothesis.
Var genes compete for limiting activation factor.
Malaria. Mechanism for switching of active var genes.
ACTIVE AREA HYPOTHESIS.
Movement of telomeric end to active area (how defined?) leads to remodeling and allows transcription. Nuclear actin associated with var gene introns could provide mechanical framework for spatial organization. Position could be involved in ‘poising’.
Malaria. Mechanism for switching of active var genes.
Active area hypothesis - EVIDENCE
An exceptional case where more than one var gene was active showed that both copies were at the same site (RNA FISH analysis).
Malaria. Mechanism for switching of active var genes.
ENHANCER ELEMENT HYPOTHESIS
H-element discovered to mediate monallelic activation of olfactory receptor genes, but an enhancer element with a similar role has not been found in plasmodium.
Malaria - rate of switching of active var genes.
Inactivation occurs at a low frequency, resulting in switching of active gene.
No genes modifying rate have yet been found.
Plasmodium var genes - generating diversity.
Frequent recombination.
Needs to maintain function.
Plasmodium var genes - generating diversity.
FREQUENT RECOMBINATION.
Occurs due to location
Occurs during mitosis
May involve multiple var genes, or several recombinations between two.
In theory, 2.4 million novel var genes generated in an infected individual but needs to maintain function
Plasmodium var genes - generating diversity. Frequent recombination. ROLE OF LOCATION.
Increased due to location near telomeres, where this is frequent.
Plasmodium var genes - generating diversity. Frequent recombination. WHEN IN CELL CYCLE
During mitosis: as demonstrated by experiment with dilution cloning and whole genome sequencing at each step.
Plasmodium var genes - generating diversity. NEED TO MAINTAIN FUNCTION.
DBLs and CIDRs.
Cross-overs.
Plasmodium var genes - generating diversity. Need to maintain diversity. DBLs and CIDRs
Var genes classed by class of DBL (Duffy binding like) and CIDRs (cysteine rich interdomain region). These need to be functionally conserved, although they can be diverse in sequence. Different classes appear to catalyze cytoadherence to different host proteins. Recombination preferentially happens within the same class.
Plasmodium var genes - generating diversity. Need to maintain diversity. Cross-overs
low sequence identity (on average 63%) but crossovers are error-free, with resulting sequence IN FRAME and domain architecture conserved (prob since recombination is between the same class). Cross-overs generally occur at an ‘identity block’
Plasmodium var genes - generating diversity. Need to maintain diversity. Cross-overs - identity blocks.
A short section with perfect sequence identity, within section of generally elevated sequence homology.
Kinases in apicoplasts
Important as signalling mediators.
Involve both Ca++ dependent protein kinases and secreted protein kinases.
Apicoplast - calcium dependent protein kinases.
Action
Regulation of host cell attachment and invasion, gliding motility and parasite egress.
In plasmodium is also involved in gametogenesis, gliding of ookinetes and switching from gliding to invasion.
Kinases in apicomplexa - secreted kinases.
Plasmodium FIKK family and Tg ROPK family secreted into host cell.
Tg rhoptry proteins alter immune response.
Alter immune response. Many predicted to be kinases or pseudokinases. No orthologues of rhoptry kinases in malaria parasites.
Molecular mechanisms of pseudokinases poorly understood.
ROP proteins crossing the cellular membrane.
Spike in conductivity of membrane suggests break in membrane which is resealed, but what mediates this is not understood, although there are several candidates. ROPs carry localization signals
ROP localisation signals
ROP16 has a nuclear localization signal. RAH domain targets to PVM.
Plasmodium FIKKs export
PEXEL motif on FIKKs lead to predicted export into RBC. But not automatic: at least one stays in parasite despite PEXEL motif.
2 thought to be involved in remodeling RBC cytoskeleton.
Purpose of FIKKs
In liver stages, alter host cell signaling, downregulating NFkB and preventing apoptosis.
Apicomplexan egress
Potential therapeutic target.
Mechanism
Signalling in egress
Permeabilisation in egress.
Apicomplexan egress. MECHANISM
o Signal must be given – intrinsic egress cue
o Activation of motility and secretes egress effector proteins
o Requires breaching of multiple barriers including PVM, host cytosolic structure like cytoskeleton and host plasma membrane.
o Permeabilisation of PVM a few minutes prior to egress was calcium and parasite dependent.
Apicomplexan egress - signalling in egress.
K+ and Ca++ (involved in motility) important.
Abscisic acid, ABA.
Apicomplexan egress - signalling in egress. ABA
induces production of cyclic ADP-ribose and hence Ca++ release from intracellular pool (prob ER), triggering secriont of microneme proteins. ABA is probably synthesized in apicoplast given plant lineage.
Apicomplexan permeabilisation.
Toxoplasma - pore forming protein.
Plasmodium - proteases key
Possible role for host calpain proteases too.