Module 3: MALARIA Flashcards
Describe the life cycle of malaria
3 stages of malaria:
- mosquito stage (sexual reproduction= definitive host)
- liver stage (asexual reproduction)
- blood stage (asexual reproduction, major amplification stage)
mosquito stage: mos bites human, ingests gametocytes, microgametes penetrate macrogamete producing zygotes –> zygotes become motile & elongate (ookinetes) –> become oocytes –> grow & meiosis –> sporozoites –> sporozoites penetrate gut wall –> salivary glands –> mos bites another human injects sporozoites
liver :sporozoites infect macrophage-like liver cells –> become schizonts –> release merozoites (can lay dormant in liver up to weeks/years, then release when conditions are right ) –> asexual reproduction
blood: asexual reproduction, major amplification.
merozoite infects rbc –> rbc sticks to blood vessel wall (cytoadherence), moves out of circulation –> asexual reproduction produces more merozoite that busts out to infect more rbc
some parasites differentiate into gametocytes –> injested by mosquito again
why is malarial infection delayed?
when mos bites- there are few sporozoites injected into humans. in the liver, the parasite can lay dormant for up to weeks-years, will only get symptoms when it invades the bloodstream (rbc)
DISEASE only occurs in the bloodstage
what are the symptoms of malaria
- fever/ chills/ anemia (might not get symptoms up to 2 weeks after bitten)
- most deaths result from P.falciparum
1. cerebral anemia
2. severe anemia
3. placental anemia - P.vivax= high morbidity, low mortality (high disease, low death)
why? because it releases hypnozoites (latent form that can live in the liver for years- explains why some peoplekeep getting malaria)
what is the purpose of cytoadherence/ sequestration of malaria
to avoid splenic clearance
- usually blood moving through spleen filtered through fenestrations that remove old/damaged cells by macrophage like clearance system
but in malaria- merozoites infect rbc and cuase it to stick to blood vessel wall- doesnt move to spleen to get cleared & can replicate
what is hemozoin and what is its function
Hemozoin is the disposal product of heme, formed when parasite infects rbc & digests heme)
Parasite infects rbc (needs nutreints & space to grow) so it digests Hb releases digested haem, becomes hemozoin ( since haem is very toxic, digested haem polymerised into crystal called hemozoin)
why doesnt every child infected with malaria die?
different patterns of cytoadherence. PfEMP1 will cause rbc to adhere to blood vessel of different sites
because the PfEMP1 is specific. 60 different var genes determine the shape of PfEMP1 = infected rbc will express specific PfEMP1 that targets specific rececptor on microvascular endothelium (Blood vessel wall) of different organs
what is responsible for the WAVES of parasitemia/ infection in malaria
PfEMP1 specificity is constantly changing to escape the body’s immune system.
specific var gene encodes for specific PfEMP1 gene that dictates which receptor on the blood vessel of which site the infected rbc will bind to. first wave may be a PfEMP1 that causes rbc to bind to skeletal muscle blood walls –> body builds immunity to this (eg. might make antibodies that target & destroy this specific PfEMP1) –> then the parasite can mutate = change var gene of PfEMP1 –> new PfEMP1 now targets diff site (brain) = a new wave of infection that body has not yet made an immune response to
immune system is always a step behind
what is the purpose of P.falciparum continously changing the PfEMP1 var genes
since P. falciparum does not have a latent form (like P.vivax does to persist in host until conditions are right). IN order to increase its survival it needs to persist in the host for as long as possible to incrase chance it can transmit to ANOTHER person
What are the var genes ?
var genes encode the PfEMPs
- there are approx 60 var genes per genome
- they are located on 14 chromosomes, particularly concentrated at the ends
how does parasite change the var genes?
Clonal antigenic variation= allows parasite to switch to use different genes
- these genes are epigenetically modified (histone modification + nuclear location)
- by changing gene expression, can switch on / off genes to change PfEMP1
Explain why placental malaria causes reinfection of previously recovered patients
women who are infected as kids, still have parasite in blood dont get sick anymore because their bodies have developed immunity against the previous pfemp1. When a female gets pregnant, the placenta- new organ- forms and the parasite induces a new type of PfEMP1 that targets the CSA on syncitiotrophoblasts in the placenta. This means the patinet will get sick again because previously there had not been the selective force present to cause the body to build immunity against this specific pfemp1 that targets csa
how are var genes silenced while allowing only 1 to be expressed?
the Pfemp protein is encoded by 60 different var genes, located on 14 chr, particularly concentrated at the ends.
each time a pfemp protein is expressed, 1 var gene is switched on whilst the other 59 are silenced by HETEROCHROMATIN.
- limits Transcription factors accessibility to the DNA in order to activate gene transcription
- epigenetic control of transcription
- histone modification /heterochromatin at the nuclear periphery = genes are inaccessible to transcription factors
- a particular LOCALISATION is assocaited with new histone modification that permits transcription= NEEDS CSA SELECTION:
on the condition of CSA SELECTION: the silenced var2csa gene will physically move to the TRANSCRIPTIONALLY ACTIVE SITE where TFs are able to access the DNA, transcribe those gene, making a new pfemp1 protein that speicifcally targets the csa on placental blood walls
why is there more heterogeneity in var genes compared to other genes
ectopic recombination
- end of chr align , recombination of NON-HOMOLOGOUS chromsomes
what is the purpose of gene clustering at the end of p.falciparum chr
- heterochromatin formation= to silence the 59 /60 genes so to express a specific type of pfemp1
- to allow for RECOMBINATION BETWEEN HETEROLOGOUS CHROMSOMES= ectopic recombination= where NON-homologous chr align to produce high heterogeneity (variance) among var genes
describe the function of KAHRP & what happens when KAHRP is knocked out
kahrp gene codes for knob protein
- knob is essential for cytoadherence- it stabilises cytoadherence of Pfemp1 on parasite on blood wall
- knob knockout = parasite infected rbc isnt able to stick of blood walls = no cytoadherence