Abstract

Multiple factors are involved in the variability of host's response to P. falciparum infection, like the intensity and seasonality of malaria transmission, the virulence of parasite and host characteristics like age or genetic make-up. Although admitted nowadays, the involvement of host genetic factors remains unclear. Discordant results exist, even concerning the best-known malaria resistance genes that determine the structure or function of red blood cells. Here we report on a genome-wide linkage and association study for P. falciparum infection intensity and mild malaria attack among a Senegalese population of children and young adults from 2 to 18 years old. A high density single nucleotide polymorphisms (SNP) genome scan (Affimetrix GeneChip Human Mapping 250K-nsp) was performed for 626 individuals: i.e. 249 parents and 377 children out of the 504 ones included in the follow-up. The population belongs to a unique ethnic group and was closely followed-up during 3 years. Genome-wide linkage analyses were performed on four clinical and parasitological phenotypes and association analyses using the family based association tests (FBAT) method were carried out in regions previously linked to malaria phenotypes in literature and in the regions for which we identified a linkage peak. Analyses revealed three strongly suggestive evidences for linkage: between mild malaria attack and both the 6p25.1 and the 12q22 regions (empirical p-value = 5×10−5 and 9×10−5 respectively), and between the 20p11q11 region and the prevalence of parasite density in asymptomatic children (empirical p-value = 1.5×10−4). Family based association analysis pointed out one significant association between the intensity of plasmodial infection and a polymorphism located in ARHGAP26 gene in the 5q31–q33 region (p-value = 3.7×10−5). This study identified three candidate regions, two of them containing genes that could point out new pathways implicated in the response to malaria infection. Furthermore, we detected one gene associated with malaria infection in the 5q31–q33 region.

Highlights

  • Plasmodium falciparum (P. falciparum) malaria represents one of the most important causes of mortality and morbidity in tropical areas

  • Four children with less than 8 thick blood smears (TBS) during the follow-up were excluded from analyses

  • Based association analysis to explore the chromosomal regions we identified during linkage analysis (6p25.1, 12q22, 9q34 and 20p11q11) and the 5q31q33 and 10p15 regions, which have been described as involved in the control of parasitemia and malaria fever episodes respectively [23,29], we performed a linkage and association study using family based association tests (FBAT) software

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Summary

Introduction

Plasmodium falciparum (P. falciparum) malaria represents one of the most important causes of mortality and morbidity in tropical areas. A new general pattern is emerging, based on recent publications [4,5], that malaria incidence is decreasing worldwide [6]. This situation stresses the necessity to pursue fundamental research activities in order to improve the understanding of malaria physiopathology, and to help to develop strategies and tools for a better control. Among the clinical presentations of malaria, asymptomatic parasitemia (i.e parasitemia without fever or any clinical sign), and mild malaria attack defined as the association of fever and parasitemia are the most frequent and have very important consequences in term of morbidity and economic effects [7,8]. Discordant results exist, even concerning the best-known malaria resistance genes that determine the structure or function of red blood cells [11,12]

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