Abstract

An in-depth knowledge of the host molecules and biological pathways that contribute towards the pathogenesis of cerebral malaria would help guide the development of novel prognostics and therapeutics. Genome-wide transcriptional profiling of the brain tissue during experimental cerebral malaria (ECM ) caused by Plasmodium berghei ANKA parasites in mice, a well established surrogate of human cerebral malaria, has been useful in predicting the functional classes of genes involved and pathways altered during the course of disease. To further understand the contribution of individual genes to the pathogenesis of ECM, we examined the biological relevance of three molecules – CD14, galectin-3, and OX40 that were previously shown to be overexpressed during ECM. We find that CD14 plays a predominant role in the induction of ECM and regulation of parasite density; deletion of the CD14 gene not only prevented the onset of disease in a majority of susceptible mice (only 21% of CD14-deficient compared to 80% of wildtype mice developed ECM, p<0.0004) but also had an ameliorating effect on parasitemia (a 2 fold reduction during the cerebral phase). Furthermore, deletion of the galectin-3 gene in susceptible C57BL/6 mice resulted in partial protection from ECM (47% of galectin-3-deficient versus 93% of wildtype mice developed ECM, p<0.0073). Subsequent adherence assays suggest that galectin-3 induced pathogenesis of ECM is not mediated by the recognition and binding of galectin-3 to P. berghei ANKA parasites. A previous study of ECM has demonstrated that brain infiltrating T cells are strongly activated and are CD44+CD62L− differentiated memory T cells [1]. We find that OX40, a marker of both T cell activation and memory, is selectively upregulated in the brain during ECM and its distribution among CD4+ and CD8+ T cells accumulated in the brain vasculature is approximately equal.

Highlights

  • Cerebral malaria (CM) is the most severe consequence of a Plasmodium falciparum infection and along with severe anemia is a major pathogenic factor behind the approximately 1 million deaths per year, mostly in children aged 2–5 years living in subSaharan Africa

  • In cumulative data collected from two independent experiments (n = 10 per group for experiment 1 and 9 CD14-KO and 10 WT for experiment 2), we find that following infection with P. berghei ANKA (Pb-A) parasites, 16 of 20 (80%) WT mice developed experimental cerebral malaria (ECM) (Fig. 1A) by day 8

  • Because previous studies have demonstrated an ability of galectin-3 to adhere to T. cruzi, S. mansoni, and L. major protozoan parasites [26,27,29], we investigated whether galectin-3 induced pathogenesis of ECM might be mediated by the binding of galectin-3 to Pb-A parasites

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Summary

Introduction

Cerebral malaria (CM) is the most severe consequence of a Plasmodium falciparum infection and along with severe anemia is a major pathogenic factor behind the approximately 1 million deaths per year, mostly in children aged 2–5 years living in subSaharan Africa. A substantial amount of our knowledge regarding the underlying molecular mechanisms that contribute towards the pathogenesis of CM comes from studies using the P. berghei ANKA murine model of experimental cerebral malaria (ECM), a wellestablished surrogate of human CM. In this murine model, depending on the host genetic background, mice can be broadly categorized as susceptible or resistant to ECM. Resistant mice (as well as a small portion of susceptible mice) do not exhibit clinical or pathological symptoms of ECM during this 6–10 day window of infection but instead succumb to hyperparasitemia and severe anemia between days 15–21 post-infection

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