Abstract

BackgroundPlacental malaria is a disease linked to the sequestration of Plasmodium falciparum infected red blood cells (IRBC) in the placenta, leading to reduced materno-fetal exchanges and to local inflammation. One of the virulence factors of P. falciparum involved in cytoadherence to chondroitin sulfate A, its placental receptor, is the adhesive protein VAR2CSA. Its localisation on the surface of IRBC makes it accessible to the immune system. VAR2CSA contains six DBL domains. The DBL6ε domain is the most variable. High variability constitutes a means for the parasite to evade the host immune response. The DBL6ε domain could constitute a very attractive basis for a vaccine candidate but its reported variability necessitates, for antigenic characterisations, identifying and classifying commonalities across isolates.Methodology/Principal FindingsLocal alignment analysis of the DBL6ε domain had revealed that it is not as variable as previously described. Variability is concentrated in seven regions present on the surface of the DBL6ε domain. The main goal of our work is to classify and group variable sequences that will simplify further research to determine dominant epitopes. Firstly, variable sequences were grouped following their average percent pairwise identity (APPI). Groups comprising many variable sequences sharing low variability were found. Secondly, ELISA experiments following the IgG recognition of a recombinant DBL6ε domain, and of peptides mimicking its seven variable blocks, allowed to determine an APPI cut-off and to isolate groups represented by a single consensus sequence.Conclusions/SignificanceA new sequence approach is used to compare variable regions in sequences that have extensive segmental gene relationship. Using this approach, the VAR2CSA DBL6 domain is composed of 7 variable blocks with limited polymorphism. Each variable block is composed of a limited number of consensus types. Based on peptide based ELISA, variable blocks with 85% or greater sequence identity are expected to be recognized equally well by antibody and can be considered the same consensus type. Therefore, the analysis of the antibody response against the classified small number of sequences should be helpful to determine epitopes.

Highlights

  • The severity of Plasmodium falciparum malaria is partially related to alterations of the infected red blood cells (IRBC) induced by parasite proteins exported to the IRBC membrane during parasite development

  • Pregnancy-associated malaria (PAM) parasites adhere to chondroitin sulphate A (CSA) [4,5], a glycosaminoglycan expressed by the syncytiotrophoblast layer of the placenta

  • Several studies have shown that a single var gene, var2csa, is highly transcribed and expressed in both in vitro CSA-selected P. falciparum IRBC and parasites isolated from infected placentas [6,7,8,9,10]

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Summary

Introduction

The severity of Plasmodium falciparum malaria is partially related to alterations of the IRBC induced by parasite proteins exported to the IRBC membrane during parasite development. During pregnancy, infected women may develop antibodies that inhibit IRBC binding CSA, and these women appear to be protected against PAM during subsequent pregnancies. Primigravidae lack these antibodies, which suggests that PAM parasites express novel surface molecules to which women have not been exposed previously [4,11,12,13]. It has been shown that this immune response is at least partially directed against VAR2CSA and that antibody levels to VAR2CSA are sex- and parity-dependent These antibodies are associated with reduced severity of PAM [16,17], further supporting the role of VAR2CSA as the CSA adhesin in PAM. The DBL6e domain could constitute a very attractive basis for a vaccine candidate but its reported variability necessitates, for antigenic characterisations, identifying and classifying commonalities across isolates

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