<p dir="ltr">Tuberculosis (TB), caused by <i>Mycobacterium tuberculosis</i> (<i>Mtb</i>), and human immunodeficiency virus-1 (HIV) are major public health concerns, individually and in combination. The status of the host immune system, previous <i>Mtb</i> infection and HIV-mediated T cell exhaustion, can have significant impacts on immune dynamics during reinfection. Individuals with asymptomatic latent TB infection (LTBI) may be protected against <i>Mtb </i>reinfection, as demonstrated by animal and <i>in vitro </i>studies. However, the underlying dynamics and protective mechanisms of LTBI are poorly understood. In HIV, long-term infection in children and associated T cell exhaustion leads to weakened immune responses to HIV reinfection. The complexity of these infections, particularly in the context of the heightened vulnerability of HIV+ individuals to TB, underscores the need for novel investigative approaches to study host-pathogen and pathogen-pathogen interactions. To this, we have developed an agent-based model (ABM) as a mechanistic computational tool to simulate the immune response to <i>Mtb </i>and HIV, separately and during coinfection. Our ABM integrates clinical and experimental data; simulates immune cell dynamics between macrophages, CD4+ and CD8+ T cells; and produces emergent granuloma-like structures – a critical response to <i>Mtb</i>. This <i>in silico</i> approach allows us to efficiently explore host-pathogen interactions and their clinical implications. By unraveling the complex interplay of immune cell activation, T cell exhaustion, and pathogen dynamics, our model offers insights that could guide the development of targeted therapies. By quantifying the multifaceted nature of these diseases and their interactions, we highlight the potential of computational approaches in understanding and treating complex diseases, individually and in combination.</p>

Ansätze der mathematischen Modellierung ermöglichen die Analyse der dynamischen Eigenschaften biologischer Systeme und den Einfluß spezifischer Funktionen. Das Ziel dieser Arbeit ist es verschiedene Aspekte der Interaktionen zwischen Wirt und Krankheitserregern zu analysieren. In Kapitel 3 diskutiere ich ein Modell der zellulären Antwort auf Hitzeschockstress im Pilz Candida albicans. Das Modell in Form von gewöhnlichen Differentialgleichungen erörtert mehrere Aspekte des Systems, wie z.B. die erworbene Thermotoleranz und eine perfekte Anpassung an die Beanspruchung durch die Temperaturwechsel. Im Rahmen der Interaktionen zwischen Wirt und Krankheitserreger ist die Studie relevant, da die Entwicklung von Fieber eine primäre Antwort des Organismus auf eine Pilzinvasion ist. Die Dynamik von C. albicans Virulenzfaktoren, wie z.B. der Übergang vom Hefe- zum Hyphenstadium, und die Abwehrmechanismen des Wirts bestimmen den Zustand des Pilzes, d.h. ob er als Kommensale oder Krankheitserreger vorkommt. Mit Hilfe einer agenten-basierten Modellierungstechnik, in Kapitel 4, untersuche ich die Auswirkungen potenzieller medikamentöser Behandlungen von Pilzpopulationen und ihre Effektivität. In Kapitel 5 analysiere ich die Dynamik der C. albicans Hefe- und Hyphenpopulationen unter der Annahme, das zwischen den Individuen beider Populationen paarweise Wechselwirkungen bestehen, die zusätzlich von Fresszellen und Ernährungsbedingungen beeinflusst werden. Das erste Modell basiert auf den Prinzipien der Spieltheorie. Aus dieser Studie lässt sich die Hypothese aufstellen, dass sich im Verlauf der Infektion die evolutionäre Spieldynamik von der Snowdrift Spieldynamik in Richtung Gefangendilemma verschiebt. Im zweiten Modell untersuche ich die Umschaltraten zwischen Hefen und Hyphen. Das Modell zeigt, dass in Pilzpopulationen die Ausprägung verschiedener Phänotypen der Grund für die erhöhte Überlebensfähigkeit der Population sein könnte. / Mathematical modeling approaches facilitate the analysis of dynamic properties of mechanisms triggering specific functions of biological systems. Through this work I aim to shed light on various aspects of host-pathogen interactions. In Chapter 3, I discuss a model of heat shock stress response activated in the fungus Candida albicans. The model in form of ordinary differential equations reveals several features of the system, such as acquired thermotolerance and a perfect molecular adaptation to the thermal insult. The study is relevant in the context of host-pathogen interactions since development of fever is a primary host response to fungal invasion. The dynamics of C. albicans virulence factors, e.g., yeast to hypha transition, and defense mechanisms of the host determine the state of the fungi, i.e. whether to act as a commensal or as a foe. Through application of an agent-based modeling technique, in Chapter 4, I investigate effects of potential drug treatments on fungal populations and their effectivity in the fungal clearance. In Chapter 5, I analyze the dynamics of candida yeast and hyphal populations assuming pairwise interactions influenced by phagocytic cells and nutritional conditions. The first model is based on game theory principles. From the study it can be hypothesized that during the course of infection the evolutionary game dynamics shift from Snowdrift game dynamics toward Prisoners’ dilemma. In the second model, I examine switching rates between yeast and hypha. The model reveals that phenotypic variations may occur in order to increase the fitness of the population.

Fusarium head blight (FHB), caused mainly by Fusarium graminearum (teleomorph: Gibberella zeae), is one of the most damaging diseases of wheat. A ‘Brio’/‘TC 67’ spring wheat population was used to map quantitative trait loci (QTLs) for resistance to FHB, and to study the association of morphological and developmental characteristics with FHB resistance. Interval mapping (IM) detected a major QTL on chromosome 5AL for resistance to disease severity (type II resistance) and Fusarium-damaged kernels (FDK) under greenhouse and field conditions, respectively. Inconsistent QTL(s) was also detected on chromosome 5BS for disease severity and index using field data. The associations of plant height and number of days to anthesis were negative with disease incidence, severity, index, and deoxynivalenol (DON) accumulation data under field conditions. However, number of days to anthesis was positively correlated with disease severity (greenhouse) and FDK (field). Awnedness had a negative effect on FHB, namely the presence of awns resulted in less disease in the population. Spike threshability also affected FHB so that the hard threshable genotypes represented lower disease. Phylogenetic relationships of putative F. graminearum isolates from different sources were characterized using Tri101 gene sequencing data. Canadian and Iranian isolates clustered in F. graminearum lineage 7 (=F. graminearum sensu stricto) within the F. graminearum clade while the isolates received from CIMMYT, Mexico were placed in F. graminearum lineage 3 (=Fusarium boothii) within the Fg clade or Fusarium cerealis. The PCR assay based on the Tri12 gene revealed the presence of the NIV, 3-ADON, and 15-ADON chemotypes with 15-ADON being the predominant chemotype. While we did not find the NIV chemotype among the Canadian isolates, it was the predominant chemotype among the Iranian isolates. High variation in aggressiveness was observed among and within Fusarium species tested, with the isolates of F. graminearum sensu stricto being the most aggressive and the NIV chemotype being the least aggressive. The interactions between Fusarium isolates and wheat genotypes from different sources were investigated by inoculating isolates of F. graminearum sensu stricto and F. boothii on wheat genotypes. Significant differences were observed among the genotypes inoculated by single isolates. Results also showed significant interactions between Fusarium isolates and wheat genotypes. The F. boothii isolates from CIMMYT produced low disease symptom and infection on wheat genotypes regardless of the origin of the genotypes while F. graminearum sensu stricto isolates from Canada and Iran resulted in higher FHB scores.

Fusarium head blight (FHB), caused mainly by Fusarium graminearum (teleomorph: Gibberella zeae), is one of the most damaging diseases of wheat. A ‘Brio’/‘TC 67’ spring wheat population was used to map quantitative trait loci (QTLs) for resistance to FHB, and to study the association of morphological and developmental characteristics with FHB resistance. Interval mapping (IM) detected a major QTL on chromosome 5AL for resistance to disease severity (type II resistance) and Fusarium-damaged kernels (FDK) under greenhouse and field conditions, respectively. Inconsistent QTL(s) was also detected on chromosome 5BS for disease severity and index using field data. The associations of plant height and number of days to anthesis were negative with disease incidence, severity, index, and deoxynivalenol (DON) accumulation data under field conditions. However, number of days to anthesis was positively correlated with disease severity (greenhouse) and FDK (field). Awnedness had a negative effect on FHB, namely the presence of awns resulted in less disease in the population. Spike threshability also affected FHB so that the hard threshable genotypes represented lower disease. Phylogenetic relationships of putative F. graminearum isolates from different sources were characterized using Tri101 gene sequencing data. Canadian and Iranian isolates clustered in F. graminearum lineage 7 (=F. graminearum sensu stricto) within the F. graminearum clade while the isolates received from CIMMYT, Mexico were placed in F. graminearum lineage 3 (=Fusarium boothii) within the Fg clade or Fusarium cerealis. The PCR assay based on the Tri12 gene revealed the presence of the NIV, 3-ADON, and 15-ADON chemotypes with 15-ADON being the predominant chemotype. While we did not find the NIV chemotype among the Canadian isolates, it was the predominant chemotype among the Iranian isolates. High variation in aggressiveness was observed among and within Fusarium species tested, with the isolates of F. graminearum sensu stricto being the most aggressive and the NIV chemotype being the least aggressive. The interactions between Fusarium isolates and wheat genotypes from different sources were investigated by inoculating isolates of F. graminearum sensu stricto and F. boothii on wheat genotypes. Significant differences were observed among the genotypes inoculated by single isolates. Results also showed significant interactions between Fusarium isolates and wheat genotypes. The F. boothii isolates from CIMMYT produced low disease symptom and infection on wheat genotypes regardless of the origin of the genotypes while F. graminearum sensu stricto isolates from Canada and Iran resulted in higher FHB scores.

Made available in DSpace on 2014-07-29T15:16:38Z (GMT). No. of bitstreams: 1 Dissertacao Deyze Alencar Soares.pdf: 632456 bytes, checksum: 33012995df8eabb3f4b7509fe372764d (MD5) Previous issue date: 2010-03-26 / Paracoccidioides brasiliensis, a thermodimorphic fungus, is the causative agent of the most prevalent systemic mycosis in Latin America, paracoccidioidomycosis. The phospholipase B (PLB) enzyme is considered an important virulence factor in this dimorphic fungus, involved in the immune response of the host-pathogen interaction. Our objective was to determine whether a P. brasiliensis (Pb18) PLB is involved in adhesion / internalization of yeast and evasion of host immune responses. The effect of PLB was analysed using specific inhibition of PLB (alexidine dihydrochloride) and pulmonary surfactant in an ex vivo model (Pb18) of alveolar macrophage (MHS cells) infection. PLB enzyme assays and real time RT-PCR (qRTPCR) analysis of genes differentially expressed in the process of evasion: plb1 (phospholipase B1), icl1 (isocitrate lyase) and sod3 (Cu, Zn dismutase) and immune responses: clec2 (C-type lectin domain 2), cd14 (cluster of differentiation 14), tlr2 (toll-like receptor 2), nfkb (nuclear factor kappa B), nkrf (NF-kappaB repressing factor), il1&#946; (inteleukin-1&#946;) and tnf&#945; (tumor necrosis factor alpha) were carried out using selective inhibition of PLB activity and pulmonary surfactant. The levels of cytokines inteleukin 10 (IL-10), IL-12 and TNF-&#945;) were also determined by ELISA. PLB activity under adhesion conditions of P. brasiliensis (Pb18) to alveolar macrophage cells was found at high levels up to 6 hours post-infection. In the conditions of exposure to pulmonary surfactant and alexidine dihydrochloride, PLB activity and the level of transcripts of genes related to phagocytosis and inflammatory response were measured. We found that PLB activity had an influence on the phagocytic activity of alveolar macrophages. Alexidine dihydrochloride (0,25 &#956;M) selectively inhibited PLB activity by 66% and decreased significantly the adhesion and internalization of yeast on MHS cells. Genes involved in phagocytosis (trl2 and cd14) and inflammatory response (nrkf, tnf&#945; and il1&#946;) were down-regulated in the presence of the PLB inhibitor. In contrast, the PLB activity and internalization of fungal yeast cells increased significantly in the presence of pulmonary surfactant (100 &#956;g/mL) and genes such as clec2, important for effective phagocytosis by MHS cells, and the pro-inflammatory inhibitor (nkrf) were up-regulated. Also, the pulmonary surfactant did not alter cytokine production, while alexidine dihydrochloride decreased the levels of IL-10 and increased the levels of IL-12 and TNF-&#945;. In addition, through simultaneous analyses of gene expression for the pathogen, P. brasiliensis, we found upregulation of the genes sod3, icl1 and plb1, required for the evasion of alveolar macrophages. P. brasiliensis PLB is important for the binding and internalization of yeast at macrophage surfaces. The specific effect of inhibiting PLB enzyme activity indicates that adhesion may be facilitated indirectly via fatty acid release from phospholipids of the membrane of host cells. This is the first study to show that PLB activity may modulate immune responses to P. brasiliensis infection. / Paracoccidioides brasiliensis, fungo dimórfico, é o agente etiológico principal micose sistêmica da América Latina, paracoccidioidomicose. A enzima fosfolipase B (PLB) é considerada um importante fator de virulência nesse fungo dimórfico e está envolvida na resposta imune da interação patógeno-hospedeiro. Nosso objetivo foi determinar se a PLB de P. brasiliensis (Pb18) está envolvida na adesão e internalização de leveduras e na evasão da resposta imune hospedeira. O efeito da PLB foi analisado usando o inibidor seletivo de PLB (alexidine dihydrochloride) e o surfactante pulmonar (Survanta) em um modelo ex vivo de infecção de macrófagos alveolares (MHS) com Pb18. Ensaio enzimático de PLB e análise de genes diferencialmente expressos por RT-PCR em tempo real (qRT-PCR) no processo de evasão: plb1 (fosfolipase B1), icl1 (isocitrato liase) e sod3 (Cu, Zn dismutase); e na resposta imune: clec2 (lecitina tipo-C 2), cd14 (cluster de diferenciação 14), tlr2 (receptor toll-like 2), nfkb (fator nuclear kappaB), nkrf (repressor fator nuclear kappaB), il1&#946; (interleucina- 1 beta) e tnf&#945; (fator de necrose tumoral alfa) foram realizados usando o inibidor seletivo da atividade de PLB e surfactante pulmonar. Os níveis de citocinas interleucina 10 (IL-10), IL-12 e TNF- &#945;) foram determinados por ELISA. A atividade de PLB usadas em baixas condições para a adesão de P. brasiliensis (Pb18) obteve altos níveis em 6 horas pós-infecção. Na presença do surfactante pulmonar e alexidine dihydrochloride, a atividade da PLB e os níveis de transcritos dos genes relacionados à fagocitose e à resposta inflamatória foram quantificados. A PLB teve influência na atividade fagocítica dos macrófagos. Alexidine dihydrochloride (0,25 &#956;M) inibiu seletivamente a atividade PLB em 66% e diminuiu significativamente a adesão e internalização de leveduras por macrófagos alveolares (MHS). Genes envolvidos na fagocitose (trl2 e cd14) e resposta inflamatória (nrkf, tnf&#945; e il1&#946;) foram reprimidos na presença do inibidor de PLB. Em contraste, a atividade PLB e internalização de leveduras aumentou significativamente na presença do surfactante pulmonar (100 &#956;g/mL) e genes assim como clec2, importante para uma fagocitose efetiva pelos macrófagos alveolares (MHS), e o inibidor pró-inflamatório (nkrf) foram induzidos. Entretanto, o surfactante pulmonar não alterou a produção de citocinas, enquanto que alexidine dihydrochloride diminuiu os níveis de IL-10 e aumentou os níveis de IL-12 e TNF-&#945;. Em adição, nas análises simultâneas de expressão de genes, P. brasiliensis, houve indução dos genes sod3, icl1 e plb1, requeridos para a evasão dos macrófagos alveolares. A PLB de P. brasiliensis é importante na adesão e internalização de leveduras pelos macrófagos alveolares. O efeito específico da inibição da atividade da PLB indica que a adesão pode ser facilitada indiretamente via liberação de ácidos graxos dos fosfolipídeos de membrana das células hospedeiras. Esse é o primeiro estudo mostrando que a atividade da PLB pode modular a resposta imune à infecção pelo P. brasiliensis.

Die Durchfallerkrankung Giardiasis wird durch den Protisten Giardia duodenalis ausgelöst. Die Infektion erfolgt fäkal-oral, meist über kontaminiertes Trinkwasser. Der Parasit kolonisiert den oberen Bereich des Dünndarms und heftt sich an das Epithel, wodurch es die Krankheitsbeschwerden auslöst. Allerdings sind Details über die Mechanismen der Pathogenese unbekannt. Dazu kommt, dass der Ausgang einer Infektion fallspezifisch starken Schwankungen unterworfen ist, von selbst-limitierend bis chronisch und asymptomatischer Kolonisierung bis hin zur schweren Enteritis. Ein möglicher Pathomechanismus ist der Wegfall der Barrierefunktion des Dünndarmepithels, z.B. durch Beeinträchtigung von tight junctions oder Zelltod. In dieser Arbeit wurden Effekte von G. duodenalis auf in vitro Modellsysteme des humanen Dünndarmepithels untersucht. Dazu wurden hauptsächlich Daten über die Barrierefunktion sowohl von der weit verbreiteten Caco-2 Zelllinie, als auch über ein neu etabliertes humanes Dünndarmorganoidsystem, erhoben. Es konnte gezeigt werden, dass mehrere - mitunter in der Literatur als hochvirulent beschriebene - G. duodenalis Isolate zu keinerlei Beeinträchtigung der Barrierefunktion oder irgendeiner anderen untersuchten potenziellen Schädigung an zwei unterschiedlichen Caco-2 Zelllinien unter diversen Infektions- und Kulturbedingungen führte. Jedoch andererseits das neu entwickelte Dünndarmorganoidsystem mit pseudo-luminalem Medium TYI S 33 reproduzierbar die Zerstörung des Epithelmodells mit Zellverlust, Zelltod (apoptotisch und nicht-apoptotisch), Störung der tight junctions (Abbau und Dislokation von Claudinen und ZO-1) und den Verlust von Mikrovilli innerhalb ein bis zwei Tage nach Parasiteninfektion zeigen konnte. Zudem wurde das Auftauchen von ClCa-1-Signalen unter andauerndem Infektionsstress beobachtet, was die Differenzierung bzw. Metaplasie zu Becherzellen nahelegt, jedoch keine Wirtsreaktion auf die Gewebszerstörung zu sein scheint. / The protozoan parasite Giardia duodenalis is the etiological agent for the intestinal diarrheal disease giardiasis. Infections are acquired via the fecal-oral route, mostly via uptake of cysts from contaminated drinking water. The colonization of the hosts’ duodenum and upper jejunum and the attachment of Giardia trophozoites onto the epithelium is the cause of a variety of gastrointestinal complaints but the exact pathomechanisms are unknown. Furthermore, the outcome of Giardia infections varies greatly between individuals, ranging from self-limiting to chronic, and asymptomatic to severe enteritis. One proposed mechanism for the pathogenesis is the breakdown of intestinal barrier function, e.g. by tight junction impairment or induction of cell death. In this work, effects of G. duodenalis on in vitro models of the human small intestinal epithelium were investigated by studying mainly barrier-related properties and changes of widely used Caco-2 cells as well as newly established human small intestinal organoid-derived monolayers (ODMs). It could be shown that several isolates of G. duodenalis, some described as highly virulent, fail to induce barrier dysfunction or any other investigated pathological effect on two Caco-2 cell lines under various infection and culturing conditions. On the other side, by developing a new organoid-based model system and the use of luminal mock medium TYI-S-33, considerable epithelial disruption (including loss of cells), cell death (apoptosis and non-apoptotic), tight junction impairment (degradation and dislocation of claudins and ZO-1), and microvilli depletion reproducibly induced by G. duodenalis trophozoites between one and two days after infection could be observed. Moreover, emergence of ClCa-1 positive cells with ongoing parasite infections suggest epithelial differentiation or metaplasia towards goblet cells, which is furthermore not associated to tissue damage.

Yersinia pestis (Y. pestis), as the causative agent of plague, has caused deaths estimated to more than 200 million people in three historical plague pandemics, including the infamous Black Death in medieval Europe. Although infection with Yersinia pestis can mostly be limited by antibiotics and only 2000-5000 cases are observed worldwide each year, this bacterium is still a concern for bioterrorism and recognized as a category A select agent by the Centers for Disease Control and Prevention (CDC). The investigation into the host-pathogen interactions during Y. pestis infection is important to advance and broaden our knowledge about plague pathogenesis for the development of better vaccines and treatments. Y. pestis is an expert at evading innate immune surveillance through multiple strategies, several mediated by its type three secretion system (T3SS). It is known that the bacterium induces rapid and robust cell death in host macrophages and dendritic cells. Although the T3SS effector YopJ has been determined to be the factor inducing cytotoxicity, the specific host cellular pathways which are targeted by YopJ and responsible for cell death remain poorly defined. This thesis research has established the critical roles of caspase-8 and RIP kinases in Y. pestis-induced macrophage cell death. Y. pestis-induced cytotoxicity is completely inhibited in RIP1-/- or RIP3-/-caspase-8-/- macrophages or by specific chemical inhibitors. Strikingly, this work also indicates that macrophages deficient in either RIP1, or caspase-8 and RIP3, have significantly reduced infection-induced production of IL-1β, IL-18, TNFα and IL-6 cytokines; impaired activation of NF-κB signaling pathway and greatly compromised caspase-1 processing; all of which are critical for innate immune responses and contribute to fight against pathogen infection. Y. pestis infection causes severe and often rapid fatal disease before the development of adaptive immunity to the V bacterium, thus the innate immune responses are critical to control Y. pestis infection. Our group has previously established the important roles of key molecules of the innate immune system: TLR4, MyD88, NLRP12, NLRP3, IL-18 and IL-1β, in host responses against Y. pestis and attenuated strains. Yersinia has proven to be a good model for evaluating the innate immune responses during bacterial infection. Using this model, the role of caspase-8 and RIP3 in counteracting bacterial infection has been determined in this thesis work. Mice deficient in caspase-8 and RIP3 are very susceptible to Y. pestis infection and display reduced levels of pro-inflammatory cytokines in spleen and serum, and decreased myeloid cell death. Thus, both in vitro and in vivo results indicate that caspase-8 and RIP kinases are key regulators of macrophage cell death, NF-κB and caspase-1 activation in Yersinia infection. This thesis work defines novel roles for caspase-8 and RIP kinases as the central components in innate immune responses against Y. pestis infection, and provides further insights to the host-pathogen interaction during bacterial challenge.

Unlike the adaptive immune system, the innate immune system has classically been characterized as being devoid of memory functions. However, recent research shows that innate myeloid and lymphoid cells have the ability to retain memory of prior pathogen exposure and become primed to elicit a robust, broad-spectrum response to subsequent infection. This phenomenon has been termed innate immune memory or trained immunity. Innate immune memory is induced via activation of pattern recognition receptors and the actions of cytokines on hematopoietic progenitors and stem cells in bone marrow and innate leukocytes in the periphery. The trained phenotype is induced and sustained via epigenetic modifications that reprogram transcriptional patterns and metabolism. These modifications augment antimicrobial functions, such as leukocyte expansion, chemotaxis, phagocytosis, and microbial killing, to facilitate an augmented host response to infection. Alternatively, innate immune memory may contribute to the pathogenesis of chronic diseases, such as atherosclerosis and Alzheimer's disease.

Una de les forces selectives més fortes que han afectat a les poblacions humanes en la història més recent és el paràsit de la malària: Plasmodium falciparum, que és la causa de varis exemples d'adaptació induïda per patògens en els éssers humans. Una forma especial de malària és l'associada a l'embaràs, que es caracteritza per l'acumulació d'eritròcits infectats en la placenta, i que pot arribar a causar fins a 200.000 morts maternoinfantils cada any. L'objectiu d'aquest treball és descriure com aquesta forma peculiar de malària ha afectat la variació genètica humana. Amb aquesta finalitat, hem utilitzat mètodes tant de la genètica evolutiva com de l'epidemiologia molecular, resultant en la primera investigació a gran escala de la base genètica de la malària placentària. Els resultats ofereixen una nova visió sobre els gens que modulen el risc d'infecció, ,així com de la selecció natural actuant sobre les vies cel·lulars implicades en la patogènesi de la malaltia. Finalment, també aportem noves dades sobre l'estructura genètica de les poblacions sub-saharianes analitzades. / One of the strongest selective forces affecting human populations in recent history is the malaria parasite Plasmodium falciparum, which is the cause of a variety of well-established examples of pathogen-induced adaptation in humans. A special form of malaria is pregnancy-associated malaria, which is characterised by the accumulation of infected erythrocytes in the placenta, and causes up to 200,000 maternal and infant deaths every year. The aim of this work is to characterise how this particular form of malaria has shaped human genetic variation. To that end we use methods of both evolutionary genetics and molecular epidemiology, reporting the first large-scale investigation of the genetic basis of placental infection. Our results provide new insights into genes modulating the risk of infection, as well as natural selection acting on cellular pathways involved in the pathogenesis of the disease. Finally, we also provide new data on the genetic structure of affected populations in Sub-Saharan Africa.