Le long de la frontière entre la Thaïlande et le Myanmar (TMB), le paludisme se caractérise par une forte hétérogénéité de la transmission, une forte prévalence en porteurs sub-microscopiques et par l’émergence de la résistance à l’artémisinine chez Plasmodium falciparum. L'identification précoce des « foyers » infectieux et leurs éliminations sont nécessaires pour contenir la résistance à l'artémisinine. L'objectif de cette thèse était de démontrer l’intérêt d’utiliser des biomarqueurs sérologiques de l'exposition humaine aux piqûres d'anophèles (gSG6-P1) et au Plasmodium (CSP & MSP1-19) pour quantifier le contact homme-vecteur et identifier les foyers résiduels de transmission. Des papiers filtres contenant du sang ont été prélevés sur une cohorte de 2600 personnes suivie tous les 3 mois jusqu'à 18 mois et analysés par dosage immuno-enzymatique (ELISA). Nos résultats ont montré que les niveaux de réponse IgG à l'antigène gSG6-P1 variaient selon le village, la saison et l'âge et étaient positivement corrélés à l'abondance des espèces anophèles et des vecteurs primaires de paludisme. Une association significative et positive a été observée entre la réponse de l'anticorps au gSG6-P1 et le taux d'inoculation entomologique (EIR), démontrant ainsi que l'hétérogénéité de la transmission du paludisme était directement associée à un comportement de piqûre hétérogène. Des études complémentaires ont montré que le biomarqueur salivaire était pertinent pour détecter des variations micro géographiques dans la transmission à P. falciparum. Cela s’est traduit par des chevauchements significatifs entre les foyers infectieux à P. falciparum et ceux à forts répondeurs en anticorps anti-salive d’anopheles (gSG6-P1). Dans l'ensemble, ces résultats indiquent que le biomarqueur salivaire d'Anopheles est prometteur pour les études épidémiologiques et pourrait guider la mise en œuvre d’interventions de lutte antivectorielle « ciblées » afin d'éliminer les foyers résiduels de paludisme. / Malaria along the Thailand-Myanmar border (TMB) displays geographical heterogeneity and is characterized by high prevalence of submicroscopic carriage and the emergence artemisinin resistance in P. falciparum. Timely identification and elimination of remaining P. falciparum transmission “hotspots” is essential to contain artemisinine resistance. The aim of this study was to address the relevance of using serological biomarkers of human exposure to anopheles bites (gSG6-P1) and Plasmodium antigens to identify remaining sources of transmission and to measure spatial and temporal changes in human vector contact along the TMB. Blood spots were collected in filter papers among a cohort of 2600 people followed every 3 months up to 18 months, and used for analysis by enzyme-linked immunosorbent assay (ELISA). Our findings showed that the levels of IgG responses to gSG6-P1 antigen varied according to village, season, and age and were positively associated with the abundance of total Anopheles species and primary malaria vectors. A significant and positive association was noted between the Antibody response to gSG6-P1 and the entomological inoculation rate (EIR) hence demonstrating that heterogeneity in malaria transmission was directly associated with heterogeneous biting behavior. Further investigations showed that salivary biomarker was relevant to detect small scale variations in P. falciparum malaria. This was supported by scan statistics showing that P. falciparum clusters partially overlap the gSG6-P1 clusters. Altogether, these findings indicates Anopheles salivary biomarker as great potential for epidemiological studies and could be useful to guide the implementation of hotspot–targeted vector control interventions with the aim to achieve malaria elimination.

Ce travail a eu pour objectif de caractériser les parasites P. falciparum, infectant les femmes enceintes et responsables du paludisme associé à la grossesse. Dans la première partie de ce travail, le phénotype d’adhérence et le profil d'expression des gènes var chez les parasites infectant les femmes enceintes ont été étudiés. Ces analyses ont été réalisées sur des isolats parasitaires collectés dans deux études menées au Bénin entre 2008 et 2013. La première étude, sur des isolats prélevés dans le cadre d'une étude de cohorte de femmes enceintes dans les zones rurales au Bénin, a montré que les parasites qui infectent les femmes dans le premier trimestre de la grossesse expriment déjà un phénotype placentaire. Dans une deuxième étude, portant sur les isolats prélevés en prospective chez des femmes enceintes se présentant en consultations prénatales dans les centres de santé à Cotonou, une analyse plus détaillée des propriétés d'adhérence des hématies parasitées par P. falciparum, a confirmé nos premiers résultats. Cette étude a souligné une plus grande complexité dans les propriétés d’adhérence des isolats obtenus pendant le premier trimestre de grossesse qui adhèrent sur plusieurs récepteurs. Tout au long de la grossesse cette diversité phénotypique s’affine vers des phénotypes typiquement placentaires. Ce travail a également démontré, qu'au-delà de la parasitémie, l'adhérence à la CSA est un facteur important au regard de l’issue défavorable de la grossesse ; les parasites qui infectent les primigestes adhèrent en moyenne plus à la CSA que ceux provenant des multigestes. Conformément aux travaux antérieurs, les études menées au Bénin ont montré que le gène var2csa est le membre de la famille des gènes var qui est préférentiellement transcrit par les parasites infectant la femme enceinte. L’expression de la protéine correspondante à la surface des érythrocytes infectés a été démontrée grâce à des anticorps spécifiques. Cette expression a été étroitement associée à la capacité des isolats à adhérer, in vitro, à la CSA. La deuxième partie de ce travail a examiné le potentiel vaccinal de VAR2CSA par l’exploration des régions peptidiques impliquées dans l'acquisition d'anticorps « anti-adhérence ». En utilisant une approche d'immunisation génétique chez la souris, nous avons été en mesure d'identifier la région minimale de VAR2CSA située dans son extrémité N-terminale comme étant le site qui concentre les épitopes anti-adhérence. Les IgG induites contre la région NTS-DBL2X de VAR2CSA ont été capables d’inhiber l'adhérence de plus de 60% ??des isolats naturels de P. falciparum à la CSA. Cette étude a par ailleurs mis en évidence des propriétés fonctionnelles des IgG qui seraient souche-spécifique ainsi qu’a aidé à formuler une hypothèse concernant la combinaison antigénique des variants de VAR2CSA nécessaires pour garantir une activité optimale sur des isolats de terrain. La dernière partie de ce travail a porté sur l'analyse du polymorphisme des séquences de VAR2CSA dans sa partie N-terminale chez les isolats de terrain. Ces analyses ont démontré l'existence d'une région dimorphique dans le domaine structurellement critique ID1, qui a révélé une association très intéressante avec la survenue d'infections à très forte densité de parasite. Le travail développé dans cette thèse a permis de mettre à jour les connaissances sur les parasites qui infectent les femmes pendant la grossesse et de formuler des hypothèses sur les pistes d'optimisation moléculaire, nécessaires au développement d'un vaccin efficace à base de VAR2CSA. / This thesis aimed to characterize the P. falciparum parasites infecting pregnant women and causing pregnancy-associated malaria (PAM). In the first part of this work, cytoadherence phenotype and var genes expression profile of pregnant women parasites have been investigated on parasite isolates collected in two studies conducted in Benin between 2008 and 2013. The first study on isolates collected as part of a cohort study of pregnant women in rural areas in Benin, showed that parasites which infect women in the first trimester of pregnancy already express placental phenotype. In a second study on isolates collected prospectively from pregnant women attending antenatal clinics in health centers in Cotonou, the analysis of the adhesion phenotype using multiple host receptors described so far confirmed the first results and highlighted a greater complexity of the binding properties in isolates collected during the first trimester and those obtained from multigravidae. This study also demonstrated that beyond parasitaemia, adhesion to CSA is a major factor for poor pregnancy outcomes. Consistent with previous reports, studies in Benin showed that var2csa was the most transcribed var gene by PAM-isolates and its surface expression on infected erythrocyte (IE) was demonstrated with specific antibodies. This was closely linked to the ability of isolates to adhere to CSA in vitro. The second part of the work investigated the vaccine potency of VAR2CSA by exploring the region of var2csa involved in the acquisition of anti-adhesion antibodies. Using a DNA immunization approach performed in mice, we were able to identify the var2csa minimal region located in its N-terminus as the site that concentrates the anti-adhesion epitopes. The NTS-DBL2X region of VAR2CSA has been found to induce cross-reactive antibodies that inhibit adhesion of more than 60% of field P. falciparum isolates to CSPG. This study highlighted some strain-specific properties in functionality of the antibodies induced and helped formulate a hypothesis of antigenic FCR3 and 3D7 variants combination for optimal activity on field isolates. The last part of this work focused on the analysis of sequence polymorphism in the N-terminal part of VAR2CSA expressed by field isolates. The analysis demonstrated the existence of a dimorphic region within the structurally critical ID1 domain that revealed a very interesting association with the occurrence of infections with very high parasite density. The work developed in this thesis updates knowledge on parasites infecting women during pregnancy and formulates hypotheses on the molecular optimization tracks necessary for the development of an effective VAR2CSA-based vaccine.

Ce travail avait pour objectif : 1) évaluer le portage de gamétocytes et leur génotype avant et après le traitement d’une part, et d’étudier leur infectivité ; 2) exprimer le domaine catalytique (PfMCA1-cd-Sc) de la métacaspase de Plasmodium falciparum (PfMCA1) chez la levure et 3) tester in vitro l’activité antiplasmodiale de nouvelles molécules synthétiques dérivées des pyrano et ferro-quinoléines sur des clones de laboratoire 3D7 et Dd2. Pour cela, le test in vivo de 28 jours de l’OMS, les marqueurs moléculaires de résistance et le « direct feeding » ont été utilisés pour le premier objectif. La culture des levures, l’expression des protéines de la métacaspase 1 de Plasmodium falciparum, le western blot, le test de prolifération et de survie, et les marqueurs de mort cellulaire ont servi pour le second objectif et enfin, la culture parasitaire et tests in vitro par la méthode de fluorimétrie au Sybr Green I ont permis l’évaluation de l’activité antiplasmodiale de nouvelles molécules. Nous avons démontré que les gamétocytes post-traitement étaient porteurs de mutations ponctuelles et plus infectants dans le groupe chloroquine ; que l’expression hétérologue du domaine catalytique de la métacaspase de Plasmodium falciparum (PfMCA1) dans la levure Saccharomyces cerevisiae entraînait une mort clonale de type apoptotique et un retard de croissance dépendant de l’activité VAD-Protéase et enfin, que les substitues aromatiques à base de pyrimidine ou de benzylméthylamine ferrocène révèlent une activité satisfaisante par rapport à la méthoxyéthylidene sur les clones 3D7 et Dd2. / Plasmodium species use programmed cell death for the survival of their offspring as some prokaryotic parasites. This study was designed to - assess the gametocytes carrier and their genotypes before/ after treatment and studying their infectivity; - express the catalytic domain (PfMCA1-cd-Sc) of Plasmodium falciparum metacaspase (PfMCA1) in yeast; - Test the “in vitro” anti-plasmodial activity of pyrano and ferro- quinolines derived new synthetic molecules on 3D7 and Dd2 Chloroquine laboratory clones. The 28-day “in vivo” WHO test, molecular markers of resistance and direct feeding; yeast culture, protein expression of P. falciparum metacaspase 1, Western blot, proliferation and survival test, and cell death markers were used to achieve the first two objectives while parasite culture and in vitro tests by the method of fluorimetry in SYBR Green I was used to evaluate the anti-plasmodial activity of new molecules. Results show that post-treatment gametocytes were carriers of point mutations and the most infective in the Chloroquine group. The heterologous expression of PfMCA1 catalytic domain in Saccharomyces cerevisiae resulted in apoptotic clonal death and growth retardation activity-dependent Protease-VAD, showing the involvement of PfMCA1 in the process of cell death. The aromatic substitutes with pyrimidine or benzyldimethylamine ferrocene residues showed satisfactory activity against the methoxyethylidene on 3D7 and Dd2. The data suggest that the structural optimization of these compounds based on pyrimidine and ferrocene is more interesting from the standpoint anti-plasmodial activity for candidate molecules in the near future.

L'objectif de mon travail de thèse a été la synthèse de nouveaux agents antipaludiques afin de développer une nouvelle chimiothérapie pour lutter contre l'émergence de résistance multi-drogues de Plasmodium falciparum. Notre choix s'est porté sur le développement de trois nouvelles séries de composés: les quinolones qui inhibent le processus de respiration des mitochondries, les benzamidines qui inhibent la formation de l'hémozoïne et les alkylamidines qui bloquent le métabolisme phospholipidique. Dans le groupe du professeur O'Neill à Liverpool, la première partie de mon travail a été concentrée sur la synthèse de dérivés de 4-quinolone en faisant varier la chaîne latérale (chapitre II). La seconde partie de mon travail a été la synthèse de dérivés dibenzamidines en variant le linker hétérocyclique (chapitre III). Pour ce travail, le linker a été modifié: la chaîne alkoxy de la pentamidine a été remplacée par l'hétérocycle correspondant pour fournir les différentes séries de composés (thiazole, triazole, furane ou aziridine). Trois différents paramètres ont été étudiés pour ces dérivés: la position de la fonction amidine sur le cycle aromatique, l'angle entre les deux benzamidines et la position de l'hétérocycle au sein de la molécule. Pour tous ces composés, les activités antipaludiques in vivo ont été déterminées. Dans le groupe du professeur Durand à Montpellier, la première partie de mon travail a été la synthèse de dérivés alkylamidines en faisant varier le linker et en introduisant un noyau aromatique dans la tête polaire des reversed amidines. Le but était d'étudier l'influence du noyau aromatique sur l'activité antipaludique des drogues ainsi que le développement de leurs prodrogues (chapitre IV). Pour tous ces composés, les activités antipaludiques in vitro et in vivo ont été mesurées. La seconde partie de mon travail a été la réalisation des essais de stabilité et de bioconversion des différentes prodrogues dissymétriques (chapitre V). Les différentes conditions utilisées ont été optimisées sur la pentamidoxime. / The objective of my PhD work was the synthesis of new antimalarial agents in order to develop a new chemotherapy to fight the emerging multi-drug resistant strains of Plasmodium falciparum malaria. Our choice has been the development of three new series of drugs: quinolones which inhibit the mitochondrial respiration process, benzamidines which inhibit hemozoin formation and alkylamidines which block phospholipid metabolism. Within the O'Neill group (Liverpool), the first part of my work has been focussed on the synthesis of 4-quinolone derivatives, varying the side chain (chapter II). The second part of my work has been the synthesis of dibenzamidine derivatives, varying the heterocyclic linker (chapter III). Within this work, the linker was modified in the following ways: alkoxy chain of pentamidine was replaced by the corresponding heterocycle to give four different series of compounds (thiazole, triazole, furane or aziridine). Three different parameters were studied for these derivatives: position of the amidine function on the aromatic ring, the angle between the two benzamidines and the position of the heterocyclic ring in the molecule. For these drugs, in vitro antimalarial activities have been measured. Within the Durand group (Montpellier), the first part of my work has been focussed on the synthesis of derivatives varying the linker of the bis-C-alkylamidines and introducing an aromatic ring in the polar head of the reversed amidines. The aim was to study the influence of the aromatic ring on the antimalarial activity of the drugs as well as the development of their prodrugs (chapter IV). For all these drugs and prodrugs, in vitro and in vivo antimalarial activities have been measured. The second part of my work has been based on the stability and bioconversion studies of different asymmetrical prodrugs (chapter V). The different conditions used for these studies have been optimised on the pentamidoxime.

Le paludisme est causé par l'infection et la destruction des érythrocytes par les parasites protozoaires appartenant au genre Plasmodium. Au cours de son développement dans l'érythrocyte,Plasmodium falciparum requiert la biosynthèse massive de membranes dont les principaux constituants lipidiques sont des phospholipides. La phosphatidylcholine (PC) et la phosphatidyléthanolamine (PE) représentent à elles deux environ 80 % des lipides membranaires et l'inhibition de leur biosynthèse est létale pour le parasite. La PC et la PE sont synthétisées par le parasite, principalement via les voies de novo dépendantes de la CDP-choline et de la CDP-éthanolamine (ou voies de Kennedy) en utilisant respectivement la choline et l'éthanolamine comme précurseurs. Ces travaux de thèse se focalisent sur les deux enzymes CTP:phosphocholine etCTP:phosphoéthanolamine cytidylyltransférase (PfCCT et PfECT, respectivement), catalysant les étapes limitantes des voies de Kennedy. Chez Plasmodium, les CCT et ECT possèdent deux domaines cytidylyltransférases (CT) portant l'activité catalytique, séparés par une longue région de liaison. Pour la CCT, cette duplication est retrouvée seulement chez trois organismes, tous faisant partie du phylumdes Apicomplexes : Babesia, Theileria et Plasmodium, alors que la présence de deux domaines CT estune caractéristique retrouvée chez toutes les ECT étudiées à ce jour. La première partie de ce travail de thèse concerne la caractérisation biochimique et l'inhibition la PfCCT Nous avons montré que les deux domaines CT de la PfCCT sont actifs à l'inverse de la PfECT pour laquelle seul le domaine CTN-terminal est catalytiquement actif. A la suite d'un criblage virtuel basé sur la structure de l'enzyme,nous avons identifié un composé princeps capable d'inhiber l'activité de la PfCCT in vitro, la synthèse de PC et la croissance parasitaire. Ce premier composé actif (haut µM) représente une base pour l'optimisation future de nouveaux composés plus efficaces. Dans la deuxième partie de cette thèse,nous avons déterminé le mécanisme catalytique, la spécificité de liaison des ligands et l'organisation structurale de la PfECT grâce à la combinaison d'approches biochimiques et biophysiques. L'ensemble des résultats présentés dans ce manuscrit apportent un éclairage important concernant le fonctionnement de ces deux cibles potentielles et constituent des étapes essentielles à l'élaboration d'une approche thérapeutique. / Malaria is caused by the infection and destruction of red blood cells by protozoan parasitesbelonging to the genus Plasmodium. During its intra-erythrocytic development, Plasmodiumfalciparum requires massive biosynthesis of membranes which are mainly composed of phospholipids.Phosphatidylcholine (PC) and phosphatidylethanolamine (PE) together represent about 80% of thetotal membrane lipids and inhibition of their biosynthesis leads to parasite death. PC and PE aresynthesized by the parasite's machinery mainly through the de novo CDP-choline and CDPethanolamine(Kennedy) pathways using respectively choline and ethanolamine as precursors. Thisstudy focuses on the rate limiting steps of these pathways catalyzed by CTP:phosphocholine andCTP:phosphoethanolamine cytidylytransferases (PfCCT and PfECT, respectively). In Plasmodiumspecies, both CCT and ECT contain two catalytic cores (CT domains) separated by a long linker.Interestingly, for CCT this feature is found only in three organisms, all from the phylum ofApicomplexa: Babesia, Theileria and Plasmodium, whereas the presence of two CT domains is ageneral feature in all ECTs known so far. The first part of this work consists in the biochemicalcharacterization of PfCCT and the investigation of its druggability. We showed that both PfCCT CTdomains are active and display similar kinetic parameters while only the N-terminal CT domain wasactive in PfECT. Subsequent to an in silico structure-based screening of compounds libraries, weidentified a PfCCT inhibitor able to inhibit PC synthesis as well as P. falciparum growth in vitro in thehigh µM range. This compound represents a first step toward the optimization of future more potentcompounds. In the second part of this study, we investigated the catalytic mechanism of PfECT anddeciphered its interactions with its ligands using biochemical, biophysical and structural approaches.Collectively, these results bring new insights into the biochemical and structural properties of thesetwo keys enzymes of the phospholipid metabolism in P. falciparum and pave the way for their futuredevelopment as potential drug target.

L’artésunate est désormais le traitement de référence du paludisme grave au plan mondial. Cependant, des cas d’anémie hémolytique différée ont été décrits chez 20% à 25% des voyageurs traités. L’épisode hémolytique survient 2 à 3 semaines après traitement. Environ la moitié des patients vont nécessiter une transfusion sanguine. L’artésunate induit un phénomène original en physiologie humaine : le “pitting” ou épépinage splénique des érythrocytes parasités. Il consiste en l’expulsion du parasite mort de l’érythrocyte hôte lorsque celui-ci traverse une structure microcirculatoire splénique appelée « fente interendothéliale ». Ces érythrocytes pittés retournent sans destruction immédiate dans la circulation générale. Nous avons étudié l’efficacité et la tolérance de l’artésunate intraveineux chez 123 voyageurs atteints de paludisme grave. Cent dix-sept patients ont survécu (95%). Parmi 78 patients suivis plus de 8 jours, 76 (97%) ont eu une anémie au cours du suivi et 21 une hémolyse différée typique (27%). Dans ce sous groupe de patients la chute médiane en hémoglobine a été de 1,3g/dl avec un nadir <7g/dl dans 15% des cas. Un seul patient a été transfusé. Le marquage de la protéine parasitaire Resa, véritable empreinte de l’infection érythrocytaire par Plasmodium falciparum, permet la visualisation des érythrocytes pittés. Chez 21 patients non transfusés le pic de concentration en érythrocytes pittés est survenu durant la première semaine. Chez 9 patients évoluant vers une hémolyse différée le pic de pittés était significativement plus élevé que chez 12 patients présentant d’autres profils évolutifs d’anémie (0,30 vs. 0,07 ; P = 0,0001). Une concentration d’érythrocytes pittés au pic supérieure à 180 millions/l aurait prédit le risque d’hémolyse différée avec une sensibilité de 89% et une spécificité de 83%. Utilisant la technologie ImageStream* l’étude morphologique érythrocytaire chez 4 patients a montré que l’infection plasmodiale suivi de pitting entraine une réduction de surface projetée de 8,9%. Cette altération pourrait contribuer à la réduction de la durée de vie des érythrocytes pittés. La destruction différée des érythrocytes infectés et épargnés par le pitting durant le traitement par artésunate est un mécanisme original d’anémie hémolytique. Ce travail a permis de structurer l’espace nosologique de l’anémie post-thérapeutique au cours du paludisme, de clarifier la physiopathologie de l’hémolyse différée et d’identifier certains de ses mécanismes. Malgré l’incidence élevée de l’hémolyse différée, l’anémie résultante n’est préoccupante que dans 15% des cas et ne remet pas en cause le bénéfice de l’artésunate par rapport à la quinine dans le traitement du paludisme grave. La concentration précoce des érythrocytes pittés pourrait être un marqueur prédictif intéressant de la survenue d’une hémolyse différée post-artésunate. / Worldwide, artesunate is now the recommended treatment for severe malaria. However cases of delayed hemolytic anemia have been described in 20% to 25% travelers treated with artesunate. The episode usually occurs 2 to 3 weeks after the end of the treatment. About half on the inpatients need blood transfusion. Artesunate induces an original phenomenon called splenic “pitting” of parasitized erythrocyte. The dead parasite is expelled from the host erythrocyte when it comes through a microcirculatory structure called inter-endothelial slit. These pitted red blood cells go back to the general blood circulation without destruction. We have studied efficacy and tolerance of intravenous artesunate in 123 patients with imported severe malaria, of whom 117 have survived (95%). Among 78 patients followed more than 8 days, 76 (97%) suffered from anemia during follow-up and 21 had a typical delayed hemolysis pattern (27%). In this sub group the median loss of hemoglobin was 1.3g/dl with a nadir below 7g/dl in 15% of them. Only one patient was transfused. The labelling of Resa protein, a plasmodium protein included in the bilayer membrane of the red blood cell, allowed the visualization of pitted cells. In 21 patients non transfused, the pitted cells peak occured during the first week post treatment. In 9 patients with typical delayed hemolysis pattern, the pitted cells peak was higher than in the 12 patients with other kind of anemia patterns (0.30 vs. 0.07 ; P = 0.0001). A pitted cells concentration above 180 millions/l would have predicted the risk of late hemolysis with 89% sensitivity and 83% specificity. Red blood cell morphology was studied using ImageStream* technology in 4 patients. It has shown that infection and pitting process induces a membrane projected area loss of 8.9%. This loss could explain the reduced life span of the pitted red blood cells. Differed destruction of the erythrocytes first infected and then spared by pitting process during the treatment with artesunate is a new pattern of hemolytic anemia during malaria. This work has provided a nosological framework of post therapy hemolysis during malaria, a clarified pathophysiology of delayed hemolysis and has identified potential explanatory mechanisms. Notwithstanding the high incidence of hemolysis, the resulting anemia is severe in 15% of the patients and does not jeopardize the advantage of artesunate compared to quinine in the treatment of severe malaria. Early pitted cells concentration could be a surrogate marker to determine the risk of delayed hemolysis and anemia after artesunate treatment.

Orientador: Fabio Trindade Maranhão Costa / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-18T14:00:00Z (GMT). No. of bitstreams: 1 Kayano_AnaCarolinaAndradeVitor_M.pdf: 4619978 bytes, checksum: 3bf657caae96f9c4faf7fcdf7e519956 (MD5) Previous issue date: 2011 / Resumo: Para superar o problema do aumento de resistência às drogas, os medicamentos tradicionais são fontes importantes na investigação de potenciais novos antimaláricos. Caesalpinia pluviosa, mais conhecida como 'sibipiruna', é originária do Brasil e estudos mostraram que este gênero apresenta várias propriedades farmacológicas, incluindo a atividade antimalárica. O extrato bruto obtido da casca foi submetido ao fracionamento com diferentes solventes resultando em sete frações. Para avaliar a citotoxicidade do extrato e frações em células MCF-7 foi realizado o ensaio de MTT. Essas amostras foram testadas in vitro contra P. falciparum cloroquino sensível (3D7) e resistente (S20) e in vivo em camundongos infectados por P. chabaudi. A interação da fração etanólica 100% de C. pluviosa com o artesunato foi avaliado e análises de espectrometria de massas foram realizados. As frações etanólica 100% e metanólica 50% apresentaram atividade antimalárica significativa em concentrações não tóxicas, e o ensaio de interação medicamentosa do artesunato com a fração etanólica 100% foi sinérgico. Essa fração foi capaz de inibir significativamente a parasitemia dos animais de forma dose dependente após 4 dias de tratamento (0-3 dia pós infecção). Além disso, análise de espectrometria de massas revelou a presença do íon m/z 303.0450, sugerindo a presença de quercetina. No entanto, em uma segunda análise com o padrão de quercetina mostrou íons diferentes como m/z 137 e 153. Nossos resultados mostram que a fração etanólica 100% de C. pluviosa apresentou atividade antimalárica in vitro em concentrações não tóxicas e esse efeito foi potencializado com a presença de artesunato. Além disso, essa atividade antimalárica foi também sustentada após o tratamento in vivo de camundongos infectados. Finalmente, as análises de espectrometria de massas sugerem que um novo composto, provavelmente um isômero da quercetina, possa estar relacionado à atividade antimalárica da fração etanólica 100% / Abstract: To overcome the problem of increasing drug resistance traditional medicines are an important source for investigation of potential new antimalarials. Caesalpinia pluviosa, commonly named 'sibipiruna', is originated from Brazil and studies showed that this genus present multiple therapeutic properties, including antimalarial activity. Crude extract obtained from stem bark was purified with different solvents, resulting in seven fractions. MTT assay was performed to evaluate cytotoxicity in MCF-7 cells. The crude extract and its fractions were tested in vitro against chloroquine-sensitive (3D7) and -resistant (S20) strains of Plasmodium falciparum and in vivo in P. chabaudi-infected mice. In vitro interaction with artesunate and C. pluviosa fraction was assessed and mass spectrometry analyses were conducted. At non-toxic concentrations the 100% ethanolic and 50% methanolic fractions presented significant antimalarial activity against both 3D7 and S20 strains, and drug interaction assays with artesunate showed a synergistic effect with 100% ethanolic fraction. This fraction was able to inhibit mice parasitemia significantly and in a dose dependent manner after 4 days treatment (0-3 post-infection). Moreover, mass spectrometry analyses revealed the presence of an ion corresponding to m/z 303.0450, suggesting the presence of quercetin. However, a second set of analyses, with the standard quercetin, showed distinct ions of m/z 137 and 153. Our findings show that the 100% ethanolic fraction of C. pluviosa exhibited antimalarial activity in vitro at non-toxic concentrations and this effect was potentiated with the presence of artesunate. Moreover, this antimalarial activity was also sustained in vivo after treatment of infected mice. Finally, mass spectrometry analyses suggest a new compound, most likely an isomer of quercetin, related with antimalarial activity of the 100% ethanolic fraction / Mestrado / Imunologia / Mestre em Genética e Biologia Molecular

Orientador: Fabio Trindade Maranhão Costa / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-29T19:18:42Z (GMT). No. of bitstreams: 1 Bastos_MarceleFontenelle_D.pdf: 23599395 bytes, checksum: 51577c364bf25d45e672a187e5d0bc4a (MD5) Previous issue date: 2015 / Resumo: Acredita-se que o sequestro de eritrócitos infectados por Plasmodium falciparum (Pf-EIs) na microvasculatura de órgão vitais, contribua para a patogênese de síndromes graves da malária, como a malária cerebral (MC), síndrome da angústia respiratória grave, anemia grave e malária na gravidez. Apesar do tratamento com drogas antimaláricas eficazes, mortalidade significativa ainda é observada em casos graves da doença. Assim, tem sido sugerido o uso de terapias adjuvantes. Nesse sentido, polissacarídeos sulfatados, como a heparina, têm demonstrado capacidade em inibir a citoaderência de P. falciparum a vários receptores do hospedeiro, inibir a invasão de merozoítos e romper rosetas. A heparina foi utilizada no passado como tratamento para malária grave, no entanto o seu uso foi interrompido devido à ocorrência de efeitos colaterais graves, tais como hemorragia. Além disso, muitos desses polissacarídeos sulfatados são derivados de mamíferos, o que aumenta o risco de contaminação por agentes patogênicos, como príons. Apesar de muitos compostos terem sido testados como terapia adjuvante para diferentes aspectos patogênicos da malária grave, nenhum destes demonstrou evidência inequívoca de melhora dos pacientes nos testes clínicos. Sendo assim, nesse estudo, investigamos a ação de dois polissacarídeos sulfatados extraídos de invertebrados na citoadesão e desenvolvimento de P. falciparum. Já foi demonstrado que esses compostos; o condroitim sulfato fucosilado (FucCS), extraído do pepino-do-mar Ludwigothurea grisea, e o análogo da heparina (heparam sulfato), extraído do molusco bivalve Nodipecten nodosus; possuem ação anticoagulante e antitrombótica, porém em menor escala do que a heparina comercial. Além disso, apresentam efeito anti-inflamatório e antimetastático. Aqui, nós mostramos que o FucCS e o heparam sulfato (HS) de molusco foram eficazes em inibir a citoadesão de P. falciparum em condições estáticas e de fluxo a células endoteliais de pulmão humano (HLECs). Eles também foram capazes de inibir o desenvolvimento parasitário por interferir na invasão de merozoítos. Além de romper rosetas eficientemente. Ainda, o FucCS inibiu a adesão de Pf-EIs a criocortes de placenta. Finalmente, a remoção das cadeias de fucose sulfatadas presentes na estrutura do FucCS praticamente aboliu o efeito inibitório do composto, evidenciando a importância dessas cadeias para sua atividade. Sendo assim, sugerimos o FucCS e o HS de molusco como candidatos promissores a terapia adjuvante no tratamento da malária grave e na prevenção ao agravamento da doença, além de abrir perspectivas para continuação e aprofundamento do estudo desses compostos no tratamento da malária / Abstract: It is believed that sequestration of Plasmodium falciparum-infected erythrocytes (Pf-iEs) in the microvasculature of vital organs, contributes to the pathogenesis of severe malaria syndromes such as, cerebral malaria (CM), severe respiratory distress, severe anemia and malaria in pregnancy (MiP). Despite treatment with effective antimalarial drugs, high mortality is still observed in severe cases of the disease. Thus, the use of adjuvant therapies has been suggested. Accordingly, sulfated polysaccharides, such as heparin, have been shown to prevent P. falciparum cytoadherence to several host receptors, inhibit merozoite invasion and disrupt rosettes. Heparin was used in the past as treatment for severe malaria, however its use was abandoned due to the occurrence of serious side effects such as bleeding. Moreover, many of these compounds are derived from mammals, which increase the risk of contamination by pathogens, such as prions. Although many compounds have been tested as adjunct therapy to different pathophysiological features of severe malaria, none of them showed clear evidence of patients¿ improvement in clinical trials. Therefore, in this study, we investigated the action of two sulfated compounds extracted from invertebrates in P. falciparum cytoadhesion and development. It has been shown that these compounds; chondroitin sulfate fucosylated (FucCS), extracted from the sea cucumber Ludwigothurea grisea, and the heparin analogue (heparan sulfate), extracted from the bivalve mollusk Nodipecten nodosus; have anticoagulant and antithrombotic action, but on a smaller scale than the commercial heparin. They also have anti-inflammatory and antimetastatic effect. Here, we show that FucCS and mollusk heparan sulfate (HS) were effective in inhibiting P. falciparum cytoadhesion, under static and flow conditions to human lung endothelial cells (HLECs). They were also able to block parasite development by interfering with merozoite invasion, and to disrupt rosettes efficiently. In addition, FucCS inhibited Pf-iEs adhesion to placenta cryosections. Finally, removal of sulfated fucose branches on the FucCS molecule virtually abolished its inhibitory effect, indicting a central role played by these structures. Then, we suggest FucCS and mollusk HS as promising candidates for adjunct therapy in the treatment of severe malaria and in preventing disease worsening. Also, we open new avenues to understand the mechanisms of action of these compounds in malaria treatment / Doutorado / Imunologia / Doutora em Genética e Biologia Molecular

Plasmodium falciparum e Toxoplasma gondii são protozoários parasitas pertencentes ao filo Apicomplexa. Apirases são enzimas metabolizadoras de nucleotídeos extracelulares. Nesta tese mostramos pela primeira vez a presença de um membro desta família de enzimas em P. falciparum, o qual foi capaz de degradar ATP extracelular. Análises por RT-qPCR revelaram a expressão da apirase durante todo o ciclo intraeritrocítico. A adição de inibidores desta classe de enzimas foi capaz de prejudicar o desenvolvimento dos parasitas e a invasão de novas hemácias pelos merozoitos, sugerindo assim um papel da apirase nestes processos. A via de sinalização por Ca2+ é universal e vital para todas as células. Para melhor entender a fisiologia celular de P. falciparum construímos uma nova linhagem de parasitas transgênicos, PfGCaMP3, que nos tornam capazes de monitorar a dinâmica de Ca2+ sem o uso de protocolos invasivos de marcação. De modo semelhante utilizamos uma nova linhagem de T. gondii expressando de forma estável o indicador de Ca2+ GCaMP3 para estudar o papel deste íon na saída da célula. T. gondii possui o Ca2+ necessário para promover este processo, entretanto Ca2+ extracelular age como um fator intensificador neste passo essencial do ciclo lítico. / Plasmodium falciparum and Toxoplasma gondii are protozoan parasites that belong to phylum Apicomplexa. Apirases are metabolizing enzymes of extracellular nucleotides. In this work we show for the first time the presence of an apyrase in P. falciparum, which was able to degrade extracellular ATP. RTqPCR analysis revealed the expression of apyrase throughout the intraerythrocytic cycle. Addition of apyrase inhibitors was able to impair the development of the parasites and the invasion of new erythrocytes by merozoites, thus suggesting a role of apyrase in these processes. Calcium signaling is universal and vital to all cells. To better understand the cellular physiology of P. falciparum we construct a new strain of transgenic parasites, PfGCaMP3, which enable us to monitor the Ca2+ dynamics without using invasive protocols. Similarly we use a new strain of T. gondii that stably express the Ca2+ indicator GCaMP3 to study the role Ca2+ in parasite egress. T. gondii has the Ca2+ required to promote this process, however extracellular Ca2+ acts as an enhancer factor in this crucial step of the lytic cycle.

Nesta dissertação, foi caracterizada a via de biossíntese de tiamina (Vitamina B1) nas três formas intraeritrocitárias de P. falciparum. Foram realizadas marcações metabólicas, utilizando diferentes precursores radioativos envolvidos na biossíntese de tiamina, já descritos para outros organismos. A utilização do precursor [1-14C] acetato de sódio demonstrou que a via de biossíntese de tiamina encontra-se ativa em todos os estágios intraeritrocitários de P. falciparum. Investigamos os precursores que poderiam estar envolvidos na biossíntese do intermediário tiazol, e nossos dados sugerem que a cistéina é a doadora do enxofre presente na molécula de tiamina; que o aminoácido tirosina pode ser o precursor da biossíntese de tiamina, e nicotinamida não é utilizada como precursor em P. falciparum. Também se avaliou o efeito da fosmidomicina e 3ClDHP e foi demonstrado que ambos propiciaram uma inibição no crescimento dos parasitas. Estes dados sugerem que a via de biossíntese de tiamina, pode ser explorada como alvo para drogas antimaláricas, devido ausência em humanos. / In the present work we have demonstrated the biosynthesis of thiamin (vitamin B1) in the intraerytrocytic stages of P. falciparum. We have demonstrated active biosynthesis of thiamine in the three parasite stages metabolically labeled with [1-14C] sodium acetate. We also investigated which precursors could be involved in the biosynthesis of the thiazole intermediate, by metabolic labelling with different precursors. Our data suggest that the sulphur present in the thiamine molecule is formed from cysteine white that tyrosine can be the precursor of thiamine biosynthesis. Nicotinamide is not utilized as a precursor in P.falciparum. We also investigated the effect of fosmidomycin (an inhibitor of the DOXP reductoisomerase in the MEP pathway) and 3CIDHP (an analogue of bacimethrin) in vitro cultures and both showed an inhibitory effect on parasite growth. These data suggest that the biosynthesis of thiamine can be an attractive target for the development of antimalarial drugs since this pathway is absent in humans.