My dissertation responds to recent calls for a critical medical humanities and a literature of global health by first investigating the function of literature in the development of earlier specialties in international health, with tropical medicine at the turn of the twentieth century as a key example. Scholarship in history and rhetoric of the period has described the formation of modern disciplines as a separation of scientific and literary textual traditions, predicated on the rise of distinct genres for the production of scientific knowledge, namely the scientific article, the case study, and the medical report. These genres were certainly used by key specialists of the tropics to establish a new rhetoric for description and to reduce the role of the imagination when dealing with human and geographic difference. Yet their writing on sub-Saharan Africa continued to signal a disciplinary disorder. Malaria, in particular, demanded the use of scene and figuration for the classification of space, ecologies, diseases and natives--rhetoric derived from literary genres, particularly the travelogue, memoir and novella. The result is a corpus I call malaria literature, one that includes works as disparate as Richard Burton's travel account, First Footsteps in East Africa (1856), Patrick Manson's textbook, Tropical Diseases: Manual of the Diseases of Warm Climates (1898), Joseph Conrad's novella, Heart of Darkness (1899), AR Paterson's pamphlet, A Guide to the Prevention of Malaria in Kenya (1935) and Isak Dinesen's memoir, Out of Africa (1937). I read these five texts as part of an undisciplined library underwriting the construction of a modern medical specialty, and thus illustrate how the positivist turn in Africanist discourse became an incomplete effort to distance medical writing from traditions of poesis. Instead of a rupture between the literary and the scientific, I find a sustained epistemic complicity: a set of persistent knowledge-producing relations between both representational modes, where metaphors for space work with microbial notions of contagion to define disease and shape policy. Reading for such complicity, I argue, recasts tropical medicine as a confluence of scientific and literary traditions. It also complicates contemporary notions of medical literature developed after World War II, the birth of the World Health Organization, decolonization and the emergence of global health, and it enables the field of literary studies to enter into debates about the ethics of public health endeavors from a vantage point unique to the study of representations of disease.

A identificação de focos de transmissão pode ser de grande utilidade no controle da malária. Por esse motivo, hospitais em regiões endêmicas buscam saber os locais que foram visitados anteriormente por pacientes. No entanto, tais informações, obtidas através de questionários fornecidos aos pacientes, são geralmente vagas e muitas vezes imprecisas. Isto torna o processo manual, lento e de pouca valia em estudos epidemiológicos de larga escala. Baseando-se no fato de que uma parcela significativa da população possui celulares com GPS, o objetivo deste projeto é melhorar a acurácia, organização e dinâmica do processo de coleta de dados de geolocalização de pacientes infectados. Um sistema (https://sipos.fcf.usp.br) foi desenvolvido para que pacientes que chegam aos hospitais possam, sob consentimento voluntário, fornecer os dados de GPS dos seus celulares. Os dados dos usuários, que são tratados de forma anônima, são automaticamente processados e armazenados de forma segura. Através do sistema SiPoS Explorer, epidemiologistas e especialistas em saúde pública podem explorar e analisar os dados de geolocalização, permitindo, desta forma, que regiões vulneráveis sejam priorizadas durante campanhas de controle. / The identification of regions with high rates of infection can be of great use in the control of malaria. For this reason, hospitals in endemic regions seek to know the places previously visited by patients. However, such information, obtained through questionnaires provided to patients, is usually vague, inaccurate and not integrated into databases. This makes the process manual, slow and of little value in large-scale epidemiological studies. Based on the fact that a significant portion of the population has smartphones equipped with GPS, this project aims to improve the accuracy and organization of the process of collecting geolocation data from infected patients. The Sickness Positioning System (https://sipos.fcf.usp.br) was developed so that patients who arrive at hospitals can, with voluntary consent, provide the GPS data collected by their smartphones. User data, which is handled anonymously, is automatically processed and securely stored. Through the SiPoS Explorer system (https://sipos.fcf.usp.br/explorer), epidemiologists and public health experts can explore and analyze geolocation data, thereby allowing vulnerable regions to be prioritized during control campaigns.

Pang, Lap-yin. / "42" in title is subscript. / "July 2000." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (p. 163-173). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

A identificação de focos de transmissão pode ser de grande utilidade no controle da malária. Por esse motivo, hospitais em regiões endêmicas buscam saber os locais que foram visitados anteriormente por pacientes. No entanto, tais informações, obtidas através de questionários fornecidos aos pacientes, são geralmente vagas e muitas vezes imprecisas. Isto torna o processo manual, lento e de pouca valia em estudos epidemiológicos de larga escala. Baseando-se no fato de que uma parcela significativa da população possui celulares com GPS, o objetivo deste projeto é melhorar a acurácia, organização e dinâmica do processo de coleta de dados de geolocalização de pacientes infectados. Um sistema (https://sipos.fcf.usp.br) foi desenvolvido para que pacientes que chegam aos hospitais possam, sob consentimento voluntário, fornecer os dados de GPS dos seus celulares. Os dados dos usuários, que são tratados de forma anônima, são automaticamente processados e armazenados de forma segura. Através do sistema SiPoS Explorer, epidemiologistas e especialistas em saúde pública podem explorar e analisar os dados de geolocalização, permitindo, desta forma, que regiões vulneráveis sejam priorizadas durante campanhas de controle. / The identification of regions with high rates of infection can be of great use in the control of malaria. For this reason, hospitals in endemic regions seek to know the places previously visited by patients. However, such information, obtained through questionnaires provided to patients, is usually vague, inaccurate and not integrated into databases. This makes the process manual, slow and of little value in large-scale epidemiological studies. Based on the fact that a significant portion of the population has smartphones equipped with GPS, this project aims to improve the accuracy and organization of the process of collecting geolocation data from infected patients. The Sickness Positioning System (https://sipos.fcf.usp.br) was developed so that patients who arrive at hospitals can, with voluntary consent, provide the GPS data collected by their smartphones. User data, which is handled anonymously, is automatically processed and securely stored. Through the SiPoS Explorer system (https://sipos.fcf.usp.br/explorer), epidemiologists and public health experts can explore and analyze geolocation data, thereby allowing vulnerable regions to be prioritized during control campaigns.

Malaria has been a major driving force in the evolution of the human genome. In sub-Saharan African populations, two neighbouring polymorphisms in the Complement Receptor 1 (CR1) gene, named Swain-Langley (Sl2) and McCoy (McCb), occur at high frequencies, consistent with selection by malaria. This thesis investigates the association between these two polymorphisms and severe malaria. Previous studies into this area have produced conflicting findings. Using a large case-control study of severe malaria in Kenyan children and statistical models adjusted for confounders, I found that the Sl2 polymorphism was associated with markedly reduced odds of cerebral malaria and death, while the McCb polymorphism was associated with increased odds of cerebral malaria. I also identified an interaction between Sl2 and α+thalassaemia, with the protective association of Sl2 greatest in children with normal α-globin. Following these epidemiological findings, I explored potential biological hypotheses which might explain them. The first approach examined whether the Sl2 and McCb polymorphisms affected how CR1 forms clusters on erythrocyte membranes, a process which is key in the binding and transfer of immune complexes from erythrocytes to macrophages. Using erythrocytes from Kenyan children, I performed immunofluorescence assays (IFAs) with confocal microscopy to quantify CR1 cluster number and volume. I found no association between the Sl2 and McCb polymorphisms and either the number or volume of CR1 clusters formed. The second approach investigated whether the cerebral malaria-specific associations seen with Sl2 and McCb might be due to expression of CR1 by human brain endothelial cells (HBEC). The immortalised cell line HBEC-5i was investigated for expression of CR1 using IFA, flow cytometry, western blotting, functional C3b degradation assays, mass spectrometry, immunoprecipitation and siRNA knockdown experiments. A pool of α-CR1 monoclonal antibodies recognised an intracellular antigen in permeabilised HBEC-5i cells which was a similar molecular weight to CR1 on western blotting. However, when the α-CR1 monoclonal antibodies were tested individually, only E11 recognised an HBEC-5i antigen. Further investigative approaches did not support the presence of CR1 on HBEC-5i cells, instead suggesting that E11 was not specific for CR1 and was instead recognising a protein in the Golgi apparatus. The final approach was to examine whether the Sl2 and McCb polymorphisms might influence the binding of the complement components mannose binding lectin, C1q and L-ficolin to the LHR-D region of CR1. I aimed to generate recombinant proteins of the LHR-D region which included the polymorphisms. Site-directed mutagenesis of the region was successful and subcloning and expression of the mutant amplicons will be performed at a later date. In summary, I have identified opposing associations between the Sl2 and McCb polymorphisms and cerebral malaria, which do not appear to be due to differences in CR1 clustering or expression of CR1 by human brain endothelial cells. My investigation into whether the polymorphisms might influence complement component binding is ongoing.

Student Number : 0318930A - PhD thesis - School of Animal, Plant and Environmental Studies - Faculty of Science / The widespread use of pyrethroid insecticides has led to the emergence of significant insecticide resistance in various parts of the world. An unprecedented increase in the number of annual malaria cases reported in Kwazulu Natal, South Africa in 1999 to 2000 was attributed to the re-emergence of pyrethroid-resistant Anopheles funestus Giles. Resistance was metabolic-based with increased monooxygenase (P450) metabolising the pyrethroid insecticides. This emphased the need to understand the molecular mechanisms conferring pyrethroid resistance in An. funestus. The present study aimed to firstly isolate P450 genes in An. funestus and secondly, to identify P450 gene over-expressed in a resistant (FUMOZ-R) strain compared to a susceptible (FANG) strain. A third aim was to construct an An. funestus cDNA library to lay the foundation for future studies on P450 monooxygenses. Degenerate primers based on conserved regions of three An. gambiae P450 families were used to amplify cDNAs from An. funestus. Eleven CYP4, four CYP6 and five CYP9 partial genes were isolated and sequenced. BLAST results revealed that An. funestus P450s have a high sequence similarity to An. gambiae with above 75% identity at the amino acid level. The exception was CYP9J14. The An. gambiae P450 with the closest similarity to CYP9J14 exhibited only 55% identity suggesting a recent duplication event in CYP9J14. Molecular phylogenetic analysis also supported this hypothesis. Intron positions were highly conserved between the two species. Expression studies using blot analysis implicated CYP6P9, an ortholog of CYP6P3 in An. gambiae, as the over-expressed P450. Dot blot analysis revealed a 500-fold expression higher in FUMOZ-R strain compared with FANG strain. Semiquantitative PCR revealed that CYP6P9 was developmentally regulated. Expression was not detected in eggs and was higher in larvae compared to pupae. Quantitative real time PCR showed that CYP6P9 expression was 4.5-fold higher in 3-day old FUMOZ-R males than females and 3.5-fold higher in the 14-day old males than 14- day old females. Statistically, this difference was not significant suggesting that CYP6P9 expression is not sex specific. The An. funestus cDNA library construction in λTriplEx2 vector was successful with a titre of 4.9 x108 pfu/ml and a transformation efficiency of 98%.

Malaria is a vector borne, acute febrile illness, caused by Plasmodium parasites. Malaria impacts the medical and socioeconomic development programs of affected communities, as it diverts both individual and national resources into managing the disease burden. The purpose of this study was to explore and evaluate household determinants of malaria in Mutasa District, Zimbabwe. The precede-proceed theoretical model guided the study. Secondary data from Demographic Health Survey and District Health Management Information System, and current data from household determinant questionnaires, were used to evaluate the influence and significance of identified household determinants. Multiple logistic regression models were used to examine the association between malaria prevalence and the identified household determinant factors. The study result showed the existence of household determinant factors that affected the prevalence of malaria in Mutasa District. The presence of livestock animals within a 50-meter radius of the household, ownership of animal drawn carts and low socioeconomic status significantly increased malaria risk, while availability of drinking water within a 50-meter radius of the household, significantly reduced malaria risk. Other variables, although not statistically significant, had varied levels of malaria infection risk. The study results may contribute to positive social change by providing an insight into innovative strategies that enhance existing interventions. The study results may also provide opportunities for upgrading malaria intervention policies and sustainable community participation, thus enhancing malaria elimination efforts

Malaria and HIV are among the most important global health problems of our time and together are responsible for approximately 3 million deaths annually. These two diseases overlap in many regions of the world including sub-Saharan Africa, Southeast Asia and South America, leading to a higher risk of co-infection. In this study, we generated and characterized hybrid molecules to target P. falciparum and HIV simultaneously for a potential HIV/malaria combination therapy. Hybrid molecules were synthesized by covalent fusion between azidothymidine (AZT) and dihydroartemisinin (DHA), tetraoxane or chloroquine (CQ); and a small library was generated and tested for antiviral and antimalarial activity. Our data suggest that dihyate is the most potent molecule in vitro, with antiplasmodial activity comparable to that of DHA (IC50 = 26 nM, SI > 3000), a moderate activity against HIV (IC50 = 2.9 µM; SI > 35) and safe to HeLa cells at concentrations used in the assay (CC50 > 100 µM). Pharmacokinetic studies further revealed that dihyate is metabolically unstable and is cleaved following an O-dealkylation once in contact with cytochrome P450 enzymes. The later further explains the uneffectiveness of dihyate against the CQ-sensitive P. berghei N strain in mice when administered by oral route at 20 mg/kg. Here, we report on a first approach to develop antimalarial/anti-HIV hybrid molecules and future optimization efforts will aim at producing second generation hybrid molecules to improve activity against HIV as well as compound bioavailability. With the emergence of resistant parasites against all the counterpart drugs of artemisinin derivatives used in artemisinin based combination therapies (ACTs), the introduction of antibiotics in the treatment of malaria has renewed interest on the identification of antibiotics with potent antimalarial properties. In this study we also investigated the antiplasmodial potential of thiostrepton and derivatives, synthesized using combinations of tail truncation, oxidation, and addition of lipophilic thiols to the terminal dehydroamino acid. We showed that derivatives SS231 and SS234 exhibit a better antiplasmodial activity (IC50 = 1 µM SI > 59 and SI > 77 respectively) than thiostrepton (IC50 = 8.95 µM, SI = 1.7). The antiplasmodial activity of these derivatives was observed at concentrations which are not hemolytic and non-toxic to human cell lines. Thiostrepton and derivatives appeared to exhibit transmission blocking properties when administered at their IC50 or IC90 concentrations and our data also showed that they attenuate proteasome activity of Plasmodium, which resulted in an accumulation of ubiquitinated proteins after incubation with their IC80 concentrations. Our results indicate that the parasite’s proteasome could be an attractive target for therapeutic intervention. In this regard, thiostrepton derivatives are promising candidates by dually acting on two independent targets, the proteasome and the apicoplast, with the capacity to eliminate both intraerythrocytic asexual and transmission stages of the parasite. To further support our findings, we evaluated the activity of a new class of antimalarial and proteasome inhibitors namely peptidyl sulfonyl fluorides on gametocyte maturation and analogues AJ34 and AJ38 were able to completely suppress gametocytogenesis at IC50 concentrations (0.23 µM and 0.17 µM respectively) suggesting a strong transmission blocking potential. The proteasome, a major proteolytic complex, responsible for the degradation and re-cycling of non-functional proteins has been studied only indirectly in P. falciparum. In addition, an apparent proteasome-like protein with similarity to bacterial ClpQ/hslV threonine-peptidases was predicted in the parasite. Antibodies were generated against the proteasome subunits alpha type 5 (α5-SU), beta type 5 (β5-SU) and pfhslV in mice and we showed that the proteasome is expressed in both sexual and asexual blood stages of P. falciparum, where they localize in the nucleus and in the cytoplasm. However, expression of PfhslV was only observed in trophozoites and shizonts. The trafficking of the studied proteasome subunits was further investigated by generating parasites expressing GFP tagged proteins. The expression of α5-SU-GFP in transgenic parasite appeared to localize abundantly in the cytoplasm of all blood stages, and no additional information was obtained from this parasite line. In conclusion, our data highlight two new tools towards combination therapy. Hybrid molecules represent promising tools for the cure of co-infected individuals, while very potent antibiotics with a wide scope of activities could be useful in ACTs by eliminating resistant parasites and limiting transmission of both, resistances and disease. / Malaria und HIV gehören zu den wichtigsten weltweiten Gesundheitsproblemen unserer Zeit und verursachen jährlich zusammen fast drei Millionen Todesfälle. Das Verbreitungsgebiet beider Krankheit überschneidet sich in vielen Weltregionen wie Afrika südlich der Sahara, Südostasien und Südamerika, was zu einem erhöhten Risiko für Koinfektionen führt. Während der vorliegenden Arbeit stellten wir Hybridmoleküle her und charakterisierten diese in Bezug auf ihre gleichzeitige Wirksamkeit gegen P. falciparum und HIV mit dem Ziel einer möglichen Kombinationstherapie gegen beide Krankheiten. Diese Hybridmoleküle wurden durch kovalente Verbindung von Azidothymidin (AZT) mit Dihydroartemisinin (DHA), Tetraoxan und Chloroquin (CQ) hergestellt. Die dabei hergestellte kleine Molekülsammlung wurde auf antivirale Wirkung und Wirkung gegen Malaria getestet. In vitro ist, gemäß unserer Daten, Dihyate das wirksamste Molekül, mit einer dem DHA vergleichbaren Wirksamkeit gegen Plasmodium (IC50 = 26 nM, SI > 3000), einer mittelmäßigen Wirksamkeit gegen HIV (IC50 = 2.9 µM; SI > 35) und keiner Wirkung auf HeLa-Zellen bei den im Versuch verwendeten Konzentrationen (CC50 > 100 µM). Weiterhin ergaben pharmakokinetische Studien, dass Dihyate metabolisch instabil ist und nach einer O-Dealkylierung gespalten wird, sobald es in Kontakt mit Cytochrom P450 Enzymen kommt. Dies erklärt auch die Unwirksamkeit von Dihyate gegen dem CQ-sensitiven P. berghei N Stamm im Mausversuch bei oraler Gabe von 20mg/kg. Wir berichten hier von einem ersten Ansatz Hybridmoleküle gegen Malaria/ HIV zu entwickeln. Zukünftige Verbesserungen werden darauf abzielen Hybridmoleküle der zweiten Generation herzustellen um sowohl die Wirksamkeit gegen HIV als auch die Bioverfügbarkeit zu verbessern. Auf Grund der Entwicklung von Resistenzen gegenüber sämtliche Substanzen, die zusammen mit Artemisinin in Kombinationstherapien genutzt werden, hat die Verwendung von Antibiotika bei der Behandlung der Malaria das Interesse daran neu geweckt, Antibiotika mit starker Wirksamkeit gegenüber Plasmodium aufzuspüren. Während der vorliegenden Studie untersuchten wir die Wirksamkeit von Thiostrepton und seinen Derivaten gegenüber Plasmodium. Diese Derivate wurden durch Kombinationen von Verkürzung der Seitenkette, Oxidation und der Anbringung von lipophilen Thiolen an die endständige Dehydroaminosäure hergestellt. Wir konnten zeigen, dass die Derivate SS231 und SS234 (IC50 = 1 µM SI > 59 und SI > 77) eine bessere Wirksamkeit gegen Plasmodium besitzen als Thiostrepton (IC50 = 8.95 µM, SI = 1.7). Diese Wirksamkeit konnte bei Konzentrationen beobachtet werden, die nicht hämolytisch sind und ungiftig gegenüber menschlichen Zelllinien. Thiostrepton und seine Derivate zeigten transmissionsblockierende Eigenschaften, wenn sie in Konzentrationen, die ihren IC50- oder IC90-Werten entsprachen, eingesetzt wurden. Unsere Daten zeigen auch, dass diese Substanzen die Aktivität des Proteasoms von Plasmodium abschwächen, was zu einer Anreicherung von ubiquitinierten Proteinen führte, wenn die Parasiten mit den Substanzen in IC80-Konzentrationen inkubiert wurden. Unsere Ergebnisse sprechen dafür, dass das Proteasom ein attraktives Ziel für therapeutische Maßnahmen sein kann. In diesem Zusammenhang sind die Derivate des Thiostreptons vielversprechende Kandidaten, da sie gleichzeitig an zwei unabhängigen Zielstrukturen angreifen, dem Proteasom und dem Apicoplasten und die Fähigkeit besitzen, sowohl die asexuellen Blutstadien als auch diejenigen Blutstadien, die für die Weitergabe des Parasiten verantwortlich sind, zu beseitigen. Um unsere Ergebnisse weiter zu untermauern, untersuchten wir die Wirkung von Peptidyl-Sulfonyl-Fluoriden, einer neuen Klasse von Substanzen mit Wirksamkeit gegen Malaria und hemmender Wirkung gegenüber dem Proteasom auf die Reifung von Gametozyten. Die Substanzen AJ34 und AJ38 unterdrückten die Bildung von Gametozyten vollständig, wenn sie in Konzentrationen, die ihren IC50-Werten (0.23 µM und 0.17 µM) entsprachen, eingesetzt wurden. Dies spricht für ein starkes transmissionsblockierendes Potential dieser Substanzen. Das Proteasom, ein bedeutender proteinabbauender Komplex, der für den Abbau und die Wiedergewinnung nicht funktioneller Proteine verantwortlich ist, wurde bisher nur indirekt in P. falciparum untersucht. Zusätzlich wurde die Existenz eines, dem Proteasom-ähnlichen, Proteins mit Ähnlichkeiten zu bakteriellen ClpQ/hslV Threonin-Peptidasen in Plasmodium vermutet. Gegen die Untereinheiten alpha 5 (α5-SU), beta 5 (β5-SU) und gegen pfhslV wurden in Mäusen Antikörper generiert. Mit diesen konnten wir zeigen, dass das Proteasom sowohl in den asexuellen als auch in den sexuellen Blutstadien von P. falciparum exprimiert wird und im Zellkern und im Zytoplasma lokalisiert sind. Die Expression von PfhslV konnte jedoch nur in Trophozoiten und Schizonten beobachtet werden. Der Transport der Proteasomuntereinheiten wurde weiterhin durch die Herstellung von transgenen Parasiten, die GFP-markierte Proteine bilden, untersucht. Die Expression von α5-SU-GFP in transgenen Parasiten schien im Zytoplasma aller Blutstadien lokalisiert zu sein, wobei durch diese Parasiten keine zusätzlichen Informationen gewonnen werden konnten. Zusammengefasst sprechen unsere Daten für zwei neue Werkzeuge für Kombinationstherapien. Hybridmoleküle sind vielversprechende Werkzeuge zur Heilung von gleichzeitig mit Malaria und HIV infizierten Patienten. Sehr wirksame Antibiotika mit einem breiten Wirkungsspektrum könnten in Artemisinin-Kombinationstherapien nützlich werden, wenn es darum geht, resistente Parasiten zu beseitigen und die Übertragung sowohl der Resistenz als auch der Krankheit zu verringern.

The sexual phase of Plasmodium falciparum begins with the differentiation of intraerythrocytic sexual stages, termed gametocytes, in the human host. Mature gametocytes circulate in the peripheral blood and are taken up by the mosquito during the blood meal. These stages are essential for the spread of the malaria disease and form gametes in the mosquito midgut within minutes. A highly conserved family of six secreted proteins has been identified in Plasmodium falciparum. They comprise multiple adhesive domains and are termed PfCCp1 through PfCCp5, and PfFNPA. It was revealed in this work that PfCCp multi-domain adhesion proteins form protein complexes in gametocytes and on the surface of newly emerged macrogametes by adhesion domain-mediated binding. Co-Immunoprecipitation assays with activated gametocyte lysates show interactions between PfCCp proteins and indicate surface association via Pfs230 and Pfs25. Pfs230 is connected with the plasma membrane of the parasite by its interaction partner Pfs48/45. This protein is linked to the plasma membrane by a GPI anchor and presumably retains the multi-protein complex on the surface of newly emerged macrogametes in the mosquito midgut. A WD40 domain containing protein was identified to be part of this protein complex. It might serve as platform for the assembly of the multi protein complex or mediate the interplay among proteins, as suggested from known functions of the WD40 domain repeats. During egress from the host erythrocyte, the emerging gametes become vulnerable to factors of the human complement, which is taken up with the blood meal. In this thesis it was found that the complement system is active for about one hour post feeding. Macrogametes defend against complement-mediated lysis by co-opting the human complement regulators Factor H and FHL-1 from the blood-meal. These serum proteins bind via its SCR domains 5-7 to the surface of macrogametes. Once bound, they trigger complement inactivation of the alternative pathway, which prevents induction of complement lysis on the surface of the malaria parasite. Antibodies against Factor H are able to impair the sexual development in vitro and are able to block transmission to the mosquito. Interaction studies on endogenous proteins and immobilized recombinant proteins revealed the PfGAP50 protein as binding partner of Factor H and FHL-1. This protein was hitherto described as a glideosome-associated protein in invasive parasite stages, but has not yet been characterized in gametes. First localization studies indicate a relocation of PfGAP50 from the inner membrane complex to the surface of macrogametes. Malaria still persists as one of the deadliest infectious diseases worldwide. Investigations on the essential transmissive stages, gametocytes and gametes of Plasmodium falciparum, stood in the background of research for a long time. This work deciphered details on protein interactions on the surface of the malaria parasite and provides first information about coactions between the parasite and the human complement in the mosquito midgut. / Die Sexualphase von Plasmodium falciparum beginnt mit der Ausbildung von intraerythrozytären Sexualstadien, sogenannten Gametozyten, im menschlichen Wirt. Reife Gametozyten zirkulieren im peripheren Blut und werden während der Blutmahlzeit von der Mücke aufgenommen. Dieses Parasitenstadium ist ausschlaggebend für die Verbreitung von Malaria und bildet im Mückendarm innerhalb von Minuten Gameten. In Plasmodium falciparum wurde eine hochkonservierte Familie bestehend aus sechs sekretierten Proteinen entdeckt. Diese bestehen aus verschiedenen Adhäsionsdomänen und werden PfCCp1 bis PfCCp5 und PfFNPA genannt. In dieser Arbeit wurde gezeigt, dass PfCCp Multiadhäsionsproteine Komplexe in Gametozyten und auf der Oberfläche von jungen Makrogameten mittels domänenvermittelter Bindungen bilden. Ko-Immunpräzipitationen mit Lysat aus aktivierten Gametozyten zeigten oberflächenvermittelte Interaktionen der PfCCp Proteine durch Pfs230 und Pfs25. Pfs230 ist mit seinen Interaktionspartner Pfs48/45 durch einen GPI-Anker mit der Plasmamembran des Parasiten verbunden. Der Multi-Proteinkomplex wird somit auf der Oberfläche von jungen weiblichen Gameten festgehalten. Zudem wurde in dem neu identifizierten Proteinkomplex ein Protein entschlüsselt welches WD40-Domänen aufweist. Bereits bekannte Funktionen von sich wiederholenden WD40-Domänen lassen vermuten, dass dieses Protein möglicher-weise als Plattform für den Zusammenbau des Proteinkomplexes dient oder das Wechselspiel zwischen Proteinen vermittelt. Während des Ausbruchs aus der Wirtszelle, dem Erythrozyten, werden Gameten angreifbar für Faktoren des humanen Komplements, welches mit der Blutmahlzeit in den Mückendarm aufgenommen wird. In dieser Arbeit wurde ermittelt, dass das Komplementsystem nach der Blutmahlzeit etwa eine Stunde lang im Mückendarm aktiv ist. Durch die Bindung der Regulatoren Faktor H und FHL-1 des menschlichen Komplementsystems aus der Blutmahlzeit, schützen sich Makrogameten gegen eine komplementvermittelte Lyse. Diese Serumproteine binden mittels ihrer SCR-Domänen 5-7 an die Oberfläche von Makrogameten und vermitteln damit die Inaktivierung des alternativen Komplementweges. Dadurch schützen sie sich vor der komplementinduzierten Lyse auf der Oberfläche des Parasiten. Antikörper gegen Faktor H vermindern die sexuelle Entwicklung in vitro und können die Weiterentwicklung des Erregers in der Mücke blockieren. Interaktionsstudien mit endogenen Proteinen und immoblilisierten rekombinanten Proteinen offenbarten PfGAP50 als Bindungspartner von Faktor H und FHL-1. PfGAP50 wurde bislang einem Motorkomplex zugeschrieben, welcher für die Parasitenbewegung von invasiven Stadien zuständig ist. Es wurde jedoch bis heute nicht in Gameten charakterisiert. Erste Lokalisationsstudien weisen auf eine Relokalisierung von PfGAP50 vom inneren Membrankomplex zur Oberfläche von Makrogameten hin. Malaria ist weiterhin eine der tödlichsten Infektionskrankheiten weltweit. Die Erforschung dieser für die Übertragung essentiellen Stadien, den Gametozyten und Gameten von Plasmodium falciparum, stand lange im Hintergrund der Forschung. Diese Arbeit entschlüsselt Details über Proteininteraktionen auf der Oberfläche des Malariaparasiten und beschreibt das Zusammenwirken des Parasiten mit dem menschlichen Komplementsystem im Darm der Mücke.

Die vorliegende Arbeit, die im Rahmen des SFB 630 „Erkennung, Gewinnung und funktiona-le Analyse von Wirkstoffen gegen Infektionskrankheiten“ erstellt worden ist, beschäftigt sich mit der Entwicklung und Synthese der bisquartären Bisnaphthalimide und deren antimikro-biellen Eigenschaften, speziell gegen Erreger tropischer Infektionskrankheiten, wie Plasmo-dien und Trypanosomen aber auch Bakterien wie Staphylococcus aureus. Erste Testungen einer kleinen Bibliothek verschiedener mono- und bisquartärer Phthal- und Naphthalimide im SFB 630 offenbarten deren antimikrobielles Potenzial. Daher war es das Hauptziel dieser Arbeit, durch systematische Variation der verschiedenen Strukturbestandteile diese Bibliothek zu erweitern. Dazu mussten zuerst die entsprechenden Naphthalin-1,8-dicarbonsäure-Anhydride hergestellt werden. Im nächsten Schritt wurden diese mit einem N,N-Dimethylaminopropylamin-Derivat zum Imid kondensiert und abschließend mit einem Alkyl-Linker zur bisquartären Verbindung alkyliert. So konnte die Bibliothek um 25 Verbin-dungen erweitert werden. Dabei umfassten die Variationen die Alkylkettenlänge zwischen den quartären Stickstoffen mit 3–14 Methylen-Einheiten, das aromatische Substitutionsmuster mit Amino- bzw. Nitrogruppen und symmetrische, wie asymmetrische Bisnaphthalimide. Durch anschließende antimikrobielle Testung und qualitativen Vergleich der ermittelten IC50-Werte konnten verschiedene strukturelle Merkmale der Bisnaphthalimide identifiziert werden, die einen positiven Einfluss auf die Aktivität gegen den untersuchten Mikroorganismus haben. / The present work focuses on the design and synthesis of bisquaternary bisnaphthalimides and their antimicrobial properties, esp. against causative agents of tropical infectious diseases like Plasmodia or Trypanosoma but also bacteria like Staphylococcus aureus. The work was sup-ported by the SFB 630 “Recognition, Preparation and functional Analysis of Agents against Infectious Diseases”. First tests of a small compound library, consisting of several mono- and bisquaternary phthal- and naphthalimides, revealed their antimicrobial potential. Hence, it was the primary purpose of this work to broaden this library through systematical structural variations. Therefor the corresponding naphthalic anhydrides had to be synthesized. In the next step the anhydrides were condensed to the corresponding imide by reaction with an N,N-dimethylaminopropyl-amine derivative. The obtained naphthaimides were finally alkylated by means of α,ω-dihaloalkane to give the bisquaternary compound. The so achieved variations included the length of the alkyl-chain linker (C3–C14), the aromatic substitution pattern (nitro- and amino groups) and, symmetrical as well as unsymmetrical bisnaphthalimides. Subsequently, these compounds were tested against the aforementioned microorganisms. By comparing of the determined IC50-values several structural characteristics could be identified which are important to the antimicrobial activity.