Die Hälfte der Weltbevölkerung lebt mit dem Risiko, an einer schweren Malaria tropica zu erkranken. Zunehmende Resistenzen von Plasmodium falciparum gegen gängige Therapeutika erschweren eine Behandlung, und es existiert keine Möglichkeit frühzeitig die Wirksamkeit der angewandten Medikation festzustellen. Die Bestimmung der Parasitämie als einzig verfügbarer Parameter kann auch bei erfolgreicher Therapie noch über den ersten Tag ansteigen. Das Ziel dieser Studie war, lichtmikroskopische Parameter zu finden, mit denen der Erfolg einer Therapie frühzeitig festgestellt werden kann. So wurden im Rahmen einer Fallstudie die Plasmodien eines an einer schweren Malaria tropica erkrankten Patienten auf morphologische Veränderungen im Verlauf der Chinin-Therapie untersucht. Die Beurteilung der Plasmodien erfolgte durch eine Einteilung nach ihrer Lage im Erythrozyten und der Kern-Plasma-Relation der Ringformen, anschliessend wurden die Ergebnisse durch eine Vermessung der Plasmodien am Computer verifiziert. Es zeigte sich, dass ein Therapieerfolg anhand der Veränderung in der Morphologie der Ringformen bereits in den ersten Stunden nach Therapiebeginn festgestellt werden kann. So lässt sich innerhalb der ersten drei Stunden ein Wechsel von kleinen Ringformen mit dünnem, homogenem Zytoplasmaband zu vergrösserten Ringformen mit einem verbreiterten und inhomogenen Zytoplasma finden. Im weiteren konnten ab der 7. Therapiestunde eine zunehmende Lageveränderungen der Plasmodien im Erythrozyten aufgezeigt werden. So waren ab diesem Zeitpunkt zunehmend Plasmodien, die die Erythrozyten-Membran hervorwölben (Arbeitstitel „Accentué“-Formen), im peripheren Blutausstrich des Patienten zu sehen. Dass die Änderung der Kern-Plasma-Relation der Ringformen ursächlich einer direkten Medikamentenwirkung zuzuschreiben sind, konnte in einem abschliessenden „in vitro“-Studienteil gezeigt werden, in welchem Plasmodien-Kulturen unter Chinin-Einfluss mit Kontrollkulturen ohne Medikamenteneinfluss verglichen wurden. / This case study examines early morphological changes of Plasmodium falciparum under treatment, visible by light microscopy. A transition from small thin ring shapes to thick rings during the early hours of treatment could be demonstrated, as well as an increase in erythrocyte surface distorsion by the plasmodia, beginning after 7 hours of treatment. These findings could help to recognise resistances to medication within hours of beginning treatment and may save crucial time for patients.

Transmission of the malaria parasite from man to the mosquito requires the formation of sexual parasite stages, the gametocytes. The gametocytes are the only parasite stage that is able to survive in the mosquito midgut and to undergo further development – gamete formation and fertilization. Numerous sexual stage-specific proteins have been discovered, some of which play crucial roles for parasite transmission. However, the functions of many sexual stage proteins remain elusive. Amongst the sexual stage-specific proteins are the proteins of the PfCCp proteins family, which exhibit numerous adhesion domains in their protein structures. For four members of the protein family, PfCCp1 to PfCCp4 gene-disruptant parasite lines had been already studied. Amongst these, PfCCp2 and PfCCp3 showed an important role for development of the parasites in the mosquito. In the present work the study of gene-disrupted parasites of the PfCCp Protein family was completed. PfCCp5-KO and PfFNPA-KO parasite lines were characterized to a great extent and many properties were similar to those of other PfCCp proteins. The co-dependent expression previously reported to be a phenomenon of PfCCp proteins was also observed in these two mutants, although to lesser extent. When either PfCCp5 or PfFNPA were absent, all other proteins were detected in reduced abundance only. Co-dependent expression manifests exclusively on the protein level. Transcript levels were not altered as RT-PCR showed. Amongst PfCCp proteins numerous proteinproteins interactions are taking place. The previously described multimeric protein complexes also include further sexual stage-specific proteins like Pfs230, Pfs48/45 and Pfs25. Recently, a new component of PfCCp-based multimeric protein complexes had been identified. The protein was named PfWLP1 (WD repeat protein-like protein 1) due to its possession of several WD40 repeats. In the present study expression of this uncharacterized protein was investigated via indirect IFA. It was expressed in asexual blood stages and gametocytes. Upon gamete formation and fertilization its expression ceased. Another sexual stage protein studied in this work was PfactinII. It was shown to be exclusively expressed in sexual stages. In gametocytes it co-localizes with Pfs230 and correct localization of PfactinII depends on presence of Pfs230. Transcript analysis by means of RT-PCR revealed the expression of several components of the IMC in gametocytes. Furthermore, five or six myosin genes encoded in the P. falciparum genome were detected in gametocytes. Gametocyte egress was studied on the ultrastructural level via transmission electron microscopy and an inside-out type of egress was observed. Firstly, the membrane of the parasitophorous vacuole (PVM) was lysed and only thereafter the membrane of the red blood cell (RBCM) ruptured. Furthermore, a new inductor of gametogenesis was identified: The K+/H+ ionophore nigericin induced gametocytes activation in the absence of xanthurenic acid (XA), which is responsible for gamtetocyte activation in the mosquito midgut. Selective permeabilization of RBCM and PVM by the mild detergent saponin, showed that in the absence of these membranes male gametocytes were still able to perceive both XA and the drop in temperature. Thus, the receptors for both factors signaling the parasite transmission to the mosquito, seem to be of parasitic origin. LC/MS/MS analysis confirmed the ability of RBCs to take up XA. With malaria eradication on the agenda of malaria research targeting the sexual stages becomes a crucial part of intervention strategies. The sexual stages are especially attractive target as they represent a population bottleneck. The here reported findings on P. falciparum gametocytes provide several potential candidate proteins for developing tools to interrupt transmission from man to mosquito. Such tools might include Transmission blocking vaccines and drugs. / Die Übertragung der Malaria vom menschlichen Wirt auf die Überträgermücke erfordert die Bildung von Sexualstadien, der Gametozyten. Dieses Parasitenstadium ist in der Lage im Mitteldarm der Mücke zu überleben und sich zu Gameten zu entwickeln, gefolgt von Befruchtung und ygotenbildung. Eine Vielzahl von in den Sexualstadien exprimierter Proteine wurde bereits entdeckt. Einige von diesen haben essentielle Funktionen für die Transmission der Parasiten auf die Mücke. Die Rolle der meisten dieser spezifisch exprimierter Protein ist jedoch ungeklärt. Zu den sexualstadienspezifischen Proteinen gehören die Proteine der PfCCp-Proteinfamilie. Für vier Proteine diese Proteinfamilie wurden bereits KO-Mutanten untersucht. Zwei Mutanten, PfCCp2-KO und PfCCp3-KO besitzen eine wichtige Funktion während der Entwicklung der Parasiten in der Mücke. In der vorliegenden Arbeit wurde die Studie der PfCCp-Proteine komplettiert. PfCCp5- und PfFNPA-defiziente Parasitenlinien wurden zu einem Großteil charakterisiert. Viele Eigenschaften dieser beiden Parasitenlinien wiesen Ähnlichkeiten zu den bisher untersuchten PfCCp-KO-Mutanten auf. Die ko-abhängige Expression welche in der PfCCp-Proteinfamilie vorkommt, wurde auch in diesen beiden Mutanten beobachtet, wenngleich in geringerem Ausmaß. In den Mutanten, in welchem entweder PfCCp5 oder PfFNPA fehlten, waren alle übrigen PfCCp-Proteine nur in reduzierter Menge nachzuweisen. Diese ko-abhängige Expression ist ausschließlich auf dem Proteinlevel zu beobachten. Die Transkription der jeweiligen Gene hingegen ist unbeeinflusst. Zahlreiche Protein-Protein-Interaktionen finden zwischen den Proteinen der Proteinfamilie statt. The zuvor beschriebenen multimeren Proteinkomplexe schließen auch weitere sexualstadienspezifische Proteine ein, wie Pfs230, Pfs48/45 und Pfs25. Kürzlich wurde eine neue Komponente der PfCCp-basierten Multiproteinkomplexe identifiziert. Dieses Protein wurde PfWLP1 (WD repeat protein-like protein 1) genannt, da es mehrere WD40 repeat Domänen besitzt. In der vorliegenden Arbeit wurde das bisher unbeschriebene Protein mittels indirekter immunfluoreszenzstudien charakterisiert. PfWLP1 ist sowohl in asexuellen Blutstadien als auch in Gametozyten exprimiert. Nach der Gametenbildung und Fertilisation nimmt die Expression des Proteins ab. Ein weiteres Protein der Sexualstadien, welches in dieser Arbeit untersucht wurde, ist PfactinII. Es wurde gezeigt, dass dieses Protein ausschließlich in den Sexualstadien vorliegt. In Gametozyten ko-lokalisiert es mit Pfs230 und die korrekte Lokalisierung ist abhängig von der Anwesenheit von Pfs230. Mittels RT-PCR wurden mehrere Komponenten des inneren Membrankomplexes in Gametozyten nachgewiesen. Weiterhin wurden Transkripte für fünf der sechs Myosin-Gene, welche im Genom von P. falciparum exprimiert sind, nachgewiesen. Der Austritt der Gametozyten aus der Wirtszelle wurde auf ultrastruktureller Ebene mittels Transmissionselektronenmikroskopie untersucht. Hierbei wurde gezeigt, dass die Lyse der den Parasiten umgebenden Membranen von innen nach außen geschieht. Das heißt, dass zunächst die Membran der parasitophoren Vakuole (PVM) lysiert wird, und erst anschließend die Erythrozyten-Plasmamembran (RBCM). Als neuer Induktor der Gametozytenaktivierung wurde Nigericin identifiziert. Nigericin ist ein K+/H+-Ionophor, welcher in Abwesenheit von XA in der Lage ist, die Gametenbildung zu identifizieren. Die selektive Permeabilisierung der beiden den Gametozyten umgebenden Membranen, PVM und RBCM, zeigte, dass männliche Gametozyten nach Entfernung der beiden Membranen, in der Lage sind, den Temperaturabfall und XA zu perzipieren. Somit kann geschlussfolgert werden, dass die Rezeptoren beider Stimuli parasitischen Ursprungs sind. LC/MS/MS-Analysen bestätigten, dass Erythrozyten in der Lage sind, XA aufzunehmen. Die Sexualstadien des Malariaparasiten nehmen mehr und mehr an Bedeutung zu, da langfristig nicht nur eine Eindämmung der Malaria in endemischen Gebieten sondern die Auslöschung der Malaria angestrebt wird. Die Sexualstadien sind ein attraktiver Angriffspunkt aufgrund ihrer Bedeutung für die Transmission der Krankheit. Zum anderen ist die auf den Vektor übertragene Parasitenanzahl vergleichsweise gering. Die Ergebnisse der vorliegenden Arbeit zeigen mehrere potentielle Kandidatenproteine auf, welche für die Entwicklung von Interventionsstrategien von Bedeutung sein könnten. Als Interventionsstrategien wären sowohl transmissionsblockierenden Vakzine als auch transmissionsblockierende Wirkstoffe denkbar.

Besides HIV and tuberculosis, malaria still is one of the most devastating infectious diseases especially in developing countries, with Plasmodium falciparum being responsible for the frequently lethal form of malaria tropica. It is a major cause of mortality as well as morbidity, whereby pregnant women and children under the age of five years are most severely affected. Rapidly emerging drug resistances and the lack of an effective and safe vaccine hamper the combat against malaria by chemical and pharmacological regimens, and moreover the poor socio-economic and healthcare conditions in malaria-endemic countries are compromising the extermination of this deadly tropical disease to a large extent. Malaria research is still questing for druggable targets in the parasitic protozoan which pledge to be refractory against evolving resistance-mediating mutations and yet constitute affordable and compliant antimalarial chemotherapeutics. The parasite kinome consists of members that represent most eukaryotic protein kinase groups, but also contains several groups that can not be assigned to conservative ePK groups. Moreover, given the remarkable divergence of plasmodial kinases in respect to the human host kinome and the fact that several plasmodial kinases have been identified that are essential for the intraerythrocytic developmental cycle, these parasite enzymes represent auspicious targets for antimalarial regimens. Despite elaborate investigations on several other ePK groups, merely scant research has been conducted regarding the four identified members of the cyclin-dependent kinase-like kinase (CLK) family, PfCLK-1-4. In other eukaryotes, CLKs are involved in mRNA processing and splicing by means of phosphorylation of serine/arginine-rich (SR) proteins, which are crucial components of the splicing machinery in the alternative splicing pathway. All four PfCLKs are abundantly expressed in asexual parasites and gametocytes, and stage-specific expression profiles of PfCLK-1 and PfCLK-2 exhibited nucleus-associated localization and an association with phosphorylation activity. In the course of this study, PfCLK-3 and PfCLK-4 were functionally characterized by indirect immunofluorescence, Western blot analysis and kinase activity assays. These data confirm that the two kinases are primarily expressed in the nucleus of trophozoites and both kinases possess in vitro phosphorylation activity on physiological substrates. Likewise PfCLK-1 and PfCLK-2, reverse genetic studies exhibited the indispensability of both PfCLKs on the asexual life cycle of P. falciparum, rendering them as potential candidates for antiplasmodial strategies. Moreover, this study was conducted to identify putative SR proteins as substrates of all four PfCLKs. Previous alignments revealed a significant homology of the parasite CLKs to yeast SR protein kinase Sky1p. Kinase activity assays showed in vitro phosphorylation of the yeast Sky1p substrate and SR protein Npl3p by precipitated PfCLKs. In addition, four homologous plasmodial SR proteins were identified that are phosphorylated by PfCLKs in vitro: PfASF-1, PFSRSF12, PfSFRS4 and PfSR-1. All four parasite SR splicing factors are predominantly expressed in the nuclei of trophozoites. For PfCLK-1, a co-localization with the SR proteins was verified. Finally, a library of human and microbial CLK inhibitors and the antiseptic chlorhexidine (CHX) was screened to determine their inhibitory effect on different parasite life cycle stages and on the PfCLKs specifically. Five inhibitors out of 63 compounds from the investigated library were selected that show a moderate inhibition on asexual life cycle stages with IC50 values ranging between approximately 4 and 8 µM. Noteworthy, these inhibitors belong to the substance classes of aminopyrimidines or oxo-β-carbolines. Actually, the antibiotic compound CHX demonstrated an IC50 in the low nanomolar range. Stage-of-inhibition assays revealed that CHX severely affects the formation of schizonts. All of the selected CLKs inhibitors also affect gametocytogenesis as well as gametogenesis, as scrutinized in gametocyte toxicity assays and exflagellation assays, respectively. Kinase activity assays confirm a specific inhibition of CLK-mediated phosphorylation of all four kinases, when the CLK inhibitors are applied on immunoprecipitated PfCLKs. These findings on PfCLK-inhibiting compounds are initial attempts to determine putative antimalarial compounds targeting the PfCLKs. Moreover, these results provide an effective means to generate chemical kinase KOs in order to phenotypically study the role of the PfCLKs especially in splicing events and mRNA metabolism. This approach of functionally characterizing the CLKs in P. falciparum is of particular interest since the malarial spliceosome is still poorly understood and will gain further insight into the parasite splicing machinery. / Neben HIV und Tuberkulose stellt Malaria vor allem in Entwicklungsländern immer noch eine der verheerendsten Infektionskrankheiten dar, wobei Plasmodium falciparum für die oft tödlich verlaufende Form der Malaria tropica verantwortlich ist. Sie ist eine der Hauptgründe für Mortalität und Morbitität, von der vor allem schwangere Frauen und Kinder unter fünf Jahren am schlimmsten betroffen sind. Das Fehlen eines effektiven und ungefährlichen Impfstoffes und sich schnell ausbreitende Medikamentenresistenzen erschweren die Bekämpfung von Malaria mit Arzneimitteln. Darüber hinaus beeinträchtigen die schlechten sozioökonomischen Bedingungen und der mangelhafte Zustand des Gesundheitssystems in Malaria-endemischen Ländern die Elimination dieser tödlichen Tropenkrankheit in hohem Maße. Die Malariaforschung ist immer noch auf der Suche nach vielversprechenden Angriffspunkten im Parasiten, die widerstandsfähig gegenüber sich entwickelnden resistenz-vermittelnden Mutationen sind und dennoch erschwingliche und verträgliche Chemotherapeutika gegen Malaria darstellen. Das Kinom des Parasiten besteht aus Vertretern der meisten eukaryotischen Proteinkinase-Gruppen und enthält zudem einige Gruppen, die keiner der konventionellen Gruppen zuordenbar sind. Darüber hinaus stellen Kinasen vielversprechende Angriffspunkte für Malariamedikamente dar, da das Parasitenkinom bemerkenswerte Divergenzen gegenüber dem Wirtskinom aufweist und zudem einige Parasitenkinasen identifiziert wurden, die unerlässlich für den Replikationszyklus von asexuellen Parasiten sind. Trotz umfangreicher Untersuchungen anderer Kinasegruppen des Parasiten wurden die vier identifizierten Vertreter der Zyklin-abhängige-Kinase-ähnlichen Kinasen (cyclin-dependent kinase-like kinases, CLKs) bisher kaum untersucht. In anderen Eukaryoten sind CLKs an der mRNA-Prozessierung und am Spleißen durch die Phosphorylierung von Serin/Arginin-reichen (SR-) Proteinen beteiligt, welche wiederum Komponenten der Spleißmaschinerie sind. Alle vier PfCLKs sind abundant exprimiert in asexuellen Parasiten sowie Gametozyten, und stadien-spezifische Expressionsprofile von PfCLK-1 und PfCLK-2 zeigten eine Kern-assoziierte Expression sowie Phosphorylierungsaktivität in in vitro-Aktivitätsstudien. Im Verlauf dieser Studie wurden PfCLK-3 und PfCLK-4 mittels indirekter Immunfluoreszenzstudien, Western Blot-Analysen und Kinaseaktivitätsassays funktionell charakterisiert. Die Ergebnisse bestätigen, dass beide Kinasen vorrangig im Nukleus von P. falciparum-Trophozoiten lokalisiert sind und Phosphorylierungsaktivität gegenüber physiologischen Substraten in vitro aufweisen. Ähnlich wie für PfCLK-1 und PfCLK-2 konnte in Reverse-Genetik-Studien gezeigt werden, dass sowohl PfCLK-3 als auch PfCLK-4 essentiell für den asexuellen Replikationszyklus von P. falciparum sind. Dieser Umstand macht beide Kinasen zu potenziellen Angriffspunkten für antiplasmodiale Bekämpfungsstrategien. Des Weiteren wurde diese Studie ausgeführt, um mögliche Interaktionspartner aller vier PfCLKs zu identifizieren. Vorangegangene Sequenzabgleiche brachten eine bemerkenswerte Homologie der Parasiten-CLKs zur SR-Proteinkinase Sky1p der Bäckerhefe zu Tage. Kinaseaktivitätsassays zeigten Phosphorylierung des Sky1p-Substrates und SR-Proteins Npl3p durch präzipitierte PfCLKs in vitro. Außerdem wurden vier homologe plasmodiale SR-Proteine bzw. mutmaßliche Spleißfaktoren identifiziert, die ebenso von den PfCLKs in vitro phosphoryliert werden: PfASF-1, PFSRSF12, PfSFRS4 und PfSR-1. Alle vier Parasiten-Spleißfaktoren sind vorwiegend in Kernen von Trophozoiten exprimiert. Für PfCLK-1 konnte eine Ko-Lokalisation mit den SR-Proteinen nachgewiesen werden. Abschließend wurden eine Sammlung humaner und mikrobieller CLK-Inhibitoren sowie das Antiseptikum Chlorhexidin (CHX) auf ihren hemmenden Effekt auf verschiedene Lebenszyklusstadien von P. falciparum und gezielt auf die PfCLKs überprüft. Es wurden fünf Inhibitoren aus einer Sammlung von 63 Substanzen auserwählt, die eine moderate Hemmung auf asexuelle Lebenszyklusstadien aufwiesen, mit IC50-Werten zwischen ungefähr 4 und 8 µM. Das Antibiotikum CHX zeigte sogar einen IC50-Wert im niedrigen nanomolaren Bereich. Nachfolgende Stage-of-Inhibition-Assays deckten auf, dass CHX die Entwicklung von Schizonten enorm beeinträchtigt. Wie in Gametozyten-Toxizitätsassays und Exflagellationsassays ermittelt wurde, hemmen alle ausgewählten CLK-Inhibitoren ferner sowohl die Gametozytogenese als auch die Gametogenese. Kinaseaktivitätsassays bestätigen eine spezifische Hemmung der CLK-vermittelten Phosphorylierung aller vier Kinasen, wenn die CLK-Inhibitoren auf immunopräzipitierte PfCLKs angewendet wurden. Diese Erkenntnisse über PfCLK-hemmende Substanzen sind erste Ansätze, um mögliche Wirkstoffe gegen Malaria zu finden, die die PfCLKs als Angriffspunkte haben. Zudem stellen diese Resultate ein wirksames Mittel zur Verfügung, um chemische Kinase-Knockout-Parasiten zu generieren. Diese können dann verwendet werden, um die Rolle der PfCLKs vor allen in Bezug auf Spleißvorgänge und mRNA-Metabolismus phänotypisch zu untersuchen. Der Ansatz, die CLKs des Parasiten funktionell zu charakterisieren, ist von besonderem Interesse, da das Spleißosom des Malariaparasiten immer noch nicht ausreichend erforscht ist. Dadurch können weitere Erkenntnisse über die Spleißmaschinerie des Parasiten gewonnen werden.

Notre objectif a été d'évaluer (i) l'importance de Plasmodium vivax dans les infections palustres à Madagascar, (ii) la sensibilité de ce parasite à la chloroquine et à la sulfadoxinepyriméthamine, (iii) et la place des marqueurs moléculaires pour la surveillance de la résistance aux antipaludiques et de la circulation des souches parasitaires.<br />Pour cela, notre étude a été conduite sur 8 sites sentinelles. Les patients présentant un paludisme causé par P. vivax ont été inclus dans des tests d'efficacité thérapeutique selon les critères de l'OMS. L'analyse de polymorphismes génétiques sur les gènes pvcrt-o, pvmdr1, pvdhfr et pvdhps, impliqués dans la résistance aux antipaludiques, ainsi que sur les gènes pvcsp, pvmsp3, pvmsp1 utilisés pour le génotypage des souches a été réalisée sur les isolats<br />collectés. Des marqueurs microsatellites ont également été recherchés pour évaluer la diversité génétique de ces isolats, ainsi que la circulation des souches parasitaires et la propagation des isolats résistants.

Undergraduate honors paper--Mount Holyoke College, 2006. Dept. of Biological Sciences. / Includes bibliographical references (leaves 80-84).

La existencia de una interacción o no a distintos niveles de una infección concomitante entre el Trypanosoma cruzi y del Plasmodium sp en un mismo hospedero humano, no fue aeún bien definida. Krettli et al. (1977) citado por Cox F. (2001) en un estudio experimental efectuado en ratones, observó la exacerbación de la parasitemia para T. cruzi durante una infección palúdica simultánea. En otro estudio realizado en la ciudad de Bermejo en Bolivia durante la gestión 2003, se presentaron resultados preliminares que indicaron una tasa de prevalencia de enfermedad de Chagas congénita en niños nacidos de madres con infección palúdica periférica al momento del parto, superior a la presentada en neonatos de madres que no cursaron infección palúdica durante su gestación. Esta diferencia no alcanzó la significación estadística suficiente. Por lo tanto la malaria de la madre durante el embarazo puede influir sobre la enfermedad de Chagas en el binomio madre-niño. Este estudio se realizó en la ciudad de Yacuiba al sur de Bolivia. Este fue un estudio observacional, tipo cohorte, prospectivo; en el cual la unidad de observación fue el binomio madre-niño durante el periodo gestacional y luego del parto el recién nacido hasta el primer mes de vida. Las variables de exposición fueron: malaria en la gestante y seropositividad para la enfermedad de Chagas en la madre, y las variables resultado: la presencia de parasitemia detectable para T. cruzi en sangre periférica en la madre y la enfermedad de Chagas congénita. El periodo de estudio abarcó 18 meses, en los cuales 357 gestantes ingresaron al estudio. Como resultados se estableció en la mujer embarazada que la prevalencia de infecciones palúdicas durante la gestación fue de 11.5% (41/357), 9% en los controles prenatales; la tasa de seroprevalencia para la enfermedad de Chagas fue de 41.5% (148/357) y la tasa de parasitemia detectable en sangre periférica para T. cruzi de 12% (43/357). En el neonato se observó una incidencia de la enfermedad de Chagas congénito del 2% (7/359) y una tasa de transmisión congénita del 4.7% (7/148). Las coinfecciones dadas por P. vivax y T. cruzi en las madres fueron del 7.6% y del 2.8% (la primera seropositividad para la enfermedad de Chagas e infección palúdica y la segunda parasitemia detectable para T. cruzi en sangre periférica e infección palúdica durante la gestación respectivamente). Los predictores más potentes para la presencia de parasitemia para 7'. cruzi en sangre periférica en las gestantes seroreactivas para la enfermedad de Chagas fueron: habitar una vivienda precaria y la presencia de infecciones palúdicas en el segundo trimestre de gestación y ser primigesta. Concluyéndose que existe un riesgo aumentado de presentar parasitemia para T. cruzi en la madre y el niño debido a la malaria durante el embarazo

Malaria is one of the biggest current global health problems, and with the increasing occurance of drug resistant Plasmodium falciparum strains, there is an urgent need for new antimalarial drugs. Given the important role of carbonic anhydrase in Plasmodium falciparum (PfCA), it is a potential novel drug target. Heterologous expression of malaria proteins is problematic due to the unusual codon usage of the Plasmodium genome, so to overcome this problem a synthetic PfCA gene was designed, optimized for expression in Pichia pastoris. This gene was also modified to avoid glycosylation, and cloned into the vector pPICZαA under the control of the methanol inducible promoter AOX1. To facilitate export of the protein into the growth medium, the gene was fused in-frame with the α-factor secretion signal from Saccharomyces cerevisiae. The construct was successfully integrated in the genome of P. pastoris GS115, and attempts were made to express the protein and purify it using immobilized metal ion affinity chromatography.In this work, no expression of the PfCA protein could be detected, so further research should focus on optimization of expression conditions, or redesign of the expression vector.

Malaria, caused by Plasmodium, is one of the most devastating infectious diseases of the world in terms of mortality as well as morbidity (WHO, 2002). The development of resistance in the Plasmodium falciparum against the present antimalarials has made the situation very alarming (Trape et al., 2000). To combat this situation, new antimalarials as well as identification of new drug targets are urgently required. The discovery of the presence of type II fatty acid biosynthesis system in the malarial parasite has offered several promising new targets for this mission. This thesis describes the successful cloning of fabZ from Plasmodium falciparum, its expression in E. coli, single step affinity purification, kinetic characterization and most importantly discovery of two small molecule inhibitors (Sharma et al., 2003). The study was executed to gain insights into the structure and function of PfFabZ to get better understanding of the interactions with its substrate analogs, novel inhibitors and also acyl carrier protein (PfACP). The molecular details of the interactions of the two novel inhibitors were also determined. Lastly, the residues of PfFabZ important for the interaction with PfACP were successfully elucidated. Chapter 1 presents a brief review of the literature about the disease as well as the life cycle, biology and the metabolic pathways operational in malarial parasite, Plasmodium falciaparum. The discovery of type II FAS in P. falciparum and the aims and the scope of the thesis are also discussed. The quest of developing new antimalarials, study of the mechanism of actions of antimalarials such as quinine and its derivatives along with the major metabolic pathways (Purine, pyrimidine, phospholipids, carbohydrate metabolism, folate and heme biosynthesis pathways etc.) existing in P. falciparum are described in detail in this chapter. Origin and importance of apicoplast in P. falciaprum is also described in brief. For long, it was believed that Plasmodium spp. are incapable of de novo fatty acid synthesis but this view has undergone substantial revision due to the recent discovery of plant and bacterial type of fatty acid biosynthesis pathway in them (Surolia and Surolia, 2001). As this pathway is distinct from that of the human host it has accelerated the momentum for the discovery of new antimalarials (Surolia and Surolia, 2001). The Chapter also surveys the details of type II FAS in bacteria, particularly that of E. coli (Rock and Cronan, 1996). The dehydratase step which is the third step of fatty acid elongation cycle has been covered in considerable detail. Lastly, it focuses on the recent advancement in the understanding of fatty acid biosynthesis system in Plasmodium falciparum along with some inhibitors targeting the malarial FAS. As each enzyme of the Plasmodium FAS can serve as good antimalarial targets, my work focuses on the dehydratase step catalyzed by β-hydroxyacyl-ACP dehydratase (PfFabZ). Cloning, expression and kinetic characterization of PfFabZ forms the major content of Chapter 2. The PlasmoDB data base was searched for this gene and the mined out open reading frame contained sequence of the putative FabZ together with the bipartite leader polypeptide. Our aim was to clone the mature PfFabZ without the bipartite leader sequence. Amplification of the mature pffabZ using Plasmodium falciparum genomic DNA revealed the presence of an intron in the ORF and the gene was finally cloned by RT-PCR in pET-28a(+) vector. It was expressed with an N-terminal hexahistidine tag in BL-21(DE3) cells and purified to near homogeneity but the protein was insoluble and unstable. Truncation of 12 residues from the N-terminal end improved the stability and solubility of the protein by 3-5 fold. Truncated PfFabZ was used for all future experiments. FabZs from other sources are reported to be hexamer in solution but PfFabZ showed homodimeric arrangement in the conditions used for gel filtration as well as dynamic light scattering studies. Kinetics of PfFabZ was characterized using substrate analogs, β-hydroxybutryl-CoA (forward substrate) and Crotonoyl-CoA (reverse substrate). Both the forward and reverse reaction were thoroughly characterized by spectrophotometry and HPLC and the reverse reaction was found to be 7 times faster than the forward reaction. Km οf crotonoyl-CoA was calculated to be 86 µM and kcat/Km of 220 M-1s-1 whereas the Kmfor β-hydroxybutryl-CoA was found to be 199 µM and kcat/Kmof 80.2 M-1s-1. The kinetic data clearly indicates the higher affinity of PfFabZ for the reverse substrate. Chapter 3 describes the discovery of two small molecules inhibitors, NAS-21 and NAS-91 for PfFabZ, their detailed inhibition kinetics and their effect on the growth of Plasmodium falciparum in culture. These inhibitors were the first inhibitors to be reported for FabZ class of enzymes with an IC50 ranging below 15 µM. Both of them inhibited PfFabZ following competitive kinetics with respect to the substrates utilized for both the forward and reverse reactions. The inhibition data were analyzed by Lineweaver-Burk and Dixon plots and both inhibitors showed competitive inhibition kinetics with dissociation constant in submicromolar range. Binding constants for both the inhibitors were also determined by fluorescence titration method and were calculated to be 1.6 (± 0.04) X 106 M-1 for NAS-91 and 1.2 (± 0.03) X 106 M-1 for NAS-21. These inhibitors were checked on Plasmodium falciparum culture and both inhibited parasite growth with IC50 values of 7 µM and 100 µM for NAS-21 and NAS-91, respectively. They also inhibited the incorporation of [1,2-14C]-acetate in the fatty acids of the P. falciparum conforming the inhibition of fatty acid biosynthesis. FabZ class of enzymes are thought to contain His-Glu as a catalytic dyad. Based on the disparity in the arrangement of residues at the active site of the dimeric (Swarnamukhi et al., 2006) and hexameric forms of PfFabZ in the crystal structures (Kosteriva et al., 2005), we set out to elucidate the active site residues in PfFabZ which is described in Chapter 4. The role of each of the presumed active site residues His-133 and Glu-147 along with Arg-99 and His-98 were analyzed by chemical modification studies and site directed mutagenesis. Single and double mutants were prepared and the activity of the mutants was monitored by spectrophotometry and isothermal titration calorimetry (ITC). It was concluded that in PfFabZ, His-133 and Glu-147 makes the catalytic dyad, His-98 might be important in directing the substrate in correct orientation while Arg-99 is involved in maintaining the active site loop in proper orientation rather than taking direct part in catalysis. Chapter 4 also concludes that dimeric form of PfFabZ is inactive species and turns into active hexameric form in the presence of substrate. Chapter 5 describes the molecular details of NAS-21 and NAS-91 interactions with PfFabZ. The fact that both these compounds inhibited PfFabZ in competitive manner, prompted me to examine their interaction with the residues in the active site tunnel. Apart from the His-133 and Glu-147 catalytic dyad the only polar residue is His-98 and chemical modification and site directed mutagenesis studies were done to elucidate the interactions of these residues with NAS-21 and NAS-91. Both the inhibitors were able to protect the modification of histidines by DEPC in wild type PfFabZ, His-98-Ala mutant and His-133-Ala mutant but with differential strength, indicating that they do interact with histidines. The interaction of these inhibitors was further confirmed by determining the dissociation constants of wPfFabZ, His-98-Ala, His-133-Ala, His-98-Ala/His-133-Ala double mutant, Glu-147-Ala mutant by fluorescence titration method. The results obtained from chemical modification and fluorescence titration studies confirmed that NAS-21 interacts strongly with histidines, His-98 and His-133 but not with Glu-147. On the other hand NAS-91 interacts loosely with His-98 and His-133 but strongly with Glu-147. Chapter 5 concludes with the observation that both the inhibitors (NAS-21 and NAS-91) interact with the active site residues of PfFabZ, preventing the substrate to enter the active site tunnel. Acyl carrier protein (ACP) is a small acidic protein to which the acyl chain intermediates are tethered and shuttled from one enzyme to another for the completion of fatty acid elongation cycle. Whenever acyl carrier proteins are expressed in E. coli, they are present in three forms apo, holo and acyl-ACPs. Chapter 6 describes a novel method for the expression of histidine tagged PfACP in pure holo form, protocol for the cleavage of his-tag from PfACP by thrombin preparation of homogenous singly enriched ie PfACP [15N]-labeled or [13C]-labeled PfACP as well as doubly enriched [15N]-[13C] PfACP samples for its structure elucidation by NMR (Sharma et al., 2005). These studies also constituted reporting of a holo-ACP structure from any of the sources for the first time (Sharma, et. al. 2006). The purified pure holo-PfACP was further used for the interaction studies with PfFabZ. Earlier studies have shown that ACP interacts with FAS enzymes via helix II with conserved set of residues but the molecular details of the interactions are poorly known (Zhang, et. al., 2003). We have recently solved the NMR structure (Sharma, et. al., 2006) of PfACP and crystal structure of PfFabZ (Swarnamukhi, et. al., 2006). So, both the structures were docked using Cluspro server. Chapter 7 elucidates the roles of important residues on PfFabZ surface near the active site entry which are responsible for interacting with PfACP. The residues lining the active site entry were identified and mutated. The residues lining the active site tunnel of PfFabZ are Arg102, Lys104, Lys105, Lys123, Leu94, Phe95, Ala96, Gly97, Ile128, Ile145, Phe150 and Ala151. Charged residues were mutated to alanine and also to oppositely charged residues while the neutral residues were changed to charged residues. The interaction of PfFabZ mutants with PfACP was studied by ACP independent enzymatic assay and surface plasmon resonance (SPR) spectroscopy. It was concluded that PfFabZ and PfACP interaction is mainly governed by electrostatic interaction made by the charged residues (Lys104 being the most important residue) and is fine tuned by hydrophobic interactions. Chapter 8 summarizes the findings of the thesis. FabZ from Plasmodium falciparum was cloned and biochemically characterized. Two inhibitors for this enzyme were discovered and their molecular details of binding to PfFabZ were elucidated. The presence of catalytic dyad was confirmed and finally the residues of PfFabZ important for interaction with PfACP were elucidated. Appendix I describes the inhibition of PfENR (enoyl ACP reductase), the rate limiting and the fourth enzyme of the fatty acid elongation pathway by green tea extracts. Three tea catechins (EGCG, EGC and ECG) and two plant polyphenols (quercetin and buteine) were selected for the inhibition study. All the catechins inhibited PfENR potently with Ki values in nanomolar range. Among the five compounds studied, EGCG was found to be the best inhibitor. All of them blocked the NADH binding site showing competitive kinetics with respect to NADH and uncompetitive kinetics with crotonoyl-CoA, the substrate analog. Most importantly, the catechins potentiated the inhibition of PfENR by triclosan, a well known PfENR inhibitor. We also report that in the presence of tea catechins triclosan behaves as a slow-tight binding inhibitor of PfENR. The overall inhibition constant of triclosan in the presence of EGCG was calculated to be 2pM which is 50 times better than the earlier reported values with NAD+ (Kapoor, et. al., 2004).

<p>Malaria is one of the biggest current global health problems, and with the increasing occurance of drug resistant <em>Plasmodium falciparum</em> strains, there is an urgent need for new antimalarial drugs. Given the important role of carbonic anhydrase in <em>Plasmodium falciparum</em> (PfCA), it is a potential novel drug target. Heterologous expression of malaria proteins is problematic due to the unusual codon usage of the <em>Plasmodium </em>genome, so to overcome this problem a synthetic PfCA gene was designed, optimized for expression in <em>Pichia pastoris</em>. This gene was also modified to avoid glycosylation, and cloned into the vector pPICZαA under the control of the methanol inducible promoter AOX1. To facilitate export of the protein into the growth medium, the gene was fused in-frame with the α-factor secretion signal from <em>Saccharomyces cerevisiae</em>. The construct was successfully integrated in the genome of <em>P. pastoris</em> GS115, and attempts were made to express the protein and purify it using immobilized metal ion affinity chromatography.In this work, no expression of the PfCA protein could be detected, so further research should focus on optimization of expression conditions, or redesign of the expression vector.</p>

Reproduction de : Mémoire du D.E.S. : Pharmacie hospitalière et des collectivités : Nantes : 2009. Reproduction de : Thèse d'exercice : Pharmacie : Nantes : 2009. / Bibliogr.