Repeat polymorphisms in the low-complexity regions of Plasmodium falciparum ABC transporters and associations with in vitro antimalarial responses

ABSTRACT

Antimicrob Agents Chemother

The Plasmodium falciparum genome is rich in regions of low amino acid complexity which evolve with few constraints on size. To explore the extent of diversity in these loci, we sequenced repeat regions in pfmdr1, pfmdr5, pfmdr6, pfmrp2, and the antigenic locus pfmsp8 in laboratory and cultured-adapted clinical isolates. We further assessed associations between the repeats and parasite in vitro responses to 7 antimalarials to determine possible adaptive roles of these repeats in drug tolerance. Our results show extensive repeat variations in the reference and clinical isolates in all loci. We also observed a modest increase in dihydroartemisinin activity in parasites harboring the pfmdr1 sequence profile 7-2-10 (reflecting the number of asparagine repeats, number of aspartate repeats, and number of asparagine repeats in the final series of the gene product) (P = 0.0321) and reduced sensitivity to chloroquine, mefloquine, quinine, and dihydroartemisinin in those with the 7-2-11 profile (P = 0.0051, 0.0068, 0.0011, and 0.0052, respectively). Interestingly, we noted an inverse association between two drugs whereby isolates with 6 asparagine repeats encoded by pfmdr6 were significantly more susceptible to piperaquine than those with 8 (P = 0.0057). Against lumefantrine, those with 8 repeats were, however, more sensitive (P = 0.0144). In pfmrp2, the 7-DNNNTS/NNNNTS (number of DNNNTS or NNNNTS motifs; underlining indicates dimorphism) repeat group was significantly associated with a higher lumefantrine 50% inhibitory concentration (IC50) (P = 0.008) than in those without. No associations were observed with pfmsp8. These results hint at the probable utility of some repeat conformations as markers of in vitro antimalarial response; hence, biochemical functional studies to ascertain their role in P. falciparum are required.

Okombo, J., Abdi, A. I., Kiara, S. M., Mwai, L., Pole, L., Sutherland, C. J., Nzila, A., Ochola-Oyier, L. I.

Pages:6196-204, Volume:57, Edition:10/2/2013, Date,Dec

Link:

Notes:1098-6596|Okombo, John|Abdi, Abdirahman I|Kiara, Steven M|Mwai, Leah|Pole, Lewa|Sutherland, Colin J|Nzila, Alexis|Ochola-Oyier, Lynette Isabella|Wellcome Trust/United Kingdom|Journal Article|Research Support, Non-U.S. Gov’t|United States|Antimicrob Agents Chemother. 2013 Dec;57(12):6196-204. doi: 10.1128/AAC.01465-13. Epub 2013 Sep 30.

ISBN: 0066-4804 Permanent ID: PMC3837885 Accession Number: 24080667

Author Address: Kenya Medical Research Institute/Wellcome Trust Collaborative Research Program, Kilifi, Kenya.

STATISTICS