How Do You Solve a Problem Like Malaria?

malaria_researcher
Photo courtesy of NIH/NIAID

Malaria affects nearly half of the world’s population, with almost 80% of cases in sub-Saharan Africa and India. While there have been many strides in education and prevention campaigns over the last 30 years, there were over 200 million cases documented in 2017 with over 400,000 deaths, and the majority were young children. Despite being preventable and treatable, malaria continues to thrive in areas that are high risk for transmission. Recently, clinicians started rolling out use of the first approved vaccine, though clinical trials showed it is only about 30% effective. Meanwhile, researchers must continue to focus on innovative efforts to improve diagnostics, treatment and prevention to reduce the burden in these areas.

Continue reading “How Do You Solve a Problem Like Malaria?”

Radical Eradication: A (Population) Crash Course in Genetic Engineering

Malaria is a life-threatening blood disease that plagues nearly two-thirds of the world’s population. The disease in manifested by parasites of the Plasmodium genus and transmitted to humans through the bite of female Anopheles mosquitoes, which serve as the primary disease vectors. Roughly 200 million people per year are infected with malaria, and approximately 400,000 deaths are reported annually, with children under the age of five comprising the majority of victims.

Africa disproportionately bears the global brunt of this devastating illness, with approximately 92% of all reported cases, as well as 93% of all reported deaths, originating from the continent. This can be partially attributed to the fact that the conditions for transmission are essentially ideal there: the principal vector species Anopheles gambiae are abundant in this region, and not only do they prefer to source their blood from humans over animals, but the mosquitoes also tend to have a longer lifespan, which allows the most common and deadly malaria parasite, Plasmodium falciparum, to complete its life cycle, which contributes to higher disease transmission efficacy.

Though malaria is a preventable disease, often the areas affected most lack access or resources, or are politically unstable, all factors that can contribute to the absence of consistent, functional malaria control programs. Though malaria is also a curable disease, it has long been debated whether eradication was even within the realm of possibility. There are four species of Plasmodium parasites responsible for the pathogenesis of malaria and each exhibit different forms of drug resistance and each responds differently to different medications. This alone makes the prospect of developing a single overarching vaccine for all strains of malaria an improbable achievement and the idea of eradication practically impossible.

A CRISP[E]R APPROACH

In a study recently published in Nature Biotechnology, a team of scientists were able to effectively implement a new, though indubitably controversial, type of genetic modification. The team was able to weaponize mosquitoes to take out…other mosquitoes! They were able to engineer male mosquitoes to rapidly pass down a fatal mutation through generations of their own species, effectively sterilizing all female offspring, eliminating the possibility of successful reproduction and resulting in a population crash. Continue reading “Radical Eradication: A (Population) Crash Course in Genetic Engineering”

Could Your Dog Meds End Malaria or Zika Infections?

Mosquito photo
Will the sun soon be setting on dangerous mosquito populations?

Could that once-monthly beef-flavored pill you give your dog to kill fleas and ticks save thousands of human lives in Zika virus- and malaria-infected areas of the world?

That’s the hypothesis examined in a 2018 publication “Repurposing isoxazoline veterinary drugs for control of vector-borne human diseases”, published by Miglianico, et al., in PNAS.

Vector-Borne Diseases Under Siege
Mosquito-transmitted diseases, such as malaria and Zika virus, and sand fly-transmitted leishmaniasis are major causes of mortality in sub-tropical regions. Although with a lower mortality incidence, mosquito-borne West Nile virus has spread in temperate regions such as Europe and the United States. Continue reading “Could Your Dog Meds End Malaria or Zika Infections?”

Protein Kinase Inhibitors Show Promise in Malaria Study

Life cycle of the Malaria parasite.
Life cycle of the Malaria parasite.
A paper published in on August 8 in ChemBioChem has identified a number of small molecule kinase inhibitors that may have potential as antimalarial drugs. The authors, Derbyshire et al from Duke University, used a panel of human kinase inhibitors to screen for activity against malaria parasites. Using a high-throughput screening approach, they were able to identify several potential drug targets among the kinases of Plasmodium sp.,—most of which were effective against the parasite during both it’s blood-borne and liver-based life cycle stages.

Liver and blood-stage malaria parasites have different gene expression profiles and infect different host cells. The authors exploited these differences to try to specifically identify compounds that were active against the parasite while it was still in the liver, the idea being that any drug-based prevention strategy needs to be effective against the parasites in the liver in order to eradicate infection.

The authors screened a library of over 1300 kinase inhibitors that included several compounds already being used in clinical trials for anti-cancer activity. Initial screening was performed in human liver-derived HepG2 cells infected with Plasmodium berghei expressing a luciferase reporter. Compounds that decreased parasite load by more than 95% were further characterized in dose-response experiments, and promising hits were tested in using luminescent and fluorescent cell based assays to identify compounds that were not toxic to liver cells. Continue reading “Protein Kinase Inhibitors Show Promise in Malaria Study”

Chikungunya Virus and the Promise of a Virus-Like Particle Vaccine

My family and I just returned from a week-long camping trip along the North Shore of Lake Superior in Minnesota. It is beautiful country, filled with lakes, rivers, ponds—and mosquitoes, lots and lots of mosquitoes. We went prepared for the worse. We had a screen tent, head nets and tubes and tubes of insect repellent because in this area of the world, mosquitoes are a flying, buzzing, picnic-ruining, itch-inducing pest. In the US, though, a pest is really all they are. In other areas of the world they are a flying, buzzing, disease-carrying, deadly menace.

Image courtesy of James Gathany and the CDC
Image courtesy of James Gathany and the CDC

Mosquitos act as vectors for many diseases including malaria, Dengue fever, Yellow fever, encephalitis, West Nile Virus and chikungunya virus. Many of these diseases are deadly; in fact, mosquitoes are responsible for more human deaths than any other animal (~725,000 deaths annually). Although most of these diseases have a long and infamous history, two of them, West Nile virus (first identified in 1932) and chikungunya virus (first identified in 1950), are relative new comers on the world health stage. Continue reading “Chikungunya Virus and the Promise of a Virus-Like Particle Vaccine”

Genetically Modified Mosquitoes Fight Malaria

Image courtesy of James Gathany and the CDC
Image courtesy of James Gathany and the CDC

Mosquitos: They are the scourge of summer activities—the annoying buzzing noise as they fly around our ears and the pain, itching and swelling associated with their bites. Worst of all, certain species of mosquitoes can transmit diseases such as West Nile virus, Dengue fever and malaria. Defense mechanisms such as mosquito repellent, covering my head with netting and wearing heavy clothing are often insufficient against the swarm of hungry insects. It’s enough to make me want to stay indoors.

Those people who cannot escape these pests have a higher risk of being bitten and contracting a disease such as malaria, which killed an estimated 627,000 people in 2012, mostly in Africa and southeast Asia (1). A common step in malaria reduction programs in high-risk areas is reducing the number of Anopheles gambiae mosquitoes, which act as the host for malaria-causing parasites. This often involves massive amounts of insecticides, including limited amounts of the much maligned but very effective insecticide dichlorodiphenyltrichloroethane (DDT). Due to these programs, the World Health Organization (WHO) estimates that between 2000 and 2012, malaria mortality rates decreased by 42% worldwide, including a 48% decrease in children under 5 years of age. Clearly these programs are saving lives, but wouldn’t it be nice to achieve the same thing with fewer pesticides?

A recent report in Nature Communications makes me hopeful that we can.

Continue reading “Genetically Modified Mosquitoes Fight Malaria”

Hope for an Anti-Malaria Vaccine

anophelesAlthough it is more than 200 years since Jenner’s pioneering work on vaccination, there are still many infectious diseases that resist the development of effective vaccines. Somewhat shockingly, despite years of research effort, there are still no highly effective vaccines against human parasitic diseases. Malaria, the most problematic of these, kills more than half a million people each year—many of these infants and children, qualifying the mosquito that transmits the parasite as one of the most dangerous creatures on earth. Not surprisingly then, recent hopeful news of an anti-malaria vaccine that appears to protect against the disease has been greeted with enthusiasm.

The search for an effective anti-malaria vaccine has been fraught with difficulty due to the complex life cycle of the parasite (Plasmodium falciparum and other Plasmoduim species), compounded by its propensity to change its surface composition and develop resistance to various treatment efforts. The parasite thus presents an ever-changing target for treatment efforts. In the absence of an effective vaccine, anti-malarial efforts have been dependent on drug treatment (also liable to development of resistance), eradication programs, and preventive measures such as insecticide-laced mosquito netting. Continue reading “Hope for an Anti-Malaria Vaccine”

Innate Immune Memory in Mosquitoes: The Latest Buzz in the Fight against Malaria

Research on Malaria, World Health Organisation/Institut Pasteur. Female mosquito with body swollen with blood of person she has bitten. It is at this stage that the Malaria parasite is passed to the victim.

For many of us mosquitoes are an itchy aggravation. They come in the evenings in the warmer months. They disrupt hikes, camping trips and picnics, leaving behind itching reminders that have us reaching for antihistamines and no-itch creams. For people in some areas of the world however, mosquitoes are more than just a pest with an itchy calling card, they are a deadly menace. Mosquitoes of the genus Anopheles can carry Plasmodium, the parasitic micro-organism that causes malaria.

According to the World Health Organization, there were an estimated 243 million cases of malaria worldwide in 2008. Most of these cases were in Africa, followed by South-East Asia and the Eastern Mediterranean (1). In that year, malaria caused an estimated 863,000 deaths, and tragically, the majority of these deaths were in children younger than five. Continue reading “Innate Immune Memory in Mosquitoes: The Latest Buzz in the Fight against Malaria”