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Obaldía N. The human malaria- Aotus monkey model: a historical perspective in antimalarial chemotherapy research at the Gorgas Memorial Laboratory-Panama. Antimicrob Agents Chemother 2024:e0033824. [PMID: 38837364 DOI: 10.1128/aac.00338-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024] Open
Abstract
The human malaria-Aotus monkey model has served the malaria research community since its inception in 1966 at the Gorgas Memorial Laboratory (GML) in Panama. Spanning over five decades, this model has been instrumental in evaluating the in vivo efficacy and pharmacokinetics of a wide array of candidate antimalarial drugs, whether used singly or in combination. The animal model could be infected with drug-resistant and susceptible Plasmodium falciparum and Plasmodium vivax strains that follow a characteristic and reproducible course of infection, remarkably like human untreated and treated infections. Over the years, the model has enabled the evaluation of several synthetic and semisynthetic endoperoxides, for instance, artelinic acid, artesunate, artemether, arteether, and artemisone. These compounds have been evaluated alone and in combination with long-acting partner drugs, commonly referred to as artemisinin-based combination therapies, which are recommended as first-line treatment against uncomplicated malaria. Further, the model has also supported the evaluation of the primaquine analog tafenoquine against blood stages of P. vivax, contributing to its progression to clinical trials and eventual approval. Besides, the P. falciparum/Aotus model at GML has also played a pivotal role in exploring the biology, immunology, and pathogenesis of malaria and in the characterization of drug-resistant P. falciparum and P. vivax strains. This minireview offers a historical overview of the most significant contributions made by the Panamanian owl monkey (Aotus lemurinus lemurinus) to malaria chemotherapy research.
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Affiliation(s)
- Nicanor Obaldía
- Center for the Evaluation of Antimalarial Drugs and Vaccines, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama, Republic of Panama
- Department of Immunology and Infectious Diseases, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Abstract
SUMMARYThe study of malaria in the laboratory relies on either thein vitroculture of human parasites, or the use of non-human malaria parasites in laboratory animals. In this review, we address the use of non-human primate malaria parasite species (NHPMPs) in laboratory research. We describe the features of the most commonly used NHPMPs, review their contribution to our understanding of malaria to date, and discuss their potential contribution to future studies.
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Obaldía N, Dow GS, Gerena L, Kyle D, Otero W, Mantel PY, Baro N, Daniels R, Mukherjee A, Childs LM, Buckee C, Duraisingh MT, Volkman SK, Wirth DF, Marti M. Altered drug susceptibility during host adaptation of a Plasmodium falciparum strain in a non-human primate model. Sci Rep 2016; 6:21216. [PMID: 26880111 PMCID: PMC4754742 DOI: 10.1038/srep21216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 01/19/2016] [Indexed: 01/07/2023] Open
Abstract
Infections with Plasmodium falciparum, the most pathogenic of the Plasmodium species affecting man, have been reduced in part due to artemisinin-based combination therapies. However, artemisinin resistant parasites have recently emerged in South-East Asia. Novel intervention strategies are therefore urgently needed to maintain the current momentum for control and elimination of this disease. In the present study we characterize the phenotypic and genetic properties of the multi drug resistant (MDR) P. falciparum Thai C2A parasite strain in the non-human Aotus primate model, and across multiple passages. Aotus infections with C2A failed to clear upon oral artesunate and mefloquine treatment alone or in combination, and ex vivo drug assays demonstrated reduction in drug susceptibility profiles in later Aotus passages. Further analysis revealed mutations in the pfcrt and pfdhfr loci and increased parasite multiplication rate (PMR) across passages, despite elevated pfmdr1 copy number. Altogether our experiments suggest alterations in parasite population structure and increased fitness during Aotus adaptation. We also present data of early treatment failures with an oral artemisinin combination therapy in a pre-artemisinin resistant P. falciparum Thai isolate in this animal model.
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Affiliation(s)
- Nicanor Obaldía
- Department of Immunology and Infectious Diseases, Harvard
- T.H. Chan School of Public Health, Boston, MA, United States.,Center for the Evaluation of Antimalarial Drugs and Vaccines, Tropical Medicine Research/Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Republic of Panama
| | - Geoffrey S Dow
- Walter Reed Army Institute of Research, Silver Springs, MD, United States
| | - Lucia Gerena
- Walter Reed Army Institute of Research, Silver Springs, MD, United States
| | - Dennis Kyle
- Department of Global Health, University of South Florida, Tampa, FL, United States
| | - William Otero
- Center for the Evaluation of Antimalarial Drugs and Vaccines, Tropical Medicine Research/Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Republic of Panama
| | - Pierre-Yves Mantel
- Department of Immunology and Infectious Diseases, Harvard
- T.H. Chan School of Public Health, Boston, MA, United States
| | - Nicholas Baro
- Department of Immunology and Infectious Diseases, Harvard
- T.H. Chan School of Public Health, Boston, MA, United States
| | - Rachel Daniels
- Department of Immunology and Infectious Diseases, Harvard
- T.H. Chan School of Public Health, Boston, MA, United States
| | - Angana Mukherjee
- Department of Immunology and Infectious Diseases, Harvard
- T.H. Chan School of Public Health, Boston, MA, United States
| | - Lauren M Childs
- Center for Communicable Disease Dynamics and Harvard
- T.H. Chan School of Public Health, Boston, MA, United States.,Department of Epidemiology, Harvard
- T.H. Chan School of Public Health, Boston, MA, United States
| | - Caroline Buckee
- Center for Communicable Disease Dynamics and Harvard
- T.H. Chan School of Public Health, Boston, MA, United States.,Department of Epidemiology, Harvard
- T.H. Chan School of Public Health, Boston, MA, United States
| | - Manoj T Duraisingh
- Department of Immunology and Infectious Diseases, Harvard
- T.H. Chan School of Public Health, Boston, MA, United States
| | - Sarah K Volkman
- Department of Immunology and Infectious Diseases, Harvard
- T.H. Chan School of Public Health, Boston, MA, United States.,The Broad Institute of MIT and Harvard, Cambridge, MA, United States.,School of Nursing and Health Sciences, Simmons College, Boston, MA United States
| | - Dyann F Wirth
- Department of Immunology and Infectious Diseases, Harvard
- T.H. Chan School of Public Health, Boston, MA, United States.,The Broad Institute of MIT and Harvard, Cambridge, MA, United States
| | - Matthias Marti
- Department of Immunology and Infectious Diseases, Harvard
- T.H. Chan School of Public Health, Boston, MA, United States
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Efficacy of intravenous methylene blue, intravenous artesunate, and their combination in preclinical models of malaria. Malar J 2014; 13:415. [PMID: 25336091 PMCID: PMC4210502 DOI: 10.1186/1475-2875-13-415] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 06/17/2014] [Indexed: 11/16/2022] Open
Abstract
Background Intravenous artesunate (IV AS) is the present treatment of choice for severe malaria, but development of artemisinin resistance indicates that a further agent will be needed. Methylene blue (MB) is an approved human agent for IV and oral use, and is already being investigated for oral treatment of uncomplicated malaria. To initiate investigation of IV MB for severe malaria, the efficacy of IV MB was compared to IV AS and to their combination in rat and non-human primate malaria models. Methods IV MB was compared to IV AS and to their combination in the Plasmodium berghei-infected rat, a self-curing model; the Plasmodium falciparum-infected Aotus monkey, a fatal model; and the Plasmodium cynomolgi-infected rhesus monkey, a fatal model. Key endpoints were clearance of all parasites from the blood and cure (clearance without recrudescence). Results In rats, the minimal dose of individual drugs and their combination that cleared parasites from all animals was 20 mg IV MB/kg/day, 60 mg IV AS/kg/day and 10 mg IV MB/kg/day plus 30 mg IV AS/kg/day. In Aotus, 8 mg IV MB/kg/day and 8 mg IV AS/kg/day each cured two of three monkeys by one day after therapy, and the third monkey in each group was cured two days later. The combination of both drugs did not result in superior efficacy. In rhesus, 8 mg IV MB/kg/day and 8 mg IV AS/kg/day performed comparably: parasite clearance occurred by day 3 of therapy, although only one of four animals in each dose group cured. Eight mg/kg/day of both drugs in combination was 100% successful: all four of four animals cured. Conclusions In each of the three animal models, the efficacy of IV MB was approximately equal to that of standard of care IV AS. In the rat and rhesus models, the combination was more effective than either single agent. This preclinical data suggests that IV MB, alone or in combination with IV AS, is effective against Plasmodium spp. and can be evaluated in severe malaria models.
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Obaldia N, Otero W, Marin C, Aparicio J, Cisneros G. Long-term effect of a simple nest-box on the reproductive efficiency and other life traits of an Aotus lemurinus lemurinus monkey colony: an animal model for malaria research. J Med Primatol 2011; 40:383-91. [PMID: 21781134 DOI: 10.1111/j.1600-0684.2011.00489.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The long-term effect of a PVC pipe nest-box on the reproductive efficiency and other life traits of an Aotus monkey-breeding colony have not been characterized. METHODS AND RESULTS We analyzed laboratory records of the Gorgas Memorial Institute (GMI) Aotus monkey colony in Panama for the period 1999-2010 and found a 273% increase in the annual mean life births in the following 7 years after the introduction of a PVC pipe nest-box in 2002, as well as increases in the mean body mass and survival of laboratory-bred monkeys. Other life traits such as inter-birth interval, parity, birth sex distribution, mortality, and longevity were also determined. CONCLUSIONS The use of a PVC pipe nest-box significantly improved the reproductive efficiency and other life traits of the GMI Aotus breeding colony.
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Affiliation(s)
- Nicanor Obaldia
- Antimalarial Drug and Vaccine Evaluation Center, Tropical Medicine Research, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama.
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Arnold L, Tyagi RK, Meija P, Swetman C, Gleeson J, Pérignon JL, Druilhe P. Further improvements of the P. falciparum humanized mouse model. PLoS One 2011; 6:e18045. [PMID: 21483851 PMCID: PMC3069031 DOI: 10.1371/journal.pone.0018045] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 02/18/2011] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND It has been shown previously that it is possible to obtain growth of Plasmodium falciparum in human erythrocytes grafted in mice lacking adaptive immune responses by controlling, to a certain extent, innate defences with liposomes containing clodronate (clo-lip). However, the reproducibility of those models is limited, with only a proportion of animals supporting longstanding parasitemia, due to strong inflammation induced by P. falciparum. Optimisation of the model is much needed for the study of new anti-malarial drugs, drug combinations, and candidate vaccines. MATERIALS/METHODS We investigated the possibility of improving previous models by employing the intravenous route (IV) for delivery of both human erythrocytes (huRBC) and P. falciparum, instead of the intraperitoneal route (IP), by testing various immunosuppressive drugs that might help to control innate mouse defences, and by exploring the potential benefits of using immunodeficient mice with additional genetic defects, such as those with IL-2Rγ deficiency (NSG mice). RESULTS We demonstrate here the role of aging, of inosine and of the IL-2 receptor γ mutation in controlling P. falciparum induced inflammation. IV delivery of huRBC and P. falciparum in clo-lip treated NSG mice led to successful infection in 100% of inoculated mice, rapid rise of parasitemia to high levels (up to 40%), long-lasting parasitemia, and consistent results from mouse-to-mouse. Characteristics were closer to human infection than in previous models, with evidence of synchronisation, partial sequestration, and receptivity to various P. falciparum strains without preliminary adaptation. However, results show that a major IL-12p70 inflammatory response remains prevalent. CONCLUSION The combination of the NSG mouse, clodronate loaded liposomes, and IV delivery of huRBC has produced a reliable and more relevant model that better meets the needs of Malaria research.
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Affiliation(s)
- Ludovic Arnold
- Malaria Vaccine Development Laboratory, Institut Pasteur, Paris, France
| | | | - Pedro Meija
- Malaria Vaccine Development Laboratory, Institut Pasteur, Paris, France
| | - Claire Swetman
- Malaria Vaccine Development Laboratory, Institut Pasteur, Paris, France
| | - James Gleeson
- Malaria Vaccine Development Laboratory, Institut Pasteur, Paris, France
| | | | - Pierre Druilhe
- Malaria Vaccine Development Laboratory, Institut Pasteur, Paris, France
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