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Kiganda I, Bogaerts J, Wieske LHE, Deyou T, Atilaw Y, Uwamariya C, Miah M, Said J, Ndakala A, Akala HM, Herrebout W, Trybala E, Bergström T, Yenesew A, Erdelyi M. Antiviral Rotenoids and Isoflavones Isolated from Millettia oblata ssp. teitensis. J Nat Prod 2024; 87:1003-1012. [PMID: 38579352 PMCID: PMC11061832 DOI: 10.1021/acs.jnatprod.3c01288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/24/2024] [Accepted: 03/24/2024] [Indexed: 04/07/2024]
Abstract
Three new (1-3) and six known rotenoids (5-10), along with three known isoflavones (11-13), were isolated from the leaves of Millettia oblata ssp. teitensis. A new glycosylated isoflavone (4), four known isoflavones (14-18), and one known chalcone (19) were isolated from the root wood extract of the same plant. The structures were elucidated by NMR and mass spectrometric analyses. The absolute configuration of the chiral compounds was established by a comparison of experimental ECD and VCD data with those calculated for the possible stereoisomers. This is the first report on the use of VCD to assign the absolute configuration of rotenoids. The crude leaves and root wood extracts displayed anti-RSV (human respiratory syncytial virus) activity with IC50 values of 0.7 and 3.4 μg/mL, respectively. Compounds 6, 8, 10, 11, and 14 showed anti-RSV activity with IC50 values of 0.4-10 μM, while compound 3 exhibited anti-HRV-2 (human rhinovirus 2) activity with an IC50 of 4.2 μM. Most of the compounds showed low cytotoxicity for laryngeal carcinoma (HEp-2) cells; however compounds 3, 11, and 14 exhibited low cytotoxicity also in primary lung fibroblasts. This is the first report on rotenoids showing antiviral activity against RSV and HRV viruses.
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Affiliation(s)
- Ivan Kiganda
- Department
of Chemistry, University of Nairobi, P.O. Box 30197, 00100 Nairobi, Kenya
- Department
of Chemistry − BMC, Uppsala University, SE-751 23 Uppsala, Sweden
| | - Jonathan Bogaerts
- Department
of Chemistry, University of Antwerp, 2020 Antwerp, Belgium
| | - Lianne H. E. Wieske
- Department
of Chemistry − BMC, Uppsala University, SE-751 23 Uppsala, Sweden
| | - Tsegaye Deyou
- Department
of Chemistry, Salale University, P.O. Box 245, QPVQ+6C7, Fitche, Ethiopia
| | - Yoseph Atilaw
- Department
of Chemistry − BMC, Uppsala University, SE-751 23 Uppsala, Sweden
| | - Colores Uwamariya
- Department
of Infectious Diseases/Virology, Institute of Biomedicine, Sahlgrenska
Academy, University of Gothenburg, S-413 46 Gothenburg, Sweden
| | - Masum Miah
- Department
of Infectious Diseases/Virology, Institute of Biomedicine, Sahlgrenska
Academy, University of Gothenburg, S-413 46 Gothenburg, Sweden
| | - Joanna Said
- Department
of Infectious Diseases/Virology, Institute of Biomedicine, Sahlgrenska
Academy, University of Gothenburg, S-413 46 Gothenburg, Sweden
| | - Albert Ndakala
- Department
of Chemistry, University of Nairobi, P.O. Box 30197, 00100 Nairobi, Kenya
| | - Hoseah M. Akala
- Walter
Reed Army Institute of Research - Africa (WRAIR-A), Kenya Medical Research Institute (KEMRI), P.O. Box 54, 40100 Kisumu, Kenya
| | - Wouter Herrebout
- Department
of Chemistry, University of Antwerp, 2020 Antwerp, Belgium
| | - Edward Trybala
- Department
of Infectious Diseases/Virology, Institute of Biomedicine, Sahlgrenska
Academy, University of Gothenburg, S-413 46 Gothenburg, Sweden
| | - Tomas Bergström
- Department
of Infectious Diseases/Virology, Institute of Biomedicine, Sahlgrenska
Academy, University of Gothenburg, S-413 46 Gothenburg, Sweden
| | - Abiy Yenesew
- Department
of Chemistry, University of Nairobi, P.O. Box 30197, 00100 Nairobi, Kenya
| | - Mate Erdelyi
- Department
of Chemistry − BMC, Uppsala University, SE-751 23 Uppsala, Sweden
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Sifuna PM, Mbinji M, Lucas TO, Onyango I, Akala HM, Waitumbi JN, Ogutu BR, Hutter JN, Otieno W. The Walter Reed Project, Kisumu Field Station: Impact of Research on Malaria Policy, Management, and Prevention. Am J Trop Med Hyg 2024:tpmd230115. [PMID: 38653233 DOI: 10.4269/ajtmh.23-0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 02/16/2024] [Indexed: 04/25/2024] Open
Abstract
The Walter Reed Project is a collaboration between the Walter Reed Army Institute of Research of the United States Department of Defense and the Kenya Medical Research Institute. The Kisumu field station, comprising four campuses, has until recently been devoted primarily to research on malaria countermeasures. The Kombewa Clinical Research Center is dedicated to conducting regulated clinical trials of therapeutic and vaccine candidates in development. The center's robust population-based surveillance platform, along with an active community engagement strategy, guarantees consistent recruitment and retention of participants in clinical trials. The Malaria Diagnostic Center, backed by WHO-certified microscopists and a large malaria blood film collection, champions high-quality malaria diagnosis and strict quality assurance through standardized microscopy trainings. The Malaria Drug Resistance Laboratory leverages cutting-edge technology such as real-time Polymerase Chain Reaction (qPCR) to conduct comprehensive research on resistance markers and obtain information on drug efficacy. The laboratory has been working on validating artemisinin resistance markers and improving tracking methods for current and future antimalarial compounds. Finally, the Basic Science Laboratory employs advanced genomic technology to examine endpoints such as immunogenicity and genomic fingerprinting for candidate drugs and vaccine efficacy. Herein, we examine the site's significant contributions to malaria policy, management, and prevention practices in Kenya and around the world.
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Affiliation(s)
- Peter M Sifuna
- Kenya Medical Research Institute, Kisumu, Kenya
- U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya
| | - Michal Mbinji
- Kenya Medical Research Institute, Kisumu, Kenya
- U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya
| | - Tina O Lucas
- Kenya Medical Research Institute, Kisumu, Kenya
- U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya
| | - Irene Onyango
- Kenya Medical Research Institute, Kisumu, Kenya
- U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya
| | - Hoseah M Akala
- Kenya Medical Research Institute, Kisumu, Kenya
- U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya
| | - John N Waitumbi
- Kenya Medical Research Institute, Kisumu, Kenya
- U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya
| | - Bernhards R Ogutu
- Kenya Medical Research Institute, Kisumu, Kenya
- U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya
| | - Jack N Hutter
- U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya
| | - Walter Otieno
- Kenya Medical Research Institute, Kisumu, Kenya
- U.S. Army Medical Research Directorate-Africa, Kisumu, Kenya
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Amwoma JG, Kituyi S, Wakoli DM, Ochora DO, Chemwor G, Maisiba R, Okore W, Opot B, Juma D, Muok EM, Garges EC, Egbo TE, Nyabuga FN, Andagalu B, Akala HM. Comparative analysis of peripheral whole blood transcriptome from asymptomatic carriers reveals upregulation of subsets of surface proteins implicated in Plasmodium falciparum phenotypic plasticity. Biochem Biophys Rep 2024; 37:101596. [PMID: 38146350 PMCID: PMC10749222 DOI: 10.1016/j.bbrep.2023.101596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/17/2023] [Accepted: 11/27/2023] [Indexed: 12/27/2023] Open
Abstract
The molecular mechanism underlying Plasmodium falciparum's persistence in the asymptomatic phase of infection remains largely unknown. However, large-scale shifts in the parasites' gene expression during asymptomatic infections may enhance phenotypic plasticity, maximizing their fitness and leading to the persistence of the asymptomatic infections. To uncover these mechanisms, we aimed to identify parasite genetic factors implicated in asymptomatic infections through whole transcriptome analysis. We analyzed publicly available transcriptome datasets containing asymptomatic malaria (ASM), uncomplicated malaria (SM), and malaria-naïve (NSM) samples from 35 subjects for differentially expressed genes (DEGs) and long noncoding RNAs. Our analysis identified 755 and 1773 DEGs in ASM vs SM and NSM, respectively. These DEGs revealed sets of genes coding for proteins of unknown functions (PUFs) upregulated in ASM vs SM and ASM, suggesting their role in underlying fundamental molecular mechanisms during asymptomatic infections. Upregulated genes in ASM vs SM revealed a subset of 24 clonal variant genes (CVGs) involved in host-parasite and symbiotic interactions and modulation of the symbiont of host erythrocyte aggregation pathways. Moreover, we identified 237 differentially expressed noncoding RNAs in ASM vs SM, of which 11 were found to interact with CVGs, suggesting their possible role in regulating the expression of CVGs. Our results suggest that P. falciparum utilizes phenotypic plasticity as an adaptive mechanism during asymptomatic infections by upregulating clonal variant genes, with long noncoding RNAs possibly playing a crucial role in their regulation. Thus, our study provides insights into the parasites' genetic factors that confer a fitness advantage during asymptomatic infections.
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Affiliation(s)
- Joseph G. Amwoma
- Department of Biological Sciences, University of Embu, Kenya
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Sarah Kituyi
- Department of Biological Sciences, University of Embu, Kenya
- Forgarty International Center of the National Institutes of Health, Bethesda, MD, USA
| | - Dancan M. Wakoli
- Department of Biochemistry and Molecular Biology, Egerton University, Kenya
| | - Douglas O. Ochora
- Department of Biological Sciences, School of Pure and Applied Sciences, Kisii University, Kenya
- DSI/NWU, Preclinical Drug Development Platform, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Gladys Chemwor
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Risper Maisiba
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Winnie Okore
- Department of Biomedical Sciences and Technology, Maseno University, Kenya
| | - Benjamin Opot
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Dennis Juma
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Eric M.O. Muok
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Eric C. Garges
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya
| | - Timothy E. Egbo
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya
| | | | - Ben Andagalu
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Hoseah M. Akala
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
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Ochora DO, Murithi C, Masai RJ, Abdi F, Cheruyiot A, Katuura E, Asiimwe S, Nabatanzi A, Anywar G, Oryem-Origa H, Namukobe J, Kakudidi EK, Yenesew A, Akala HM, Kamau E. Ex vivo and in vitro antiplasmodial activity and toxicity of Caesalpinia decapetala (Roth) Alston (Fabaceae). J Ethnopharmacol 2024; 318:117007. [PMID: 37549860 DOI: 10.1016/j.jep.2023.117007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/26/2023] [Accepted: 08/04/2023] [Indexed: 08/09/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Malaria is among the most prevalent and devastating parasitic diseases globally with most cases reported in Sub-Saharan Africa. One of the major reasons for the high malaria prevalence is the ever-increasing emergence of resistant strains of malaria-causing parasites to the currently used antimalarial drugs. This, therefore, calls for the search for antimalarial compounds with alternative modes of action. Plants used in traditional medicine for the treatment of malaria offer possible sources of such compounds. Caesalpinia decapetala has been used traditionally for the treatment of various diseases including malaria. However, the antiplasmodial activity of the plant has never been reported. AIM OF THE STUDY To determine the ex vivo and in vitro antiplasmodial activities of the extracts of the roots, stem bark and leaves of Caesalpinia decapetala. METHODOLOGY The roots, stem bark and leaves of Caesalpinia decapetala (Roth) Alston (Caesalpiniaceae) were collected and air-dried under a shade then extracted consecutively with dichloromethane and methanol (1:1 (v/v) (4 × 0.8 L). The extracts were tested for antiplasmodial activities against four strains of Plasmodium falciparum (W2, DD2, 3D7, and D6) and fresh P. falciparum field isolates using the SYBR green I assay. The mean fifty percent inhibition concentration (IC50) was determined for each assay. An acute oral toxicity test was done based on the Organization for Economic Cooperation and Development (OECD 425) guidelines using Swiss albino mice. RESULTS The leaves and stem bark extracts showed good antiplasmodial activities with IC50 values of 4.54 and 4.86 μg/mL, respectively, when tested against the fresh field isolates ex vivo. Similarly, the roots extract showed an IC50 value of 6.49 μg/mL when tested against field isolates ex vivo. The roots extract showed the highest antiplasmodial activities among the samples when tested against W2 (IC50 = 6.12 μg/mL), DD2 (IC50 = 8.17 μg/mL), and D6 (IC50 = 16.02 μg/mL) strains of P. falciparum whereas the leaves showed the highest activity (IC50 = 9.3 μg/mL) when tested against the 3D7 strain of P. falciparum. No mortality was observed for the mice treated with 2000 mg/kg of the leaves and stem bark extracts. The mouse treated with 2000 mg/kg of the roots extracts regained weight by day 12 of the observation period. CONCLUSION Caesalpinia decapetala has the potential to suppress the growth of P. falciparum thereby contributing to combating the recurrent emergence of antimalarial drug resistance.
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Affiliation(s)
- Douglas O Ochora
- Department of Biological Sciences, School of Pure and Applied Sciences, Kisii University, P.O. Box 408-40200, Kisii, Kenya; DSI/NWU, Preclinical Drug Development Platform, Faculty of Health Sciences, North-West University, Private Bag X6001, 2520, Potchefstroom, South Africa; United States Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, P.O. Box 54-40100, Kisumu, Kenya.
| | - Caroline Murithi
- Department of Biology, Faculty of Science and Technology, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya.
| | - Rael J Masai
- Department of Biological Sciences, School of Pure and Applied Sciences, Kisii University, P.O. Box 408-40200, Kisii, Kenya.
| | - Farid Abdi
- United States Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, P.O. Box 54-40100, Kisumu, Kenya.
| | - Agnes Cheruyiot
- United States Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, P.O. Box 54-40100, Kisumu, Kenya.
| | - Esther Katuura
- Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda.
| | - Savina Asiimwe
- Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda.
| | - Alice Nabatanzi
- Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda.
| | - Godwin Anywar
- Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda.
| | - Hannington Oryem-Origa
- Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda.
| | - Jane Namukobe
- Department of Chemistry, College of Natural Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda.
| | - Esezah K Kakudidi
- Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, P. O. Box 7062, Kampala, Uganda.
| | - Abiy Yenesew
- Department of Chemistry, Faculty of Science and Technology, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya.
| | - Hoseah M Akala
- United States Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, P.O. Box 54-40100, Kisumu, Kenya.
| | - Edwin Kamau
- Department of Pathology and Area Laboratory Services, Tripler Army Medical Center, Honolulu, Hawaii (HI), USA.
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Kamau E, Maisiba R, Dear N, Esber A, Parikh AP, Iroezindu M, Bahemana E, Kibuuka H, Owuoth J, Maswai J, Opot B, Okoth RO, Abdi F, Mwalo M, Juma D, Andagalu B, Akala HM, Shah N, Crowell TA, Cowden J, Polyak CS, Ake JA. Implications of asymptomatic malaria infections on hematologic parameters in adults living with HIV in malaria-endemic regions with varying transmission intensities. Int J Infect Dis 2023; 137:82-89. [PMID: 37788741 DOI: 10.1016/j.ijid.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 09/22/2023] [Accepted: 09/24/2023] [Indexed: 10/05/2023] Open
Abstract
OBJECTIVES HIV and malaria coinfection impacts disease management and clinical outcomes. This study investigated hematologic abnormalities in malaria-asymptomatic people living with HIV (PLHIV) in regions with differing malaria transmission. METHODS Study participants were enrolled in the African Cohort Study: two sites in Kenya, one in Uganda, and one in Nigeria. Data was collected at enrollment and every 6 months. Logistic regression estimated odds ratios for associations between HIV/malaria status and anemia, thrombocytopenia, and leucopenia. RESULTS Samples from 1587 participants with one or more visits comprising 1471 (92.7%) from PLHIV and 116 (7.3%) without HIV were analyzed. Parasite point prevalence significantly differed across the study sites (P <0.001). PLHIV had higher odds of anemia, with males at lower odds compared to females; the odds of anemia decreased with age, reaching significance in those ≥50 years old. Participants in Kisumu, Kenya had higher odds of anemia compared to other sites. PLHIV had higher odds of leucopenia, but malaria co-infection was not associated with worsened leucopenia. The odds of thrombocytopenia were decreased in HIV/malaria co-infection compared to the uninfected group. CONCLUSION Hematological parameters are important indicators of health and disease. In PLHIV with asymptomatic malaria co-infection enrolled across four geographic sites in three African countries, abnormalities in hematologic parameters differ in different malaria transmission settings and are region-specific.
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Affiliation(s)
- Edwin Kamau
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; Department of Pathology and Area Laboratory Service, Tripler Army Medical Center, Honolulu, USA.
| | - Risper Maisiba
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Nicole Dear
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, USA
| | - Allahna Esber
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, USA
| | - Ajay P Parikh
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, USA
| | - Michael Iroezindu
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; HJF Medical Research International, Abuja, Nigeria
| | - Emmanuel Bahemana
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; HJF Medical Research International, Mbeya, Tanzania
| | - Hannah Kibuuka
- Makerere University Walter Reed Project, Kampala, Uganda
| | - John Owuoth
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya; HJF Medical Research International, Kisumu, Kenya
| | - Jonah Maswai
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; U.S. Army Medical Research Directorate - Africa, Kericho, Kenya
| | - Benjamin Opot
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Raphael O Okoth
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Farid Abdi
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Maureen Mwalo
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Dennis Juma
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Ben Andagalu
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya; Kenya Medical Research Institute, Kisumu, Kenya
| | - Hoseah M Akala
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Neha Shah
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA
| | - Trevor A Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, USA
| | - Jessica Cowden
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, Kisumu, Kenya
| | - Christina S Polyak
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, USA
| | - Julie A Ake
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA
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Ochora DO, Mogire RM, Masai RJ, Yeda RA, Mwakio EW, Amwoma JG, Wakoli DM, Yenesew A, Akala HM. Ex vivo and In vitro antiplasmodial activities of approved drugs predicted to have antimalarial activities using chemogenomics and drug repositioning approach. Heliyon 2023; 9:e18863. [PMID: 37583763 PMCID: PMC10424068 DOI: 10.1016/j.heliyon.2023.e18863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/31/2023] [Accepted: 07/31/2023] [Indexed: 08/17/2023] Open
Abstract
High malaria mortality coupled with increased emergence of resistant multi-drug resistant strains of Plasmodium parasite, warrants the development of new and effective antimalarial drugs. However, drug design and discovery are costly and time-consuming with many active antimalarial compounds failing to get approved due to safety reasons. To address these challenges, the current study aimed at testing the antiplasmodial activities of approved drugs that were predicted using a target-similarity approach. This approach is based on the fact that if an approved drug used to treat another disease targets a protein similar to Plasmodium falciparum protein, then the drug will have a comparable effect on P. falciparum. In a previous study, in vitro antiplasmodial activities of 10 approved drugs was reported of the total 28 approved drugs. In this study, six out of 18 drugs that were previously not tested, namely epirubicin, irinotecan, venlafaxine, palbociclib, pelitinib, and PD153035 were tested for antiplasmodial activity. The drug susceptibility in vitro assays against five P. falciparum reference strains (D6, 3D7, W2, DD2, and F32 ART) and ex vivo assays against fresh clinical isolates were done using the malaria SYBR Green I assay. Standard antimalarial drugs were included as controls. Epirubicin and irinotecan showed excellent antiplasmodial ex vivo activity against field isolates with mean IC50 values of 0.044 ± 0.033 μM and 0.085 ± 0.055 μM, respectively. Similar activity was observed against W2 strain where epirubicin had an IC50 value of 0.004 ± 0.0009 μM, palbociclib 0.056 ± 0.006 μM, and pelinitib 0.057 ± 0.013 μM. For the DD2 strain, epirubicin, irinotecan and PD 153035 displayed potent antiplasmodial activity (IC50 < 1 μM). Epirubicin and irinotecan showed potent antiplasmodial activities (IC50 < 1 μM) against DD2, D6, 3D7, and F32 ART strains and field isolates. This shows the potential use of these drugs as antimalarials. All the tested drugs showed antiplasmodial activities with IC50 values below 20 μM, which suggests that our target similarity-based strategy is successful at predicting antiplasmodial activity of compounds thereby circumventing challenges in antimalarial drug discovery.
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Affiliation(s)
- Douglas O. Ochora
- Department of Biological Sciences, School of Pure and Applied Sciences, Kisii University, P.O. Box 408-40200, Kisii, Kenya
- DSI/NWU, Preclinical Drug Development Platform, Faculty of Health Sciences, North-West University, Private Bag X6001, 2520, Potchefstroom, South Africa
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)—Walter Reed Project, P.O. Box 54-40100, Kisumu, Kenya
| | - Reagan M. Mogire
- Kenya Medical Research Institute (KEMRI) – Kemri-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya
| | - Rael J. Masai
- Department of Biological Sciences, School of Pure and Applied Sciences, Kisii University, P.O. Box 408-40200, Kisii, Kenya
| | - Redemptah A. Yeda
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)—Walter Reed Project, P.O. Box 54-40100, Kisumu, Kenya
| | - Edwin W. Mwakio
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)—Walter Reed Project, P.O. Box 54-40100, Kisumu, Kenya
| | - Joseph G. Amwoma
- Department of Biological Sciences, University of Embu P. O. Box 6-60100, Embu, Kenya
| | - Dancan M. Wakoli
- Department of Biochemistry and Molecular Biology, Egerton University, P.O. Box 536-20115, Egerton-Njoro, Kenya
| | - Abiy Yenesew
- Department of Chemistry, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya
| | - Hoseah M. Akala
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)—Walter Reed Project, P.O. Box 54-40100, Kisumu, Kenya
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Muema JM, Mutunga JM, Obonyo MA, Getahun MN, Mwakubambanya RS, Akala HM, Cheruiyot AC, Yeda RA, Juma DW, Andagalu B, Johnson JL, Roth AL, Bargul JL. Isoliensinine from Cissampelos pariera rhizomes exhibits potential gametocytocidal and anti-malarial activities against Plasmodium falciparum clinical isolates. Malar J 2023; 22:161. [PMID: 37208735 DOI: 10.1186/s12936-023-04590-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 05/15/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND The unmet demand for effective malaria transmission-blocking agents targeting the transmissible stages of Plasmodium necessitates intensive discovery efforts. In this study, a bioactive bisbenzylisoquinoline (BBIQ), isoliensinine, from Cissampelos pariera (Menispermaceae) rhizomes was identified and characterized for its anti-malarial activity. METHODS Malaria SYBR Green I fluorescence assay was performed to evaluate the in vitro antimalarial activity against D6, Dd2, and F32-ART5 clones, and immediate ex vivo (IEV) susceptibility for 10 freshly collected P. falciparum isolates. To determine the speed- and stage-of-action of isoliensinine, an IC50 speed assay and morphological analyses were performed using synchronized Dd2 asexuals. Gametocytocidal activity against two culture-adapted gametocyte-producing clinical isolates was determined using microscopy readouts, with possible molecular targets and their binding affinities deduced in silico. RESULTS Isoliensinine displayed a potent in vitro gametocytocidal activity at mean IC50gam values ranging between 0.41 and 0.69 µM for Plasmodium falciparum clinical isolates. The BBIQ compound also inhibited asexual replication at mean IC50Asexual of 2.17 µM, 2.22 µM, and 2.39 µM for D6, Dd2 and F32-ART5 respectively, targeting the late-trophozoite to schizont transition. Further characterization demonstrated a considerable immediate ex vivo potency against human clinical isolates at a geometric mean IC50IEV = 1.433 µM (95% CI 0.917-2.242). In silico analyses postulated a probable anti-malarial mechanism of action by high binding affinities for four mitotic division protein kinases; Pfnek1, Pfmap2, Pfclk1, and Pfclk4. Additionally, isoliensinine was predicted to possess an optimal pharmacokinetics profile and drug-likeness properties. CONCLUSION These findings highlight considerable grounds for further exploration of isoliensinine as an amenable scaffold for malaria transmission-blocking chemistry and target validation.
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Affiliation(s)
- Jackson M Muema
- Department of Biochemistry, Jomo Kenyatta University of Agriculture and Technology (JKUAT), Nairobi, Kenya.
- U.S. Army Medical Research Directorate-Africa (USAMRD-A), Centre for Global Health Research (CGHR), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
| | - James M Mutunga
- U.S. Army Medical Research Directorate-Africa (USAMRD-A), Centre for Global Health Research (CGHR), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
- Department of Biological Sciences, School of Pure and Applied Sciences, Mount Kenya University, Thika, Kenya
- School of Engineering Design, Technology and Professional Programs, Pennsylvania State University, University Park, PA, 16802, USA
| | - Meshack A Obonyo
- Department of Biochemistry and Molecular Biology, Egerton University, Egerton, Kenya
| | - Merid N Getahun
- International Centre of Insect Physiology and Ecology (Icipe), Nairobi, Kenya
| | | | - Hoseah M Akala
- U.S. Army Medical Research Directorate-Africa (USAMRD-A), Centre for Global Health Research (CGHR), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Agnes C Cheruiyot
- U.S. Army Medical Research Directorate-Africa (USAMRD-A), Centre for Global Health Research (CGHR), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Redemptah A Yeda
- U.S. Army Medical Research Directorate-Africa (USAMRD-A), Centre for Global Health Research (CGHR), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Dennis W Juma
- U.S. Army Medical Research Directorate-Africa (USAMRD-A), Centre for Global Health Research (CGHR), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Ben Andagalu
- U.S. Army Medical Research Directorate-Africa (USAMRD-A), Centre for Global Health Research (CGHR), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Jaree L Johnson
- U.S. Army Medical Research Directorate-Africa (USAMRD-A), Centre for Global Health Research (CGHR), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Amanda L Roth
- U.S. Army Medical Research Directorate-Africa (USAMRD-A), Centre for Global Health Research (CGHR), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Joel L Bargul
- Department of Biochemistry, Jomo Kenyatta University of Agriculture and Technology (JKUAT), Nairobi, Kenya.
- International Centre of Insect Physiology and Ecology (Icipe), Nairobi, Kenya.
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Chemwor GC, Andagalu BM, Onyango IA, Opot BH, Okoth RO, Yedah RA, Juma JA, Mwakio EW, Wakoli DM, Amwoma JG, Cheruiyot AC, Juma DW, Ogutu BR, Egbo TE, Garges EC, Roth AL, Kamau E, Watson OJ, Akala HM. Therapeutic response to artemisinin combination therapies among individuals with Plasmodium falciparum single infection versus mixed Plasmodium species infections: A retrospective post-hoc analysis in Kisumu County, western Kenya. Int J Infect Dis 2023; 132:17-25. [PMID: 37061211 DOI: 10.1016/j.ijid.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 03/24/2023] [Accepted: 04/03/2023] [Indexed: 04/17/2023] Open
Abstract
OBJECTIVE This study examined the treatment response of mixed versus single species Plasmodium falciparum infections to artemisinin-based combination therapies (ACTs). METHODS 1211 blood samples collected on days 0, 7, 14, 21, 28, 35, and 42 from 173 individuals enrolled under two randomized ACT efficacy studies were diagnosed for malaria using 18s rRNA-based real-time PCR. All recurrent parasitaemia were characterized for Plasmodium species composition and times to reinfection during 42-day follow up compared across ACTs. FINDINGS Day 0 samples had 71.1% (116/163) single P. falciparum infections and 28.2% (46/163) co-infections. 54.0% (88/163) of individuals tested Plasmodium positive at least once between days 7 - 42. 19.3% (17/88) of individuals with recurrent infections were infected with a different Plasmodium species than observed at day 0, with 76.5% (13/17) of these "hidden" infections appearing after clearing P. falciparum present at day 0. Artesunate-mefloquine (16.4) and dihydroartemisinin-piperaquine (17.6) had increased clearance rates over artemether-lumefantrine (21.0). Dihydroartemisinin-piperaquine exhibited the longest duration of reinfection prophylaxis. Cure rates were comparable across each species composition. INTERPRETATION No differences in clearance rates were found depending on whether the infection contained other species other than P. falciparum. Significantly longer durations of protection were observed for individuals treated with dihydroartemisinin-piperaquine.
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Affiliation(s)
- Gladys C Chemwor
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, P. O. Box 54 - 40100, Kisumu, Kenya
| | - Ben M Andagalu
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, P. O. Box 54 - 40100, Kisumu, Kenya
| | - Irene A Onyango
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, P. O. Box 54 - 40100, Kisumu, Kenya
| | - Benjamin H Opot
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, P. O. Box 54 - 40100, Kisumu, Kenya
| | - Raphael O Okoth
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, P. O. Box 54 - 40100, Kisumu, Kenya
| | - Redemptah A Yedah
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, P. O. Box 54 - 40100, Kisumu, Kenya
| | - Jackline A Juma
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, P. O. Box 54 - 40100, Kisumu, Kenya
| | - Edwin W Mwakio
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, P. O. Box 54 - 40100, Kisumu, Kenya
| | - Dancan M Wakoli
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, P. O. Box 54 - 40100, Kisumu, Kenya
| | - Joseph G Amwoma
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, P. O. Box 54 - 40100, Kisumu, Kenya
| | - Agnes C Cheruiyot
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, P. O. Box 54 - 40100, Kisumu, Kenya
| | - Dennis W Juma
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, P. O. Box 54 - 40100, Kisumu, Kenya
| | - Bernhards R Ogutu
- Centre for Clinical Research, Kenya Medical Research Institute, Kisumu, Kenya; Centre for Research in Therapeutic Sciences (CREATES), Strathmore University, Nairobi, Kenya
| | - Timothy E Egbo
- United States Army Medical Research Directorate-Africa, Kenya (USAMRD-A)
| | - Eric C Garges
- United States Army Medical Research Directorate-Africa, Kenya (USAMRD-A)
| | - Amanda L Roth
- United States Army Medical Research Directorate-Africa, Kenya (USAMRD-A); Medical Communications for Combat Casualty Care, 1540 Porter Street, Fort Detrick MD 21702
| | - Edwin Kamau
- United States Army Medical Research Directorate-Africa, Kenya (USAMRD-A); Department of Pathology and Area Laboratory Services, Tripler Army Medical Center, Honolulu, HI 96589, United States of America
| | - Oliver J Watson
- Medical Research Council, Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Hoseah M Akala
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI) / Walter Reed Project, P. O. Box 54 - 40100, Kisumu, Kenya.
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Oluoch PO, Forconi CS, Oduor CI, Ritacco DA, Akala HM, Bailey JA, Juliano JJ, Ong'echa JM, Münz C, Moormann AM. Distinctive Kaposi Sarcoma-Associated Herpesvirus Serological Profile during Acute Plasmodium falciparum Malaria Episodes. Int J Mol Sci 2023; 24:ijms24076711. [PMID: 37047683 PMCID: PMC10095526 DOI: 10.3390/ijms24076711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 04/14/2023] Open
Abstract
The seroprevalence of Kaposi sarcoma-associated herpesvirus (KSHV) and the incidence of endemic Kaposi sarcoma (KS) overlap with regions of malaria endemicity in sub-Saharan Africa. Multiple studies have shown an increased risk of KSHV seroconversion in children from high malaria compared to low malaria regions; however, the impact of acute episodes of Plasmodium falciparum (P. falciparum) malaria on KSHV's biphasic life cycle and lytic reactivation has not been determined. Here, we examined KSHV serological profiles and viral loads in 134 children with acute malaria and 221 healthy children from high malaria regions in Kisumu, as well as 77 healthy children from low malaria regions in Nandi. We assayed KSHV, Epstein-Barr virus (EBV), and P. falciparum malaria antibody responses in these three by multiplexed Luminex assay. We confirmed that KSHV seroprevalence was significantly associated with malaria endemicity (OR = 1.95, 1.18-3.24 95% CI, p = 0.01) with 71-77% seropositivity in high-malaria (Kisumu) compared to 28% in low-malaria (Nandi) regions. Furthermore, KSHV serological profiles during acute malaria episodes were distinct from age-matched non-malaria-infected children from the same region. Paired IgG levels also varied after malaria treatment, with significantly higher anti-ORF59 at day 0 but elevated ORF38, ORF73, and K8.1 at day 3. Acute malaria episodes is characterized by perturbation of KSHV latency in seropositive children, providing further evidence that malaria endemicity contributes to the observed increase in endemic KS incidence in sub-Saharan Africa.
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Affiliation(s)
- Peter O Oluoch
- Division of Infectious Diseases and Immunology, Department of Medicine, Chan Medical School, University of Massachusetts, Worcester, MA 01605, USA
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu 40100, Kenya
| | - Catherine S Forconi
- Division of Infectious Diseases and Immunology, Department of Medicine, Chan Medical School, University of Massachusetts, Worcester, MA 01605, USA
| | - Cliff I Oduor
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu 40100, Kenya
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, Providence, RI 02903, USA
| | - Dominic A Ritacco
- Division of Infectious Diseases and Immunology, Department of Medicine, Chan Medical School, University of Massachusetts, Worcester, MA 01605, USA
| | - Hoseah M Akala
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu 40100, Kenya
| | - Jeffrey A Bailey
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, Providence, RI 02903, USA
| | - Jonathan J Juliano
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - John M Ong'echa
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu 40100, Kenya
| | - Christian Münz
- Viral Immunobiology, Institute of Experimental Immunology, University of Zurich, CH-8057 Zurich, Switzerland
| | - Ann M Moormann
- Division of Infectious Diseases and Immunology, Department of Medicine, Chan Medical School, University of Massachusetts, Worcester, MA 01605, USA
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Andagalu B, Watson OJ, Onyango I, Opot B, Okoth R, Chemwor G, Sifuna P, Juma D, Cheruiyot A, Yeda R, Okudo C, Wafubwa J, Yalwala S, Abuom D, Ogutu B, Cowden J, Akala HM, Kamau E. Malaria Transmission Dynamics in a High-Transmission Setting of Western Kenya and the Inadequate Treatment Response to Artemether-Lumefantrine in an Asymptomatic Population. Clin Infect Dis 2023; 76:704-712. [PMID: 35767269 PMCID: PMC9938745 DOI: 10.1093/cid/ciac527] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 06/13/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Assessing the infectious reservoir is critical in malaria control and elimination strategies. We conducted a longitudinal epidemiological study in a high-malaria-burden region in Kenya to characterize transmission in an asymptomatic population. METHODS 488 study participants encompassing all ages in 120 households within 30 clusters were followed for 1 year with monthly sampling. Malaria was diagnosed by microscopy and molecular methods. Transmission potential in gametocytemic participants was assessed using direct skin and/or membrane mosquito feeding assays, then treated with artemether-lumefantrine. Study variables were assessed using mixed-effects generalized linear models. RESULTS Asexual and sexual parasite data were collected from 3792 participant visits, with 903 linked with feeding assays. Univariate analysis revealed that the 6-11-year-old age group was at higher risk of harboring asexual and sexual infections than those <6 years old (odds ratio [OR] 1.68, P < .001; and OR 1.81, P < .001), respectively. Participants with submicroscopic parasitemia were at a lower risk of gametocytemia compared with microscopic parasitemia (OR 0.04, P < .001), but they transmitted at a significantly higher rate (OR 2.00, P = .002). A large proportion of the study population who were infected at least once remained infected (despite treatment) with asexual (71.7%, 291/406) or sexual (37.4%, 152/406) parasites. 88.6% (365/412) of feeding assays conducted in individuals who failed treatment the previous month resulted in transmissions. CONCLUSIONS Individuals with asymptomatic infection sustain the transmission cycle, with the 6-11-year age group serving as an important reservoir. The high rates of artemether-lumefantrine treatment failures suggest surveillance programs using molecular methods need to be expanded for accurate monitoring and evaluation of treatment outcomes.
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Affiliation(s)
- Ben Andagalu
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Oliver J Watson
- Medical Research Council, Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Irene Onyango
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Benjamin Opot
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Raphael Okoth
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Gladys Chemwor
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Peter Sifuna
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Dennis Juma
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Agnes Cheruiyot
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Redemptah Yeda
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Charles Okudo
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Jackline Wafubwa
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Santos Yalwala
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - David Abuom
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | | | - Jessica Cowden
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Hoseah M Akala
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Edwin Kamau
- Department of Emerging and Infectious Diseases (DEID), US Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya.,US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.,Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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11
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Andagalu B, Watson OJ, Onyango I, Opot B, Okoth R, Chemwor G, Sifuna P, Juma D, Cheruiyot A, Yeda R, Okudo C, Wafubwa J, Yalwala S, Abuom D, Ogutu B, Cowden J, Akala HM, Kamau E. Reply to Blanken et al. Clin Infect Dis 2023; 76:557-559. [PMID: 36069376 DOI: 10.1093/cid/ciac741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/26/2022] [Accepted: 09/02/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ben Andagalu
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - Oliver J Watson
- Medical Research Council, Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Irene Onyango
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - Benjamin Opot
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - Raphael Okoth
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - Gladys Chemwor
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - Peter Sifuna
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - Dennis Juma
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - Agnes Cheruiyot
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - Redemptah Yeda
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - Charles Okudo
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - Jackline Wafubwa
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - Santos Yalwala
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - David Abuom
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | | | - Jessica Cowden
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - Hoseah M Akala
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
| | - Edwin Kamau
- Department of Emerging and Infectious Diseases, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute/Walter Reed Project, Kisumu, Kenya
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Department of Pathology and Area Laboratory Services, Tripler Army Medical Center, Honolulu, Hawaii, USA
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12
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Wakoli DM, Ondigo BN, Ochora DO, Amwoma JG, Okore W, Mwakio EW, Chemwor G, Juma J, Okoth R, Okudo C, Yeda R, Opot BH, Cheruiyot AC, Juma D, Roth A, Ogutu BR, Boudreaux D, Andagalu B, Akala HM. Impact of parasite genomic dynamics on the sensitivity of Plasmodium falciparum isolates to piperaquine and other antimalarial drugs. BMC Med 2022; 20:448. [PMID: 36397090 PMCID: PMC9673313 DOI: 10.1186/s12916-022-02652-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Dihydroartemisinin-piperaquine (DHA-PPQ) is an alternative first-line antimalarial to artemether-lumefantrine in Kenya. However, recent reports on the emergence of PPQ resistance in Southeast Asia threaten its continued use in Kenya and Africa. In line with the policy on continued deployment of DHA-PPQ, it is imperative to monitor the susceptibility of Kenyan parasites to PPQ and other antimalarials. METHODS Parasite isolates collected between 2008 and 2021 from individuals with naturally acquired P. falciparum infections presenting with uncomplicated malaria were tested for in vitro susceptibility to piperaquine, dihydroartemisinin, lumefantrine, artemether, and chloroquine using the malaria SYBR Green I method. A subset of the 2019-2021 samples was further tested for ex vivo susceptibility to PPQ using piperaquine survival assay (PSA). Each isolate was also characterized for mutations associated with antimalarial resistance in Pfcrt, Pfmdr1, Pfpm2/3, Pfdhfr, and Pfdhps genes using real-time PCR and Agena MassARRAY platform. Associations between phenotype and genotype were also determined. RESULTS The PPQ median IC50 interquartile range (IQR) remained stable during the study period, 32.70 nM (IQR 20.2-45.6) in 2008 and 27.30 nM (IQR 6.9-52.8) in 2021 (P=0.1615). The median ex vivo piperaquine survival rate (IQR) was 0% (0-5.27) at 95% CI. Five isolates had a PSA survival rate of ≥10%, consistent with the range of PPQ-resistant parasites, though they lacked polymorphisms in Pfmdr1 and Plasmepsin genes. Lumefantrine and artemether median IC50s rose significantly to 62.40 nM (IQR 26.9-100.8) (P = 0.0201); 7.00 nM (IQR 2.4-13.4) (P = 0.0021) in 2021 from 26.30 nM (IQR 5.1-64.3); and 2.70 nM (IQR 1.3-10.4) in 2008, respectively. Conversely, chloroquine median IC50s decreased significantly to 10.30 nM (IQR 7.2-20.9) in 2021 from 15.30 nM (IQR 7.6-30.4) in 2008, coinciding with a decline in the prevalence of Pfcrt 76T allele over time (P = 0.0357). The proportions of piperaquine-resistant markers including Pfpm2/3 and Pfmdr1 did not vary significantly. A significant association was observed between PPQ IC50 and Pfcrt K76T allele (P=0.0026). CONCLUSIONS Circulating Kenyan parasites have remained sensitive to PPQ and other antimalarials, though the response to artemether (ART) and lumefantrine (LM) is declining. This study forms a baseline for continued surveillance of current antimalarials for timely detection of resistance.
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Affiliation(s)
- Dancan M Wakoli
- Department of Biochemistry and Molecular Biology, Egerton University, Egerton-Njoro, Kenya. .,Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya.
| | - Bartholomew N Ondigo
- Department of Biochemistry and Molecular Biology, Egerton University, Egerton-Njoro, Kenya.,Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - Douglas O Ochora
- Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, Kampala, Uganda
| | - Joseph G Amwoma
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya.,Department of Biological Sciences, University of Embu, Embu, Kenya
| | - Winnie Okore
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya.,Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno, Kenya
| | - Edwin W Mwakio
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya
| | - Gladys Chemwor
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya
| | - Jackeline Juma
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya
| | - Raphael Okoth
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya
| | - Charles Okudo
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya
| | - Redemptah Yeda
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya
| | - Benjamin H Opot
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya
| | - Agnes C Cheruiyot
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya
| | - Dennis Juma
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya
| | - Amanda Roth
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya
| | - Benhards R Ogutu
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya
| | - Daniel Boudreaux
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya
| | - Ben Andagalu
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya
| | - Hoseah M Akala
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/ Walter Reed Project, Kisumu, Kenya.
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13
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Andagalu B, Lu P, Onyango I, Bergmann-Leitner E, Wasuna R, Odhiambo G, Chebon-Bore LJ, Ingasia LA, Juma DW, Opot B, Cheruiyot A, Yeda R, Okudo C, Okoth R, Chemwor G, Campo J, Wallqvist A, Akala HM, Ochiel D, Ogutu B, Chaudhury S, Kamau E. Age-dependent antibody profiles to plasmodium antigens are differentially associated with two artemisinin combination therapy outcomes in high transmission setting. Front Med (Lausanne) 2022; 9:991807. [PMID: 36314027 PMCID: PMC9606348 DOI: 10.3389/fmed.2022.991807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/27/2022] [Indexed: 11/28/2022] Open
Abstract
The impact of pre-existing immunity on the efficacy of artemisinin combination therapy is largely unknown. We performed in-depth profiling of serological responses in a therapeutic efficacy study [comparing artesunate-mefloquine (ASMQ) and artemether-lumefantrine (AL)] using a proteomic microarray. Responses to over 200 Plasmodium antigens were significantly associated with ASMQ treatment outcome but not AL. We used machine learning to develop predictive models of treatment outcome based on the immunoprofile data. The models predict treatment outcome for ASMQ with high (72–85%) accuracy, but could not predict treatment outcome for AL. This divergent treatment outcome suggests that humoral immunity may synergize with the longer mefloquine half-life to provide a prophylactic effect at 28–42 days post-treatment, which was further supported by simulated pharmacokinetic profiling. Our computational approach and modeling revealed the synergistic effect of pre-existing immunity in patients with drug combination that has an extended efficacy on providing long term treatment efficacy of ASMQ.
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Affiliation(s)
- Ben Andagalu
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Pinyi Lu
- Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, U.S. Army Medical Research and Development Command, Fort Detrick, MD, United States,Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, United States
| | - Irene Onyango
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Elke Bergmann-Leitner
- Biologics Research and Development, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Ruth Wasuna
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Geoffrey Odhiambo
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Lorna J. Chebon-Bore
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Luicer A. Ingasia
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Dennis W. Juma
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Benjamin Opot
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Agnes Cheruiyot
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Redemptah Yeda
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Charles Okudo
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Raphael Okoth
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Gladys Chemwor
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Joseph Campo
- Antigen Discovery Inc., Irvine, CA, United States
| | - Anders Wallqvist
- Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, U.S. Army Medical Research and Development Command, Fort Detrick, MD, United States
| | - Hoseah M. Akala
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | - Daniel Ochiel
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya
| | | | - Sidhartha Chaudhury
- Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, U.S. Army Medical Research and Development Command, Fort Detrick, MD, United States,Center for Enabling Capabilities, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Edwin Kamau
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project, Kisumu, Kenya,U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, United States,Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States,*Correspondence: Edwin Kamau, ,
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14
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Yeda R, Okudo C, Owiti E, Biwot G, Momanyi C, Korir W, Mitsanze T, Tegerei C, Juma D, Opot B, Mwakio E, Chemwor G, Okoth R, Ochora DO, Cheruiyot AC, Roth A, Akala HM, Andagalu B. Burden of malaria infection among individuals of varied blood groups in Kenya. Malar J 2022; 21:251. [PMID: 36050680 PMCID: PMC9438094 DOI: 10.1186/s12936-022-04251-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 07/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background The ABO blood groups consist of A, B, and H carbohydrate antigens, which regulate protein activities during malaria infection in humans. Understanding the interplay between the malaria parasite and blood group antigens is essential in understanding new interventions to reduce the global burden of malaria. This study assessed the burden of malaria infection among individuals with varying blood groups seeking treatment at selected hospitals in Kenya. Methods A total of 366 samples from an ongoing malaria surveillance study were diagnosed for malaria by microscopy and further typed for blood group using ABO blood grouping. Age and sex were recorded in a data sheet, and analysed using R software version 4. Groups’ proportions (blood group, malaria infection, age and sex) were compared using Pearson’s Chi-square and Fischer exact tests. Wilcoxon and Kruskal-Wallis tests were performed and P-value < 0.05 was considered significant after Bonferroni correction for multiple comparisons. To understand the effect of each blood group on parasitaemia, multivariate logistic regression was used to model ABO blood group in relation to parasitaemia. Results Of the 366 samples analysed, 312 were malaria positive, mean age was 9.83 years (< 5 years n = 152 (48.41%), 6 to 17 years n = 101 (32.16%) and > 18 years n = 61 (19.43%)). Malaria prevalence was higher among females than males, 54.46% and 45.54%, respectively. Kisumu enrolled the highest number 109 (35%)) of malaria cases, Kombewa 108 (35%), Malindi 32 (10%), Kisii 28 (9%), Marigat 23 (7%), and Kericho 12 (4%). Blood group O+ was the most prevalent among the enrolled individuals (46.50%), A+ (27.71%), B+ (21.02%) and AB+ (4.78%) respectively. Compared to blood group O+, blood group B+ individuals were (14%) were more likely to habour Plasmodium falciparum infection as opposed to A+ and AB+ individuals, that were 7% and 20%, respectively,. Those living in malaria-endemic zones presented with higher parasite densities compared to those living in malaria-epidemic (p = 0.0061). Individuals bearing B + blood group are more likely to habour high parasitaemia compared to O + blood group bearers (OR = 4.47, CI = 1.53–13.05, p = 0.006). Conclusion Individuals of blood group B harbour high parasitaemia compared with the blood group O, Additionally, blood group A and B present with symptoms at lower parasitaemia than blood group O. Regardles of malaria transmission zones, individuals from endemic zones showed up with high parasitaemia and among them were more individuals of blood groups A and B than individuals of blood group O. Implying that these individuals were more at risk and require additional attention and effective case management. Garphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04251-1.
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Affiliation(s)
- Redemptah Yeda
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
| | - Charles Okudo
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Eunice Owiti
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Gladys Biwot
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Cliff Momanyi
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Winnie Korir
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Thoya Mitsanze
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Caroline Tegerei
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Dennis Juma
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Benjamin Opot
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Edwin Mwakio
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Gladys Chemwor
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Raphael Okoth
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Douglas O Ochora
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.,Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, P.O. Box 7062, Kampala, Uganda
| | - Agnes C Cheruiyot
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Amanda Roth
- Walter Reed Army Institute of Research, Silver Spring, USA
| | - Hoseah M Akala
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Ben Andagalu
- Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
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15
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Akampurira D, Akala HM, Derese S, Heydenreich M, Yenesew A. A new C-C linked benzophenathridine-2-quinoline dimer, and the antiplasmodial activity of alkaloids from Zanthoxylum holstzianum. Nat Prod Res 2022:1-11. [PMID: 35139708 DOI: 10.1080/14786419.2022.2034810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The CH2Cl2/MeOH (1:1) extract of Zanthoxylum holstzianum stem bark showed good antiplasmodial activity (IC50 2.5 ± 0.3 and 2.6 ± 0.3 µg/mL against the W2 and D6 strains of Plasmodium falciparum, respectively). From the extract five benzophenanthridine alkaloids [8-acetonyldihydrochelerythrine (1), nitidine (2), dihydrochelerythine (3), norchelerythrine (5), arnottianamide (8)]; a 2-quinolone alkaloid [N-methylflindersine (4)]; a lignan [4,4'-dihydroxy-3,3'-dimethoxylignan-9,9'-diyl diacetate (7)] and a dimer of a benzophenanthridine and 2-quinoline [holstzianoquinoline (6)] were isolated. The CH2Cl2/MeOH (1:1) extract of the root bark afforded 1, 3-6, 8, chelerythridimerine (9) and 9-demethyloxychelerythrine (10). Holstzianoquinoline (6) is new, and is the second dimer linked by a C-C bond of a benzophenanthridine and a 2-quinoline reported thus far. The compounds were identified based on spectroscopic evidence. Amongst five compounds (1-5) tested against two strains of P. falciparum, nitidine (IC50 0.11 ± 0.01 µg/mL against W2 and D6 strains) and norchelerythrine (IC50 value of 0.15 ± 0.01 µg/mL against D6 strain) were the most active.
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Affiliation(s)
- Denis Akampurira
- Department of Chemistry, University of Nairobi, Nairobi, Kenya.,Department of Chemistry, Kyambogo University, Kyambogo, Kampala, Uganda
| | - Hoseah M Akala
- Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRD-A/K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya
| | - Solomon Derese
- Department of Chemistry, University of Nairobi, Nairobi, Kenya
| | | | - Abiy Yenesew
- Department of Chemistry, University of Nairobi, Nairobi, Kenya
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16
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Ochora DO, Kakudidi EK, Namukobe J, Ipulet P, Wakoli DM, Okore W, Mwakio EW, Yeda RA, Cheruiyot AC, Juma DW, Andagalu B, Roth AL, Ogutu BR, Yenesew A, Akala HM. Synergism in Antiplasmodial Activities of Artemether and Lumefantrine in Combination with Securidaca longipedunculata Fresen (Polygalaceae). Plants (Basel) 2021; 11:47. [PMID: 35009051 PMCID: PMC8747340 DOI: 10.3390/plants11010047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 11/16/2022]
Abstract
Malaria is the most lethal parasitic disease in the world. The frequent emergence of resistance by malaria parasites to any drug is the hallmark of sustained malaria burden. Since the deployment of artemisinin-based combination therapies (ACTs) it is clear that for a sustained fight against malaria, drug combination is one of the strategies toward malaria elimination. In Sub-Saharan Africa where malaria prevalence is the highest, the identification of plants with a novel mechanism of action that is devoid of cross-resistance is a feasible strategy in drug combination therapy. Thus, artemether and lumefantrine were separately combined and tested with extracts of Securidaca longipedunculata, a plant widely used to treat malaria, at fixed extract-drug ratios of 4:1, 3:1, 1:1, 1:2, 1:3, and 1:4. These combinations were tested for antiplasmodial activity against three strains of Plasmodium falciparum (W2, D6, and DD2), and seven field isolates that were characterized for molecular and ex vivo drug resistance profiles. The mean sum of fifty-percent fractional inhibition concentration (FIC50) of each combination and singly was determined. Synergism was observed across all fixed doses when roots extracts were combined with artemether against D6 strain (FIC50 0.403 ± 0.068) and stems extract combined with lumefantrine against DD2 strain (FIC50 0.376 ± 0.096) as well as field isolates (FIC50 0.656 ± 0.067). Similarly, synergism was observed in all ratios when leaves extract were combined with lumefantrine against W2 strain (FIC50 0.456 ± 0.165). Synergism was observed in most combinations indicating the potential use of S. longipedunculata in combination with artemether and lumefantrine in combating resistance.
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Affiliation(s)
- Douglas O. Ochora
- Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, Kampala P.O. Box 7062-10207, Uganda; (E.K.K.); (P.I.)
| | - Esezah K. Kakudidi
- Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, Kampala P.O. Box 7062-10207, Uganda; (E.K.K.); (P.I.)
| | - Jane Namukobe
- Department of Chemistry, College of Natural Sciences, Makerere University, Kampala P.O. Box 7062-10207, Uganda;
| | - Perpetua Ipulet
- Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, Kampala P.O. Box 7062-10207, Uganda; (E.K.K.); (P.I.)
| | - Dancan M. Wakoli
- Department of Biochemistry and Molecular Biology, Egerton University, Njoro P.O. Box 536-20115, Kenya;
- United States Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI)—Walter Reed Project, Kisumu, Kisumu P.O. Box 54-40100, Kenya;
| | - Winnie Okore
- United States Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI)—Walter Reed Project, Kisumu, Kisumu P.O. Box 54-40100, Kenya;
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno P.O. Box Private Bag-40105, Kenya; (E.W.M.); (R.A.Y.); (A.C.C.); (D.W.J.); (B.A.); (A.L.R.)
| | - Edwin W. Mwakio
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno P.O. Box Private Bag-40105, Kenya; (E.W.M.); (R.A.Y.); (A.C.C.); (D.W.J.); (B.A.); (A.L.R.)
| | - Redempthah A. Yeda
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno P.O. Box Private Bag-40105, Kenya; (E.W.M.); (R.A.Y.); (A.C.C.); (D.W.J.); (B.A.); (A.L.R.)
| | - Agnes C. Cheruiyot
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno P.O. Box Private Bag-40105, Kenya; (E.W.M.); (R.A.Y.); (A.C.C.); (D.W.J.); (B.A.); (A.L.R.)
| | - Dennis W. Juma
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno P.O. Box Private Bag-40105, Kenya; (E.W.M.); (R.A.Y.); (A.C.C.); (D.W.J.); (B.A.); (A.L.R.)
| | - Ben Andagalu
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno P.O. Box Private Bag-40105, Kenya; (E.W.M.); (R.A.Y.); (A.C.C.); (D.W.J.); (B.A.); (A.L.R.)
| | - Amanda L. Roth
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno P.O. Box Private Bag-40105, Kenya; (E.W.M.); (R.A.Y.); (A.C.C.); (D.W.J.); (B.A.); (A.L.R.)
| | - Bernhards R. Ogutu
- Centre for Clinical Research, Kenya Medical Research Institute (KEMRI), Kisumu P.O. Box 1578-40100, Kenya;
| | - Abiy Yenesew
- Department of Chemistry, University of Nairobi, Nairobi P.O. Box 30197-00100, Kenya;
| | - Hoseah M. Akala
- Department of Biomedical Sciences and Technology, School of Public Health and Community Development, Maseno University, Maseno P.O. Box Private Bag-40105, Kenya; (E.W.M.); (R.A.Y.); (A.C.C.); (D.W.J.); (B.A.); (A.L.R.)
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17
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Kamau E, Yates A, Maisiba R, Singoei V, Opot B, Adeny R, Arima CO, Otieno V, Sumbi CS, Okoth RO, Abdi F, Mwalo M, Ochola J, Otieno J, Ake J, Imbach M, Turley HA, Juma D, Akala HM, Owuoth J, Andagalu B, Crowell TA, Nwoga C, Cowden J, Polyak CS. Epidemiological and clinical implications of asymptomatic malaria and schistosomiasis co-infections in a rural community in western Kenya. BMC Infect Dis 2021; 21:937. [PMID: 34503469 PMCID: PMC8431856 DOI: 10.1186/s12879-021-06626-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria and schistosomiasis present considerable disease burden in tropical and sub-tropical areas and severity is worsened by co-infections in areas where both diseases are endemic. Although pathogenesis of these infections separately is well studied, there is limited information on the pathogenic disease mechanisms and clinical disease outcomes in co-infections. In this study, we investigated the prevalence of malaria and schistosomiasis co-infections, and the hematologic and blood chemistry abnormalities in asymptomatic adults in a rural fishing community in western Kenya. METHODS This sub-study used samples and data collected at enrollment from a prospective observational cohort study (RV393) conducted in Kisumu County, Kenya. The presence of malaria parasites was determined using microscopy and real-time-PCR, and schistosomiasis infection by urine antigen analysis (CCA). Hematological analysis and blood chemistries were performed using standard methods. Statistical analyses were performed to compare demographic and infection data distribution, and hematologic and blood chemistry parameters based on different groups of infection categories. Clinically relevant hematologic conditions were analyzed using general linear and multivariable Poisson regression models. RESULTS From February 2017 to May 2018, we enrolled 671 participants. The prevalence of asymptomatic Plasmodium falciparum was 28.2% (157/556) and schistosomiasis 41.2% (229/562), with 18.0% (100/556) of participants co-infected. When we analyzed hematological parameters using Wilcoxon rank sum test to evaluate median (IQR) distribution based on malarial parasites and/or schistosomiasis infection status, there were significant differences in platelet counts (p = 0.0002), percent neutrophils, monocytes, eosinophils, and basophils (p < 0.0001 each). Amongst clinically relevant hematological abnormalities, eosinophilia was the most prevalent at 20.6% (116/562), whereas thrombocytopenia was the least prevalent at 4.3% (24/562). In univariate model, Chi-Square test performed for independence between participant distribution in different malaria parasitemia/schistosomiasis infection categories within each clinical hematological condition revealed significant differences for thrombocytopenia and eosinophilia (p = 0.006 and p < 0.0001, respectively), which was confirmed in multivariable models. Analysis of the pairwise mean differences of liver enzyme (ALT) and kidney function (Creatinine Clearance) indicated the presence of significant differences in ALT across the infection groups (parasite + /CCA + vs all other groups p < .003), but no differences in mean Creatinine Clearance across the infection groups. CONCLUSIONS Our study demonstrates the high burden of asymptomatic malaria parasitemia and schistosomiasis infection in this rural population in Western Kenya. Asymptomatic infection with malaria or schistosomiasis was associated with laboratory abnormalities including neutropenia, leukopenia and thrombocytopenia. These abnormalities could be erroneously attributed to other diseases processes during evaluation of diseases processes. Therefore, evaluating for co-infections is key when assessing individuals with laboratory abnormalities. Additionally, asymptomatic infection needs to be considered in control and elimination programs given high prevalence documented here.
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Affiliation(s)
- Edwin Kamau
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Adam Yates
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Suite 400, Bethesda, MD, 20817, USA
| | - Risper Maisiba
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Valentine Singoei
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,HJF Medical Research International, Kisumu, Kenya
| | - Benjamin Opot
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Rose Adeny
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Cornel O Arima
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Victor Otieno
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Catherine S Sumbi
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Raphael O Okoth
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Farid Abdi
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Maurine Mwalo
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Jew Ochola
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,HJF Medical Research International, Kisumu, Kenya
| | - June Otieno
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Julie Ake
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Michelle Imbach
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Suite 400, Bethesda, MD, 20817, USA
| | - Hannah A Turley
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Suite 400, Bethesda, MD, 20817, USA
| | - Dennis Juma
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Hoseah M Akala
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - John Owuoth
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,HJF Medical Research International, Kisumu, Kenya
| | - Ben Andagalu
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya.,Kenya Medical Research Institute, Kisumu, Kenya
| | - Trevor A Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Suite 400, Bethesda, MD, 20817, USA
| | - Chiaka Nwoga
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Suite 400, Bethesda, MD, 20817, USA
| | - Jessica Cowden
- United States Army Medical Research Directorate-Africa, Nairobi, Kenya
| | - Christina S Polyak
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA. .,Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Suite 400, Bethesda, MD, 20817, USA.
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18
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Ochora DO, Kakudidi E, Namukobe J, Heydenreich M, Coghi P, Yang LJ, Mwakio EW, Andagalu B, Roth A, Akala HM, Wong VKW, Yenesew A. A new benzophenone, and the antiplasmodial activities of the constituents of Securidaca longipedunculata fresen (Polygalaceae). Nat Prod Res 2021; 36:2758-2766. [PMID: 34000936 DOI: 10.1080/14786419.2021.1925272] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Extracts from Securidaca longipedunculata showed antiplasmodial activities against reference clones and clinical isolates using SYBR Green I method. A new benzophenone, 2,3,4,5-tetramethoxybenzophenone (1) was isolated and characterized along with seven known compounds: 4-hydroxy-2,3-dimethoxybenzophenone (2); 3-hydroxy-5-methoxybiphenyl (3), methyl-2-hydroxy-6-methoxybenzoate (4), benzyl-2-hydroxy-6-methoxybenzoate (5), 2-hydroxy-6-methoxybenzoic acid (6), 2,4,5-trimethoxybenzophenone (7) and 2-methoxy-3,4-methylenedioxybenzophenone (8). Compounds 1 and 2 showed ex vivo antiplasmodial activities (IC50 28.8 μM and 18.6 μM, respectively); while 5 and 8 showed in vivo activities (IC50 19.7 μM and 14.5 μM, respectively) against D6 strain. In a cytotoxicity assay, all the extracts (with an exception of the MeOH extract of the leaves) and pure compounds were not toxic to the normal LO2 and BEAS cell-lines, while the methanol roots extract (IC50 66.4 µg/mL against A549, and 77.4 µg/mL against HepG2), compounds 6 (IC50 22.2 µM against A549) and 7 (IC50 45.2 µM against HepG2) were weakly active against cancerous cell-lines.
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Affiliation(s)
- Douglas O Ochora
- Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, Kampala, Uganda
| | - Esezah Kakudidi
- Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, Kampala, Uganda
| | - Jane Namukobe
- Department of Chemistry, College of Natural Sciences, Makerere University, Kampala, Uganda
| | | | - Paolo Coghi
- School of Pharmacy, Macau University of Science and Technology, Macau, China
| | - Li Jun Yang
- Dr. Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Edwin W Mwakio
- United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Ben Andagalu
- United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Amanda Roth
- United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Hoseah M Akala
- United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Vincent K W Wong
- Dr. Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Abiy Yenesew
- Department of Chemistry, University of Nairobi, Nairobi, Kenya
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19
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Gupta Y, Goicoechea S, Pearce CM, Mathur R, Romero JG, Kwofie SK, Weyenberg MC, Daravath B, Sharma N, Poonam, Akala HM, Kanzok SM, Durvasula R, Rathi B, Kempaiah P. The emerging paradigm of calcium homeostasis as a new therapeutic target for protozoan parasites. Med Res Rev 2021; 42:56-82. [PMID: 33851452 DOI: 10.1002/med.21804] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/10/2020] [Accepted: 03/31/2021] [Indexed: 12/13/2022]
Abstract
Calcium channels (CCs), a group of ubiquitously expressed membrane proteins, are involved in many pathophysiological processes of protozoan parasites. Our understanding of CCs in cell signaling, organelle function, cellular homeostasis, and cell cycle control has led to improved insights into their structure and functions. In this article, we discuss CCs characteristics of five major protozoan parasites Plasmodium, Leishmania, Toxoplasma, Trypanosoma, and Cryptosporidium. We provide a comprehensive review of current antiparasitic drugs and the potential of using CCs as new therapeutic targets. Interestingly, previous studies have demonstrated that human CC modulators can kill or sensitize parasites to antiparasitic drugs. Still, none of the parasite CCs, pumps, or transporters has been validated as drug targets. Information for this review draws from extensive data mining of genome sequences, chemical library screenings, and drug design studies. Parasitic resistance to currently approved therapeutics is a serious and emerging threat to both disease control and management efforts. In this article, we suggest that the disruption of calcium homeostasis may be an effective approach to develop new anti-parasite drug candidates and reduce parasite resistance.
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Affiliation(s)
- Yash Gupta
- Infectious Diseases, Mayo Clinic, Jacksonville, Florida, 32224, USA
| | - Steven Goicoechea
- Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois, USA
| | - Catherine M Pearce
- Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois, USA
| | - Raman Mathur
- Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois, USA
| | - Jesus G Romero
- Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois, USA
| | - Samuel K Kwofie
- Department of Biomedical Engineering, School of Engineering Sciences, College of Basic & Applied Sciences, West African Center for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, College of Basic & Applied Sciences, University of Ghana, Accra, Ghana
| | - Matthew C Weyenberg
- Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois, USA
| | - Bharathi Daravath
- Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois, USA
| | - Neha Sharma
- Department of Chemistry, Hansraj College University Enclave, University of Delhi, Delhi, India
| | - Poonam
- Department of Chemistry, Miranda House University Enclave, University of Delhi, Delhi, India
| | | | - Stefan M Kanzok
- Department of Biology, Loyola University Chicago, Chicago, Illinois, USA
| | - Ravi Durvasula
- Infectious Diseases, Mayo Clinic, Jacksonville, Florida, 32224, USA
| | - Brijesh Rathi
- Department of Chemistry, Hansraj College University Enclave, University of Delhi, Delhi, India
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20
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Akala HM, Watson OJ, Mitei KK, Juma DW, Verity R, Ingasia LA, Opot BH, Okoth RO, Chemwor GC, Juma JA, Mwakio EW, Brazeau N, Cheruiyot AC, Yeda RA, Maraka MN, Okello CO, Kateete DP, Managbanag JR, Andagalu B, Ogutu BR, Kamau E. Plasmodium interspecies interactions during a period of increasing prevalence of Plasmodium ovale in symptomatic individuals seeking treatment: an observational study. The Lancet Microbe 2021; 2:e141-e150. [DOI: 10.1016/s2666-5247(21)00009-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 12/07/2020] [Accepted: 01/15/2021] [Indexed: 11/28/2022]
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21
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Chepkirui C, Ochieng PJ, Sarkar B, Hussain A, Pal C, Yang LJ, Coghi P, Akala HM, Derese S, Ndakala A, Heydenreich M, Wong VKW, Erdélyi M, Yenesew A. Antiplasmodial and antileishmanial flavonoids from Mundulea sericea. Fitoterapia 2020; 149:104796. [PMID: 33271256 DOI: 10.1016/j.fitote.2020.104796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 10/18/2020] [Accepted: 11/24/2020] [Indexed: 11/18/2022]
Abstract
Five known compounds (1-5) were isolated from the extract of Mundulea sericea leaves. Similar investigation of the roots of this plant afforded an additional three known compounds (6-8). The structures were elucidated using NMR spectroscopic and mass spectrometric analyses. The absolute configuration of 1 was established using ECD spectroscopy. In an antiplasmodial activity assay, compound 1 showed good activity with an IC50 of 2.0 μM against chloroquine-resistant W2, and 6.6 μM against the chloroquine-sensitive 3D7 strains of Plasmodium falciparum. Some of the compounds were also tested for antileishmanial activity. Dehydrolupinifolinol (2) and sericetin (5) were active against drug-sensitive Leishmania donovani (MHOM/IN/83/AG83) with IC50 values of 9.0 and 5.0 μM, respectively. In a cytotoxicity assay, lupinifolin (3) showed significant activity on BEAS-2B (IC50 4.9 μM) and HePG2 (IC50 10.8 μM) human cell lines. All the other compounds showed low cytotoxicity (IC50 > 30 μM) against human lung adenocarcinoma cells (A549), human liver cancer cells (HepG2), lung/bronchus cells (epithelial virus transformed) (BEAS-2B) and immortal human hepatocytes (LO2).
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Affiliation(s)
- Carolyne Chepkirui
- Department of Chemistry, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya
| | - Purity J Ochieng
- Department of Chemistry, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya
| | - Biswajyoti Sarkar
- Department of Zoology, West Bengal State University, Barasat, North 24 Parganas, West Bengal, India
| | - Aabid Hussain
- Department of Zoology, West Bengal State University, Barasat, North 24 Parganas, West Bengal, India
| | - Chiranjib Pal
- Department of Zoology, West Bengal State University, Barasat, North 24 Parganas, West Bengal, India
| | - Li Jun Yang
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Paolo Coghi
- School of Pharmacy, Macau University of science and technology, Macau, China
| | - Hoseah M Akala
- Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu, Nairobi, Kenya
| | - Solomon Derese
- Department of Chemistry, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya
| | - Albert Ndakala
- Department of Chemistry, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya
| | - Matthias Heydenreich
- Institut für Chemie, Universität Potsdam, Karl-Liebknecht-Str. 24-25, D-14476, Potsdam, Germany
| | - Vincent K W Wong
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Máté Erdélyi
- Department of Chemistry - BMC, Uppsala University, SE-752 37 Uppsala, Sweden.
| | - Abiy Yenesew
- Department of Chemistry, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya.
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22
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Wanjala CNL, Bergmann-Leitner E, Akala HM, Odhiambo G, Ogutu BR, Andagalu B, Kamau E, Ochiel D. The role of complement immune response on artemisinin-based combination therapy in a population from malaria endemic region of Western Kenya. Malar J 2020; 19:168. [PMID: 32349765 PMCID: PMC7191791 DOI: 10.1186/s12936-020-03242-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/18/2020] [Indexed: 02/05/2023] Open
Abstract
Background Naturally acquired immunity (NAI), which is characterized by protection against overt clinical disease and high parasitaemia, is acquired with age and transmission intensity. The role of NAI on the efficacy of anti-malarial drugs, including artemisinin-based combinations used as the first-line treatment for uncomplicated Plasmodium falciparum, has not been fully demonstrated. This study investigated the role of NAI in response to artemisinin-based combination therapy (ACT), in symptomatic patients living in western Kenya, a high malaria transmission area. Methods Sera samples from malaria immune participants (n = 105) in a therapeutic efficacy study were assessed for in vitro growth inhibitory activity against the 3D7 strain of P. falciparum using a fluorescent-based growth inhibition assay (GIA). Participants’ age and parasite clearance parameters were used in the analysis. Pooled sera from malaria naïve participants (n = 6) with no Plasmodium infection from malaria non-endemic regions of Kenya was used as negative control. Results The key observations of the study were as follows: (1) Sera with intact complement displayed higher GIA activity at lower (1%) serum dilutions (p < 0.0001); (2) there was significant relationship between GIA activity, parasite clearance rate (p = 0.05) and slope half-life (p = 0.025); and (3) age was a confounding factor when comparing the GIA activity with parasite clearance kinetics. Conclusion This study demonstrates for the first time there is synergy of complement, pre-existing immunity, and drug treatment in younger patients with symptomatic malaria in a high-transmission area.
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Affiliation(s)
- Christine N L Wanjala
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project (WRP), Kisumu, Kenya.,School of Physical and Biological Sciences Zoology Department, Maseno University, Maseno, Kenya
| | - Elke Bergmann-Leitner
- Malaria Biologics Branch, Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Hoseah M Akala
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project (WRP), Kisumu, Kenya
| | - Geoffrey Odhiambo
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project (WRP), Kisumu, Kenya.,School of Physical and Biological Sciences Zoology Department, Maseno University, Maseno, Kenya
| | - Bernhards R Ogutu
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project (WRP), Kisumu, Kenya.,KEMRI, Nairobi, Kenya
| | - Ben Andagalu
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project (WRP), Kisumu, Kenya
| | - Edwin Kamau
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project (WRP), Kisumu, Kenya. .,U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA.
| | - Daniel Ochiel
- Department of Emerging and Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)/Walter Reed Project (WRP), Kisumu, Kenya.,School of Physical and Biological Sciences Zoology Department, Maseno University, Maseno, Kenya
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23
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Maraka M, Akala HM, Amolo AS, Juma D, Omariba D, Cheruiyot A, Opot B, Okello Okudo C, Mwakio E, Chemwor G, Juma JA, Okoth R, Yeda R, Andagalu B. A seven-year surveillance of epidemiology of malaria reveals travel and gender are the key drivers of dispersion of drug resistant genotypes in Kenya. PeerJ 2020; 8:e8082. [PMID: 32201636 PMCID: PMC7073242 DOI: 10.7717/peerj.8082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/21/2019] [Indexed: 11/20/2022] Open
Abstract
Malaria drug resistance is a global public health concern. Though parasite mutations have been associated with resistance, other factors could influence the resistance. A robust surveillance system is required to monitor and help contain the resistance. This study established the role of travel and gender in dispersion of chloroquine resistant genotypes in malaria epidemic zones in Kenya. A total of 1,776 individuals presenting with uncomplicated malaria at hospitals selected from four malaria transmission zones in Kenya between 2008 and 2014 were enrolled in a prospective surveillance study assessing the epidemiology of malaria drug resistance patterns. Demographic and clinical information per individual was obtained using a structured questionnaire. Further, 2 mL of blood was collected for malaria diagnosis, parasitemia quantification and molecular analysis. DNA extracted from dried blood spots collected from each of the individuals was genotyped for polymorphisms in Plasmodium falciparum chloroquine transporter gene (Pfcrt 76), Plasmodium falciparum multidrug resistant gene 1 (Pfmdr1 86 and Pfmdr1 184) regions that are putative drug resistance genes using both conventional polymerase chain reaction (PCR) and real-time PCR. The molecular and demographic data was analyzed using Stata version 13 (College Station, TX: StataCorp LP) while mapping of cases at the selected geographic zones was done in QGIS version 2.18. Chloroquine resistant (CQR) genotypes across gender revealed an association with chloroquine resistance by both univariate model (p = 0.027) and by multivariate model (p = 0.025), female as reference group in both models. Prior treatment with antimalarial drugs within the last 6 weeks before enrollment was associated with carriage of CQR genotype by multivariate model (p = 0.034). Further, a significant relationship was observed between travel and CQR carriage both by univariate model (p = 0.001) and multivariate model (p = 0.002). These findings suggest that gender and travel are significantly associated with chloroquine resistance. From a gender perspective, males are more likely to harbor resistant strains than females hence involved in strain dispersion. On the other hand, travel underscores the role of transport network in introducing spread of resistant genotypes, bringing in to focus the need to monitor gene flow and establish strategies to minimize the introduction of resistance strains by controlling malaria among frequent transporters.
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Affiliation(s)
- Moureen Maraka
- School of Health Sciences, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Siaya, Kenya
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa Kenya (USAMRD-A Kenya)/Kenya Medical Research Institute (KEMRI), Kisumu, Kisumu, Kenya
| | - Hoseah M. Akala
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa Kenya (USAMRD-A Kenya)/Kenya Medical Research Institute (KEMRI), Kisumu, Kisumu, Kenya
| | - Asito S. Amolo
- School of Health Sciences, Jaramogi Oginga Odinga University of Science and Technology, Bondo, Siaya, Kenya
| | - Dennis Juma
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa Kenya (USAMRD-A Kenya)/Kenya Medical Research Institute (KEMRI), Kisumu, Kisumu, Kenya
| | - Duke Omariba
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa Kenya (USAMRD-A Kenya)/Kenya Medical Research Institute (KEMRI), Kisumu, Kisumu, Kenya
| | - Agnes Cheruiyot
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa Kenya (USAMRD-A Kenya)/Kenya Medical Research Institute (KEMRI), Kisumu, Kisumu, Kenya
| | - Benjamin Opot
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa Kenya (USAMRD-A Kenya)/Kenya Medical Research Institute (KEMRI), Kisumu, Kisumu, Kenya
| | - Charles Okello Okudo
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa Kenya (USAMRD-A Kenya)/Kenya Medical Research Institute (KEMRI), Kisumu, Kisumu, Kenya
| | - Edwin Mwakio
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa Kenya (USAMRD-A Kenya)/Kenya Medical Research Institute (KEMRI), Kisumu, Kisumu, Kenya
| | - Gladys Chemwor
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa Kenya (USAMRD-A Kenya)/Kenya Medical Research Institute (KEMRI), Kisumu, Kisumu, Kenya
| | - Jackline A. Juma
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa Kenya (USAMRD-A Kenya)/Kenya Medical Research Institute (KEMRI), Kisumu, Kisumu, Kenya
| | - Raphael Okoth
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa Kenya (USAMRD-A Kenya)/Kenya Medical Research Institute (KEMRI), Kisumu, Kisumu, Kenya
| | - Redemptah Yeda
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa Kenya (USAMRD-A Kenya)/Kenya Medical Research Institute (KEMRI), Kisumu, Kisumu, Kenya
| | - Ben Andagalu
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Africa Kenya (USAMRD-A Kenya)/Kenya Medical Research Institute (KEMRI), Kisumu, Kisumu, Kenya
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Muiruri P, Juma DW, Ingasia LA, Chebon LJ, Opot B, Ngalah BS, Cheruiyot J, Andagalu B, Akala HM, Nyambati VCS, Ng'ang'a JK, Kamau E. Selective sweeps and genetic lineages of Plasmodium falciparum multi-drug resistance (pfmdr1) gene in Kenya. Malar J 2018; 17:398. [PMID: 30376843 PMCID: PMC6208105 DOI: 10.1186/s12936-018-2534-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 10/20/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND There are concerns that resistance to artemisinin-based combination therapy might emerge in Kenya and sub-Saharan Africa (SSA) in the same pattern as was with chloroquine and sulfadoxine-pyrimethamine. Single nucleotide polymorphisms (SNPs) in critical alleles of pfmdr1 gene have been associated with resistance to artemisinin and its partner drugs. Microsatellite analysis of loci flanking genes associated with anti-malarial drug resistance has been used in defining the geographic origins, dissemination of resistant parasites and identifying regions in the genome that have been under selection. METHODS This study set out to investigate evidence of selective sweep and genetic lineages in pfmdr1 genotypes associated with the use of artemether-lumefantrine (AL), as the first-line treatment in Kenya. Parasites (n = 252) from different regions in Kenya were assayed for SNPs at codons 86, 184 and 1246 and typed for 7 neutral microsatellites and 13 microsatellites loci flanking (± 99 kb) pfmdr1 in Plasmodium falciparum infections. RESULTS The data showed differential site and region specific prevalence of SNPs associated with drug resistance in the pfmdr1 gene. The prevalence of pfmdr1 N86, 184F, and D1246 in western Kenya (Kisumu, Kericho and Kisii) compared to the coast of Kenya (Malindi) was 92.9% vs. 66.7%, 53.5% vs. to 24.2% and 96% vs. to 87.9%, respectively. The NFD haplotype which is consistent with AL selection was at 51% in western Kenya compared to 25% in coastal Kenya. CONCLUSION Selection pressures were observed to be different in different regions of Kenya, especially the western region compared to the coastal region. The data showed independent genetic lineages for all the pfmdr1 alleles. The evidence of soft sweeps in pfmdr1 observed varied in direction from one region to another. This is challenging for malaria control programs in SSA which clearly indicate effective malaria control policies should be based on the region and not at a country wide level.
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Affiliation(s)
- Peninah Muiruri
- Global Emerging Infections Surveillance Program, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute, P.O. Box 54, 40100, Kisumu, Kenya
- Department of Biochemistry, School of Biomedical Sciences, Jomo Kenyatta University of Agriculture and Technology, P.O. Box 62000, 00200, Nairobi, Kenya
| | - Denis W Juma
- Global Emerging Infections Surveillance Program, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute, P.O. Box 54, 40100, Kisumu, Kenya
| | - Luicer A Ingasia
- Global Emerging Infections Surveillance Program, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute, P.O. Box 54, 40100, Kisumu, Kenya
| | - Lorna J Chebon
- Global Emerging Infections Surveillance Program, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute, P.O. Box 54, 40100, Kisumu, Kenya
| | - Benjamin Opot
- Global Emerging Infections Surveillance Program, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute, P.O. Box 54, 40100, Kisumu, Kenya
| | - Bidii S Ngalah
- Global Emerging Infections Surveillance Program, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute, P.O. Box 54, 40100, Kisumu, Kenya
| | - Jelagat Cheruiyot
- Global Emerging Infections Surveillance Program, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute, P.O. Box 54, 40100, Kisumu, Kenya
| | - Ben Andagalu
- Global Emerging Infections Surveillance Program, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute, P.O. Box 54, 40100, Kisumu, Kenya
| | - Hoseah M Akala
- Global Emerging Infections Surveillance Program, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute, P.O. Box 54, 40100, Kisumu, Kenya
| | - Venny C S Nyambati
- Department of Biochemistry, School of Biomedical Sciences, Jomo Kenyatta University of Agriculture and Technology, P.O. Box 62000, 00200, Nairobi, Kenya
| | - Joseph K Ng'ang'a
- Department of Biochemistry, School of Biomedical Sciences, Jomo Kenyatta University of Agriculture and Technology, P.O. Box 62000, 00200, Nairobi, Kenya
| | - Edwin Kamau
- Global Emerging Infections Surveillance Program, United States Army Medical Research Directorate-Africa, Kenya Medical Research Institute, P.O. Box 54, 40100, Kisumu, Kenya.
- Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
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de Laurent ZR, Chebon LJ, Ingasia LA, Akala HM, Andagalu B, Ochola-Oyier LI, Kamau E. Polymorphisms in the K13 Gene in Plasmodium falciparum from Different Malaria Transmission Areas of Kenya. Am J Trop Med Hyg 2018; 98:1360-1366. [PMID: 29582728 DOI: 10.4269/ajtmh.17-0505] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The development of artemisinin (ART)-resistant parasites in Southeast Asia (SEA) threatens malaria control globally. Mutations in the Kelch 13 (K13)-propeller domain have been useful in identifying ART resistance in SEA. ART combination therapy (ACT) remains highly efficacious in the treatment of uncomplicated malaria in Sub-Saharan Africa (SSA). However, it is crucial that the efficacy of ACT is closely monitored. Toward this effort, this study profiled the prevalence of K13 nonsynonymous mutations in different malaria ecological zones of Kenya and in different time periods, before (pre) and after (post) the introduction of ACT as the first-line treatment of malaria. Nineteen nonsynonymous mutations were present in the pre-ACT samples (N = 64) compared with 22 in the post-ACT samples (N = 251). Eight of these mutations were present in both pre- and post-ACT parasites. Interestingly, seven of the shared single-nucleotide polymorphisms were at higher frequencies in the pre-ACT than the post-ACT parasites. The A578S mutation reported in SSA and the V568G mutation reported in SEA were found in both pre- and post-ACT parasites, with their frequencies declining post-ACT. D584Y and R539K mutations were found only in post-ACT parasites; changes in these codons have also been reported in SEA with different amino acids. The N585K mutation described for the first time in this study was present only in post-ACT parasites, and it was the most prevalent mutation at a frequency of 5.2%. This study showed the type, prevalence, and frequency of K13 mutations that varied based on the malaria ecological zones and also between the pre- and post-ACT time periods.
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Affiliation(s)
- Zaydah R de Laurent
- Center for Biotechnology and Bioinformatics, University of Nairobi, Nairobi, Kenya.,Kenya Medical Research Institute/United States Army Medical Research Directorate-Kenya, Kisumu, Kenya
| | - Lorna J Chebon
- Kenya Medical Research Institute/United States Army Medical Research Directorate-Kenya, Kisumu, Kenya
| | - Luicer A Ingasia
- Kenya Medical Research Institute/United States Army Medical Research Directorate-Kenya, Kisumu, Kenya
| | - Hoseah M Akala
- Kenya Medical Research Institute/United States Army Medical Research Directorate-Kenya, Kisumu, Kenya
| | - Ben Andagalu
- Kenya Medical Research Institute/United States Army Medical Research Directorate-Kenya, Kisumu, Kenya
| | - Lynette Isabella Ochola-Oyier
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.,Center for Biotechnology and Bioinformatics, University of Nairobi, Nairobi, Kenya
| | - Edwin Kamau
- Kenya Medical Research Institute/United States Army Medical Research Directorate-Kenya, Kisumu, Kenya.,Walter Reed National Military Medical Center (WRNMMC), Bethesda, Maryland
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Mogire RM, Akala HM, Macharia RW, Juma DW, Cheruiyot AC, Andagalu B, Brown ML, El-Shemy HA, Nyanjom SG. Target-similarity search using Plasmodium falciparum proteome identifies approved drugs with anti-malarial activity and their possible targets. PLoS One 2017; 12:e0186364. [PMID: 29088219 PMCID: PMC5663372 DOI: 10.1371/journal.pone.0186364] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 10/01/2017] [Indexed: 11/23/2022] Open
Abstract
Malaria causes about half a million deaths annually, with Plasmodium falciparum being responsible for 90% of all the cases. Recent reports on artemisinin resistance in Southeast Asia warrant urgent discovery of novel drugs for the treatment of malaria. However, most bioactive compounds fail to progress to treatments due to safety concerns. Drug repositioning offers an alternative strategy where drugs that have already been approved as safe for other diseases could be used to treat malaria. This study screened approved drugs for antimalarial activity using an in silico chemogenomics approach prior to in vitro verification. All the P. falciparum proteins sequences available in NCBI RefSeq were mined and used to perform a similarity search against DrugBank, TTD and STITCH databases to identify similar putative drug targets. Druggability indices of the potential P. falciparum drug targets were obtained from TDR targets database. Functional amino acid residues of the drug targets were determined using ConSurf server which was used to fine tune the similarity search. This study predicted 133 approved drugs that could target 34 P. falciparum proteins. A literature search done at PubMed and Google Scholar showed 105 out of the 133 drugs to have been previously tested against malaria, with most showing activity. For further validation, drug susceptibility assays using SYBR Green I method were done on a representative group of 10 predicted drugs, eight of which did show activity against P. falciparum 3D7 clone. Seven had IC50 values ranging from 1 μM to 50 μM. This study also suggests drug-target association and hence possible mechanisms of action of drugs that did show antiplasmodial activity. The study results validate the use of proteome-wide target similarity approach in identifying approved drugs with activity against P. falciparum and could be adapted for other pathogens.
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Affiliation(s)
- Reagan M. Mogire
- Department of Molecular Biology and Biotechnology, Pan African University Institute of Science, Technology and Innovation, Nairobi, Kenya
| | - Hoseah M. Akala
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI)—Walter Reed Project, Kisumu, Kenya
| | - Rosaline W. Macharia
- Centre for Biotechnology and Bioinformatics, University of Nairobi, Nairobi, Kenya
| | - Dennis W. Juma
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI)—Walter Reed Project, Kisumu, Kenya
| | - Agnes C. Cheruiyot
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI)—Walter Reed Project, Kisumu, Kenya
| | - Ben Andagalu
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI)—Walter Reed Project, Kisumu, Kenya
| | - Mathew L. Brown
- Department of Emerging Infectious Diseases (DEID), United States Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI)—Walter Reed Project, Kisumu, Kenya
| | - Hany A. El-Shemy
- Department of Biochemistry, Faculty of Agriculture, Cairo University, Giza, Egypt
| | - Steven G. Nyanjom
- Department of Biochemistry, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
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Muiva-Mutisya LM, Atilaw Y, Heydenreich M, Koch A, Akala HM, Cheruiyot AC, Brown ML, Irungu B, Okalebo FA, Derese S, Mutai C, Yenesew A. Antiplasmodial prenylated flavanonols from Tephrosia subtriflora. Nat Prod Res 2017; 32:1407-1414. [PMID: 28714338 DOI: 10.1080/14786419.2017.1353510] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The CH2Cl2/MeOH (1:1) extract of the aerial parts of Tephrosia subtriflora afforded a new flavanonol, named subtriflavanonol (1), along with the known flavanone spinoflavanone B, and the known flavanonols MS-II (2) and mundulinol. The structures were elucidated by the use of NMR spectroscopy and mass spectrometry. The absolute configuration of the flavanonols was determined based on quantum chemical ECD calculations. In the antiplasmodial assay, compound 2 showed the highest activity against chloroquine-sensitive Plasmodium falciparum reference clones (D6 and 3D7), artemisinin-sensitive isolate (F32-TEM) as well as field isolate (KSM 009) with IC50 values 1.4-4.6 μM without significant cytotoxicity against Vero and HEp2 cell lines (IC50 > 100 μM). The new compound (1) showed weak antiplasmodial activity, IC50 12.5-24.2 μM, but also showed selective anticancer activity against HEp2 cell line (CC50 16.9 μM).
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Affiliation(s)
| | - Yoseph Atilaw
- a Department of Chemistry , University of Nairobi , Nairobi , Kenya
| | | | - Andreas Koch
- b Institut für Chemie , Universität Potsdam , Potsdam , Germany
| | - Hoseah M Akala
- c United States Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI)/Walter Reed Project (WRP) , Kisumu , Kenya
| | - Agnes C Cheruiyot
- c United States Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI)/Walter Reed Project (WRP) , Kisumu , Kenya
| | - Matthew L Brown
- c United States Army Medical Research Directorate-Kenya (USAMRD-K), Kenya Medical Research Institute (KEMRI)/Walter Reed Project (WRP) , Kisumu , Kenya
| | - Beatrice Irungu
- d Centre for Traditional Medicine and Drug Research , Kenya Medical Research Institute , Nairobi , Kenya
| | - Faith A Okalebo
- e Department of Pharmacology and Pharmacognosy , University of Nairobi , Nairobi , Kenya
| | - Solomon Derese
- a Department of Chemistry , University of Nairobi , Nairobi , Kenya
| | - Charles Mutai
- f Department of Medical Laboratory Sciences , Masinde Muliro University of Sciences and Technology , Kakamega , Kenya
| | - Abiy Yenesew
- a Department of Chemistry , University of Nairobi , Nairobi , Kenya
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28
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Okoth DA, Akala HM, Johnson JD, Koorbanally NA. Alkyl phenols, alkenyl cyclohexenones and other phytochemical constituents from Lannea rivae (chiov) Sacleux (Anacardiaceae) and their bioactivity. Med Chem Res 2016. [DOI: 10.1007/s00044-016-1521-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Achieng AO, Muiruri P, Ingasia LA, Opot BH, Juma DW, Yeda R, Ngalah BS, Ogutu BR, Andagalu B, Akala HM, Kamau E. Temporal trends in prevalence of Plasmodium falciparum molecular markers selected for by artemether-lumefantrine treatment in pre-ACT and post-ACT parasites in western Kenya. Int J Parasitol Drugs Drug Resist 2015; 5:92-9. [PMID: 26236581 PMCID: PMC4501530 DOI: 10.1016/j.ijpddr.2015.05.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/27/2015] [Accepted: 05/28/2015] [Indexed: 01/17/2023]
Abstract
Artemether–lumefantrine (AL) became the first-line treatment for uncomplicated malaria in Kenya in 2006. Studies have shown AL selects for SNPs in pfcrt and pfmdr1 genes in recurring parasites compared to the baseline infections. The genotypes associated with AL selection are K76 in pfcrt and N86, 184F and D1246 in pfmdr1. To assess the temporal change of these genotypes in western Kenya, 47 parasite isolates collected before (pre-ACT; 1995–2003) and 745 after (post-ACT; 2008–2014) introduction of AL were analyzed. In addition, the associations of parasite haplotype against the IC50 of artemether and lumefantrine, and clearance rates were determined. Parasite genomic DNA collected between 1995 and 2014 was analyzed by sequencing or PCR-based single-base extension on Sequenom MassARRAY. IC50s were determined for a subset of the samples. One hundred eighteen samples from 2013 to 2014 were from an efficacy trial of which 68 had clearance half-lives. Data revealed there were significant differences between pre-ACT and post-ACT genotypes at the four codons (chi-square analysis; p < 0.0001). The prevalence of pfcrt K76 and N86 increased from 6.4% in 1995–1996 to 93.2% in 2014 and 0.0% in 2002–2003 to 92.4% in 2014 respectively. Analysis of parasites carrying pure alleles of K + NFD or T + YYY haplotypes revealed that 100.0% of the pre-ACT parasites carried T + YYY and 99.3% of post-ACT parasites carried K + NFD. There was significant correlation (p = 0.04) between lumefantrine IC50 and polymorphism at pfmdr1 codon 184. There was no difference in parasite clearance half-lives based on genetic haplotype profiles. This study shows there is a significant change in parasite genotype, with key molecular determinants of AL selection almost reaching saturation. The implications of these findings are not clear since AL remains highly efficacious. However, there is need to closely monitor parasite genotypic, phenotypic and clinical dynamics in response to continued use of AL in western Kenya. The prevalence of pfcrt K76 increased from 6.4% in 1995 to 93.2% in 2014 and pfmdr1 N86 from 0% in 2002 to 92.4% in 2014. 100% of pre-ACTs parasites carried T+YYY haplotype whereas 99.3% post-ACTs parasites carried K+NFD haplotype. There is resurgence of chloroquine sensitive parasite in western Kenya. AL is still highly efficacious but there are drastic genetic changes taking place in the parasite population.
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Affiliation(s)
- Angela O Achieng
- Department of Emerging Infectious Diseases, United States Army Medical Research Unit-Kenya/Kenya Medical Research Institute, Kisumu, Kenya
| | - Peninah Muiruri
- Department of Emerging Infectious Diseases, United States Army Medical Research Unit-Kenya/Kenya Medical Research Institute, Kisumu, Kenya ; Department of Biochemistry, College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Luicer A Ingasia
- Department of Emerging Infectious Diseases, United States Army Medical Research Unit-Kenya/Kenya Medical Research Institute, Kisumu, Kenya
| | - Benjamin H Opot
- Department of Emerging Infectious Diseases, United States Army Medical Research Unit-Kenya/Kenya Medical Research Institute, Kisumu, Kenya
| | - Dennis W Juma
- Department of Emerging Infectious Diseases, United States Army Medical Research Unit-Kenya/Kenya Medical Research Institute, Kisumu, Kenya
| | - Redemptah Yeda
- Department of Emerging Infectious Diseases, United States Army Medical Research Unit-Kenya/Kenya Medical Research Institute, Kisumu, Kenya
| | - Bidii S Ngalah
- Department of Emerging Infectious Diseases, United States Army Medical Research Unit-Kenya/Kenya Medical Research Institute, Kisumu, Kenya ; Institute of Tropical Medicine and Infectious Diseases, College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Bernhards R Ogutu
- Department of Emerging Infectious Diseases, United States Army Medical Research Unit-Kenya/Kenya Medical Research Institute, Kisumu, Kenya
| | - Ben Andagalu
- Department of Emerging Infectious Diseases, United States Army Medical Research Unit-Kenya/Kenya Medical Research Institute, Kisumu, Kenya
| | - Hoseah M Akala
- Department of Emerging Infectious Diseases, United States Army Medical Research Unit-Kenya/Kenya Medical Research Institute, Kisumu, Kenya
| | - Edwin Kamau
- Department of Emerging Infectious Diseases, United States Army Medical Research Unit-Kenya/Kenya Medical Research Institute, Kisumu, Kenya
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Namukobe J, Kiremire BT, Byamukama R, Kasenene JM, Akala HM, Kamau E, Dumontet V. Antiplasmodial compounds from the stem bark of Neoboutonia macrocalyx pax. J Ethnopharmacol 2015; 162:317-322. [PMID: 25535086 DOI: 10.1016/j.jep.2014.12.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 12/05/2014] [Accepted: 12/14/2014] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The plant Neoboutonia macrocalyx has been reported in traditional medicine to be used in the treatment of malaria. AIM OF THE STUDY To study the in vitro antiplasmodial activity of compounds from the stem bark of Neoboutonia macrocalyx. MATERIALS AND METHODS Compounds were extracted and purified from stem bark of Neoboutonia macrocalyx and their structure identified and confirmed by spectroscopic methods. The crude ethyl acetate extract, aqueous extract and the isolated compounds were evaluated for antiplasmodial activity against the chloroquine sensitive Sierra Leone I (D6) and chloroquine-resistant Indochina I (W2) strains of Plasmodium falciparum. RESULTS Chemical investigation of the ethyl acetate extract of Neoboutonia macrocalyx bark resulted in the identification of one new diterpenoid; neoboutomacroin (1) in addition to the four known compounds which included, a phenanthrene; 3,6-dihyroxy-1,7-dimethyl-9-methoxyphenanthrene (2), a sterol; 3-O-Acetyloleuritolic acid (3) and two diterpenoids; simplexin (4) and montanin (5). Compounds 1 and 5 displayed good antiplasmodial activity of IC50 values less than 10 μg/mL against both strains. However, all the compounds tested displayed high cytotoxic activity against MRC5 cell line with IC50 less than 10 μM. CONCLUSIONS Despite an indirect in vitro antiplasmodial activity of some compounds isolated from the stem bark of Neoboutonia macrocalyx, the identification of these bioactive compounds indicates that they may play a role in the pharmacological properties of this plant.
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Affiliation(s)
- Jane Namukobe
- Department of Chemistry, Makerere University, PO Box 7062, Kampala, Uganda
| | - Bernard T Kiremire
- Department of Chemistry, Makerere University, PO Box 7062, Kampala, Uganda
| | - Robert Byamukama
- Department of Chemistry, Makerere University, PO Box 7062, Kampala, Uganda
| | - John M Kasenene
- Mountain of the Moon University, PO Box 837, Fortportal, Uganda
| | - Hoseah M Akala
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Edwin Kamau
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Vincent Dumontet
- Centre de Recherche de Gif, Institut de Chimie des Substances Naturelles, CNRS-Avenue de la Terresse, 91198 Gif-sur-Yvette, France.
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Akala HM, Achieng AO, Eyase FL, Juma DW, Ingasia L, Cheruiyot AC, Okello C, Omariba D, Owiti EA, Muriuki C, Yeda R, Andagalu B, Johnson JD, Kamau E. Five-year tracking of Plasmodium falciparum allele frequencies in a holoendemic area with indistinct seasonal transitions. J Multidiscip Healthc 2014; 7:515-23. [PMID: 25395861 PMCID: PMC4227620 DOI: 10.2147/jmdh.s67252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The renewed malaria eradication efforts require an understanding of the seasonal patterns of frequency of polymorphic variants in order to focus limited funds productively. Although cross-sectional studies in holoendemic areas spanning a single year could be useful in describing parasite genotype status at a given point, such information is inadequate in describing temporal trends in genotype polymorphisms. For Plasmodium falciparum isolates from Kisumu District Hospital, Plasmodium falciparum chloroquine-resistance transporter gene (Pfcrt-K76T) and P. falciparum multidrug resistance gene 1 (PfMDR1-N86Y), were analyzed for polymorphisms and parasitemia changes in the 53 months from March 2008 to August 2012. Observations were compared with prevailing climatic factors, including humidity, rainfall, and temperature. METHODS Parasitemia (the percentage of infected red blood cells per total red blood cells) was established by microscopy for P. falciparum malaria-positive samples. P. falciparum DNA was extracted from whole blood using a Qiagen DNA Blood Mini Kit. Single nucleotide polymorphism identification at positions Pfcrt-K76T and PfMDR1-N86Y was performed using real-time polymerase chain reaction and/or sequencing. Data on climatic variables were obtained from http://www.tutiempo.net/en/. RESULTS A total of 895 field isolates from 2008 (n=169), 2009 (n=161), 2010 (n=216), 2011 (n=223), and 2012 (n=126) showed large variations in monthly frequency of PfMDR1-N86Y and Pfcrt-K76T as the mutant genotypes decreased from 68.4%±15% and 38.1%±13% to 29.8%±18% and 13.3%±9%, respectively. The mean percentage of parasitemia was 2.61%±1.01% (coefficient of variation 115.86%; n=895). There was no correlation between genotype or parasitemia and climatic factors. CONCLUSION This study shows variability in the frequency of Pfcrt-K76T and PfMDR1-N86Y polymorphisms during the study period, bringing into focus the role of cross-sectional studies in describing temporal genotype trends. The lack of correlation between genotypes and climatic changes, especially precipitation, emphasizes the cost of investment in genotype change.
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Affiliation(s)
- Hoseah M Akala
- Global Emerging Infections Surveillance Program, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, Walter Reed Project, Kisumu and Nairobi, Kenya
| | - Angela O Achieng
- Global Emerging Infections Surveillance Program, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, Walter Reed Project, Kisumu and Nairobi, Kenya
| | - Fredrick L Eyase
- Global Emerging Infections Surveillance Program, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, Walter Reed Project, Kisumu and Nairobi, Kenya
| | - Dennis W Juma
- Global Emerging Infections Surveillance Program, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, Walter Reed Project, Kisumu and Nairobi, Kenya
| | - Luiser Ingasia
- Global Emerging Infections Surveillance Program, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, Walter Reed Project, Kisumu and Nairobi, Kenya
| | - Agnes C Cheruiyot
- Global Emerging Infections Surveillance Program, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, Walter Reed Project, Kisumu and Nairobi, Kenya
| | - Charles Okello
- Global Emerging Infections Surveillance Program, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, Walter Reed Project, Kisumu and Nairobi, Kenya
| | - Duke Omariba
- Global Emerging Infections Surveillance Program, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, Walter Reed Project, Kisumu and Nairobi, Kenya
| | - Eunice A Owiti
- Global Emerging Infections Surveillance Program, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, Walter Reed Project, Kisumu and Nairobi, Kenya
| | - Catherine Muriuki
- Global Emerging Infections Surveillance Program, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, Walter Reed Project, Kisumu and Nairobi, Kenya
| | - Redemptah Yeda
- Global Emerging Infections Surveillance Program, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, Walter Reed Project, Kisumu and Nairobi, Kenya
| | - Ben Andagalu
- Global Emerging Infections Surveillance Program, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, Walter Reed Project, Kisumu and Nairobi, Kenya
| | - Jacob D Johnson
- Global Emerging Infections Surveillance Program, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, Walter Reed Project, Kisumu and Nairobi, Kenya
| | - Edwin Kamau
- Global Emerging Infections Surveillance Program, United States Army Medical Research Unit-Kenya, Kenya Medical Research Institute, Walter Reed Project, Kisumu and Nairobi, Kenya
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Achieng AO, Ingasia LA, Juma DW, Cheruiyot AC, Okudo CA, Yeda RA, Cheruiyot J, Akala HM, Johnson J, Andangalu B, Eyase F, Jura WGZO, Kamau E. Reduced in vitro doxycycline susceptibility in plasmodium falciparum field isolates from Kenya is associated with PfTetQ KYNNNN sequence polymorphism. Antimicrob Agents Chemother 2014; 58:5894-9. [PMID: 25070109 PMCID: PMC4187988 DOI: 10.1128/aac.02788-13] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 07/18/2014] [Indexed: 11/20/2022] Open
Abstract
Doxycycline is widely used for malaria prophylaxis by international travelers. However, there is limited information on doxycycline efficacy in Kenya, and genetic polymorphisms associated with reduced efficacy are not well defined. In vitro doxycycline susceptibility profiles for 96 Plasmodium falciparum field isolates from Kenya were determined. Genetic polymorphisms were assessed in P. falciparum metabolite drug transporter (Pfmdt) and P. falciparum GTPase tetQ (PftetQ) genes. Copy number variation of the gene and the number of KYNNNN amino acid motif repeats within the protein encoded by PftetQ were determined. Reduced in vitro susceptibility to doxycycline was defined by 50% inhibitory concentrations (IC50s) of ≥35,000 nM. The odds ratio (OR) of having 2 PfTetQ KYNNNN amino acid repeats in isolates with IC50s of >35,000 nM relative to those with IC50s of <35,000 nM is 15 (95% confidence interval [CI], 3.0 to 74.3; P value of <0.0002). Isolates with 1 copy of the Pfmdt gene had a median IC50 of 6,971 nM, whereas those with a Pfmdt copy number of >1 had a median IC50 of 9,912 nM (P = 0.0245). Isolates with 1 copy of PftetQ had a median IC50 of 6,370 nM, whereas isolates with a PftetQ copy number of >1 had a median IC50 of 3,422 nM (P < 0.0007). Isolates with 2 PfTetQ KYNNNN motif repeats had a median IC50 of 26,165 nM, whereas isolates with 3 PfTetQ KYNNNN repeats had a median IC50 of 3,352 nM (P = 0.0023). PfTetQ sequence polymorphism is associated with a reduced doxycycline susceptibility phenotype in Kenyan isolates and is a potential marker for susceptibility testing.
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Affiliation(s)
- Angela O Achieng
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya Department of Zoology, School of Biological and Physical Sciences, Maseno University, Maseno, Kenya
| | - Luiser A Ingasia
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Dennis W Juma
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Agnes C Cheruiyot
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya Department of Zoology, School of Biological and Physical Sciences, Maseno University, Maseno, Kenya
| | - Charles A Okudo
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Redemptah A Yeda
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Jelagat Cheruiyot
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Hoseah M Akala
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Jacob Johnson
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Ben Andangalu
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Fredrick Eyase
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
| | - Walter G Z O Jura
- Department of Zoology, School of Biological and Physical Sciences, Maseno University, Maseno, Kenya
| | - Edwin Kamau
- Department of Emerging Infectious Diseases-Global Emerging Infections Surveillance and Response System (DEID-GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu, Kenya
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Endale M, Ekberg A, Alao JP, Akala HM, Ndakala A, Sunnerhagen P, Erdélyi M, Yenesew A. Anthraquinones of the roots of Pentas micrantha. Molecules 2012; 18:311-21. [PMID: 23271468 PMCID: PMC6270246 DOI: 10.3390/molecules18010311] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 12/19/2012] [Accepted: 12/20/2012] [Indexed: 11/20/2022] Open
Abstract
Pentas micrantha is used in the East African indigenous medicine to treat malaria. In the first investigation of this plant, the crude methanol root extract showed moderate antiplasmodial activity against the W2- (3.37 μg/mL) and D6-strains (4.00 μg/mL) of Plasmodium falciparum and low cytotoxicity (>450 μg/mL, MCF-7 cell line). Chromatographic separation of the extract yielded nine anthraquinones, of which 5,6-dihydroxylucidin-11-O-methyl ether is new. Isolation of a munjistin derivative from the genus Pentas is reported here for the first time. The isolated constituents were identified by NMR and mass spectrometric techniques and showed low antiplasmodial activities.
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Affiliation(s)
- Milkyas Endale
- Department of Chemistry, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya
- Department of Chemistry and Molecular Biology, University of Gothenburg, SE-412 96 Gothenburg, Sweden
| | - Annabel Ekberg
- Department of Chemistry and Molecular Biology, University of Gothenburg, SE-412 96 Gothenburg, Sweden
| | - John Patrick Alao
- Department of Chemistry and Molecular Biology, University of Gothenburg, SE-412 96 Gothenburg, Sweden
| | - Hoseah M. Akala
- United States Army Medical Research Unit-Kenya, MRU 64109, APO, AE 09831, USA
| | - Albert Ndakala
- Department of Chemistry, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya
| | - Per Sunnerhagen
- Department of Chemistry and Molecular Biology, University of Gothenburg, SE-412 96 Gothenburg, Sweden
| | - Máté Erdélyi
- Department of Chemistry and Molecular Biology, University of Gothenburg, SE-412 96 Gothenburg, Sweden
- Swedish NMR Center, University of Gothenburg, P.O. Box 465, SE-405 30 Gothenburg, Sweden
- Authors to whom correspondence should be addressed; E-Mail: (M.E.); (A.Y.); Tel.: +46-31-786-9033 (M.E.); Tel.: +254-202-444-6138 (A.Y.)
| | - Abiy Yenesew
- Department of Chemistry, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya
- Authors to whom correspondence should be addressed; E-Mail: (M.E.); (A.Y.); Tel.: +46-31-786-9033 (M.E.); Tel.: +254-202-444-6138 (A.Y.)
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Owuor BO, Ochanda JO, Kokwaro JO, Cheruiyot AC, Yeda RA, Okudo CA, Akala HM. In vitro antiplasmodial activity of selected Luo and Kuria medicinal plants. J Ethnopharmacol 2012; 144:779-781. [PMID: 23041700 DOI: 10.1016/j.jep.2012.09.045] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 07/09/2012] [Accepted: 09/19/2012] [Indexed: 06/01/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Drug resistance in malaria is a recurring subject that threatens public health globally. There is an urgent need to seek new antimalarial agents. This study seeking new antimalarials from medicinal plants is guided by ethnobotany. MATERIALS AND METHODS Medicinal plants of the Luo and Kuria ethnic groups of Kenya with high usage reports were screened in vitro for their antiplasmodial activity using the SYBR Green I fluorescence assay (MSF assay). RESULTS The IC50's for drugs and total plant extracts ranged from 0.01217 to 10.679 mg/ml. Extracts were more active on chloroquine sensitive than resistant Plasmodium falciparum strains. Tylosema fassoglense, Ageratum conyzoides and Ocimum kilimandscharicum exhibited promising results. Plectranthus barbatus did not show activity. CONCLUSION Ethnobotanical knowledge was sufficiently reliable for identifying plant extracts with antiplasmodial activity.
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Affiliation(s)
- B O Owuor
- Department of Biology, Catholic University of Eastern Africa, Langata Road, P.O. Box 62157, Nairobi, Kenya.
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Yenesew A, Akala HM, Twinomuhwezi H, Chepkirui C, Irungu BN, Eyase FL, Kamatenesi-Mugisha M, Kiremire BT, Johnson JD, Waters NC. The antiplasmodial and radical scavenging activities of flavonoids of Erythrina burttii. Acta Trop 2012; 123:123-7. [PMID: 22575309 DOI: 10.1016/j.actatropica.2012.04.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 04/17/2012] [Accepted: 04/23/2012] [Indexed: 11/28/2022]
Abstract
The acetone extract of the root bark of Erythrina burttii showed in vitro antiplasmodial activity against the chloroquine-sensitive (D6) and chloroquine-resistant (W2) strains of Plasmodium falciparum with IC(50) values of 0.97 ± 0.2 and 1.73 ± 0.5 μg/ml respectively. The extract also had radical scavenging activity against 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical with an EC(50) value of 12.0 μg/ml. The isoflav-3-enes burttinol-A and burttinol-C, and the 2-arylbenzofuran derivative burttinol-D were identified as the most active antiplasmodial (IC(50)<10 μM) and free radical scavenging (EC(50)ca. 10 μM) principles. The acetone extract of E. burttii at 800 mg/kg/day, in a 4-day Plasmodium berghei ANKA suppressive test, showed in vivo antimalarial activity with 52% chemosuppression. In the same in vivo test, marginal activities were also observed for the extracts of the root and stem bark of Erythrina abyssinica and the root bark of Erythrina sacleuxii.
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Affiliation(s)
- Abiy Yenesew
- Department of Chemistry, University of Nairobi, P.O. Box 30197, Code 00100, Nairobi, Kenya.
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Endale M, Ekberg A, Akala HM, Alao JP, Sunnerhagen P, Yenesew A, Erdélyi M. Busseihydroquinones A-D from the roots of Pentas bussei. J Nat Prod 2012; 75:1299-1304. [PMID: 22709138 DOI: 10.1021/np3002223] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Four new naphthohydroquinones, named busseihydroquinones A-D (1-4), along with a known homoprenylated dihydronaphthoquinone (5), were isolated from the CH(2)Cl(2)/MeOH (1:1) extract of the roots of Pentas bussei. Although the genus Pentas is frequently used by traditional healers for the treatment of malaria, only marginal activities against the chloroquine-sensitive (D6) and the chloroquine-resistant (W2) strains of Plasmodium falciparum were observed for the crude root extract and the isolated constituents of this plant.
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Affiliation(s)
- Milkyas Endale
- Department of Chemistry, University of Nairobi , P.O. Box 30197-00100, Nairobi, Kenya
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Endale M, Alao JP, Akala HM, Rono NK, Eyase FL, Derese S, Ndakala A, Mbugua M, Walsh DS, Sunnerhagen P, Erdelyi M, Yenesew A. Antiplasmodial quinones from Pentas longiflora and Pentas lanceolata. Planta Med 2012; 78:31-35. [PMID: 21979929 DOI: 10.1055/s-0031-1280179] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The dichloromethane/methanol (1:1) extracts of the roots of Pentas longiflora and Pentas lanceolata showed low micromolar (IC(50) = 0.9-3 µg/mL) IN VITRO antiplasmodial activity against chloroquine-resistant (W2) and chloroquine-sensitive (D6) strains of PLASMODIUM FALCIPARUM. Chromatographic separation of the extract of PENTAS LONGIFLORA led to the isolation of the pyranonaphthoquinones pentalongin (1) and psychorubrin (2) with IC(50) values below 1 µg/mL and the naphthalene derivative mollugin (3), which showed marginal activity. Similar treatment of Pentas lanceolata led to the isolation of eight anthraquinones ( 4-11, IC(50) = 5-31 µg/mL) of which one is new (5,6-dihydroxydamnacanthol, 11), while three--nordamnacanthal (7), lucidin-ω-methyl ether (9), and damnacanthol (10)--are reported here for the first time from the genus Pentas. The compounds were identified by NMR and mass spectroscopic techniques.
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Affiliation(s)
- Milkyas Endale
- Department of Chemistry, University of Nairobi, Nairobi, Kenya
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Eyase FL, Akala HM, Johnson JD, Walsh DS. Inhibitory activity of ferroquine, versus chloroquine, against western Kenya Plasmodium falciparum field isolates determined by a SYBR Green I in vitro assay. Am J Trop Med Hyg 2011; 85:984-8. [PMID: 22144431 PMCID: PMC3225175 DOI: 10.4269/ajtmh.2011.11-0260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2011] [Accepted: 09/12/2011] [Indexed: 11/07/2022] Open
Abstract
Ferroquine (FQ), a chloroquine (CQ) analog, is being developed to treat persons with Plasmodium falciparum malaria. In 146 P. falciparum field isolates from western Kenya, we measured 50% inhibitory concentrations (IC(50); nM) of CQ and FQ by a SYBR Green I in vitro assay. Reference clones included W2 (CQ resistant) and D6 (CQ sensitive). Mutation analysis was done for P. falciparum CQ-resistance transporter gene (Pfcrt K76T). Median IC(50) values for FQ were lower than CQ for field isolates and the W2 clone (both P < 0.05). The Pfcrt mutation (76T), which was detected in > 80% of isolates, conferred higher CQ IC(50) values (P < 0.05) and modestly lower FQ IC(50) values (P < 0.05), versus Pfcrt wild type (K76). FQ is more potent than CQ against CQ-resistant P. falciparum field isolates and the W2 clone, and is less affected by Pfcrt 76T. These findings support the notion that FQ could be useful in treating persons with P. falciparum malaria.
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Affiliation(s)
- Fredrick L Eyase
- Department of Emerging Infectious Diseases Program, U.S. Army Medical Research Unit-Kenya, Kenya Medical Research Institute-Walter Reed Project, Kisumu, Kenya.
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Akala HM, Eyase FL, Cheruiyot AC, Omondi AA, Ogutu BR, Waters NC, Johnson JD, Polhemus ME, Schnabel DC, Walsh DS. Antimalarial drug sensitivity profile of western Kenya Plasmodium falciparum field isolates determined by a SYBR Green I in vitro assay and molecular analysis. Am J Trop Med Hyg 2011; 85:34-41. [PMID: 21734121 DOI: 10.4269/ajtmh.2011.10-0674] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
In vitro drug sensitivity and molecular analyses of Plasmodium falciparum track drug resistance. DNA-binding fluorescent dyes like SYBR Green I may allow field laboratories, proximal to P. falciparum collection sites, to conduct drug assays. In 2007-2008, we assayed 121 P. falciparum field isolates from western Kenya for 50% inhibitory concentrations (IC(50)) against 6 antimalarial drugs using a SYBR Green I in vitro assay: 91 immediate ex vivo (IEV) and 30 culture-adapted, along with P. falciparum reference clones D6 (chloroquine [CQ] sensitive) and W2 (CQ resistant). We also assessed P. falciparum mdr1 (Pfmdr1) copy number and single nucleotide polymorphisms (SNPs) at four codons. The IC(50)s for IEV and culture-adapted P. falciparum isolates were similar, and approximated historical IC(50)s. For Pfmdr1, mean copy number was 1, with SNPs common at codons 86 and 184. The SYBR Green I assay adapted well to our field-based laboratory, for both IEV and culture-adapted P. falciparum, warranting continued use.
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Affiliation(s)
- Hoseah M Akala
- Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRU-K), Kenya Medical Research Institute (KEMRI)-Walter Reed Project, Kisumu and Nairobi, Kenya.
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Spalding MD, Eyase FL, Akala HM, Bedno SA, Prigge ST, Coldren RL, Moss WJ, Waters NC. Increased prevalence of the pfdhfr/phdhps quintuple mutant and rapid emergence of pfdhps resistance mutations at codons 581 and 613 in Kisumu, Kenya. Malar J 2010; 9:338. [PMID: 21106088 PMCID: PMC3001743 DOI: 10.1186/1475-2875-9-338] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Accepted: 11/24/2010] [Indexed: 12/01/2022] Open
Abstract
Background Anti-malarial drug resistance in Kenya prompted two drug policy changes within a decade: sulphadoxine-pyrimethamine (SP) replaced chloroquine (CQ) as the first-line anti-malarial in 1998 and artemether-lumefantrine (AL) replaced SP in 2004. Two cross-sectional studies were conducted to monitor changes in the prevalence of molecular markers of drug resistance over the period in which SP was used as the first-line anti-malarial. The baseline study was carried out from 1999-2000, shortly after implementation of SP, and the follow-up study occurred from 2003-2005, during the transition to AL. Materials and methods Blood was collected from malaria smear-positive, symptomatic patients presenting to outpatient centers in Kisumu, Kenya, during the baseline and follow-up studies. Isolates were genotyped at codons associated with SP and CQ resistance. In vitro IC50 values for antifolates and quinolones were determined for isolates from the follow-up study. Results The prevalence of isolates containing the pfdhfr N51I/C59R/S108N/pfdhps A437G/K540E quintuple mutant associated with SP-resistance rose from 21% in the baseline study to 53% in the follow-up study (p < 0.001). Isolates containing the pfdhfr I164L mutation were absent from both studies. The pfdhps mutations A581G and A613S/T were absent from the baseline study but were present in 85% and 61%, respectively, of isolates from the follow-up study. At follow-up, parasites with mutations at five pfdhps codons, 436, 437, 540, 581, and 613, accounted for 39% of isolates. The CQ resistance-associated mutations pfcrt K76T and pfmdr1 N86Y rose from 82% to 97% (p = 0.001) and 44% to 76% (p < 0.001), respectively, from baseline to follow-up. Conclusions During the period in which SP was the first-line anti-malarial in Kenya, highly SP-resistant parasites emerged, including isolates harboring pfdhps mutations not previously observed there. SP continues to be widely used in Kenya; however, given the highly resistant genotypes observed in this study, its use as a first-line anti-malarial should be discouraged, particularly for populations without acquired immunity to malaria. The increase in the pfcrt K76T prevalence, despite efforts to reduce CQ use, suggests that either these efforts are not adequate to alleviate CQ pressure in Kisumu, or that drug pressure is derived from another source, such as the second-line anti-malarial amodiaquine.
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Affiliation(s)
- Maroya D Spalding
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Yenesew A, Twinomuhwezi H, Kabaru JM, Akala HM, Kiremire BT, Heydenreich M, Peter MG, Eyase FI, Waters NC, Walsh DS. Antiplasmodial and larvicidal flavonoids from Derris trifoliata. B CHEM SOC ETHIOPIA 2009. [DOI: 10.4314/bcse.v23i3.47665] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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