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Odera DO, Tuju J, Mwai K, Nkumama IN, Fürle K, Chege T, Kimathi R, Diehl S, Musasia FK, Rosenkranz M, Njuguna P, Hamaluba M, Kapulu MC, Frank R, Osier FHA, Abdi AI, Chi PC, de Laurent Z, Jao I, Kamuya D, Kamuyu G, Makale J, Murungi L, Musyoki J, Muthui M, Mwacharo J, Kariuki S, Mwanga D, Mwongeli J, Ndungu F, Njue M, Nyangweso G, Kimani D, Ngoi JM, Musembi J, Ngoto O, Otieno E, Ooko M, Shangala J, Wambua J, Mohammed KS, Omuoyo D, Mosobo M, Kibinge N, Kinyanjui S, Bejon P, Lowe B, Marsh K, Marsh V, Abebe Y, Billingsley PF, Sim BKL, Hoffman SL, James ER, Richie TL, Audi A, Olewe F, Oloo J, Ongecha J, Ongas MO, Koskei N, Bull PC, Hodgson SH, Kivisi C, Imwong M, Murphy SC, Ogutu B, Tarning J, Winterberg M, Williams TN. Anti-merozoite antibodies induce natural killer cell effector function and are associated with immunity against malaria. Sci Transl Med 2023; 15:eabn5993. [PMID: 36753561 DOI: 10.1126/scitranslmed.abn5993] [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] [Indexed: 02/10/2023]
Abstract
Natural killer (NK) cells are potent immune effectors that can be activated via antibody-mediated Fc receptor engagement. Using multiparameter flow cytometry, we found that NK cells degranulate and release IFN-γ upon stimulation with antibody-opsonized Plasmodium falciparum merozoites. Antibody-dependent NK (Ab-NK) activity was largely strain transcending and enhanced invasion inhibition into erythrocytes. Ab-NK was associated with the successful control of parasitemia after experimental malaria challenge in African adults. In an independent cohort study in children, Ab-NK increased with age, was boosted by concurrent P. falciparum infections, and was associated with a lower risk of clinical episodes of malaria. Nine of the 14 vaccine candidates tested induced Ab-NK, including some less well-characterized antigens: P41, P113, MSP11, RHOPH3, and Pf_11363200. These data highlight an important role of Ab-NK activity in immunity against malaria and provide a potential mechanism for evaluating vaccine candidates.
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Affiliation(s)
- Dennis O Odera
- Centre of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany.,Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - James Tuju
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Kennedy Mwai
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.,Epidemiology and Biostatistics Division, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Irene N Nkumama
- Centre of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Kristin Fürle
- Centre of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Timothy Chege
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Rinter Kimathi
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Stefan Diehl
- Centre of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Fauzia K Musasia
- Centre of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Micha Rosenkranz
- Centre of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Patricia Njuguna
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Mainga Hamaluba
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Melissa C Kapulu
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Roland Frank
- Centre of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Faith H A Osier
- Centre of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany.,Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.,Department of Life Sciences, Imperial College London, UK
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Standing JF, Ongas MO, Ogwang C, Kagwanja N, Murunga S, Mwaringa S, Ali R, Mturi N, Timbwa M, Manyasi C, Mwalekwa L, Bandika VL, Ogutu B, Waichungo J, Kipper K, Berkley JA. Dosing of Ceftriaxone and Metronidazole for Children With Severe Acute Malnutrition. Clin Pharmacol Ther 2018; 104:1165-1174. [PMID: 29574688 PMCID: PMC6282491 DOI: 10.1002/cpt.1078] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 08/08/2017] [Revised: 03/15/2018] [Accepted: 03/18/2018] [Indexed: 12/12/2022]
Abstract
Infants and young children with severe acute malnutrition (SAM) are treated with empiric broad-spectrum antimicrobials. Parenteral ceftriaxone is currently a second-line agent for invasive infection. Oral metronidazole principally targets small intestinal bacterial overgrowth. Children with SAM may have altered drug absorption, distribution, metabolism, and elimination. Population pharmacokinetics of ceftriaxone and metronidazole were studied, with the aim of recommending optimal dosing. Eighty-one patients with SAM (aged 2-45 months) provided 234 postdose pharmacokinetic samples for total ceftriaxone, metronidazole, and hydroxymetronidazole. Ceftriaxone protein binding was also measured in 190 of these samples. A three-compartment model adequately described free ceftriaxone, with a Michaelis-Menten model for concentration and albumin-dependent protein binding. A one-compartment model was used for both metronidazole and hydroxymetronidazole, with only 1% of hydroxymetronidazole predicted to be formed during first-pass. Simulations showed 80 mg/kg once daily of ceftriaxone and 12.5 mg/kg twice daily of metronidazole were sufficient to reach therapeutic targets.
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Affiliation(s)
- Joseph F. Standing
- Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
- Paediatric Infectious Diseases Research GroupInstitute for Infection and Immunity, St. George's, University of LondonLondonUK
| | - Martin O. Ongas
- Center for Research in Therapeutic SciencesStrathmore UniversityNairobiKenya
- KEMRI‐Centre for Clinical ResearchNairobiKenya
| | | | | | | | | | - Rehema Ali
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya
| | - Neema Mturi
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya
| | - Moline Timbwa
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya
- Mbagathi County HospitalNairobiKenya
| | - Christine Manyasi
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya
- Mbagathi County HospitalNairobiKenya
| | - Laura Mwalekwa
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya
- Coast General HospitalMombasaKenya
| | | | - Bernhards Ogutu
- Center for Research in Therapeutic SciencesStrathmore UniversityNairobiKenya
- KEMRI‐Centre for Clinical ResearchNairobiKenya
| | | | - Karin Kipper
- Analytical Services International, St George's University of LondonLondonUK
- Institute of ChemistryUniversity of TartuTartuEstonia
| | - James A. Berkley
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya
- The Childhood Acute Illness & Nutrition (CHAIN) NetworkNairobiKenya
- Centre for Tropical Medicine & Global Health, Nuffield Department of MedicineUniversity of OxfordOxfordUK
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