Plasmodium falciparum K13 mutations in Africa and Asia impact artemisinin resistance and parasite fitness

The emergence of mutant K13-mediated artemisinin (ART) resistance in Plasmodium falciparum malaria parasites has led to widespread treatment failures across Southeast Asia. In Africa, K13-propeller genotyping confirms the emergence of the R561H mutation in Rwanda and highlights the continuing domina...

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Main Authors: Stokes, BH, Dhingra, SK, Rubiano, K, Mok, S, Straimer, J, Gnädig, NF, Deni, I, Schindler, KA, Bath, JR, Ward, KE, Striepen, J, Yeo, T, Ross, LS, Legrand, E, Ariey, F, Cunningham, CH, Souleymane, IM, Gansané, A, Nzoumbou-Boko, R, Ndayikunda, C, Kabanywanyi, AM, Uwimana, A, Smith, SJ, Kolley, O, Ndounga, M, Warsame, M, Leang, R, Nosten, F, Anderson, TJ, Rosenthal, PJ, Ménard, D, Fidock, DA
Format: Journal article
Language:English
Published: eLife Sciences Publications 2021
_version_ 1797058676144472064
author Stokes, BH
Dhingra, SK
Rubiano, K
Mok, S
Straimer, J
Gnädig, NF
Deni, I
Schindler, KA
Bath, JR
Ward, KE
Striepen, J
Yeo, T
Ross, LS
Legrand, E
Ariey, F
Cunningham, CH
Souleymane, IM
Gansané, A
Nzoumbou-Boko, R
Ndayikunda, C
Kabanywanyi, AM
Uwimana, A
Smith, SJ
Kolley, O
Ndounga, M
Warsame, M
Leang, R
Nosten, F
Anderson, TJ
Rosenthal, PJ
Ménard, D
Fidock, DA
author_facet Stokes, BH
Dhingra, SK
Rubiano, K
Mok, S
Straimer, J
Gnädig, NF
Deni, I
Schindler, KA
Bath, JR
Ward, KE
Striepen, J
Yeo, T
Ross, LS
Legrand, E
Ariey, F
Cunningham, CH
Souleymane, IM
Gansané, A
Nzoumbou-Boko, R
Ndayikunda, C
Kabanywanyi, AM
Uwimana, A
Smith, SJ
Kolley, O
Ndounga, M
Warsame, M
Leang, R
Nosten, F
Anderson, TJ
Rosenthal, PJ
Ménard, D
Fidock, DA
author_sort Stokes, BH
collection OXFORD
description The emergence of mutant K13-mediated artemisinin (ART) resistance in Plasmodium falciparum malaria parasites has led to widespread treatment failures across Southeast Asia. In Africa, K13-propeller genotyping confirms the emergence of the R561H mutation in Rwanda and highlights the continuing dominance of wild-type K13 elsewhere. Using gene editing, we show that R561H, along with C580Y and M579I, confer elevated in vitro ART resistance in some African strains, contrasting with minimal changes in ART susceptibility in others. C580Y and M579I cause substantial fitness costs, which may slow their dissemination in high-transmission settings, in contrast with R561H that in African 3D7 parasites is fitness neutral. In Cambodia, K13 genotyping highlights the increasing spatio-temporal dominance of C580Y. Editing multiple K13 mutations into a panel of Southeast Asian strains reveals that only the R561H variant yields ART resistance comparable to C580Y. In Asian Dd2 parasites C580Y shows no fitness cost, in contrast with most other K13 mutations tested, including R561H. Editing of point mutations in ferredoxin or mdr2, earlier associated with resistance, has no impact on ART susceptibility or parasite fitness. These data underline the complex interplay between K13 mutations, parasite survival, growth and genetic background in contributing to the spread of ART resistance.
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spelling oxford-uuid:24d02c06-c99a-469c-92f8-1d3ccb0743942022-03-26T11:52:13ZPlasmodium falciparum K13 mutations in Africa and Asia impact artemisinin resistance and parasite fitnessJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:24d02c06-c99a-469c-92f8-1d3ccb074394EnglishSymplectic ElementseLife Sciences Publications2021Stokes, BHDhingra, SKRubiano, KMok, SStraimer, JGnädig, NFDeni, ISchindler, KABath, JRWard, KEStriepen, JYeo, TRoss, LSLegrand, EAriey, FCunningham, CHSouleymane, IMGansané, ANzoumbou-Boko, RNdayikunda, CKabanywanyi, AMUwimana, ASmith, SJKolley, ONdounga, MWarsame, MLeang, RNosten, FAnderson, TJRosenthal, PJMénard, DFidock, DAThe emergence of mutant K13-mediated artemisinin (ART) resistance in Plasmodium falciparum malaria parasites has led to widespread treatment failures across Southeast Asia. In Africa, K13-propeller genotyping confirms the emergence of the R561H mutation in Rwanda and highlights the continuing dominance of wild-type K13 elsewhere. Using gene editing, we show that R561H, along with C580Y and M579I, confer elevated in vitro ART resistance in some African strains, contrasting with minimal changes in ART susceptibility in others. C580Y and M579I cause substantial fitness costs, which may slow their dissemination in high-transmission settings, in contrast with R561H that in African 3D7 parasites is fitness neutral. In Cambodia, K13 genotyping highlights the increasing spatio-temporal dominance of C580Y. Editing multiple K13 mutations into a panel of Southeast Asian strains reveals that only the R561H variant yields ART resistance comparable to C580Y. In Asian Dd2 parasites C580Y shows no fitness cost, in contrast with most other K13 mutations tested, including R561H. Editing of point mutations in ferredoxin or mdr2, earlier associated with resistance, has no impact on ART susceptibility or parasite fitness. These data underline the complex interplay between K13 mutations, parasite survival, growth and genetic background in contributing to the spread of ART resistance.
spellingShingle Stokes, BH
Dhingra, SK
Rubiano, K
Mok, S
Straimer, J
Gnädig, NF
Deni, I
Schindler, KA
Bath, JR
Ward, KE
Striepen, J
Yeo, T
Ross, LS
Legrand, E
Ariey, F
Cunningham, CH
Souleymane, IM
Gansané, A
Nzoumbou-Boko, R
Ndayikunda, C
Kabanywanyi, AM
Uwimana, A
Smith, SJ
Kolley, O
Ndounga, M
Warsame, M
Leang, R
Nosten, F
Anderson, TJ
Rosenthal, PJ
Ménard, D
Fidock, DA
Plasmodium falciparum K13 mutations in Africa and Asia impact artemisinin resistance and parasite fitness
title Plasmodium falciparum K13 mutations in Africa and Asia impact artemisinin resistance and parasite fitness
title_full Plasmodium falciparum K13 mutations in Africa and Asia impact artemisinin resistance and parasite fitness
title_fullStr Plasmodium falciparum K13 mutations in Africa and Asia impact artemisinin resistance and parasite fitness
title_full_unstemmed Plasmodium falciparum K13 mutations in Africa and Asia impact artemisinin resistance and parasite fitness
title_short Plasmodium falciparum K13 mutations in Africa and Asia impact artemisinin resistance and parasite fitness
title_sort plasmodium falciparum k13 mutations in africa and asia impact artemisinin resistance and parasite fitness
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