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Journal article : Review

Understanding P. falciparum asymptomatic infections: a proposition for a transcriptomic approach

Abstract:
Malaria is still a significant public health burden in the tropics. Infection with malaria causing parasites results in a wide range of clinical disease presentations, from severe to uncomplicated or mild, and in the poorly understood asymptomatic infections. The complexity of asymptomatic infections is due to the intricate interplay between factors derived from the human host, parasite, and environment. Asymptomatic infections often go undetected and provide a silent natural reservoir that sustains malaria transmission. This creates a major obstacle for malaria control and elimination efforts. Numerous studies have tried to characterize asymptomatic infections, unanimously revealing that host immunity is the underlying factor in the maintenance of these infections and in the risk of developing febrile malaria infections. An in-depth understanding of how host immunity and parasite factors interact to cause malaria disease tolerance is thus required. This review primarily focuses on understanding anti-inflammatory and pro-inflammatory responses to asymptomatic infections in malaria endemic areas, to present the view that it is potentially the shift in host immunity toward an anti-inflammatory profile that maintains asymptomatic infections after multiple exposures to malaria. Conversely, symptomatic infections are skewed toward a pro-inflammatory immune profile. Moreover, we propose that these infections can be better interrogated using next generation sequencing technologies, in particular RNA sequencing (RNA-seq), to investigate the immune system using the transcriptome sampled during a clearly defined asymptomatic infection.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.3389/fimmu.2019.02398

Authors


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Role:
Author
ORCID:
0000-0001-7721-5534
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Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
ORCID:
0000-0003-4393-0470


Publisher:
Frontiers Media
Journal:
Frontiers in Immunology More from this journal
Volume:
10
Article number:
2398
Publication date:
2019-10-15
Acceptance date:
2019-09-25
DOI:
EISSN:
1664-3224
Pmid:
31681289


Language:
English
Keywords:
Subtype:
Review
Pubs id:
1090033
Local pid:
pubs:1090033
Deposit date:
2021-05-19

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