Clinically relevant atovaquone-resistant human malaria parasites fail to transmit by mosquito.



Balta, Victoria A ORCID: 0000-0003-0685-6697, Stiffler, Deborah, Sayeed, Abeer, Tripathi, Abhai K ORCID: 0000-0001-9848-0142, Elahi, Rubayet, Mlambo, Godfree, Bakshi, Rahul P, Dziedzic, Amanda G, Jedlicka, Anne E ORCID: 0000-0003-3826-2973, Nenortas, Elizabeth
et al (show 8 more authors) (2023) Clinically relevant atovaquone-resistant human malaria parasites fail to transmit by mosquito. Nature communications, 14 (1). 6415-.

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Abstract

Long-acting injectable medications, such as atovaquone, offer the prospect of a "chemical vaccine" for malaria, combining drug efficacy with vaccine durability. However, selection and transmission of drug-resistant parasites is of concern. Laboratory studies have indicated that atovaquone resistance disadvantages parasites in mosquitoes, but lack of data on clinically relevant Plasmodium falciparum has hampered integration of these variable findings into drug development decisions. Here we generate atovaquone-resistant parasites that differ from wild type parent by only a Y268S mutation in cytochrome b, a modification associated with atovaquone treatment failure in humans. Relative to wild type, Y268S parasites evidence multiple defects, most marked in their development in mosquitoes, whether from Southeast Asia (Anopheles stephensi) or Africa (An. gambiae). Growth of asexual Y268S P. falciparum in human red cells is impaired, but parasite loss in the mosquito is progressive, from reduced gametocyte exflagellation, to smaller number and size of oocysts, and finally to absence of sporozoites. The Y268S mutant fails to transmit from mosquitoes to mice engrafted with human liver cells and erythrocytes. The severe-to-lethal fitness cost of clinically relevant atovaquone resistance to P. falciparum in the mosquito substantially lessens the likelihood of its transmission in the field.

Item Type: Article
Uncontrolled Keywords: Animals, Humans, Mice, Anopheles, Parasites, Plasmodium falciparum, Malaria, Malaria, Falciparum, Vaccines, Antiparasitic Agents, Antimalarials, Atovaquone
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 13 Dec 2023 11:41
Last Modified: 13 Dec 2023 11:41
DOI: 10.1038/s41467-023-42030-x
Open Access URL: https://doi.org/10.1038/s41467-023-42030-x
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3177319