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Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Immunol. | doi: 10.3389/fimmu.2019.02398

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

 Lynette I. Ochola-Oyier1*, Kelvin M. Kimenyi1, 2 and  Kevin Wamae1
  • 1KEMRI Wellcome Trust Research Programme, Kenya
  • 2University of Nairobi, Kenya

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 to 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 towards an anti-inflammatory profile that maintains asymptomatic infections after multiple exposure to malaria. Conversely, symptomatic infections are skewed towards 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 an asymptomatic infection.

Keywords: asymptomatic, Malaria, Immunity, Cytokines, Transcriptomics

Received: 13 Jun 2019; Accepted: 25 Sep 2019.

Copyright: © 2019 Ochola-Oyier, Kimenyi and Wamae. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Lynette I. Ochola-Oyier, KEMRI Wellcome Trust Research Programme, Kilifi, Kenya, liochola@kemri-wellcome.org