Malaria and G6PDMalaria is the most common, widespread, and destructive infectious disease in the developing world; it is a significant public health risk to people inhabiting and visiting developing countries. According to the Centers for Disease Control and Prevention website, there are approximately 350-500 million cases of malaria recorded each year; more than one million of these people die (“Malaria”). Malaria is the result of poverty in the developing world; regions of the world where malaria is prominent do not have sufficient medical resources. The people of these regions also have unsanitary living conditions and are surrounded by destitution. The regions of the world that experience the most malarial outbreaks are tropical and subtropical regions, such as areas in the
Some worrisome symptoms and bodily defects induced by malaria parasites include: fever, joint pains, spleen and liver enlargements, and hemoglobinuria. A classical symptom of malaria is fever, caused by multiple bursts of merozoites exploding their host red blood cells in the bloodstream. A malaria-infected individual will also experience cycles of chills and rigor that differ in length depending on which strain the person has contracted. Some malaria symptoms and their causes are still poorly understood, which provides incentive for scientists, researchers, and sponsors to unearth and fund malaria prevention methods.
Plasmodium protozoan parasites cause malaria. These parasites are unicellular microbes that symbiotically rely on their host species. Anopheles female mosquitoes feed on the blood of a malaria-infected person when young, thus becoming infected with the parasites as well. Therefore, infectious malaria parasites are spread through vector transmission from a mosquito to a human. Plasmodium sporozoites travel in the saliva of Anopheles females into the bloodstream of a human. These sporozoites rapidly progress into the first of their two pathways. They infect the hepatocytes of the liver within the 30 minutes following their invasion of the bloodstream; this is the exoerythrocytic pathway. The sporozoites asexually proliferate for one to two weeks before their mass-produced merozoites break free of the host cells, traveling through the blood to claim red blood cells as their new hosts; this is the erythrocytic phase of the parasite’s life cycle. There are four malaria parasites that are infamous for infecting humans. These parasites are: Plasmodium falciparum, P. vivax, P. ovale, and P. malariae; P. falciparum is the most severe form of the disease.
However, molecular studies and research provide hope for malaria prevention, especially of the P. falciparum strain. P. J. Mason et al. believe that human red blood cell glucose-6-phosphate dehydrogenase (G6PD) somehow relates to the G6PD of P. falciparum. They find that the C-terminal sequence of human red blood cell (HRBC) G6PD is homologous to the N-terminal of P. falciparum G6PD (30). So the structures of the C-terminal sequence of HRBC G6PD and the N-terminal of P. falciparum G6PD could share similar structures, but have different functions, or they could have corresponding or related locations within their proteins. The “C-terminal [is defined as] the end of a protein (either the polymerases involved in the process of transcription or the polypeptide product of the DNA) corresponding to the 3’end of the coding sequence for that protein” (“
G6PD is an enzyme that catalyzes the first step in the pentose phosphate pathway. In this step, NADP+ is transformed into NADPH due to the conversion of glucose-6-phostphate into 6-phosphoglucono- δ-lactone by G6PD. Cells need NADPH in order to protect themselves from oxidative stress. This stress comes from a variety of triggers. Oxidants, which are potent oxygen compounds, build up when an individual contracts a fever or when he or she ingests certain medications or foods, such as fava beans. G6PD also accounts for the normal life span for red blood cells. The following diagram, from GenomeNet, provides a summary of the first step in the pentose phosphate pathway (“KEGG REACTION”):
The pentose phosphate pathway is metabolic; it provides the reducing energy for cells by maintaining NADPH levels. NADPH manages glutathione level in cells, which is the mechanism that protects red blood cells from oxidative damage.
G6PD can be homodimeric or tetradimeric; the latter of which is found in humans. It has eight chains that resemble ribbons. These ribbons contain NADP molecules embedded within the proteins. G6PD is a multimer; generally, eight NADP molecules are found within a large protein. The following picture is a G6PD tetramer that was found in an article on ScienceDirect.com (Shannon et al.):
G6PD deficiency is a disease where red blood cells do not have the G6PD enzyme. Oxidative stress triggers—foods, illnesses, medications—cause individuals to suffer the symptoms of G6PD. The inheritance of G6PD deficiency is sex-linked; it is transmitted from a healthy-carrier mother to her son, since mostly males display the symptoms of this disease because the gene for G6PD is carried on the X chromosome. Daughters that inherit the trait would be healthy carriers like their mothers. G6PD deficiency is the most common enzyme deficiency disease in the world. There are quite a few advantages and disadvantages to G6PD deficiency. For example, one disadvantage is that hemolytic anemia can result if a G6PD deficient patient undergoes oxidative stress.
G6PD deficiency research would be advantageous to malaria prevention in the developing world because, for unknown reasons, malaria parasites do not survive in G6PD deficient cells. Some other advantages to this deficiency include resistance to cancer, stoke, and cardiovascular disease; resistance to the most morbid form of malaria—P. falciparum—is a major advantage since most of the malaria parasite’s life is spent in either the liver or red blood cells, causing it to easily avoid the immune system so easily and be incredibly problematic to cure or prevent. Furthermore, merozoites can wrap themselves in the lysed liver cells once they leave the liver and move to red blood cells, disguising themselves to avoid attacks from the immune system. The sticky surface proteins of P. falciparum can be shifted between a wide variety of roughly 60 or more types of proteins per parasite to evade recognition by the immune system; parasite populations can thus have endless variations and combinations of these surface proteins. Patients with malaria can experience hemorrhages because of the sticky surface proteins that P. falciparum attaches to red blood cells, causing them to stick to blood vessel walls, halt the merozoites’ circulation, and avoid destruction in the spleen.
The studies of G6PD and its structure and function can be applied to the developing world. Researchers could study G6PD deficiency inheritance more in-depth so that a method of controlling the severity of the deficiency through its genetic expression can be found. This way, someone could conceivably be protected from malaria without experiencing the harsh side-effects of G6PD deficiency. Favism is not as widespread as malaria, but since it is another name for G6PD deficiency, it is another avenue for research and application. Favism seems to be developing as an evolutionarily advantageous genetic trait in regions of the world where malaria is prominent (“What is G6PD Deficiency?”). Since this condition is occurring naturally, it should be further researched as a malaria prevention method.
Malaria is the result of poverty in the developing world, but it also causes poverty and poor economic development. This causes an enormous struggle for inhabitants of developing countries because of their increased struggle for wealth and a significant decrease in their already poor quality of life. Jobs become difficult to create and maintain, and thus the well-being of the inhabitants suffers. Family members that were a significant source of income die, leaving emotionally and financially distraught relatives, and because the disease is so widespread and the economy is hindered, those that are still suffering lack adequate medical care. If more enzymes or pathway variations or mutations are discovered that protect against malaria with few other symptoms and side-effects, the developing world would significantly benefit.
Works Cited
Griffiths, Paul, and Karola Stotz. "Glossary." Representing Genes: Testing Competing Philosophical Analyses of the Gene Concept in Contemporary Molecular Biology. 31 Oct. 2006.
"KEGG REACTION: R00835 R02736." GenomeNet. Feb. 2008.
"Malaria: Topic Home." Centers for Disease Control and Prevention. 31 Jan. 2008. Dept. of Health and Human Services. 22 Feb. 2008
Mason, Philip J., David Stevens, Amalia Diez, Stuart W. Knight, Deborah A. Scopes, and Tom J. Vulliamy. "Human Hexose-6-Phosphate Dehydrogenase (Glucose 1-." Blood Cells, Molecules, and Diseases 25 (1999): 30-37. 22 Feb. 2008
Shannon, W N., Sheila Gover, Veronica M. Lam, and Margaret J. Adams. "Human Glucose-6- Phosphate Dehydrogenase: the Crystal Structure Reveals a Structural NADP+ Molecule and Provides Insights Into Enzyme Deficiency." Structure 8 (2000): 293-303. 22 Feb. 2008
Bibliography
Adams, John H. "Malaria." Microsoft® Encarta® 2006 [CD].
Blandin, Stephanie A., and Elena A. Levashina. "Reverse Genetics Analysis of Antiparasitic Responses in the Malaria Vector, Anopheles gambiae." Innate Immunity.
"Blood disease." Encyclopædia Britannica. 2008. Encyclopædia Britannica Online. 10 Feb. 2008.
Boëte, Christophe, ed. Genetically Modified Mosquitoes for Malaria Control.
“Glucose-6-phosphate dehydrogenase deficiency." Encyclopædia Britannica. 2008. Encyclopædia Britannica Online. 10 Feb. 2008.
Mattingly, P. F. The Biology of Mosquito-Borne Disease.
"Metabolism." Encyclopædia Britannica. 2008. Encyclopædia Britannica Online. 10 Feb. 2008.
T-W-Fiennes, Richard N. Zoonoses and the Origins and Ecology of Human Disease.
"What is G6PD Deficiency?" G6PD Deficiency Association. 2008. UNIAMO ( Italian Federation for Rare Diseases). 10 Feb. 2008