Haplotype association between haptoglobin (Hp2) and Hp promoter SNP (A-61C) may explain previous controversy of haptoglobin and malaria protection.

<h4>Background</h4>Malaria is one of the strongest recent selective pressures on the human genome, as evidenced by the high levels of varying haemoglobinopathies in human populations-despite the increased risk of mortality in the homozygous states. Previously, functional polymorphisms of...

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Main Authors: Sharon E Cox, Conor Doherty, Sarah H Atkinson, Chidi V Nweneka, Anthony J C Fulford, Hala Ghattas, Kirk A Rockett, Dominic P Kwiatkowski, Andrew M Prentice
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2007-04-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0000362&type=printable
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author Sharon E Cox
Conor Doherty
Sarah H Atkinson
Chidi V Nweneka
Anthony J C Fulford
Hala Ghattas
Kirk A Rockett
Dominic P Kwiatkowski
Andrew M Prentice
author_facet Sharon E Cox
Conor Doherty
Sarah H Atkinson
Chidi V Nweneka
Anthony J C Fulford
Hala Ghattas
Kirk A Rockett
Dominic P Kwiatkowski
Andrew M Prentice
author_sort Sharon E Cox
collection DOAJ
description <h4>Background</h4>Malaria is one of the strongest recent selective pressures on the human genome, as evidenced by the high levels of varying haemoglobinopathies in human populations-despite the increased risk of mortality in the homozygous states. Previously, functional polymorphisms of Hp, coded by the co-dominant alleles Hp1 and Hp2, have been variously associated with several infectious diseases, including malaria susceptibility.<h4>Methodology/principal findings</h4>Risk of a clinical malarial episode over the course of a malarial transmission season was assessed using active surveillance in a cohort of Gambian children aged 10-72 months. We report for the first time that the major haplotype for the A-61C mutant allele in the promoter of haptoglobin (Hp)-an acute phase protein that clears haemoglobin released from haemolysis of red cells-is associated with protection from malarial infection in older children, (children aged >or=36 months, >500 parasites/ul and temperature >37.5 degrees C; OR = 0.42; [95% CI 0.24-0.73] p = 0.002) (lr test for interaction, <36 vs >or=36 months, p = 0.014). Protection was also observed using two other definitions, including temperature >37.5 degrees C, dipstick positive, plus clinical judgement of malaria blinded to dipstick result (all ages, OR = 0.48, [95% CI 0.30-0.78] p = 0.003; >or=36 months, OR = 0.31, [95% CI 0.15-0.62] p = 0.001). A similar level of protection was observed for the known protective genetic variant, sickle cell trait (HbAS).<h4>Conclusions/significance</h4>We propose that previous conflicting results between Hp phenotypes/genotypes and malaria susceptibility may be explained by differing prevalence of the A-61C SNP in the populations studied, which we found to be highly associated with the Hp2 allele. We report the -61C allele to be associated with decreased Hp protein levels (independent of Hp phenotype), confirming in vitro studies. Decreased Hp expression may lead to increased oxidant stress and increased red cell turnover, and facilitate the development of acquired immunity, similar to a mechanism suggested for sickle cell trait.
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spelling doaj-art-0bfb45fef32c46398e1ec14d44a468552025-08-20T02:00:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032007-04-0124e36210.1371/journal.pone.0000362Haplotype association between haptoglobin (Hp2) and Hp promoter SNP (A-61C) may explain previous controversy of haptoglobin and malaria protection.Sharon E CoxConor DohertySarah H AtkinsonChidi V NwenekaAnthony J C FulfordHala GhattasKirk A RockettDominic P KwiatkowskiAndrew M Prentice<h4>Background</h4>Malaria is one of the strongest recent selective pressures on the human genome, as evidenced by the high levels of varying haemoglobinopathies in human populations-despite the increased risk of mortality in the homozygous states. Previously, functional polymorphisms of Hp, coded by the co-dominant alleles Hp1 and Hp2, have been variously associated with several infectious diseases, including malaria susceptibility.<h4>Methodology/principal findings</h4>Risk of a clinical malarial episode over the course of a malarial transmission season was assessed using active surveillance in a cohort of Gambian children aged 10-72 months. We report for the first time that the major haplotype for the A-61C mutant allele in the promoter of haptoglobin (Hp)-an acute phase protein that clears haemoglobin released from haemolysis of red cells-is associated with protection from malarial infection in older children, (children aged >or=36 months, >500 parasites/ul and temperature >37.5 degrees C; OR = 0.42; [95% CI 0.24-0.73] p = 0.002) (lr test for interaction, <36 vs >or=36 months, p = 0.014). Protection was also observed using two other definitions, including temperature >37.5 degrees C, dipstick positive, plus clinical judgement of malaria blinded to dipstick result (all ages, OR = 0.48, [95% CI 0.30-0.78] p = 0.003; >or=36 months, OR = 0.31, [95% CI 0.15-0.62] p = 0.001). A similar level of protection was observed for the known protective genetic variant, sickle cell trait (HbAS).<h4>Conclusions/significance</h4>We propose that previous conflicting results between Hp phenotypes/genotypes and malaria susceptibility may be explained by differing prevalence of the A-61C SNP in the populations studied, which we found to be highly associated with the Hp2 allele. We report the -61C allele to be associated with decreased Hp protein levels (independent of Hp phenotype), confirming in vitro studies. Decreased Hp expression may lead to increased oxidant stress and increased red cell turnover, and facilitate the development of acquired immunity, similar to a mechanism suggested for sickle cell trait.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0000362&type=printable
spellingShingle Sharon E Cox
Conor Doherty
Sarah H Atkinson
Chidi V Nweneka
Anthony J C Fulford
Hala Ghattas
Kirk A Rockett
Dominic P Kwiatkowski
Andrew M Prentice
Haplotype association between haptoglobin (Hp2) and Hp promoter SNP (A-61C) may explain previous controversy of haptoglobin and malaria protection.
PLoS ONE
title Haplotype association between haptoglobin (Hp2) and Hp promoter SNP (A-61C) may explain previous controversy of haptoglobin and malaria protection.
title_full Haplotype association between haptoglobin (Hp2) and Hp promoter SNP (A-61C) may explain previous controversy of haptoglobin and malaria protection.
title_fullStr Haplotype association between haptoglobin (Hp2) and Hp promoter SNP (A-61C) may explain previous controversy of haptoglobin and malaria protection.
title_full_unstemmed Haplotype association between haptoglobin (Hp2) and Hp promoter SNP (A-61C) may explain previous controversy of haptoglobin and malaria protection.
title_short Haplotype association between haptoglobin (Hp2) and Hp promoter SNP (A-61C) may explain previous controversy of haptoglobin and malaria protection.
title_sort haplotype association between haptoglobin hp2 and hp promoter snp a 61c may explain previous controversy of haptoglobin and malaria protection
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0000362&type=printable
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