Aus dem Institut für Physiologie der Universität Tübingen Abteilung Physiologie I Abteilungsleiter: Professor Dr. F. Lang Clcn2 polymorphisms in Africans from an endemic malaria area Inaugural-Dissertation zur Erlangung des Doktorgrades der Medizin der Medizinischen Fakultät der Eberhard Karls Universität zu Tübingen vorgelegt von Jochen Paul aus Friedrichshafen 2006 Dekan: Professor Dr. I. B. Autenrieth 1. Berichterstatter: Privatdozent Dr. S. M. Huber 2. Berichterstatter: Professor P. Kremsner 1 2 Contents: 1 Introduction ................................................................................... 1 1.1 Malaria..........................1 1.1.1 Life cycle..................3 1.1.2 Clinical symptoms.....................................................................4 1.2 Infected erythrocytes.....5 1.2.1 New permeability pathways .......................................................5 1.2.2 PSAC – plasmodial erythrocyte surface anion.............................6 channel .....................................................6 1.2.3 Infection-Induced Outwardly Rectifying Anion ..........................7 Channels...................................................7 1.2.4 Alterations of the Host Erythrocyte Volume ...............................9 1.2.5 ClC-2 Channels in Plasmodium-infected .................................
Aus dem Institut für Physiologie der Universität Tübingen Abteilung Physiologie I Abteilungsleiter: Professor Dr. F. Lang Clcn2 polymorphisms in Africans from an endemic malaria area InauguralDissertationzur Erlangung des Doktorgrades der M edizin der Medizinischen Fakultät der Eberhard Karls Universität zu Tübingen vorgelegt von Jochen Paul aus Friedrichshafen 2006
Dekan: Professor Dr. I. B. Autenrieth 1. Berichterstatter: Privatdozent Dr. S. M. Huber 2. Berichterstatter: Professor P. Kremsner
Contents:1 Introduction ................................................................................... 11.1Malaria..........................................................................................11.1.1Lifecycle..................................................................................31.1.2Clinicalsymptoms.....................................................................41.2Infectederythrocytes.....................................................................51.2.1Newpermeabilitypathways.......................................................51.2.2PSACplasmodialerythrocytesurfaceanion.............................6anch....l.ne................................................6................................1.2.3 Infection-Induced Outwardly Rectifying Anion ..........................7....7................................................................nnleCah....s...........1.2.4AlterationsoftheHostErythrocyteVolume...............................91.2.5 ClC -2 Channels inmPmsaluido........................ed......ni-tcef01............1.0................................................................ochryter....esyt1.3ClC2Channel.............................................................................121.3.1 General features of Cl- 12channels ...............................................1.3.2 Molecular genetics of ClC -2 .................................................... 121.3.3TopologyofCLCchannels......................................................151.3.4 Functional properties of ClC -2 ................................................. 171.3.5 Physiological functions of ClC -2 channels ................................ 181.4Objectivesofthestudy................................................................202 Materials and Methods .............................................................. 212.1Patients........................................................................................212.2Molecularbiologicalmaterialsandmethods...............................222.2.1Polymerasechainreaction(PCR).............................................222.2.2AgarosegelelectophoresisofDNA..........................................242.2.3 Sequence analysis .................................................................... 252.2.4Productsandkits.....................................................................262.3Electrophysiogicalmaterialsandmethods..................................272.3.1BuffersandSolutions..............................................................272.3.2 Oocyte isolation and preparation .............................................. 292.3.2 cRNA-syntheses / in jection...................................................... 30
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2.3.3Two-electrodevoltage-clamp(TEVC)......................................302.3.4 Three dimensional structural model of the CBS1 ...................... 32domain of ClC -2...................................................................... 323 Results ........................................................................................... 333.1Molecularbiology........................................................................333.1.1 Frequency of polymorphisms ................................................... 333.1.2 Polymorphic positions in the Clcn2 gene .................................. 353.2Electrophysiology........................................................................373.2.1 Isoosmotic bath solution .......................................................... 373.2.2 Voltage dependence and kinetics (isoosmotic).......................... 403.2.3 Hypoosmotic cell swelling ....................................................... 443.2.4 Voltage dependence and kinetics (hypoosmotic)....................... 473.3ModelofClC2channel...............................................................523.4CystathionineBetaSynthase1domain......................................533.4.1AlignmentoftheCBS-domains................................................533.4.2 CLC-CBS-domain1 3D-model ................................................. 544 Discussion ..................................................................................... 554.1Sourcesoferror...........................................................................554.1.1 General aspects of the oocyte expression system....................... 554.1.2 Oocytes and cRNA .................................................................. 554.1.3 Solutions ................................................................................. 564.2Identificationofpolymorphisms.................................................574.3Functionalcharacterizationofpolymorphisms...........................584.4 Influence of polymorphisms on malaria ......................................605 Summary....................................................................................... 616 References..................................................................................... 637 Appendix....................................................................................... 717.1Acknowledgment.........................................................................717.2CurriculumVitae........................................................................72
1 Introduction
1.1 Malaria Malaria is an infectious disease transmitted by the bite of the female Anopheles mosquito. Today approximately 40% of the world's population, mostly those living in some of the world’s poorest countries, are at risk of malaria. It causes more than 300 million acute illnesses and at least 1 million deaths per year. Around 90% of these deaths occur in Africa where young children are seen as being especially at risk. According to the WHO every 30 seconds one African child is killed by Malaria (WHO, 2005). The disease is found mainly throughout the tropical and sub-tropical regions of the world.
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Figure 1: Malaria distribution in 2005 according to the World Health Organization (www.who.int) Over the last few years the situation has become even more complex because Malaria parasites have been developing unacceptable levels of resistance to one drug after another.
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Malaria is caused by intracellular protozoan parasites of the genusPlasmodium. When an infected Anopheles mosquito takes a blood meal the parasite enters the human host. Protozoas are unicellular eukaryotic organisms which undergo a series of changes to evade detection of the immune system, infect liver hepatocytes and red blood cells (RBC) and the liver, and finally, develop into a form that infects a mosquito again when an infected person is bitten. Four species ofPlasmodiumcan produce Malaria in its various forms: Plasmodium falciparum Malaria tropica Plasmodium viva Tertia malaria (Indian sub-continent and Central America) Plasmodium ovaleTertian malaria (relatively unusual outside Africa) Plasmodium malariaeQuartan malaria (most endemic areas, sub-Saharan Africa) According to the WHOP. vivaxandP. falciparumare the most common forms. P. falciparumcauses the most severe and often lethal type of malaria infection. In regions of the world where malaria had been eliminated concern surrounding the spread of malaria is increasing. Malaria, along with HIV/AIDS and Tuberculosis, is one of the major public health challenges facing the poorest countries of the world.