- Open Access
Population genetic structure and natural selection of Plasmodium falciparum apical membrane antigen-1 in Myanmar isolates
© The Author(s) 2018
- Received: 1 October 2017
- Accepted: 30 January 2018
- Published: 7 February 2018
Plasmodium falciparum apical membrane antigen-1 (PfAMA-1) is one of leading blood stage malaria vaccine candidates. However, genetic variation and antigenic diversity identified in global PfAMA-1 are major hurdles in the development of an effective vaccine based on this antigen. In this study, genetic structure and the effect of natural selection of PfAMA-1 among Myanmar P. falciparum isolates were analysed.
Blood samples were collected from 58 Myanmar patients with falciparum malaria. Full-length PfAMA-1 gene was amplified by polymerase chain reaction and cloned into a TA cloning vector. PfAMA-1 sequence of each isolate was sequenced. Polymorphic characteristics and effect of natural selection were analysed with using DNASTAR, MEGA4, and DnaSP programs. Polymorphic nature and natural selection in 459 global PfAMA-1 were also analysed.
Thirty-seven different haplotypes of PfAMA-1 were identified in 58 Myanmar P. falciparum isolates. Most amino acid changes identified in Myanmar PfAMA-1 were found in domains I and III. Overall patterns of amino acid changes in Myanmar PfAMA-1 were similar to those in global PfAMA-1. However, frequencies of amino acid changes differed by country. Novel amino acid changes in Myanmar PfAMA-1 were also identified. Evidences for natural selection and recombination event were observed in global PfAMA-1. Among 51 commonly identified amino acid changes in global PfAMA-1 sequences, 43 were found in predicted RBC-binding sites, B-cell epitopes, or IUR regions.
Myanmar PfAMA-1 showed similar patterns of nucleotide diversity and amino acid polymorphisms compared to those of global PfAMA-1. Balancing natural selection and intragenic recombination across PfAMA-1 are likely to play major roles in generating genetic diversity in global PfAMA-1. Most common amino acid changes in global PfAMA-1 were located in predicted B-cell epitopes where high levels of nucleotide diversity and balancing natural selection were found. These results highlight the strong selective pressure of host immunity on the PfAMA-1 gene. These results have significant implications in understanding the nature of Myanmar PfAMA-1 along with global PfAMA-1. They also provide useful information for the development of effective malaria vaccine based on this antigen.
- Plasmodium falciparum
- Apical membrane antigen-1
- Genetic diversity
- Natural selection
Global incidence and mortality of malaria have decreased in recent years, but malaria is still a great public health concern. In 2015, there were approximately 212 million clinical cases of malaria with an estimated 429,000 deaths . The challenge for malaria control and elimination has increased due to the spread of parasites with resistance to anti-malarial drugs and insecticide-resistant Anopheles mosquitoes. The lack of effective vaccines is one of the major obstacles in combating malaria. Therefore, development of efficacious vaccine is urgently needed for malaria control. Up to date, several candidate proteins including circumsporozoite protein (CSP), Duffy-binding protein (DBP), merozoite surface protein-1 (MSP-1), apical membrane antigen-1 (AMA-1), and thrombospondin related anonymous protein (TRAP) have been tested for their potentials as candidate antigens to develop effective vaccines . The majority of these antigens are expressed either in pre-erythrocytic and erythrocytic stages [2, 3]. However, genetic polymorphisms identified in these parasite antigens are great hurdles to develop effective vaccines since they generate a variant-specific immune response which is less effective against parasites with other genetic variants [4–6].
Apical membrane antigen-1 (AMA-1) is a 83-kDa type I integral membrane protein that is mainly expressed in the merozoite and sporozoite [7, 8]. Biological function of AMA-1 is not clearly understood yet, but its stage specific expression and localization suggest that the protein might play a crucial role in invasion of erythrocytes and hepatocytes by malaria parasites [8–11]. Structure analysis of AMA-1 revealed that this protein consists of a signal sequence, a cysteine-rich ectodomain, a conserved cytoplasmic region and a transmembrane region . The ectodomain of AMA-1 is further subdivided into three domains, domains I, II, and III. The ectodomain AMA-1 is very immunogenic and natural immune responses against the domain have been reported in patients exposed to Plasmodium falciparum and Plasmodium vivax [13–16]. Immunization with AMA-1 can produce antibodies to effectively inhibit the invasion of erythrocyte by malaria parasite and confer protective immune responses [15, 17]. As a result, AMA-1 is a leading blood stage vaccine candidate for malaria control [16, 18, 19]. Several studies have shown that anti-AMA-1 antibodies confer protective immunity in adults living in malaria-endemic areas [20, 21]. However, these antibodies recognize either conserved or allele-specific epitopes of AMA-1, resulting limited protection against different alleles . AMA-1 is known to be less variable than other malaria vaccine candidate antigens such as MSPs or CSP, but AMA-1 also possesses genetic diversity among global malaria parasites. A high rate of polymorphisms has been identified in domain I of AMA-1 and this region appears to be a major target of anti-AMA-1 protective antibodies [23–28]. To design an efficient and protective malaria vaccine, it is essential to monitor genetic variations of vaccine candidate antigens among global malaria isolates circulating in endemic areas .
The incidence of malaria in Myanmar has decreased in recent years. However, Myanmar still accounts for more than half of the malaria cases and approximately three quarters of the malaria deaths in the Greater Mekong Subregion . Although P. falciparum cases have decreased in recent years [1, 31], this species is still the most critical concern for malaria control and prevention in Myanmar with the emergence of artemisinin resistance . In this study, population genetic structure and natural selection of P. falciparum AMA-1 (PfAMA-1) in Myanmar P. falciparum isolates were analysed.
Blood samples and ethics
Amplification and sequencing analysis of PfAMA-1
Genomic DNA of parasite was extracted from 200 µl of whole blood sample of patients using QIAamp DNA Blood Kit (Qiagen, Hilden, Germany) following the manufacturer’s instruction. Full-length PfAMA-1 gene was amplified by PCR. PfAMA-1 gene-specific primers were designed based on complete coding sequences of PfAMA-1 of P. falciparum isolates 3D7 (GenBank Accession No.: U65407) and FC27 (GenBank Accession No.: M27133). Forward and reverse primers were 5′-GTACTTGTTATAAATTGTACA-3′ and 5′-TTTTAGCATAAAAGAGAAGC-3′, respectively. Thermal cycling parameters for PCR were as follows: one cycle of an initial denaturation at 94 °C for 5 min, 30 cycles of 94 °C for 1 min, annealing at 55 °C for 1 min and extension at 72 °C for 2 min, followed by a final extension step at 72 °C for 10 min. Nested PCR with primers 5′-ACAAAAATGAGAAAATTATACTGC-3′ and 5′-TTAATAGTATGGTTTTTCCATCAGAAC-3′ was performed with the same amplification condition, if necessary. To minimize nucleotide mis-incorporation into sequences during PCR amplification, Ex Taq DNA polymerase (Takara, Otsu, Japan) with proof-reading activity was used in all PCR. Each PCR product was analysed by electrophoresis on 1% agarose gels. The resulting PCR product was cut from the gel followed by gel purification. It was then cloned into T&A cloning vector (Real Biotech Corporation, Banqiao City, Taiwan). Each ligation mixture was transformed into Escherichia coli DH5α competent cells. Colony PCR was performed with the nested PCR primers to identify positive clones with appropriate insert. Nucleotide sequences of cloned PCR product were subjected to automatic DNA sequencing using M13 forward and M13 reverse primers. Sequencing was also carried out using two additional specific internal primers (5′-CAGGGAAATGTCCAGTATTTGGTA-3′ and 5′-TTCCATCGACCCATAATCCG-3′) to obtain clear sequences for central part of PfAMA-1. At least two clones from each isolate were sequenced to ensure sequencing accuracy. Some isolates underwent three or fourfold sequence coverage to confirm the existence of rare polymorphisms. These nucleotide sequences are deposited at GenBank under Accession Numbers KU893276–KU893333.
Nucleotide sequence polymorphism analysis and neutrality test
Nucleotide and deduced amino acid sequences of PfAMA-1 were analysed using EditSeq and SeqMan programs in DNASTAR package (DNASTAR, Madison, WI, USA). Nucleotide sequence polymorphism analysis was conducted for 58 PfAMA-1 sequences. Numbers of segregating sites (S), haplotypes (H), haplotype diversity (Hd), nucleotide diversity (π), and average number of pair-wise nucleotide differences within a population (K) were estimated using DnaSP ver. 5.10.00 . Value of π was calculated to estimate step-wise diversity throughout the full-length PfAMA-1 based on a sliding window of 100 bases with a step size of 25 bp. Values of non-synonymous (dN) and synonymous (dS) substitutions were estimated and were compared using Z test (P < 0.05 was considered significant) in MEGA4 program  based on method of Nei and Gojobori  with Jukes and Cantor correction. The Tajima’s D value  and Fu and Li’s D and F values  were analysed using DnaSP ver. 5.10.00 to evaluate neutral theory of evolution . Recombination parameter (R), which included the effective population size and probability of recombination between adjacent nucleotides per generation, and minimum number of recombination events (Rm) were analysed by DnaSP ver. 5.10.00 . Linkage disequilibrium (LD) between different polymorphic sites was computed based on the R2 index using DnaSP ver. 5.10.00 .
Population diversity of PfAMA-1 among global P. falciparum isolates
Genetic diversity of PfAMA-1 in global P. falciparum isolates was analysed. Parasite populations from Ghana (n = 37, AB715698–AB715734), Papua New Guinea (PNG: n = 90, AB715870–AB715959), Philippines (n = 55, AB715815–AB715869), Solomon Islands (n = 50, AB715960–AB716009), Tanzania (n = 62, AB715636–AB715679), Thailand (n = 80, AB715735–AB715814), and Vanuatu (n = 85, AB716010–AB716094) were included in this analysis. These publically available sequences covered full-length sequences of PfAMA-1. Nucleotide sequence polymorphism analysis and neutrality test for each population were performed using DnaSP ver. 5.10.00  and MEGA4 program  as described above. Genetic differentiation among parasite populations was calculated based on fixation index (Fst) to estimate pairwise DNA sequence diversity between and within populations using DnaSP ver. 5.10.01 . To investigate relationships among PfAMA-1 haplotypes, the haplotype network for a total of 517 PfAMA-1 sequences including 58 Myanmar sequences and the 459 publically available sequences from Ghana, PNG, Philippines, Solomon Islands, Tanzania, Thailand, and Vanuatu was constructed using the program NETWORK version 18.104.22.168 with the Median Joining algorithm . To assess whether genetic diversity in PfAMA-1 within P. falciparum isolates were associated with host’s immune pressure, genetic diversity in predicted B-cell epitopes, intrinsically unstructured/disordered regions (IUR), and RBC binding regions in global PfAMA-1 were analysed [40, 41]. Nucleotide diversity and natural selection of each region were also analysed using DnaSP ver. 5.10.00 , as described above.
Sequence polymorphism in Myanmar PfAMA-1 sequences
Amino acid polymorphisms in Myanmar PfAMA-1 compared to global PfAMA-1
Nucleotide diversity and natural selection of Myanmar PfAMA-1
Estimates of DNA sequence polymorphism and tests of neutrality at PfAMA-1 among Plasmodium falciparum Myanmar isolates
Segregating sites (S)
Singleton variable sites
Parsimony informative sites
Total no. of mutations
Hd ± SD
π ± SD
dN − dS
0.702 ± 0.052
0.00282 ± 0.00027
(P > 0.1)
0.912 ± 0.024
0.02120 ± 0.00161
(P > 0.1)
0.860 ± 0.023
0.00752 ± 0.00057
(P > 0.1)
0.871 ± 0.024
0.01629 ± 0.00080
(P > 0.1)
0.761 ± 0.027
0.00581 ± 0.00047
(P > 0.1)
0.948 ± 0.019
0.01064 ± 0.00051
(P > 0.1)
Nucleotide diversity and natural selection of PfAMA-1 in global isolates
Estimates of DNA sequence polymorphism and tests of neutrality at PfAMA-1 among global Plasmodium falciparum
Segregating sites (S)
Singleton variable sites
Parsimony informative sites
Total no. of mutations
Hd ± SD
π ± SD
Fu and Li’s D
Fu and Li’s F
(n = 58)
0.948 ± 0.019
0.01064 ± 0.00053
(P > 0.1)
(P > 0.1)
(P > 0.1)
(n = 80)
0.920 ± 0.013
0.01103 ± 0.00020
(P < 0.05)
(P > 0.1)
(P < 0.05)
(n = 55)
0.916 ± 0.019
0.01136 ± 0.00027
(0.1 > P > 0.05)
(P < 0.05)
(P < 0.02)
(n = 90)
0.954 ± 0.007
0.01226 ± 0.00016
(0.1 > P > 0.05)
(P < 0.05)
(P < 0.02)
(n = 50)
0.862 ± 0.021
0.01179 ± 0.00027
(P < 0.05)
(P < 0.05)
(P < 0.02)
(n = 85)
0.633 ± 0.028
0.01012 ± 0.00031
(P < 0.01)
(P > 0.1)
(P < 0.05)
(n = 37)
0.992 ± 0.008
0.01405 ± 0.00034
(P > 0.1)
(P > 0.1)
(P > 0.1)
(n = 62)
0.989 ± 0.005
0.01361 ± 0.00021
(P > 0.1)
(P > 0.1)
(P > 0.1)
Recombination and linkage disequilibrium
Comparison of recombination events between global PfAMA-1
Haplotype network analysis
Nucleotide differentiation among global PfAMA-1
Pairwise FST estimates for PfAMA-1
Association between natural selection and host immune pressure
Population genetic structure and natural selection of PfAMA-1 among Myanmar P. falciparum isolates were analysed in this study. Most of amino acid changes identified in Myanmar PfAMA-1 were clustered at domains I and III, consistent with previous reports on PfAMA-1 from other endemic areas [40, 42–45]. Overall distribution patterns and frequencies of amino acid changes found in Myanmar PfAMA-1 were similar to those of global PfAMA-1 analysed in this study, but several differences among and between global PfAMA-1 were also identified. The implication of these substantial geographic differentiations is currently unclear. Considering that only a limited number of PfAMA-1 sequences in each geographical area were analysed in this study, these amino acid changes and their different frequencies may not be statistically significant. Indeed, many amino acid changes found in global PfAMA-1 were commonly detected and evenly distributed among global PfAMA-1 sequences, although their frequencies differed among and between populations. Further examination of PfAMA-1 nucleotide and amino acid variations in diverse PfAMA-1 populations with a larger number of global PfAMA-1 sequences would be necessary to better understand the polymorphic nature of PfAMA-1. It is also worthy to mention that Myanmar PfAMA-1 sequences analysed in this study were from P. falciparum isolates that collected in restricted areas of Myanmar. Therefore, nation-wide analysis of PfAMA-1 in P. falciparum isolates collected from various regions of Myanmar is also needed to clearly understand the genetic diversity and population structure of Myanmar PfAMA-1.
The π value for global PfAMA-1 varied, ranging from 0.01012 (Vanuatu) to 0.01405 (Ghana). The π values in African PfAMA-1 sequences (Ghana and Tanzania) were relatively higher than those in Asian or Pacific PfAMA-1 sequences. Nucleotide diversity was not evenly distributed through Myanmar PfAMA-1. The 5ʹ-T, domain II and 3ʹ-T showed low levels of nucleotide diversity, indicating that these regions might be more conserved with lower frequency of polymorphisms. Meanwhile, much higher value of nucleotide diversity was observed at domain I and domain III. Highly similar patterns of nucleotide diversity were also detected in global PfAMA-1 analysed in this study, strongly indicating that global PfAMA-1 might share highly similar nucleotide diversity across this gene. The dN − dS value for Myanmar full-length PfAMA-1 was positive, implying balancing selection in this gene. However, the dN − dS value for 5ʹ-T was negative, suggesting negative or purifying natural selection in this domain. Tajima’s D value (the statistic value predicting departure from neutrality) for Myanmar PfAMA-1 also suggested that this gene might have evolved under balancing selection. In sliding plot analysis of Tajima’s D, general patterns of Tajima’s D values across Myanmar PfAMA-1 were similar to those of global PfAMA-1, although differences among and between PfAMA-1 from different countries were also found. Regardless of theses slight differences, domains I and III and the junction between domains II and III shared very similar patterns of Tajima’s D values in global PfAMA-1, indicating that these regions might be dominant targets for host immune response. Fu and Li’s D and F tests also provided evidence for balancing selection in global PfAMA-1. These results collectively suggest that domains I and III of Myanmar PfAMA-1 are highly polymorphic with strong selection force acting on these domains, similar to other global PfAMA-1. Meiotic recombination between the adjacent polymorphic sites is one of main forces that drive allelic diversity in Plasmodium parasites . Substantial levels of recombination events in PfAMA-1 from different geographical isolates have been reported previously [40, 43, 45–49]. Recombination events within Myanmar PfAMA-1 and decline of LD index R2 with the increase of nucleotide distance of the sequences evidenced meiotic recombination in Myanmar PfAMA-1, consistent with previous studies [40, 43, 45–49]. Higher values of recombination events were found in African PfAMA-1 sequences (Ghana and Tanzania) than those of PfAMA-1 from other geographical areas, suggesting that African PfAMA-1 might have more opportunity to have recombination events than other geographical PfAMA-1 probably due to high multiclonal infections, subsequent cross fertilization, and recombination in mosquitoes. High values of recombination parameters and very rapid decay of LD detected in global PfAMA-1 are independent and concordant indicators of high meiotic recombination rate in global PfAMA-1, supporting the notion that recombination is another important factor generating genetic diversity in global PfAMA-1.
Fst is a measure of population substructure and is one of the most useful tools for analysing the overall genetic differentiation among populations. Fst values at each locus are considered as no differentiation (0), low genetic differentiation (0–0.05), moderate differentiation (0.05–0.15), or high differentiation (0.15–0.25) . Fst values for Myanmar PfAMA-1 in comparison with PfAMA-1 from other different geographical populations showed moderate levels of genetic differentiation, ranging from 0.058281 to 0.09740. Fst values between PfAMA-1 populations belonging to the same geographical area were relatively low. In particular, the value between Ghana and Tanzania was very low (0.00019), suggesting very low genetic differentiation among these two populations. However, Vanuatu showed relatively high Fst values for Ghana (0.12425) and Tanzania (0.14141), providing evidence for geographical isolation followed by population subdivision in these regions. Overall Fst values between global PfAMA-1 were in moderate differentiation ranges, indicating limited genetic differentiation of PfAMA-1 among global parasite populations.
The significant ratio of dN/dS and evidence of positive natural selection identified in PfAMA-1 of Myanmar and the other seven P. falciparum populations suggest that amino acid replacements are generally favored in PfAMA-1 and this adaptive evolution is presumably due to host immune pressure. Previous studies have suggested that polymorphic amino acid residues identified in PfAMA-1 are located on one side of the molecule, thereby exposing them to the exterior environment more easily with more access to host immune responses [40, 43, 51]. A recent study has provided information on potential RBC-binding regions, B-cell epitopes, and IURs across the ectodomain of PfAMA-1 . To assess the association between natural selection and host immune pressure for PfAMA-1, genetic polymorphisms in predicted RBC-binding sites, B-cell epitopes, and IUR regions were analysed. Most amino acid changes found in global PfAMA-1 were predicted to be localized at the predicted RBC-binding sites, B-cell epitopes, or IUR regions of PfAMA-1. Eight of 11 predicted B-cell epitopes were polymorphic. In particular, B-cell epitopes 3, 4, 5, 8, and 10 (corresponding to domain I, junction between domain II and III, and domain III) showed high levels of nucleotide diversity in global PfAMA-1 analysed. Tajima’s D values for these predicted B-cells epitopes also suggested that these epitopes were under natural selection. The C1-L cluster, which located near the hydrophobic pocket of domain I in PfAMA-1, affects binding capacity of inhibitory monoclonal antibody, thereby contributing to antibody escape [52–55]. Global PfAMA-1 analysed in this study had clustering amino acid polymorphisms, including tri- and hepta-morphic changes in C1-L region. This supports the notion that strong natural selection force which generates genetic diversity of PfAMA-1, thereby contributing to host immune escape acts on this region [21, 54, 55]. Meanwhile, only a few less frequent dimorphic amino acid changes were identified in loop II of global PfAMA-1, the target of 4G2 inhibitory antibody , coinciding with results of a previous study . High degree of amino acid sequence conservation of the loop II among global PfAMA-1 further supports the hypothesis that amino acid sequences in this region are subjected to strong natural selection. Therefore, this region might be useful as a component of PfAMA-1-based vaccine.
To develop a globally effective malaria vaccine based on PfAMA-1, it would be important to understand whether PfAMA-1 haplotypes with distinct clusters are antigenically different. Haplotype network analysis of 517 global PfAMA-1 sequences suggested that a total of 174 distinct haplotypes were identified among global population. No haplotype that fully covers haplotypes from all geographical areas analyzed in this study was identified. PfAMA-1 based vaccines currently studied are based on sequences of most extensively studied forms of P. falciparum, 3D7 and FVO [57–59]. However, only 13.7% of global PfAMA-1 haplotypes analysed in this study was identical to the FVO. The frequency of global PfAMA-1 haplotypes with identical sequence to 3D7 was much lower. These raised a concern that vaccine based on these two forms of haplotypes may not offer effective protection for global P. falciparum isolates. A recent report suggested that PfAMA-1 sequence variations may not necessarily be strong predictors of antigenic differences or the level of cross-inhibitory antibody activity because not all polymorphic residues contribute equally to antibody binding and escape . Antigenic diversity of PfAMA-1 is limited and a vaccine targeting a small number of PfAMA-1 alleles might be sufficient for coverage against naturally-circulating P. falciparum populations in different endemic areas . The results of this study also suggested that the genetic diversity is relatively limited among global PfAMA-1, even though substantial geographic differentiations were also identified among the populations. However, global PfAMA-1 is under natural selection and high level of meiotic recombination that can produce new alleles occurs in the gene population. And therefore, a multi-allele approach for developing PfAMA-1 based malaria vaccines should be considered to maximize vaccine efficacy.
Overall patterns of nucleotide diversity and distributions of amino acid changes found in Myanmar PfAMA-1 were similar to those from global PfAMA-1, albeit several amino acid changes were identified only in Myanmar PfAMA-1. Balancing natural selection across PfAMA-1 and high degree of recombination events observed in Myanmar and global PfAMA-1 suggest that natural selection and intragenic recombination might be main driving forces that generate genetic diversity in global PfAMA-1. Most common amino acid changes found in global PfAMA-1 were located at predicted B-cell epitopes. High degree of nucleotide diversity and balancing natural selection of the B-cell epitope regions suggest that strong natural selection might have act on epitopes associated with host immune pressure for PfAMA-1. Limited genetic differentiation of PfAMA-1 was estimated between and among global parasite populations, even though highly complicated haplotype diversity was identified in global population. However, global PfAMA-1 is under natural selection and high level of meiotic recombination that can produce new alleles occurs in the gene population.
The results of this study warrant continuous examination of PfAMA-1 nucleotide and amino acid variations in global PfAMA-1 to better understand the polymorphic nature of PfAMA-1 and design effective vaccine against global P. falciparum populations.
JMK and JL carried out genetic analysis of PfAMA-1. MM, HJ, MKM and KL contributed the blood sample collection. JMK, JL, TIK, TLT, HGL, WMS, TSK and BKN analysed and interpreted the data. TSK and BKN designed and supervised the experiments. JMK, TLT, HGL and BKN wrote the draft of the manuscript. All authors read and approved the final manuscript.
We thank the staffs in Department of Medical Research Pyin Oo Lwin Branch and the health professionals in Naung Cho, Pyin Oo Lwin and Tha Beik Kyin townships for their contribution and technical support in field study.
The authors declare that they have no competing interests.
Availability of data and materials
The original datasets analysed in the current study are available from the corresponding author upon request.
Consent for publication
All authors have given their consent for publication.
Ethics approval and consent to participate
This study was approved by the Ethics Review Committee, Department of Medical Research, Myanmar (97/Ethics 2015), and by the Ethical Review Committee of Inha University School of Medicine, Korea (INHA 15-013). Informed written consent and permission were obtained from each individual.
This work was supported by the National Research Foundation of Korea (NRF) grants funded by the Korea government (MSIP) (NRF-2015R1A2A2A01004310) and the Korea government (MEST) (NRF-2015K1A3A9A01034893).
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- WHO. World malaria report 2016. Geneva: World Health Organization; 2016.Google Scholar
- Richards JS, Beeson JG. The future for blood-stage vaccines against malaria. Immunol Cell Biol. 2009;87:377–90.View ArticlePubMedGoogle Scholar
- Florens L, Washburn MP, Raine JD, Anthony RM, Grainger M, Haynes JD, et al. A proteomic view of the Plasmodium falciparum life cycle. Nature. 2002;419:520–6.View ArticlePubMedGoogle Scholar
- Takala SL, Plowe CV. Genetic diversity and malaria vaccine design, testing and efficacy: preventing and overcoming ‘vaccine resistant malaria. Parasite Immunol. 2009;31:560–73.View ArticlePubMedPubMed CentralGoogle Scholar
- Ferreira MU, da Silva Nunes M, Wunderlich G. Antigenic diversity and immune evasion by malaria parasites. Clin Diagn Lab Immunol. 2004;11:987–95.PubMedPubMed CentralGoogle Scholar
- Escalante AA, Lal AA, Ayala FJ. Genetic polymorphism and natural selection in the malaria parasite Plasmodium falciparum. Genetics. 1998;149:189–202.PubMedPubMed CentralGoogle Scholar
- Healer J, Crawford S, Ralph S, McFadden G, Cowman AF. Independent translocation of two micronemal proteins in developing Plasmodium falciparum merozoites. Infect Immun. 2002;70:5751–8.View ArticlePubMedPubMed CentralGoogle Scholar
- Silvie O, Franetich JF, Charrin S, Mueller MS, Siau A, Bodescot M, et al. A role for apical membrane antigen 1 during invasion of hepatocytes by Plasmodium falciparum sporozoites. J Biol Chem. 2004;279:9490–6.View ArticlePubMedGoogle Scholar
- Peterson MG, Marshall VM, Smythe JA, Crewther PE, Lew A, Silva A, Anders RF, Kemp DJ. Integral membrane protein located in the apical complex of Plasmodium falciparum. Mol Cell Biol. 1989;9:3151–4.View ArticlePubMedPubMed CentralGoogle Scholar
- Mitchell GH, Thomas AW, Margos G, Dluzewski AR, Bannister LH. Apical membrane antigen 1, a major malaria vaccine candidate, mediates the close attachment of invasive merozoites to host red blood cells. Infect Immun. 2004;72:154–8.View ArticlePubMedPubMed CentralGoogle Scholar
- Yap A, Azevedo MF, Gilson PR, Weiss GE, O’Neill MT, Wilson DW, et al. Conditional expression of apical membrane antigen 1 in Plasmodium falciparum shows it is required for erythrocyte invasion by merozoites. Cell Microbiol. 2014;16:642–56.View ArticlePubMedPubMed CentralGoogle Scholar
- Hodder AN, Crewther PE, Matthew ML, Reid GE, Moritz RL, Simpson RJ, et al. The disulfide bond structure of Plasmodium apical membrane antigen-1. J Biol Chem. 1996;271:29446–52.View ArticlePubMedGoogle Scholar
- Udhayakumar V, Kariuki S, Kolczack M, Girma M, Roberts JM, Oloo AJ, et al. Longitudinal study of natural immune responses to the Plasmodium falciparum apical membrane antigen (AMA-1) in a holoendemic region of malaria in western Kenya: Asembo Bay Cohort Project VIII. Am J Trop Med Hyg. 2001;65:100–7.View ArticlePubMedGoogle Scholar
- Cortés A, Mellombo M, Masciantonio R, Murphy VJ, Reeder JC, Anders RF. Allele specificity of naturally acquired antibody responses against Plasmodium falciparum apical membrane antigen 1. Infect Immun. 2005;73:422–30.View ArticlePubMedPubMed CentralGoogle Scholar
- Rodrigues MH, Rodriques KM, Oliveira TR, Cômodo AN, Rodriques MM, Kocken CH, et al. Antibody response of naturally infected individuals to recombinant Plasmodium vivax apical membrane antigen-1. Int J Parasitol. 2005;35:185–92.View ArticlePubMedGoogle Scholar
- Moncunill G, Mayor A, Jiménez A, Nhabomba A, Casas-Vila N, Puyol L, et al. High antibody responses against Plasmodium falciparum in immigrants after extended periods of interrupted exposure to malaria. PLoS ONE. 2013;8:e73624.View ArticlePubMedPubMed CentralGoogle Scholar
- Gentil F, Bargieri DY, Leite JA, Françoso KS, Patricio MB, Espíndola NM, et al. A recombinant vaccine based on domain II of Plasmodium vivax apical membrane antigen 1 induces high antibody titres in mice. Vaccine. 2010;28:6183–90.View ArticlePubMedGoogle Scholar
- Remarque EJ, Faber BW, Kocken CH, Thomas AW. Apical membrane antigen 1: a malaria vaccine candidate in review. Trends Parasitol. 2008;24:74–84.View ArticlePubMedGoogle Scholar
- Thera MA, Coulibaly D, Kone AK, Guindo AB, Traore K, Sall AH, et al. Phase 1 randomized controlled trial to evaluate the safety and immunogenicity of recombinant Pichia pastoris-expressed Plasmodium falciparum apical membrane antigen 1 (PfAMA1-FVO [25-545]) in healthy Malian adults in Bandiagara. Malar J. 2016;15:442.View ArticlePubMedPubMed CentralGoogle Scholar
- Osier FH, Fegan G, Polley SD, Murungi L, Verra F, Tetteh KK, Lowe B, et al. Breadth and magnitude of antibody responses to multiple Plasmodium falciparum merozoite antigens are associated with protection from clinical malaria. Infect Immun. 2008;76:2240–8.View ArticlePubMedPubMed CentralGoogle Scholar
- Mugyenyi CK, Elliott SR, McCallum FJ, Anders RF, Marsh K, Beeson JG. Antibodies to polymorphic invasion-inhibitory and non-inhibitory epitopes of Plasmodium falciparum apical membrane antigen 1 in human malaria. PLoS ONE. 2013;8:e68304.View ArticlePubMedPubMed CentralGoogle Scholar
- Polley SD, Mwangi T, Kocken CH, Thomas AW, Dutta S, Lanar DE, et al. Human antibodies to recombinant protein constructs of Plasmodium falciparum apical membrane antigen1 (AMA1) and their associations with protection from malaria. Vaccine. 2004;23:718–28.View ArticlePubMedGoogle Scholar
- Escalante AA, Grebert HM, Chaiyaroj SC, Magris M, Biswas S, Nahlen BL, et al. Polymorphism in the gene encoding the apical membrane antigen-1 (AMA-1) of Plasmodium falciparum. X. Asembo Bay Cohort Project. Mol Biochem Parasitol. 2001;113:279–87.View ArticlePubMedGoogle Scholar
- Polley SD, Conway DJ. Strong diversifying selection on domains of the Plasmodium falciparum apical membrane antigen 1 gene. Genetics. 2001;158:1505–12.PubMedPubMed CentralGoogle Scholar
- Moon SU, Na BK, Kang JM, Kim JY, Cho SH, Park YK, et al. Genetic polymorphism and effect of natural selection at domain I of apical membrane antigen-1 (AMA-1) in Plasmodium vivax isolates from Myanmar. Acta Trop. 2010;114:71–5.View ArticlePubMedGoogle Scholar
- Arnott A, Mueller I, Ramsland PA, Siba PM, Reeder JC, Barry AE. Global population structure of the genes encoding the malaria vaccine candidate, Plasmodium vivax apical membrane antigen 1(PvAMA1). PLoS Negl Trop Dis. 2013;7:e2506.View ArticlePubMedPubMed CentralGoogle Scholar
- Terheggen U, Drew DR, Hodder AN, Cross NJ, Mugyenyi CK, Barry AE, et al. Limited antigenic diversity of Plasmodium falciparum apical membrane antigen 1 supports the development of effective multi-allele vaccines. BMC Med. 2014;12:183.View ArticlePubMedPubMed CentralGoogle Scholar
- Kang JM, Lee J, Cho PY, Moon SU, Ju HL, Ahn SK, et al. Population genetic structure and natural selection of apical membrane antigen-1 in Plasmodium vivax Korean isolates. Malar J. 2015;14:455.View ArticlePubMedPubMed CentralGoogle Scholar
- Volkman SK, Ndiaye D, Diakite M, Koita OA, Nwakanma D, Daniels RF, et al. Application of genomics to field investigations of malaria by the international centers of excellence for malaria research. Acta Trop. 2012;121:324–32.View ArticlePubMedGoogle Scholar
- WHO. Malaria in the Greater Mekong Subregion: regional and country profiles. Geneva: World Health Organization; 2010.Google Scholar
- Kang JM, Cho PY, Moe M, Lee J, Jun H, Lee HW, et al. Comparison of the diagnostic performance of microscopic examination with nested polymerase chain reaction for optimum malaria diagnosis in Upper Myanmar. Malar J. 2017;16:119.View ArticlePubMedPubMed CentralGoogle Scholar
- Tun KM, Imwong M, Lwin KM, Win AA, Hlaing TM, Hlaing T, et al. Spread of artemisinin-resistant Plasmodium falciparum in Myanmar: a cross-sectional survey of the K13 molecular marker. Lancet Infect Dis. 2015;15:415–21.View ArticlePubMedPubMed CentralGoogle Scholar
- Snounou G, Singh B. Nested PCR analysis of Plasmodium parasites. Methods Mol Med. 2002;72:189–203.PubMedGoogle Scholar
- Librado P, Rozas J. DnaSP v5: a software for comprehensive analysis of DNA polymorphism data. Bioinformatics. 2009;23:1451–2.View ArticleGoogle Scholar
- Tamura K, Dudley J, Nei M, Kumar S. MEGA4: molecular evolutionary genetics analysis (MEGA) software version 4.0. Mol Biol Evol. 2007;24:1596–9.View ArticlePubMedGoogle Scholar
- Nei M, Gojobori T. Simple methods for estimating the numbers of synonymous and nonsynonymous nucleotide substitutions. Mol Biol Evol. 1986;3:418–26.PubMedGoogle Scholar
- Tajima F. Statistical method for testing the neutral mutation hypothesis by DNA polymorphism. Genetics. 1989;123:585–95.PubMedPubMed CentralGoogle Scholar
- Fu YX, Li WH. Statistical tests of neutrality of mutations. Genetics. 1993;133:693–709.PubMedPubMed CentralGoogle Scholar
- Bandelt HJ, Forster P, Röhl A. Median-joining networks for inferring intraspecific phylogenies. Mol Biol Evol. 1999;16:37–48.View ArticlePubMedGoogle Scholar
- Mehrizi AA, Sepehri M, Karimi F, Djadid ND, Zakeri S. Population genetics, sequence diversity and selection in the gene encoding the Plasmodium falciparum apical membrane antigen 1 in clinical isolates from the south-east of Iran. Infect Genet Evol. 2013;17:51–61.View ArticlePubMedGoogle Scholar
- Urquiza M, Suarez JE, Cardenas C, Lopez R, Puentes A, Chavez F, et al. Plasmodium falciparum AMA-1 erythrocyte binding peptides implicate AMA-1 as erythrocyte binding protein. Vaccine. 2000;19:508–13.View ArticlePubMedGoogle Scholar
- Cortés A, Mellombo M, Mueller I, Benet A, Reeder JC, Anders RF. Geographical structure of diversity and differences between symptomatic and asymptomatic infections for Plasmodium falciparum vaccine candidate AMA1. Infect Immun. 2003;71:1416–26.View ArticlePubMedPubMed CentralGoogle Scholar
- Basu M, Maji AK, Mitra M, Sengupta S. Natural selection and population genetic structure of domain-I of Plasmodium falciparum apical membrane antigen-1 in India. Infect Genet Evol. 2013;18:247–56.View ArticlePubMedGoogle Scholar
- Al-Qahtani AA, Abdel-Muhsin AM, Bin Dajem SM, AlSheikh AA, Bohol MF, Al-Ahdal MN, et al. Comparative sequence analysis of domain I of Plasmodium falciparum apical membrane antigen 1 from Saudi Arabia and worldwide isolates. Infect Genet Evol. 2016;39:381–8.View ArticlePubMedGoogle Scholar
- Zhu X, Zhao Z, Feng Y, Li P, Liu F, Liu J, et al. Genetic diversity of the Plasmodium falciparum apical membrane antigen I gene in parasite population from the China–Myanmar border area. Infect Genet Evol. 2016;39:155–62.View ArticlePubMedPubMed CentralGoogle Scholar
- Eisen DP, Marshall VM, Billman-Jacobe H, Coppel RL. A Plasmodium falciparum apical membrane antigen-1 (AMA-1) gene apparently generated by intragenic recombination. Mol Biochem Parasitol. 1999;100:243–6.View ArticlePubMedGoogle Scholar
- Garg S, Alam MT, Das MK, Dev V, Kumar A, Dash AP, et al. Sequence diversity and natural selection at domain I of the apical membrane antigen 1 among Indian Plasmodium falciparum populations. Malar J. 2007;6:154.View ArticlePubMedPubMed CentralGoogle Scholar
- Quang ND, Hoa PT, Tuan MS, Viet NX, Jalloh A, Matsuoka H. Polymorphism at the apical membrane antigen 1 gene (AMA1) of the malaria parasite Plasmodium falciparum in a Vietnamese population. Biochem Genet. 2009;47:370–83.View ArticlePubMedGoogle Scholar
- Mardani A, Keshavarz H, Heidari A, Hajjaran H, Raeisi A, Khorramizadeh MR. Genetic diversity and natural selection at the domain I of apical membrane antigen-1 (AMA-1) of Plasmodium falciparum in isolates from Iran. Exp Parasitol. 2012;130:456–62.View ArticlePubMedGoogle Scholar
- Balloux F, Lugon-Moulin N. The estimation of population differentiation with microsatellite markers. Mol Ecol. 2002;11:155–65.View ArticlePubMedGoogle Scholar
- Bai T, Becker M, Gupta A, Strike P, Murphy VJ, Anders RF, Batchelor AH. Structure of AMA1 from Plasmodium falciparum reveals a clustering of polymorphisms that surround a conserved hydrophobic pocket. Proc Natl Acad Sci USA. 2005;102:12736–41.View ArticlePubMedPubMed CentralGoogle Scholar
- Coley AM, Parisi K, Masciantonio R, Hoeck J, Casey JL, Murphy VJ, et al. The most polymorphic residue on Plasmodium falciparum apical membrane antigen 1 determines binding of an invasion-inhibitory antibody. Infect Immun. 2006;74:2628–36.View ArticlePubMedPubMed CentralGoogle Scholar
- Coley AM, Gupta A, Murphy VJ, Bai T, Kim H, Foley M, et al. Structure of the malaria antigen AMA1 in complex with a growth inhibitory antibody. PLoS Pathog. 2007;3:1308–19.PubMedGoogle Scholar
- Dutta S, Lee SY, Batchelor AH, Lanar DE. Structural basis of antigenic escape of a malaria vaccine candidate. Proc Natl Acad Sci USA. 2007;104:12488–93.View ArticlePubMedPubMed CentralGoogle Scholar
- Harris KS, Adda CG, Khore M, Drew DR, Valentini-Gatt A, Fowkes FJ, et al. Use of immunodampening to overcome diversity in the malarial vaccine candidate apical membrane antigen 1. Infect Immun. 2014;82:4707–17.View ArticlePubMedPubMed CentralGoogle Scholar
- Collins CR, Withers-Martinez C, Bentley GA, Batchelor AH, Thomas AW, Blackman MJ. Fine mapping of an epitope recognized by an invasion inhibitory monoclonal antibody on the malaria vaccine candidate apical membrane antigen 1. J Biol Chem. 2007;282:7431–41.View ArticlePubMedGoogle Scholar
- Thera MA, Doumbo OK, Coulibaly D, Laurens MB, Kone AK, Guindo AB, et al. Safety and immunogenicity of an AMA1 malaria vaccine in Malian children: results of a phase 1 randomized controlled trial. PLoS ONE. 2010;5:e9041.View ArticlePubMedPubMed CentralGoogle Scholar
- Thera MA, Doumbo OK, Coulibaly D, Laurens MB, Ouattara A, Kone AK, et al. A field trial to assess a blood-stage malaria vaccine. N Engl J Med. 2011;365:1004–13.View ArticlePubMedPubMed CentralGoogle Scholar
- Laurens MB, Thera MA, Coulibaly D, Ouattara A, Kone AK, Guindo AB, et al. Extended safety, immunogenicity and efficacy of a blood-stage malaria vaccine in malian children: 24-month follow-up of a randomized, double blinded phase 2 trial. PLoS ONE. 2013;8:e79323.View ArticlePubMedPubMed CentralGoogle Scholar
- Drew DR, Hodder AN, Wilson DW, Foley M, Mueller I, Siba PM, et al. Defining the antigenic diversity of Plasmodium falciparum apical membrane antigen 1 and the requirements for a multi-allele vaccine against malaria. PLoS ONE. 2012;7:e51023.View ArticlePubMedPubMed CentralGoogle Scholar