title: Allelic dimorphism of the erythrocyte binding antigen-175 (eba-175) gene of Plasmodium falciparum and severe malaria: Significant association of the C-segment with fatal outcome in Ghanaian children.
abstract: BACKGROUND
  The erythrocyte binding antigen-175 (EBA-175) on Plasmodium falciparum merozoites mediates sialic acid dependent binding to glycophorin A on host erythrocytes and, therefore, plays a crucial role in cell invasion. Dimorphic allele segments have been found in its encoding gene with a 342 bp segment present in FCR-3 strains (F-segment) and a 423 bp segment in CAMP strains (C-segment). Possible associations of the dimorphism with severe malaria have been analysed in a case-control study in northern Ghana.
  
  
  METHODS
  Blood samples of 289 children with severe malaria and 289 matched parasitaemic but asymptomatic controls were screened for eba-175 F- and C-segments by nested polymerase chain reaction.
  
  
  RESULTS
  In children with severe malaria, prevalences of F-, C- and mixed F-/C-segments were 70%, 19%, and 11%, respectively. The C-segment was found more frequently in severe malaria cases whereas mixed infections were more common in controls. Infection with strains harbouring the C-segment significantly increased the risk of fatal outcome.
  
  
  CONCLUSIONS
  The results show that the C-segment is associated with fatal outcome in children with severe malaria in northern Ghana, suggesting that it may contribute to the virulence of the parasite.
authors.affiliation: Berlin Institute of Tropical Medicine, Berlin, Germany. jakob.cramer@charite.de
authors.forename: Jakob P
authors.initials: JP
authors.lastname: Cramer
authors.forename: Frank P
authors.initials: FP
authors.lastname: Mockenhaupt
authors.forename: Ingo
authors.initials: I
authors.lastname: Möhl
authors.forename: Sabine
authors.initials: S
authors.lastname: Dittrich
authors.forename: Ekkehardt
authors.initials: E
authors.lastname: Dietz
authors.forename: Rowland N
authors.initials: RN
authors.lastname: Otchwemah
authors.forename: Stephan
authors.initials: S
authors.lastname: Ehrhardt
authors.forename: Ulrich
authors.initials: U
authors.lastname: Bienzle
authors.forename: Tomas
authors.initials: T
authors.lastname: Jelinek
mesh_terms: D000483:Alleles; D000818:Animals; D000953:Antigens, Protozoan / Q000737:chemistry / Q000235:genetics* / Q000502:physiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016054:DNA, Protozoan / Q000737:chemistry / Q000302:isolation & purification; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000401:mortality* / Q000469:parasitology*; D008297:Male; D010963:Plasmodium falciparum / Q000235:genetics* / Q000472:pathogenicity; D016133:Polymerase Chain Reaction; D015800:Protozoan Proteins / Q000737:chemistry / Q000235:genetics* / Q000502:physiology; D014774:Virulence
chemical_list: D000953:Antigens, Protozoan; D016054:DNA, Protozoan; D015800:Protozoan Proteins; C065668:erythrocyte-binding antigen 175, Plasmodium