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Journal Articles Cell Metabolism Year : 2022

A hypometabolic defense strategy against malaria

Susana Ramos
Qian Wu
Rui Martins
Inês Mahú
Elsa Seixas
Fabienne Rajas
Gilles Mithieux


Hypoglycemia is a clinical hallmark of severe malaria, the often-lethal outcome of Plasmodium falciparum infection. Here, we report that malaria-associated hypoglycemia emerges from a non-canonical resistance mechanism, whereby the infected host reduces glycemia to starve Plasmodium. This hypometabolic response is elicited by labile heme, a byproduct of hemolysis that induces illness-induced anorexia and represses hepatic glucose production. While transient repression of hepatic glucose production prevents unfettered immune-mediated inflammation, organ damage, and anemia, when sustained over time it leads to hypoglycemia, compromising host energy expenditure and adaptive thermoregulation. The latter arrests the development of asexual stages of Plasmodium via a mechanism associated with parasite mitochondrial dysfunction. In response, Plasmodium activates a transcriptional program associated with the reduction of virulence and sexual differentiation toward the generation of transmissible gametocytes. In conclusion, malaria-associated hypoglycemia represents a trade-off of a hypometabolic-based defense strategy that balances parasite virulence versus transmission.
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Dates and versions

inserm-03413821 , version 1 (17-10-2022)



Susana Ramos, Temitope Ademolue, Elisa Jentho, Qian Wu, Joel Guerra, et al.. A hypometabolic defense strategy against malaria. Cell Metabolism, 2022, 34 (8), pp.1183-1200.e12. ⟨10.1016/j.cmet.2022.06.011⟩. ⟨inserm-03413821⟩
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