Fitness costs and the rapid spread of kelch13-C580Y substitutions conferring artemisinin resistance

Shalini Nair, Xue Li, Grace A. Arya, Marina McDew-White, Marco Ferrari, François Nosten, Tim J.C. Anderson

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Fitness costs are key determinants of whether drug resistance alleles establish and how fast they spread within populations. More than 125 different kelch13 alleles, each containing a different amino acid substitution, have arisen in Southeast Asian malaria parasite (Plasmodium falciparum) populations under artemisinin selection over the past 15 years in a dramatic example of a soft selective event. However, just one of these alleles (C580Y) is now outcompeting other alleles in multiple different countries and is spreading toward fixation. Here we examine the fitness consequences of C580Y, relative to another less successful kelch13 mutation (R561H), to try to explain the distinctive dynamics of C580Y. We hypothesized that C580Y will show lower fitness costs than other kelch13 substitutions in the absence of artemisinin treatment. We used CRISPR/Cas9 methods to introduce single mutations (C580Y or R561H) or synonymous control edits into a wild-type parasite isolated on the Thailand-Myanmar border, conducted replicated head-to-head competition assays, and determined the outcome of competition using deep sequencing of kelch13 amplicons. Contrary to our predictions, these experiments reveal that C580Y carries higher fitness costs (s [selection coefficient] 0.15 0.008 [1 standard error {SE}]) than R561H (s 0.084 0.005). Furthermore, R561H outcompetes C580Y in direct competition (s 0.065 0.004). We conclude that fitness costs of C580Y in isolation are unlikely to explain the rapid spread of this substitution.

Original languageEnglish (US)
Article numbere00605-18
JournalAntimicrobial Agents and Chemotherapy
Volume62
Issue number9
DOIs
StatePublished - Sep 1 2018
Externally publishedYes

Fingerprint

Alleles
Costs and Cost Analysis
Parasites
Clustered Regularly Interspaced Short Palindromic Repeats
Myanmar
High-Throughput Nucleotide Sequencing
Mutation
Falciparum Malaria
Thailand
Amino Acid Substitution
Drug Resistance
Population
artemisinine

Keywords

  • Amplicon sequencing
  • CRISPR/Cas9
  • Fitness costs
  • Selection coefficient

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Nair, S., Li, X., Arya, G. A., McDew-White, M., Ferrari, M., Nosten, F., & Anderson, T. J. C. (2018). Fitness costs and the rapid spread of kelch13-C580Y substitutions conferring artemisinin resistance. Antimicrobial Agents and Chemotherapy, 62(9), [e00605-18]. https://doi.org/10.1128/AAC.00605-18

Fitness costs and the rapid spread of kelch13-C580Y substitutions conferring artemisinin resistance. / Nair, Shalini; Li, Xue; Arya, Grace A.; McDew-White, Marina; Ferrari, Marco; Nosten, François; Anderson, Tim J.C.

In: Antimicrobial Agents and Chemotherapy, Vol. 62, No. 9, e00605-18, 01.09.2018.

Research output: Contribution to journalArticle

Nair, S, Li, X, Arya, GA, McDew-White, M, Ferrari, M, Nosten, F & Anderson, TJC 2018, 'Fitness costs and the rapid spread of kelch13-C580Y substitutions conferring artemisinin resistance', Antimicrobial Agents and Chemotherapy, vol. 62, no. 9, e00605-18. https://doi.org/10.1128/AAC.00605-18
Nair, Shalini ; Li, Xue ; Arya, Grace A. ; McDew-White, Marina ; Ferrari, Marco ; Nosten, François ; Anderson, Tim J.C. / Fitness costs and the rapid spread of kelch13-C580Y substitutions conferring artemisinin resistance. In: Antimicrobial Agents and Chemotherapy. 2018 ; Vol. 62, No. 9.
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