# Role of the gut microbiota in shaping severity of malaria

> **NIH NIH R01** · INDIANA UNIVERSITY INDIANAPOLIS · 2020 · $516,986

## Abstract

Infections by parasites of the genus Plasmodium cause more than 200 million cases of malaria and kill more
than 400,000 people annually, the majority of whom are Plasmodium falciparum-infected children in sub-
Saharan Africa. Most Plasmodium infections are either asymptomatic or cause only mild malaria. A small
proportion of infections progress to severe malaria that can be life threatening. To date, the host factors that
predispose patients to developing severe malaria are not known, and it has not been possible to identify risk
factors that predict progression from asymptomatic infection to severe malaria. These knowledge gaps hinder
discovery of new strategies for the prevention of severe malaria. Using multiple Plasmodium species and
mouse strains, we have recently published the novel observation that mice with distinct gut bacterial
communities exhibit differences in the severity of malaria and humoral immune response following infection
with Plasmodium. Mice resistant to severe malaria exhibit elevated T follicular helper (Tfh) and germinal center
(GC) B cell numbers and accelerated antibody class switching following Plasmodium yoelii infection compared
to susceptible mice. When mice predicated to develop mild malaria were treated with antibodies that disrupt
Tfh-GC B cell communication, they developed high parasite burdens, similar to mice that develop severe
malaria. These new observations support the scientific premise of this application and suggest that gut
microbiome-mediated modulation of the GC reaction may be a critical mechanism underlying the development
of severe malaria. The objective of this proposal is to determine the immunological mechanisms by which the
gut microbiome determines susceptibility to severe malaria and identify the specific microbes and metabolites
responsible for this outcome. These studies will move the field of malaria pathogenesis forward in new
directions and may lead to new translational approaches to control severe malaria, which could, in turn, save
the hundreds of thousands of lives lost to severe malaria each year. The central hypothesis of this proposal
is that specific microbes and their metabolites modulate GC reactions to determine susceptibility to severe
malaria. Our hypothesis will be tested through the following specific aims: Aim 1. Determine the dynamics of
gut microbiota-mediated modulation of the GC reaction in mice. Aim 2. Determine the Tfh cell- and GC B cell-
intrinsic pathways modulated by the gut microbiota in mice. Aim 3. Identify the specific gut bacteria and their
metabolites that determine resistance or susceptibility to severe malaria in mice.

## Key facts

- **NIH application ID:** 9831124
- **Project number:** 5R01AI123486-05
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** Nathan Schmidt
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $516,986
- **Award type:** 5
- **Project period:** 2017-01-11 → 2021-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9831124

## Citation

> US National Institutes of Health, RePORTER application 9831124, Role of the gut microbiota in shaping severity of malaria (5R01AI123486-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9831124. Licensed CC0.

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