To determine whether levels of A-to-I editing of RNA are transiently reduced as part of the innate immune response to P.falciparum infection, we analysed RNA-sequencing data for levels of A-to-I editing, in different models of protection from malaria infection. We found that across many different models of infection, including a) protected Fulani individuals, compared to control Mossi individuals, b) individuals participating in P.falciparum vaccination studies (compared to unvaccinated individuals), c) individuals with repeated prior infection by P.falciparum (compared to people who have never been exposed to malaria before), and d) young individuals as they transition from susceptibility to resistance to malaria after repeated natural exposures to P.falciparum (with non-symptomatic individuals compared to symptomatic individuals in the same community), there were reduced levels of editing in protected individuals, and conversely increased levels of editing in unprotected individuals. This analysis shows that levels of A-to-I editing change in individuals following P.falciparum infection, and specifically supports our hypothesis that A-to-I editing levels are reduced in individuals protected from malaria.
We also looked at specific cell types involved in the changes of A-to-I editing. By treating immune cells isolated from the blood of healthy blood donors with P.falciparum grown in culture, we could see that innate immune cells such as monocytes, macrophages, and dendritic cells had reduced levels of ADAR1 expression and reduced A-to-I RNA editing shortly after exposure to stimuli found in malaria, within just a few hours.
Finally, to see if reduced levels of ADAR1 and/or A-to-I editing levels are enough to give protection against malaria, we used a rodent malaria (P.yoelii) to infect normal (wild-type) mice, and mice with only one working copy of the Adar1 gene (Adar1 +/- heterozygous mice). In normal mice, the malaria infection last about 30 days, before there is no more P.yoelli parasite detected in their blood. In Adar1+/- mice, there is significantly less P.yoelii parasite detected in their blood, over the whole 30 days of the infection. This strongly supports our hypothesis that reduced levels of ADAR1 and A-to-I RNA editing can drive a protective immune response against malaria.