Association mapping by pooled sequencing identifies TOLL 11 as a protective factor against Plasmodium falciparum in Anopheles gambiae

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Study Justification:
– The study aims to address the limitations of current genome-wide association study (GWAS) techniques in mosquitoes, which are characterized by high nucleotide diversity, low linkage disequilibrium, and complex population stratification.
– By combining the power of linkage mapping with the resolution of genetic association, the study provides a novel mapping strategy for the mosquito system.
– The study focuses on identifying genetic factors that protect against Plasmodium falciparum infection in Anopheles gambiae, the mosquito species responsible for transmitting malaria.
Highlights:
– The study successfully identifies a locus encoding two Toll-family proteins, specifically TOLL 11, as a protective factor against P. falciparum infection in A. gambiae.
– The findings demonstrate the applicability of the novel mapping strategy for genetic mapping in a complex non-model genome.
– The study presents an efficient and cost-effective method for genetic mapping using natural variation segregating in defined founder colonies.
Recommendations:
– The study recommends the use of the novel mapping strategy for first-pass mapping of phenotypes in Anopheles mosquitoes, as an alternative to population-based GWAS.
– The approach should facilitate mapping of other traits involved in physiology, epidemiology, and behavior in Anopheles mosquitoes.
Key Role Players:
– Researchers with expertise in genetics, genomics, and mosquito biology.
– Entomologists and parasitologists familiar with Anopheles mosquitoes and Plasmodium falciparum.
– Laboratory technicians skilled in DNA extraction, sequencing, and genotyping.
– Bioinformaticians proficient in data analysis and interpretation.
Cost Items for Planning Recommendations:
– Research equipment and supplies for DNA extraction, sequencing, and genotyping.
– Laboratory personnel salaries and training.
– Computational resources for data analysis.
– Research permits and ethical approvals.
– Publication and dissemination costs.
– Travel and accommodation for fieldwork and collaboration.

The strength of evidence for this abstract is 8 out of 10.
The evidence in the abstract is strong because the study used a novel mapping strategy combining linkage mapping and genetic association to identify candidate genomic loci for influence upon parasite infection levels in mosquitoes. The study also confirmed significant SNPs in a locus encoding two Toll-family proteins and demonstrated the protective effect of TOLL 11 against P. falciparum infection. However, to improve the evidence, the study could include a larger sample size and replicate the findings in independent populations.

Background: The genome-wide association study (GWAS) techniques that have been used for genetic mapping in other organisms have not been successfully applied to mosquitoes, which have genetic characteristics of high nucleotide diversity, low linkage disequilibrium, and complex population stratification that render population-based GWAS essentially unfeasible at realistic sample size and marker density. Methods: We designed a novel mapping strategy for the mosquito system that combines the power of linkage mapping with the resolution afforded by genetic association. We established founder colonies from West Africa, controlled for diversity, linkage disequilibrium and population stratification. Colonies were challenged by feeding on the infectious stage of the human malaria parasite, Plasmodium falciparum, mosquitoes were phenotyped for parasite load, and DNA pools for phenotypically similar mosquitoes were Illumina sequenced. Phenotype-genotype mapping was carried out in two stages, coarse and fine. Results: In the first mapping stage, pooled sequences were analysed genome-wide for intervals displaying relativereduction in diversity between phenotype pools, and candidate genomic loci were identified for influence upon parasite infection levels. In the second mapping stage, focused genotyping of SNPs from the first mapping stage was carried out in unpooled individual mosquitoes and replicates. The second stage confirmed significant SNPs in a locus encoding two Toll-family proteins. RNAi-mediated gene silencing and infection challenge revealed that TOLL 11 protects mosquitoes against P. falciparum infection. Conclusions: We present an efficient and cost-effective method for genetic mapping using natural variation segregating in defined recent Anopheles founder colonies, and demonstrate its applicability for mapping in a complex non-model genome. This approach is a practical and preferred alternative to population-based GWAS for first-pass mapping of phenotypes in Anopheles. This design should facilitate mapping of other traits involved in physiology, epidemiology, and behaviour.

Wild caught A. gambiae s.l. females originated either from Burkina Faso (Goundry region) or from Mali (Bancoumana region). Gravid females were captured by aspiration indoors, ensuring that at the time of capture they had already mated assortatively under natural conditions and bloodfed. They were then placed individually in oviposition tubes with wet filter paper. Females that laid eggs were collected and stored in ethanol before genomic DNA extraction. Eggs from individual oviposition were placed in a pan of water with Tetramin fish food. Emerged adults were reared under standard conditions at 26 °C and 80 % humidity, 12 h light/dark cycle with access to cotton soaked in 10 % sucrose solution. Females that laid eggs were typed for species, molecular form and the molecular karyotype of the 2La chromosomal inversion [16]. Maternal genotype was determined by genotyping. Because mating occurred in nature, the paternal genotype was inferred by genotyping F1 offspring. Isofemale families identified as A. coluzzii (M form) with the karyotype 2La/a, were used to initiate colonies. No hybrid families resulting from MxS form crosses were seen. Founder colony 03 (Fd03) was started with the F1 offspring from six mated females originating from Mali and founder colonies 5 (Fd05) and 9 (Fd09) were created with the offspring of 10 and 11, respectively, females from Burkina Faso. Colonies are routinely monitored for species and 2La inversion karyotype. Individual mosquitoes from founder colonies Fd03, Fd05, and Fd09 were genotyped for five microsatellite markers (2 L.17686896, 2 L.19444747, 2 L.41431233, 2 L.40133863, and H603) using described primers and methods [3]. The naming convention of the indicated microsatellites is chromosome arm:nucleotide coordinate. Microsatellite data were used for estimates of pairwise Fst among colonies and the wild source population. Pairwise Fst values were calculated using Genepop [33] and neighbour joining trees were constructed using Mega 2.1 [34]. Estimates of founder colony diversity were performed on mosquito samples 3–5 months prior to mapping by pooled sequencing, thus diversity and divergence as shown in Fig. 1 should accurately represent diversity present at the mapping stage. P. falciparum isolate NF54 was cultured using an automated tipper-table system [35] as implemented in the CEPIA mosquito infection facility of the Institut Pasteur [24]. For infection, mature gametocytes are added to fresh erythrocytes in AB human serum, mixed gently, and transferred to a membrane feeder prewarmed to 37 °C. Mosquitoes were allowed to feed for 15 min, and only fully engorged females were used for further analysis. Infection phenotypes were oocyst infection prevalence and intensity. Oocyst prevalence is the fraction of mosquitoes carrying at least one oocyst, while intensity is the number of oocysts per mosquito determined only in the subset of mosquitoes with ≥1 oocyst. Midguts of bloodfed females were dissected 7–8 days post-infection, stained in 1xPBS buffer with 0.4 % mercury dibromofluorescein (Sigma) and the number of oocysts per midgut was determined by light microscopy. Carcasses of the dissected mosquitoes were stored at −20 °C until DNA extraction. Genomic DNA was extracted from individual female mosquitoes by homogenization in 100ul DNAZol (Invitrogen, CA, USA) using a disposable pestle, following the manufacturer’s protocol. Based on the observed number of a P. falciparum oocysts, mosquitoes were assigned to one of three phenotype categories, and phenotype pools were constituted from ≥14 mosquitoes each for i) the “Zero” pool of bloodfed mosquitoes carrying zero oocysts, ii) the “Low” pool with 1–6 oocysts, and iii) the “High” pool with ≥10 oocysts. Thresholds for phenotype pools are determined empirically. Specifically for Fd03, the zero pool was comprised of 20 mosquitoes, the low pool (carrying 1–5 oocysts) included 17 mosquitoes and the high pool (>10 oocysts) included 14 mosquitoes. The entire infection comprised 93 individuals and the pools included 51, or 55 %. For Fd09, each pool was comprised of 20 individuals, with the low pool defined as 1–6 oocysts and the high pool as >29 oocysts. The complete infection had 102 individuals and thus the pools comprised 59 % of the entire infection. DNA concentrations were determined by the picogreen method [36], and DNAs of individual mosquitoes were combined at equal molarity to obtain a total of 700 ng per phenotype pool. The pooled DNAs were submitted to Illumina sequencing and sequenced to an average depth of 40× per pool or ~ 2× per mosquito. Illumina sequences were aligned to the AgamP3 genome [20] using Bowtie version 0.12.7 [37]. Reads with low mapping quality (MQ < 40) were removed and allele frequencies called using samtools mpileup [38]. Apparent low frequency variants, which could be either true low frequency alleles or sequencing errors, are irrelevant in a windowed analysis of pooled samples, and were not resolved. Pooled heterozygosity was calculated across sliding windows (10 kb windows, 1 kb steps) for each of the phenotype pools individually, as well as for the whole founder colony combined, using the Hp metric proposed by Qanbari et al. [39]. Relative diversity (HpR) was calculated as the proportion of heterozygosity in a phenotype pool relative to total heterozygosity within the whole founder colony after normalising for overall read-depth in each pool. Standard deviation of HpR values (SHpR) was used to identify regions with over-represented haplotypes as compared to the whole founder colony. High-SHpR regions within ≤5 Mb were combined to constitute a single locus. To establish significance thresholds, random resampling was performed for 1000 permutations for each window. SHpR values were then segmented using the fastseg Bioconductor [40] package to identify clearly differing regions. Regions below 1e−4 probability according to the permutation analysis were removed. Three regions were selected for subsequent fine mapping: two from Fd09 and one from Fd03. Loci identified from pooled sequence during the genome-wide mapping phase were filtered on the basis of differences in the proportion of reads showing the alternate allele (used here as a proxy for minor allele frequency). SNPs with the greatest differences in read-counts between phenotype pools were used to design SNP plexes for genotyping using the Sequenom MassARRAY platform. A single plex (20–25 individual SNP assays) was designed for each locus. Individual DNAs from the same experimental infection that was pool-sequenced, including individuals used to generate the pools and additional samples that did not contribute to the phenotype pools, were typed with SNPs specific to that founder colony. For both Fd03 and Fd09 there were 42 individuals that were SNP genotyped, but had not been part of the original extreme pools. These individuals either had zero oocysts or phenotypes intermediate between the low and high pools. In addition, a second, completely independent experimental infection of the same founder colony that had not been subjected to pooled sequencing was genotyped in the same way. This independent infection of Fd03 had 41 individual mosquitoes whose infection levels varied from 0 to 23 oocysts. Correlation between allele frequencies derived from pooled sequencing and individual genotyping via Sequenom is presented in Additional file 6. Individual mosquitos were categorized into binary phenotypes with respect to infection prevalence (uninfected/infected) and infection intensity (low infected/high infected) using the same oocyst cutoffs employed for pooling. Logistic regression was used to test for significant association with phenotype using PLINK [41] and all statistics controlled for multiple testing. Replicate infections were tested for significance both individually and across replicates. Pool sequencing is a relatively young variant of whole genome sequencing, and it is a challenge to ascertain candidate SNP assays for individual genotyping, which may limit the efficiency of replicating pooled sequence loci using individual genotyping [42]. Putative variants were filtered for sequencing quality, and consequences of variants were called for both colonies using the Ensembl Variant Effect Predictor (v2.3) [43] against VectorBase genebuild AgamP3.5 [44] and using Ensembl API 65.3 (Dec 2011). Enrichment for gene ontology terms was calculated by Fisher’s exact test using custom R scripts and topGO, from the Bioconductor suite [45]. dN:dS ratios were assessed by locus counting using custom R scripts. Due to the lack of available codon substitution data for this species, multiple substitutions or codon bias could not be analysed in dN:dS results. Molecular karyotyping of the 2Rb inversion for Fd09 was carried out by a published method [46]. Molecular karyotyping results were confirmed against a panel of individuals previously karyotyped by polytene chromosome analysis (not shown). Double-stranded RNAs were synthesized from PCR amplicons using the T7 Megascript Kit (Life Technologies) as described previously [24]. Primers are listed in Additional file 7. For each targeted gene, 500 ng of dsRNA (but not more than 207 nl volume) were injected into the thorax of cold-anesthetized 1-day-old A. gambiae females using a nanoinjector (Nanoject II; Drummond). The efficiency of gene silencing was monitored 4 d after dsRNA injection as follows. cDNA synthesis was performed using the M-MLV reverse transcriptase with random hexamers (Invitrogen). In each case, 1 μg of total RNA was used in triplicate reactions. The triplicates were pooled and the mixture was used as template for PCR analysis. Primers used in PCR for gene silencing verification are listed in Additional file 7. Verification of gene silencing is shown in Additional file 8. Midgut oocysts were counted as described above, and were analysed for the same two phenotypes, infection prevalence and oocyst intensity. Oocyst infection values for gene silencing experiments were calculated from replicates of ≥30 dissected mosquitoes. All replicates per condition were analysed for oocyst infection prevalence. In contrast, for analysis of oocyst intensity, only the mosquitoes carrying ≥1 oocyst are considered. Therefore, for analysis of differences in oocyst intensity, a threshold of ≥30 % oocyst infection prevalence per replicate was imposed [2, 32]. For statistical analysis, comparisons of infection prevalence were made using the Chi Square test, and comparisons of oocyst intensity (excluding mosquitoes with zero oocysts) using the non-parametric Wilcoxon Mann Whitney test. At least two independent replicate infections were performed per condition. Replicates were analysed independently using the tests described above. If at least one replicate met the significance criterion of p ≤ 0.05, a third replicate was done. The p-values from independent tests of significance were combined using the meta-analytical approach of Fisher [47], and this combined p value is reported here. The threshold for combined significance was defined as p = 0.01.

Based on the provided information, it is not clear how the study on the genetic mapping of Plasmodium falciparum in Anopheles gambiae can directly contribute to improving access to maternal health. However, here are some potential innovations that could be considered to improve access to maternal health:

1. Telemedicine: Implementing telemedicine programs that allow pregnant women in remote areas to access prenatal care and consultations with healthcare providers through video calls or mobile apps.

2. Mobile clinics: Setting up mobile clinics that can travel to rural areas to provide prenatal care, vaccinations, and other essential maternal health services.

3. Community health workers: Training and deploying community health workers who can provide basic prenatal care, education, and support to pregnant women in underserved communities.

4. Maternal health vouchers: Introducing voucher programs that provide pregnant women with access to essential maternal health services, such as prenatal care, skilled birth attendance, and postnatal care.

5. Maternal health education: Developing and implementing comprehensive maternal health education programs that empower women with knowledge about pregnancy, childbirth, and postpartum care.

6. Emergency transportation: Establishing emergency transportation systems, such as ambulances or motorcycle taxis, to ensure timely access to healthcare facilities for pregnant women in emergency situations.

7. Maternal health financing: Exploring innovative financing mechanisms, such as microinsurance or community-based health financing, to make maternal health services more affordable and accessible to all women.

8. Maternal health technology: Investing in the development and adoption of innovative technologies, such as portable ultrasound devices or wearable devices for monitoring maternal health indicators, to improve early detection of complications and enhance the quality of care.

9. Maternity waiting homes: Establishing maternity waiting homes near healthcare facilities to accommodate pregnant women who live far away and need to stay close to the facility before giving birth.

10. Strengthening healthcare systems: Investing in the overall strengthening of healthcare systems, including infrastructure, human resources, and supply chain management, to ensure that maternal health services are available and accessible to all women.
AI Innovations Description
The provided description does not directly relate to improving access to maternal health. However, based on the information provided, it appears that the study focuses on genetic mapping and identifying genetic factors that protect mosquitoes against Plasmodium falciparum infection, which causes malaria. This research could potentially contribute to the development of innovative strategies to control malaria, which indirectly impacts maternal health in areas where malaria is prevalent. It is important to note that further research and development would be needed to translate these findings into practical solutions for improving access to maternal health.
AI Innovations Methodology
The provided text is a scientific research paper describing a methodology for mapping genetic factors that influence Plasmodium falciparum infection levels in Anopheles gambiae mosquitoes. It does not directly address innovations to improve access to maternal health or describe a methodology to simulate the impact of these innovations.

To improve access to maternal health, here are some potential recommendations:

1. Telemedicine: Implementing telemedicine programs can provide remote access to healthcare professionals for prenatal care, consultations, and monitoring of high-risk pregnancies. This can be especially beneficial for women in rural or underserved areas.

2. Mobile health (mHealth) applications: Developing mobile applications that provide educational resources, appointment reminders, and personalized health information can empower pregnant women to take an active role in their own healthcare. These apps can also facilitate communication between healthcare providers and patients.

3. Community health workers: Training and deploying community health workers who can provide basic prenatal care, health education, and referrals to pregnant women in remote or marginalized communities can improve access to maternal health services.

4. Maternal health clinics: Establishing dedicated maternal health clinics in underserved areas can provide comprehensive prenatal care, delivery services, and postnatal care to women who may otherwise have limited access to healthcare facilities.

To simulate the impact of these recommendations on improving access to maternal health, a methodology could include the following steps:

1. Define the target population: Identify the specific population or region where the recommendations will be implemented. Consider factors such as demographics, geographic location, and existing healthcare infrastructure.

2. Collect baseline data: Gather data on the current state of maternal health in the target population, including metrics such as maternal mortality rates, access to prenatal care, and health outcomes for mothers and infants.

3. Design and implement interventions: Develop and implement the recommended innovations, such as telemedicine programs, mHealth applications, community health worker training, or establishment of maternal health clinics. Ensure that these interventions are tailored to the specific needs and context of the target population.

4. Monitor and evaluate: Continuously monitor the implementation of the interventions and collect data on key indicators, such as the number of women accessing maternal health services, improvements in health outcomes, and user satisfaction. Use qualitative and quantitative methods to assess the impact of the interventions.

5. Analyze and interpret data: Analyze the collected data to evaluate the effectiveness of the interventions in improving access to maternal health. Compare the baseline data with the post-intervention data to identify any significant changes or improvements.

6. Adjust and refine: Based on the findings from the evaluation, make any necessary adjustments or refinements to the interventions. This could involve scaling up successful interventions, addressing any barriers or challenges identified, or modifying the interventions based on user feedback.

7. Repeat and expand: If the interventions show positive results, consider expanding their implementation to other regions or populations with similar needs. Continuously monitor and evaluate the interventions to ensure ongoing improvement and sustainability.

By following this methodology, it is possible to simulate the impact of innovations on improving access to maternal health and make evidence-based decisions for scaling up successful interventions.

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