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Haemoglobin C protects against clinicalPlasmodium falciparum malaria

Naturevolume 414, pages305–308 (2001)Cite this article

Abstract

Haemoglobin C (HbC; β6Glu → Lys) is common in malarious areas of West Africa, especially in Burkina Faso1,2. Conclusive evidence exists on the protective role against severe malaria of haemoglobin S (HbS; β6Glu → Val) heterozygosity3, whereas conflicting results for the HbC trait have been reported4,5,6,7,8,9,10 and no epidemiological data exist on the possible role of the HbCC genotype.In vitro studies suggested that HbCC erythrocytes fail to support the growth ofP. falciparum11,12 but HbC homozygotes with highP. falciparum parasitaemias have been observed10. Here we show, in a large case–control study performed in Burkina Faso on 4,348 Mossi subjects, that HbC is associated with a 29% reduction in risk of clinical malaria in HbAC heterozygotes (P = 0.0008) and of 93% in HbCC homozygotes (P = 0.0011). These findings, together with the limited pathology of HbAC and HbCC13 compared to the severely disadvantaged HbSS and HbSC genotypes and the low βS gene frequency in the geographic epicentre of βC1,2,14, support the hypothesis that, in the long term and in the absence of malaria control, HbC would replace HbS in central West Africa.

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Acknowledgements

We thank all the children in this study, and their parents and teachers, for their understanding and assistance. We thank the paediatric and laboratory staff of the Centre Hospitalier National Yalgado Quédraogo and of the Saint Camille Health Centre of Ouagadougou, Burkina Faso, for technical assistance. This work was based at the Centre National de Recherche et Formation sur le Paludisme of the Ministry of Health of Burkina Faso, co-sponsored by the Italian Cooperation (MAE-DGCS). Financial support was also provided by the European Community and by the Conferenza Episcopale Italiana.

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Authors and Affiliations

  1. Dipartimento di Scienze di Sanità Pubblica, Sezione di Parassitologia, WHO Collaborating Centre for Malaria Epidemiology and Control,

    David Modiano, Gaia Luoni, Elena Rastrelli, Anna Olivieri, Carlo Calissano, Giacomo Maria Paganotti, Leila D'Urbano & Mario Coluzzi

  2. Istituto Pasteur Fondazione Cenci Bolognetti, University of Rome “La Sapienza”, Rome, 00185, Italy

    David Modiano, Federica Verra & Mario Coluzzi

  3. Centre National de Recherche et Formation sur le Paludisme, Ministère de la Santé,

    Bienvenu Sodiomon Sirima & Amadou Konaté

  4. Centre Medical Saint-Camille,

    Jacques Simporé

  5. Service de Pédiatrie, Centre Hospitalier National Yalgado Ouedraogo, Ouagadougou, 01 BP 2208, Burkina Faso

    Issa Sanou & Alphonse Sawadogo

  6. Dipartimento di Biologia, Università “Tor Vergata”, Rome, 00133, Italy

    Guido Modiano

Authors
  1. David Modiano

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  2. Gaia Luoni

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  3. Bienvenu Sodiomon Sirima

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  4. Jacques Simporé

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  5. Federica Verra

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  6. Amadou Konaté

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  7. Elena Rastrelli

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  8. Anna Olivieri

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  9. Carlo Calissano

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  10. Giacomo Maria Paganotti

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  11. Leila D'Urbano

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  13. Alphonse Sawadogo

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  14. Guido Modiano

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  15. Mario Coluzzi

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Corresponding author

Correspondence toDavid Modiano.

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Modiano, D., Luoni, G., Sirima, B.et al. Haemoglobin C protects against clinicalPlasmodium falciparum malaria.Nature414, 305–308 (2001). https://doi.org/10.1038/35104556

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