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NK cell cytotoxicity is transiently enhanced during acute malaria and modulated by the host microenvironment
Pengjun Xi, Patrick A. Sandoz, Maximilian Julius Lautenbach, Eleni Bilev, Björn Önfelt, Anna Färnert, Quirin Hammer, Christopher Sundling
Pengjun Xi, Patrick A. Sandoz, Maximilian Julius Lautenbach, Eleni Bilev, Björn Önfelt, Anna Färnert, Quirin Hammer, Christopher Sundling
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Research Article Immunology Infectious disease Inflammation

NK cell cytotoxicity is transiently enhanced during acute malaria and modulated by the host microenvironment

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Abstract

Natural killer (NK) cells are pivotal in the early immune response to Plasmodium falciparum infection, yet their functional dynamics and regulation remain incompletely understood. In a longitudinal study of patients with malaria in a nonendemic setting, we observed a transient but potent activation of NK cell cytotoxicity during acute malaria, characterized by rapid granzyme B–mediated killing and elevated expression of genes associated with cytotoxicity (PRF1, GZMB, and GZMA). This heightened activity was supported by increased plasma levels of granzymes and proinflammatory cytokines, which enhanced NK cell function in vitro. However, plasma samples from clinical malaria also contained inhibitory mediators, including soluble cytokine receptors, which dampened NK cell responses. These findings reveal that the host microenvironment orchestrates a tightly regulated NK cell response that potentiates cytotoxicity during acute infection and rapidly downmodulates it after treatment. Understanding this balance between activation and suppression may inform strategies to harness NK cells for malaria control while minimizing immunopathology.

Authors

Pengjun Xi, Patrick A. Sandoz, Maximilian Julius Lautenbach, Eleni Bilev, Björn Önfelt, Anna Färnert, Quirin Hammer, Christopher Sundling

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Figure 1

NK cell dynamics and protein expression during and after acute malaria.

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NK cell dynamics and protein expression during and after acute malaria.
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(A) Representative FACS plot showing gating strategy for NK cell subsets based on CD56 and CD16 expression. (B) Percent CD56bright, CD56dim, CD56–, proliferating (Ki67+), and activated (CD38+HLA-DR+) cells out of total NK cells. (C) Percent Ki67+ cells among NK cell subsets and activated NK cells. (D) The ratio between Ki67+ cells out of total NK cells, indicating preferential enrichment. (E–L) Expression of NK cell markers (E) CD8, (F) CD57, (G) FcRγ, (H) PLZF, (I) NKG2A, (J) NKG2C, (K) perforin, and (L) granzyme B among CD56bright, CD56dim, and CD56– NK cells. Protein levels were compared between acute (blue circles) and convalescent (12 month; orange boxes) time points for matched donor samples (n = 14). Statistical analyses for (B and E–L) were done using 2-tailed paired t tests. Analysis for (D) was done using one-way ANOVA followed by Tukey’s post hoc test. *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001.

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