4.7 Article

Cytochrome b Drug Resistance Mutation Decreases Babesia Fitness in the Tick Stages But Not the Mammalian Erythrocytic Cycle

Journal

JOURNAL OF INFECTIOUS DISEASES
Volume 225, Issue 1, Pages 135-145

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiab321

Keywords

Ixodes scapularis; endochin-like quinolone; drug resistance; transmission; vector

Funding

  1. National Institutes of Health [R01AI123321, R01AI138139, R01AI152220, R01AI136118, R01AI100569, R01AI141412]
  2. Steven and Alexandra Cohen Foundation [Lyme 62 2020]
  3. US Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development Program [i01 BX003312]
  4. US Department of Defense Peer Reviewed Medical Research Program [PR181134]
  5. U.S. Department of Veterans Affairs VA Merit Review Award [BX004522]
  6. CDMRP [1102723, PR181134] Funding Source: Federal RePORTER

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This study found that a mutation in the Babesia microti mitochondrial cytochrome b gene confers resistance to an anti-Babesial drug, but reduces parasite fitness in the arthropod vector. Mutant parasites developing in the tick vector are genetically unstable, possibly leading to the reemergence of the wild-type allele during the nymphal stage. The presence of this mutation in Babesia microti parasites may be decreased by passage through the tick vector, but could persist in the environment if present when ticks feed.
Human babesiosis is an emerging tick-borne malaria-like illness caused by Babesia parasites following their development in erythrocytes. Here, we show that a mutation in the Babesia microti mitochondrial cytochrome b (Cytb) that confers resistance to the antibabesial drug ELQ-502 decreases parasite fitness in the arthropod vector. Interestingly, whereas the mutant allele does not affect B. microti fitness during the mammalian blood phase of the parasite life cycle and is genetically stable as parasite burden increases, ELQ-502-resistant mutant parasites developing in the tick vector are genetically unstable with a high rate of the wild-type allele emerging during the nymphal stage. Furthermore, we show that B. microti parasites with this mutation are transmitted from the tick to the host, raising the possibility that the frequency of Cytb resistance mutations may be decreased by passage through the tick vector, but could persist in the environment if present when ticks feed.

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