The role of septin 9 in the regulation of vascular permeability in malaria-associated acute respiratory distress syndrome

Abstract

Malaria is a huge public health problem worldwide and caused 409,000 deaths in 2019. Its severe form can manifest in the lungs, a disease known as acute respiratory distress syndrome (ARDS). Not much is known about the development of malaria-associated ARDS (MA-ARDS), especially regarding the mechanisms of increased vascular permeability. Previously, we established a murine model with Plasmodium berghei ANKA-infected DBA/2 mice that mimics several aspects of human ARDS, such as pulmonary edema, hemorrhages, pleural effusion and hypoxemia. Our previous in vitro results pointed to an increase in vascular permeability when infected erythrocytes come into contact with endothelial cells via RhoA activation and FAK alteration. Recently, using a proteomic discovery strategy, we observed the overexpression of 32 proteins in the lung tissue of DBA/2 mice infected with P. berghei ANKA that developed ARDS, and among them, Sep-tin 9. As this protein promotes cytoskeletal rearrangements and turnover of focal adhesions by directing Rho/ROCK and FAK signaling, we hypothesized that Septin 9 could be a key molecule for increased vascular permeability in SRDA associated with malaria. Therefore, if this hypothesis is confirmed, intervention in this signaling pathway could help patients not to develop severe malaria.