Acute Plasmodium Infection Promotes Interferon-Gamma-Dependent Resistance to Ebola Virus Infection

Abstract

Summary: During the 2013–2016 Ebola virus (EBOV) epidemic, a significant number of patients admitted to Ebola treatment units were co-infected with Plasmodium falciparum, a predominant agent of malaria. However, there is no consensus on how malaria impacts EBOV infection. The effect of acute Plasmodium infection on EBOV challenge was investigated using mouse-adapted EBOV and a biosafety level 2 (BSL-2) model virus. We demonstrate that acute Plasmodium infection protects from lethal viral challenge, dependent upon interferon gamma (IFN-γ) elicited as a result of parasite infection. Plasmodium-infected mice lacking the IFN-γ receptor are not protected. Ex vivo incubation of naive human or mouse macrophages with sera from acutely parasitemic rodents or macaques programs a proinflammatory phenotype dependent on IFN-γ and renders cells resistant to EBOV infection. We conclude that acute Plasmodium infection can safeguard against EBOV by the production of protective IFN-γ. These findings have implications for anti-malaria therapies administered during episodic EBOV outbreaks in Africa. : Rogers et al. demonstrate that acute Plasmodium infection protects against lethal Ebola virus challenge. Protection is conferred by Plasmodium-elicited interferon gamma (IFN-γ) that causes M1 polarization of tissue macrophages. These studies provide insight into conflicting clinical data regarding whether malaria protects or sensitizes hosts to Ebola virus. Keywords: Plasmodium, Ebola virus, macrophage polarization, co-infection, interferon gamma, malaria, filovirus, innate immunity, macrophage