Amitriptyline inhibits Plasmodium development in infected red blood cells by modulating sphingolipid metabolism and glucose uptake - 20/07/25
, Anne Ninnemann a, Hanna Abberger a, b, c, Fabian Schumacher d, Eyad Naser e, Leopold Purkart f, Francois Korbmacher f, g, Luiza Martins Nascentes Melo h, Nadine Beckmann e, Vivien Blietschau a, Julia Falkenstein a, Burkhard Kleuser d, Alpaslan Tasdogan h, Erich Gulbins e, Alexander Carpinteiro e, Robert Klopfleisch i, Jan Buer a, Astrid M. Westendorf a, Kai Matuschewski f, Wiebke Hansen aAbstract |
Malaria remains a global health challenge, necessitating novel therapeutic approaches. Here, we explore the role of the sphingolipid metabolism in Plasmodium infection. We focus on the enzyme acid sphingomyelinase (Asm), which hydrolyzes sphingomyelin to ceramide, a structural but also bioactive membrane molecule. We demonstrate induction of Asm activity in infected mice, leading to elevated ceramide levels in infected red blood cells. Pharmacological inhibition of Asm with the functional inhibitor amitriptyline in Plasmodium yoelii (Py)- and Plasmodium berghei ANKA (PbA)-infected mice significantly reduces parasitemia and mitigates disease-associated pathology. Amitriptyline treatment also reduces T cell activation, preserving blood-brain barrier integrity upon PbA infection. Remarkably, we observe inhibition of Plasmodium falciparum growth in vitro upon exposure to amitriptyline. Mechanistically, we elucidate that amitriptyline impedes intra-erythrocytic parasite development, due to a reduced glucose uptake and thereby interfering with the spreading of blood-stage Plasmodium parasites. Our findings highlight the therapeutic promise of targeting sphingolipid metabolism to combat Plasmodium infections.
El texto completo de este artículo está disponible en PDF.Graphical Abstract |
Highlights |
• | Asm activity and ceramide levels increase in RBCs during Plasmodium infection. |
• | Amitriptyline reduces parasitemia and disease severity in murine malaria models. |
• | Treatment limits T cell activation and preserves blood-brain barrier integrity. |
• | Amitriptyline blocks Plasmodium falciparum growth in vitro. |
• | Glucose uptake into infected erythrocytes is reduced by amitriptyline. |
Keywords : Malaria, Amitriptyline, Acid sphingomyelinase, Ceramide, S1P, Glucose
Esquema
Vol 189
Artículo 118331- août 2025 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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