TY - JOUR TI - Common host variation drives malaria parasite fitness in healthy human red cells AU - Ebel, Emily R AU - Kuypers, Frans A AU - Lin, Carrie AU - Petrov, Dmitri A AU - Egan, Elizabeth S A2 - Tung, Jenny A2 - Perry, George H VL - 10 PY - 2021 DA - 2021/09/23 SP - e69808 C1 - eLife 2021;10:e69808 DO - 10.7554/eLife.69808 UR - https://doi.org/10.7554/eLife.69808 AB - The replication of Plasmodium falciparum parasites within red blood cells (RBCs) causes severe disease in humans, especially in Africa. Deleterious alleles like hemoglobin S are well-known to confer strong resistance to malaria, but the effects of common RBC variation are largely undetermined. Here, we collected fresh blood samples from 121 healthy donors, most with African ancestry, and performed exome sequencing, detailed RBC phenotyping, and parasite fitness assays. Over one-third of healthy donors unknowingly carried alleles for G6PD deficiency or hemoglobinopathies, which were associated with characteristic RBC phenotypes. Among non-carriers alone, variation in RBC hydration, membrane deformability, and volume was strongly associated with P. falciparum growth rate. Common genetic variants in PIEZO1, SPTA1/SPTB, and several P. falciparum invasion receptors were also associated with parasite growth rate. Interestingly, we observed little or negative evidence for divergent selection on non-pathogenic RBC variation between Africans and Europeans. These findings suggest a model in which globally widespread variation in a moderate number of genes and phenotypes modulates P. falciparum fitness in RBCs. KW - malaria KW - Plasmodium falciparum KW - red blood cells KW - parasite fitness KW - natural variation JF - eLife SN - 2050-084X PB - eLife Sciences Publications, Ltd ER -