Ebola Virus and Malaria Coinfection: How Infection with One Pathogen May Protect Against Another

SUMMARY Both malaria and Ebola virus have been the centre of global health care efforts in recent years, due to the massive ongoing disease burden of malaria and the largest Ebola outbreak in history in West Africa. However, little is known about the interplay of these two diseases within the same host, and it has been suggested that coinfection with Ebola virus and Plasmodium falciparum, the causative agent of malaria, may impact survival outcomes in Ebola patients. While the existing literature is conflicting, it is obvious that there is some level of interaction that needs to be further explored. I propose a potential mechanism by which P. falciparum infection prior to infection with Ebola virus could have a protective role, namely in the ability of P. falciparum to induce an antiviral-like immune response to the protozoan, which in turn protects against severe Ebola virus infection. Secreted glycoprotein of Ebola virus normally functions to inhibit proinflammatory cytokine production and inhibits macrophage activation in order to provide a pool of susceptible host cells, however following the priming of the immune system by P. falciparum infection, Ebola’s immune modulating actions are inhibited which leaves the immune system more able to effectively clear the infection. In order to elucidate the mechanism at play, in vivo studies will be crucial in determining direction of correlation as well as factors involving severity of viremia or parasitemia. The immune modulation at play could be elucidated by utilizing CyTOF technology (a mass spectrometry based technique) in order to get a better understanding of the cytokine milieu and activation states of the immune cells of the innate immune system.