Using genetic tools to understand the interactions between infection and nutrition
Sarah Atkinson
MBBS, BSc, MRCPCH, DTM&H, PhD, PGDipPID
Senior Lecturer and Honorary Consultant in Paediatrics and Paediatric Infectious Disease
Dr Sarah Atkinson is a Wellcome Trust Career Re-entry Fellow and Senior Lecturer in the Department of Paediatrics and at the KEMRI-Wellcome Trust Research Programme in Kilifi Kenya. Sarah completed her training in paediatrics and paediatric infectious disease in London, Newcastle and Oxford. Sarah first joined the Department of Paediatrics in 2007 as a Clinical Lecturer and has been based in Kenya since 2013. She is interested in using genetic epidemiology and other tools to understand the relationship between nutrition and infection in children.
Both micronutrient deficiencies and infectious diseases are common among children living in sub-Saharan Africa, but little is known about the effect that they have on each other. For example could malaria be causing iron deficiency, which affects >40% of children in Kilifi? We previously found that iron deficiency increases markedly over the malaria season in African children. The human hormone hepcidin controls iron regulation and prevents iron absorption and recycling. We found that hepcidin levels are unusually high in malaria even in asymptomatic infection suggesting that iron absorption may be impaired for prolonged periods in children who already have precarious iron intake. We are using genetic and epidemiological methods to investigate the impact of malaria on iron status. It is possible that elimination of malaria might also prevent an important cause of iron deficiency.
Nutritional status may also influence the risk of infection. The safety of iron supplementation is an important concern since pathogens require iron for their growth. I am using a Mendelian randomization (MR) to address the question of whether a child's iron status is causally related to their risk of malaria and/or bacterial infection. MR is an approach that utilizes the random allocation of genetic variants at conceptioin to investigate causality between an intermediate trait (iron status) and disease (infection). In order to identify genetic variants for MR, I am conducting the first genome-wide association study of iron status and hepcidin levels in African populations. Validated genetic variants will be taken forward to large MR case-control studies of severe malaria and bacteraemia using stored samples from the Kilifi Biobank and the MalariaGEN Consortium.
Key publications
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Ironing out sex differences in tuberculosis prevalence
Journal article
Atkinson S. and Yates TA., (2017), International Journal of Tuberculosis and Lung Disease
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Malaria and Age Variably but Critically Control Hepcidin Throughout Childhood in Kenya.
Journal article
Atkinson SH. et al, (2015), EBioMedicine, 2, 1478 - 1486
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Combinatorial effects of malaria season, iron deficiency, and inflammation determine plasma hepcidin concentration in African children.
Journal article
Atkinson SH. et al, (2014), Blood, 123, 3221 - 3229
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Expression of the iron hormone hepcidin distinguishes different types of anemia in African children.
Journal article
Pasricha S-R. et al, (2014), Sci Transl Med, 6
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Epistasis between the haptoglobin common variant and α+thalassemia influences risk of severe malaria in Kenyan children.
Journal article
Atkinson SH. et al, (2014), Blood, 123, 2008 - 2016
Recent publications
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Malaria is a cause of iron deficiency in African children
Journal article
ATKINSON S. et al, (2020), Nature Medicine
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How Severe Anaemia Might Influence the Risk of Invasive Bacterial Infections in African Children.
Journal article
Abuga KM. et al, (2020), Int J Mol Sci, 21
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Effects of vitamin D deficiency on neurobehavioural outcomes in children: a systematic review.
Journal article
Mutua AM. et al, (2020), Wellcome Open Research, 5, 28 - 28
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Effects of vitamin D deficiency on neurobehavioural outcomes in children: a systematic review
Journal article
Mutua A. et al, (2020)
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Vitamin D Status Is Not Associated with Cognitive or Motor Function in Pre-School Ugandan Children.
Journal article
Mutua AM. et al, (2020), Nutrients, 12
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Interferon-gamma polymorphisms and risk of iron deficiency and anaemia in Gambian children.
Journal article
Abuga KM. et al, (2020), Wellcome Open Research, 5, 40 - 40
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Interferon-gamma polymorphisms and risk of iron deficiency and anaemia in Gambian children
Journal article
Abuga KM. et al, (2020), Wellcome Open Research, 5, 40 - 40
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Iron deficiency is associated with reduced levels of Plasmodium falciparum-specific antibodies in African children
Journal article
ATKINSON S. et al, (2020), Clinical Infectious Diseases