Professor Sanjeev Krishna is Professor of Molecular Parasitology and Professor of Medicine at St George's. He is also an honorary consultant in infectious disease and medicine.
He maintains a wide-ranging programme of research in malaria, spanning laboratory studies providing new insight into parasite biology, clinical studies aiming to refine treatments for malaria, and research into a newly discovered form of malaria transmitted to humans from monkeys. He also has strong interests in the development of new diagnostic technologies for diseases such as malaria and tuberculosis (TB), which will not only confirm the disease, but also guide the choice of most effective treatment regimes.
Professor Krishna’s research focuses on infectious disease, particularly malaria, encompassing diagnostics, the mechanism of action of drugs, identification of new drug targets, and clinical studies of drug responses. His group has a particular interest in parasite transporter proteins, which are targeted by existing antimalarial drugs and are also promising new targets.
In a wide-ranging programme of research, Professor Krishna’s group spans basic research into the function of Plasmodium transporters, translational studies on transporters as drug targets, and clinical studies to refine treatments for P falciparum malaria and to understand better P knowlesi malaria, a zoonotic form of malaria affecting parts of South-East Asia.
Professor Krishna also has a strong interest in diagnostics. He is principal investigator of a €5.2m EU Framework Programme VII project, Nanomal, which is developing a low-cost point-of-care diagnostic for malaria. As well as rapidly identifying the presence of the parasite, the device will also provide a drug resistance profile. The technology is also being adapted for use with TB, and may be applicable to other tropical infectious diseases.
Over the past 30 years, Professor Krishna has made numerous important contributions across a wide range of translational and clinical research, including:
Artemisinin mechanism of action: Identifying the SERCA/PfATP6 transporter as the likely target of the artemisinin antimalarial, and raising awareness of the potential for the development of artemisinin resistance.
Drug resistance: Identifying pfmdr1 copy number expansion as a predictor of treatment failure to commonly used antimalarial drugs; an assay used in this research is now used globally in epidemiological surveys of resistance carried out by the World Wide Antimalarial Resistance Network (WWARN).
Treatment: Leading clinical studies to establish optimal dosing regimes for artesunate and other antimalarial treatments.
New drug targets: Confirming the Plasmodium glucose transporter (PfHT) as a valid antimalarial drug target; compounds targeting PfHT are in preclinical development.
Pathophysiological studies: Establishing the importance of and mechanisms underlying lactic acidosis and hypoglycaemia in children with severe malaria, and exploring potential treatments.
Diagnostics: Improving staging of second stage human African trypanosomiasis with neopterin.
In 2007 Professor Krishna was awarded an ScD at the University of Cambridge. In 1994 he was awarded a Wellcome Trust Senior Clinical Fellowship at St George’s, University of London.
Professor Krishna read natural sciences at the University of Cambridge and completed a medical degree at University of Oxford in 1982. He began clinical studies on malaria at the Wellcome Trust Unit in Thailand as a medical student and continued with laboratory studies while working towards a DPhil at the Weatherall Institute of Molecular Medicine in Oxford.
Professor Krishna is also a consultant physician in infectious diseases at St George’s Hospital and chairs the Technical Advisory Group for sleeping sickness for the Foundation for Innovative New Diagnostics (FIND). He sits on a Wellcome Trust/DBT India Alliance Selection Panel and on the editorial boards of a number of journals, including PLoS Medicine Journal of Infectious Diseases. He is a section editor of BMC Infectious Diseases, Editorial Advisor at the Lancet, and a member of the board for the British Medical Bulletin. He is a Fellow of the Academy of Medical Sciences.
Pulcini S, Staines HM, Pitman JK, Slavic K, Doerig C, Halbert J, Tewari R, Shah F, Avery MA, Haynes RK, Krishna S (2013). Expression in yeast links field polymorphisms in PfATP6 to in vitro artemisinin resistance and identifies new inhibitor classes. Journal of Infectious Diseases (in press)
Krishna S and Kremsner PG. (2013). Anti-dogmatic about artemisinin resistance: re-appraisal as treatment failure of artemisinin combination therapy. Trends in Parasitology (in press).
Guttery DS, Pittman JK, Frénal K, Poulin B, McFarlane LR, Slavic K, Wheatley S, Soldati-Favre D, Krishna S, Tewari R, Staines HM. (2013). The Plasmodium berghei Ca2+/H+ exchanger, PbCAX, is essential for environmental tolerance to Ca2+ during sexual development. PLoS Pathogen 9(2): e1003191.
Kremsner PG, Taylor T, Issifou S, Kombila M, Chimalizeni Y, Kawaza K, Akotet KB, Duscha M, Mordmüller B, Kösters K, Humberg A, Miller RS, Weina P, Duparc S, Möhrle J, Kun JFJ, Planche T, Teja-Isavadharm P, Simpson JA, Köhler C, Krishna S. (2011). A simplified intravenous artesunate regimen for severe malaria. Journal of Infectious Diseases 205: 312-319.
Slavic K, Straschil U, Reininger L, Doerig C, Morin C, Teware R, Krishna S. (2010). Life cycle studies of the hexose transporter of Plasmodium species. Molecular Microbiology 75: 1402-1413.
Gomes MF, Faiz MA, Gyapong J, Warasme M, Agbenyega T, Babiker A, Baiden F, Bin Yunus E, Binka F, Ckerk C, Folb P, Hassan R, Hossein Md A, Kimbute O, Kitua A, Krishna S, Makasi C, Mensah N, Mrango Z, Olliaro P, Peto R, Peto TJ, Rahman MR, Ribiero I, Samad R, White NJ for the Study 13 research group. (2009). Pre-referral rectal artesunate to prevent death and disability in severe malaria: placebo-controlled trial. The Lancet 373: 557-66.
Planche T, Aghaizu A, Holliman R, Polienicki J, Breathack A, Krishna S. (2008). Diagnosis of Clostridium difficile by use of toxin detection kits: a systematic review. Lancet Infectious Diseases 8: 777-84.
Agranoff D, Fernandez-Reyes D, Papadopoulos M, Rojas SA, Herbster M, Loosemore A, Tarelli E, Sheldon J, Schwenk A, Pollok R, Rayner C and Krishna S. (2006). Diagnosis of tuberculosis by serum proteomic fingerprinting. The Lancet 368: 1012-1021.
Price RN, Uhlemann A-C, Brockman A, McGready R, Ashley E, Phaipun L, Patel R, Laing K. Looareesuwan S, White N.J, Nosten F, Krishna S. (2004). Mefloquine resistance in Plasmodium falciparum and increased pfmdr1 gene copy number. The Lancet 364: 438-447.
Eckstein-Ludwig U, Webb RJ, van Goethem IDA, East JM, Lee AG, Kimura M, O’Niell PM, Bray P, Ward S, Krishna S. (2003). Artemisinins target the SERCA of Plasmodium falciparum. Nature 424: 957-961.
Dr Henry Staines, Senior Research Fellow
Dr Cathy Moore, Postdoctoral Fellow
Mr Leon McFarlane, Research Assistant
Dr Omar Jallow, Researcher
Dr Guillaume Bouyer, Senior Visting Fellow
Beatrix Teo, Medical Student
Hajnalka Kovacsevics, Administrator
Ksenjia Slavic, Genetic and molecular studies of the hexose transporter of plasmodium species. First studies illustrating essentiality of the hexose transporter in different life cycle stages
Dr Mathew Cowan, The application of proteomics to the discovery of biomarkers of disease severity and prognosis in chronic liver disease. This study prospectively evaluated biomarker discovery for a problem that usually requires invasive diagnostic procedures
Serena Puccini, Studies on the mechanisms of action of artemisinins and the role of PfATP6. This work established a yeast expression system in which to examine how artemisinins act
Anne-Catrin Uhlemann, Plasmodium falciparum transporters as drug targets. This work defined mutation in PfATP6 as well as establishing the clinical relevance of increased pfmdr1 copy number
Farrah Amor Fatih, Investigation of the cytoadherence and drug sensitivity of malaria. This was field work on ex vivo isolates of Plasmodium knowlesi
Dr Cyrus Daneshwer, Clinical studies on naturally acquired Plasmodium falciparum. This was the first detailed clinical description of a newly emerged species of malaria
Professor Peter Kremsner, University of Tübingen and Albert Schweitzer Hospital, Lambaréné, Gabon.
Dr Pedro Gil, Karolinska Institute.
Dr Nadia Schoenmaker, University of Cambridge.
EU FP7 Programme
Co-ordinator Nanomal €3,992,000
July 2012 – June 2015. (~€1,100,000 to St George's, University of London).
Development of a handheld device for diagnosis of malaria and drug resistance
EDCTP. EDCTP fosmidomycin-clindamycin €3,300,000
€220,000 to St George's, University of London
Development of Fosmidomycin and Clindamycin, in a Fixed Dose Combination for the Treatment of Acute Uncomplicated Plasmodium falciparum Malaria
MRC. Medical Research Council £5,300,000
Prinical Investigator; Dr T. Saddiq
September 2010 – August 2015
Enabling and translating advances in diagnostic and communication technologies to reduce the burden of STIs.
Medicines for Malaria Venture $50,000
April 2012 – March 2013
Discovery of inhibitors of PfHT
Professor Krishna delivers lectures to both undergraduate and postgraduate students.