The application of IRS and larvicides to reduce and control populations abundance of Aedes, Culex and Anopheles mosquitoes responsible for dengue, Rift Valley, West Nile and malaria infections witnessed significant decline in the years 1970s and 1980s. With the persistent mosquito-borne disease foci and endemicity in the major Saudi cities, Jeddah, Makkah, Madinah, Aseer and Jazan, in the South-Western and southern borders regions, renewed governments efforts ushered in enhanced pest surveillance coupled with integrated vector control programs implementation showed significant decline of total national cases from 2000 till now. However, as a side-effect, insecticide resistance in local populations has occurred and developed.
In the current study, three non-synonymous point mutations on 989, 1016 and 1534 positions and type A and B introns on VGSC were reported detected in field-caught Ae. aegypti mosquito samples in 2016 from Jeddah, Saudi Arabia. No samples that harbored the wild-type at the three mutation loci simultaneously were identified. The I1011M/V mutation was absent in Jeddah, even though this substitution of isoleucine on 1011 position is prevalent in Latin America countries [39, 41, 53-55], and spread in Thailand and Vietnam but at low frequencies [56, 57].
So far, to our knowledge, Saudi Arabia is the place with the most variation in kdr mutations associated with high resistance to pyrethroids in the Middle East countries, probably due to long-term usage of high doses of pyrethroids in vector control programs in and all major cities, especially in Jeddah since the first dengue epidemics in 1994. This is different from the reported kdr polymorphisms of Ae. aegypti populations from India and Pakistan. High prevalence of the F1534C mutation, and a low frequency of I1011M/V and V1016I mutations, with the absence of the 989P allele, were observed in India [25]. In Pakistan, all the studied mosquito samples harbored the homozygous F1534C mutation, whereas no mutation on the 1016 position has been identified yet [58].
The percentage of homozygous V1016G and S989P mutations co-occurrence was high (65.0%) in Jeddah. The V1016G mutation plays a critical role in kdr resistance against pyrethroid compounds [22, 23, 58]. Linkage association has been observed between the 989 and 1016 loci in Ae. aegypti populations of Saudi Arabia [18], Myanmar [59], Thailand [60].
It is speculated the S989P may serve as a compensatory mutation to the V1016G, to reduce the fitness cost on the mosquito [22] and strengthen the response of V1016G to permethrin and deltamethrin [61]. Additionally, double homozygous mutations at positions 989 and 1016 combined with either wild-type or heterozygous mutation at 1534 position were common in Jeddah’s population, in agreement with the speculation that the 1016 and 1534 loci were not independent for linkage disequilibrium analysis [62]. Further, the genotype with the triple mutation haplotype predominated in the tested mosquito samples, with an occupation of 45% (PGC/PGF). Additionally, one individual possessing triple homozygous mutation on 989, 1016, and 1534 loci was found in this study. In field-collected mosquitoes, the triple homozygous mutation was in low frequency in the population [32, 58, 59, 63, 64], probably due to fitness cost exerted on the mosquito by this triple mutation [61, 65]. Whereas, the artificially-introduced triple mutation, using the Xenopus oocyte expression systems, appeared to confer a higher level of resistance to both permethrin and deltamethrin than those carrying the individual mutations, probably for synergistic effect of the combination of mutant alleles [22, 23, 61]. Li et al., [30] suggested that the F1534C mutation could possibly serve as a compensatory mutation for reducing the fitness cost on the mosquito induced by the V1016G mutation. Thus, whether the homozygous triple mutations on 989, 1016, and 1534 loci showing insecticide resistance in field mosquitoes is yet to be ascertained.
The intron polymorphism of VGSC could serve as a marker to study the evolution of kdr mutations [38, 53]. Based on sequence size, the introns located between exons 20 and 21 were classified into type A (250 pb) and type B (234 pb) [53]. Analysis of intron sequences obtained in our study and homologous sequences retrieved from GenBank showed that the intron type was significantly associated with 1016 (χ2 = 34.333, df = 2, P = 0.000), and 1534 (χ2 = 18.005, df = 2, P = 0.000) allele type. Further, all the individuals possessing the V1016G mutation, either heterozygous or homozygous harbored the type A intron, but not vice versa. This result is in contrast to Saavedra-Rodriguez et al.,’s [39] suggestion that the V1016G mutation was distributed independently in haplotypes possessing either the type A or type B intron. Additionally, the global data analysis showed that the two intron types were distributed evenly in both heterozygous or homozygous F1534C mutation, but the homozygous wild-type F1534 was mainly associated with the type A intron, and not vice versa as well. In Jeddah, six of the examined mosquito individuals were harboring the homozygous F1534C mutation. Among them, five individuals with the SVC/SVC genotype possessed the type B intron, while the individual carrying the homozygous triple mutation (PGC/PGC) was coupled with the type A intron. In Taiwan Province, China, the F1534C was found to be strictly associated with the type B intron, and the V1016G mutation coexisted with the type A intron [38]. By contrast, in Africa, the point mutation at 1534 site was found to be strongly linked with the type A intron in Ghana, but only one heterozygote point mutation V1016I was recorded, except the F1534C mutations [66]. Additionally, V1016I was reported to locate at the haplotype possessing the type A intron, with no 1534 variation observed in Brazil [53, 67]. The mutation at position 1016 is associated with resistance to both type I and II pyrethroids, while the F1534C allele is primarily associated with resistance to type I pyrethroids, and the V1016I mutation did not alter channel sensitivity to pyrethroids in Xenopus oocytes [22, 23]. Based on the evidences above, we speculate that kdr mutations incline to coexist with the type A intron. When a mutation occurred in either 1016 or 1534 positions, it would be linked to the type A intron. While in case of co-mutation, the type A intron distributes more frequently with the V1016G/I mutation rather than the mutation F1534C. It is probably due to balancing the fitness cost on the mosquito by increasing compensatory advantage or linkage disequilibrium [61, 68].
It is speculated that the type B intron is the ancestral clade of clade 1, because that the Ae. aegypti was originally from Africa and the majority of African individuals belong to type B [66, 69]. In view of the phylogenetic tree obtained with available global data of the intron sequences, 100%, 83.33% and 70.40% individuals from North America, Latin America and Asian countries respectively, were type A intron. By contrast, 73.91% of sequences from Africa belonged to the type B intron. According to our analyses above, the type A intron coexistence with kdr mutations is common, especially the V1016G mutation; while the type B couples with the wild-type or F1534C mutation when the V1016G mutation is absent. This variable pattern of association, may reflect the history of insecticide treatment in different continents. The major disease burden of malaria is in Africa and South-East Asia [70]. The mutation on 1534 locus may have arisen in Aedes species due to earlier or current use of DDT for larvicides spraying and IRS to control malaria since the middle of the last century [41, 71]. Whereas both in Latin and North America countries, vector control is mainly focused on Aedes species (mainly Ae. aegypti and Ae. albopictus) vectors of dengue, Chikungunya, yellow fever, and Zika [72]. For the domestic and endophagic habitats of Ae. aegypti, pyrethroid insecticides are widely and randomly used in household aerosol insecticides for public and personal protection, since that pyrethroids have the advantages of high efficacy against mosquito vectors, low mammalian toxicity and short residual action [73]. In South Asia countries, the higher frequency of type A intron than that of type B may indicate different selective pressures resulting in different histories of intense and unrestricted insecticide usage. It is probably that first, the F1534C mutations occurred due to the extensive use of DDT or type I pyrethroids, as both insecticides have the same target site [41], then V1016G has been selected by the subsequent and wide use of type II pyrethroids, as cypermethrin and deltamethrin [59].
Both the non-synonymous mutation G119S (GGC/AGC) and silent mutation T506T on ace-1 [42] have not been detected in our sequences in Ae. aegypti samples from Jeddah. While it does not indicate that the Ae. aegypti population was completely susceptible to organophosphate and carbamate compounds, as both types of insecticides have the same target site. In bioassay tests, the Ae. aegypti population from Jeddah was tolerant to the fenitrothion [18], indicating that other than kdr mutations, or more likely, enzymatic mechanisms are involved in conferring resistance in mosquitoes. In Central Java, Indonesia, although the G119S mutation was absent, a degree of resistance to malathion was observed in Ae. aegypti [1].
Reports on target-site mutations on VGSC and ace-1 genes of Cx. quinquefasciatus are rare compared of that on Ae. aegypti. However, the insecticide resistance level of the Cx. quinquefasciatus in Jeddah may even worse as inferred from the fixation of mutation allele both on VGSC and ace-1 genes. In the studied mosquito samples in Jeddah, the kdr homozygous genotype TTT/TTT occupied most (90.48%) of the individuals. While the heterozygous genotype GGC/AGC on ace-1 gene was detected in all samples of Cx. quinquefasciatus. This is probably related to constant exposure due the extensive use of insecticides for routine spraying campaigns of public health, or for domestic use against mosquito vectors and other insect pests in Jeddah region. Similarity, the homozygous susceptible 1014 genotype was absent in samples collected in 2011 from Zanzibar, East Africa [74]. In India, most of the studied mosquito samples harbored the heterozygous genotype TTT/TTA, with the frequency of 75% in Cx. quinquefasciatus samples [43].
Limitations of this study
One major limitation of our study is the small sample sizes of mosquitoes used for detection on target site mutations of insecticide resistance genes. Whereas, the primary survey reveals the widespread of kdr in predominant mosquitoes in Jeddah. Further, bioassay tests on both larvae and adult mosquitoes are required to evaluate the status of insecticide resistance in practice. And the underlying metabolic mechanism responsible for insecticide resistance is worth exploring.