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Peterson MS, Joyner CJ, Cordy RJ, Salinas JL, Machiah D, Lapp SA, Meyer EVS, Gumber S, Galinski MR. Plasmodium vivax Parasite Load Is Associated With Histopathology in Saimiri boliviensis With Findings Comparable to P vivax Pathogenesis in Humans. Open Forum Infect Dis 2019; 6:ofz021. [PMID: 30937329 PMCID: PMC6436601 DOI: 10.1093/ofid/ofz021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 02/03/2023] Open
Abstract
Background Plasmodium vivax can cause severe malaria with multisystem organ dysfunction and death. Clinical reports suggest that parasite accumulation in tissues may contribute to pathogenesis and disease severity, but direct evidence is scarce. Methods We present quantitative parasitological and histopathological analyses of tissue sections from a cohort of naive, mostly splenectomized Saimiri boliviensis infected with P vivax to define the relationship of tissue parasite load and histopathology. Results The lung, liver, and kidney showed the most tissue injury, with pathological presentations similar to observations reported from autopsies. Parasite loads correlated with the degree of histopathologic changes in the lung and liver tissues. In contrast, kidney damage was not associated directly with parasite load but with the presence of hemozoin, an inflammatory parasite byproduct. Conclusions This analysis supports the use of the S boliviensis infection model for performing detailed histopathological studies to better understand and potentially design interventions to treat serious clinical manifestations caused by P vivax.
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Affiliation(s)
| | | | - Regina J Cordy
- Emory Vaccine Center, Yerkes National Primate Research Center
| | - Jorge L Salinas
- Emory Vaccine Center, Yerkes National Primate Research Center.,Division of Infectious Diseases, Department of Medicine, School of Medicine
| | - Deepa Machiah
- Division of Pathology, Yerkes National Primate Research Center
| | - Stacey A Lapp
- Emory Vaccine Center, Yerkes National Primate Research Center
| | | | | | - Sanjeev Gumber
- Division of Pathology, Yerkes National Primate Research Center.,Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Mary R Galinski
- Emory Vaccine Center, Yerkes National Primate Research Center.,Division of Infectious Diseases, Department of Medicine, School of Medicine
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S. Chidi A, O. Mattew W, A. Benjamin A, U. Peter A, C. Uche N. The Modulatory Activity of Justicia carnea in Plasmodium Infected Mice. ACTA ACUST UNITED AC 2018. [DOI: 10.31586/biochemistry.0304.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Exploring pancreatic pathology in Plasmodium falciparum malaria patients. Sci Rep 2018; 8:10456. [PMID: 29993021 PMCID: PMC6041343 DOI: 10.1038/s41598-018-28797-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 06/28/2018] [Indexed: 01/11/2023] Open
Abstract
Hypoglycaemia is an important complication of Plasmodium falciparum malaria infection, which can be lethal if not treated. A decrease in blood sugar (BS) level has been correlated with disease severity, parasitaemia and the use of certain antimalarial drugs. This study explored the relationship between pancreatic pathology, including the expressions of insulin and glucagon in the islets of Langerhans, and the BS levels in P. falciparum malaria patients. Pancreatic tissues from malaria patients were divided into three groups, namely those with BS < 40 mg/dl, BS = 40–120 mg/dl, and BS > 120 mg/dl. In P. falciparum malaria, pancreatic tissues showed numerous parasitised red blood cells (PRBCs) in the capillaries, oedema, acinar necrosis and the presence of inflammatory cells. The islet size and the expression of insulin were significantly increased in P. falciparum malaria patients with hypoglycaemia. In addition, insulin expression was positively correlated with islet size and negatively correlated with BS levels. This pioneer study documents an increase in insulin expression and an increase in islet size in hypoglycaemic patients with P. falciparum malaria. This could contribute to the pathogenesis of hypoglycaemia and provides evidence for the potential need to effectively manage the hypoglycaemia seen in malaria infection.
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Maknitikul S, Luplertlop N, Chaisri U, Maneerat Y, Ampawong S. Featured Article: Immunomodulatory effect of hemozoin on pneumocyte apoptosis via CARD9 pathway, a possibly retarding pulmonary resolution. Exp Biol Med (Maywood) 2018; 243:395-407. [PMID: 29402133 DOI: 10.1177/1535370218757458] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Plasmodium falciparum, the most virulent malaria parasite species, causes severe symptoms especially acute lung injury (ALI), of which characterized by alveolar epithelium and endothelium destruction and accelerated to blood-gas-barrier breakdown. Parasitized erythrocytes, endothelial cells, monocytes, and cytokines are all involved in this mechanism, but hemozoin (HZ), the parasitic waste from heme detoxification, also mainly contributes. In addition, it is not clear why type II pneumocyte proliferation, alveolar restorative stage, is rare in malaria-associated ALI. To address this, in vitro culture of A549 cells with Plasmodium HZ or with interleukin (IL)-1β triggered by HZ and monocytes (HZ-IL-1β) was conducted to determine their alveolar apoptotic effect using ethidium bromide/acridine orange staining, annexin-V-FITC/propidium iodide staining, and electron mircroscopic study. Caspase recruitment domain-containing protein 9 ( CARD9), the apoptotic regulator gene, and IL-1β were quantified by reverse-transcriptase PCR. Junctional cellular defects were characterized by immunohistochemical staining of E-cadherin. The results revealed that cellular apoptosis and CARD9 expression levels were extremely high 24 h after induction by HZ-IL-1β when compared to the HZ- and non-treated groups. E-cadherin was markedly down-regulated by HZ-IL-1β and HZ treatments. CARD9 expression was positively correlated with IL-1β expression and the number of apoptotic cells. Interestingly, the localization of HZ in the vesicular surfactant of apoptotic pneumocyte was also identified and submitted to be a cause of alveolar resolution abnormality. Thus, HZ triggers monocytes to produce IL-1β and induces pneumocyte type II apoptosis through CARD9 pathway in association with down-regulated E-cadherin, which probably impairs alveolar resolution in malaria-associated ALI. Impact statement The present work shows the physical and immunomodulatory properties of hemozoin on the induction of pneumocyte apoptosis in relation to IL-1β production through the CARD9 pathway. This occurrence may be a possible pathway for the retardation of lung resolution leading to blood-gas-barrier breakdown. Our findings lead to the understanding of the host-parasite relationship focusing on the dysfunction in ALI induced by HZ, a possible pathway of the recovering lung epithelial retardation in malaria-associated ARDS.
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Affiliation(s)
- Sitang Maknitikul
- 1 Department of Tropical Pathology, 115374 Faculty of Tropical Medicine, Mahidol University , Ratchathewi, Bangkok 10400, Thailand
| | - Natthanej Luplertlop
- 2 Department of Microbiology and Immunology, 115374 Faculty of Tropical Medicine, Mahidol University , Ratchathewi, Bangkok 10400, Thailand
| | - Urai Chaisri
- 1 Department of Tropical Pathology, 115374 Faculty of Tropical Medicine, Mahidol University , Ratchathewi, Bangkok 10400, Thailand
| | - Yaowapa Maneerat
- 1 Department of Tropical Pathology, 115374 Faculty of Tropical Medicine, Mahidol University , Ratchathewi, Bangkok 10400, Thailand
| | - Sumate Ampawong
- 1 Department of Tropical Pathology, 115374 Faculty of Tropical Medicine, Mahidol University , Ratchathewi, Bangkok 10400, Thailand
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Scaccabarozzi D, Deroost K, Corbett Y, Lays N, Corsetto P, Salè FO, Van den Steen PE, Taramelli D. Differential induction of malaria liver pathology in mice infected with Plasmodium chabaudi AS or Plasmodium berghei NK65. Malar J 2018; 17:18. [PMID: 29316914 PMCID: PMC5761140 DOI: 10.1186/s12936-017-2159-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 12/23/2017] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Cerebral malaria and severe anaemia are the most common deadly complications of malaria, and are often associated, both in paediatric and adult patients, with hepatopathy, whose pathogenesis is not well characterized, and sometimes also with acute respiratory distress syndrome (ARDS). Here, two species of murine malaria, the lethal Plasmodium berghei strain NK65 and self-healing Plasmodium chabaudi strain AS which differ in their ability to cause hepatopathy and/or ARDS were used to investigate the lipid alterations, oxidative damage and host immune response during the infection in relation to parasite load and accumulation of parasite products, such as haemozoin. METHODS Plasma and livers of C57BL/6J mice injected with PbNK65 or PcAS infected erythrocytes were collected at different times and tested for parasitaemia, content of haemozoin and expression of tumour necrosis factor (TNF). Hepatic enzymes, antioxidant defenses and lipids content and composition were also evaluated. RESULTS In the livers of P. berghei NK65 infected mice both parasites and haemozoin accumulated to a greater extent than in livers of P. chabaudi AS infected mice although in the latter hepatomegaly was more prominent. Hepatic enzymes and TNF were increased in both models. Moreover, in P. berghei NK65 infected mice, increased lipid peroxidation, accumulation of triglycerides, impairment of anti-oxidant enzymes and higher collagen deposition were detected. On the contrary, in P. chabaudi AS infected mice the antioxidant enzymes and the lipid content and composition were normal or even lower than uninfected controls. CONCLUSIONS This study demonstrates that in C57BL/6J mice, depending on the parasite species, malaria-induced liver pathology results in different manifestations, which may contribute to the different outcomes. In P. berghei NK65 infected mice, which concomitantly develop lethal acute respiratory distress syndrome, the liver tissue is characterized by an excess oxidative stress response and reduced antioxidant defenses while in P. chabaudi AS infected mice hepatopathy does not lead to lipid alterations or reduction of antioxidant enzymes, but rather to inflammation and cytokine burst, as shown earlier, that may favour parasite killing and clearance of the infection. These results may help understanding the different clinical profiles described in human malaria hepatopathy.
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Affiliation(s)
- Diletta Scaccabarozzi
- Department of Pharmacological and Molecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Katrien Deroost
- Rega Institute for Medical Research, KU Leuven-University of Leuven, Louvain, Belgium.,The Francis Crick Institute, London, UK
| | - Yolanda Corbett
- Department of Pharmacological and Molecular Sciences, Università degli Studi di Milano, Milan, Italy.,Dipartimento di Bioscienze, Università degli Studi di Milano, Milan, Italy
| | - Natacha Lays
- Rega Institute for Medical Research, KU Leuven-University of Leuven, Louvain, Belgium
| | - Paola Corsetto
- Department of Pharmacological and Molecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Fausta Omodeo Salè
- Department of Pharmacological and Molecular Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Donatella Taramelli
- Department of Pharmacological and Molecular Sciences, Università degli Studi di Milano, Milan, Italy.
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Maknitikul S, Luplertlop N, Grau GER, Ampawong S. Dysregulation of pulmonary endothelial protein C receptor and thrombomodulin in severe falciparum malaria-associated ARDS relevant to hemozoin. PLoS One 2017; 12:e0181674. [PMID: 28732053 PMCID: PMC5521846 DOI: 10.1371/journal.pone.0181674] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 07/04/2017] [Indexed: 12/20/2022] Open
Abstract
To investigate the role of the protein C system, endothelial protein C receptor (EPCR) and thrombomodulin (TM) in the pathogenesis of malaria-associated acute respiratory distress syndrome (ARDS) in relation to hemozoin and proinflammatory cytokines-induced type II pneumocyte injury and -aggravated pulmonary resolution. A total of 29 left-over lung specimens that were obtained from patients who died from severe falciparum malaria were examined. Histopathological, immunohistochemical and electron microscopic analyses revealed that ARDS coexisted with pulmonary edema and systemic bleeding; the severity was dependent on the level of hemozoin deposition in the lung and internal alveolar hemorrhaging. The loss of EPCR and TM was primarily identified in ARDS patients and was related to the level of hemozoin, parasitized red blood cell (PRBC) and white blood cell accumulation in the lung. Moreover, an in vitro analysis demonstrated that interleukin-13 and -31 and hemozoin induced pneumocytic cell injury and apoptosis, as assessed by EB/AO staining, electron microscopy and the up-regulation of CARD-9 mRNA (caspase recruitment domain-9 messenger-ribonucleic acid). The dysregulation of EPCR and TM in the lung, especially in those with increased levels of hemozoin, may play an important role in the pathogenesis of malaria-associated ARDS through an apoptotic pathway.
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Affiliation(s)
- Sitang Maknitikul
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Natthanej Luplertlop
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Georges E. R. Grau
- Vascular Immunology, Department of Pathology, Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia
| | - Sumate Ampawong
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, Thailand
- * E-mail:
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Wichapoon B, Punsawad C, Viriyavejakul P. Expression of cleaved caspase-3 in renal tubular cells in Plasmodium falciparum malaria patients. Nephrology (Carlton) 2017; 22:79-84. [PMID: 26729581 DOI: 10.1111/nep.12715] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 12/24/2015] [Accepted: 12/28/2015] [Indexed: 11/28/2022]
Abstract
AIM In Plasmodium falciparum malaria, the clinical manifestation of acute kidney injury (AKI) is commonly associated with acute tubular necrosis (ATN) in the kidney tissues. Renal tubular cells often exhibit various degrees of cloudy swelling, cell degeneration, and frank necrosis. To study individual cell death, this study evaluates the degree of renal tubular necrosis in association with apoptosis in malarial kidneys. METHODS Kidney tissues from P. falciparum malaria with AKI (10 cases), and without AKI (10 cases) were evaluated for tubular pathology. Normal kidney tissues from 10 cases served as controls. Tubular necrosis was assessed quantitatively in kidney tissues infected with P. falciparum malaria, based on histopathological evaluation. In addition, the occurrence of apoptosis was investigated using cleaved caspase-3 marker. Correlation between tubular necrosis and apoptosis was analyzed. RESULTS Tubular necrosis was found to be highest in P. falciparum malaria patients with AKI (36.44% ± 3.21), compared to non-AKI (15.88% ± 1.63) and control groups (2.58% ± 0.39) (all p < 0.001). In the AKI group, the distal tubules showed a significantly higher degree of tubular necrosis than the proximal tubules (p = 0.021) and collecting tubules (p = 0.033). Tubular necrosis was significantly correlated with the level of serum creatinine (r = 0.596, p = 0.006), and the occurrence of apoptosis (r = 0.681, p = 0.001). CONCLUSION In malarial AKI, the process of apoptosis occurs in ATN.
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Affiliation(s)
- Benjamas Wichapoon
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, 10400, Thailand
| | - Chuchard Punsawad
- School of Medicine, Walailak University, 222 Thasala District, Nakhon Si Thammarat, 80161, Thailand
| | - Parnpen Viriyavejakul
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, 10400, Thailand
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Roussilhon C, Bang G, Bastaert F, Solhonne B, Garcia-Verdugo I, Peronet R, Druilhe P, Sakuntabhai A, Mecheri S, Sallenave JM. The antimicrobial molecule trappin-2/elafin has anti-parasitic properties and is protective in vivo in a murine model of cerebral malaria. Sci Rep 2017; 7:42243. [PMID: 28181563 PMCID: PMC5299836 DOI: 10.1038/srep42243] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 01/05/2017] [Indexed: 11/18/2022] Open
Abstract
According to the WHO, and despite reduction in mortality rates, there were an estimated 438 000 malaria deaths in 2015. Therefore new antimalarials capable of limiting organ damage are still required. We show that systemic and lung adenovirus (Ad)-mediated over-expression of trappin-2 (T-2) an antibacterial molecule with anti-inflammatory activity, increased mice survival following infection with the cerebral malaria-inducing Plasmodium berghei ANKA (PbANKA) strain. Systemically, T-2 reduced PbANKA sequestration in spleen, lung, liver and brain, associated with a decrease in pro-inflammatory cytokines (eg TNF-α in spleen and lung) and an increase in IL-10 production in the lung. Similarly, local lung instillation of Ad-T-2 resulted in a reduced organ parasite sequestration and a shift towards an anti-inflammatory/repair response, potentially implicating monocytes in the protective phenotype. Relatedly, we demonstrated in vitro that human monocytes incubated with Plasmodium falciparum-infected red blood cells (Pf-iRBCs) and IgGs from hyper-immune African human sera produced T-2 and that the latter colocalized with merozoites and inhibited Pf multiplication. This array of data argues for the first time for the potential therapeutic usefulness of this host defense peptide in human malaria patients, with the aim to limit acute lung injury and respiratory distress syndrom often observed during malaria episodes.
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Affiliation(s)
- Christian Roussilhon
- Unité de génétique fonctionnelle des maladies infectieuses and CNRS Unité de recherche associée 3012; Paris, 75015, France
| | - Gilles Bang
- Unité de génétique fonctionnelle des maladies infectieuses and CNRS Unité de recherche associée 3012; Paris, 75015, France
| | - Fabien Bastaert
- Unité de Défense Innée et Inflammation, Institut Pasteur, 25 rue du Dr Roux, Paris, 75015, France
- INSERM U874, Institut Pasteur
- INSERM U1152, Faculté de Médicine site Bichat, Université Paris Diderot, Université Sorbonne Paris-Cité, 16, rue Henri Huchard, Paris, 75018, France
| | - Brigitte Solhonne
- Unité de Défense Innée et Inflammation, Institut Pasteur, 25 rue du Dr Roux, Paris, 75015, France
- INSERM U874, Institut Pasteur
- INSERM U1152, Faculté de Médicine site Bichat, Université Paris Diderot, Université Sorbonne Paris-Cité, 16, rue Henri Huchard, Paris, 75018, France
| | - Ignacio Garcia-Verdugo
- Unité de Défense Innée et Inflammation, Institut Pasteur, 25 rue du Dr Roux, Paris, 75015, France
- INSERM U874, Institut Pasteur
- INSERM U1152, Faculté de Médicine site Bichat, Université Paris Diderot, Université Sorbonne Paris-Cité, 16, rue Henri Huchard, Paris, 75018, France
| | - Roger Peronet
- Institut Pasteur, Unité de Biologie des Interactions Hôte Parasites, CNRS ERL9195 and INSERM U1201, Paris F-75015, France
- CNRS ERL9195 and INSERM U1201, Paris F-75015, France
- INSERM U1201, Paris F-75015, France
| | | | - Anavaj Sakuntabhai
- Unité de génétique fonctionnelle des maladies infectieuses and CNRS Unité de recherche associée 3012; Paris, 75015, France
| | - Salaheddine Mecheri
- Institut Pasteur, Unité de Biologie des Interactions Hôte Parasites, CNRS ERL9195 and INSERM U1201, Paris F-75015, France
- CNRS ERL9195 and INSERM U1201, Paris F-75015, France
- INSERM U1201, Paris F-75015, France
| | - Jean-Michel Sallenave
- Unité de Défense Innée et Inflammation, Institut Pasteur, 25 rue du Dr Roux, Paris, 75015, France
- INSERM U874, Institut Pasteur
- INSERM U1152, Faculté de Médicine site Bichat, Université Paris Diderot, Université Sorbonne Paris-Cité, 16, rue Henri Huchard, Paris, 75018, France
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Xiao S, Liu J, Huang S, Lu F. Increased Gal-9 and Tim-3 expressions during liver damage in a murine malarial model. Parasitol Res 2016; 115:663-72. [PMID: 26486943 DOI: 10.1007/s00436-015-4784-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 10/06/2015] [Indexed: 01/25/2023]
Abstract
Malaria has been one of the most devastating tropical parasite infectious diseases popular around the world. Severe malaria is characterized by multiple organ dysfunctions, especially liver damage. However, the mechanisms of malarial liver injury remain to be better clarified. In this study, Kunming mice inoculated intraperitoneally (i.p.) with 10(6) Plasmodium berghei ANKA (PbANKA)-infected red blood cells (iRBCs) were investigated at days 5, 10, 15, and 20 post-infection (p.i.) to elucidate the profiles of T-cell immunoglobulin and mucin domain-3 (Tim-3) and its ligand galecin-9 (Gal-9) in the development of liver injury. The histopathology of livers and spleens from PbANKA-infected mice were observed, the parasite burdens of the livers and spleens using quantitative real-time PCR (qRT-PCR), Tim-3- and Gal-9-positive cells in the livers and spleens using immunohistochemical staining, and the mRNA levels of Tim-3, Gal-9, and cytokines in both the livers and spleens using qRT-PCR were examined. Our results showed that parasite burdens in the livers and spleens were significantly increased with time after PbANKA infection. Histological scores of both the liver and spleen tissues were significantly increased with time; the numbers of Tim-3- and Gal-9-positive cells were significantly increased in both the livers and spleens using immunohistochemical staining, and the mRNA levels of Tim-3 and Gal-9 in the livers and spleens were also significantly increased after infection. Our data suggests that the increase of Tim-3/Gal-9 expressions may play an important role in the liver damage during P. berghei infection.
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Jain A, Kaushik R, Kaushik RM. Malarial hepatopathy: Clinical profile and association with other malarial complications. Acta Trop 2016; 159:95-105. [PMID: 27019056 DOI: 10.1016/j.actatropica.2016.03.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 03/19/2016] [Accepted: 03/24/2016] [Indexed: 01/16/2023]
Abstract
This prospective study assessed the incidence, clinical profile and outcome of malarial hepatopathy and its association with other complications in patients with malaria, proved by peripheral blood smear examination and rapid malaria test. Hyperbilirubinemia (Serum bilirubin >3mg/dL) with >3-fold rise in serum aminotransferases in absence of a different explanation for such derangement was considered as malarial hepatopathy. Of 134 (falciparum-81, vivax-48 and mixed falciparum and vivax-5) malaria cases, hyperbilirubinemia occurred in 41.04%. Serum aspartate aminotransferase (AST) was raised >3-fold in 17.16% and serum alanine aminotransferase (ALT) in 4.47% cases. Malarial hepatopathy was observed in 4.47% (falciparum-5 and vivax malaria-1) cases, but had insignificant association with the type of malaria (p=0.532). Serum bilirubin, AST and ALT levels were higher while age was lower in both overall (p<0.05 each) and falciparum malaria cases with hepatopathy than without hepatopathy (p<0.05 each). Malarial hepatopathy was associated with a higher incidence of cerebral malaria, shock, acute respiratory distress syndrome (ARDS) and acute kidney injury in both overall (p<0.05 each) and falciparum malaria (p<0.05 each) and hyponatremia and disseminated intravascular coagulation only in overall malaria (p<0.05). Malarial hepatopathy had significant association with duration of hospitalization, parasite clearance time, fever clearance time and jaundice clearance time in overall (p<0.05 each) and falciparum (p<0.05 each) but not vivax malaria cases (p>0.05 each). Mortality occurred in 1 (20%) case of falciparum-induced hepatopathy with an overall mortality of 16.66%. ARDS (p=0.003) and shock (p=0.026) were independently associated with malarial hepatopathy overall while only ARDS with falciparum-induced hepatopathy (p=0.006). Thus, hepatocellular dysfunction is common in malaria but that qualifying as malarial hepatopathy is not common. Malarial hepatopathy is likely to occur in presence of other malarial complications. It is an epiphenomenon in severe malaria and indicative of severe disease. Establishing a particular association with malaria or mortality would require a larger case-control study of severe malaria.
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Affiliation(s)
- Anshika Jain
- Department of Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, P. O. Jolly Grant, 248016 Dehradun, Uttarakhand, India.
| | - Reshma Kaushik
- Department of Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, P. O. Jolly Grant, 248016 Dehradun, Uttarakhand, India.
| | - Rajeev Mohan Kaushik
- Department of Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, P. O. Jolly Grant, 248016 Dehradun, Uttarakhand, India.
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Thonsranoi K, Glaharn S, Punsawad C, Chaisri U, Krudsood S, Viriyavejakul P. Increased synapsin I expression in cerebral malaria. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:13996-14004. [PMID: 26823711 PMCID: PMC4713497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 10/22/2015] [Indexed: 06/05/2023]
Abstract
Synapsin I is a neuronal phosphoprotein contained in the synaptic vesicles of mammalian central and peripheral nervous systems. It regulates both neurotransmitter release and synaptic formation. Variations in synapsin I expression in the brain have been reported to cause brain malfunction. In severe malaria, neurological complications, such as convulsion, delirium and coma, suggest abnormalities in the release of neurotransmitters. This study evaluated synapsin I expression in cerebral malaria (CM). An immunohistochemical method was used to study the semi-quantitative and qualitative expression of synapsin I in the brain of CM patients (10 cases) who died with Plasmodium falciparum, compared with non-cerebral malaria (NCM) (4 cases), and control brain tissues (5). Synapsin I was expressed in the gray matter of the cerebral cortex and the molecular layer of the cerebellum, as a diffusely dense precipitate pattern in the neuropil, with no immunoreactivity in the neurons, neuronal dendrites, glial cells, endothelial cells, and Purkinje cells. The findings were similarly demonstrated in CM, NCM, and control brain tissues. However, in the granular layer of the cerebellum, a significant increase in synapsin I expression was observed in the granule cells, and the glomerular synaptic complex, from the CM group, compared with the NCM, and control brain tissues (all P < 0.05). Parasitemia showed a positive correlation with synapsin I expression in the granule cells (on admission: Spearman's ρ = 0.600, P = 0.023) (before death: Spearman's ρ = 0.678, P = 0.008), and glomerular synaptic complex (before death: Spearman's ρ = 0.571, P = 0.033). It was hypothesized that CM causes pre-synaptic excitation and eventually activation of synapsin I, leading to increased neurotransmitter release. Synapsin I inhibitor should be investigated further as a target for a therapeutic intervention to alleviate neurological symptoms in severe malaria.
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Affiliation(s)
- Klairoong Thonsranoi
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol UniversityBangkok 10400, Thailand
| | - Supattra Glaharn
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol UniversityBangkok 10400, Thailand
| | - Chuchard Punsawad
- School of Medicine, Walailak UniversityNakhon Si Thammarat 80161, Thailand
| | - Urai Chaisri
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol UniversityBangkok 10400, Thailand
| | - Srivicha Krudsood
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol UniversityBangkok 10400, Thailand
| | - Parnpen Viriyavejakul
- Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol UniversityBangkok 10400, Thailand
- Center for Emerging and Neglected Infectious Diseases, Mahidol UniversitySalaya, Nakhon Pathom 73170, Thailand
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Walker AS, Lourenço J, Hill AVS, Gupta S. Modeling Combinations of Pre-erythrocytic Plasmodium falciparum Malaria Vaccines. Am J Trop Med Hyg 2015; 93:1254-1259. [PMID: 26503278 PMCID: PMC4674243 DOI: 10.4269/ajtmh.14-0767] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 08/06/2015] [Indexed: 01/18/2023] Open
Abstract
Despite substantial progress in the control of Plasmodium falciparum infection due to the widespread deployment of insecticide-treated bed nets and artemisinin combination therapies, malaria remains a prolific killer, with over half a million deaths estimated to have occurred in 2013 alone. Recent evidence of the development of resistance to treatments in both parasites and their mosquito vectors has underscored the need for a vaccine. Here, we use a mathematical model of the within-host dynamics of P. falciparum infection, fit to data from controlled human malaria infection clinical trials, to predict the efficacy of co-administering the two most promising subunit vaccines, RTS,S/AS01 and ChAd63-MVA ME-TRAP. We conclude that currently available technologies could be combined to induce very high levels of sterile efficacy, even in immune-naive individuals.
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Affiliation(s)
- Andrew S. Walker
- *Address correspondence to Andrew S. Walker, Department of Zoology, University of Oxford, South Parks Road, Oxford, OX1 3PS, United Kingdom. E-mail:
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From within host dynamics to the epidemiology of infectious disease: Scientific overview and challenges. Math Biosci 2015; 270:143-55. [PMID: 26474512 DOI: 10.1016/j.mbs.2015.10.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Since their earliest days, humans have been struggling with infectious diseases. Caused by viruses, bacteria, protozoa, or even higher organisms like worms, these diseases depend critically on numerous intricate interactions between parasites and hosts, and while we have learned much about these interactions, many details are still obscure. It is evident that the combined host-parasite dynamics constitutes a complex system that involves components and processes at multiple scales of time, space, and biological organization. At one end of this hierarchy we know of individual molecules that play crucial roles for the survival of a parasite or for the response and survival of its host. At the other end, one realizes that the spread of infectious diseases by far exceeds specific locales and, due to today's easy travel of hosts carrying a multitude of organisms, can quickly reach global proportions. The community of mathematical modelers has been addressing specific aspects of infectious diseases for a long time. Most of these efforts have focused on one or two select scales of a multi-level disease and used quite different computational approaches. This restriction to a molecular, physiological, or epidemiological level was prudent, as it has produced solid pillars of a foundation from which it might eventually be possible to launch comprehensive, multi-scale modeling efforts that make full use of the recent advances in biology and, in particular, the various high-throughput methodologies accompanying the emerging -omics revolution. This special issue contains contributions from biologists and modelers, most of whom presented and discussed their work at the workshop From within Host Dynamics to the Epidemiology of Infectious Disease, which was held at the Mathematical Biosciences Institute at Ohio State University in April 2014. These contributions highlight some of the forays into a deeper understanding of the dynamics between parasites and their hosts, and the consequences of this dynamics for the spread and treatment of infectious diseases.
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Butler NS, Schmidt NW. Erythropoietin-producing hepatocellular receptor B2 receptor tyrosine kinase: A novel regulator of infection- and inflammation-induced liver fibrosis. Hepatology 2015; 62:680-3. [PMID: 25914283 PMCID: PMC4549189 DOI: 10.1002/hep.27868] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 04/22/2015] [Indexed: 12/12/2022]
Affiliation(s)
- Noah S. Butler
- Department of Microbiology and Immunology, University of
Oklahoma Health Sciences Center, 940 Stanton L. Young Blvd., Oklahoma City, OK
73104,Correspondence: Noah S. Butler
()
| | - Nathan W. Schmidt
- Department of Microbiology and Immunology, University of
Louisville School of Medicine, 505 S. Hancock St., Louisville, KY 40202
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Mimche PN, Brady LM, Bray CF, Mimche SM, Thapa M, King TP, Quicke K, McDermott CD, Lee CM, Grakoui A, Morgan ET, Lamb TJ. The receptor tyrosine kinase EphB2 promotes hepatic fibrosis in mice. Hepatology 2015; 62:900-14. [PMID: 25784101 PMCID: PMC4549176 DOI: 10.1002/hep.27792] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 03/15/2015] [Indexed: 12/27/2022]
Abstract
UNLABELLED Beyond the well-defined role of the Eph (erythropoietin-producing hepatocellular) receptor tyrosine kinases in developmental processes, cell motility, cell trafficking/adhesion, and cancer, nothing is known about their involvement in liver pathologies. During blood-stage rodent malaria infection we have found that EphB2 transcripts and proteins were up-regulated in the liver, a result likely driven by elevated surface expression on immune cells including macrophages. This was significant for malaria pathogenesis because EphB2(-/-) mice were protected from malaria-induced liver fibrosis despite having a similar liver parasite burden compared with littermate control mice. This protection was correlated with a defect in the inflammatory potential of hepatocytes from EphB2(-/-) mice resulting in a reduction in adhesion molecules, chemokine/chemokine receptor RNA levels, and infiltration of leukocytes including macrophages/Kupffer cells, which mediate liver fibrosis during rodent malaria infections. These observations are recapitulated in the well-established carbon tetrachloride model of liver fibrosis in which EphB2(-/-) carbon tetrachloride-treated mice showed a significant reduction of liver fibrosis compared to carbon tetrachloride-treated littermate mice. Depletion of macrophages by clodronate-liposomes abrogates liver EphB2 messenger RNA and protein up-regulation and fibrosis in malaria-infected mice. CONCLUSION During rodent malaria, EphB2 expression promotes malaria-associated liver fibrosis; to our knowledge, our data are the first to implicate the EphB family of receptor tyrosine kinases in liver fibrosis or in the pathogenesis of malaria infection.
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Affiliation(s)
- Patrice N. Mimche
- Division of Infectious Diseases, Department of Pediatrics, Emory University School of Medicine and Emory Children's Centre, 2015 Uppergate Drive, Atlanta, Georgia 30322, USA
| | - Lauren M. Brady
- Division of Infectious Diseases, Department of Pediatrics, Emory University School of Medicine and Emory Children's Centre, 2015 Uppergate Drive, Atlanta, Georgia 30322, USA
| | - Christian F. Bray
- Division of Infectious Diseases, Department of Pediatrics, Emory University School of Medicine and Emory Children's Centre, 2015 Uppergate Drive, Atlanta, Georgia 30322, USA
| | - Sylvie M. Mimche
- Department of Pharmacology, Emory University School of Medicine, Atlanta, GA 30322
| | - Manoj Thapa
- Division of Microbiology and Immunology, Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA 30322
| | - Thayer P. King
- Division of Infectious Diseases, Department of Pediatrics, Emory University School of Medicine and Emory Children's Centre, 2015 Uppergate Drive, Atlanta, Georgia 30322, USA
| | - Kendra Quicke
- Division of Infectious Diseases, Department of Pediatrics, Emory University School of Medicine and Emory Children's Centre, 2015 Uppergate Drive, Atlanta, Georgia 30322, USA
| | - Courtney D. McDermott
- Division of Infectious Diseases, Department of Pediatrics, Emory University School of Medicine and Emory Children's Centre, 2015 Uppergate Drive, Atlanta, Georgia 30322, USA
| | - Choon M. Lee
- Department of Pharmacology, Emory University School of Medicine, Atlanta, GA 30322
| | - Arash Grakoui
- Division of Microbiology and Immunology, Emory Vaccine Center, Emory University School of Medicine, Atlanta, GA 30322
| | - Edward T. Morgan
- Department of Pharmacology, Emory University School of Medicine, Atlanta, GA 30322
| | - Tracey J. Lamb
- Division of Infectious Diseases, Department of Pediatrics, Emory University School of Medicine and Emory Children's Centre, 2015 Uppergate Drive, Atlanta, Georgia 30322, USA
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Gutierrez JB, Galinski MR, Cantrell S, Voit EO. WITHDRAWN: From within host dynamics to the epidemiology of infectious disease: Scientific overview and challenges. Math Biosci 2015:S0025-5564(15)00085-1. [PMID: 25890102 DOI: 10.1016/j.mbs.2015.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
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Affiliation(s)
- Juan B Gutierrez
- Department of Mathematics, Institute of Bioinformatics, University of Georgia, Athens, GA 30602, United States .
| | - Mary R Galinski
- Emory University School of Medicine, Division of Infectious Diseases, Emory Vaccine Center, Yerkes National Primate Research Center, Emory University, 954 Gatewood Road, Atlanta, GA 30329, United States .
| | - Stephen Cantrell
- Department of Mathematics, University of Miami, Coral Gables, FL 33124, United States .
| | - Eberhard O Voit
- Department of Biomedical Engineering, Georgia Institute of Technology, 313 Ferst Drive, Suite 4103, Atlanta, GA 30332-0535, United States .
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