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Kabyemela ER, Fried M, Kurtis JD, Moses G, Gorres JP, Muehlenbachs A, Duffy PE. Fetal Cytokine Balance, Erythropoietin and Thalassemia but Not Placental Malaria Contribute to Fetal Anemia Risk in Tanzania. Front Immunol 2021; 12:624136. [PMID: 33995348 PMCID: PMC8120033 DOI: 10.3389/fimmu.2021.624136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/19/2021] [Indexed: 12/21/2022] Open
Abstract
Fetal anemia is common in malaria-endemic areas and a risk factor for anemia as well as mortality during infancy. Placental malaria (PM) and red cell abnormalities have been proposed as possible etiologies, but the relationship between PM and fetal anemia has varied in earlier studies, and the role of red cell abnormalities has not been studied in malaria-endemic areas. In a Tanzanian birth cohort study designed to elucidate the pathogenesis of severe malaria in young infants, we performed a cross-sectional analysis of risk factors for fetal anemia. We determined PM status, newborn red cell abnormalities, and maternal and cord blood levels of iron regulatory proteins, erythropoietin (EPO), cytokines and cytokine receptors. We examined the relationship between these factors and fetal anemia. Fetal anemia was present in 46.2% of the neonates but was not related to PM. Maternal iron deficiency was common (81.6%), most frequent in multigravidae, and interacted with parity to modify risk of fetal anemia, but it was not directly related to risk. Among offspring of iron-deficient women, the odds of fetal anemia increased with fetal α+-thalassemia, as well as these patterns of cord blood cytokines: increased cord IL-6, decreased TNF-RI, and decreased sTfR. The EPO response to fetal anemia was low or absent and EPO levels were significantly decreased in newborns with the most severe anemia. This study from an area of high malaria transmission provides evidence that 1) fetal α+-thalassemia and cytokine balance, but not PM at delivery, are related to fetal anemia; 2) maternal iron deficiency increases the risk that other factors may cause fetal anemia; and 3) fetal anemia has a multifactorial etiology that may require a variety of interventions, although measures that reduce maternal iron deficiency may be generally beneficial.
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Affiliation(s)
- Edward R Kabyemela
- Mother Offspring Malaria Studies (MOMS) Project, Seattle Biomedical Research Institute, Seattle, WA, United States.,School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Michal Fried
- Mother Offspring Malaria Studies (MOMS) Project, Seattle Biomedical Research Institute, Seattle, WA, United States.,Laboratory of Malaria Immunology and Vaccinology, National Institutes of Allergy and Infectious Diseases, National Institutes of Health (NIH), Bethesda, MD, United States
| | - Jonathan D Kurtis
- Department of Pathology and Laboratory Medicine, Center for International Health Research, Rhode Island Hospital, Brown University, Providence, RI, United States
| | - Gwamaka Moses
- Mother Offspring Malaria Studies (MOMS) Project, Seattle Biomedical Research Institute, Seattle, WA, United States.,Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya, Tanzania
| | - J Patrick Gorres
- Laboratory of Malaria Immunology and Vaccinology, National Institutes of Allergy and Infectious Diseases, National Institutes of Health (NIH), Bethesda, MD, United States
| | - Atis Muehlenbachs
- Mother Offspring Malaria Studies (MOMS) Project, Seattle Biomedical Research Institute, Seattle, WA, United States
| | - Patrick E Duffy
- Mother Offspring Malaria Studies (MOMS) Project, Seattle Biomedical Research Institute, Seattle, WA, United States.,Laboratory of Malaria Immunology and Vaccinology, National Institutes of Allergy and Infectious Diseases, National Institutes of Health (NIH), Bethesda, MD, United States
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Buriak I, Fleck RA, Goltsev A, Shevchenko N, Petrushko M, Yurchuk T, Puhovkin A, Rozanova S, Guibert EE, Robert MC, de Paz LJ, Powell-Palm MJ, Fuller B. Translation of Cryobiological Techniques to Socially Economically Deprived Populations—Part 1: Cryogenic Preservation Strategies. J Med Device 2020. [DOI: 10.1115/1.4045878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
Use of cold for preservation of biological materials, avoidance of food spoilage and to manage a variety of medical conditions has been known for centuries. The cryobiological science justified these applications in the 1960s increasing their use in expanding global activities. However, the engineering and technological aspects associated with cryobiology can be expensive and this raises questions about the abilities of resource-restricted low and middle income countries (LMICs) to benefit from the advances. This review was undertaken to understand where or how access to cryobiological advances currently exist and the constraints on their usage. The subject areas investigated were based on themes which commonly appear in the journal Cryobiology. This led in the final analysis for separating the review into two parts, with the first part dealing with cold applied for biopreservation of living cells and tissues in science, health care and agriculture, and the second part dealing with cold destruction of tissues in medicine. The limitations of the approaches used are recognized, but as a first attempt to address these topics surrounding access to cryobiology in LMICs, the review should pave the way for future more subject-specific assessments of the true global uptake of the benefits of cryobiology.
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Affiliation(s)
- Iryna Buriak
- Department of Cryomicrobiology, Institute for Problems of Cryobiology and Cryomedicine, National Academy of Sciences of Ukraine, 23, Pereyaslavska str, Kharkiv 61016, Ukraine
| | - Roland A. Fleck
- Centre for Ultrastructural Imaging, Kings College London, New Hunts House, Guy's Campus, London SE1 1 UL, United Kingdom
| | - Anatoliy Goltsev
- Department of Cryopathophysiology and Immunology, Institute for Problems of Cryobiology and Cryomedicine, National Academy of Sciences, 23, Pereyaslavska str, Kharkiv 61016, Ukraine
| | - Nadiya Shevchenko
- Laboratory of Phytocryobiology, Institute for Problems of Cryobiology and Cryomedicine, National Academy of Sciences of Ukraine, 23, Pereyaslavska str, Kharkiv 61016, Ukraine
| | - Maryna Petrushko
- Department for Cryobiology of Reproduction System, Institute for Problems of Cryobiology and Cryomedicine, National Academy of Sciences of Ukraine, 23, Pereyaslavska str, Kharkiv 61016, Ukraine
| | - Taisiia Yurchuk
- Department for Cryobiology of Reproduction System, Institute for Problems of Cryobiology and Cryomedicine, National Academy of Sciences of Ukraine, 23, Pereyaslavska str, Kharkiv 61016, Ukraine
| | - Anton Puhovkin
- Department for Cryobiology of Reproduction System, Institute for Problems of Cryobiology and Cryomedicine, National Academy of Sciences of Ukraine, 23, Pereyaslavska str, Kharkiv 61016, Ukraine
| | - Svitlana Rozanova
- Department of Cryobiophysics, Institute for Problems of Cryobiology and Cryomedicine, National Academy of Sciences of Ukraine, 23, Pereyaslavska str, Kharkiv 61016, Ukraine
| | - Edgardo Elvio Guibert
- Departamento de Ciencias Biologicas, Centro Binacional (Argentina-Italia) de Investigaciones en Criobiología Clínica y Aplicada, Universidad Nacional de Rosario, Avda. Arijon 28BIS, Rosario 2000, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Avda. Arijon 28BIS, Rosario 2000, Argentina
| | - Maria Celeste Robert
- Centro Binacional (Argentina-Italia) de Investigaciones en Criobiología Clínica y Aplicada, Universidad Nacional de Rosario, Avda. Arijon 28BIS, Rosario 2000, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Avda. Arijon 28BIS, Rosario 2000, Argentina
| | - Leonardo Juan de Paz
- Centro Binacional (Argentina-Italia) de Investigaciones en Criobiología Clínica y Aplicada, Universidad Nacional de Rosario, Avda. Arijon 28BIS, Rosario 2000, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas, Avda. Arijon 28BIS, Rosario 2000, Argentina
| | - Matthew J. Powell-Palm
- Department of Mechanical Engineering, University of California Berkeley, 6124 Etcheverry Hall, Hearst Ave, Berkeley, CA 94720
| | - Barry Fuller
- Division of Surgery and Interventional Science, UCL Medical School, Royal Free Hospital, London NW3 2QG, United Kingdom
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