1
|
Müller K, Silvie O, Mollenkopf HJ, Matuschewski K. Pleiotropic Roles for the Plasmodium berghei RNA Binding Protein UIS12 in Transmission and Oocyst Maturation. Front Cell Infect Microbiol 2021; 11:624945. [PMID: 33747980 PMCID: PMC7973279 DOI: 10.3389/fcimb.2021.624945] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 01/15/2021] [Indexed: 11/21/2022] Open
Abstract
Colonization of the mosquito host by Plasmodium parasites is achieved by sexually differentiated gametocytes. Gametocytogenesis, gamete formation and fertilization are tightly regulated processes, and translational repression is a major regulatory mechanism for stage conversion. Here, we present a characterization of a Plasmodium berghei RNA binding protein, UIS12, that contains two conserved eukaryotic RNA recognition motifs (RRM). Targeted gene deletion resulted in viable parasites that replicate normally during blood infection, but form fewer gametocytes. Upon transmission to Anopheles stephensi mosquitoes, both numbers and size of midgut-associated oocysts were reduced and their development stopped at an early time point. As a consequence, no salivary gland sporozoites were formed indicative of a complete life cycle arrest in the mosquito vector. Comparative transcript profiling in mutant and wild-type infected red blood cells revealed a decrease in transcript abundance of mRNAs coding for signature gamete-, ookinete-, and oocyst-specific proteins in uis12(-) parasites. Together, our findings indicate multiple roles for UIS12 in regulation of gene expression after blood infection in good agreement with the pleiotropic defects that terminate successful sporogony and onward transmission to a new vertebrate host.
Collapse
Affiliation(s)
- Katja Müller
- Department of Molecular Parasitology, Institute of Biology, Humboldt University, Berlin, Germany.,Parasitology Unit, Max Planck Institute for Infection Biology, Berlin, Germany
| | - Olivier Silvie
- Centre d'Immunologie et des Maladies Infectieuses, INSERM, CNRS, Sorbonne Université, Paris, France
| | - Hans-Joachim Mollenkopf
- Core Facility Microarray/Genomics, Max Planck Institute for Infection Biology, Berlin, Germany
| | - Kai Matuschewski
- Department of Molecular Parasitology, Institute of Biology, Humboldt University, Berlin, Germany.,Parasitology Unit, Max Planck Institute for Infection Biology, Berlin, Germany
| |
Collapse
|
2
|
Mukosera GT, Liu T, Manaen M, Zhu L, Power G, Schroeder H, Blood AB. Deferoxamine produces nitric oxide under ferricyanide oxidation, blood incubation, and UV-irradiation. Free Radic Biol Med 2020; 160:458-470. [PMID: 32828952 PMCID: PMC11059783 DOI: 10.1016/j.freeradbiomed.2020.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/03/2020] [Accepted: 08/09/2020] [Indexed: 11/29/2022]
Abstract
Deferoxamine (DFO), an iron chelator, is used therapeutically for the removal of excess iron in multiple clinical conditions such as beta thalassemia and intracerebral hemorrhage. DFO is also used as an iron chelator and hypoxia-mimetic agent in in vivo and in vitro basic research. Here we unexpectedly discover DFO to be a nitric oxide (NO) precursor in experiments where it was intended to act as an iron chelator. Production of NO from aqueous solutions of DFO was directly observed by ozone-based chemiluminescence using a ferricyanide-based assay and was confirmed by electron paramagnetic resonance (EPR). DFO also produced NO following exposure to ultraviolet light, and its incubation with sheep adult and fetal blood resulted in considerable formation of iron nitrosyl hemoglobin, as confirmed by both visible spectroscopy and EPR. These results suggest that experiments using DFO can be confounded by concomitant production of NO, and offer new insight into some of DFO's unexplained clinical side effects such as hypotension.
Collapse
Affiliation(s)
- George T Mukosera
- Lawrence D Longo Center for Perinatal Biology and Department of Pediatrics, Loma Linda University, 11175 Campus Street, Loma Linda, CA, 92354, USA
| | - Taiming Liu
- Lawrence D Longo Center for Perinatal Biology and Department of Pediatrics, Loma Linda University, 11175 Campus Street, Loma Linda, CA, 92354, USA
| | - Meshach Manaen
- Lawrence D Longo Center for Perinatal Biology and Department of Pediatrics, Loma Linda University, 11175 Campus Street, Loma Linda, CA, 92354, USA
| | - Lingchao Zhu
- Department of Chemistry, University of California-Riverside 501 Big Springs Road, Riverside, CA 92521, USA
| | - Gordon Power
- Lawrence D Longo Center for Perinatal Biology and Department of Pediatrics, Loma Linda University, 11175 Campus Street, Loma Linda, CA, 92354, USA
| | - Hobe Schroeder
- Lawrence D Longo Center for Perinatal Biology and Department of Pediatrics, Loma Linda University, 11175 Campus Street, Loma Linda, CA, 92354, USA
| | - Arlin B Blood
- Lawrence D Longo Center for Perinatal Biology and Department of Pediatrics, Loma Linda University, 11175 Campus Street, Loma Linda, CA, 92354, USA.
| |
Collapse
|
3
|
Georgalas I, Makris G, Papaconstantinou D, Petrou P, Chalkiadaki E, Droutsas K, Andreanos K, Kanakis M. A Pilot Optical Coherence Tomography Angiography Study on Superficial and Deep Capillary Plexus Foveal Avascular Zone in Patients With Beta-Thalassemia Major. Invest Ophthalmol Vis Sci 2020; 60:3887-3896. [PMID: 31529120 DOI: 10.1167/iovs.19-27291] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate foveal avascular zone (FAZ) changes in the superficial (SCP) and deep (DCP) capillary plexuses in beta-thalassemia major (BTM) patients, as shown in optical coherence tomography angiography. Methods Nonrandomized, comparative case series of 54 eyes of 27 BTM patients and 46 eyes of 23 healthy controls, utilizing an automated FAZ detection algorithm. Measurements included FAZ area and FAZ shape descriptors (convexity, circularity, and contour temperature). Results were compared between the two groups, and correlated to iron load and chelation therapy parameters. Results SCP and DCP FAZ area were not significantly different between the control and BTM groups (P = 0.778 and P = 0.408, respectively). The same was true regarding SCP FAZ convexity (P = 0.946), circularity (P = 0.838), and contour temperature (P = 0.907). In contrast, a statistically significant difference was detected between controls and BTM group regarding DCP FAZ convexity (P = 0.013), circularity (P = 0.010), and contour temperature (P = 0.014). Desferrioxamine dosage was strongly correlated to the DCP area (r = 0.650, P = 0.05) and liver magnetic resonance imaging/T2-star to DCP circularity (r = -0.492, P = 0.038). Correlations were also revealed between urine Fe excretion and DCP convexity (r = 0.531, P = 0.019), circularity (r = 0.661, P = 0.002), and contour temperature (r = -0.591, P = 0.008). Conclusions Retinal capillary plexuses and especially DCP seem to present unique morphologic changes in BTM patients, not in the FAZ area, but in specific shape descriptors, indicating minor but detectable FAZ changes. These changes correlate well with iron load and chelation therapy parameters. Their clinical importance and pathophysiologic implications remain to be elucidated through further studies.
Collapse
Affiliation(s)
- Ilias Georgalas
- First Department of Ophthalmology, National and Kapodistrian University of Athens, G. Gennimatas Hospital, Athens, Greece
| | - Georgios Makris
- Department of Ophthalmology, G. Gennimatas Hospital, Athens, Greece
| | - Dimitrios Papaconstantinou
- First Department of Ophthalmology, National and Kapodistrian University of Athens, G. Gennimatas Hospital, Athens, Greece
| | - Petros Petrou
- First Department of Ophthalmology, National and Kapodistrian University of Athens, G. Gennimatas Hospital, Athens, Greece
| | - Evangelia Chalkiadaki
- First Department of Ophthalmology, National and Kapodistrian University of Athens, G. Gennimatas Hospital, Athens, Greece
| | - Konstantinos Droutsas
- First Department of Ophthalmology, National and Kapodistrian University of Athens, G. Gennimatas Hospital, Athens, Greece
| | - Konstantinos Andreanos
- First Department of Ophthalmology, National and Kapodistrian University of Athens, G. Gennimatas Hospital, Athens, Greece
| | - Menelaos Kanakis
- Department of Ophthalmology, Patras University School of Medicine, Rion, Patras, Greece
| |
Collapse
|
4
|
Kumar A, Singh KP, Bali P, Anwar S, Kaul A, Singh OP, Gupta BK, Kumari N, Noor Alam M, Raziuddin M, Sinha MP, Gourinath S, Sharma AK, Sohail M. iNOS polymorphism modulates iNOS/NO expression via impaired antioxidant and ROS content in P. vivax and P. falciparum infection. Redox Biol 2017; 15:192-206. [PMID: 29268202 PMCID: PMC5738204 DOI: 10.1016/j.redox.2017.12.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 11/30/2017] [Accepted: 12/12/2017] [Indexed: 01/09/2023] Open
Abstract
Nitric oxide (NO) has dicotomic influence on modulating host-parasite interplay, synchronizing physiological orchestrations and diagnostic potential; instigated us to investigate the plausible association and genetic regulation among NO level, components of oxidative stress, iNOS polymorphisms and risk of malaria. Here, we experimentally elucidate that iNOS promoter polymorphisms are associated with risk of malaria; employing mutation specific genotyping, functional interplay using western blot and RT-PCR, quantitative estimation of NO, total antioxidant content (TAC) and reactive oxygen species (ROS). Genotyping revealed significantly associated risk of P. vivax (adjusted OR = 1.92 and 1.72) and P. falciparum (adjusted OR = 1.68 and 1.75) infection with SNP at iNOS-954G/C and iNOS-1173C/T positions, respectively; though vivax showed higher risk of infection. Intriguingly, mutation and infection specific differential upregulation of iNOS expression/NO level was observed and found to be significantly associated with mutant genotypes. Moreover, P. vivax showed pronounced iNOS protein (2.4 fold) and mRNA (2.5 fold) expression relative to healthy subjects. Furthermore, TAC and ROS were significantly decreased in infection; and differentially decreased in mutant genotypes. Our findings endorse polymorphic regulation of iNOS expression, altered oxidant-antioxidant components and evidences of risk association as the hallmark of malaria pathogenesis. iNOS/NO may serve as potential diagnostic marker in assessing clinical malaria. Polymorphism of iNOS revealed significantly associated risk of P. vivax and P. falciparum malaria and vivax showed higher risk of infection. We observed mutation and infection specific differential expression of iNOS/NO cascade. We investigated mutation specific antioxidant and ROS orchestration and observed lower TAC and ROS content in infection. Evaluated the clinical correlation among stratified axillary temperature, NO and haemoglobin content during infection.
Collapse
Affiliation(s)
- Amod Kumar
- University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Krishn Pratap Singh
- University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Prerna Bali
- National Institute of Malaria Research, Dawarka, Delhi, India
| | - Shadab Anwar
- School of Life Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Asha Kaul
- National Institute of Malaria Research, Dawarka, Delhi, India
| | - Om P Singh
- National Institute of Malaria Research, Dawarka, Delhi, India
| | - Birendra Kumar Gupta
- University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Nutan Kumari
- Department of Physiology, Patna Medical College and Hospital, Patna, India
| | - Md Noor Alam
- University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | - Mohammad Raziuddin
- University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India
| | | | | | - Ajay Kumar Sharma
- University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India.
| | - Mohammad Sohail
- University Department of Zoology, Vinoba Bhave University, Hazaribag, Jharkhand, India.
| |
Collapse
|
5
|
Nairz M, Haschka D, Demetz E, Weiss G. Iron at the interface of immunity and infection. Front Pharmacol 2014; 5:152. [PMID: 25076907 PMCID: PMC4100575 DOI: 10.3389/fphar.2014.00152] [Citation(s) in RCA: 209] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 06/10/2014] [Indexed: 12/18/2022] Open
Abstract
Both, mammalian cells and microbes have an essential need for iron, which is required for many metabolic processes and for microbial pathogenicity. In addition, cross-regulatory interactions between iron homeostasis and immune function are evident. Cytokines and the acute phase protein hepcidin affect iron homeostasis leading to the retention of the metal within macrophages and hypoferremia. This is considered to result from a defense mechanism of the body to limit the availability of iron for extracellular pathogens while on the other hand the reduction of circulating iron results in the development of anemia of inflammation. Opposite, iron and the erythropoiesis inducing hormone erythropoietin affect innate immune responses by influencing interferon-gamma (IFN-γ) mediated (iron) or NF-kB inducible (erythropoietin) immune effector pathways in macrophages. Thus, macrophages loaded with iron lose their ability to kill intracellular pathogens via IFN-γ mediated effector pathways such as nitric oxide (NO) formation. Accordingly, macrophages invaded by the intracellular bacterium Salmonella enterica serovar Typhimurium increase the expression of the iron export protein ferroportin thereby reducing the availability of iron for intramacrophage bacteria while on the other side strengthening anti-microbial macrophage effector pathways via increased formation of NO or TNF-α. In addition, certain innate resistance genes such as natural resistance associated macrophage protein function (Nramp1) or lipocalin-2 exert part of their antimicrobial activity by controlling host and/or microbial iron homeostasis. Consequently, pharmacological or dietary modification of cellular iron trafficking enhances host resistance to intracellular pathogens but may increase susceptibility to microbes in the extracellular compartment and vice versa. Thus, the control over iron homeostasis is a central battlefield in host–pathogen interplay influencing the course of an infectious disease in favor of either the mammalian host or the pathogenic invader.
Collapse
Affiliation(s)
- Manfred Nairz
- Department of Internal Medicine VI-Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck Innsbruck, Austria
| | - David Haschka
- Department of Internal Medicine VI-Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck Innsbruck, Austria
| | - Egon Demetz
- Department of Internal Medicine VI-Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck Innsbruck, Austria
| | - Günter Weiss
- Department of Internal Medicine VI-Infectious Diseases, Immunology, Rheumatology, Pneumology, Medical University of Innsbruck Innsbruck, Austria
| |
Collapse
|
6
|
Golenser J, Domb A, Leshem B, Kremsner P, Luty A. Iron chelators as drugs against malaria pose a potential risk. Redox Rep 2013; 8:268-71. [PMID: 14962362 DOI: 10.1179/135100003225002880] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Jacob Golenser
- Department of Parasitology, The Hebrew University, Jerusalem, Israel.
| | | | | | | | | |
Collapse
|
7
|
Clark M, Fisher NC, Kasthuri R, Cerami Hand C. Parasite maturation and host serum iron influence the labile iron pool of erythrocyte stage Plasmodium falciparum. Br J Haematol 2013; 161:262-9. [PMID: 23398516 DOI: 10.1111/bjh.12234] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 12/20/2012] [Indexed: 12/30/2022]
Abstract
Iron is a critical and tightly regulated nutrient for both the malaria parasite and its human host. The importance of the relationship between host iron and the parasite has been underscored recently by studies showing that host iron supplementation may increase the risk of falciparum malaria. It is unclear what host iron sources the parasite is able to access. We developed a flow cytometry-based method for measuring the labile iron pool (LIP) of parasitized erythrocytes using the nucleic acid dye STYO 61 and the iron sensitive dye, calcein acetoxymethyl ester (CA-AM). This new approach enabled us to measure the LIP of P. falciparum through the course of its erythrocytic life cycle and in response to the addition of host serum iron sources. We found that the LIP increases as the malaria parasite develops from early ring to late schizont stage, and that the addition of either transferrin or ferric citrate to culture media increases the LIP of trophozoites. Our method for detecting the LIP within malaria parasitized RBCs provides evidence that the parasite is able to access serum iron sources as part of the host vs. parasite arms race for iron.
Collapse
Affiliation(s)
- Martha Clark
- Department of Microbiology and Immunology, University of North Carolina-Chapel Hill, Chapel Hill, USA, United States
| | | | | | | |
Collapse
|
8
|
Spottiswoode N, Fried M, Drakesmith H, Duffy PE. Implications of malaria on iron deficiency control strategies. Adv Nutr 2012; 3:570-8. [PMID: 22797994 PMCID: PMC3649728 DOI: 10.3945/an.111.001156] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The populations in greatest need of iron supplementation are also those at greatest risk of malaria: pregnant women and young children. Iron supplementation has been shown to increase malaria risk in these groups in numerous studies, although this effect is likely diminished by factors such as host immunity, host iron status, and effective malaria surveillance and control. Conversely, the risk of anemia is increased by malaria infections and preventive measures against malaria decrease anemia prevalence in susceptible populations without iron supplementation. Studies have shown that subjects with malaria experience diminished absorption of orally administered iron, so that as a consequence, iron supplementation may have generally reduced efficacy in malarious populations. A possible mechanistic link between malaria, poor absorption of iron, and anemia is provided by recent research on hepcidin, the human iron control hormone. Our improved understanding of iron metabolism may contribute to the control of malaria and the treatment of anemia. Malaria surveillance and control are necessary components of programs to control iron deficiency and may enhance the efficacy of iron supplementation.
Collapse
Affiliation(s)
- Natasha Spottiswoode
- Laboratory of Malaria Immunology and Vaccinology, NIAID, National Institutes of Health, Bethesda, MD; and,Molecular Immunology Group, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, UK
| | - Michal Fried
- Laboratory of Malaria Immunology and Vaccinology, NIAID, National Institutes of Health, Bethesda, MD; and
| | - Hal Drakesmith
- Molecular Immunology Group, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, UK
| | - Patrick E. Duffy
- Laboratory of Malaria Immunology and Vaccinology, NIAID, National Institutes of Health, Bethesda, MD; and
| |
Collapse
|
9
|
Schümann K, Solomons NW, Romero-Abal ME, Orozco M, Weiss G, Marx J. Oral Administration of Ferrous Sulfate, but not of Iron Polymaltose or Sodium Iron Ethylenediaminetetraacetic Acid (NaFeEDTA), Results in a Substantial Increase of Non-Transferrin-Bound Iron in Healthy Iron-Adequate Men. Food Nutr Bull 2012; 33:128-36. [DOI: 10.1177/156482651203300206] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Oral iron supplementation with ferrous sulfate (FeSO4) at dosage levels suggested by the international guidelines poses a safety hazard to young children with malaria. Exposure to loosely bound iron in the circulation has been advanced as a potential factor. Objective To evaluate the kinetics of circulating concentrations of plasma iron and non-transferrin-bound iron (NTBI) in response to oral iron administration in healthy adults. Methods Plasma samples were collected at 90-minute intervals over a period of 270 minutes from 10 healthy Guatemalan men after oral administration of water or 100 mg of iron from each of three iron compounds: FeSO4, sodium iron ethylenediaminetetraacetic acid (NaFeEDTA), and iron polymaltose. The four tests were administered in an individually randomized sequence. Serum iron concentration was measured spectrophotometrically by the ferrozine method, and NTBI concentration was measured by a fluorometric competitive binding assay. The kinetic response and the maximal and cumulative changes in circulating concentrations of the biomarkers of interest were compared. Results Serum iron and NTBI responses to oral administration of FeSO4 were significantly greater than responses to plain water or the other two iron compounds. NTBI concentrations after NaFeEDTA or iron polymaltose ingestion were not different from those determined after water intake. Conclusions Administration of two iron compounds of proven bioavailability, but with complex absorption characteristics, is associated with a negligible NTBI response, potentially mitigating the safety concerns associated with iron supplementation in malarial areas.
Collapse
|
10
|
Gwamaka M, Kurtis JD, Sorensen BE, Holte S, Morrison R, Mutabingwa TK, Fried M, Duffy PE. Iron deficiency protects against severe Plasmodium falciparum malaria and death in young children. Clin Infect Dis 2012; 54:1137-44. [PMID: 22354919 DOI: 10.1093/cid/cis010] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Iron supplementation may increase malaria morbidity and mortality, but the effect of naturally occurring variation in iron status on malaria risk is not well studied. METHODS A total of 785 Tanzanian children living in an area of intense malaria transmission were enrolled at birth, and intensively monitored for parasitemia and illness including malaria for up to 3 years, with an average of 47 blood smears. We assayed plasma samples collected at routine healthy-child visits, and evaluated the impact of iron deficiency (ID) on future malaria outcomes and mortality. RESULTS ID at routine, well-child visits significantly decreased the odds of subsequent parasitemia (23% decrease, P < .001) and subsequent severe malaria (38% decrease, P = .04). ID was also associated with 60% lower all-cause mortality (P = .04) and 66% lower malaria-associated mortality (P = .11). When sick visits as well as routine healthy-child visits are included in analyses (average of 3 iron status assays/child), ID reduced the prevalence of parasitemia (6.6-fold), hyperparasitemia (24.0-fold), and severe malaria (4.0-fold) at the time of sample collection (all P < .001). CONCLUSIONS Malaria risk is influenced by physiologic iron status, and therefore iron supplementation may have adverse effects even among children with ID. Future interventional studies should assess whether treatment for ID coupled with effective malaria control can mitigate the risks of iron supplementation for children in areas of malaria transmission.
Collapse
Affiliation(s)
- Moses Gwamaka
- Mother-Offspring Malaria Studies Project, Seattle Biomedical Research Institute, Washington, USA
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Zimmerman GA, Castro-Faria-Neto H. Persistent cognitive impairment after cerebral malaria: models, mechanisms and adjunctive therapies. Expert Rev Anti Infect Ther 2011; 8:1209-12. [PMID: 21073283 DOI: 10.1586/eri.10.117] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
12
|
Tussing-Humphreys L, Pini M, Ponemone V, Braunschweig C, Fantuzzi G. Suppressed cytokine production in whole blood cultures may be related to iron status and hepcidin and is partially corrected following weight reduction in morbidly obese pre-menopausal women. Cytokine 2010; 53:201-6. [PMID: 21145254 DOI: 10.1016/j.cyto.2010.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Revised: 11/15/2010] [Accepted: 11/18/2010] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Assess ex vivo whole-blood (WB) cytokine production and its association with iron status and serum hepcidin in obese versus non-obese women. Determine the change in ex vivo WB cytokine production 6 months after restrictive bariatric surgery in the obese group. SUBJECTS Seventeen obese (BMI: 46.6±7.9 kg/m²) and 19 non-obese (BMI: 22.5±3.0 kg/m²), pre-menopausal women; frequency matched for hemoglobin, age and race. MEASUREMENTS At baseline control and ex vivo stimulated IL-6, IL-10, IL-22, IFNγ, and TNFα from heparinized WB cultures, hemoglobin from finger-stick and transferrin receptor, hepcidin, CRP, IL-6, HOMA-IR from fasted serum samples and anthropometric parameters were assessed in the women. All parameters were reassessed 6-months following restrictive bariatric surgery in the obese women only. RESULTS Whole blood ex vivo LPS and ZY stimulated production of IL-6, TNFα, and IFNγ was reduced, IL-22 increased, and IL-10 was unaffected in obese compared with the non-obese women. Furthermore, ex vivo stimulated production of IL-6 and TNFα normalized, but IFNγ production remained unchanged with weight loss following restrictive bariatric surgery. In the obese women, serum transferrin receptor (a marker of iron status) and serum hepcidin were correlated with ex vivo stimulated IFNγ production at baseline. CONCLUSION Ex vivo LPS and ZY stimulated cytokine production from WB cultures was altered in pre-menopausal women with morbid obesity. Significant weight loss resulted in normalization of some but not all observed alterations. Furthermore, iron status and serum hepcidin were associated with ex vivo LPS and ZY stimulated IFNγ in obesity.
Collapse
Affiliation(s)
- Lisa Tussing-Humphreys
- United States Department of Agriculture - Agricultural Research Service, Southern Regional Research Center, 282 Knapp Hall, Highland Road, Baton Rouge, LA 70803, USA
| | | | | | | | | |
Collapse
|
13
|
Mbugi EV, Meijerink M, Veenemans J, Jeurink PV, McCall M, Olomi RM, Shao JF, Chilongola JO, Verhoef H, Savelkoul HFJ. Effect of nutrient deficiencies on in vitro Th1 and Th2 cytokine response of peripheral blood mononuclear cells to Plasmodium falciparum infection. Malar J 2010; 9:162. [PMID: 20546583 PMCID: PMC2901354 DOI: 10.1186/1475-2875-9-162] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Accepted: 06/14/2010] [Indexed: 11/20/2022] Open
Abstract
Background An appropriate balance between pro-inflammatory and anti-inflammatory cytokines that mediate innate and adaptive immune responses is required for effective protection against human malaria and to avoid immunopathology. In malaria endemic countries, this immunological balance may be influenced by micronutrient deficiencies. Methods Peripheral blood mononuclear cells from Tanzanian preschool children were stimulated in vitro with Plasmodium falciparum-parasitized red blood cells to determine T-cell responses to malaria under different conditions of nutrient deficiencies and malaria status. Results The data obtained indicate that zinc deficiency is associated with an increase in TNF response by 37%; 95% CI: 14% to 118% and IFN-γ response by 74%; 95% CI: 24% to 297%. Magnesium deficiency, on the other hand, was associated with an increase in production of IL-13 by 80%; 95% CI: 31% to 371% and a reduction in IFN-γ production. These results reflect a shift in cytokine profile to a more type I cytokine profile and cell-cell mediated responses in zinc deficiency and a type II response in magnesium deficiency. The data also reveal a non-specific decrease in cytokine production in children due to iron deficiency anaemia that is largely associated with malaria infection status. Conclusions The pathological sequels of malaria potentially depend more on the balance between type I and type II cytokine responses than on absolute suppression of these cytokines and this balance may be influenced by a combination of micronutrient deficiencies and malaria status.
Collapse
Affiliation(s)
- Erasto V Mbugi
- Cell Biology and Immunology Group, Wageningen University, The Netherlands
| | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Corna G, Campana L, Pignatti E, Castiglioni A, Tagliafico E, Bosurgi L, Campanella A, Brunelli S, Manfredi AA, Apostoli P, Silvestri L, Camaschella C, Rovere-Querini P. Polarization dictates iron handling by inflammatory and alternatively activated macrophages. Haematologica 2010; 95:1814-22. [PMID: 20511666 DOI: 10.3324/haematol.2010.023879] [Citation(s) in RCA: 222] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Macrophages play a key role in iron homeostasis. In peripheral tissues, they are known to polarize into classically activated (or M1) macrophages and alternatively activated (or M2) macrophages. Little is known on whether the polarization program influences the ability of macrophages to store or recycle iron and the molecular machinery involved in the processes. DESIGN AND METHODS Inflammatory/M1 and alternatively activated/M2 macrophages were propagated in vitro from mouse bone-marrow precursors and polarized in the presence of recombinant interferon-γ or interleukin-4. We characterized and compared their ability to handle radioactive iron, the characteristics of the intracellular iron pools and the expression of molecules involved in internalization, storage and export of the metal. Moreover we verified the influence of iron on the relative ability of polarized macrophages to activate antigen-specific T cells. RESULTS M1 macrophages have low iron regulatory protein 1 and 2 binding activity, express high levels of ferritin H, low levels of transferrin receptor 1 and internalize--albeit with low efficiency -iron only when its extracellular concentration is high. In contrast, M2 macrophages have high iron regulatory protein binding activity, express low levels of ferritin H and high levels of transferrin receptor 1. M2 macrophages have a larger intracellular labile iron pool, effectively take up and spontaneously release iron at low concentrations and have limited storage ability. Iron export correlates with the expression of ferroportin, which is higher in M2 macrophages. M1 and M2 cells activate antigen-specific, MHC class II-restricted T cells. In the absence of the metal, only M1 macrophages are effective. CONCLUSIONS Cytokines that drive macrophage polarization ultimately control iron handling, leading to the differentiation of macrophages into a subset which has a relatively sealed intracellular iron content (M1) or into a subset endowed with the ability to recycle the metal (M2).
Collapse
Affiliation(s)
- Gianfranca Corna
- H San Raffaele Institute, DIBIT-3A1, via Olgettina 58, 20132 Milano, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Weiss G. Iron metabolism in the anemia of chronic disease. Biochim Biophys Acta Gen Subj 2009; 1790:682-93. [DOI: 10.1016/j.bbagen.2008.08.006] [Citation(s) in RCA: 192] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2008] [Revised: 07/27/2008] [Accepted: 08/14/2008] [Indexed: 02/08/2023]
|
16
|
Anaemia in advanced chronic fasciolosis. Acta Trop 2008; 108:35-43. [PMID: 18805388 DOI: 10.1016/j.actatropica.2008.08.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2007] [Revised: 08/23/2008] [Accepted: 08/26/2008] [Indexed: 11/20/2022]
Abstract
The association between fasciolosis-induced anaemia and related factors has been quantified in a rodent model. Haematological parameters were analysed in Wistar rats at 20 and 60 weeks post-infection (p.i.). Pigment stones and bile specimens were collected. Serum IgG1, IgG2a and IgE were determined in rat serum samples. Cytokine levels have been correlated with haematological parameters. The screening for gastrointestinal bleeding was carried out. Bacteriological bile cultures revealed viable bacteria in 53.8% of specimens at 60 weeks p.i. The results show that the type of anaemia in fasciolosis might be considered a biomarker of the chronicity period of the disease, changing from normocytic to macrocytic in the early chronic period (20 weeks p.i.) and to microcytic in the advanced chronic period (60 weeks p.i.). Likewise, changing from normochromic in the early chronic period to hypochromic in the advanced chronic period. Multivariate analysis suggested an association between anaemia and the following factors: fluke burden, eggs per gram of faeces, body area of parasite, presence of blood in faeces, IgG1 and eosinophil levels, and % of splenic weight. Of all variables analysed, the fluke burden is the one which presents the highest anaemia risk, even exceeding the variable presence of blood in faeces. The development of anaemia appears to be complex and may involve multiple mechanisms. However, to the mechanisms that until now explain Fascioliosis-related anaemia (compensatory increase in erythrocyte production and a continuous drain on iron stores resulting from the parasites' blood-sucking activities) the following causes ought to be added: haemolysis of red blood cells, the general effects of inflammation on erythropoiesis, concomitant parasitic and bacterial infections and pre-morbid nutritional abnormalities. Extrapolation to human fasciolosis is discussed. The results of the rodent model lead to the assumption that a high risk of anaemia in subjects with a heavy parasitic burden in human hyperendemic areas of fasciolosis is to be expected.
Collapse
|
17
|
Theurl I, Fritsche G, Ludwiczek S, Garimorth K, Bellmann-Weiler R, Weiss G. The Macrophage: A Cellular Factory at the Interphase Between Iron and Immunity for the Control of Infections. Biometals 2005; 18:359-67. [PMID: 16158228 DOI: 10.1007/s10534-005-3710-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Igor Theurl
- Department of General Internal Medicine, Clinical Immunology and Infectious Diseases Medical University, A-6020, Innsbruck, Austria
| | | | | | | | | | | |
Collapse
|
18
|
Nyakeriga AM, Williams TN, Marsh K, Wambua S, Perlmann H, Perlmann P, Grandien A, Troye-Blomberg M. Cytokine mRNA expression and iron status in children living in a malaria endemic area. Scand J Immunol 2005; 61:370-5. [PMID: 15853921 DOI: 10.1111/j.1365-3083.2005.01573.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Iron deficiency has been reported to affect both malaria pathogenesis and cell-mediated immune responses; however, it is unclear whether the protection afforded by iron deficiency is mediated through direct effects on the parasite, through immune effector functions or through both. We have determined cytokine mRNA expression levels in 59 children living in a malaria endemic area on the coast of Kenya who we selected on the basis of their biochemical iron status. Real-time quantitative reverse transcriptase polymerase chain reaction analysis of cytokine mRNA levels of peripheral blood mononuclear cells (PBMC) obtained from these children showed an association between interleukin-4 (IL-4) mRNA levels and all the biochemical indices of iron that we measured. Furthermore, IL-10 mRNA was higher in parasite blood smear-positive children than in blood smear-negative children irrespective of their iron status. This study suggests that IL-4 expression by PBMC may be affected by iron status.
Collapse
MESH Headings
- Anemia, Iron-Deficiency/blood
- Anemia, Iron-Deficiency/immunology
- Anemia, Iron-Deficiency/parasitology
- Animals
- Child, Preschool
- Cohort Studies
- Cytokines/biosynthesis
- Cytokines/genetics
- Cytokines/immunology
- Endemic Diseases
- Female
- Humans
- Interleukins/biosynthesis
- Interleukins/genetics
- Interleukins/immunology
- Kenya/epidemiology
- Leukocytes, Mononuclear/immunology
- Leukocytes, Mononuclear/parasitology
- Malaria, Falciparum/blood
- Malaria, Falciparum/epidemiology
- Malaria, Falciparum/immunology
- Male
- Nitric Oxide Synthase/biosynthesis
- Nitric Oxide Synthase/genetics
- Nitric Oxide Synthase/immunology
- Nitric Oxide Synthase Type II
- Plasmodium falciparum/immunology
- RNA, Messenger/biosynthesis
- RNA, Messenger/genetics
- Regression Analysis
- Reverse Transcriptase Polymerase Chain Reaction
- Tumor Necrosis Factor-alpha/biosynthesis
- Tumor Necrosis Factor-alpha/genetics
- Tumor Necrosis Factor-alpha/immunology
Collapse
Affiliation(s)
- A M Nyakeriga
- KEMRI/Wellcome Trust Programme, Centre for Geographic Medicine Research, Coast, Kilifi District Hospital, Kilifi, Kenya.
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Gordeuk VR, Loyevsky M. Antimalarial effect of iron chelators. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2003; 509:251-72. [PMID: 12572998 DOI: 10.1007/978-1-4615-0593-8_13] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- Victor R Gordeuk
- George Washington University Medical Center, 2150 Pennsylvania Ave NW, Washington, DC 20037, USA
| | | |
Collapse
|
20
|
Tahara K, Nishiya K, Hisakawa N, Wang H, Hashimoto K. Suppressive Effect of Iron on Concanavalin A‐Induced Multinucleated Giant Cell Formation by Human Monocytes. Immunol Invest 2003; 32:229-43. [PMID: 14603992 DOI: 10.1081/imm-120025103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Immune dysfunction in patients with iron overload has been reported. Iron disturbed CD2 expression on T-cells, cell-mediated immunity by Th1 cells and monocyte functions including phagocytosis and natural killer activity. In the present study, we examined the effects of iron and desferrioxamine (DFX, an iron chelator) on generation of multinucleated giant cells (MGC) by human monocytes in vitro. Human monocytes were isolated from venous blood and cultured with concanavalin A (Con A) stimulation with additives, ferric citrate (Fe-citrate) or sodium citrate (Na-citrate) or DFX for 4 days. The cells were fixed and subjected to Wright staining. MGC formation was observed under light microscopy. Con A induced MGC formation in a dose-dependent manner, and reached a plateau after 3 days of incubation. MGC formation was suppressed when Con A-stimulated monocytes were cultured with the co-addition of Fe-citrate but not Na-citrate only in the early phase of culture (less than 24 hours). DFX also suppressed MGC formation in a dose-dependent manner. Using flow cytometry analysis, the co-addition of Fe-citrate significantly suppressed CD18 (beta2 integrin) and CD54 (ICAM-I) but not CD11a (alpha integrin) expression on Con A-stimulated monocytes. Iron supressed the generation of MGC by human monocytes in vitro. These observations suggested that iron might affect MGC generation by down-regulation of adhesion molecule expression on monocytes.
Collapse
Affiliation(s)
- Kiyoshi Tahara
- Second Department of Internal Medicine, Kochi Medical School, Nankoku City, Kochi, Japan
| | | | | | | | | |
Collapse
|
21
|
Abstract
Anaemia of chronic disease (ACD), the most frequent anaemia among hospitalized patients, develops under chronic inflammatory disorders such as chronic infections, cancer or autoimmune diseases. A number of different pathways contribute to ACD, such as diversion of iron traffic, a diminished erythropoiesis, a blunted response to erythropoietin, erythrophagocytosis and bone marrow invasion by tumour cells and pathogens. Nevertheless, ACD is a reflection of an activated immune system and possibly results from an innovative defence strategy of the body in order to withdraw the essential growth factor iron from invading pathogens and to increase the efficacy of cell-mediated immunity. Diagnosis of ACD can be assessed by examination of chances in serum iron parameters with low to normal serum iron, transferrin saturation and transferrin concentrations on the one hand and normal to increased ferritin, zinc protoporphyrin IX and cytokine levels on the other side. Therapy of ACD includes the cure of the underlying the disease. Apart from this transfusions for rapid correction of haemoglobin levels, and human recombinant erythropoietin for prolonged therapy are used. However, response rates to recombinant erythropoietin are sometimes low. Iron alone should be strictly avoided due to its growth-promoting effect towards micro-organisms and tumour cells and because of it capacity to inhibit T-cell-mediated immune effector pathways. We urgently need prospective clinical trials to gain knowledge about the effects of anaemia correction and/or the use of erythropoietin towards the course of the underlying disease, to find out if a combination therapy with erythropoietin and iron may be beneficial in ACD and to define therapeutic end-points.
Collapse
Affiliation(s)
- Günter Weiss
- Department of Internal Medicine, University Hospital, Anichstr 35, A-6020 Innsbruck, Austria.
| |
Collapse
|
22
|
Abstract
Iron is a crucial element for many central metabolic pathways of the body. Lack of iron leads to growth arrest and anaemia while increased accumulation of this metal, as it occurs in highly frequent inherited diseases such as hereditary haemochromatosis and thalassaemia, is associated with toxic radical formation and progressive tissue damage. As shown by several groups, iron also modulates immune effector mechanisms, such as cytokine activities (IFN-gamma effector pathways towards macrophages), nitric oxide (NO) formation or immune cell proliferation, and thus host immune surveillance. Therefore, gaining control over iron homeostasis is one of the central battlefields in deciding the fate of an infection with intracellular pathogens or a malignant disease. Thus, the reticulo-endothelial system has evoked sophisticated strategies to control iron metabolism in general and especially the handling of the metal within immune cells.
Collapse
Affiliation(s)
- Günter Weiss
- Department of Internal Medicine, University Hospital, Anichstrasse 35, A-6020 Innsbruck, Austria.
| |
Collapse
|
23
|
Aldieri E, Ghigo D, Tomatis M, Prandi L, Fenoglio I, Costamagna C, Pescarmona G, Bosia A, Fubini B. Iron inhibits the nitric oxide synthesis elicited by asbestos in murine macrophages. Free Radic Biol Med 2001; 31:412-7. [PMID: 11461780 DOI: 10.1016/s0891-5849(01)00612-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Crocidolite fibers stimulated nitric oxide synthase (NOS) activity and expression in glial and alveolar murine macrophages: this effect was inhibited by iron supplementation and enhanced by iron chelation. We suggest that in these cells crocidolite stimulates NOS expression by decreasing the iron bioavailability and activating an iron-sensitive transcription factor.
Collapse
Affiliation(s)
- E Aldieri
- Department of Genetics, Biology, and Biochemistry, University of Torino, Via Santena, 5/bis-10126 Torino, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Clinical Consequences of New Insights in the Pathophysiology of Disorders of Iron and Heme Metabolism. Hematology 2000. [DOI: 10.1182/asheducation.v2000.1.39.20000039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This review examines the clinical consequences for the practicing hematologist of remarkable new insights into the pathophysiology of disorders of iron and heme metabolism. The familiar proteins of iron transport and storage—transferrin, transferrin receptor, and ferritin—have recently been joined by a host of newly identified proteins that play critical roles in the molecular management of iron homeostasis. These include the iron-regulatory proteins (IRP-1 and -2), HFE (the product of the HFE gene that is mutated in most patients with hereditary hemochromatosis), the divalent metal transporter (DMT1), transferrin receptor 2, ceruloplasmin, hephaestin, the “Stimulator of Fe Transport” (SFT), frataxin, ferroportin 1 and others. The growing appreciation of the roles of these newly identified proteins has fundamental implications for the clinical understanding and laboratory evaluation of iron metabolism and its alterations with iron deficiency, iron overload, infection, and inflammation.In Section I, Dr. Brittenham summarizes current concepts of body and cellular iron supply and storage and reviews new means of evaluating the full range of body iron stores including genetic testing for mutations in the HFE gene, measurement of serum ferritin iron, transferrin receptor, reticulocyte hemoglobin content and measurement of tissue iron by computed tomography, magnetic resonance imaging and magnetic susceptometry using superconducting quantum interference device (SQUID) instrumentation.In Section II, Dr. Weiss discusses the improved understanding of the molecular mechanisms underlying alterations in iron metabolism due to chronic inflammatory disorders. The anemia of chronic disorders remains the most common form of anemia found in hospitalized patients. The network of interactions that link iron metabolism with cellular immune effector functions involving pro- and anti-inflammatory cytokines, acute phase proteins and oxidative stress is described, with an emphasis on the implications for clinical practice.In Section III, Dr. Brissot and colleagues discuss how the diagnosis and management of hereditary hemochromatosis has changed following the identification of the gene, HFE, that is mutated in most patients with hereditary hemochromatosis, and the subsequent development of a genotypic test. The current understanding of the molecular effects of HFE mutations, the usefulness of genotypic and phenotypic approaches to screening and diagnosis and recommendations for management are summarized.
Collapse
|
25
|
Clinical Consequences of New Insights in the Pathophysiology of Disorders of Iron and Heme Metabolism. Hematology 2000. [DOI: 10.1182/asheducation.v2000.1.39.39] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
AbstractThis review examines the clinical consequences for the practicing hematologist of remarkable new insights into the pathophysiology of disorders of iron and heme metabolism. The familiar proteins of iron transport and storage—transferrin, transferrin receptor, and ferritin—have recently been joined by a host of newly identified proteins that play critical roles in the molecular management of iron homeostasis. These include the iron-regulatory proteins (IRP-1 and -2), HFE (the product of the HFE gene that is mutated in most patients with hereditary hemochromatosis), the divalent metal transporter (DMT1), transferrin receptor 2, ceruloplasmin, hephaestin, the “Stimulator of Fe Transport” (SFT), frataxin, ferroportin 1 and others. The growing appreciation of the roles of these newly identified proteins has fundamental implications for the clinical understanding and laboratory evaluation of iron metabolism and its alterations with iron deficiency, iron overload, infection, and inflammation.In Section I, Dr. Brittenham summarizes current concepts of body and cellular iron supply and storage and reviews new means of evaluating the full range of body iron stores including genetic testing for mutations in the HFE gene, measurement of serum ferritin iron, transferrin receptor, reticulocyte hemoglobin content and measurement of tissue iron by computed tomography, magnetic resonance imaging and magnetic susceptometry using superconducting quantum interference device (SQUID) instrumentation.In Section II, Dr. Weiss discusses the improved understanding of the molecular mechanisms underlying alterations in iron metabolism due to chronic inflammatory disorders. The anemia of chronic disorders remains the most common form of anemia found in hospitalized patients. The network of interactions that link iron metabolism with cellular immune effector functions involving pro- and anti-inflammatory cytokines, acute phase proteins and oxidative stress is described, with an emphasis on the implications for clinical practice.In Section III, Dr. Brissot and colleagues discuss how the diagnosis and management of hereditary hemochromatosis has changed following the identification of the gene, HFE, that is mutated in most patients with hereditary hemochromatosis, and the subsequent development of a genotypic test. The current understanding of the molecular effects of HFE mutations, the usefulness of genotypic and phenotypic approaches to screening and diagnosis and recommendations for management are summarized.
Collapse
|
26
|
Chiwakata CB, Hemmer CJ, Dietrich M. High levels of inducible nitric oxide synthase mRNA are associated with increased monocyte counts in blood and have a beneficial role in Plasmodium falciparum malaria. Infect Immun 2000; 68:394-9. [PMID: 10603415 PMCID: PMC97148 DOI: 10.1128/iai.68.1.394-399.2000] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To date, there have been conflicting reports concerning the clinical significance of nitric oxide (NO) in Plasmodium falciparum malaria. Some authors have proposed that NO contributes to the development of severe and complicated malaria, while others have argued that NO has a protective role. To investigate these apparently contradictory reports, reverse transcription-coupled PCR was used to study inducible NO synthase (iNOS) in whole-blood RNA samples from patients with severe and complicated malaria or uncomplicated malaria and from healthy donors. This work produced three principal findings. First, samples of patients with severe and complicated malaria were variably positive, with weak to moderate intensity. Markedly higher iNOS RNA levels were observed in samples of patients with uncomplicated malaria than in patients with severe and complicated malaria. Samples of healthy donors were uniformly negative. Second, since we initially demonstrated iNOS expression in whole-blood RNA samples, we extended our investigations to individual blood cells such as monocytes, lymphocytes, neutrophils, and platelets to identify the cellular source of iNOS. We found that iNOS was expressed predominantly in monocytes. Third, retrospective statistical analysis of monocyte counts clearly demonstrated that patients with uncomplicated malaria had higher monocyte counts at the time of presentation than patients with severe and complicated malaria. Taken together, our findings give room to the interpretation that NO may have a beneficial rather than a deleterious role in falciparum malaria.
Collapse
Affiliation(s)
- C B Chiwakata
- Department of Medicine, Bernhard Nocht Institute for Tropical Medicine, D-20359 Hamburg, Germany
| | | | | |
Collapse
|
27
|
Abstract
In recent years there has been much interest in the development of iron (Fe) chelators for treatment of a number of clinical conditions in addition to beta-thalassaemia. These include cancer, anthracycline-mediated cardiotoxicity, malaria, AIDS and the severe neurodegenerative disease, Friedreich's ataxia. In this review I will discuss the most recent advances achieved in the potential treatment of these conditions using Fe chelators.
Collapse
|
28
|
Murata K, Takano F, Fushiya S, Oshima Y. Potentiation by febrifugine of host defense in mice against Plasmodium berghei NK65. Biochem Pharmacol 1999; 58:1593-601. [PMID: 10535750 DOI: 10.1016/s0006-2952(99)00244-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The effect of febrifugine, the main alkaloidal constituent of an antimalarial crude drug, Dichroa febrifuga Lour., on protective immunity in mice infected with erythrocytic stage Plasmodium berghei NK65 was investigated. Febrifugine was administered orally, at a dose of 1 mg/kg/day, to mice before and/or after they were infected intraperitoneally with 2 x 10(6) parasitized red blood cells. Then, mortality and the levels of parasitemia and plasma NO3- [a degradation product of nitric oxide (NO)] were monitored. Febrifugine significantly reduced the mortality and the level of parasitemia. The plasma NO3- concentration began to rise within 2 days after treatment with febrifugine and declined to normal in 2 days when the mice were treated orally with febrifugine once a day for 3 consecutive days before parasite infection. This antimalarial activity of febrifugine was reduced by both N(G)-monomethyl-L-arginine and aminoguanidine. These results indicate that the increased production of NO by febrifugine plays an important role in host defense against malaria infection in mice.
Collapse
Affiliation(s)
- K Murata
- Department of Pharmacognosy, Faculty of Pharmaceutical Sciences, Tohoku University, Sendai, Japan
| | | | | | | |
Collapse
|
29
|
Arun Kumar C, Das UN. Lipid peroxides, nitric oxide and essential fatty acids in patients with Plasmodium falciparum malaria. Prostaglandins Leukot Essent Fatty Acids 1999; 61:255-8. [PMID: 10574650 DOI: 10.1054/plef.1999.0098] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Long chain polyunsaturated fatty acids derived from essential fatty acids have been shown to be toxic to Plasmodium falciparum both in vitro and in vivo. Here, we present evidence to suggest that in patients with Plasmodium falciparum malaria the levels of lipid peroxides (a marker of free radical generation) nitric oxide (a potent free radical with immunomodulatory actions), and concentrations of linoleic acid (LA) and alpha-linolenic acid (ALA) are low, whereas those of eicosapentaenoic acid (EPA) are high. The ability of the fatty acids to kill P. falciparum is dependent on their capacity to stimulate free radical generation in neutrophils and macrophages. EPA is more potent than LA in killing the parasite. In view of this, the results of the present study suggest that in patients with P. falciparum malaria the decreased levels of lipid peroxides and nitric oxide may contribute to the persistence of the infection, whereas elevated levels of EPA may be a feeble attempt to overcome this defect.
Collapse
Affiliation(s)
- C Arun Kumar
- Division of Internal Medicine, Clinical Immunology and Biochemistry, LV Prasad Eye Institute, Hyderabad, India
| | | |
Collapse
|
30
|
Minodier P, Lanza-Silhol F, Piarroux R, Garnier JM, Dumon H, Unal D. [Imported pediatric malaria in Marseille]. Arch Pediatr 1999; 6:935-43. [PMID: 10519026 DOI: 10.1016/s0929-693x(99)80585-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
UNLABELLED Imported malaria is frequently observed in pediatric practices within geographical areas which have a migrant population. MATERIAL AND METHODS All the pediatric malaria cases of a university children's hospital (Marseilles, southern France) had been studied retrospectively. The period of the study was from January 1987 to December 1997. Inclusion criteria were based on clinical diagnosis criteria established by WHO. RESULTS Three hundred and fifteen clinical cases were observed. Ninety-nine percent were confirmed by blood smears. Eighty-six percent of the patients came from the archipelago of the Comoro Islands in the Indian Ocean. Twenty percent were not given chemoprophylaxis, and 77% of the patients with chemoprophylaxis were not compliant. Fever (92%), splenomegaly (61%), vomiting and/or diarrhea (50%) were frequently observed. Neurological signs (23%), especially headaches (15%), were noted. The causative species was Plasmodium falciparum in 76%; coinfections with two species were observed in 9%. Halofantrine was commonly used for therapy (64%), but relapses were noted with this drug. No death was observed during the study. DISCUSSION Imported pediatric malaria is rare in France. Clinical signs may lead to misdiagnosis when splenomegaly is not obvious, or when vomiting and/or diarrhea, cough or otitis occur. Diagnosis relies on blood smears. Curative medications are chloroquine or halofantrine, with special attention to heart troubles. Mefloquine is rarely used in children. Quinine is reserved for serious attacks. Concerning chimioprophylaxy, medical prescriptions should be adapted to the stay abroad, and patient compliance to medications could be improved.
Collapse
Affiliation(s)
- P Minodier
- Service de pédiatrie, CHU Nord, Marseille, France
| | | | | | | | | | | |
Collapse
|
31
|
Camacho LH, Wilairatana P, Weiss G, Mercader MA, Brittenham GM, Looareesuwan S, Gordeuk VR. The eosinophilic response and haematological recovery after treatment for Plasmodium falciparum malaria. Trop Med Int Health 1999; 4:471-5. [PMID: 10470337 DOI: 10.1046/j.1365-3156.1999.00426.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
To examine a possible relationship between the immune response and haematological recovery after acute falciparum malaria, we followed peripheral blood eosinophil counts and haemoglobin concentrations for 4 weeks after starting effective treatment in 70 adult Thai patients. Eosinophils are induced by Th-2 cytokines as well as other stimuli. Eosinophil counts were elevated in only 8 (11%) of the subjects at presentation, but were increased in 65 (93%) by day 7. Eosinophil counts then decreased markedly by day 14, followed by a second increase until day 28. A significant positive correlation was found between peak eosinophil counts on day 7 and the haemoglobin concentration on day 28, both in 16 subjects without stool parasites (r = 0.65, P = 0.006) and in 54 patients with stool parasites (r = 0.32; P = 0.0019). These results suggest that a robust eosinophilic response shortly after completing antimalarial therapy predicts a good recovery from malaria-associated anaemia.
Collapse
Affiliation(s)
- L H Camacho
- Department of Medicine, George Washington University Medical Center, Washington DC, USA.
| | | | | | | | | | | | | |
Collapse
|
32
|
Abstract
Malaria is one of the major global health problems, and an urgent need for the development of new antimalarial agents faces the scientific community. A considerable number of iron(III) chelators, designed for purposes other than treating malaria, have antimalarial activity in vitro, apparently through the mechanism of withholding iron from vital metabolic pathways of the intra-erythrocytic parasite. Certain iron(II) chelators also have antimalarial activity, but the mechanism of action appears to be the formation of toxic complexes with iron rather than the withholding of iron. Several of the iron(III)-chelating compounds also have antimalarial activity in animal models of plasmodial infection. Iron chelation therapy with desferrioxamine, the only compound of this nature that is widely available for use in humans, has clinical activity in both uncomplicated and severe malaria in humans.
Collapse
Affiliation(s)
- G F Mabeza
- Department of Medicine, University of Zimbabwe Medical School, Harare
| | | | | | | |
Collapse
|
33
|
Affiliation(s)
- W Peters
- CABI Bioscience, Tropical Parasitic Diseases Unit, St Albans, Hertfordshire, UK
| |
Collapse
|
34
|
Murata K, Takano F, Fushiya S, Oshima Y. Enhancement of NO production in activated macrophages in vivo by an antimalarial crude drug, Dichroa febrifuga. JOURNAL OF NATURAL PRODUCTS 1998; 61:729-733. [PMID: 9644055 DOI: 10.1021/np970433o] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The effect of an antimalarial crude drug, Dichroafebrifuga Lour. on nitric oxide (NO) production in bacillus Calmette Guérin-induced mouse peritoneal macrophages activated by lipopolysaccharide was investigated. The NO production was significantly enhanced by an oral administration of a MeOH extract of D. febrifuga. Febrifugine (1) was isolated as the main active compound, and the activation was dose-dependent in the dosage range of 0.1-1 mg/kg/day.
Collapse
Affiliation(s)
- K Murata
- Department of Pharmacognosy, and Experimental Station for Medicinal Plant Studies, Faculty of Pharmaceutical Sciences, Tohoku University, Aoba-yama, Aoba-ku, Sendai 980-77, Japan
| | | | | | | |
Collapse
|
35
|
Biemba G, Gordeuk VR, Thuma PE, Mabeza GF, Weiss G. Prolonged macrophage activation and persistent anaemia in children with complicated malaria. Trop Med Int Health 1998; 3:60-5. [PMID: 9484971 DOI: 10.1046/j.1365-3156.1998.00168.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine if prolonged immune activation may be associated with the persistence of anaemia after treatment for severe malaria, we measured serum concentrations of neopterin and interleukin-4 during one week of antimalarial therapy and determined haemoglobin levels one month later. Neopterin is a clinically valuable marker for monitoring activation of macrophages by gamma-interferon and thus reflects the TH-1 immune response. Interleukin-4 is a major cytokine that tends to be inhibited by TH-1 activity. METHOD The study population consisted of 26 Zambian children < 6 years of age who presented with cerebral malaria to a rural hospital in 1994 and who were treated with quinine for seven days. Six children (23%) were anaemic (haemoglobin < 11 g/dl) one month after completing antimalarial therapy. RESULTS On admission, concentrations of neopterin were markedly elevated in all patients. During the seven days of anti-malarial therapy, neopterin levels remained elevated in the 6 children who proved to have persistent anaemia one month after finishing treatment but declined significantly (P = 0.008) in the 20 children who corrected their haemoglobin levels by that time. Conversely, interleukin-4 levels declined in the children with persistent anaemia (P = 0.043) but not in the other children. CONCLUSION Persistence of the TH-1 mediated immune response and associated activation of macrophages may be involved in the pathogenesis of lingering anaemia after treatment of malaria.
Collapse
Affiliation(s)
- G Biemba
- Macha Mission Hospital, Choma, Zambia
| | | | | | | | | |
Collapse
|
36
|
Wiklund L, Nilsson F, Scherstén H, Sjöquist PO, Tazelaar H, Miller VM, McGregor CG. Treatment with an antioxidant inhibits vascular changes caused by circulating lymphocytes during acute lung rejection in dogs. Transplantation 1997; 64:807-11. [PMID: 9326402 DOI: 10.1097/00007890-199709270-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Experiments were designed to evaluate the effect of treatment with an inhibitor of lipid peroxidation, H 290/51, on the interaction of lymphocytes and pulmonary arteries during acute lung rejection. It was hypothesized that inhibition of lipid peroxidation would reduce contractions of the pulmonary arteries to autogenous rejection-activated lymphocytes. METHODS Single-lung transplantation was performed in three groups of dogs: group 1 was maintained on immunosuppression for 8 days postoperatively; in group 2, immunosuppression was discontinued on postoperative day 5, so that rejection occurred on postoperative day 8; in group 3, immunosuppression was discontinued after 5 days, and the lipid peroxidation inhibitor H 290/51 was given orally for 3 days. The pulmonary arteries were removed, cut into rings, and suspended in organ chambers for measurement of isometric force. RESULTS Macrophage-depleted mononuclear cells (MNCs; lymphocytes) isolated from blood caused cell number-dependent contractions in rings of the pulmonary arteries from all dogs. In the rejecting dogs treated with H 290/51 (group 3), contractions to MNCs were significantly greater in rings without endothelium compared to rings with endothelium. Contractions to MNCs with or without endothelium were reduced by adding deteroxamine to the medium but not by adding superoxide dismutase and catalase. CONCLUSIONS The results of this study show that treatment with a lipid peroxidation inhibitor, H 290/51, does not prevent acute rejection of transplanted lungs. The treatment with the peroxidation inhibitor modifies contractions of the pulmonary arteries in response to rejection-activated lymphocytes, indicating that reactive oxidative metabolites may be involved in the vasoactive response resulting from this interaction.
Collapse
Affiliation(s)
- L Wiklund
- Division of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | | | | | | | | | | |
Collapse
|