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Ara Jo-Pereira M, Sheikh V, Sereti I, Barreto-Duarte B, Arriaga MÍB, Tib Rcio R, Vinhaes CL, Pinto-de-Almeida M, Wang J, Rupert A, Roby G, Shaffer D, Ananworanich J, Phanuphak N, Sawe F, Andrade BB. Association between severe anaemia and inflammation, risk of IRIS and death in persons with HIV: A multinational cohort study. EBioMedicine 2022; 85:104309. [PMID: 36283285 PMCID: PMC9593179 DOI: 10.1016/j.ebiom.2022.104309] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND After initiating antiretroviral therapy (ART), approximately 25% of people with HIV (PWH) may develop Immune Reconstitution Inflammatory Syndrome (IRIS), which is associated with increased morbidity and mortality. Several reports have demonstrated that low haemoglobin (Hb) levels are a risk factor for IRIS. To what extent the severity of anaemia contributes to the risk of IRIS and/or death is still insufficiently explored. METHODS We investigated both the presence and severity of anaemia in PWH in a multinational cohort of ART-naïve patients. A large panel of plasma biomarkers was measured pre-ART and patients were followed up for 6 months. IRIS or deaths during this period were considered as outcomes. We performed multidimensional analyses, logistic regression, and survival curves to delineate associations. FINDINGS Patients with severe anaemia (SA) presented a distinct systemic inflammatory profile, characterized by higher TNF, IL-6, and IL-27 levels. SA was independently associated with IRIS, with a higher risk of both early IRIS onset and death. Among IRIS patients, those with SA had a higher risk of mycobacterial IRIS. INTERPRETATION PWH with SA display a more pronounced inflammatory profile, with an elevated risk of developing IRIS earlier and a statistically significant higher risk of death. FUNDING Intramural Research Program of National Institute of Allergy and Infectious Diseases/National Institutes of Health (NIAID/NIH). Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Finance code: 001) and the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil.
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Affiliation(s)
- Mariana Ara Jo-Pereira
- Instituto Gon..alo Moniz, Funda...·o Oswaldo Cruz, Salvador, Brazil; Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil; Programa de P..s-Gradua...·o em Patologia Humana e Experimental, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Virginia Sheikh
- National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Irini Sereti
- National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Beatriz Barreto-Duarte
- Instituto Gon..alo Moniz, Funda...·o Oswaldo Cruz, Salvador, Brazil; Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil; Programa de P..s-Gradua...·o em Cl.ínica M..dica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Curso de Medicina, Universidade Salvador (UNIFACS), Salvador, Bahia, Brazil
| | - Mar Ía B Arriaga
- Instituto Gon..alo Moniz, Funda...·o Oswaldo Cruz, Salvador, Brazil; Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil; Programa de P..s-Gradua...·o em Patologia Humana e Experimental, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Rafael Tib Rcio
- Instituto Gon..alo Moniz, Funda...·o Oswaldo Cruz, Salvador, Brazil; Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil; Programa de P..s-Gradua...·o em Patologia Humana e Experimental, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Caian L Vinhaes
- Instituto Gon..alo Moniz, Funda...·o Oswaldo Cruz, Salvador, Brazil; Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil; Bahiana School of Medicine and Public Health, Bahia Foundation for the Development of Sciences, Salvador, Brazil
| | - Manuella Pinto-de-Almeida
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil; Curso de Medicina, Universidade Salvador (UNIFACS), Salvador, Bahia, Brazil
| | - Jing Wang
- Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Adam Rupert
- National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Gregg Roby
- National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Douglas Shaffer
- Kenya Medical Research Institute, Henry Jackson Foundation Medical Research International, Bethesda, MD, USA; Walter Reed Army Institute of Research/US Army Medical Research Directorate-Africa, Nairobi, Kenya
| | - Jintanat Ananworanich
- South East Asia Research Collaboration with Hawaii, Henry M. Jackson Foundation for the Advancement of Military Medicine, United States Military HIV Research Program, Bethesda, MD, USA
| | | | - Fred Sawe
- Kenya Medical Research Institute, Henry Jackson Foundation Medical Research International, Bethesda, MD, USA
| | - Bruno B Andrade
- Instituto Gon..alo Moniz, Funda...·o Oswaldo Cruz, Salvador, Brazil; Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil; Programa de P..s-Gradua...·o em Patologia Humana e Experimental, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Programa de P..s-Gradua...·o em Cl.ínica M..dica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Curso de Medicina, Universidade Salvador (UNIFACS), Salvador, Bahia, Brazil.
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Dobbs KR, Crabtree JN, Dent AE. Innate immunity to malaria-The role of monocytes. Immunol Rev 2020; 293:8-24. [PMID: 31840836 PMCID: PMC6986449 DOI: 10.1111/imr.12830] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/19/2019] [Accepted: 11/25/2019] [Indexed: 12/12/2022]
Abstract
Monocytes are innate immune cells essential for host protection against malaria. Upon activation, monocytes function to help reduce parasite burden through phagocytosis, cytokine production, and antigen presentation. However, monocytes have also been implicated in the pathogenesis of severe disease through production of damaging inflammatory cytokines, resulting in systemic inflammation and vascular dysfunction. Understanding the molecular pathways influencing the balance between protection and pathology is critical. In this review, we discuss recent data regarding the role of monocytes in human malaria, including studies of innate sensing of the parasite, immunometabolism, and innate immune training. Knowledge gained from these studies may guide rational development of novel antimalarial therapies and inform vaccine development.
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Affiliation(s)
- Katherine R. Dobbs
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, USA
- Division of Pediatric Infectious Diseases, University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, OH, USA
| | - Juliet N. Crabtree
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Arlene E. Dent
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, USA
- Division of Pediatric Infectious Diseases, University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, OH, USA
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3
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Circulating Monocytes, Tissue Macrophages, and Malaria. J Trop Med 2019; 2019:3720838. [PMID: 31662766 PMCID: PMC6791199 DOI: 10.1155/2019/3720838] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 07/22/2019] [Accepted: 08/06/2019] [Indexed: 12/19/2022] Open
Abstract
Malaria is a significant cause of global morbidity and mortality. The Plasmodium parasite has a complex life cycle with mosquito, liver, and blood stages. The blood stages can preferentially affect organs such as the brain and placenta. In each of these stages and organs, the parasite will encounter monocytes and tissue-specific macrophages—key cell types in the innate immune response. Interactions between the Plasmodium parasite and monocytes/macrophages lead to several changes at both cellular and molecular levels, such as cytokine release and receptor expression. In this review, we summarize current knowledge on the relationship between malaria and blood intervillous monocytes and tissue-specific macrophages of the liver (Kupffer cells), central nervous system (microglia), and placenta (maternal intervillous monocytes and fetal Hofbauer cells). We describe their potential roles in modulating outcomes from infection and areas for future investigation.
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Otterdal K, Berg A, Michelsen AE, Patel S, Tellevik MG, Haanshuus CG, Fevang B, Aukrust P, Langeland N, Ueland T. Soluble markers of neutrophil, T-cell and monocyte activation are associated with disease severity and parasitemia in falciparum malaria. BMC Infect Dis 2018; 18:670. [PMID: 30563486 PMCID: PMC6299500 DOI: 10.1186/s12879-018-3593-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 12/06/2018] [Indexed: 01/15/2023] Open
Abstract
Background The immune response during P. falciparum infection is a two-edged sword, involving dysregulation of the inflammatory responses with several types of immune cells participating. Here we examined T-cell, monocyte/macrophage and neutrophil activation during P. falciparum infection by using soluble activation markers for these leukocyte subsets. Methods In a prospective cross-sectional study clinical data and blood samples were collected from adults in Mozambique with P. falciparum infection, with (n = 70) and without (n = 61) co-infection with HIV-1, as well as HIV-infected patients with similar symptoms but without malaria (n = 58) and healthy controls (n = 52). Soluble (s)CD25, sCD14, sCD163 and myeloperoxidase (MPO) as markers for T-cell, monocyte/macrophage and neutrophil activation, respectively as well as CX3CL1, granzyme B and TIM-3 as markers of T-cell subsets and T-cell exhaustion, were analyzed. Results All patient groups had raised levels of activation markers compared with healthy controls. Levels of sCD25 and MPO increased gradually from patient with HIV only to patient with malaria only, with the highest levels in the HIV/malaria group. In the malaria group as a whole, MPO, sCD14 and in particular sCD25 were correlated with disease severity. sCD163, sCD25 and in particular MPO correlated with the degree of parasitemia as assessed by qPCR. Patients with falciparum malaria also had signs of T-cell subset activation (i.e. increased granzyme B and CX3CL1) and T-cell exhaustion as assessed by high levels of TIM-3 particularly in patients co-infected with HIV. Conclusion Our data support a marked immune activation in falciparum malaria involving all major leukocyte subsets with particular enhanced activation of neutrophils and T-cells in patients co-infected with HIV. Our findings also support a link between immune activation and immune exhaustion during falciparum malaria, particularly in relation to T-cell responses in patients co-infected with HIV. Electronic supplementary material The online version of this article (10.1186/s12879-018-3593-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kari Otterdal
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, Nydalen, 0424, Oslo, Norway.
| | - Aase Berg
- Department of Medicine, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway.,Department of Medicine, Central Hospital of Maputo, 1100, Maputo, Mozambique
| | - Annika E Michelsen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, Nydalen, 0424, Oslo, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway
| | - Sam Patel
- Department of Medicine, Central Hospital of Maputo, 1100, Maputo, Mozambique
| | - Marit G Tellevik
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, 5021, Bergen, Norway
| | - Christel G Haanshuus
- National Centre for Tropical Infectious Diseases, Department of Medicine, Haukeland University Hospital, 5021, Bergen, Norway
| | - Børre Fevang
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, Nydalen, 0424, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, 0372, Oslo, Norway.,K.G. Jebsen Inflammatory Research Center, University of Oslo, 0424, Oslo, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, Nydalen, 0424, Oslo, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway.,Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, 0372, Oslo, Norway.,K.G. Jebsen Inflammatory Research Center, University of Oslo, 0424, Oslo, Norway
| | - Nina Langeland
- Department of Clinical Science, University of Bergen, 5021, Bergen, Norway.,Department of Medicine, Haukeland University Hospital, 5021, Bergen, Norway.,Department of Medicine, Haraldsplass Deaconess Hospital, 5009, Bergen, Norway
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, PO Box 4950, Nydalen, 0424, Oslo, Norway.,Faculty of Medicine, University of Oslo, 0316, Oslo, Norway.,K.G. Jebsen Inflammatory Research Center, University of Oslo, 0424, Oslo, Norway.,K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, 9019, Tromsø, Norway
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5
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Ortega-Pajares A, Rogerson SJ. The Rough Guide to Monocytes in Malaria Infection. Front Immunol 2018; 9:2888. [PMID: 30581439 PMCID: PMC6292935 DOI: 10.3389/fimmu.2018.02888] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 11/26/2018] [Indexed: 12/14/2022] Open
Abstract
While half of the world's population is at risk of malaria, the most vulnerable are still children under five, pregnant women and returning travelers. Anopheles mosquitoes transmit malaria parasites to the human host; but how Plasmodium interact with the innate immune system remains largely unexplored. The most recent advances prove that monocytes are a key component to control parasite burden and to protect host from disease. Monocytes' protective roles include phagocytosis, cytokine production and antigen presentation. However, monocytes can be involved in pathogenesis and drive inflammation and sequestration of infected red blood cells in organs such as the brain, placenta or lungs by secreting cytokines that upregulate expression of endothelial adhesion receptors. Plasmodium DNA, hemozoin or extracellular vesicles can impair the function of monocytes. With time, reinfections with Plasmodium change the relative proportion of monocyte subsets and their physical properties. These changes relate to clinical outcomes and might constitute informative biomarkers of immunity. More importantly, at the molecular level, transcriptional, metabolic or epigenetic changes can “prime” monocytes to alter their responses in future encounters with Plasmodium. This mechanism, known as trained immunity, challenges the traditional view of monocytes as a component of the immune system that lacks memory. Overall, this rough guide serves as an update reviewing the advances made during the past 5 years on understanding the role of monocytes in innate immunity to malaria.
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Affiliation(s)
- Amaya Ortega-Pajares
- Department of Medicine at Royal Melbourne Hospital, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Stephen J Rogerson
- Department of Medicine at Royal Melbourne Hospital, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
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Weinberg JB, Volkheimer AD, Rubach MP, Florence SM, Mukemba JP, Kalingonji AR, Langelier C, Chen Y, Bush M, Yeo TW, Granger DL, Anstey NM, Mwaikambo ED. Monocyte polarization in children with falciparum malaria: relationship to nitric oxide insufficiency and disease severity. Sci Rep 2016; 6:29151. [PMID: 27385484 PMCID: PMC4935839 DOI: 10.1038/srep29151] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 06/15/2016] [Indexed: 12/23/2022] Open
Abstract
We earlier established that nitric oxide (NO) is protective against severe malaria and that arginine and NO levels are reduced in malaria patients. We now show that an M2-like blood monocyte phenotype is significantly associated with hypoargininemia, NO insufficiency, and disease severity in Tanzanian children with falciparum malaria. Compared to control children (n = 106), children with moderately severe (n = 77) and severe falciparum malaria (n = 129) had significantly higher mononuclear cell arginase 1 mRNA, protein, and enzyme activity; lower NOS2 mRNA; lower plasma arginine; and higher plasma IL-10, IL-13, and IL-4. In addition, monocyte CD206 and CD163 and plasma soluble CD163 were elevated. Multivariate logistic regression analysis revealed a significant correlation of risk of severe malaria with both plasma IL-10 and soluble CD163 levels. Monocyte M2 skewing likely contributes to NO bioinsufficiency in falciparum malaria in children. Treatments that reverse the M2 polarization may have potential as adjunctive treatment for malaria.
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Affiliation(s)
- J Brice Weinberg
- Duke University and V.A. Medical Centers, Durham, North Carolina, USA
| | | | - Matthew P Rubach
- Duke University and V.A. Medical Centers, Durham, North Carolina, USA
| | | | | | | | | | - Youwei Chen
- Duke University and V.A. Medical Centers, Durham, North Carolina, USA
| | - Margaret Bush
- Duke University and V.A. Medical Centers, Durham, North Carolina, USA
| | - Tsin W Yeo
- Menzies School of Health Research and Charles Darwin University, Darwin, Australia
| | - Donald L Granger
- University of Utah and V.A. Medical Centers, Salt Lake City, Utah, USA
| | - Nicholas M Anstey
- Menzies School of Health Research and Charles Darwin University, Darwin, Australia
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7
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Ab-Rahman HA, Rahim H, AbuBakar S, Wong PF. Macrophage Activation Syndrome-Associated Markers in Severe Dengue. Int J Med Sci 2016; 13:179-86. [PMID: 26941578 PMCID: PMC4773282 DOI: 10.7150/ijms.13680] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 01/05/2016] [Indexed: 12/18/2022] Open
Abstract
Hemophagocytosis, a phenomenon of which activated macrophages phagocytosed hematopoietic elements was reportedly observed in severe dengue patients. In the present study, we investigated whether markers of macrophage activation syndrome (MAS) can be used as differential diagnostic markers of severe dengue. Two hundred and eight confirmed dengue patients were recruited for the study. Sandwich ELISA was used to determine serum ferritin, soluble CD163 (sCD163), and soluble CD25 (sCD25) levels. The population of circulating CD163 (mCD163) monocytes was determined using flow cytometry. Receiver operating characteristic (ROC) analysis was plotted to determine the predictive validity of the biomarkers. Serum ferritin and sCD163 were found significantly increased in severe dengue patients compared to dengue fever patients (P = 0.003). A fair area under ROC curves (AUC) at 0.72 with a significant P value of 0.004 was observed for sCD163. sCD25 and mCD163 levels were not significantly different between severe dengue and dengue fever patients. Our findings suggest that in addition to serum ferritin, sCD163 can differentiate severe dengue from that of dengue fever patients. Hence, sCD163 level can be considered for use as a predictive marker for impending severe dengue.
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Affiliation(s)
- Hasliana Azrah Ab-Rahman
- 1. Tropical Infectious Disease Research & Education Centre (TIDREC), Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia;; 2. Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Hafiz Rahim
- 4. Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Sazaly AbuBakar
- 1. Tropical Infectious Disease Research & Education Centre (TIDREC), Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia;; 2. Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Pooi-Fong Wong
- 3. Department of Pharmacology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Ruizendaal E, van Leeuwen E, Mens PF. Peripheral and placental biomarkers in women with placental malaria: a systematic review. Biomark Med 2015; 9:217-39. [PMID: 25731209 DOI: 10.2217/bmm.14.117] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Placental malaria (PM) causes significant morbidity in mothers and infants. Diagnosis of PM during pregnancy is however problematic due to placental sequestration of parasites. Host biomarkers may therefore be used as a diagnostic method. In this systematic review most studies focused on inflammatory markers. A trend was observed for increased IL-10 and TNF-α in PM positives. These markers are however unspecific, thus a combination of multiple biomarkers involved in different pathophysiological pathways of PM is indicated. Of interest are inflammatory markers (TNF-R2, CXCL-13), markers of lipid metabolism (APO-B), angiogenesis (sFlt-1) and hormones (estradiol). As the majority of published studies tested biomarker levels only at delivery, more longitudinal cohort studies will be necessary to detect biomarkers during pregnancy that can predict PM.
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Affiliation(s)
- Esmée Ruizendaal
- KIT Biomedical Research, Royal Tropical Institute (KIT), Amsterdam, The Netherlands
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Aubouy A, Olagnier D, Bertin G, Ezinmegnon S, Majorel C, Mimar S, Massougbodji A, Deloron P, Pipy B, Coste A. Nrf2-driven CD36 and HO-1 gene expression in circulating monocytes correlates with favourable clinical outcome in pregnancy-associated malaria. Malar J 2015; 14:358. [PMID: 26385579 PMCID: PMC4575452 DOI: 10.1186/s12936-015-0888-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 09/03/2015] [Indexed: 12/21/2022] Open
Abstract
Background Pregnancy-associated malaria (PAM) constitutes one of the most severe forms of malaria infection leading to fetal growth restriction and high risk of infant death. The severity of the pathology is largely attributed to the recruitment of monocytes and macrophages in the placenta which is evidenced by dysregulated inflammation found in placental blood. Importantly, CD36+ monocytes/macrophages are also thought to participate in the tight control of the pro- and anti-inflammatory responses following Plasmodium detection through elimination of apoptotic cells and malaria-infected erythrocytes, internalization and recycling of oxidized forms of low-density lipoprotein and collaboration with TLR2 in pro-inflammatory response. Interestingly, previous work demonstrated that CD36 expression was upregulated on inflammatory macrophages following stimulation of the Nrf2 transcription factor, whilst the PPARγ pathway was inhibited and non-functional in the same inflammatory conditions. This current study examined the possible role of Nrf2-driven gene expression, CD36 and Haem-Oxygenase-1 (HO-1), in PAM clinical outcomes. Methods Clinical data and biological samples including peripheral blood mononuclear cells were collected from 27 women presenting PAM. Polychromatic flow cytometry was used to characterize innate immune cell subpopulations and quantify CD36 protein expression level on monocytes. mRNA levels of CD36, PPARγ, Nrf2 and HO-1 were determined by qPCR and related to clinical outcomes. Finally, the capacity of monocytes to modulate CD36 expression upon rosiglitazone or sulforaphane treatment, two respective PPARγ or Nrf2 activators, was also investigated. Results The CD36 receptor, mostly expressed by CD14+ circulating monocytes, statistically correlated with increased infant birth weights. Interestingly, mRNA levels of the transcription factor Nrf2 and the enzyme HO-1 also correlated with lower parasitaemia and increased infant birth weight, while PPARγ mRNA levels did not. Finally, monocytes isolated from low infant birth weight pregnant women were capable of up-regulating CD36 via the Nrf2 pathway ex vivo. Conclusions Altogether these results suggest that Nrf2-driven CD36 and HO-1 expression on innate immune cells could contribute to a protective and detoxifying mechanism during PAM. More powered and mechanistical studies are however needed to strengthen the conclusions of this study. Electronic supplementary material The online version of this article (doi:10.1186/s12936-015-0888-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Agnès Aubouy
- Institut de Recherche pour le Développement (IRD), Université Paul Sabatier Toulouse III, UMR 152 Pharma-Dev, CHU Rangueil, Bâtiment L1, 1 Avenue du Pr Jean Poulhès, 31059, Toulouse, France.
| | - David Olagnier
- Institut de Recherche pour le Développement (IRD), Université Paul Sabatier Toulouse III, UMR 152 Pharma-Dev, CHU Rangueil, Bâtiment L1, 1 Avenue du Pr Jean Poulhès, 31059, Toulouse, France. .,Lady Davis Institute-Jewish General Hospital, McGill University, Montreal, Canada.
| | - Gwladys Bertin
- Institut de Recherche pour le Développement (IRD), PRES Sorbonne Paris Cité, Université Paris Descartes, UMR 216 Mère et enfant face aux infections tropicales, Paris, France.
| | - Sem Ezinmegnon
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et l'Enfance (CERPAGE), Cotonou, Benin.
| | - Clarisse Majorel
- Institut de Recherche pour le Développement (IRD), Université Paul Sabatier Toulouse III, UMR 152 Pharma-Dev, CHU Rangueil, Bâtiment L1, 1 Avenue du Pr Jean Poulhès, 31059, Toulouse, France. .,Laboratoire Insulaire du Vivant et de l'Environnement (LIVE-EA 4243), Université de la Nouvelle-Caledonie (UNC), Nouméa, New Caledonia.
| | - Saliha Mimar
- Institut de Recherche pour le Développement (IRD), Université Paul Sabatier Toulouse III, UMR 152 Pharma-Dev, CHU Rangueil, Bâtiment L1, 1 Avenue du Pr Jean Poulhès, 31059, Toulouse, France.
| | - Achille Massougbodji
- Centre d'Etude et de Recherche sur le Paludisme Associé à la Grossesse et l'Enfance (CERPAGE), Cotonou, Benin.
| | - Philippe Deloron
- Institut de Recherche pour le Développement (IRD), PRES Sorbonne Paris Cité, Université Paris Descartes, UMR 216 Mère et enfant face aux infections tropicales, Paris, France.
| | - Bernard Pipy
- Institut de Recherche pour le Développement (IRD), Université Paul Sabatier Toulouse III, UMR 152 Pharma-Dev, CHU Rangueil, Bâtiment L1, 1 Avenue du Pr Jean Poulhès, 31059, Toulouse, France.
| | - Agnès Coste
- Institut de Recherche pour le Développement (IRD), Université Paul Sabatier Toulouse III, UMR 152 Pharma-Dev, CHU Rangueil, Bâtiment L1, 1 Avenue du Pr Jean Poulhès, 31059, Toulouse, France.
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10
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Peng QL, Zhang YL, Shu XM, Yang HB, Zhang L, Chen F, Lu X, Wang GC. Elevated Serum Levels of Soluble CD163 in Polymyositis and Dermatomyositis: Associated with Macrophage Infiltration in Muscle Tissue. J Rheumatol 2015; 42:979-87. [DOI: 10.3899/jrheum.141307] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2015] [Indexed: 01/04/2023]
Abstract
Objective.To investigate serum levels of soluble CD163 (sCD163) in patients with polymyositis (PM) and dermatomyositis (DM), and to correlate these to clinical manifestations and laboratory data.Methods.Serum levels of sCD163 were detected in 24 patients with PM, 84 patients with DM, and 46 healthy controls by using the ELISA method. Immunohistochemistry staining of macrophage infiltration in muscle tissue using anti-CD163 monoclonal antibody was conducted on muscle biopsy specimens from 13 patients with PM and 17 with DM.Results.Serum levels of sCD163 were significantly increased in patients compared with healthy controls (p < 0.001). Patients with interstitial lung disease (ILD) had statistically higher sCD163 levels than patients without ILD (p < 0.001). High serum sCD163 levels were associated with increased incidence of antinuclear antibody (p < 0.05), higher serum levels of immunoglobulin G (p < 0.01) and immunoglobulin A (p < 0.05), and increased erythrocyte sedimentation rates (p < 0.01). Serum sCD163 levels were inversely correlated with CD3+ T cell counts in peripheral blood of patients (r = −0.306, p < 0.01). Cross-sectional assessment and longitudinal study revealed a significant correlation between serum sCD163 levels and disease activity. Patients with high serum sCD163 levels showed a higher incidence of CD163+ macrophage infiltration in muscle tissue than patients with normal sCD163 levels (chi-square value = 10.804, p < 0.01).Conclusion.Serum levels of sCD163 were significantly elevated and correlated with disease severity in patients with PM/DM, suggesting serum sCD163 as a promising biomarker in the disease evaluation of PM/DM. Our finding of elevated serum sCD163 levels associated with muscle macrophage infiltration highlights the role activated macrophage plays in the pathogenesis of PM/DM.
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