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Naser RH, Rajaii T, Farash BRH, Seyyedtabaei SJ, Hajali V, Sadabadi F, Saburi E. Hematological changes due to malaria - An update. Mol Biochem Parasitol 2024; 259:111635. [PMID: 38857772 DOI: 10.1016/j.molbiopara.2024.111635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 06/12/2024]
Abstract
Malaria, a parasitic infection caused by the genus Plasmodium, results to over 20 million reported cases annually worldwide. Most individuals exhibit various symptoms, and blood analysis plays a crucial role in determining the appropriate treatment approach. This study discusses various hematologic complications associated with different Plasmodium species. A review of scientific databases including PubMed, Science Direct, Web of Science, Scopus, EMBASE, Magiran, SID, IranMedex was conducted using standard keywords such as Plasmodium, malaria, anemia and blood disorders (hematologic disorder) between 2000 and 2024. The review focused on articles pertaining to clinical trials, prospective cohort, retrospective, cross-sectional and case-control studies. Articles evaluating the effects of malaria on blood cells and indices, with target groups including human and animals, were included. Articles not written in English or Farsi were excluded. Our review revealed that, apart from iron deficiency anemia and vascular dysfunction contributed in part by adhesion of infected RBC to endothelium, decreases in hematocrit and hemoglobin levels, as part of pancytopenia and thrombocytopenia, are characteristic of Plasmodium infection. Additionally, the occurrence of inflammation due to the release of inflammatory cytokines and complement activation can complicate the clinical features of malaria in individuals with hematologic conditions.
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Affiliation(s)
- Rana Hussein Naser
- Department of Science, College of Basic Education, University of Diyala, Iraq
| | - Toktam Rajaii
- Health center no.1, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bibi Razieh Hosseini Farash
- Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Cutaneous Leishmania Research Center, Mashhad University of Medical Sciences, Iran
| | | | - Vahid Hajali
- Department of Neuroscience, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Sadabadi
- Cutaneous Leishmania Research Center, Mashhad University of Medical Sciences, Iran
| | - Ehsan Saburi
- Medical Genetics and Molecular Medicine Department, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Khasanah U, Nurrahmah QI, Amalia T, Putri ZN, Imrokatul Mufidah, Napik R, Lyrawati D, Pratita Ihsan BR, Febrianti ME. Oral acute toxicity study and in vivo antimalarial activity of Strychnos lucida R. Br. tablet. JOURNAL OF ETHNOPHARMACOLOGY 2024; 330:118200. [PMID: 38621467 DOI: 10.1016/j.jep.2024.118200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Malaria eradication has been a major goal of the Indonesian government since 2020. Medicinal plants, such as Strychnos lucida R. Br., are empirically used to treat malaria through traditional preparation methods. However, the safety and efficacy of these plants have not yet been confirmed. Therefore, further investigations are necessary to confirm the safety and efficacy of S. lucida as an antimalarial agent. AIMS OF THE STUDY To quantify the concentration of brucine in the S. lucida extract, determine the acute oral toxicity of the standardized extract, and evaluate the in vivo antimalarial potency of S. lucida tablet (SLT). MATERIALS AND METHODS Acute oral toxicity of S.lucida extract was determined using the Organization for Economic Co-operation and Development 420 procedure, and the analytical method for brucine quantification was validated using high-performance liquid chromatography. In addition, antimalarial activity was determined using the Peter's four-day suppressive method. RESULTS Acute toxicity analysis revealed S. lucida as a low-toxicity compound with a cut-off median lethal dose of 2000-5000 mg/kg body weight [BW], which was supported by the hematological and biochemical profiles of the kidneys, liver, and pancreas (p > 0.05). Extract standardization revealed that S. lucida contained 3.91 ± 0.074% w/w brucine, adhering to the limit specified in the Indonesian Herbal Pharmacopeia. Antimalarial test revealed that SLT inhibited the growth of Plasmodium berghei by 27.74-45.27%. Moreover, SLT improved the hemoglobin and hematocrit levels. White blood cell and lymphocyte counts were lower in the SLT-treated group than in the K (+) group (p < 0.05). CONCLUSION Histopathological and biochemical evaluations revealed that S. lucida extract was safe at a dose of 2000 mg/kg BW with low toxicity. SLT inhibited Plasmodium growth and improved the hemoglobin, hematocrit, and red blood cell profiles. Additionally, SLT reduced the lymphocyte and WBC counts and increased the monocyte and thrombocyte counts as part of the immune system response against Plasmodium infection.
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Affiliation(s)
- Uswatun Khasanah
- Department of Pharmacy, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, Indonesia.
| | - Queen Intan Nurrahmah
- Department of Pharmacy, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, Indonesia.
| | - Thia Amalia
- Department of Pharmacy, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, Indonesia.
| | - Zada Nabila Putri
- Undergraduate Study Program of Pharmacy, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, Indonesia.
| | - Imrokatul Mufidah
- Undergraduate Study Program of Pharmacy, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, Indonesia.
| | - Roisatun Napik
- Undergraduate Study Program of Pharmacy, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, Indonesia.
| | - Diana Lyrawati
- Department of Pharmacy, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, Indonesia.
| | | | - Maya Eka Febrianti
- Undergraduate Study Program of Pharmacy, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, Indonesia.
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van Wijk XMR, Sanchez Oviol Z, Winter WE, Harris NS, Marin MJ. An Introduction to the Complete Blood Count for Clinical Chemists: Platelets. J Appl Lab Med 2024; 9:833-847. [PMID: 38549553 DOI: 10.1093/jalm/jfae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/12/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND The most ordered laboratory test worldwide is the complete blood count (CBC). CONTENT In this primer, an introduction to platelet testing in the context of the CBC is provided with a discussion of the laboratory evaluation of platelet abnormalities including thrombocytopenia and thrombocytosis. SUMMARY As clinical chemists continue to be tasked to direct laboratories outside of the traditional clinical chemistry sections such as hematology, expertise must be developed. This primer is dedicated to that effort.
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Affiliation(s)
| | - Zaraith Sanchez Oviol
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, United States
| | - William E Winter
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, United States
| | - Neil S Harris
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, United States
| | - Maximo J Marin
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, United States
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Ider M, Ceylan C, Naseri A, Ceylan O, Durgut MK, Ok M, Iyigun SS, Erol BB, Sahin HB, Kilickaya MC. Evaluation of endothelial glycocalyx injury biomarkers in feline hemotropic mycoplasmosis. Sci Rep 2024; 14:12931. [PMID: 38839816 PMCID: PMC11153643 DOI: 10.1038/s41598-024-62359-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/16/2024] [Indexed: 06/07/2024] Open
Abstract
The present study aimed to investigate endothelial glycocalyx (eGCx) damage in cats with feline hemotropic mycoplasmosis caused by Mycoplasma haemofelis using selected biomarkers and to determine the diagnostic and prognostic significance of these biomarkers. The study included 25 cats with feline hemotropic mycoplasmosis and 10 healthy cats. Clinical examination, blood gas analysis, complete blood count, and biochemical analysis were performed. Hemotropic mycoplasmosis diagnosed by microscopic examination and molecularly confirmed by PCR targeting the Mycoplasma haemofelis 16s rRNA gene. To evaluate endothelial glycocalyx damage, syndecan-1, endothelin-1 (ET-1), asymmetric dimethylarginine (ADMA), and vascular endothelial growth factor-A (VEGF-A) concentrations were measured using cat-specific commercial ELISA kits. Of the cats with feline hemotropic mycoplasmosis, 14 (56%) survived and 11 (44%) died. While syndecan-1 and ET-1 concentrations were significantly higher in cats with hemotropic mycoplasmosis compared to the control group (p < 0.001), no statistically significant difference was found for ADMA and VEGF-A concentrations (p > 0.05). Endothelial glycocalyx biomarkers showed significant correlations with each other and with hematological parameters (p < 0.01). The results of the ROC analysis showed that ET-1 with area under the curve (AUC) of 0.821 (p < 0.01) and VEGF-A with AUC of 0.805 (p < 0.010) were found to be significant prognostic indicators. In conclusion, this study demonstrated that serum syndecan-1 and ET-1 can be used as diagnostic and serum ET-1 and VEGF-A as prognostic biomarkers in cats with hemotropic mycoplasmosis. Our results indicate the development of eGCx damage in feline hemotropic mycoplasmosis and suggest that glycocalyx disruption may contribute to the pathogenesis of the disease.
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Affiliation(s)
- Merve Ider
- Department of Internal Medicine, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey.
| | - Ceylan Ceylan
- Department of Parasitology, Faculty of Veterinary Medicine, Siirt University, Siirt, Turkey
| | - Amir Naseri
- Department of Internal Medicine, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey
| | - Onur Ceylan
- Department of Parasitology, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey
| | - Murat Kaan Durgut
- Department of Internal Medicine, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey
| | - Mahmut Ok
- Department of Internal Medicine, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey
| | - Suleyman Serhat Iyigun
- Department of Internal Medicine, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey
| | - Busra Burcu Erol
- Department of Internal Medicine, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey
| | - Hatice Betul Sahin
- Department of Internal Medicine, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey
| | - Merve Cansu Kilickaya
- Department of Internal Medicine, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey
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Selimaj Kontoni V, Goetghebuer T, Hainaut M, Vanderfaeillie A, Nguyen VTP, Jourdain S, Pace D. Imported Malaria in Children: A Study Over an 11-Year Period in Brussels. Pediatr Infect Dis J 2023; 42:733-738. [PMID: 37406181 DOI: 10.1097/inf.0000000000003986] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
BACKGROUND Malaria is a major global public health concern in endemic countries and imported childhood malaria is increasing in malaria non-endemic countries. METHODS This was a retrospective case review of all laboratory-confirmed malaria cases in children 0-16 years admitted between 2009 and 2019 in 2 large university teaching Hospitals in Brussels. RESULTS A total of 160 children with a median age of 6.8 years (range 5-191 months) were included. We identified 109 (68%) children living in Belgium who had acquired malaria during their visit to malaria-endemic countries to visiting friends and relatives (VFRs), 49 children (31%) visitors or newly installed migrants, and 2 Belgian tourists. Peak seasonal incidence occurred between August and September. Plasmodium falciparum was responsible for 89% of all malaria cases. Almost 80% of children living in Belgium visited a travel clinic for advice, but only one-third reported having taken the prophylaxis schedule according to the recommendations. Based on WHO criteria, 31 children (19.3%) developed severe malaria; most of the patients with severe malaria were VFR travelers and were significantly younger, had higher leukocytosis, had more thrombocytopenia, higher CRP, and lower natremia compared with patients with an uncomplicated course. All children recovered fully. CONCLUSIONS Malaria is a significant cause of morbidity among returning travelers and newly arrived immigrants to Belgium. Most of the children had an uncomplicated disease course. Physicians should educate families about traveling to malaria-endemic areas to correct malaria preventive measures and prophylaxis.
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Affiliation(s)
| | - Tessa Goetghebuer
- Department of Pediatrics, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Marc Hainaut
- Department of Pediatrics, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Anna Vanderfaeillie
- Department of Pediatrics, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Vo Thanh Phuong Nguyen
- Department of Pediatrics, Laboratoire d'Hematologie, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Sarah Jourdain
- Department of Pediatrics, Hopital Universitaire Des Enfants Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
| | - David Pace
- Department of Pediatrics, Mater Dei Hospital, Msida, Malta
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Saleh AG, Shehab AY, Abdul-Ghani R, Allam AF, Osman MM, Ibrahim HS, El-Taweel HA, Moneer EA, Hagras NAE, Farag HF. Key cytokines and hematological parameters in patients with uncomplicated falciparum malaria in Hodeidah, Yemen. Cytokine 2023; 164:156156. [PMID: 36857851 DOI: 10.1016/j.cyto.2023.156156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/14/2023] [Accepted: 02/11/2023] [Indexed: 02/28/2023]
Abstract
Immunity to malaria has a major role in controlling disease and pathogenesis with cytokine production being involved in almost every phase of the immune response. The present study aimed to assess hematological variables and to measure plasma levels of TNFα, IFNγ and IL10, their ratios, and their relation to parasitemia among patients with uncomplicated falciparum malaria in Hodeidah, Yemen. Forty patients with uncomplicated P. falciparum monoinfection and 40 healthy age and sex-matched controls were enrolled in the study. Parasitological diagnosis was confirmed, and parasite density was estimated. Plasma cytokine levels, hematologic parameters, and the presence of gametocytes were determined. Results revealed higher TNFα, IFNγ and IL10 in patients than in controls. A relatively higher IL10 production was demonstrated by the significantly lower TNFα/IL10 and IFNγ/IL10 ratios in patients than in controls. TNFα and IL10 correlated positively with parasite density. Lower Hb levels, RBC, lymphocyte and platelet counts, and higher neutrophil and reticulocyte counts were observed in patients compared to controls. Reticulocyte count was higher and IFNγ level was lower in the presence of gametocytes. Conclusively, uncomplicated falciparum malaria is associated with the ability to regulate the production of pro-inflammatory and anti-inflammatory cytokines. This mediates parasite clearance while simultaneously avoiding severe pathology.
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Affiliation(s)
- Ali Gamali Saleh
- Faculty of Medicine and Health Sciences, Hodeidah University, Yemen
| | - Amel Youssef Shehab
- Department of Parasitology, Medical Research Institute, University of Alexandria, Egypt
| | - Rashad Abdul-Ghani
- Department of Medical Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen and Tropical Disease Research Center, Faculty of Medicine and Health Sciences, University of Science and Technology, Sana'a, Yemen
| | - Amal Farahat Allam
- Department of Parasitology, Medical Research Institute, University of Alexandria, Egypt
| | - Mervat Mostafa Osman
- Department of Parasitology, Medical Research Institute, University of Alexandria, Egypt
| | - Heba Said Ibrahim
- Department of Parasitology, Medical Research Institute, University of Alexandria, Egypt
| | - Hend Ali El-Taweel
- Department of Parasitology, Medical Research Institute, University of Alexandria, Egypt.
| | - Esraa Abdelhamid Moneer
- Department of Medical Laboratory, Faculty of Applied Health Sciences Technology, Pharos University, Alexandria, Egypt
| | - Nancy Abd-Elkader Hagras
- Department of Medical Laboratory, Faculty of Applied Health Sciences Technology, Pharos University, Alexandria, Egypt
| | - Hoda Fahmy Farag
- Department of Parasitology, Medical Research Institute, University of Alexandria, Egypt
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Algın A, Özdemir S, Arslan E, Özkan A. Investigating the association between various platelet indices and different clinical sub-groups of severe malaria. Malawi Med J 2023; 35:3-8. [PMID: 38124700 PMCID: PMC10645904 DOI: 10.4314/mmj.v35i1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Aim To evaluate the ability of platelet count, mean platelet volume, platelet distribution width, and platelet mass index to predict the severity of malaria. Materials and Methods This study was conducted as a retrospective cohort study at a tertiary hospital in Somali. Patients grouped as severe and non-severe malaria. We compared groups in terms of platelet count, mean platelet volume, platelet distribution width, and platelet mass index. Results A total of 131 patients were included in the final analysis. Of the patients, 77 (58.7%) had non-severe malaria, and 54 (41.3%) had severe malaria. The multivariate analysis revealed that there was no significant difference between the groups in terms of platelet count, mean platelet volume, platelet distribution width, and platelet mass index (p: 0.183, 0.323, 0.204, and 0.139, respectively). In the receiver operating characteristic analysis, the area under the curve values for platelet count, mean platelet volume, platelet distribution width, and platelet mass index were 0.699, 0.619, 0.504, and 0.675, respectively. Conclusion Of the platelet indices, platelet count, mean platelet volume, platelet distribution width, and platelet mass index were not clinically significant markers that could be used to predict the severity of malaria.
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Affiliation(s)
- Abdullah Algın
- Department of Emergency Medicine, Health of Sciences University, Ümraniye Training and Research Hospital, Istanbul, Turkey
- Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Serdar Özdemir
- Department of Emergency Medicine, Health of Sciences University, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Ebubekir Arslan
- Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Abuzer Özkan
- Department of Emergency Medicine, Health of Sciences University, Ümraniye Training and Research Hospital, Istanbul, Turkey
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Zhou M, Xie J, Kawase O, Nishikawa Y, Ji S, Zhu S, Cao S, Xuan X. Characterization of anti-erythrocyte and anti-platelet antibodies in hemolytic anemia and thrombocytopenia induced by Plasmodium spp. and Babesiaspp. infection in mice. Front Cell Infect Microbiol 2023; 13:1143138. [PMID: 37124034 PMCID: PMC10140361 DOI: 10.3389/fcimb.2023.1143138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/20/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction Malaria and Babesiosis are acute zoonotic disease that caused by infection with the parasite in the phylum Apicomplexa. Severe anemia and thrombocytopenia are the most common hematological complication of malaria and babesiosis. However, the mechanisms involved have not been elucidated, and only a few researches focus on the possible role of anti-erythrocyte and anti-platelet antibodies. Methods In this study, the Plasmodium yoelii, P. chabaudi, Babesia microti and B. rodhaini infected SCID and ICR mice. The parasitemia, survival rate, platelet count, anti-platelet antibodies, and the level of IFN-γ and interleukin (IL) -10 was tested after infection. Furthermore, the P. yoelii, P. chabaudi, B. rodhaini and B. microti infected ICR mice were treated with artesunate and diminaze, the development of the anti-erythrocyte and anti-platelet antibodies in chronic stage were examined. At last, the murine red blood cell and platelet membrane proteins probed with auto-antibodies induced by P. yoelii, P. chabaudi, B. rodhaini, and B. microti infection were characterized by proteomic analysis. Results and discussion The high anti-platelet and anti-erythrocyte antibodies were detected in ICR mice after P. yoelii, P. chabaudi, B. rodhaini, and B. microti infection. Actin of murine erythrocyte and platelet is a common auto-antigen in Plasmodium and Babesia spp. infected mice. Our findings indicate that anti-erythrocyte and anti-platelet autoantibodies contribute to thrombocytopenia and anemia associated with Plasmodium spp. and Babesia spp. infection. This study will help to understand the mechanisms of malaria and babesiosis-related thrombocytopenia and hemolytic anemia.
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Affiliation(s)
- Mo Zhou
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Hokkaido, Japan
- Jiangsu Key Laboratory for High-tech Research and Development of Veterinary Biopharmaceuticals, Jiangsu Agri-animal Husbandry Vocational College, Taizhou, China
- Engineering Technology Research Center for Modern Animal Science and Novel Veterinary Pharmaceutic Development, Jiangsu Agri-animal Husbandry Vocational College, Taizhou, China
| | - Jun Xie
- Jiangsu Key Laboratory for High-tech Research and Development of Veterinary Biopharmaceuticals, Jiangsu Agri-animal Husbandry Vocational College, Taizhou, China
- Engineering Technology Research Center for Modern Animal Science and Novel Veterinary Pharmaceutic Development, Jiangsu Agri-animal Husbandry Vocational College, Taizhou, China
| | - Osamu Kawase
- Department of Biology, Premedical Sciences, Dokkyo Medical University, Tochigi, Japan
| | - Yoshifumi Nishikawa
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Hokkaido, Japan
| | - Shengwei Ji
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Hokkaido, Japan
| | - Shanyuan Zhu
- Jiangsu Key Laboratory for High-tech Research and Development of Veterinary Biopharmaceuticals, Jiangsu Agri-animal Husbandry Vocational College, Taizhou, China
- Engineering Technology Research Center for Modern Animal Science and Novel Veterinary Pharmaceutic Development, Jiangsu Agri-animal Husbandry Vocational College, Taizhou, China
| | - Shinuo Cao
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Hokkaido, Japan
- Jiangsu Key Laboratory for High-tech Research and Development of Veterinary Biopharmaceuticals, Jiangsu Agri-animal Husbandry Vocational College, Taizhou, China
- Engineering Technology Research Center for Modern Animal Science and Novel Veterinary Pharmaceutic Development, Jiangsu Agri-animal Husbandry Vocational College, Taizhou, China
- *Correspondence: Shinuo Cao, ; Xuenan Xuan,
| | - Xuenan Xuan
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Hokkaido, Japan
- *Correspondence: Shinuo Cao, ; Xuenan Xuan,
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Anemia, Thrombocytopenia, and Changes in Biochemical Parameters Occurring in Patients with Uncomplicated Plasmodium falciparum Malaria: Data Analysis from Antimalarial Efficacy-Randomized Trials in Dakar and Kaolack Regions, Senegal. J Parasitol Res 2022; 2022:1635791. [PMID: 36588779 PMCID: PMC9800081 DOI: 10.1155/2022/1635791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 12/24/2022] Open
Abstract
Background Artemisinin-based Combination Therapies (ACTs) are widely used in the treatment of uncomplicated malaria. Plasmodium falciparum infection is often accompanied by disturbances of hematological and biochemical parameters. The objective of this study was to evaluate the changes in biochemical and hematological parameters during uncomplicated malaria in patients treated with ACTs. Methods Data from patient with uncomplicated Plasmodium falciparum malaria were pooled from different open-randomized trial evaluating the efficacy of Artesunate-Mefloquine (ASMQ), Artesunate-Amodiaquine (ASAQ), Artemether-Lumefantrine (AL), and Dihydro-artemisinin-Piperaquine (DHAPQ) combinations. Biochemical (transaminases, creatinine, and bilirubin) and hematological (hemoglobin and platelet levels) parameters were performed at baseline (D0) and at day 7 after treatment (D7). Data were analyzed as both continuous and categorical variables with 95% confidence interval. Risks and trends were calculated using multivariate logistic random effect models. Results A total of 720 patients with completed biological data were included in the analysis (320 in the AL arm, 160 in the ASMQ arm, 120 in the DHAPQ arm, and 88 in the ASAQ arm). The mean age of the patients was 9.43 ± 9.1 years. Male subjects represented 58.47% (sex ratio was 1.4 for males). The mean hemoglobin level at inclusion (D0) was 9.79 g/dl and anemia (Hb < 11 g/dl) was 71.43% (aOR = 1.16 [0.68 - 1.98]p = 0.57). At D7, hemoglobin level was 9.63 g/dl and anemia was significantly more frequent (78.29% [p = 0.002]). The mean platelet count at day 0 was 154075.5 platelets/mm3 of blood and 339328.7 platelets/mm3 at day 7. Thrombocytopenia was about 53.61% and was associated with malaria (aOR = 3.4 [2.18 - 5.3]p < 10-3). 19.58% of patients had abnormal ALT and 40.28% had abnormal AST at D0. 27.22% of patients had normal bilirubin at D0. Renal function was normal in all patients in the study. Normalization of transaminases was noted between D0 and D7. The percentage of subjects with normal bilirubin increased between D0 and D7. Renal function did not vary significantly between D0 and D7. Conclusion Results from this analysis showed that subjects with high parasitaemia had a greater risk of anemia and thrombocytopenia. Artemisinin combinations were well-tolerated as no major biological disturbances were noted. The effects of ACTs on hematologic and biochemical parameters were not different.
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Ojo RJ, Jonathan IG, Adams MD, Gyebi G, Longdet IY. Renal and hepatic dysfunction parameters correlate positively with gender among patients with recurrent malaria cases in Birnin Kebbi, Northwest Nigeria. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2022. [DOI: 10.1186/s43162-022-00164-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
Background
Simultaneous increase in transaminases and bilirubin is an indicator of hepatic dysfunction in malaria. Malaria-induced hyperbilirubinemia has been associated with acute kidney injury and pathogenesis of cerebral malaria which are significantly associated with mortality in malaria infection. This retrospective study was designed to assess the lipid profile, and hematological, renal and hepatic function data of malaria patients in Sir Yahaya Memorial hospital Birnin Kebbi from 2016 to 2020 who are 18 years and above.
Methods
The data of all patients between 2016 and 2020 who are 18 years and above were collected. Complete data of 370 subjects who met the inclusion criteria which consist of 250 malaria subjects and 120 control subjects were analyzed.
Results
The results showed that females constitute 65.2% of malaria patients with complete records while the remaining 34.8% were males. Age distribution of the patients showed that the infection was more prevalent among 26–45 years and least among 65 years and above. Anemia and thrombocytopenia were prevalent among the female malaria patients compared to the male patients. Liver and kidney function parameters analyzed correlate positively with the gender. The infected male showed higher dysfunction in liver parameters while infected female patients showed significant dysfunction in kidney function parameters and lipid profile.
Conclusions
In conclusion, to prevent the potential widespread of acute renal and hepatic failure with the attendant morbidity and mortality among malaria patients, it is recommended that liver and kidney function tests be mandated for patients with recurring malaria and those with a history of treatment failure in the endemic area to ensure early diagnosis of malarial induced kidney and liver injury among malaria patients.
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Tovar Acero C, Ramírez-Montoya J, Velasco MC, Avilés-Vergara PA, Ricardo-Caldera D, Duran-Frigola M, Quintero G, Cantero ME, Rivera-Correa J, Rodriguez A, Fernanda Yasnot-Acosta M. IL-4, IL-10, CCL2 and TGF-β as potential biomarkers for severity in Plasmodium vivax malaria. PLoS Negl Trop Dis 2022; 16:e0010798. [PMID: 36178979 PMCID: PMC9555658 DOI: 10.1371/journal.pntd.0010798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 10/12/2022] [Accepted: 09/08/2022] [Indexed: 11/23/2022] Open
Abstract
Cytokines and chemokines are immune response molecules that display diverse functions, such as inflammation and immune regulation. In Plasmodium vivax infections, the uncontrolled production of these molecules is thought to contribute to pathogenesis and has been proposed as a possible predictor for disease complications. The objective of this study was to evaluate the cytokine profile of P. vivax malaria patients with different clinical outcomes to identify possible immune biomarkers for severe P. vivax malaria. The study included patients with non-severe (n = 56), or severe (n = 50) P. vivax malaria and healthy controls (n = 50). Patient plasma concentrations of IL-4, IL-2, CXCL10, IL-1β, TNF-α, CCL2, IL-17A, IL-6, IL-10, IFN-γ, IL-12p70, CXCL8 and active TGF-β1 were determined through flow cytometry. The levels of several cytokines and chemokines, CXCL10, IL-10, IL-6, IL-4, CCL2 and IFN-γ were found to be significantly higher in severe, compared to non-severe P. vivax malaria patients. Severe thrombocytopenia was positively correlated with IL-4, CXCL10, IL-6, IL-10 and IFN-γ levels, renal dysfunction was related to an increase in IL-2, IL-1β, IL-17A and IL-8, and hepatic impairment with CXCL10, MCP-1, IL-6 and IFN-γ. A Lasso regression model suggests that IL-4, IL-10, CCL2 and TGF-β might be developed as biomarkers for severity in P. vivax malaria. Severe P. vivax malaria patients present specific cytokine and chemokine profiles that are different from non-severe patients and that could potentially be developed as biomarkers for disease severity. Plasmodium vivax is one of the main species responsible for malaria in the world. The pathogenic mechanisms leading to the development of severe P. vivax malaria are not yet fully understood. Immune system molecules such as cytokines and chemokines actively participate in the control of the infection, however, their uncontrolled production can influence alterations in organs such as the liver, kidneys, among others. In this study we show that there is a differential concentration of some cytokines and chemokines between patients with non-severe malaria and severe P. vivax malaria; and that there are associations between these molecules with manifestations that occur in severe malaria. Four molecules with potential to become biomarkers of severity were identified.
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Affiliation(s)
- Catalina Tovar Acero
- Grupo Investigaciones Microbiológicas y Biomédicas de Córdoba, GIMBIC, Universidad de Córdoba, Montería, Córdoba, Colombia
- Grupo de Enfermedades Tropicales y Resistencia Bacteriana, Universidad del Sinú, Montería, Córdoba, Colombia
- Doctorado de Medicina Tropical, SUE Caribe, Universidad de Cartagena, Bolívar, Colombia
- * E-mail: (CTA); (MFYA)
| | - Javier Ramírez-Montoya
- Grupo de Investigación en Estadística, Universidad de Córdoba, Montería, Córdoba, Colombia
| | - María Camila Velasco
- Grupo Investigaciones Microbiológicas y Biomédicas de Córdoba, GIMBIC, Universidad de Córdoba, Montería, Córdoba, Colombia
| | - Paula A. Avilés-Vergara
- Grupo de Enfermedades Tropicales y Resistencia Bacteriana, Universidad del Sinú, Montería, Córdoba, Colombia
| | - Dina Ricardo-Caldera
- Grupo de Enfermedades Tropicales y Resistencia Bacteriana, Universidad del Sinú, Montería, Córdoba, Colombia
| | | | - Gustavo Quintero
- Grupo Investigaciones Microbiológicas y Biomédicas de Córdoba, GIMBIC, Universidad de Córdoba, Montería, Córdoba, Colombia
| | - Myriam Elena Cantero
- Grupo Investigaciones Microbiológicas y Biomédicas de Córdoba, GIMBIC, Universidad de Córdoba, Montería, Córdoba, Colombia
| | - Juan Rivera-Correa
- New York University School of Medicine, New York, New York, United States of America
| | - Ana Rodriguez
- New York University School of Medicine, New York, New York, United States of America
| | - María Fernanda Yasnot-Acosta
- Grupo Investigaciones Microbiológicas y Biomédicas de Córdoba, GIMBIC, Universidad de Córdoba, Montería, Córdoba, Colombia
- * E-mail: (CTA); (MFYA)
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12
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Mandala W, Munyenyembe A, Sulani I, Soko M, Mallewa J, Hiestand J. Acute Malaria in Malawian Children and Adults is Characterized by Thrombocytopenia That Normalizes in Convalescence. J Blood Med 2022; 13:485-494. [PMID: 36092852 PMCID: PMC9462550 DOI: 10.2147/jbm.s376476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background Plasmodium falciparum malaria has been linked with significant perturbations of the peripheral cell-mediated immune system during acute phase. Some of these changes include lower than normal platelet counts. Although the exact mechanisms that drive thrombocytopenia in P. falciparum malaria are not fully known, a number of hypotheses have been proposed. We conducted two sets of studies with one aimed at determining platelet counts in Malawian children, and the other in adults during acute P. falciparum malaria and a month post treatment. Materials and Methods We recruited a total of 113 HIV-uninfected children with acute malaria [n=54 with uncomplicated malaria (UCM), n=30 with severe malarial anemia (SMA), n=29 presenting with cerebral malaria (CM)]. We also recruited 42 HIV-uninfected healthy controls. Out of the 113 participants with malaria, 73 (65%) [n=34 (63%) UCM, n=21 (70%) SMA and n=18 (62%) CM] were successfully followed-up one month after treatment. A 5mL peripheral blood sample was collected for platelet count using HMX Haematological Analyzer analysis both at baseline (acute malaria) and at follow-up a month later. Platelet counts were also determined in blood samples of 106 HIV-uninfected adults, 47 of whom presented with UCM and 29 with severe malaria (SM) and these counts were compared to those of 30 healthy controls. Of the malaria cases, platelet counts for 44 UCM and 21 SM were determined again during follow-up a month after treatment. Results In both children and adults, platelet counts were significantly lower during acute disease compared to the levels in the healthy controls with the lowest levels observed in CM (children) or SM (adults). These lower than normal levels increased close to normal levels a month post treatment. Conclusion P. falciparum malaria in Malawian children and adults was characterized by profound thrombocytopenia which recovered during convalescence.
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Affiliation(s)
- Wilson Mandala
- Basic Sciences Department, Kamuzu University of Health Sciences, Blantyre, Malawi.,Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi.,Academy of Medical Sciences, Malawi University of Science and Technology, Thyolo, Malawi
| | - Alinane Munyenyembe
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Innocent Sulani
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Monica Soko
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Jane Mallewa
- Medicine Department, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Jasmin Hiestand
- Medicine Department, Kamuzu University of Health Sciences, Blantyre, Malawi
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13
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Castillo-Fernández N, Soriano-Pérez MJ, Lozano-Serrano AB, Luzón-García MP, Cabeza-Barrera MI, Vázquez-Villegas J, Pérez-Moyano R, Moya-Ruíz A, Salas-Coronas J. Misleading eosinophil counts in migration-associated malaria: do not miss hidden helminthic co-infections. Travel Med Infect Dis 2022; 49:102415. [DOI: 10.1016/j.tmaid.2022.102415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/14/2022] [Accepted: 07/30/2022] [Indexed: 10/16/2022]
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14
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Nguee SYT, Júnior JWBD, Epiphanio S, Rénia L, Claser C. Experimental Models to Study the Pathogenesis of Malaria-Associated Acute Respiratory Distress Syndrome. Front Cell Infect Microbiol 2022; 12:899581. [PMID: 35677654 PMCID: PMC9168995 DOI: 10.3389/fcimb.2022.899581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
Malaria-associated acute respiratory distress syndrome (MA-ARDS) is increasingly gaining recognition as a severe malaria complication because of poor prognostic outcomes, high lethality rate, and limited therapeutic interventions. Unfortunately, invasive clinical studies are challenging to conduct and yields insufficient mechanistic insights. These limitations have led to the development of suitable MA-ARDS experimental mouse models. In patients and mice, MA-ARDS is characterized by edematous lung, along with marked infiltration of inflammatory cells and damage of the alveolar-capillary barriers. Although, the pathogenic pathways have yet to be fully understood, the use of different experimental mouse models is fundamental in the identification of mediators of pulmonary vascular damage. In this review, we discuss the current knowledge on endothelial activation, leukocyte recruitment, leukocyte induced-endothelial dysfunction, and other important findings, to better understand the pathogenesis pathways leading to endothelial pulmonary barrier lesions and increased vascular permeability. We also discuss how the advances in imaging techniques can contribute to a better understanding of the lung lesions induced during MA-ARDS, and how it could aid to monitor MA-ARDS severity.
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Affiliation(s)
- Samantha Yee Teng Nguee
- A*STAR Infectious Diseases Labs (A*STAR ID Labs), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | | | - Sabrina Epiphanio
- Department of Clinical and Toxicological Analyses, Faculty of Pharmaceutical Science, University of São Paulo, São Paulo, Brazil
| | - Laurent Rénia
- A*STAR Infectious Diseases Labs (A*STAR ID Labs), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore, Singapore
| | - Carla Claser
- Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
- *Correspondence: Carla Claser,
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15
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Setto JM, Libonati RMF, Ventura AMRDS, Chaves TDSS, Sequeira CG, Martins Filho AJ, Machado RLD, Franceschin SDCC, Barreto JTT. Association between vitamin D serum levels and clinical, laboratory, and parasitological parameters in patients with malaria from an endemic area of the Amazon. Rev Soc Bras Med Trop 2022; 55:e00772021. [PMID: 35416868 PMCID: PMC9009878 DOI: 10.1590/0037-8682-0077-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 02/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background: Some studies have suggested the importance of vitamin D [25(OH)D] in malaria clinical practice. The prevalence of 25(OH)D deficiency in the Amazon population is not well known, and there are few studies in patients with malaria. This study aimed to evaluate 25(OH)D serum levels in patients with malaria and determine their relationships with epidemiological, clinical, laboratory, and parasitemia data. Methods: An analytical cross-sectional study of 123 patients with malaria and 122 individuals without malaria was performed in Itaituba, Pará, Brazil, from January 2018 to October 2019, by evaluating sociodemographic, clinical-epidemiological, parasitological, and laboratory data and adopting a 5% significance level. Parametric tests (Student's t-test), non-parametric tests (Mann-Whitney U), and Spearman’s correlation ([rs], for non-parametric variables) were used according to the nature of the distribution of the variables. For the qualitative variables, Pearson's chi-square test, Fisher's exact test, and the G test were used. Spearman's correlation was used to compare the results of the 25(OH)D levels and blood counts performed among patients and the control group. Results: Malaria patients residing in a mining area had 25(OH)D serum levels that were significantly lower than those in the control group residing in the mining area, though both were within normal levels. Red blood cell counts had an inverse correlation with parasitemia (Plasmodium falciparum), and platelet levels had an inverse correlation with parasitemia (Plasmodium vivax). 25(OH)D deficiency was evidenced in Itaituba, in the state of Pará, which is an endemic area of malaria in the Amazon region.
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Affiliation(s)
- Janaina Maria Setto
- Marinha do Brasil, Centro de Instrução Almirante Braz de Aguiar, Belém, PA, Brasil.,Universidade Federal do Pará, Núcleo de Medicina Tropical, Programa de Pós-Graduação em Doenças Tropicais, Belém, PA, Brasil
| | - Rosana Maria Feio Libonati
- Universidade Federal do Pará, Núcleo de Medicina Tropical, Programa de Pós-Graduação em Doenças Tropicais, Belém, PA, Brasil
| | - Ana Maria Revoredo da Silva Ventura
- Instituto Evandro Chagas, Laboratório de Ensaios Clínicos em Malária, Ananindeua, PA, Brasil.,Universidade Estadual do Pará, Centro de Ciências Biológicas e da Saúde, Belém, PA, Brasil
| | - Tânia do Socorro Souza Chaves
- Instituto Evandro Chagas, Laboratório de Ensaios Clínicos em Malária, Ananindeua, PA, Brasil.,Universidade Federal do Pará, Centro Universitário do Estado do Pará, Belém, PA, Brasil
| | - Carina Guilhon Sequeira
- Universidade Estadual do Pará, Centro de Ciências Biológicas e da Saúde, Departamento de Saúde Integrada, Belém, PA, Brasil
| | | | - Ricardo Luiz Dantas Machado
- Universidade Federal Fluminense, Programa de Pós-Graduação em Microbiologia e Parasitologia, Rio de Janeiro, RJ, Brasil
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16
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Effects of Gymnema inodorum Leaf Extract on the Alteration of Blood Coagulation Parameters and Platelet Count in Plasmodium berghei-Infected Mice. J Parasitol Res 2022; 2022:4225682. [PMID: 35310010 PMCID: PMC8933115 DOI: 10.1155/2022/4225682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 03/01/2022] [Indexed: 11/18/2022] Open
Abstract
Malaria remains highly prevalent and one of the major causes of morbidity and mortality in tropical and subtropical regions. Alteration of blood coagulation and platelets has played an important role and attributed to increased morbidity in malaria. Hence, this study was performed to investigate the efficacy of Gymnema inodorum leaf extract on Plasmodium berghei-induced alteration of blood coagulation parameters and platelet numbers in mice. Groups of ICR mice were inoculated with 1 × 107 parasitized red blood cells of P. berghei ANKA (PbANKA) and given orally by gavage with 100, 250, and 500 mg/kg of G. inodorum leaf extract (GIE). Chloroquine (10 mg/kg) was used as a positive control. Platelet count and blood coagulation parameters were measured. The results showed that PbANKA induced thrombocytopenia in mice as indicated by markedly decreased platelet count. Decreased platelet count had a negative correlation with the degree of parasitemia with R2 value of 0.6668. Moreover, significantly (p < 0.05) shortened activated partial thromboplastin time was found in PbANKA-infected group, while prothrombin time and thrombin time were still normal. GIE gave significantly (p < 0.05) good results with respect to platelet count, compared with the results obtained from positive and healthy controls. Additionally, GIE reversed the alteration of blood coagulation parameters when compared to untreated mice. The highest efficacy of GIE was observed at a dose of 500 mg/kg. It was concluded that GIE exerted a protective effect on thrombocytopenia and altered blood coagulation parameters induced by PbANKA infection in mice. This plant may be a future candidate for alternative antimalarial development.
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17
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Wunderlich F, Delic D, Gerovska D, Araúzo-Bravo MJ. Vaccination Accelerates Liver-Intrinsic Expression of Megakaryocyte-Related Genes in Response to Blood-Stage Malaria. Vaccines (Basel) 2022; 10:vaccines10020287. [PMID: 35214745 PMCID: PMC8880532 DOI: 10.3390/vaccines10020287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 02/04/2023] Open
Abstract
Erythropoiesis and megakaryo-/thrombopoiesis occur in the bone marrow proceeding from common, even bipotent, progenitor cells. Recently, we have shown that protective vaccination accelerates extramedullary hepatic erythroblastosis in response to blood-stage malaria of Plasmodium chabaudi. Here, we investigated whether protective vaccination also accelerates extramedullary hepatic megakaryo-/thrombopoiesis. Female Balb/c mice were twice vaccinated with a non-infectious vaccine before infecting with 106 P. chabaudi-parasitized erythrocytes. Using gene expression microarrays and quantitative real-time PCR, transcripts of genes known to be expressed in the bone marrow by cells of the megakaryo-/thrombocytic lineage were compared in livers of vaccination-protected and unprotected mice on days 0, 1, 4, 8, and 11 p.i. Livers of vaccination-protected mice responded with expression of megakaryo-/thrombocytic genes faster to P. chabaudi than those of unvaccinated mice, evidenced at early patency on day 4 p.i., when livers exhibited significantly higher levels of malaria-induced transcripts of the genes Selp and Pdgfb (p-values < 0.0001), Gp5 (p-value < 0.001), and Fli1, Runx1, Myb, Mpl, Gp1ba, Gp1bb, Gp6, Gp9, Pf4, and Clec1b (p-values < 0.01). Together with additionally analyzed genes known to be related to megakaryopoiesis, our data suggest that protective vaccination accelerates liver-intrinsic megakaryo-/thrombopoiesis in response to blood-stage malaria that presumably contributes to vaccination-induced survival of otherwise lethal blood-stage malaria.
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Affiliation(s)
- Frank Wunderlich
- Department of Biology, Heinrich-Heine-University, 40225 Düsseldorf, Germany;
| | - Denis Delic
- Boehringer Ingelheim Pharma GmbH & Co. KG, 88400 Biberach, Germany
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, 68167 Heidelberg, Germany
- Correspondence: (D.D.); (M.J.A.-B.)
| | - Daniela Gerovska
- Computational Biology and Systems Biomedicine, Biodonostia Health Research Institute, 20014 San Sebastian, Spain;
| | - Marcos J. Araúzo-Bravo
- Computational Biology and Systems Biomedicine, Biodonostia Health Research Institute, 20014 San Sebastian, Spain;
- IKERBASQUE, Basque Foundation for Science, 48009 Bilbao, Spain
- TransBioNet Thematic Network of Excellence for Transitional Bioinformatics, Barcelona Supercomputing Center, 08034 Barcelona, Spain
- Correspondence: (D.D.); (M.J.A.-B.)
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18
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Uncomplicated Plasmodium vivax malaria: mapping the proteome from circulating platelets. Clin Proteomics 2022; 19:1. [PMID: 34991449 PMCID: PMC8903537 DOI: 10.1186/s12014-021-09337-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 12/21/2021] [Indexed: 01/07/2023] Open
Abstract
Background Thrombocytopenia is frequent in Plasmodium vivax malaria but the role of platelets in pathogenesis is unknown. Our study explores the platelet (PLT) proteome from uncomplicated P. vivax patients, to fingerprint molecular pathways related to platelet function. Plasma levels of Platelet factor 4 (PF4/CXCL4) and Von Willebrand factor (VWf), as well as in vitro PLTs—P. vivax infected erythrocytes (Pv-IEs) interactions were also evaluated to explore the PLT response and effect on parasite development. Methods A cohort of 48 patients and 25 healthy controls were enrolled. PLTs were purified from 5 patients and 5 healthy controls for Liquid Chromatography–Mass spectrometry (LC–MS/MS) analysis. Plasma levels of PF4/CXCL4 and VWf were measured in all participants. Additionally, P. vivax isolates (n = 10) were co-cultured with PLTs to measure PLT activation by PF4/CXCL4 and Pv-IE schizonts formation by light microscopy. Results The proteome from uncomplicated P. vivax patients showed 26 out of 215 proteins significantly decreased. PF4/CXCL4 was significantly decreased followed by other proteins involved in platelet activation, cytoskeletal remodeling, and endothelial adhesion, including glycoprotein V that was significantly decreased in thrombocytopenic patients. In contrast, acute phase proteins, including SERPINs and Amyloid Serum A1 were increased. High levels of VWf in plasma from patients suggested endothelial activation while PF4/CXCL4 plasma levels were similar between patients and controls. Interestingly, high levels of PF4/CXCL4 were released from PLTs—Pv-IEs co-cultures while Pv-IEs schizont formation was inhibited. Conclusions The PLT proteome analyzed in this study suggests that PLTs actively respond to P. vivax infection. Altogether, our findings suggest important roles of PF4/CXCL4 during uncomplicated P. vivax infection through a possible intracellular localization. Our study shows that platelets are active responders to P. vivax infection, inhibiting intraerythrocytic parasite development. Future studies are needed to further investigate the molecular pathways of interaction between platelet proteins found in this study and host response, which could affect parasite control as well as disease progression. Supplementary Information The online version contains supplementary material available at 10.1186/s12014-021-09337-7.
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19
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Abstract
BACKGROUND Plasmodium vivax infects an estimated 7 million people every year. Previously, vivax malaria was perceived as a benign condition, particularly when compared to falciparum malaria. Reports of the severe clinical impacts of vivax malaria have been increasing over the last decade. METHODS AND FINDINGS We describe the main clinical impacts of vivax malaria, incorporating a rapid systematic review of severe disease with meta-analysis of data from studies with clearly defined denominators, stratified by hospitalization status. Severe anemia is a serious consequence of relapsing infections in children in endemic areas, in whom vivax malaria causes increased morbidity and mortality and impaired school performance. P. vivax infection in pregnancy is associated with maternal anemia, prematurity, fetal loss, and low birth weight. More than 11,658 patients with severe vivax malaria have been reported since 1929, with 15,954 manifestations of severe malaria, of which only 7,157 (45%) conformed to the World Health Organization (WHO) diagnostic criteria. Out of 423 articles, 311 (74%) were published since 2010. In a random-effects meta-analysis of 85 studies, 68 of which were in hospitalized patients with vivax malaria, we estimated the proportion of patients with WHO-defined severe disease as 0.7% [95% confidence interval (CI) 0.19% to 2.57%] in all patients with vivax malaria and 7.11% [95% CI 4.30% to 11.55%] in hospitalized patients. We estimated the mortality from vivax malaria as 0.01% [95% CI 0.00% to 0.07%] in all patients and 0.56% [95% CI 0.35% to 0.92%] in hospital settings. WHO-defined cerebral, respiratory, and renal severe complications were generally estimated to occur in fewer than 0.5% patients in all included studies. Limitations of this review include the observational nature and small size of most of the studies of severe vivax malaria, high heterogeneity of included studies which were predominantly in hospitalized patients (who were therefore more likely to be severely unwell), and high risk of bias including small study effects. CONCLUSIONS Young children and pregnant women are particularly vulnerable to adverse clinical impacts of vivax malaria, and preventing infections and relapse in this groups is a priority. Substantial evidence of severe presentations of vivax malaria has accrued over the last 10 years, but reporting is inconsistent. There are major knowledge gaps, for example, limited understanding of the underlying pathophysiology and the reason for the heterogenous geographical distribution of reported complications. An adapted case definition of severe vivax malaria would facilitate surveillance and future research to better understand this condition.
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Affiliation(s)
| | - Prabin Dahal
- Infectious Diseases Data Observatory–IDDO, Oxford, United Kingdom
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Mayfong Mayxay
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Institute of Research and Education Development (IRED), University of Health Sciences, Ministry of Health, Vientiane, Laos
- Lao–Oxford–Mahosot Hospital–Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Laos
| | - Elizabeth A. Ashley
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Lao–Oxford–Mahosot Hospital–Wellcome Trust Research Unit, Mahosot Hospital, Vientiane, Laos
- * E-mail:
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20
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Peterson MS, Joyner CJ, Brady JA, Wood JS, Cabrera-Mora M, Saney CL, Fonseca LL, Cheng WT, Jiang J, Lapp SA, Soderberg SR, Nural MV, Humphrey JC, Hankus A, Machiah D, Karpuzoglu E, DeBarry JD, Tirouvanziam R, Kissinger JC, Moreno A, Gumber S, Voit EO, Gutiérrez JB, Cordy RJ, Galinski MR. Clinical recovery of Macaca fascicularis infected with Plasmodium knowlesi. Malar J 2021; 20:486. [PMID: 34969401 PMCID: PMC8719393 DOI: 10.1186/s12936-021-03925-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Kra monkeys (Macaca fascicularis), a natural host of Plasmodium knowlesi, control parasitaemia caused by this parasite species and escape death without treatment. Knowledge of the disease progression and resilience in kra monkeys will aid the effective use of this species to study mechanisms of resilience to malaria. This longitudinal study aimed to define clinical, physiological and pathological changes in kra monkeys infected with P. knowlesi, which could explain their resilient phenotype. METHODS Kra monkeys (n = 15, male, young adults) were infected intravenously with cryopreserved P. knowlesi sporozoites and the resulting parasitaemias were monitored daily. Complete blood counts, reticulocyte counts, blood chemistry and physiological telemetry data (n = 7) were acquired as described prior to infection to establish baseline values and then daily after inoculation for up to 50 days. Bone marrow aspirates, plasma samples, and 22 tissue samples were collected at specific time points to evaluate longitudinal clinical, physiological and pathological effects of P. knowlesi infections during acute and chronic infections. RESULTS As expected, the kra monkeys controlled acute infections and remained with low-level, persistent parasitaemias without anti-malarial intervention. Unexpectedly, early in the infection, fevers developed, which ultimately returned to baseline, as well as mild to moderate thrombocytopenia, and moderate to severe anaemia. Mathematical modelling and the reticulocyte production index indicated that the anaemia was largely due to the removal of uninfected erythrocytes and not impaired production of erythrocytes. Mild tissue damage was observed, and tissue parasite load was associated with tissue damage even though parasite accumulation in the tissues was generally low. CONCLUSIONS Kra monkeys experimentally infected with P. knowlesi sporozoites presented with multiple clinical signs of malaria that varied in severity among individuals. Overall, the animals shared common mechanisms of resilience characterized by controlling parasitaemia 3-5 days after patency, and controlling fever, coupled with physiological and bone marrow responses to compensate for anaemia. Together, these responses likely minimized tissue damage while supporting the establishment of chronic infections, which may be important for transmission in natural endemic settings. These results provide new foundational insights into malaria pathogenesis and resilience in kra monkeys, which may improve understanding of human infections.
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Affiliation(s)
- Mariko S Peterson
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- Emory University School of Medicine, Atlanta, GA, USA
| | - Chester J Joyner
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- Center for Vaccines and Immunology, Department of Infectious Diseases, University of Georgia, Athens, GA, USA
- Center for Vaccines and Immunology, Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Jessica A Brady
- School of Chemical, Materials and Biomedical Engineering, University of Georgia, Athens, GA, USA
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Jennifer S Wood
- Division of Animal Resources, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
| | - Monica Cabrera-Mora
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Celia L Saney
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
| | - Luis L Fonseca
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Wayne T Cheng
- Center for Vaccines and Immunology, Department of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - Jianlin Jiang
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
| | - Stacey A Lapp
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
| | - Stephanie R Soderberg
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- Thermo Fisher Scientific, South San Francisco, CA, USA
| | - Mustafa V Nural
- Institute of Bioinformatics, University of Georgia, Athens, GA, USA
| | - Jay C Humphrey
- Institute of Bioinformatics, University of Georgia, Athens, GA, USA
- Center for Tropical & Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | - Allison Hankus
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- The MITRE Corporation, Atlanta, GA, USA
| | - Deepa Machiah
- Division of Pathology, Yerkes National Primate Research Center, Atlanta, GA, USA
| | - Ebru Karpuzoglu
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- Department of Biosciences and Diagnostic Imaging, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Jeremy D DeBarry
- Institute of Bioinformatics, University of Georgia, Athens, GA, USA
- Center for Topical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | | | - Jessica C Kissinger
- Institute of Bioinformatics, University of Georgia, Athens, GA, USA
- Department of Genetics, University of Georgia, Athens, GA, USA
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, USA
| | - Alberto Moreno
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Sanjeev Gumber
- Division of Pathology, Yerkes National Primate Research Center, Atlanta, GA, USA
- Department of Pathology and Laboratory Medicine, Emory School of Medicine, Atlanta, GA, USA
- Pathology, Drug Safety, and DMPK, Boehringer Ingelheim Animal Health USA, Inc., Athens, GA, USA
| | - Eberhard O Voit
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Juan B Gutiérrez
- Department of Mathematics, University of Georgia, Athens, GA, USA
- Department of Mathematics, University of Texas at San Antonio, San Antonio, TX, USA
| | - Regina Joice Cordy
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Emory Vaccine Center, Emory University, Atlanta, GA, USA
- Department of Biology, Wake Forest University, Winston-Salem, NC, USA
| | - Mary R Galinski
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA.
- Emory Vaccine Center, Emory University, Atlanta, GA, USA.
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
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21
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Molecular mechanisms of hematological and biochemical alterations in malaria: A review. Mol Biochem Parasitol 2021; 247:111446. [PMID: 34953384 DOI: 10.1016/j.molbiopara.2021.111446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/20/2021] [Accepted: 12/19/2021] [Indexed: 11/20/2022]
Abstract
Malaria is a dangerous disease that contributes to millions of hospital visits and hundreds of thousands of deaths, especially in children residing in sub-Saharan Africa. Although several interventions such as vector control, case detection, and treatment are already in place, there is no substantive reduction in the disease burden. Several studies in the past have reported the emergence of resistant strains of malaria parasites (MPs) and mosquitoes, and poor adherence and inaccessibility to effective antimalarial drugs as the major factors for this persistent menace of malaria infections. Moreover, victory against MP infections for many years has been hampered by an incomplete understanding of the complex nature of malaria pathogenesis. Very recent studies have identified different complex interactions and hematological alterations induced by malaria parasites. However, no studies have hybridized these alterations for a better understanding of Malaria pathogenesis. Hence, this review thoroughly discusses the molecular mechanisms of all reported hematological and biochemical alterations induced by MPs infections. Specifically, the mechanisms in which MP-infection induces anemia, thrombocytopenia, leukopenia, dyslipidemia, hypoglycemia, oxidative stress, and liver and kidney malfunctions were presented. The study also discussed how MPs evade the host's immune response and suggested strategies to limit evasion of the host's immune response to combat malaria and its complications.
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Gupta H, Wassmer SC. Harnessing the Potential of miRNAs in Malaria Diagnostic and Prevention. Front Cell Infect Microbiol 2021; 11:793954. [PMID: 34976869 PMCID: PMC8716737 DOI: 10.3389/fcimb.2021.793954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/09/2021] [Indexed: 12/14/2022] Open
Abstract
Despite encouraging progress over the past decade, malaria remains a major global health challenge. Its severe form accounts for the majority of malaria-related deaths, and early diagnosis is key for a positive outcome. However, this is hindered by the non-specific symptoms caused by malaria, which often overlap with those of other viral, bacterial and parasitic infections. In addition, current tools are unable to detect the nature and degree of vital organ dysfunction associated with severe malaria, as complications develop silently until the effective treatment window is closed. It is therefore crucial to identify cheap and reliable early biomarkers of this wide-spectrum disease. microRNAs (miRNAs), a class of small non-coding RNAs, are rapidly released into the blood circulation upon physiological changes, including infection and organ damage. The present review details our current knowledge of miRNAs as biomarkers of specific organ dysfunction in patients with malaria, and both promising candidates identified by pre-clinical models and important knowledge gaps are highlighted for future evaluation in humans. miRNAs associated with infected vectors are also described, with a view to expandind this rapidly growing field of research to malaria transmission and surveillance.
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Affiliation(s)
- Himanshu Gupta
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Samuel C. Wassmer
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Qureshi H, Khan MI, Ahmad A, Awan UA, Khattak AA, Khan AA, Sun Y. Passive Surveillance of Malaria in Pregnant Women, Non-pregnant Women and Children Under 5 Years of Age in Bannu District, Khyber Pakhtunkhwa Pakistan. Front Med (Lausanne) 2021; 8:751456. [PMID: 34869444 PMCID: PMC8636730 DOI: 10.3389/fmed.2021.751456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Malaria among pregnant women is one of the major causes of maternal and infant mortality and morbidity, especially in high-risk areas. Therefore, our study identified the burden of malaria for pregnant women, non-pregnant women, and children under 5 years of age, and malaria service health facilities in Bannu district, Khyber Pakhtunkhwa, Pakistan. Methods: A cross-sectional study was conducted. In this survey, 15,650 individuals were surveyed, and 1,283 were malaria-positive detected. The data were collected from 80 different healthcare centers. SPSS version 23 was used for data analysis. ArcGIS version 10.8 was used for study area mapping. Results: Malaria was detected in 23.3% of children under five, 4.4% of pregnant women, and 72.3% of non-pregnant women, respectively. Moreover, P. falciparum, P. vivax, and mixed infection had a prevalence of 2.1, 96.8, and 1.1%. The most often used and effective medications to treat malaria were chloroquine (29.7%) and primaquine (69.4%). Conclusion: This study's findings depict that malaria's prevalence in the non-pregnant women's group was high. Additionally, P. vivax infection was found to be more prevalent than other types of malaria infection. Due to the scarcity of healthcare facilities in this endemic region, special attention should be directed to strengthening the malaria surveillance and eradication programs.
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Affiliation(s)
- Humera Qureshi
- Department of Mathematics and Statistics, The University of Haripur, Haripur, Pakistan
| | - Muhammad Imran Khan
- Department of Mathematics and Statistics, The University of Haripur, Haripur, Pakistan
| | - Akhlaq Ahmad
- Gungdong Provincial Key Laboratory of Allergy and Clinical Immunology, The State Key Laboratory of Respiratory Disease, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Usman Ayub Awan
- Department of Medical Laboratory Technology, The University of Haripur, Haripur, Pakistan
| | - Aamer Ali Khattak
- Department of Medical Laboratory Technology, The University of Haripur, Haripur, Pakistan
| | - Ayesha Ali Khan
- Department of Biochemistry and Molecular Biology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Yaqiong Sun
- Department of Imaging, Southern University of Science and Technology Hospital, Shenzhen, China
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Alteration of Platelet Count in Patients with Severe Non-Plasmodium falciparum Malaria: A Systematic Review and Meta-Analysis. BIOLOGY 2021; 10:biology10121275. [PMID: 34943190 PMCID: PMC8698983 DOI: 10.3390/biology10121275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/29/2021] [Accepted: 12/03/2021] [Indexed: 11/16/2022]
Abstract
The understanding of platelet biology under physiological and pathological conditions like malaria infection is critical importance in the context of the disease outcome or model systems used. The importance of severe thrombocytopenia (platelet count < 50,000 cells (µL) and profound thrombocytopenia (platelet count < 20,000 cells/µL) in malaria patients remains unclear. This study aimed to synthesize evidence regarding the risks of severe and profound thrombocytopenia in patients with severe non-Plasmodium falciparum malaria. Our overall aim was to identify potential indicators of severe non-P. falciparum malaria and the Plasmodium species that cause severe outcomes. This systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under registration ID CRD42020196541. Studies were identified from previous systematic reviews (n = 5) and the MEDLINE, Scopus, and Web of Science databases from 9 June 2019 to 9 June 2020. Studies were included if they reported the outcome of severe non-Plasmodium species infection, as defined by the World Health Organization (WHO) criteria, in patients with known platelet counts and/or severe and profound thrombocytopenia. The risk of bias was assessed using the Newcastle–Ottawa Scale (NOS). Data were pooled, and pooled prevalence (PP) and pooled odds ratios (ORs) were calculated using random effects models. Of the 118 studies identified from previous meta-nalyses, 21 met the inclusion criteria. Of the 4807 studies identified from the databases, three met the inclusion criteria. Nine studies identified from reference lists and other sources also met the inclusion criteria. The results of 33 studies reporting the outcomes of patients with severe P. vivax and P. knowlesi infection were pooled for meta-analysis. The PP of severe thrombocytopenia (reported in 21 studies) was estimated at 47% (95% confidence interval (CI): 33–61%, I2: 96.5%), while that of profound thrombocytopenia (reported in 13 studies) was estimated at 20% (95% CI: 14–27%, 85.2%). The pooled weighted mean difference (WMD) in platelet counts between severe uncomplicated Plasmodium infections (reported in 11 studies) was estimated at −28.51% (95% CI: −40.35–61%, I2: 97.7%), while the pooled WMD in platelet counts between severe non-Plasmodium and severe P. falciparum infections (reported in eight studies) was estimated at −3.83% (95% CI: −13.90–6.25%, I2: 85.2%). The pooled OR for severe/profound thrombocytopenia comparing severe to uncomplicated Plasmodium infection was 2.92 (95% CI: 2.24–3.81, I2: 39.9%). The PP of death from severe and profound thrombocytopenia was estimated at 11% (95% CI: 0–22%). These results suggest that individuals with severe non-P. falciparum infection (particularly P. vivax and P. knowlesi) who exhibit severe or profound thrombocytopenia should be regarded as high risk, and should be treated for severe malaria according to current WHO guidelines. In addition, severe or profound thrombocytopenia coupled with other clinical and microscopic parameters can significantly improve malaria diagnosis, enhance the timely treatment of malaria infections, and reduce the morbidity and mortality of severe non-P. falciparum malaria.
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Epidemiological, Physiological and Diagnostic Comparison of Plasmodium ovale curtisi and Plasmodium ovale wallikeri. Diagnostics (Basel) 2021; 11:diagnostics11101900. [PMID: 34679597 PMCID: PMC8534334 DOI: 10.3390/diagnostics11101900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 11/17/2022] Open
Abstract
Nowadays, Plasmodium ovale is divided into two non-recombinant sympatric species: Plasmodium ovale wallikeri and Plasmodium ovale curtisi. In this mini review, we summarize the available knowledge on the clinical/biological aspects of P. ovale spp. malaria and current techniques for the diagnosis/characterisation of P. ovale curtisi and P. ovale wallikeri. P. ovale wallikeri infections are characterized by a deeper thrombocytopenia and shorter latency compared to P. ovale curtisi infections, indicating that P. ovale wallikeri is more pathogenic than P. ovale curtisi. Rapid diagnosis for effective management is difficult for P. ovale spp., since specific rapid diagnostic tests are not available and microscopic diagnosis, which is recognized as the gold standard, requires expert microscopists to differentiate P. ovale spp. from other Plasmodium species. Neglect in addressing these issues in the prevalence of P. ovale spp. represents the existing gap in the fight against malaria.
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Karunaratna S, Ranaweera D, Vitharana H, Ranaweera P, Mendis K, Fernando D. Thrombocytopenia in Malaria: A Red-Herring for Dengue, Delaying the Diagnosis of Imported Malaria. J Glob Infect Dis 2021; 13:172-176. [PMID: 35017873 PMCID: PMC8697816 DOI: 10.4103/jgid.jgid_9_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 07/09/2021] [Accepted: 08/03/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction Fever and thrombocytopenia, often presenting features of malaria, are also the hallmarks of dengue infections. This study examines the degree and duration of thrombocytopenia in imported malaria infections in Sri Lanka and the extent to which this could provide a false trail in favor of a dengue diagnosis. Methods The data of all confirmed malaria cases reported in Sri Lanka from 2017 to 2019 were extracted from the national malaria database. These included detailed histories, the time to malaria diagnosis, platelet counts, and in 2019, the trail of diagnostic procedures. Results Over the 3 years, 158 malaria cases (157 imported and one introduced) were reported. Platelet counts were available in 90.5% (n = 143) of patients among whom 86% (n = 123) showed a thrombocytopenia (<150,000 cells/μl) and in nearly a third (n = 52) a severe thrombocytopenia (<50,000 cells/μl). Only 30% of patients (n = 48) were diagnosed with malaria within 3 days of the onset of symptoms, while in 37% (n = 58) it took 7 or more days. Platelet counts where significantly higher in patients who had symptoms for 7 days or more compared to those who had symptoms for <7 days (χ2 = 6.888, P = 0.009). Dengue fever was suspected first in 30% (n = 16) of the total malaria patients reported in 2019. Conclusions Low platelet counts could delay suspecting and testing for malaria. Eliciting a history of travel to a malaria-endemic country could provide an important and discerning clue to suspect and test for malaria in such patients.
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Affiliation(s)
| | | | | | | | - Kamini Mendis
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Deepika Fernando
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Silva-Filho JL, Dos-Santos JC, Judice C, Beraldi D, Venugopal K, Lima D, Nakaya HI, De Paula EV, Lopes SC, Lacerda MV, Marti M, Costa FT. Total parasite biomass but not peripheral parasitaemia is associated with endothelial and haematological perturbations in Plasmodium vivax patients. eLife 2021; 10:71351. [PMID: 34585667 PMCID: PMC8536259 DOI: 10.7554/elife.71351] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/28/2021] [Indexed: 11/13/2022] Open
Abstract
Plasmodium vivax is the major cause of human malaria in the Americas. How P. vivax infection can lead to poor clinical outcomes, despite low peripheral parasitaemia, remains a matter of intense debate. Estimation of total P. vivax biomass based on circulating markers indicates existence of a predominant parasite population outside of circulation. In this study, we investigate associations between both peripheral and total parasite biomass and host response in vivax malaria. We analysed parasite and host signatures in a cohort of uncomplicated vivax malaria patients from Manaus, Brazil, combining clinical and parasite parameters, multiplexed analysis of host responses, and ex vivo assays. Patterns of clinical features, parasite burden, and host signatures measured in plasma across the patient cohort were highly heterogenous. Further data deconvolution revealed two patient clusters, here termed Vivaxlow and Vivaxhigh. These patient subgroups were defined based on differences in total parasite biomass but not peripheral parasitaemia. Overall Vivaxlow patients clustered with healthy donors and Vivaxhigh patients showed more profound alterations in haematological parameters, endothelial cell (EC) activation, and glycocalyx breakdown and levels of cytokines regulating different haematopoiesis pathways compared to Vivaxlow. Vivaxhigh patients presented more severe thrombocytopenia and lymphopenia, along with enrichment of neutrophils in the peripheral blood and increased neutrophil-to-lymphocyte ratio (NLCR). When patients' signatures were combined, high association of total parasite biomass with a subset of markers of EC activation, thrombocytopenia, and lymphopenia severity was observed. Finally, machine learning models defined a combination of host parameters measured in the circulation that could predict the extent of parasite infection outside of circulation. Altogether, our data show that total parasite biomass is a better predictor of perturbations in host homeostasis in P. vivax patients than peripheral parasitaemia. This supports the emerging paradigm of a P. vivax tissue reservoir, particularly in the haematopoietic niche of bone marrow and spleen.
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Affiliation(s)
- João L Silva-Filho
- Laboratory of Tropical Diseases - Prof. Luiz Jacintho da Silva, Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil.,Wellcome Centre for Integrative Parasitology, Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - João Ck Dos-Santos
- Laboratory of Tropical Diseases - Prof. Luiz Jacintho da Silva, Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil.,Post-Graduation in Medical Pathophysiology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Carla Judice
- Laboratory of Tropical Diseases - Prof. Luiz Jacintho da Silva, Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil
| | - Dario Beraldi
- Wellcome Centre for Integrative Parasitology, Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - Kannan Venugopal
- Wellcome Centre for Integrative Parasitology, Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - Diogenes Lima
- School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Helder I Nakaya
- School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil.,Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Erich V De Paula
- Department of Clinical Pathology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Stefanie Cp Lopes
- Department of Clinical Pathology, School of Medical Sciences, University of Campinas, Campinas, Brazil.,Institute Leônidas & Maria Deane, Fiocruz, Manaus, Brazil.,Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Marcus Vg Lacerda
- Institute Leônidas & Maria Deane, Fiocruz, Manaus, Brazil.,Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Matthias Marti
- Wellcome Centre for Integrative Parasitology, Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, United Kingdom
| | - Fabio Tm Costa
- Laboratory of Tropical Diseases - Prof. Luiz Jacintho da Silva, Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas, Campinas, Brazil
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Nishimura J, Dharap P, Raimbault S. The utility of basic blood counts, WBC histogram and C-reactive protein in detecting malaria. BMC Infect Dis 2021; 21:1006. [PMID: 34565334 PMCID: PMC8474782 DOI: 10.1186/s12879-021-06704-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 09/16/2021] [Indexed: 11/10/2022] Open
Abstract
Background Hematology analyzers display abnormal parameters during malaria infection providing insightful information for suspecting and assessing malaria infection. The goal of this study is to demonstrate the potential of a three-part differential hematology analyzer to assess malaria, provide information about the parasitemia, and discuss the importance of combining C-reactive protein (CRP) with hematology parameters to obtain further information about the malaria infection. Methods The present study shows the results of a case–control study during the monsoon season of years 2018 and 2019 in Mumbai, India. The study considers 1008 non-malaria febrile cases, 209 P. vivax and 31 P. falciparum positive malaria samples, five cases of mixed P. vivax and P. falciparum infection, and three co-infection cases of P. vivax and dengue. Raw data from the three-part analyzer LC-667G CRP (HORIBA) and the corresponding microscopic findings (golden standard for diagnosis of malaria) were obtained for each sample. Results The medians of platelet counts (PLT) were 102.5, 109.0, and 223.0 × 103/µL, while CRP medians were 67.4, 81.4 and 10.4 mg/L in P. vivax, P. falciparum and control groups respectively (p < 0.001 in Mann–Whitney U tests between malaria and control groups). Compared with negative samples, platelets counting less than 161.5 × 103/µL were observed on malaria patients (OR 19.12, 95% CI 11.89–30.75). Especially in P. vivax cases, an abnormal peak was frequently observed in the white blood cells (WBC) histogram around the 37fL channel. The events counted around that channel showed a linear correlation with the counting of red blood cells infected predominantly with larger parasitic forms. Parameters like CRP (rs = 0.325, p < 0.001), WBC (rs = 0.285, p < 0.001) and PLT (rs = − 0.303, p < 0.001) were correlated with the parasitemia of P. vivax samples. Between the malaria and dengue groups, the highest area under the receiver operating characteristic curve was observed on CRP (0.867, CRP ≥ 26.85 mg/L). Conclusions A three-part differential hematology analyzer has the potential to not only trigger malaria diagnosis confirmation but also assess the severity of the infection when CRP is considered. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06704-5.
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Vieira-Santos F, Leal-Silva T, de Lima Silva Padrão L, Ruas ACL, Nogueira DS, Kraemer L, Oliveira FMS, Caliari MV, Russo RC, Fujiwara RT, Bueno LL. Concomitant experimental coinfection by Plasmodium berghei NK65-NY and Ascaris suum downregulates the Ascaris-specific immune response and potentiates Ascaris-associated lung pathology. Malar J 2021; 20:296. [PMID: 34210332 PMCID: PMC8248286 DOI: 10.1186/s12936-021-03824-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 06/17/2021] [Indexed: 12/22/2022] Open
Abstract
Background Ascariasis and malaria are highly prevalent parasitic diseases in tropical regions and often have overlapping endemic areas, contributing to high morbidity and mortality rates in areas with poor sanitary conditions. Several studies have previously aimed to correlate the effects of Ascaris-Plasmodium coinfections but have obtained contradictory and inconclusive results. Therefore, the present study aimed to investigate parasitological and immunopathological aspects of the lung during murine experimental concomitant coinfection by Plasmodium berghei and Ascaris suum during larvae ascariasis. Methods C57BL/6J mice were inoculated with 1 × 104P. berghei strain NK65-NY-infected red blood cells (iRBCs) intraperitoneally and/or 2500 embryonated eggs of A. suum by oral gavage. P. berghei parasitaemia, morbidity and the survival rate were assessed. On the seventh day postinfection (dpi), A. suum lung burden analysis; bronchoalveolar lavage (BAL); histopathology; NAG, MPO and EPO activity measurements; haematological analysis; and respiratory mechanics analysis were performed. The concentrations of interleukin (IL)-1β, IL-12/IL-23p40, IL-6, IL-4, IL-33, IL-13, IL-5, IL-10, IL-17A, IFN-γ, TNF and TGF-β were assayed by sandwich ELISA. Results Animals coinfected with P. berghei and A. suum show decreased production of type 1, 2, and 17 and regulatory cytokines; low leukocyte recruitment in the tissue; increased cellularity in the circulation; and low levels of NAG, MPO and EPO activity that lead to an increase in larvae migration, as shown by the decrease in larvae recovered in the lung parenchyma and increase in larvae recovered in the airway. This situation leads to severe airway haemorrhage and, consequently, an impairment respiratory function that leads to high morbidity and early mortality. Conclusions This study demonstrates that the Ascaris-Plasmodium interaction is harmful to the host and suggests that this coinfection may potentiate Ascaris-associated pathology by dampening the Ascaris-specific immune response, resulting in the early death of affected animals. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03824-w.
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Affiliation(s)
- Flaviane Vieira-Santos
- Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Department of Parasitology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Thaís Leal-Silva
- Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Department of Parasitology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luiza de Lima Silva Padrão
- Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Department of Parasitology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Cristina Loiola Ruas
- Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Department of Parasitology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Denise Silva Nogueira
- Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Department of Parasitology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Kraemer
- Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Department of Parasitology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fabrício Marcus Silva Oliveira
- Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Department of Parasitology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marcelo Vidigal Caliari
- Laboratory of Protozooses, Institute of Biological Sciences, Department of General Pathology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Remo Castro Russo
- Laboratory of Pulmonary Immunology and Mechanics, Institute of Biological Sciences, Department of Physiology and Biophysics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Toshio Fujiwara
- Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Department of Parasitology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lilian Lacerda Bueno
- Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Department of Parasitology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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Elkhalifa AME, Abdul-Ghani R, Tamomh AG, Eltaher NE, Ali NY, Ali MM, Bazie EA, KhirAlla A, DfaAlla FA, Alhasan OAM. Hematological indices and abnormalities among patients with uncomplicated falciparum malaria in Kosti city of the White Nile state, Sudan: a comparative study. BMC Infect Dis 2021; 21:507. [PMID: 34059017 PMCID: PMC8166086 DOI: 10.1186/s12879-021-06228-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hematological abnormalities are common features in falciparum malaria but vary among different populations across countries. Therefore, we compared hematological indices and abnormalities between Plasmodium falciparum-infected patients and malaria-negative subjects in Kosti city of the White Nile State, Sudan. METHODS A comparative, cross-sectional study was conducted at the Clinical Laboratory Unit of Kosti Teaching Hospital from June to December 2018. A total of 392 participants (192 P. falciparum-infected patients and 200 malaria-negative subjects) were recruited in the study. Hematological indices of hemoglobin (Hb), red blood cells (RBCs), white blood cells (WBCs) and platelets were measured, and their median values were statistically compared. RESULTS The majority of P. falciparum-infected patients (67.6%) showed a low-level parasitemia. The median values of Hb concentration, RBC count, mean corpuscular volume (MCV), mean corpuscular Hb (MCH) and mean corpuscular Hb concentration (MCHC) were significantly lower in P. falciparum-infected patients, while the median red cell distribution width (RDW) was significantly higher in the patients compared to malaria-negative subjects. Anemia, low MCV, low MCH, low MCHC and high RDW were significantly associated with falciparum malaria, but parasitemia level was not significantly associated with anemia severity. The median total WBC count was non-significantly higher in P. falciparum-infected patients, with neutropenia being significantly associated with falciparum malaria. The median platelet count was significantly lower in P. falciparum-infected patients, with thrombocytopenia being significantly associated with falciparum malaria. CONCLUSIONS Falciparum malaria among patients in Kosti city of the White Nile State, Sudan is predominantly of low-level parasitemia. It is significantly associated with anemia, low MCV, low MCH, low MCHC, high RDW, thrombocytopenia and neutropenia. However, parasitemia level is not a significant predictor of anemia severity. On the other hand, leucopenia is not useful to predict falciparum malaria. Further large-scale studies in community and healthcare settings and inclusion of patients with complicated or severe malaria and those with high parasite densities are recommended.
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Affiliation(s)
- Ahmed M E Elkhalifa
- Department of Public Health, College of Health Sciences Saudi Electronic University, Riyadh, Kingdom of Saudi Arabia.,Department of Hematology, Faculty of Medical Laboratory Sciences, University of El Imam El Mahdi, Kosti, Sudan
| | - Rashad Abdul-Ghani
- Department of Medical Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen. .,Tropical Disease Research Center, Faculty of Medicine and Health Sciences, University, of Science and Technology, Sana'a, Yemen.
| | - Abdelhakam G Tamomh
- Department of Parasitology and Medical Entomology, Faculty of Medical Laboratory Sciences, University of El Imam El Mahdi, Kosti, Sudan
| | - Nur Eldin Eltaher
- Department of Public Health, Faculty of Public and Environmental Health, University of El Imam El Mahdi, Kosti, Sudan
| | - Nada Y Ali
- Department of Hematology, Faculty of Medical Laboratory Sciences, University of El Imam El Mahdi, Kosti, Sudan
| | - Moataz M Ali
- Department of Pathology, Faculty of Medicine, University of El Imam El Mahdi, Kosti, Sudan.,Department of Pathology, Faculty of Medicine, Albaha University, Albaha, Kingdom of Saudi Arabia
| | - Elsharif A Bazie
- Department of Pediatrics, Faculty of Medicine, University of El Imam El Mahdi, Kosti, Sudan
| | - Aboagla KhirAlla
- Department of Hematology, Faculty of Medical Laboratory Sciences, University of El Imam El Mahdi, Kosti, Sudan
| | - Fatin A DfaAlla
- Department of Hematology, Faculty of Medical Laboratory Sciences, University of El Imam El Mahdi, Kosti, Sudan
| | - Omnia A M Alhasan
- Department of Hematology, Faculty of Medical Laboratory Sciences, University of El Imam El Mahdi, Kosti, Sudan
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Gebreweld A, Erkihun Y, Feleke DG, Hailu G, Fiseha T. Thrombocytopenia as a Diagnostic Marker for Malaria in Patients with Acute Febrile Illness. J Trop Med 2021; 2021:5585272. [PMID: 33936215 PMCID: PMC8055386 DOI: 10.1155/2021/5585272] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/29/2021] [Accepted: 04/02/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Thrombocytopenia is the most common hematological abnormality in patients with acute malaria. This study aimed to determine the role of thrombocytopenia as a diagnostic marker for malaria in patients with acute febrile illness. METHOD A cross-sectional health facility-based study was conducted on 423 consecutively selected acute febrile patients at Ataye District Hospital from February to May 2019 GC. A complete blood count and malaria microscopy were performed for each acute febrile patient. ROC curve analysis was performed to calculate sensitivity, specificity, positive predictive value, and negative predictive value of platelet count in predicting malaria. A P ≤ 0.05 was considered statistically significant. RESULT Out of the 423 acute febrile patients, 73 (17.3%) were microscopically confirmed malaria cases and the rest 350 (82.7%) patients had negative blood film results. Of the microscopically confirmed malaria cases, 55 (75.34%) were P. vivax and 18 (24.66%) were P. falciparum. The prevalence of thrombocytopenia among malaria patients (79.5%) was significantly higher than those in malaria negative acute febrile patients (13.7%), P < 0.001. About 67% malaria-infected patients had mild to moderate thrombocytopenia and 12.3% had severe thrombocytopenia. The ROC analysis demonstrated platelet counts <150,000/μl as an optimal cutoff value with 0.893 area under the curve, 79.5% sensitivity, 86.3% specificity, 95.3% negative predictive value, and 54.7% positive predictive value to predict malaria. CONCLUSION Malaria is still among the major public health problems in the country. Thrombocytopenia is a very good discriminatory test for the presence or absence of malaria with 79.5% sensitivity and 86.3% specificity. Therefore, this may be used in addition to the clinical and microscopic parameters to heighten the suspicion of malaria.
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Affiliation(s)
- Angesom Gebreweld
- Department of Medical Laboratory Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Yonas Erkihun
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Daniel Getacher Feleke
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gebru Hailu
- Department of Environmental Health and Behavioral Science, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Temesgen Fiseha
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Bayleyegn B, Asrie F, Yalew A, Woldu B. Role of Platelet Indices as a Potential Marker for Malaria Severity. J Parasitol Res 2021; 2021:5531091. [PMID: 37601293 PMCID: PMC10435314 DOI: 10.1155/2021/5531091] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/18/2021] [Accepted: 03/02/2021] [Indexed: 08/22/2023] Open
Abstract
Purpose Platelet parameter alteration such as platelet count and platelet indices are more common than in other blood cell lines due to diverse causative pathophysiological mechanisms in severe malaria infection. In malaria patients, no more studies evaluated platelet indices in relation to disease severity and prognosis. Therefore, this review assessed the current scientific knowledge on the potential role of platelet indices for the diagnostic marker of severe malaria infection. Results Hence, after reviewing recent literatures, elevation of mean platelet volume and platelet distribution width in addition to decreased plateletcrit and platelet counts is the known potential risk factor associated with warning signs of severe malaria. Thus, thrombocytopenia < 150 × 109/L, MPV ≥ 9.05 fL, and PDW ≥ 14.550% as well as significantly higher P-LCR and decrease in PCT are shown significant sensitivity and specificity as they are used as diagnostic and prognostic values in severe malaria infection. Conclusion Platelet indices are useful predictors of malaria severity. Immature platelet fraction (IPF%) is raised in the case of severe malaria, and it was significantly more useful than MPV. Advanced research will further investigate the platelet index abnormality associated with specific age and gender among specific malaria species.
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Affiliation(s)
- Biruk Bayleyegn
- Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Fikir Asrie
- Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Aregawi Yalew
- Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Berhanu Woldu
- Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Santos MLS, Coimbra RS, Sousa TN, Guimarães LFF, Gomes MS, Amaral LR, Pereira DB, Fontes CJF, Hawwari I, Franklin BS, Carvalho LH. The Interface Between Inflammatory Mediators and MicroRNAs in Plasmodium vivax Severe Thrombocytopenia. Front Cell Infect Microbiol 2021; 11:631333. [PMID: 33791239 PMCID: PMC8005714 DOI: 10.3389/fcimb.2021.631333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 02/17/2021] [Indexed: 11/27/2022] Open
Abstract
Severe thrombocytopenia can be a determinant factor in the morbidity of Plasmodium vivax, the most widespread human malaria parasite. Although immune mechanisms may drive P. vivax-induced severe thrombocytopenia (PvST), the current data on the cytokine landscape in PvST is scarce and often conflicting. Here, we hypothesized that the analysis of the bidirectional circuit of inflammatory mediators and their regulatory miRNAs would lead to a better understanding of the mechanisms underlying PvST. For that, we combined Luminex proteomics, NanoString miRNA quantification, and machine learning to evaluate an extensive array of plasma mediators in uncomplicated P. vivax patients with different degrees of thrombocytopenia. Unsupervised clustering analysis identified a set of PvST-linked inflammatory (CXCL10, CCL4, and IL-18) and regulatory (IL-10, IL-1Ra, HGF) mediators. Among the mediators associated with PvST, IL-6 and IL-8 were critical to discriminate P. vivax subgroups, while CCL2 and IFN-γ from healthy controls. Supervised machine learning spotlighted IL-10 in P. vivax-mediated thrombocytopenia and provided evidence for a potential signaling route involving IL-8 and HGF. Finally, we identified a set of miRNAs capable of modulating these signaling pathways. In conclusion, the results place IL-10 and IL-8/HGF in the center of PvST and propose investigating these signaling pathways across the spectrum of malaria infections.
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Affiliation(s)
| | - Roney S. Coimbra
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Tais N. Sousa
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | | | - Matheus S. Gomes
- Laboratório de Bioinformática e Análises Moleculares, Rede Multidisciplinar de Pesquisa, Ciência e Tecnologia, Universidade Federal de Uberlândia, Patos de Minas, Brazil
| | - Laurence R. Amaral
- Laboratório de Bioinformática e Análises Moleculares, Rede Multidisciplinar de Pesquisa, Ciência e Tecnologia, Universidade Federal de Uberlândia, Patos de Minas, Brazil
| | - Dhelio B. Pereira
- Dep. Pesquisa Clínica e Medicina Translacional, Centro de Pesquisas em Medicina Tropical, Porto Velho, Brazil
| | - Cor J. F. Fontes
- Departamento de Clínica Médica, Universidade Federal de Mato Grosso, Cuiabá, Brazil
| | - Ibrahim Hawwari
- Medical Faculty, Institute of Innate Immunity, University of Bonn, Bonn, Germany
| | - Bernardo S. Franklin
- Medical Faculty, Institute of Innate Immunity, University of Bonn, Bonn, Germany
| | - Luzia H. Carvalho
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
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Jiero S, Pasaribu AP. Haematological profile of children with malaria in Sorong, West Papua, Indonesia. Malar J 2021; 20:126. [PMID: 33663524 PMCID: PMC7931533 DOI: 10.1186/s12936-021-03638-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background Malaria remains a major public health problem in Indonesian Papua, with children under five years of age being the most affected group. Haematological changes, such as cytopenia that occur during malaria infection have been suggested as potential predictors and can aid in the diagnosis of malaria. This study aimed to assess the haematological alterations associated with malaria infection in children presenting with signs and symptoms of malaria. Methods A retrospective study was performed by collecting data from the medical records of malaria patients at Sorong Regional General Hospital, Sorong, West Papua, Indonesia, both from outpatient and inpatient clinics, from January 2014 until December 2017. The laboratory profile of children suffering from malaria was evaluated. Results One hundred and eighty-two children aged 1 month to 18 years old were enrolled. The subjects were mostly male (112, 61.5%) with a mean age of 6.45 years (SD = 4.3 years). Children below 5 years of age suffered the most from malaria in this study (77, 42.3%). One hundred two subjects (56%) were infected with Plasmodium falciparum. Half of the enrolled subjects (50%) had haemoglobin level (Hb) between 5.1 and 10 gr/dL. A total of 41 children (53.2%) less than 5 years old suffered from P. falciparum infection. In the age group of 5–10 years, there were 34 children (57.6%) who suffered from P. falciparum, and in the age group > 10 years, 27 children (58.7%) suffered from P. falciparum infection. Only 4 subjects (5.2%) in the less than 5 years old age group had mixed malaria infection. Among eight predictors of the haematological profile, there were five predictors that were significantly associated with the diagnostic criteria, namely haemoglobin, haematocrit, leukocytes, platelets and monocytes (p < 0.05). Generally, clinical symptoms are not significantly associated with a malaria diagnosis, and only one variable showed a significant relationship, pale, with a P value of 0.001. Conclusions Children with malaria had changes in some haematological markers, with anaemia, low platelet count, white blood count, and lymphocyte count being the most important predictors of malaria infection in the study area. These markers could be used to raise suspicion of malaria in children living in high endemic areas, such as West Papua.
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Affiliation(s)
- Syilvia Jiero
- Department of Child Health, Sorong Regional General Hospital, Sorong, West Papua, Indonesia
| | - Ayodhia Pitaloka Pasaribu
- Department of Child Health, Medical Faculty, Universitas Sumatera Utara, Dr. Mansur Street No. 5, 20156, Medan, Indonesia.
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Punnath K, Dayanand KK, Midya V, Chandrashekar VN, Achur RN, Kakkilaya SB, Ghosh SK, Kumari SN, Gowda DC. Acquired antibody responses against merozoite surface protein-1 19 antigen during Plasmodium falciparum and P.vivax infections in South Indian city of Mangaluru. J Parasit Dis 2021; 45:176-190. [PMID: 33100734 PMCID: PMC7576553 DOI: 10.1007/s12639-020-01288-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/05/2020] [Indexed: 01/13/2023] Open
Abstract
Merozoite surface protein-1 (MSP-1) of malaria parasites has been extensively studied as a malaria vaccine candidate and the antibody response to this protein is an important indicator of protective immunity to malaria. Mangaluru city and its surrounding areas in southwestern India are endemic to malaria with Plasmodium vivax being the most widespread and prevalent species although P. falciparum also frequently infects. However, no information is available on the level of protective immunity in this population. In this regard, a prospective hospital-based study was performed in malarial patients to assess antibody responses against the 19-kDa C-terminal portion of P. vivax and P. falciparum MSP-1 (MSP-119). Serum samples from 51 healthy endemic controls and 267 infected individuals were collected and anti-MSP-119 antibody levels were analyzed by ELISA. The possible association between the antibody responses and morbidity parameters such as malarial anemia and thrombocytopenia was investigated. Among the 267 infected cases, 144 had P. vivax and 123 had P. falciparum infections. Significant levels of anti-MSP-119 antibody were observed both in P. vivax (123/144; 85.4%) and P. falciparum (108/123; 87.9%) infected individuals. In both type of infections, the major antibody isotypes were IgG1 and IgG3. The IgG levels were found to be increased in patients with severe anemia and thrombocytopenia. The antibody levels were also higher in infected individuals who had several previous infections, although antibodies produced during previous infections were short lived. The predominance of cytophilic anti-MSP-119 IgG1 and IgG3 antibodies suggests the possibility of a dual role of Pv MSP-119 and Pf MSP-119 during malarial immunity and pathogenesis.
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Affiliation(s)
- Kishore Punnath
- Department of Biochemistry, Kuvempu University, Shankaraghatta, Shivamogga District, Karnataka India
- Department of Biochemistry, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangaluru, India
| | - Kiran K. Dayanand
- Department of Biochemistry, Kuvempu University, Shankaraghatta, Shivamogga District, Karnataka India
- Department of Biochemistry, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangaluru, India
| | - Vishal Midya
- Department of Biostatistics and Bioinformatics, The Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA USA
| | - Valleesha N. Chandrashekar
- Department of Biochemistry, Kuvempu University, Shankaraghatta, Shivamogga District, Karnataka India
- Department of Biochemistry, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangaluru, India
| | - Rajeshwara N. Achur
- Department of Biochemistry, Kuvempu University, Shankaraghatta, Shivamogga District, Karnataka India
| | | | - Susanta K. Ghosh
- Department of Molecular Parasitology, ICMR-National Institute of Malaria Research, Poojanahalli, Bangalore, India
| | - Suchetha N. Kumari
- Department of Biochemistry, K.S. Hegde Medical Academy, NITTE (Deemed to be University), Mangaluru, India
| | - D. Channe Gowda
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA USA
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Tovar-Acero C, Velasco MC, Avilés-Vergara PA, Ricardo-Caldera DM, Alvis EM, Ramirez-Montoya J, Yasnot Acosta MF. Liver and kidney dysfunction, hypoglycemia, and thrombocytopenia in Plasmodium vivax malaria patients at a Colombian Northwest region. Parasite Epidemiol Control 2021; 13:e00203. [PMID: 33615000 PMCID: PMC7881263 DOI: 10.1016/j.parepi.2021.e00203] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/03/2020] [Accepted: 01/13/2021] [Indexed: 12/02/2022] Open
Abstract
Plasmodium vivax has high morbidity, it is the Plasmodium species with the greatest worldwide distribution, and its ability to trigger severe symptoms is currently recognized. The present study aims to compare the clinical and epidemiological characteristics of patients with P. vivax malaria, with and without complication criteria, in an endemic area for malaria transmission in northwest Colombia. A descriptive cross-sectional study was carried out between 2017 and 2019, patients with P.vivax severe malaria (n = 50), non-severe malaria (n = 56) and healthy controls (n = 50) were included. Sociodemographic, clinical, hematological, and biochemical characteristics were analyzed. Clinical follow-up was carried out in a group of patients with severe malaria. The statistical analysis was carried out in GraphPad Prism; the Chi-square test analyzed categorical variables, comparisons of variables for the three groups were carried out by the Kruskal-Wallis test and comparison between two groups by the Mann-Whitney test. A multiple correspondence analysis described the relationship between variables, which was carried out through the R software. One hundred fifty-six individuals were linked to the study, 76 women and 80 men, between 3 and 71 years old. For 50% of the patients, it was their first malaria episode; 42% of the patients classified with severe malaria required hospitalization, compared to 7.1% of the patients with non-severe malaria. Parasitaemia was similar in both clinical groups; however, 10% of severe patients presented high parasitemia, between 20,000-135,000. The most frequent clinical characteristics in patients with severe malaria were severe thrombocytopenia in 54%, hypoglycemia in 48%, and liver and kidney failure in 30%. Biochemical and hematological parameters returned to normal in 90% of the patients with severe malaria on the third day after starting treatment. Thrombocytopenia, hypoglycemia, and liver and kidney dysfunctions were the most frequent P. vivax malaria complications in this study. Hemoglobin concentration and parasite count were not related to the clinical condition of patients. Thrombocytopenia was the most frequent finding in patients with malaria, and its severity presented an inverse relationship with the number of previous malaria episodes. Severe malaria by P. vivax in an endemic area Parasite count is not related to P. vivax complications Thrombocytopenia is the most frequent hematologic complications due to P. vivax
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Affiliation(s)
- Catalina Tovar-Acero
- Grupo Investigaciones Microbiológicas y Biomédicas de Córdoba, GIMBIC, Universidad de Córdoba.,Grupo de Enfermedades Tropicales y Resistencia Bacteriana, Universidad del Sinú, Montería, Colombia.,Doctorado de Medicina Tropical, SUE Caribe, Universidad de Cartagena, Colombia
| | - María Camila Velasco
- Grupo Investigaciones Microbiológicas y Biomédicas de Córdoba, GIMBIC, Universidad de Córdoba
| | | | | | - Erasmo Manuel Alvis
- Grupo Investigaciones Microbiológicas y Biomédicas de Córdoba, GIMBIC, Universidad de Córdoba
| | - Javier Ramirez-Montoya
- Grupo Investigaciones Microbiológicas y Biomédicas de Córdoba, GIMBIC, Universidad de Córdoba
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Klompas AM, Boswell MR, Plack DL, Smith MM. Thrombocytopenia: Perioperative Considerations for Patients Undergoing Cardiac Surgery. J Cardiothorac Vasc Anesth 2021; 36:893-905. [PMID: 33707107 DOI: 10.1053/j.jvca.2021.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 11/11/2022]
Abstract
The etiologies of thrombocytopenia in patients presenting for cardiac surgery are extensive, but clinically relevant conditions generally can be categorized by those related to decreased platelet production or increased platelet destruction. Many causes require mere acknowledgment and availability of allogeneic platelet transfusion; others have unique considerations for which providers should be familiar. The purpose of this review is to provide an overview of the common causes of thrombocytopenia, summarize the literature, and discuss perioperative considerations for patients undergoing cardiac surgery.
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Affiliation(s)
- Allan M Klompas
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, 200 First St SW, Rochester, MN
| | - Michael R Boswell
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, 200 First St SW, Rochester, MN
| | - Daniel L Plack
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, 200 First St SW, Rochester, MN
| | - Mark M Smith
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, 200 First St SW, Rochester, MN.
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Del-Tejo PL, Cubas-Vega N, Caraballo-Guerra C, da Silva BM, da Silva Valente J, Sampaio VS, Baia-da-Silva DC, Castro DB, Martinez-Espinosa FE, Siqueira AM, Lacerda MVG, Monteiro WM, Val F. Should we care about Plasmodium vivax and HIV co-infection? A systematic review and a cases series from the Brazilian Amazon. Malar J 2021; 20:13. [PMID: 33407474 PMCID: PMC7788992 DOI: 10.1186/s12936-020-03518-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 11/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria and HIV are two important public health issues. However, evidence on HIV-Plasmodium vivax co-infection (HIV/PvCo) is scarce, with most of the available information related to Plasmodium falciparum on the African continent. It is unclear whether HIV can change the clinical course of vivax malaria and increase the risk of complications. In this study, a systematic review of HIV/PvCo studies was performed, and recent cases from the Brazilian Amazon were included. METHODS Medical records from a tertiary care centre in the Western Brazilian Amazon (2009-2018) were reviewed to identify HIV/PvCo hospitalized patients. Demographic, clinical and laboratory characteristics and outcomes are reported. Also, a systematic review of published studies on HIV/PvCo was conducted. Metadata, number of HIV/PvCo cases, demographic, clinical, and outcome data were extracted. RESULTS A total of 1,048 vivax malaria patients were hospitalized in the 10-year period; 21 (2.0%) were HIV/PvCo cases, of which 9 (42.9%) had AIDS-defining illnesses. This was the first malaria episode in 11 (52.4%) patients. Seven (33.3%) patients were unaware of their HIV status and were diagnosed on hospitalization. Severe malaria was diagnosed in 5 (23.8%) patients. One patient died. The systematic review search provided 17 articles (12 cross-sectional or longitudinal studies and 5 case report studies). A higher prevalence of studies involved cases in African and Asian countries (35.3 and 29.4%, respectively), and the prevalence of reported co-infections ranged from 0.1 to 60%. CONCLUSION Reports of HIV/PvCo are scarce in the literature, with only a few studies describing clinical and laboratory outcomes. Systematic screening for both co-infections is not routinely performed, and therefore the real prevalence of HIV/PvCo is unknown. This study showed a low prevalence of HIV/PvCo despite the high prevalence of malaria and HIV locally. Even though relatively small, this is the largest case series to describe HIV/PvCo.
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Affiliation(s)
- Paola López Del-Tejo
- Programa de Pós-Graduação Em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Nadia Cubas-Vega
- Programa de Pós-Graduação Em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Cecilia Caraballo-Guerra
- Programa de Pós-Graduação Em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Bernardo Maia da Silva
- Programa de Pós-Graduação Em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Jefferson da Silva Valente
- Programa de Pós-Graduação Em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Vanderson Souza Sampaio
- Programa de Pós-Graduação Em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
- Fundação de Vigilância em Saúde do Amazonas, Manaus, Brazil
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal Do Amazonas, Manaus, Brazil
| | - Djane Clarys Baia-da-Silva
- Programa de Pós-Graduação Em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | | | - Flor Ernestina Martinez-Espinosa
- Programa de Pós-Graduação Em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
- Instituto Leônidas and Maria Deane, FIOCRUZ, Manaus, Brazil
| | | | - Marcus Vinícius Guimarães Lacerda
- Programa de Pós-Graduação Em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
- Instituto Leônidas and Maria Deane, FIOCRUZ, Manaus, Brazil
| | - Wuelton Marcelo Monteiro
- Programa de Pós-Graduação Em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
| | - Fernando Val
- Programa de Pós-Graduação Em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil.
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil.
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal Do Amazonas, Manaus, Brazil.
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Patel H, Dunican C, Cunnington AJ. Predictors of outcome in childhood Plasmodium falciparum malaria. Virulence 2020; 11:199-221. [PMID: 32063099 PMCID: PMC7051137 DOI: 10.1080/21505594.2020.1726570] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/16/2020] [Accepted: 01/20/2020] [Indexed: 12/16/2022] Open
Abstract
Plasmodium falciparum malaria is classified as either uncomplicated or severe, determining clinical management and providing a framework for understanding pathogenesis. Severe malaria in children is defined by the presence of one or more features associated with adverse outcome, but there is wide variation in the predictive value of these features. Here we review the evidence for the usefulness of these features, alone and in combination, to predict death and other adverse outcomes, and we consider the role that molecular biomarkers may play in augmenting this prediction. We also examine whether a more personalized approach to predicting outcome for specific presenting syndromes of severe malaria, particularly cerebral malaria, has the potential to be more accurate. We note a general need for better external validation in studies of outcome predictors and for the demonstration that predictors can be used to guide clinical management in a way that improves survival and long-term health.
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Affiliation(s)
- Harsita Patel
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK
| | - Claire Dunican
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK
| | - Aubrey J. Cunnington
- Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, UK
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Stanly TA, Suman R, Rani GF, O’Toole PJ, Kaye PM, Hitchcock IS. Quantitative Optical Diffraction Tomography Imaging of Mouse Platelets. Front Physiol 2020; 11:568087. [PMID: 33041864 PMCID: PMC7526686 DOI: 10.3389/fphys.2020.568087] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/25/2020] [Indexed: 11/13/2022] Open
Abstract
Platelets are specialized anucleate cells that play a major role in hemostasis following vessel injury. More recently, platelets have also been implicated in innate immunity and inflammation by directly interacting with immune cells and releasing proinflammatory signals. It is likely therefore that in certain pathologies, such as chronic parasitic infections and myeloid malignancies, platelets can act as mediators for hemostatic and proinflammatory responses. Fortunately, murine platelet function ex vivo is highly analogous to human, providing a robust model for functional comparison. However, traditional methods of studying platelet phenotype, function and activation status often rely on using large numbers of whole isolated platelet populations, which severely limits the number and type of assays that can be performed with mouse blood. Here, using cutting edge 3D quantitative phase imaging, holotomography, that uses optical diffraction tomography (ODT), we were able to identify and quantify differences in single unlabeled, live platelets with minimal experimental interference. We analyzed platelets directly isolated from whole blood of mice with either a JAK2V617F-positive myeloproliferative neoplasm (MPN) or Leishmania donovani infection. Image analysis of the platelets indicates previously uncharacterized differences in platelet morphology, including altered cell volume and sphericity, as well as changes in biophysical parameters such as refractive index (RI) and dry mass. Together, these data indicate that, by using holotomography, we were able to identify clear disparities in activation status and potential functional ability in disease states compared to control at the level of single platelets.
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Affiliation(s)
- Tess A. Stanly
- York Biomedical Research Institute, Department of Biology, University of York, York, United Kingdom
| | - Rakesh Suman
- Technology Facility, Department of Biology, University of York, York, United Kingdom
| | - Gulab Fatima Rani
- York Biomedical Research Institute, Hull York Medical School, University of York, York, United Kingdom
| | - Peter J. O’Toole
- Technology Facility, Department of Biology, University of York, York, United Kingdom
| | - Paul M. Kaye
- York Biomedical Research Institute, Hull York Medical School, University of York, York, United Kingdom
| | - Ian S. Hitchcock
- York Biomedical Research Institute, Department of Biology, University of York, York, United Kingdom
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Kraisin S, Martinod K, Desender L, Pareyn I, Verhenne S, Deckmyn H, Vanhoorelbeke K, Van den Steen PE, De Meyer SF. von Willebrand factor increases in experimental cerebral malaria but is not essential for late-stage pathogenesis in mice. J Thromb Haemost 2020; 18:2377-2390. [PMID: 32485089 DOI: 10.1111/jth.14932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 04/24/2020] [Accepted: 05/19/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Cerebral malaria (CM) is the most severe complication of malaria. Endothelial activation, cytokine release, and vascular obstruction are essential hallmarks of CM. Clinical studies have suggested a link between von Willebrand factor (VWF) and malaria pathology. OBJECTIVES To investigate the contribution of VWF in the pathogenesis of experimental cerebral malaria (ECM). METHODS Both Vwf+/+ and Vwf-/- mice were infected with Plasmodium berghei ANKA (PbANKA) to induce ECM. Alterations of plasma VWF and ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13), platelet count, neurological features, and accumulation of platelets and leukocytes in the brain were examined following infection. RESULTS Plasma VWF levels significantly increased upon PbANKA infection in Vwf+/+ animals. While ADAMTS13 activity was not affected, high molecular weight VWF multimers disappeared at the end-stage ECM, possibly due to an ongoing hypercoagulability. Although the number of reticulocytes, a preferential target for the parasites, was increased in Vwf-/- mice compared to Vwf+/+ mice early after infection, parasitemia levels did not markedly differ between the two groups. Interestingly, Vwf-/- mice manifested overall clinical ECM features similar to those observed in Vwf+/+ animals. At day 8.5 post-infection, however, clinical ECM features in Vwf-/- mice were slightly more beneficial than in Vwf+/+ animals. Despite these minor differences, overall survival was not different between Vwf-/- and Vwf+/+ mice. Similarly, PbANKA-induced thrombocytopenia, leukocyte, and platelet accumulations in the brain were not altered by the absence of VWF. CONCLUSIONS Our study suggests that increased VWF concentration is a hallmark of ECM. However, VWF does not have a major influence in modulating late-stage ECM pathogenesis.
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Affiliation(s)
- Sirima Kraisin
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Kimberly Martinod
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
- Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Linda Desender
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Inge Pareyn
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Sebastien Verhenne
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Hans Deckmyn
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Karen Vanhoorelbeke
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Philippe E Van den Steen
- Laboratory of Immunoparasitology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Simon F De Meyer
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
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Dos-Santos JCK, Silva-Filho JL, Judice CC, Kayano ACAV, Aliberti J, Khouri R, de Lima DS, Nakaya H, Lacerda MVG, De Paula EV, Lopes SCP, Costa FTM. Platelet disturbances correlate with endothelial cell activation in uncomplicated Plasmodium vivax malaria. PLoS Negl Trop Dis 2020; 14:e0007656. [PMID: 32687542 PMCID: PMC7392343 DOI: 10.1371/journal.pntd.0007656] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 07/30/2020] [Accepted: 05/30/2020] [Indexed: 12/14/2022] Open
Abstract
Platelets drive endothelial cell activation in many diseases. However, if this occurs in Plasmodium vivax malaria is unclear. As platelets have been reported to be activated and to play a role in inflammatory response during malaria, we hypothesized that this would correlate with endothelial alterations during acute illness. We performed platelet flow cytometry of PAC-1 and P-selectin. We measured platelet markers (CXCL4, CD40L, P-selectin, Thrombopoietin, IL-11) and endothelial activation markers (ICAM-1, von Willebrand Factor and E-selectin) in plasma with a multiplex-based assay. The values of each mediator were used to generate heatmaps, K-means clustering and Principal Component analysis. In addition, we determined pair-wise Pearson’s correlation coefficients to generate correlation networks. Platelet counts were reduced, and mean platelet volume increased in malaria patients. The activation of circulating platelets in flow cytometry did not differ between patients and controls. CD40L levels (Median [IQ]: 517 [406–651] vs. 1029 [732–1267] pg/mL, P = 0.0001) were significantly higher in patients, while P-selectin and CXCL4 showed a nonsignificant trend towards higher levels in patients. The network correlation approach demonstrated the correlation between markers of platelet and endothelial activation, and the heatmaps revealed a distinct pattern of activation in two subsets of P. vivax patients when compared to controls. Although absolute platelet activation was not strong in uncomplicated vivax malaria, markers of platelet activity and production were correlated with higher endothelial cell activation, especially in a specific subset of patients. Endothelial cell activation is a key process in the pathogenesis of Plasmodium vivax malaria. Platelets are classically involved in endothelial cell activation in several diseases, but their role in the context of vivax malaria remains unclear. Thrombocytopenia is the most common hematological disturbance in P. vivax-infected patients, and platelets have been implicated in parasitemia control. In this work, we studied the activation of platelets in association with endothelial cell activation in vivax malaria. Platelets retrieved from infected peripheral blood were non-activated when analyzed by flow cytometry; however, they displayed higher mean volume and significantly reduced counts. We also found higher levels of circulating factors associated with platelet activation (especially soluble CD40L), thrombopoiesis and endothelial cell activation in infected patients. Further, through pair-wise correlation and clustering analysis, we found a subgroup of patients showing significant associations between markers of platelet and endothelial activation in a pattern different from that of endemic controls. Collectively, our findings indicate a role of platelets in endothelial cell activation in vivax malaria and indicate a heterogeneous host response in the setting of uncomplicated disease, a finding to be further explored in future studies.
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Affiliation(s)
- João Conrado Khouri Dos-Santos
- Laboratório de Doenças Tropicais–Prof. Luiz Jacintho da Silva. Instituto de Biologia, Universidade Estadual de Campinas, Campinas, Brazil
- Pós-graduação em Fisiopatologia Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brazil
| | - João Luiz Silva-Filho
- Laboratório de Doenças Tropicais–Prof. Luiz Jacintho da Silva. Instituto de Biologia, Universidade Estadual de Campinas, Campinas, Brazil
| | - Carla C. Judice
- Laboratório de Doenças Tropicais–Prof. Luiz Jacintho da Silva. Instituto de Biologia, Universidade Estadual de Campinas, Campinas, Brazil
| | - Ana Carolina Andrade Vitor Kayano
- Laboratório de Doenças Tropicais–Prof. Luiz Jacintho da Silva. Instituto de Biologia, Universidade Estadual de Campinas, Campinas, Brazil
| | - Júlio Aliberti
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America
| | - Ricardo Khouri
- Instituto Gonçalo Moniz, Fiocruz Bahia, Salvador, Brazil
| | - Diógenes S. de Lima
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of Sao Paulo, São Paulo, Brazil
| | - Helder Nakaya
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of Sao Paulo, São Paulo, Brazil
| | - Marcus Vinicius Guimarães Lacerda
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Brazil
- Instituto Leônidas & Maria Deane, Fiocruz Amazônia, Manaus, Brazil
| | - Erich Vinicius De Paula
- Centro de Hematologia e Hemoterapia–Hemocentro, Universidade Estadual de Campinas, Campinas, Brazil
| | | | - Fabio Trindade Maranhão Costa
- Laboratório de Doenças Tropicais–Prof. Luiz Jacintho da Silva. Instituto de Biologia, Universidade Estadual de Campinas, Campinas, Brazil
- * E-mail:
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Costa AG, Chaves YO, Teixeira-Carvalho A, Ramasawmy R, Antonelli LRV, Barbosa L, Balieiro A, Monteiro WM, Mourão MP, Lacerda MVG, Martins-Filho OA, Costa FTM, Malheiro A, Nogueira PA. Increased platelet distribution width and reduced IL-2 and IL-12 are associated with thrombocytopenia in Plasmodium vivax malaria. Mem Inst Oswaldo Cruz 2020; 115:e200080. [PMID: 32696915 PMCID: PMC7367212 DOI: 10.1590/0074-02760200080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 06/26/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Thrombocytopenia in malaria involves platelet destruction and consumption; however, the cellular response underlying this phenomenon has still not been elucidated. OBJECTIVE To find associations between platelet indices and unbalanced Th1/Th2/Th17 cytokines as a response to thrombocytopenia in Plasmodium vivax infected (Pv-MAL) patients. METHODS Platelet counts and quantification of Th1/Th2/Th17 cytokine levels were compared in 77 patients with uncomplicated P. vivax malaria and 37 healthy donors from the same area (endemic control group - ENCG). FINDINGS Thrombocytopenia was the main manifestation in 55 patients, but was not associated with parasitaemia. The Pv-MAL patients showed increases in the mean platelet volume (MPV), which may be consistent with larger or megaplatelets. Contrary to the findings regarding the endemic control group, MPV and platelet distribution width (PDW) did not show an inverse correlation, due the increase in the heterogeneity of platelet width. In addition, the Pv-MAL patients presented increased IL-1β and reduced IL-12p70 and IL-2 serum concentrations. Furthermore, the reduction of these cytokines was associated with PDW values. MAIN CONCLUSIONS Our data demonstrate that an increase in MPV and the association between reductions of IL-2 and IL-12 and PDW values may be an immune response to thrombocytopenia in uncomplicated P. vivax malaria.
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Affiliation(s)
- Allyson Guimarães Costa
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Instituto de Pesquisa Clínica Carlos Borborema, Manaus, AM, Brasil.,Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Diretoria de Ensino e Pesquisa, Manaus, AM, Brasil.,Universidade do Estado do Amazonas, Programa de Pós-Graduação em Ciências Aplicadas à Hematologia, Manaus, AM, Brasil.,Universidade Federal do Amazonas, Programa de Pós-Graduação em Imunologia Básica e Aplicada, Manaus, AM, Brasil
| | - Yury Oliveira Chaves
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Biologia da Relação Patógeno-Hospedeiro, Manaus, AM, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Programa de Pós-Graduação em Biologia Parasitária, Rio de Janeiro, RJ, Brasil
| | - Andréa Teixeira-Carvalho
- Fundação Oswaldo Cruz-Fiocruz, Centro de Pesquisas René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brasil
| | - Rajendranath Ramasawmy
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Instituto de Pesquisa Clínica Carlos Borborema, Manaus, AM, Brasil.,Universidade Federal do Amazonas, Programa de Pós-Graduação em Imunologia Básica e Aplicada, Manaus, AM, Brasil.,Universidade Nilton Lins, Faculdade de Medicina, Manaus, AM, Brasil
| | - Lis Ribeiro Valle Antonelli
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Laboratório de Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
| | - Lucas Barbosa
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Biologia da Relação Patógeno-Hospedeiro, Manaus, AM, Brasil
| | - Antonio Balieiro
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Biologia da Relação Patógeno-Hospedeiro, Manaus, AM, Brasil
| | - Wuelton Marcelo Monteiro
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Instituto de Pesquisa Clínica Carlos Borborema, Manaus, AM, Brasil
| | - Maria Paula Mourão
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Instituto de Pesquisa Clínica Carlos Borborema, Manaus, AM, Brasil
| | - Marcus Vinicius Guimarães Lacerda
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Instituto de Pesquisa Clínica Carlos Borborema, Manaus, AM, Brasil.,Universidade do Estado do Amazonas, Programa de Pós-Graduação em Ciências Aplicadas à Hematologia, Manaus, AM, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Biologia da Relação Patógeno-Hospedeiro, Manaus, AM, Brasil
| | - Olindo Assis Martins-Filho
- Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Diretoria de Ensino e Pesquisa, Manaus, AM, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Centro de Pesquisas René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brasil
| | | | - Adriana Malheiro
- Universidade do Estado do Amazonas, Programa de Pós-Graduação em Medicina Tropical, Manaus, AM, Brasil.,Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Diretoria de Ensino e Pesquisa, Manaus, AM, Brasil.,Universidade do Estado do Amazonas, Programa de Pós-Graduação em Ciências Aplicadas à Hematologia, Manaus, AM, Brasil.,Universidade Federal do Amazonas, Programa de Pós-Graduação em Imunologia Básica e Aplicada, Manaus, AM, Brasil
| | - Paulo Afonso Nogueira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Biologia da Relação Patógeno-Hospedeiro, Manaus, AM, Brasil
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Mutala AH, Badu K, Owusu C, Agordzo SK, Tweneboah A, Abbas DA, Addo MG. Impact of malaria on haematological parameters of urban, peri-urban and rural residents in the Ashanti region of Ghana: a cross-sectional study. AAS Open Res 2020; 2:27. [PMID: 32704620 PMCID: PMC7355218 DOI: 10.12688/aasopenres.12979.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2020] [Indexed: 01/26/2023] Open
Abstract
Background: We aimed at investigating the impact of malaria on the haematological parameters of residents from different demographic settlements in the Ashanti Region of Ghana. Malaria parasites trigger changes in certain haematological parameters, which may result in a number of clinical manifestations. Differences in demographic settlements, such as rural, peri-urban and urban settlements may also influence these changes, but this has not been extensively studied in Ghana. Methods: We conducted a hospital-based, cross-sectional study from January to December 2018 in three different settlements. A total of 598 participants were recruited. Blood smears were examined to detect and quantify malaria parasitaemia, while haematological parameters were measured using a haematology analyser. Results: Participants from the rural settlement had the highest malaria prevalence (21.3%) compared to urban (11.8%) and peri-urban areas (13.3%); however, the peri-urban area had the highest median parasite density (568; IQR=190.0-1312.0). Age was significantly associated with the odds of malaria positivity (OR: 0.97; CI:0.96 - 0.99; p=4.96*10 -4). When haematological parameters of the malaria-infected study participants were compared to the parameters of uninfected participants, red blood cell count (p=0.017), haemoglobin (p=0.0165), haematocrit (p=0.0015), mean corpuscular volume (p=0.0014), plateletcrit (p<0.0001) and platelet count (p<0.0001) were all significantly lower in the malaria infected group. In addition to age, haemoglobin and plateletcrit levels were also inversely correlated with the odds of testing positive for malaria, suggesting that children who were anaemic and/or thrombocytopaenic were likely to be infected. After fitting the data to a logistic regression model comprising the three variables, the model correctly categorised 78% of uninfected study participants, but only 50% of the malaria-positive participants. Conclusions: Study participants who were positive for malaria were younger and had low haemoglobin and plateletcrit levels compared to uninfected individuals. Further studies are needed to more precisely elucidate the relationship between malaria infection,demographic and haematological parameters.
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Affiliation(s)
- Abdul-Hakim Mutala
- Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
| | - Kingsley Badu
- Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
- Kumasi Center for Collaborative Research for Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
| | - Christian Owusu
- Kumasi Center for Collaborative Research for Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
| | - Samuel Kekeli Agordzo
- Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
| | - Austine Tweneboah
- Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
- Kumasi Center for Collaborative Research for Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
| | - Dawood Ackom Abbas
- Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
| | - Matthew Glover Addo
- Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
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de Azevedo-Quintanilha IG, Medeiros-de-Moraes IM, Ferreira AC, Reis PA, Vieira-de-Abreu A, Campbell RA, Weyrich AS, Bozza PT, Zimmerman GA, Castro-Faria-Neto HC. Haem oxygenase protects against thrombocytopaenia and malaria-associated lung injury. Malar J 2020; 19:234. [PMID: 32611348 PMCID: PMC7327213 DOI: 10.1186/s12936-020-03305-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/20/2020] [Indexed: 11/10/2022] Open
Abstract
Background Malaria-triggered lung injury can occur in both severe and non-severe cases. Platelets may interact with parasitized erythrocytes, leukocytes and endothelium. These interactions can lead to microvessel obstructions and induce release of inflammatory mediators. Induction of the haem oxygenase enzyme is important in the host’s response to free haem and to several other molecules generated by infectious or non-infectious diseases. In addition, an important role for the haem oxygenase-1 isotype has been demonstrated in experimental cerebral malaria and in clinical cases. Therefore, the present work aims to determine the influence of haem oxygenase in thrombocytopaenia and acute pulmonary injury during infection with Plasmodium berghei strain NK65. Methods C57BL/6 mice were infected with P. berghei and analysed 7-10 days post-infection. For each experiment, Cobalt Protoporphyrin IX/CoPPIX or saline were administered. Bronchoalveolar lavage fluid was used for total and differential leukocyte count and for protein measurement. Lungs were used for histological analyses or for analysis of cytokines and western blotting. The lung permeability was analysed by Evans blue dye concentration. Platelet-leukocyte aggregate formation was assayed using the flow cytometer. Results Plasmodium berghei NK65 infection generated an intense lung injury, with increased levels of inflammatory mediators, oedema, and cell migration into the lung. Plasmodium berghei infection was also accompanied by marked thrombocytopaenia and formation of platelet-leukocyte aggregates in peripheral blood. Treatment with the HO-1 inducer cobalt protoporphyrin IX (CoPPIX) modified the inflammatory response but did not affect the evolution of parasitaemia. Animals treated with CoPPIX showed an improvement in lung injury, with decreased inflammatory infiltrate in the lung parenchyma, oedema and reduced thrombocytopaenia. Conclusion Data here presented suggest that treatment with CoPPIX inducer leads to less severe pulmonary lung injury and thrombocytopaenia during malaria infection, thus increasing animal survival.
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Affiliation(s)
| | | | - André C Ferreira
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.,Universidade Iguaçu, Nova Iguaçu, RJ, Brazil
| | - Patrícia A Reis
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Adriana Vieira-de-Abreu
- Division of Endocrinology, Metabolism, and Diabetes, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Robert A Campbell
- Department of Internal Medicine and Program in Molecular Medicine, University of Utah, Salt Lake City, UT, USA
| | - Andrew S Weyrich
- Department of Internal Medicine and Program in Molecular Medicine, University of Utah, Salt Lake City, UT, USA
| | - Patricia T Bozza
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Guy A Zimmerman
- Department of Internal Medicine and Program in Molecular Medicine, University of Utah, Salt Lake City, UT, USA
| | - Hugo C Castro-Faria-Neto
- Laboratório de Imunofarmacologia, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Brito MAM, Baro B, Raiol TC, Ayllon-Hermida A, Safe IP, Deroost K, Figueiredo EFG, Costa AG, Armengol MDP, Sumoy L, Almeida ACG, Hounkpe BW, De Paula EV, Fernandez-Becerra C, Monteiro WM, Del Portillo HA, Lacerda MVG. Morphological and Transcriptional Changes in Human Bone Marrow During Natural Plasmodium vivax Malaria Infections. J Infect Dis 2020; 225:1274-1283. [PMID: 32556188 PMCID: PMC8974851 DOI: 10.1093/infdis/jiaa177] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 06/08/2020] [Indexed: 12/31/2022] Open
Abstract
Background The presence of Plasmodium vivax malaria parasites in the human bone marrow (BM) is still controversial. However, recent data from a clinical case and experimental infections in splenectomized nonhuman primates unequivocally demonstrated the presence of parasites in this tissue. Methods In the current study, we analyzed BM aspirates of 7 patients during the acute attack and 42 days after drug treatment. RNA extracted from CD71+ cell suspensions was used for sequencing and transcriptomic analysis. Results We demonstrated the presence of parasites in all patients during acute infections. To provide further insights, we purified CD71+ BM cells and demonstrated dyserythropoiesis and inefficient erythropoiesis in all patients. In addition, RNA sequencing from 3 patients showed that genes related to erythroid maturation were down-regulated during acute infections, whereas immune response genes were up-regulated. Conclusions This study thus shows that during P. vivax infections, parasites are always present in the BM and that such infections induced dyserythropoiesis and ineffective erythropoiesis. Moreover, infections induce transcriptional changes associated with such altered erythropoietic response, thus highlighting the importance of this hidden niche during natural infections.
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Affiliation(s)
- Marcelo A M Brito
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Bàrbara Baro
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Tainá C Raiol
- Fiocruz Brasilia, Oswaldo Cruz Foundation, Brasilia, Brazil
| | | | - Izabella P Safe
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | - Katrien Deroost
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, Brazil
| | - Erick F G Figueiredo
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Allyson G Costa
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Maria Del P Armengol
- Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - Lauro Sumoy
- Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - Anne C G Almeida
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | | | - Erich V De Paula
- University of Campinas, Campinas, São Paulo, Brazil.,Hematology and Hemotherapy Foundation from Amazonas State, Manaus, Amazonas, Brazil
| | - Cármen Fernandez-Becerra
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - Wuelton M Monteiro
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil
| | - Hernando A Del Portillo
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain.,Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Marcus V G Lacerda
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Amazonas, Brazil.,Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.,Instituto Leônidas & Maria Deane, Fiocruz, Manaus, Amazonas, Brazil
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47
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Mourão LC, Cardoso-Oliveira GP, Braga ÉM. Autoantibodies and Malaria: Where We Stand? Insights Into Pathogenesis and Protection. Front Cell Infect Microbiol 2020; 10:262. [PMID: 32596165 PMCID: PMC7300196 DOI: 10.3389/fcimb.2020.00262] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/04/2020] [Indexed: 12/16/2022] Open
Abstract
Autoantibodies are frequently reported in patients with malaria, but whether they contribute to protection or to pathology is an issue of debate. A large body of evidence indicates that antibodies against host-self components are associated to malaria clinical outcomes such as cerebral malaria, renal dysfunction and anemia. Nonetheless, self-reactive immunoglobulins induced during an infection can also mediate protection. In light of these controversies, we summarize here the latest findings in our understanding of autoimmune responses in malaria, focusing on Plasmodium falciparum and Plasmodium vivax. We review the main targets of self-antibody responses in malaria as well as the current, but still limited, knowledge of their role in disease pathogenesis or protection.
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Affiliation(s)
- Luiza Carvalho Mourão
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Érika Martins Braga
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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48
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Mutala AH, Badu K, Owusu C, Agordzo SK, Tweneboah A, Abbas DA, Addo MG. Impact of malaria on haematological parameters of urban, peri-urban and rural residents in the Ashanti region of Ghana: a cross-sectional study. AAS Open Res 2020; 2:27. [PMID: 32704620 PMCID: PMC7355218 DOI: 10.12688/aasopenres.12979.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2020] [Indexed: 03/30/2024] Open
Abstract
Background: We aimed at investigating the impact of malaria on the haematological parameters of residents from different demographic settlements in the Ashanti Region of Ghana. Malaria parasites trigger changes in certain haematological parameters, which may result in a number of clinical manifestations. Differences in demographic settlements, such as rural, peri-urban and urban settlements may also influence these changes, but this has not been extensively studied in Ghana. Methods: We conducted a hospital-based, cross-sectional study from January to December 2018 in three different settlements. A total of 598 participants were recruited. Blood smears were examined to detect and quantify malaria parasitaemia, while haematological parameters were measured using a haematology analyser. Results: Participants from the rural settlement had the highest malaria prevalence (21.3%) compared to the urban (11.8%) and peri-urban areas (13.3%); however, the peri-urban area had the highest median parasite density (568; IQR=190.0-1312.0). Age was significantly associated with the odds of malaria positivity (OR: 0.97; CI:0.96 - 0.99). When haematological parameters of the malaria-infected study participants were compared to the parameters of uninfected participants, red blood cell count (p=0.017), haemoglobin (p=0.0165), haematocrit (p=0.0015), mean corpuscular volume (p=0.0014), plateletcrit (p<0.0001) and platelet count (p<0.0001) were all significantly lower in the malaria infected group. In addition to age, haemoglobin and plateletcrit levels were also inversely correlated with the odds of testing positive for malaria, suggesting that children who were anaemic and/or thrombocytopaenic were likely to be infected. After fitting the data to a logistic regression model comprising the three variables, the model correctly categorised 78% of uninfected study participants, but only 50% of the malaria-positive participants. Conclusions: Study participants who were positive for malaria were younger and had low haemoglobin and plateletcrit levels compared to uninfected individuals. Further studies are needed to more precisely elucidate the relationship between malaria infection,demographic and haematological parameters.
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Affiliation(s)
- Abdul-Hakim Mutala
- Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
| | - Kingsley Badu
- Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
- Kumasi Center for Collaborative Research for Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
| | - Christian Owusu
- Kumasi Center for Collaborative Research for Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
| | - Samuel Kekeli Agordzo
- Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
| | - Austine Tweneboah
- Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
- Kumasi Center for Collaborative Research for Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
| | - Dawood Ackom Abbas
- Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
| | - Matthew Glover Addo
- Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
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Assessment of Hematological Parameters in Malaria, among Adult Patients Attending the Bamenda Regional Hospital. Anemia 2020; 2020:3814513. [PMID: 32373360 PMCID: PMC7191389 DOI: 10.1155/2020/3814513] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/05/2020] [Accepted: 04/07/2020] [Indexed: 11/18/2022] Open
Abstract
Malaria, which is responsible for a substantial amount of deaths in endemic countries, has been shown to have both direct and indirect effects on the hematological parameters. Notwithstanding, some hematological parameters among populations living in malaria endemic regions have not been described consistently, as a standard for measuring malaria burden. Based on the above fact, this study was designed to assess some hematological changes and their diagnostic values in malaria infected patients. A total of 160 malaria positive adult patients, together with 81 healthy control adults were recruited for the study. For the malaria positive group, the female to male ratio was 1.38 : 1. Specifically, 74.38%, 10.00%, and 15.62% of those in the malaria positive group had mild, moderate, and severe parasitaemia, respectively. Leukemia, anemia, and thrombocytopenia were found to be significantly associated with malaria and were all estimated to be specific for the diagnosis of malaria. Anemia was, however, estimated to be both sensitive and specific for malaria diagnosis. Therefore, anemia offers the most diagnostic value in the malaria infected patients of this study.
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50
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Nunes AJD, Alvarenga DAMD, de Souza Junior JC, Peruchi AR, Gonçalves GHP, Hirano ZMB, Brito CFAD, Cremer MJ. Plasmodium infection and its association with biochemical and haematological parameters in free-living Alouatta guariba clamitans (Cabrera, 1940) (Primates: Atelidae) in Southern Brazil. Mem Inst Oswaldo Cruz 2020; 114:e190210. [PMID: 32022168 PMCID: PMC6996493 DOI: 10.1590/0074-02760190210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 12/09/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The influence of Plasmodium spp. infection in the health of
Southern brown howler monkey, Alouatta guariba clamitans,
the main reservoir of malaria in the Atlantic Forest, is still unknown. OBJECTIVES The aim of this study was to investigate the positivity rate of
Plasmodium infection in free-living howler monkeys in
an Atlantic Forest fragment in Joinville/SC and to associate the infection
with clinical, morphometrical, haematological and biochemical
alterations. METHODS Molecular diagnosis of Plasmodium infection in the captured
monkeys was performed by Nested-polymerase chain reaction
(PCR) (18S rRNA and coxI). Haematological and biochemical
parameters were compared among infected and uninfected monkeys; clinical and
morphometrical parameters were also compared. FINDINGS The positivity rate of Plasmodium infection was 70% among
forty captured animals, the highest reported for neotropical primates. None
statistical differences were detected in the clinical parameters, and
morphometric measures comparing infected and uninfected groups. The main
significant alteration was the higher alanine aminotransferase (ALT) levels
in infected compared to uninfected monkeys. MAIN CONCLUSIONS Therefore, Plasmodium infection in howler monkeys may
causes haematological/biochemical alterations which might suggest hepatic
impairment. Moreover, infection must be monitored for the
eco-epidemiological surveillance of malaria in the Atlantic Forest and
during primate conservation program that involves the animal movement, such
as translocations.
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Affiliation(s)
- Ana Júlia Dutra Nunes
- Universidade da Região de Joinville, Programa de Saúde e Meio Ambiente, Joinville, SC, Brasil
| | | | - Julio Cesar de Souza Junior
- Universidade Regional de Blumenau, Centro de Pesquisas Biológicas de Indaial, Projeto Bugio, Indaial, SC, Brasil
| | - Amanda Rezende Peruchi
- Universidade Regional de Blumenau, Centro de Pesquisas Biológicas de Indaial, Projeto Bugio, Indaial, SC, Brasil
| | | | - Zelinda Maria Braga Hirano
- Universidade Regional de Blumenau, Centro de Pesquisas Biológicas de Indaial, Projeto Bugio, Indaial, SC, Brasil
| | | | - Marta Jussara Cremer
- Universidade da Região de Joinville, Programa de Saúde e Meio Ambiente, Joinville, SC, Brasil.,Universidade da Região de Joinville, Laboratório de Ecologia e Conservação de Tetrápodes Marinhos e Costeiros, São Francisco do Sul, SC, Brasil
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