Neutrophils are essential innate immune cells that extrude chromatin in the form of neutrophil extracellular traps (NETs) when they die. This form of cell death has potent immunostimulatory activity. We show that heme-induced NETs are essential for malaria pathogenesis. Using patient samples and a mouse model, we define two mechanisms of NET-mediated inflammation of the vasculature: activation of emergency granulopoiesis via granulocyte colony-stimulating factor production and induction of the endothelial cytoadhesion receptor intercellular adhesion molecule–1. Soluble NET components facilitate parasite sequestration and mediate tissue destruction. We demonstrate that neutrophils have a key role in malaria immunopathology and propose inhibition of NETs as a treatment strategy in vascular infections.

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On 1st April 2010, the British Government announced designation of the British Indian Ocean Territory--or Chagos Archipelago--as the world's largest marine protected area (MPA). This near pristine ocean ecosystem now represents 16% of the worlds fully protected coral reef, 60% of the world's no-take protected areas and an uncontaminated reference site for ecological studies. In addition these gains for biodiversity conservation, the Chagos/BIOT MPA also offers subsidiary opportunities to act as a fisheries management tool for the western Indian Ocean, considering its size and location. While the benefits of MPAs for coral-reef dwelling species are established, there is uncertainty about their effects on pelagic migratory species. This paper reviews the increasing body of evidence to demonstrate that positive, measurable reserve effects exist for pelagic populations and that migratory species can benefit from no-take marine reserves.

This document is the work of a team assembled by the International Coral Reef Society (ICRS). The mission of ICRS is to promote the acquisition and dissemination of scientific knowledge to secure the future of coral reefs, including via relevant policy frameworks and decision-making processes. This document seeks to highlight the urgency of taking action to conserve and restore reefs through protection and management measures, to provide a summary of the most relevant and recent natural and social science that provides guidance on these tasks, and to highlight implications of these findings for the numerous discussions and negotiations taking place at the global level.

Background A procoagulant state is implicated in cerebral malaria (CM) pathogenesis, but whether disseminated intravascular coagulation (DIC) is present or associated with fatal outcome is unclear. Objectives To determine the frequency of overt DIC according to International Society on Thrombosis and Haemostasis (ISTH) criteria, in children with fatal and non-fatal CM. Patients/Methods Malawian children were recruited into a prospective cohort study in the following diagnostic groups: retinopathy positive CM (n=140), retinopathy negative CM (n=36), non-malarial coma (n=14), uncomplicated malaria (n=91), mild non-malarial febrile illness (n=85) and healthy controls (n=36). Assays in the ISTH DIC criteria were measured together with 3 fibrin-related markers, protein C, antithrombin and soluble thrombomodulin. Results and Conclusions Data enabling assignment of the presence or absence of ‘overt DIC’ were available in 98/140 children with retinopathy positive CM. Overt DIC was present in 19 (19%) and was associated with fatal outcome (Odds ratio [OR] 3.068; 95% Confidence Interval [CI] 1.085-8.609; P=0.035). The three fibrin-markers and soluble thrombomodulin levels were higher in CM cases than uncomplicated malaria cases (all P=<0.001). Mean fibrin degradation product level was higher in fatal CM (71.3 [95% CI 49.0-93.6]) than non-fatal CM (48.0 [37.7-58.2]; P=0.032), but on multivariate logistic regression, thrombomodulin was the only coagulation related marker independently associated with fatal outcome (OR 1.084 [1.017 - 1.156]; P=0.014). Despite these laboratory derangements no child in the study had clinically evident bleeding or thrombosis. Overt DIC score and high thrombomodulin levels are associated with fatal outcome in CM, but infrequently indicate a consumptive coagulopathy.