Adaptive immunity is essential in preventing recrudescence of<i>Plasmodium yoelii</i>malaria parasites after artesunate treatment

Claser, Carla; Chang, Zi Wei; Russell, Bruce; Rénia, Laurent

doi:10.1111/cmi.12763

Cited by 10 publications

(10 citation statements)

References 44 publications

(63 reference statements)

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“…A study by Xie et al (21) on the clinical features of 56 patients with imported malaria showed that 16.7% of the patients suffered from recrudescence after cure. The recrudescence mechanism of malaria is more complicated, and is generally considered to correlate with many factors, such as the species of infectious Plasmodium, antigenic variation of Plasmodium, non-standard use of antimalarial drugs, drug sensitivity, and decrease in the host's specificity immunity (22). In recent years, many studies (23)(24)(25) have found that some malaria patients suffer from recrudescence due to the decreased sensitivity to artemisinin and resistance to drugs.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Procalcitonin Recovery Level for Malaria Recrudescence

Huang

Yang

et al. 2019

Jundishapur J Microbiol

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Background: Malaria is the parasitic disease caused by Plasmodium infection, and is transmitted to humans through the bite of female anopheles. At present, malaria remains the most important cause of disease and death among children and adults. Approximately 214 million people are infected with malaria worldwide. Objectives: This study aimed to analyze the distribution level and compare procalcitonin and C-reactive protein (CRP) in malaria patients before and after treatment, with focus on discussing the prognostic value of procalcitonin recovery level for recrudescence within two weeks of antimalarial treatment. Methods: A retrospective analysis was adopted. We measured the procalcitonin and CRP inflammatory markers of 22 imported malaria patients, who were hospitalized in our hospital from January 2014 to February 2018. The trends of procalcitonin and CRP levels in three malaria patients before and after antimalarial treatment and during recrudescence were applied. Results: The procalcitonin level was significantly elevated before antimalarial treatment in 95% (21/22) of the patients, but sharply declined within two weeks after treatment. The procalcitonin levels of 59% (13/22) and 23% (5/22) of the patients were < 0.5 ng/mL and 0.5-0.8 ng/mL, respectively. The difference in the procalcitonin level before and after treatment was statistically significant (Z = 4.074, P < 0.05), and the difference in the CRP level before treatment (99.63 ± 51.63 mg/L) and after treatment (20.08 ± 13.45 mg/L) was statistically significant (t = 8.167, P < 0.05). Three patients suffered from recrudescence. The procalcitonin levels of two patients were > 1.0 ng/mL and failed to recover to the normal level within two weeks after antimalarial treatment while the procalcitonin level of one patient was 0.89 ng/mL. The dynamic observation showed that the procalcitonin level progressively increased and the procalcitonin level was 0.89 ng/mL when Plasmodium was found in the blood smear. Conclusions: The procalcitonin and CRP serum levels were significantly elevated among malaria patients. The majority of the patients recovered to the normal level within two weeks after effective antimalarial treatment and no longer suffered from recrudescence. However, the procalcitonin recovery level within two weeks after antimalarial treatment remained > 0.8 ng/mL. Hence, heightened alertness should be given to recrudescence.

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of Procalcitonin Recovery Level for Malaria Recrudescence

Huang

Yang

et al. 2019

Jundishapur J Microbiol

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“…In relation to the current malaria eradication research agenda (Rabinovich et al 2017), it is a subject that should receive attention. This type of interaction has been found to affect total clearance or otherwise of P. yoelii parasites by artesunate (Claser et al 2017), so follow-up is needed. Interpretation for P. vivax malaria might not always be straightforward.…”

Section: Drug-associated Considerations In Recurrencementioning

confidence: 99%

Biological concepts in recurrentPlasmodium vivaxmalaria

Markus

2018

Parasitology

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A curious aspect of the evolution of the hypnozoite theory of malarial relapse is its transmogrification from theory into 'fact', this being of historical, linguistic, scientific and sociological interest. As far as it goes, the hypnozoite explanation for relapse is almost certainly correct. I contend, however, that many of the genotypically homologous, non-reinfection, relapse-like Plasmodium vivax recurrences that researchers ascribe to hypnozoite activation are probably hypnozoite-independent. Indeed, some malariologists are starting to recognize that homologous P. vivax recurrences have most likely been overattributed to activation of hypnozoites. Hitherto identified, non-hypnozoite, possible plasmodial sources of recurrence that must be considered, besides circulating erythrocytic stages, include parasites in splenic dendritic cells, other cells in the spleen (in addition to infected erythrocytes there), bone marrow (importantly) and the skin. I argue that we need to take into account the possibility of a dual or multiple extra-vascular origin of P. vivax non-reinfection recurrences, not arbitrarily discount it. The existence of a P. vivax reservoir(s) is a topical subject and one of practical importance for malaria eradication. Pertinent drug-associated matters are also discussed, as is the dormancy-related significance of clues provided by blood-stage-induced malarial infection.

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“…When DCs present the processed antigen, adaptive immunity is activated. Direct cell cytotoxicity, cytokine secretion as well as anti-malarial antibody work together for effective parasite clearance [10][11][12][13]. Childhoods and young children are more susceptible to malaria infection than adults worldwide [4].…”

Section: Introductionmentioning

confidence: 99%

Adaptive immune responses mediated age-related Plasmodium yoelii 17XL and 17XNL infections in 4 and 8-week-old BALB/c mice

Wang

Liu

et al. 2021

BMC Immunol

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Backgroud It is important to expound the opposite clinical outcomes between children and adulthood for eradicate malaria. There remains unknown about the correlation between adaptive immune response and age-related in malaria. Methods 4 and 8-week-old mice were used to mimic children and adulthood, respectively. Parasitemia and the survival rate were monitored. The proportion and function of Th1 and Th2 cells were detected by FACS. The levels of IFN-γ, IL-4, total IgG, IgG1, IgG2a and Plasmodium yoelii MSP-1-specific IgG were measured by ELISA. Results The adult group showed greater resistance to P. yoelii 17XL infection, with lower parasitemia. Compared with 4-week-old mice, the percentage of CD4+T-bet+IFN-γ+ Th1 cells as well as IFN-γ production were significantly increased on day 5 p.i. in the 8-week-old mice after P. yoelii 17XNL infection. The percentage of CD4+GATA3+IL-4+ Th2 cells and CD4+CXCR5+ Tfh cells, and IL-4 production in the 8-week-old mice significantly increased on day 5 and day 10 after P. yoelii 17XNL infection. Notably, the levels of total IgG, IgG1, IgG2a and P. yoelii MSP-1-specific IgG were also significantly increased in the 8-week-old mice. PD-1, a marker of exhaustion, was up-regulated on CD4+ or activated CD4+ T cells in the 8-week-old mice as compared to the 4-week-old group. Conclusions Thus, we consider that enhanced cellular and humoral adaptive immunity might contribute to rapid clearance of malaria among adults, likely in a PD-1-dependent manner due to induction of CD4+ T cells exhaustion in P. yoelii 17XNL infected 8-week-old mice.

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Adaptive immunity is essential in preventing recrudescence ofPlasmodium yoeliimalaria parasites after artesunate treatment

Cited by 10 publications

References 44 publications

Prognostic Value of Procalcitonin Recovery Level for Malaria Recrudescence

Prognostic Value of Procalcitonin Recovery Level for Malaria Recrudescence

Biological concepts in recurrentPlasmodium vivaxmalaria

Adaptive immune responses mediated age-related Plasmodium yoelii 17XL and 17XNL infections in 4 and 8-week-old BALB/c mice

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