Exploring pancreatic pathology in Plasmodium falciparum malaria patients

Abstract

Hypoglycaemia is an important complication of Plasmodium falciparum malaria infection, which can be lethal if not treated. A decrease in blood sugar (BS) level has been correlated with disease severity, parasitaemia and the use of certain antimalarial drugs. This study explored the relationship between pancreatic pathology, including the expressions of insulin and glucagon in the islets of Langerhans, and the BS levels in P. falciparum malaria patients. Pancreatic tissues from malaria patients were divided into three groups, namely those with BS < 40 mg/dl, BS = 40–120 mg/dl, and BS > 120 mg/dl. In P. falciparum malaria, pancreatic tissues showed numerous parasitised red blood cells (PRBCs) in the capillaries, oedema, acinar necrosis and the presence of inflammatory cells. The islet size and the expression of insulin were significantly increased in P. falciparum malaria patients with hypoglycaemia. In addition, insulin expression was positively correlated with islet size and negatively correlated with BS levels. This pioneer study documents an increase in insulin expression and an increase in islet size in hypoglycaemic patients with P. falciparum malaria. This could contribute to the pathogenesis of hypoglycaemia and provides evidence for the potential need to effectively manage the hypoglycaemia seen in malaria infection.

Organotypic endothelial adhesion molecules are key for Trypanosoma brucei tropism and virulence

“…Using a combination of bioluminescence and IVM, we confirmed that the g-WAT is a major parasite reservoir (Trindade et al, 2016), and we identified a previously unknown reservoir: the pancreas. Previous works on T. cruzi (Corbett et al, 2002;Dufurrena et al, 2017;Martello et al, 2013), Plasmodium (Abhilash et al, 2016;Glaharn et al, 2018), and Toxoplasma (Nassief Beshay et al, 2018) have reported sequestration in pancreatic blood vessels, pancreatic invasion, and morphological changes in the pancreas, including acute pancreatitis in humans. The fact that the pancreas represents one of the largest reservoirs of an extracellular parasite, such as T. brucei, is puzzling, because the majority of the organ consists of exocrine tissue that produces pancreatic enzymes for digestion, including trypsin and chymotrypsin, amylase, and lipase (Shi and Liu, 2014).…”

M1 macrophage features in severe Plasmodium falciparum malaria patients with pulmonary oedema

“…The intensity of positive stained cells was graded as follows: 0 = negative; 1 = weak staining; 2 = moderate staining; 3 = strong staining. The total score (TS) for this immunohistochemical study was determined by obtaining the product of the percentage of positive cells and the intensity of the staining [22,23]. The sections were examined in a blinded manner, without prior knowledge of the patients, clinical status.…”

M1 macrophage activation in severe Plasmodium falciparum malaria patients with pulmonary oedema

“…The intensity of positive stained cells was graded as follows: 0 = negative; 1 = weak staining; 2 = moderate staining; 3 = strong staining. The total score (TS) for this immunohistochemical study was determined by obtaining the product of the percentage of positive cells and the intensity of the staining [20,21]. The sections were examined in a blinded manner, without prior knowledge of the patients, clinical status.…”