<i>Plasmodium falciparum</i>
            Maturation Abolishes Physiologic Red Cell Deformability

Cranston, Hope A.; Boylan, Charles W.; Carroll, Gregory L.; Sutera, Salvatore P.; Williamson, Joseph R.; Gluzman, Ilya Y.; Krogstad, Donald J.

doi:10.1126/science.6362007

Cited by 287 publications

(217 citation statements)

References 30 publications

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“…Exchange transfusion used as the adjunct to the antimalarial drugs rapidly reduces parasitaemia (Looaresuwan et al 1990;Salord et al 1991). Parasitized red cells are more rigid and less deformable than unparasitized red cells (Cranston et al 1984;Ahlqvist 1989). The replenishment of fresh unparasitized erythrocytes by exchange transfusion may improve rheology and tissue perfusion remarkably.…”

Section: Introductionmentioning

confidence: 99%

Exchange transfusion as an adjunct to the treatment of severe falciparum malaria

Hoontrakoon

Suputtamongkol

1998

Tropical Med Int Health

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SummaryOBJECTIVE To compare the efficacy of exchange transfusion as the adjunct to quinine treatment (21 patients) with quinine therapy alone (29 patients). METHOD A retrospective study of 50 patients with severe falciparum malaria was conducted at Chumphorn Hospital, Southern Thailand. RESULTS Clinical characteristics in both treatment groups were not significantly different although in the exchange transfusion group, the admission geometric mean parasitaemia (18 (5%), and the proportion of patients with more than 10% parasitaemia was higher (76%, P = 0.03) than in the group who received quinine alone (10 Ϯ 4%; 38%, P = 0.1). The mortality rate of patients who received exchange transfusion was 48%; that of the remainder, 69%. (P = 0.3). ARDS (P = 0.01) and oliguric renal failure (P = 0.04) were significant risk factors for death in these patients. CONCLUSION Exchange transfusion was safe and well tolerated. Results of our study revealed a 20% reduction in mortality when exchange transfusion was used as an adjunct to quinine treatment. It should therefore be considered in patients with severe falciparum malaria when possible.keywords exchange transfusion, treatment, severe falciparum malaria.correspondence Dr

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Section: Introductionmentioning

confidence: 99%

Exchange transfusion as an adjunct to the treatment of severe falciparum malaria

Hoontrakoon

Suputtamongkol

1998

Tropical Med Int Health

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“…Destruction of unparasitized cells and suppression of red cell production have also been suggested (1,5). Reduced deformability of parasitized red cells has been reported (3,8,12). Rheological changes are likely to contribute to splenic sequestration of parasitized red cells.…”

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confidence: 96%

Cytometric analysis of blood cells from malaria‐infected patients and in vitro infected blood

1993

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Blood samples from malaria-infected patients and from in vitro culture were analyzed using the H*l hematology analyzer. An attempt to find a hematologic parameter for detecting the malaria infection and to characterize the pathophysiological changes of red cells was made. The study included 18 malaria-infected patients (10 with Plasmodium falciparum and 8 with Plasmodium viva.4 and 52 normal, healthy volunteers. Increased young large lymphocyte or large unstained cell count (LUC over 3%) in the peripheral blood of malaria-infected patients was evidence for malaria infection.

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“…The membrane shear modulus of infected RBCs may increase up to ten-fold causing capillary occlusions (1,2), thereby resulting in substantial increase in resistance to blood flow. Such effects may be intensified due to the enhanced cytoadherence of Pf-RBCs to the vascular endothelium (3)(4)(5)(6).…”

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Quantifying the biophysical characteristics of Plasmodium-falciparum -parasitized red blood cells in microcirculation

Fedosov

Caswell

Suresh

et al. 2010

Proc. Natl. Acad. Sci. U.S.A.

169

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The pathogenicity of Plasmodium falciparum (Pf) malaria results from the stiffening of red blood cells (RBCs) and its ability to adhere to endothelial cells (cytoadherence). The dynamics of Pf-parasitized RBCs is studied by three-dimensional mesoscopic simulations of flow in cylindrical capillaries in order to predict the flow resistance enhancement at different parasitemia levels. In addition, the adhesive dynamics of Pf-RBCs is explored for various parameters revealing several types of cell dynamics such as firm adhesion, very slow slipping along the wall, and intermittent flipping. The parasite inside the RBC is modeled explicitly in order to capture phenomena such as "hindered tumbling" motion of the RBC and the sudden transition from firm RBC cytoadherence to flipping on the endothelial surface. These predictions are in quantitative agreement with recent experimental observations, and thus the three-dimensional modeling method presented here provides new capabilities for guiding and interpreting future in vitro and in vivo studies of malaria.adhesion | erythrocyte | malaria | mechanical properties | dissipative particle dynamics R ed blood cells parasitized by Plasmodium falciparum (Pf-RBCs) undergo irreversible changes in structure and biophysical characteristics, which can lead to drastically altered blood circulation. The membrane shear modulus of infected RBCs may increase up to ten-fold causing capillary occlusions (1, 2), thereby resulting in substantial increase in resistance to blood flow. Such effects may be intensified due to the enhanced cytoadherence of Pf-RBCs to the vascular endothelium (3-6). This adherence of Pf-RBCs is believed to be the main cause of bleeding complications in cerebral malaria due to blockages of small vessels in the brain (7). Unlike the extensive research on leukocytes, very few in vitro experiments (8-11) Recent progress in multiscale numerical modeling (12-14) allows us to model soft matter, and RBCs in particular, at sufficient detail, i.e., simulating nanometer scales while simultaneously capturing the large scale dynamics. We have developed and validated a Dissipative Particle Dynamics (DPD) model (12, 14-16) that can accurately simulate the properties and dynamic behavior of healthy RBCs as well as Pf-RBCs. The multiscale model can represent a RBC at the spectrin level with 30,000 points (17) or at a coarser level with 500 points by proper scaling of the physiologically correct parameters (12, 14, 15); hence, no ad hoc calibration is required. The predictive capability of the DPD model has been demonstrated in comparisons with microfluidic experiments that probe controlled pressure-velocity relationships of (healthy) RBC flow through microchannels whose inner openings mimic the smallest dimensions for RBC passage in the microvasculature (16). In addition, we have extended the adhesive dynamics model of (18,19) to the DPD framework, and validated it by simulating the adhesive dynamics of leukocytes for which extensive experimental results exist (20,21). In summary, ...

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Plasmodium falciparum Maturation Abolishes Physiologic Red Cell Deformability

Cited by 287 publications

References 30 publications

Exchange transfusion as an adjunct to the treatment of severe falciparum malaria

Exchange transfusion as an adjunct to the treatment of severe falciparum malaria

Cytometric analysis of blood cells from malaria‐infected patients and in vitro infected blood

Quantifying the biophysical characteristics of Plasmodium-falciparum -parasitized red blood cells in microcirculation

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