Liver and kidney dysfunction, hypoglycemia, and thrombocytopenia in Plasmodium vivax malaria patients at a Colombian Northwest region

Acero, Catalina Tovar; Velasco, María Camila; Avilés-Vergara, Paula A.; Ricardo-Caldera, Dina; Alvis, Erasmo Manuel; Montoya, Javier Ramirez; Yasnot, María Fernanda

doi:10.1016/j.parepi.2021.e00203

Cited by 8 publications

(5 citation statements)

References 38 publications

(30 reference statements)

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“…The patients in the study did not present cerebral malaria or pulmonary alterations. The clinical and epidemiological characteristics of this cohort were previously described [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

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IL-4, IL-10, CCL2 and TGF-β as potential biomarkers for severity in Plasmodium vivax malaria

et al. 2022

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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.

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“…The patients in the study did not present cerebral malaria or pulmonary alterations. The clinical and epidemiological characteristics of this cohort were previously described [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

“…In the group of patients with severe malaria, the main findings are illustrated in Fig 1 . The patients in the study did not present cerebral malaria or pulmonary alterations. The clinical and epidemiological characteristics of this cohort were previously described [26].…”

Section: Clinical Characteristics Of P Vivax Malaria Patientsmentioning

confidence: 99%

IL-4, IL-10, CCL2 and TGF-β as potential biomarkers for severity in Plasmodium vivax malaria

et al. 2022

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“…The higher the parasitaemia in the host, the higher the consumption of glucose that may lead to hypoglycaemia, mainly in severe malaria. Hypoglycaemia may provoke dizziness, palpitations, tremors and loss of consciousness [ 51 ]. Careful glucose monitoring should be targeted in these complications, especially in those patients with G6PD deficiency.…”

Section: Discussionmentioning

confidence: 99%

Duffy blood system and G6PD genetic variants in vivax malaria patients from Manaus, Amazonas, Brazil

Ferreira

Mathias

Albuquerque

et al. 2022

Malar J

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Background Over a third of the world’s population is at risk of Plasmodium vivax-induced malaria. The unique aspect of the parasite’s biology and interactions with the human host make it harder to control and eliminate the disease. Glucose-6-phosphate dehydrogenase (G6PD) deficiency and Duffy-negative blood groups are two red blood cell (RBC) variations that can confer protection against malaria. Methods Molecular genotyping of G6PD and Duffy variants was performed in 225 unrelated patients (97 with uncomplicated and 128 with severe vivax malaria) recruited at a Reference Centre for Infectious Diseases in Manaus. G6PD and Duffy variants characterizations were performed using Real Time PCR (qPCR) and PCR–RFLP, respectively. Results The Duffy blood group system showed a phenotypic distribution Fy(a + b−) of 70 (31.1%), Fy(a + b +) 96 (42.7%), Fy(a−b +) 56 (24.9%) and Fy(a−b−) 1 (0.44%.) The genotype FY*A/FY*B was predominant in both uncomplicated (45.3%) and severe malaria (39.2%). Only one Duffy phenotype Fy(a-b) was found and this involved uncomplicated vivax malaria. The G6PD c.202G > A variant was found in 11 (4.88%) females and 18 (8.0%) males, while c.376A > G was found in 20 females (8.88%) and 23 (10.22%) male patients. When combined GATA mutated and c.202G > A and c.376A > G mutated, was observed at a lower frequency in uncomplicated (3.7%) in comparison to severe malaria (37.9%). The phenotype Fy(a−b +) (p = 0.022) with FY*B/FY*B (p = 0.015) genotype correlated with higher parasitaemia. Conclusions A high prevalence of G6PD c202G > A and c.376A > G and Duffy variants is observed in Manaus, an endemic area for vivax malaria. In addition, this study reports for the first time the Duffy null phenotype Fy(a-b-) in the population of the Amazonas state. Moreover, it is understood that the relationship between G6PD and Duffy variants can modify clinical symptoms in malaria caused by P. vivax and this deserves to be further investigated and explored among this population.

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“…The main findings showed that a cohort of 142 individuals with confirmed P. falciparum , 61 with P. vivax , four with P. malariae and 37 with P. ovale infection provided the mean of platelets and standard deviation (SD) (106.4 ± 72.66) (×10 9 /L), (101.0 ± 58.69) (×10 9 /L), (82.5 ± 28.34) (×10 9 /L) and (107.9 ± 54.25) (×10 9 /L), respectively. Null hypothesis value (74.2 × 10 9 /L) was available in the literature [ 24–26 ]. To attain a 95% confidence interval with a two-sided type I error of 5% and a statistical power of 80%, 42 participants for P. falciparum , 40 for P. vivax , 94 for P. malariae and 23 for P. ovale were required, respectively.…”

Section: Methodsmentioning

confidence: 99%

Clinical characteristics of platelet-mediated killing circulating parasite of major human malaria

Bi¹,

Huang²,

Lü³

et al. 2023

Annals of Medicine

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Objective Microscopy was used to characterize platelet- Plasmodium -infected erythrocyte interactions in patients infected with Plasmodium falciparum , Plasmodium vivax , Plasmodium ovale or Plasmodium malariae , and to investigate the relationship between platelet-associated parasite killing and parasite clearance. Methods Data from 244 malaria patients admitted to the Fourth People’s Hospital of Nanning between 1 January 2011 and 30 September 2022, and 45 healthy controls, were collected prospectively and assessed retrospectively. Characteristics of platelet–erythrocyte interactions were visualized by microscopy, and blood cell count and clinical profiles of these participants were obtained from the electronic medical records. ANOVA, contingency tables and Cox proportional hazards regression models were used to do statistical analysis on the subgroups. Results Platelet enlargement and minor pseudopodia development were observed. Platelets were found directly attaching to parasitized erythrocytes by all Plasmodium species studied, especially mature stages, and lysis of parasitized erythrocytes was connected to platelet-mediated cytolysis. Platelet counts were correlated inversely with parasitaemia and duration of parasite clearance. Artemisinin combination therapy was more effective than artemisinin alone in clearing Plasmodium in patients with thrombocytopenia. Conclusions Platelet-parasitized erythrocytes cell-to-cell contacts initiated platelet-associated parasite killing and helped to limit Plasmodium infection in cases of human malaria. The weakening platelet-associated parasite killing effects could be counteracted by artemisinin combination therapy in patients with thrombocytopenia.

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Liver and kidney dysfunction, hypoglycemia, and thrombocytopenia in Plasmodium vivax malaria patients at a Colombian Northwest region

Cited by 8 publications

References 38 publications

IL-4, IL-10, CCL2 and TGF-β as potential biomarkers for severity in Plasmodium vivax malaria

IL-4, IL-10, CCL2 and TGF-β as potential biomarkers for severity in Plasmodium vivax malaria

Duffy blood system and G6PD genetic variants in vivax malaria patients from Manaus, Amazonas, Brazil

Clinical characteristics of platelet-mediated killing circulating parasite of major human malaria

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