Platelet accumulation in brain microvessels in fatal pediatric cerebral malaria
Platelet accumulation in brain microvessels in fatal pediatric cerebral malaria
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DOI：
10.1086/367960
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发表时间：
2003-02-01
影响因子：
6.4
通讯作者：
Molyneux, ME
中科院分区：
文献类型：
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作者：
Grau, GE;Mackenzie, CD;Molyneux, ME
致死性脑型疟疾（CM）的发病机制还不清楚，部分原因是在死亡前建立临床诊断的患者数据很少。在小鼠CM模型中，血小板在脑微血管中积聚，抗血小板治疗可以改善结果。我们确定了血小板是否也存在于人CM的脑血管中，并对来自马拉维儿童多个脑部位的组织进行了血小板特异性糖蛋白GPIIb-IIIa的免疫组织病理学检查，这些儿童的致命疾病是严重疟疾性贫血、CM或非疟疾性脑病。血小板在微血管内的3个位置观察到：疟疾色素和白细胞之间，与疟疾色素相关，或单独。血小板染色的平均表面积和显示血小板聚集的血管比例在CM患者中显著高于那些没有它。血小板聚集发生在CM患者的微血管系统中，并可能在疾病的发病机制中发挥作用。
The pathogenesis of fatal cerebral malaria (CM) is not well understood, in part because data from patients in whom a clinical diagnosis was established prior to death are rare. In a murine CM model, platelets accumulate in brain microvasculature, and antiplatelet therapy can improve outcome. We determined whether platelets are also found in cerebral vessels in human CM, and we performed immunohistopathology for platelet-specific glycoprotein, GPIIb-IIIa, on tissue from multiple brain sites in Malawian children whose fatal illness was severe malarial anemia, CM, or nonmalarial encephalopathy. Platelets were observed in 3 locations within microvessels: between malaria pigment and leukocytes, associated with malaria pigment, or alone. The mean surface area of platelet staining and the proportion of vessels showing platelet accumulation were significantly higher in patients with CM than in those without it. Platelet accumulation occurs in the microvasculature of patients with CM and may play a role in the pathogenesis of the disease.