Comparison of parasite sequestration in uncomplicated and severe childhood Plasmodium falciparum malaria.
Comparison of parasite sequestration in uncomplicated and severe childhood Plasmodium falciparum malaria.
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DOI：
10.1016/j.jinf.2013.04.013
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发表时间：
2013-09
影响因子：
28.2
通讯作者：
Walther, Michael
中科院分区：
文献类型：
--
作者：
Cunnington, Aubrey J.;Bretscher, Michael T.;Nogaro, Sarah I.;Riley, Eleanor M.;Walther, Michael
确定无并发症和严重恶性疟原虫疟疾患儿的寄生红细胞隔离是否不同。我们使用基于血浆恶性疟原虫富组氨酸蛋白2浓度的数学模型，对冈比亚重度（n = 127）和单纯性（n = 169）疟疾儿童的循环、总和隔离寄生虫生物量进行了定量。严重疟疾儿童的循环-和总的-但不是隔离的-寄生虫生物量估计值明显高于无并发症疟疾儿童。高乳酸血症或虚脱儿童的隔离生物量估计值与单纯性疟疾相似，而严重贫血患者的隔离生物量较高，并且在脑型疟疾和致命病例中显示出较高值的趋势。血乳酸浓度与循环和总的，但不隔离寄生虫生物量。在控制了年龄、既往抗疟治疗和感染的克隆性以及模型参数的实际变化范围后，这些发现是稳健的。广泛隔离并不是重症儿童疟疾的统一要求。高乳酸血症和虚脱的病理生理学似乎与隔离的寄生虫生物量无关。不同的机制可能是不同的严重疟疾综合征的基础，可能需要不同的治疗策略来提高生存率。
To determine whether sequestration of parasitized red blood cells differs between children with uncomplicated and severe Plasmodium falciparum malaria. We quantified circulating-, total- and sequestered-parasite biomass, using a mathematical model based on plasma concentration of P. falciparum histidine rich protein 2, in Gambian children with severe (n = 127) and uncomplicated (n = 169) malaria. Circulating- and total-, but not sequestered-, parasite biomass estimates were significantly greater in children with severe malaria than in those with uncomplicated malaria. Sequestered biomass estimates in children with hyperlactataemia or prostration were similar to those in uncomplicated malaria, whereas sequestered biomass was higher in patients with severe anaemia, and showed a trend to higher values in cerebral malaria and fatal cases. Blood lactate concentration correlated with circulating- and total-, but not sequestered parasite biomass. These findings were robust after controlling for age, prior antimalarial treatment and clonality of infection, and over a realistic range of variation in model parameters. Extensive sequestration is not a uniform requirement for severe paediatric malaria. The pathophysiology of hyperlactataemia and prostration appears to be unrelated to sequestered parasite biomass. Different mechanisms may underlie different severe malaria syndromes, and different therapeutic strategies may be required to improve survival.
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影响因子：
15.8
作者：
Bejon P;Berkley JA;Mwangi T;Ogada E;Mwangi I;Maitland K;Williams T;Scott JA;English M;Lowe BS;Peshu N;Newton CR;Marsh K
通讯作者：
Marsh K
DOI：
10.1073/pnas.95.13.7620
发表时间：
1998-06-23
影响因子：
11.1
作者：
Gravenor, MB;van Hensbroek, MB;Kwiatkowski, D
通讯作者：
Kwiatkowski, D
影响因子：
168.9
作者：
Dondorp, Arjen M.;Fanello, Caterina I.;White, Nicholas J.
通讯作者：
White, Nicholas J.
影响因子：
2.4
作者：
GRAVENOR, MB;MCLEAN, AR;KWIATKOWSKI, D
通讯作者：
KWIATKOWSKI, D
影响因子：
3.7
作者：
Ceesay, Serign J.;Casals-Pascual, Climent;Conway, David J.
通讯作者：
Conway, David J.