Fatal Plasmodium falciparum malaria causes specific patterns of splenic architectural disorganization
Fatal Plasmodium falciparum malaria causes specific patterns of splenic architectural disorganization
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DOI：
10.1128/iai.73.4.1986-1994.2005
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发表时间：
2005-04-01
影响因子：
3.1
通讯作者：
Roberts, DJ
中科院分区：
文献类型：
--
作者：
Urban, BC;Hien, TT;Roberts, DJ
脾脏对于宿主防御病原体（包括恶性疟原虫）至关重要。它具有双重作用，不仅可以从血液中清除老化或抗原改变的红细胞，而且可以作为血源性或全身性感染的主要淋巴器官。人类疟疾寄生虫恶性疟原虫在无性血液阶段在红细胞内复制，并引起可能与严重疾病相关的反复感染。尽管脾脏在针对疟疾的先天性和获得性免疫反应中发挥着至关重要的作用，但有关人类疟疾中脾脏病理学的信息却很少。我们对死于严重恶性疟疾的越南成年人的脾脏切片进行了组织学和定量免疫组织化学研究，并将研究结果与对照患者和死于全身性细菌性败血症的患者的脾脏切片的结果进行了比较。在这里，我们报告说，死于疟疾的患者的脾脏中的白髓显示出明显的结构混乱。我们观察到边缘区明显溶解，B 细胞相对减少。此外，我们发现 HLA-DR 在血窦衬里细胞上强烈表达，但在索状巨噬细胞上表达下调。恶性疟原虫感染会导致脾脏白细胞发生变化，其中许多变化在脓毒症中是看不到的。
The spleen is critical for host defense against pathogens, including Plasmodium falciparum. It has a dual role, not only removing aged or antigenically altered erythrocytes from the blood but also as the major lymphoid organ for blood-borne or systemic infections. The human malaria parasite P. falciparum replicates within erythrocytes during asexual blood stages and causes repeated infections that can be associated with severe disease. In spite of the crucial role of the spleen in the innate and acquired immune response to malaria, there is little information on the pathology of the spleen in human malaria. We performed a histological and quantitative immunohistochemical study of spleen sections from Vietnamese adults dying from severe falciparum malaria and compared the findings with the findings for spleen sections from control patients and patients dying from systemic bacterial sepsis. Here we report that the white pulp in the spleens of patients dying from malaria showed a marked architectural disorganization. We observed a marked dissolution of the marginal zones with relative loss of B cells. Furthermore, we found strong HLA-DR expression on sinusoidal lining cells but downregulation on cordal macrophages. P.falciparum infection results in alterations in splenic leukocytes, many of which are not seen in sepsis.