Loss of complement regulatory proteins on red blood cells in mild malarial anaemia and in Plasmodium falciparum induced blood-stage infection

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Oyong, Damian A
Loughland, Jessica R
SheelaNair, Arya
Andrew, Dean
Rivera, Fabian DL
Piera, Kim A
William, Timothy
Grigg, Matthew J
Barber, Bridget E
Haque, Ashraful
Engwerda, Christian R
McCarthy, James S
Anstey, Nicholas M
Boyle, Michelle J
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2019
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Abstract

Background: Anaemia is a major consequence of malaria, caused by the removal of both infected and uninfected red blood cells (RBCs) from the circulation. Complement activation and reduced expression of complement regulatory proteins (CRPs) on RBCs are an important pathogenic mechanism in severe malarial anaemia in both Plasmodium falciparum and Plasmodium vivax infection. However, little is known about loss of CRPs on RBCs during mild malarial anaemia and in low-density infection. Methods: The expression of CRP CR1, CD55, CD59, and the phagocytic regulator CD47, on uninfected normocytes and reticulocytes were assessed in individuals from two study populations: (1) P. falciparum and P. vivax-infected patients from a low transmission setting in Sabah, Malaysia; and, (2) malaria-naïve volunteers undergoing P. falciparum induced blood-stage malaria (IBSM). For clinical infections, individuals were categorized into anaemia severity categories based on haemoglobin levels. For IBSM, associations between CRPs and haemoglobin level were investigated. Results: CRP expression on RBC was lower in Malaysian individuals with P. falciparum and P. vivax mild malarial anaemia compared to healthy controls. CRP expression was also reduced on RBCs from volunteers during IBSM. Reduction occurred on normocytes and reticulocytes. However, there was no significant association between reduced CRPs and haemoglobin during IBSM. Conclusions: Removal of CRPs occurs on both RBCs and reticulocytes during Plasmodium infection even in mild malarial anaemia and at low levels of parasitaemia.

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Malaria Journal

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18

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1

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© The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Microbiology

Medical microbiology

Science & Technology

Life Sciences & Biomedicine

Infectious Diseases

Parasitology

Tropical Medicine

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Oyong, DA; Loughland, JR; SheelaNair, A; Andrew, D; Rivera, FDL; Piera, KA; William, T; Grigg, MJ; Barber, BE; Haque, A; Engwerda, CR; McCarthy, JS; Anstey, NM; Boyle, MJ, Loss of complement regulatory proteins on red blood cells in mild malarial anaemia and in Plasmodium falciparum induced blood-stage infection, Malaria Journal, 2019, 18 (1)

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