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2014 ; 210
(7
): 1100-9
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Hemoglobinopathic erythrocytes affect the intraerythrocytic multiplication of
Plasmodium falciparum in vitro
#MMPMID24688070
Glushakova S
; Balaban A
; McQueen PG
; Coutinho R
; Miller JL
; Nossal R
; Fairhurst RM
; Zimmerberg J
J Infect Dis
2014[Oct]; 210
(7
): 1100-9
PMID24688070
show ga
BACKGROUND: The mechanisms by which ?-thalassemia and sickle cell traits confer
protection from severe Plasmodium falciparum malaria are not yet fully
elucidated. We hypothesized that hemoglobinopathic erythrocytes reduce the
intraerythrocytic multiplication of P. falciparum, potentially delaying the
development of life-threatening parasite densities until parasite clearing
immunity is achieved. METHODS: We developed a novel in vitro assay to quantify
the number of merozoites released from an individual schizont, termed the
"intraerythrocytic multiplication factor" (IMF). RESULTS: P. falciparum (3D7
line) schizonts produce variable numbers of merozoites in all erythrocyte types
tested, with median IMFs of 27, 27, 29, 23, and 23 in control, HbAS, HbSS, and ?-
and ?-thalassemia trait erythrocytes, respectively. IMF correlated strongly (r(2)
= 0.97; P < .001) with mean corpuscular hemoglobin concentration, and varied
significantly with mean corpuscular volume and hemoglobin content. Reduction of
IMFs in thalassemia trait erythrocytes was confirmed using clinical parasite
isolates with different IMFs. Mathematical modeling of the effect of IMF on
malaria progression indicates that the lower IMF in thalassemia trait
erythrocytes limits parasite density and anemia severity over the first 2 weeks
of parasite replication. CONCLUSIONS: P. falciparum IMF, a parasite heritable
virulence trait, correlates with erythrocyte indices and is reduced in
thalassemia trait erythrocytes. Parasite IMF should be examined in other
low-indices erythrocytes.