Pathological features of P falciparum and mouse malarial anemia
| Mechanism . | Parameters . | References . | |
|---|---|---|---|
| Human . | Mouse . | ||
| Clearance of iRBCs | |||
| Rigidity | Parasite Ag in iRBCs | 122 | 120 |
| Opsonization | Parasite specific Abs and complement | 52, 123, 124 | 128,–130 |
| Band 3–specific Abs | 125 | ||
| Nonopsonization | Macrophage activation | 126 | 131 |
| Pitting | Deformability of RBC membrane by RESA | 127 | 132 |
| Clearance of uninfected RBCs and erythroblasts | |||
| Opsonization | Immune complexes and CD35 | 133,,–136 | Not determined |
| Nonopsonization | Macrophage activation | 44 | 57 |
| Rigidity | RSP-2 antibodies | 53 | Not identified |
| Oxidative stress | 47, 137, 138 | 56 | |
| Intravascular hemolysis | |||
| Hemoglobinemia and Hemoglobinuria | Quinine, mefloquine G6PD deficiency | 29, 30 | 57 |
| Suppression of erythropoiesis | |||
| Host genotype | Haptoglobin | 139, 140 | 40 |
| Erythroid genes | 115 | 116 | |
| Cytokines | High TNF:IL-10 | 78, 79 | 81 |
| High MIF | 88 | 87 | |
| Low IL-12 | 89 | 85 | |
| Parasite products | GPI | 98 | 97 |
| Hz | 71 | 88 | |
| Dyserythropoiesis | |||
| Abnormal precursor morphology | Eg, cytoplamsic bridging | 59 | Not observed |
| Insufficient reticulocytosis | Cell cycle arrest | 61 | 63 |
| Changes in BM precursor numbers | Decreased BFU-Es | 141 acute disease | 63 |
| Decreased CFU-Es | None reported | 142 | |
| Extramedullary erythropoiesis | |||
| Splenic erythropoiesis | None reported | 65, 66, 112 | |
| Hepatic erythropoiesis | None reported | 143 | |
| Mechanism . | Parameters . | References . | |
|---|---|---|---|
| Human . | Mouse . | ||
| Clearance of iRBCs | |||
| Rigidity | Parasite Ag in iRBCs | 122 | 120 |
| Opsonization | Parasite specific Abs and complement | 52, 123, 124 | 128,–130 |
| Band 3–specific Abs | 125 | ||
| Nonopsonization | Macrophage activation | 126 | 131 |
| Pitting | Deformability of RBC membrane by RESA | 127 | 132 |
| Clearance of uninfected RBCs and erythroblasts | |||
| Opsonization | Immune complexes and CD35 | 133,,–136 | Not determined |
| Nonopsonization | Macrophage activation | 44 | 57 |
| Rigidity | RSP-2 antibodies | 53 | Not identified |
| Oxidative stress | 47, 137, 138 | 56 | |
| Intravascular hemolysis | |||
| Hemoglobinemia and Hemoglobinuria | Quinine, mefloquine G6PD deficiency | 29, 30 | 57 |
| Suppression of erythropoiesis | |||
| Host genotype | Haptoglobin | 139, 140 | 40 |
| Erythroid genes | 115 | 116 | |
| Cytokines | High TNF:IL-10 | 78, 79 | 81 |
| High MIF | 88 | 87 | |
| Low IL-12 | 89 | 85 | |
| Parasite products | GPI | 98 | 97 |
| Hz | 71 | 88 | |
| Dyserythropoiesis | |||
| Abnormal precursor morphology | Eg, cytoplamsic bridging | 59 | Not observed |
| Insufficient reticulocytosis | Cell cycle arrest | 61 | 63 |
| Changes in BM precursor numbers | Decreased BFU-Es | 141 acute disease | 63 |
| Decreased CFU-Es | None reported | 142 | |
| Extramedullary erythropoiesis | |||
| Splenic erythropoiesis | None reported | 65, 66, 112 | |
| Hepatic erythropoiesis | None reported | 143 | |
The etiology of anemia based on observations made during the course of disease is compared for P falciparum and mouse malaria infections.
RBC indicates red blood cell; iRBC, infected red blood cell; Ag, antigen; Abs, antibodies; RESA, ring-infected erythrocyte surface antigen; RSP-2, ring surface protein 2; TNF, tumor necrosis factor α; IL, interleukin; MIF, macrophage inhibitory factor; GPI, glycophosphatidylinositol; HZ, hemozoin; BM, bone marrow; BFU-E, burst forming unit erythroid; and CFU-E, colony forming unit erythroid.