Severity of anaemia is associated with bone marrow haemozoin in children exposed to Plasmodium falciparum

Aguilar, Ruth, Moraleda, Cinta, Achtman, Ariel H., Mayor, Alfredo, Quintó, Llorenç, Cisteró, Pau, Nhabomba, Augusto, Macete, Eusebio, Schofield, Louis, Alonso, Pedro L., and Menéndez, Clara (2014) Severity of anaemia is associated with bone marrow haemozoin in children exposed to Plasmodium falciparum. British Journal of Haematology, 164 (6). pp. 877-887.

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Abstract

There are no large-scale ex vivo studies addressing the contribution of Plasmodium falciparum in the bone marrow to anaemia. The presence of malaria parasites and haemozoin were studied in bone marrows from 290 anaemic children attending a rural hospital in Mozambique. Peripheral blood infections were determined by microscopy and polymerase chain reactions. Bone marrow parasitaemia, haemozoin and dyserythropoiesis were microscopically assessed. Forty-two percent (123/290) of children had parasites in the bone marrow and 49% (111/226) had haemozoin, overlapping with parasitaemia in 83% (92/111) of cases. Sexual and mature asexual parasites were highly prevalent (62% gametocytes, 71% trophozoites, 23% schizonts) suggesting their sequestration in this tissue. Sixteen percent (19/120) of children without peripheral infection had haemozoin in the bone marrow. Haemozoin in the bone marrow was independently associated with decreased Hb concentration (P = 0·005) and was more common in dyserythropoietic bone marrows (P = 0·010). The results of this ex vivo study suggest that haemozoin in the bone marrow has a role in the pathogenesis of malarial-anaemia through ineffective erythropoiesis. This finding may have clinical implications for the development of drugs targeted to prevent and treat malarial-anaemia.

Item ID: 52617
Item Type: Article (Research - C1)
ISSN: 1365-2141
Keywords: anaemia, bone marrow, dyserythropoiesis, haemozoin, Plasmodium falciparum
Funders: Agencia de Cooperacion Internacional de Las Illes Balears, Fundación Ramón Areces, Spanish Agency for International Cooperation and Development, Victorian State Government Operational Infrastructure Support, National Health and Medical Research Council of Australia (NHMRC), Independent Research Institute Infrastructure Support Scheme
Date Deposited: 21 Feb 2018 00:16
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1108 Medical Microbiology > 110803 Medical Parasitology @ 100%
SEO Codes: 92 HEALTH > 9299 Other Health > 929999 Health not elsewhere classified @ 50%
97 EXPANDING KNOWLEDGE > 970111 Expanding Knowledge in the Medical and Health Sciences @ 50%
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