title: Loss of red blood cell-complement regulatory proteins and increased levels of circulating immune complexes are associated with severe malarial anemia.
abstract: Severe anemia is one of the most lethal complications of Plasmodium falciparum malaria. Red blood cells (RBCs) from children with severe malarial anemia are deficient in complement regulatory proteins (CR1 and CD55). A case-control, age- and sex-matched study was carried out to determine whether these deficiencies are acquired or inherited and the relative contribution of these complement regulatory protein deficiencies, the immune complex level, and the parasite density to the development of severe malarial anemia. RBC CR1 and CD55 deficiencies resolved after treatment, suggesting that these changes were acquired. Using conditional logistic regression, a decline in CD55 (or CR1) (odds ratio [OR], 4.2; 95% confidence interval [CI], 2.1-8.1; P<.001) and an increase in immune complex level (OR, 2.6; 95% CI, 1.5-4.8; P=.001) were significantly associated with severe malarial anemia.
authors.affiliation: US Army Medical Research Unit, and Kenya Medical Research Institute, Nairobi, Kenya. jstoute@kisian.mimcom.net
authors.forename: José A
authors.initials: JA
authors.lastname: Stoute
authors.forename: Alfred O
authors.initials: AO
authors.lastname: Odindo
authors.forename: Boaz O
authors.initials: BO
authors.lastname: Owuor
authors.forename: Erick K
authors.initials: EK
authors.lastname: Mibei
authors.forename: Malachi O
authors.initials: MO
authors.lastname: Opollo
authors.forename: John N
authors.initials: JN
authors.lastname: Waitumbi
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000097:blood* / Q000150:complications* / Q000276:immunology; D000818:Animals; D000936:Antigen-Antibody Complex / Q000097:blood*; D018958:CD55 Antigens / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003165:Complement System Proteins / Q000032:analysis*; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000097:blood* / Q000150:complications* / Q000276:immunology; D008297:Male; D010963:Plasmodium falciparum; D013997:Time Factors
chemical_list: D000936:Antigen-Antibody Complex; D018958:CD55 Antigens; D003165:Complement System Proteins