Age-related changes in red blood cell complement regulatory proteins and susceptibility to severe malaria.
Severe malaria-associated anemia and cerebral malaria are life-threatening complications of Plasmodium falciparum infection. Red blood cell (RBC) complement regulatory proteins (CRPs) have been implicated in the pathogenesis of both. We sought to determine whether there are age-related changes in the expression of CRPs that could explain the susceptibility to severe malaria-associated anemia in young children and the susceptibility to cerebral malaria in older children and adults. In cross-sectional surveys in malaria-endemic and -nonendemic areas of Kenya and in Reims, France, the level of RBC CRPs was lowest in young children and increased into adulthood. In case-control studies, patients with cerebral malaria and matched control subjects had higher levels of RBC CRPs than did patients with severe anemia and matched control subjects, especially during convalescence. We conclude that RBC CRP levels vary with age and that the lower levels of these proteins in young children in areas of high transmission, such as western Kenya, may place these children at greater risk of severe malaria-associated anemia than cerebral malaria.
US Army Medical Research Unit and Kenya Medical Research Institute, Nairobi, Kenya.
John N
JN
Waitumbi
Béatrice
B
Donvito
Aymric
A
Kisserli
Jacques H M
JH
Cohen
José A
JA
Stoute
D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging / Q000276:immunology*; D000740:Anemia / Q000209:etiology*; D015703:Antigens, CD / Q000097:blood*; D001742:Blackwater Fever; D018958:CD55 Antigens / Q000097:blood; D018957:CD59 Antigens / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004198:Disease Susceptibility; D004912:Erythrocytes / Q000276:immunology*; D005260:Female; D005602:France; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya; D016779:Malaria, Cerebral / Q000150:complications / Q000276:immunology; D016778:Malaria, Falciparum / Q000150:complications* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D018512:Parasitemia; D017463:Receptors, Complement 3b / Q000097:blood
D015703:Antigens, CD; D018958:CD55 Antigens; D018957:CD59 Antigens; D017463:Receptors, Complement 3b