title: Hematopoietic features and apoptosis in the bone marrow of severe Plasmodium falciparum-infected patients: preliminary study.
abstract: The mechanism of anemia in severe falciparum malaria is still not completely understood. The purpose of this study was to determine whether apoptosis in the erythroid lineage causes anemia in falciparum malaria. Bone marrow aspirated from 8 severe falciparum malaria patients, 3 normal volunteers and 5 retrospective normal bone marrow smears were investigated. By light microscopic study, 5 of 8 hyperparasitemic patients had hypocellular bone marrows and erythroid hypoplasia, whereas the other 3 patients had normal cellularity. The mean myeloid : erythroid ratio of these 5 patients was significantly (p < or = 0.05) higher than normal. Apoptosis of bone marrow nucleated cells (BMNC) could be determined from the exposure of phosphatidylserine (PS) on the cell membrane but not DNA fragmentation (180-250 bp) or ultrastructural morphology. The percentages of apoptotic BMNC and apoptotic erythroid cells in bone marrow from each patient and controls varied from low to high, and were not associated with parasitemia. This study suggests that destruction of erythroid lineage, particularly through apoptosis regulation, cannot solely account for anemia in falciparum malaria.
authors.affiliation: Department of Medical Science, National Institute of Health, Nonthaburi, Thailand.
authors.forename: Suwaporn
authors.initials: S
authors.lastname: Anantrakulsil
authors.forename: Yaowapa
authors.initials: Y
authors.lastname: Maneerat
authors.forename: Polrat
authors.initials: P
authors.lastname: Wilairatana
authors.forename: Srivicha
authors.initials: S
authors.lastname: Krudsood
authors.forename: Chaiyong
authors.initials: C
authors.lastname: Arunsuriyasak
authors.forename: Vichai
authors.initials: V
authors.lastname: Atichartakarn
authors.forename: Ratchanok
authors.initials: R
authors.lastname: Kumsiri
authors.forename: Kovit
authors.initials: K
authors.lastname: Pattanapanyasat
authors.forename: Sornchai
authors.initials: S
authors.lastname: Looareesuwan
authors.forename: Ratchanee
authors.initials: R
authors.lastname: Udomsangpetch
mesh_terms: D000740:Anemia / Q000209:etiology* / Q000469:parasitology; D000818:Animals; D017209:Apoptosis; D001854:Bone Marrow Cells / Q000469:parasitology / Q000473:pathology*; D016022:Case-Control Studies; D053938:DNA Fragmentation; D004587:Electrophoresis, Agar Gel; D041905:Erythroid Cells / Q000737:chemistry / Q000469:parasitology; D006410:Hematopoiesis; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications* / Q000469:parasitology; D023461:Myeloid Progenitor Cells / Q000737:chemistry / Q000469:parasitology; D010718:Phosphatidylserines / Q000097:blood; D010963:Plasmodium falciparum / Q000302:isolation & purification / Q000472:pathogenicity*
chemical_list: D010718:Phosphatidylserines