title: Expression of cleaved caspase-3 in renal tubular cells in Plasmodium falciparum malaria patients.
abstract: OBJECTIVE
  In Plasmodium falciparum malaria, the clinical manifestation of acute kidney injury (AKI) is commonly associated with acute tubular necrosis (ATN) in the kidney tissues. Renal tubular cells often exhibit various degrees of cloudy swelling, cell degeneration, and frank necrosis. To study individual cell death, this study evaluates the degree of renal tubular necrosis in association with apoptosis in malarial kidneys.
  
  
  METHODS
  Kidney tissues from P. falciparum malaria with AKI (10 cases), and without AKI (10 cases) were evaluated for tubular pathology. Normal kidney tissues from 10 cases served as controls. Tubular necrosis was assessed quantitatively in kidney tissues infected with P. falciparum malaria, based on histopathological evaluation. In addition, the occurrence of apoptosis was investigated using cleaved caspase-3 marker. Correlation between tubular necrosis and apoptosis was analyzed.
  
  
  RESULTS
  Tubular necrosis was found to be highest in P. falciparum malaria patients with AKI (36.44% ± 3.21), compared to non-AKI (15.88% ± 1.63) and control groups (2.58% ± 0.39) (all p < 0.001). In the AKI group, the distal tubules showed a significantly higher degree of tubular necrosis than the proximal tubules (p = 0.021) and collecting tubules (p = 0.033). Tubular necrosis was significantly correlated with the level of serum creatinine (r = 0.596, p = 0.006), and the occurrence of apoptosis (r = 0.681, p = 0.001).
  
  
  CONCLUSIONS
  In malarial AKI, the process of apoptosis occurs in ATN.
authors.affiliation: Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, 10400, Thailand.
authors.forename: Benjamas
authors.initials: B
authors.lastname: Wichapoon
authors.affiliation: School of Medicine, Walailak University, 222 Thasala District, Nakhon Si Thammarat, 80161, Thailand.
authors.forename: Chuchard
authors.initials: C
authors.lastname: Punsawad
authors.affiliation: Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, 10400, Thailand.
authors.forename: Parnpen
authors.initials: P
authors.lastname: Viriyavejakul
mesh_terms: D058186:Acute Kidney Injury / Q000201:enzymology* / Q000469:parasitology / Q000473:pathology; D017209:Apoptosis; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016022:Case-Control Studies; D053148:Caspase 3 / Q000032:analysis*; D003404:Creatinine / Q000097:blood; D004789:Enzyme Activation; D006801:Humans; D007150:Immunohistochemistry; D007673:Kidney Cortex Necrosis / Q000201:enzymology / Q000469:parasitology / Q000473:pathology; D007684:Kidney Tubules / Q000201:enzymology* / Q000469:parasitology / Q000473:pathology; D016778:Malaria, Falciparum / Q000201:enzymology* / Q000469:parasitology / Q000473:pathology; D009336:Necrosis
chemical_list: D015415:Biomarkers; D003404:Creatinine; C505407:CASP3 protein, human; D053148:Caspase 3
keywords: AKI; ATN; P. falciparum; Plasmodium falciparum; acute kidney injury; acute tubular necrosis; apoptosis; cleaved caspase-3