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Rosetting in Plasmodium vivax: a cytoadhesion phenotype associated with anaemia
Alejandro Marín-Menéndez1, Azucena Bardají, Flor E Martínez-Espinosa
1Barcelona Centre for International Health Research (CRESIB), Hospital Clinic/Universitat de Barcelona, Barcelona, Spain.
Plos Neglected Tropical Diseases
|April 18, 2013
Summary
Plasmodium vivax cytoadhesion mechanisms are unclear. Rosetting, a common P. vivax phenotype, is linked to anemia, but pregnant women showed no increased adhesion to CSA, suggesting other factors influence P. vivax propagation.
Area of Science:
- Malariology
- Infectious Diseases
- Hematology
Background:
- Severe Plasmodium vivax (P. vivax) disease mechanisms are poorly understood.
- Cytoadhesion of infected erythrocytes is a potential factor in P. vivax sequestration and organ injury.
- The physiological impact of P. vivax cytoadhesion requires further investigation.
Purpose of the Study:
- To characterize clinically relevant cytoadhesive phenotypes of P. vivax isolates.
- To investigate potential differences in cytoadhesion among pregnant women, non-pregnant women, and men.
- To explore the relationship between P. vivax cytoadhesion and anemia.
Main Methods:
- Analyzed P. vivax peripheral isolates from Manaus, Brazil, in pregnant women, non-pregnant women, and men.
- Excluded P. falciparum co-infection using PCR and genotyped P. vivax isolates.
- Assessed rosetting and adhesion to CSA, CD36, ICAM1, and placental/brain cryosections.
Main Results:
- P. vivax monoinfection was confirmed in 59 isolates; 85% were single-clone infections.
- One P. vivax haplotype was more prevalent in pregnant women (33%) compared to others (p=0.010).
- Rosetting occurred in 64% of isolates; adhesion to CSA (15%), ICAM1 (12%), and placental cryosections (9%) were observed. Rosetting intensity correlated with anemia and lower hemoglobin/hematocrit levels.
Conclusions:
- P. vivax isolates from pregnant women did not show prominent CSA adhesion, suggesting other unknown phenotypes may drive P. vivax clone propagation in this group.
- Rosetting is a frequent cytoadhesive phenotype in P. vivax infections.
- Rosetting may contribute to the development of anemia in P. vivax-infected individuals.
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