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M1 macrophage features in severe Plasmodium falciparum malaria patients with pulmonary oedema
Aekkarin Klinkhamhom1, Supattra Glaharn1, Charit Srisook1
1Department of Tropical Pathology, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Bangkok, 10400, Thailand.
Background:
Pulmonary oedema (PE) is a serious complication of Plasmodium falciparum malaria which can lead to acute lung injury in severe cases. Lung macrophages are activated during malaria infection due to a complex host-immune response. The molecular basis for macrophage polarization is still unclear but understanding the predominant subtypes could lead to new therapeutic strategies where the diseases present with lung involvement. The present study was designed to study the polarization of lung macrophages, as M1 or M2 macrophages, in the lungs of severe P. falciparum malaria patients, with and without evidence of PE.
Methods:
Lung tissue samples, taken from patients who died from severe P. falciparum malaria, were categorized into severe malaria with PE and without PE (non-PE). Expression of surface markers (CD68+, all macrophages; CD40+, M1 macrophage; and CD163+, M2 macrophage) on activated lung macrophages was used to quantify M1/M2 macrophage subtypes.
Results:
Lung injury was demonstrated in malaria patients with PE. The expression of CD40 (M1 macrophage) was prominent in the group of severe P. falciparum malaria patients with PE (63.44 ± 1.98%), compared to non-PE group (53.22 ± 3.85%, p < 0.05), whereas there was no difference observed for CD163 (M2 macrophage) between PE and non-PE groups.
Conclusions:
The study demonstrates M1 polarization in lung tissues from severe P. falciparum malaria infections with PE. Understanding the nature of macrophage characterization in malaria infection may provide new insights into therapeutic approaches that could be deployed to reduce lung damage in severe P. falciparum malaria.
Insights
Severe malaria with pulmonary oedema shows increased M1 macrophage polarization in the lungs. This finding in Plasmodium falciparum malaria may guide therapies to mitigate lung injury.
Area of Science:
- Immunology
- Pathology
- Infectious Diseases
Background:
- Pulmonary oedema (PE) is a severe complication of Plasmodium falciparum malaria, potentially leading to acute lung injury.
- Lung macrophages play a role in malaria infection's immune response, but their polarization (M1/M2 subtypes) in PE is not well understood.
- Understanding macrophage polarization in malaria could inform new therapeutic strategies for lung involvement.
Purpose of the Study:
- To investigate the polarization of lung macrophages (M1 vs. M2) in patients with severe Plasmodium falciparum malaria.
- To compare macrophage polarization in patients with and without pulmonary oedema.
Main Methods:
- Analysis of lung tissue samples from deceased patients with severe P. falciparum malaria, categorized into PE and non-PE groups.
- Quantification of M1 (CD40+) and M2 (CD163+) macrophage subtypes using surface marker expression.
- CD68+ was used to identify all macrophages.
Main Results:
- Lung injury was evident in malaria patients with PE.
- CD40 (M1 macrophage) expression was significantly higher in the PE group (63.44%) compared to the non-PE group (53.22%).
- No significant difference in CD163 (M2 macrophage) expression was observed between the PE and non-PE groups.
Conclusions:
- Severe P. falciparum malaria with PE is characterized by M1 macrophage polarization in lung tissues.
- Characterizing macrophage subtypes in malaria infection offers potential insights for developing therapies to reduce lung damage.
- Targeting M1 macrophages may be a therapeutic avenue for managing lung complications in severe malaria.
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