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Immunopathology of Acute Kidney Injury in Severe Malaria

Orestis Katsoulis1, Athina Georgiadou1,2, Aubrey J Cunnington1,2

  • 1Section of Paediatric Infectious Disease, Department of Infectious Disease, Imperial College London, London, United Kingdom.

Frontiers in Immunology
|May 10, 2021
PubMed

Insights

Severe malaria can cause acute kidney injury (AKI) through complex interactions. Understanding how parasite sequestration, hemolysis, and inflammation contribute to AKI is crucial for patient outcomes.

Area of Science:

  • Malariology
  • Nephrology
  • Immunology

Background:

  • Acute kidney injury (AKI) is a significant complication and mortality predictor in severe malaria.
  • The precise mechanisms of AKI in severe malaria remain incompletely understood.
  • Host inflammatory response overactivation is implicated, but its interaction with malaria pathology is unclear.

Purpose of the Study:

  • To review the interplay of malaria pathologies in AKI development.
  • To elucidate how parasite sequestration, microvascular obstruction, and hemolysis contribute to AKI.
  • To emphasize the systemic and localized effects of malaria on kidney function.

Main Methods:

  • Literature review and synthesis of existing research on severe malaria and AKI.
  • Analysis of the pathophysiological mechanisms linking malaria and kidney damage.
  • Discussion of the amplification of inflammatory responses by malaria-specific factors.

Main Results:

  • Parasite sequestration, microvascular obstruction, and intravascular hemolysis are key contributors to AKI in severe malaria.
  • These factors interact synergistically to amplify the host inflammatory response.
  • Systemic malaria pathology significantly influences localized kidney damage.

Conclusions:

  • AKI in severe malaria results from a complex interplay of parasitic, vascular, and inflammatory mechanisms.
  • Understanding these interactions is vital for developing targeted therapies.
  • Integrated approaches considering multi-organ involvement are necessary for managing severe malaria with AKI.
Keywords:
P. falciparumacute kidney injury (AKI)hemolysisimmune responseinflammationkidney injurymalaria

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