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Plasma Soluble Progenitor Cell Receptors as Biomarkers for Severe Anemia Among Malaria-Infected Pediatrics: A
Charles Nkansah1,2, Samuel K Appiah1,2, Felix Osei-Boakye2,3
1Department of Haematology School of Allied Health Sciences, University for Development Studies Tamale Ghana.
Insights
Soluble erythropoietin receptor (sEPO-R) levels were elevated in Ghanaian children with severe malarial anemia, correlating negatively with red blood cell counts. sEPO-R may contribute to anemia development in malaria.
Area of Science:
- Hematology
- Immunology
- Infectious Diseases
Background:
- Severe anemia in children is a significant health concern, particularly in malaria-endemic regions.
- Soluble progenitor cell receptors, such as soluble erythropoietin receptor (sEPO-R) and soluble granulocyte, macrophage-colony stimulating factor receptor (sGM-CSFR), are being investigated for their role in erythropoietic dysfunction.
Purpose of the Study:
- To assess plasma levels of sEPO-R and sGM-CSFR in children with Plasmodium falciparum infection in Ghana.
- To investigate the correlation between these soluble receptors and hematological parameters, including hemoglobin, red blood cells, hematocrit, and platelets.
- To determine the predictive value of sEPO-R for severe malarial anemia (SMA).
Main Methods:
- A case-control study involving 120 P. falciparum-infected children and 60 uninfected children (aged 12-144 months) in Ghana.
- Blood samples were analyzed for malaria microscopy, full blood count, and plasma levels of sEPO-R, sGM-CSFR, and erythropoietin (EPO) using enzyme-linked immunosorbent assays.
- Statistical analysis was performed using SPSS version 26.0.
Main Results:
- Plasma sEPO-R levels were significantly higher in children with SMA compared to non-SMA and control groups (p < 0.001).
- Plasma sGM-CSFR levels were elevated in P. falciparum-infected children but similar between SMA and non-SMA groups.
- sEPO-R showed strong negative correlations with hemoglobin (r = -0.823), RBC (r = -0.852), HCT (r = -0.790), and platelets (r = -0.810).
- A strong positive correlation was observed between sEPO-R and EPO (r = 0.901, p < 0.001).
- sEPO-R demonstrated high sensitivity (96.0%) and specificity (82.9%) in predicting severe anemia in malaria-infected children.
Conclusions:
- P. falciparum infection is associated with increased plasma levels of sGM-CSFR, sEPO-R, and EPO.
- Elevated sEPO-R levels negatively correlate with erythrocyte parameters, suggesting a potential role in the pathogenesis of severe anemia during malaria.
- Further research is recommended to explore the neutralizing effects of sEPO-R on erythropoiesis in malaria.
Background:
Soluble forms of progenitor cell receptors may be implicated in the delayed erythropoietic response during severe anemia. In this study, plasma levels of soluble erythropoietin receptor (sEPO-R) and soluble granulocyte, macrophage-colony stimulating factor receptor (sGM-CSFR) were assessed in Plasmodium falciparum-infected children in Ghana.
Methods:
This case-control study was conducted at Tamale Teaching Hospital, Ghana. One hundred and twenty P. falciparum-infected, and 60 uninfected children aged 12-144 months were recruited from April to July, 2023. About 4 mL of blood was collected for malaria microscopy, full blood count using a haematology analyser, and sEPO-R, sGM-CSFR and erythropoietin (EPO) estimation using enzyme-linked immunosorbent assays. Data were analyzed using SPSS version 26.0.
Results:
Plasma levels of sEPO-R were higher among participants with severe malarial anemia (SMA) than those in the non-SMA and control groups (p < 0.001). Plasma sGM-CSFR levels were higher in P. falciparum-infected children than in controls, but the levels were similar between the SMA and non-SMA groups. Hemoglobin (r = -0.823, p < 0.001), RBC (r = -0.852, p < 0.001), HCT (r = -0.790, p < 0.001) and platelets (r = -0.810, p < 0.001) negatively correlated with sEPO-R. There was a strong positive correlation between sEPO-R and EPO in P. falciparum-infected children (r = 0.901, p < 0.001). Plasma sEPO-R better predicted severe anemia among malaria-infected children (cut-off point: 161.5 pg/mL, sensitivity: 96.0%, specificity: 82.9%, AUC: 0.964, p < 0.001).
Conclusion:
P. falciparum-infected children had higher plasma levels of sGM-CSFR, sEPO-R and EPO. Plasma sEPO-R correlated negatively with erythrocyte parameters, suggesting a possible contribution of the endogenous receptor to the development of severe anemia in children with malaria. Further studies to investigate the neutralizing effects of sEPO-R on erythropoietic response during malaria are recommended.
