RESUMO
BACKGROUND: Plasmodium falciparum and Plasmodium vivax are responsible for most of the global burden of malaria. Although the accentuated pathogenicity of P. falciparum occurs because of sequestration of the mature erythrocytic forms in the microvasculature, this phenomenon has not yet been noted in P. vivax. The increasing number of severe manifestations of P. vivax infections, similar to those observed for severe falciparum malaria, suggests that key pathogenic mechanisms (eg, cytoadherence) might be shared by the 2 parasites. METHODS: Mature P. vivax-infected erythrocytes (Pv-iEs) were isolated from blood samples collected from 34 infected patients. Pv-iEs enriched on Percoll gradients were used in cytoadhesion assays with human lung endothelial cells, Saimiri brain endothelial cells, and placental cryosections. RESULTS: Pv-iEs were able to cytoadhere under static and flow conditions to cells expressing endothelial receptors known to mediate the cytoadhesion of P. falciparum. Although Pv-iE cytoadhesion levels were 10-fold lower than those observed for P. falciparum-infected erythrocytes, the strength of the interaction was similar. Cytoadhesion of Pv-iEs was in part mediated by VIR proteins, encoded by P. vivax variant genes (vir), given that specific antisera inhibited the Pv-iE-endothelial cell interaction. CONCLUSIONS: These observations prompt a modification of the current paradigms of the pathogenesis of malaria and clear the way to investigate the pathophysiology of P. vivax infections.
Assuntos
Eritrócitos/parasitologia , Malária Vivax/patologia , Plasmodium vivax/patogenicidade , Animais , Adesão Celular , Células Endoteliais/patologia , Eritrócitos/patologia , Feminino , Humanos , Placenta/patologia , Gravidez , SaimiriRESUMO
Assessment of the genetic diversity of Plasmodium falciparum in 110 Colombian isolates revealed that nearly all the parasites in the 97 isolates collected in endemic regions west of the Andes shared the same Pfmsp1 block 2 MAD20-type allelic variant, despite showing high diversity for other genetical markers. Analysis of published data indicated that the prevalence of this allelic variant of a major vaccine candidate antigen was already dominant since 1998. This phenomenon, which had not been hitherto recorded for a malaria blood stage antigen, is of biological and immunological interest but remains unexplained.