Lung Injury in Vivax Malaria: Pathophysiological Evidence for Pulmonary Vascular Sequestration and Posttreatment Alveolar-Capillary Inflammation
Identifieur interne : 001A68 ( Main/Exploration ); précédent : 001A67; suivant : 001A69Lung Injury in Vivax Malaria: Pathophysiological Evidence for Pulmonary Vascular Sequestration and Posttreatment Alveolar-Capillary Inflammation
Auteurs : Nicholas M. Anstey [Australie] ; Tjandra Handojo ; Michael C. F. Pain [Australie] ; Enny Kenangalem [Australie] ; Emiliana Tjitra [Indonésie] ; Ric N. Price [Royaume-Uni] ; Graeme P. Maguire [Australie]Source :
- The Journal of Infectious Diseases [ 0022-1899 ] ; 2007.
Abstract
Background. The mechanisms underlying lung injury in vivax malaria are not well understood. Inflammatory responses to Plasmodium falciparum and P. vivax, to our knowledge, have not previously been compared at an organ level. Methods. Respiratory symptoms and physiological aspects were measured longitudinally in Indonesian adults with uncomplicated vivax (n=50) and falciparum (n=50) malaria. Normal values were derived from 109 control subjects. Gas transfer was partitioned into its alveolar-capillary membrane (DM) and pulmonary capillary vascular (VC) components, to characterize the site and timing of impaired gas transfer. Results. Mean baseline VC volume was significantly reduced in vivax and falciparum malaria, improving with treatment in each species. Baseline DM function was not impaired in either species. The progressive deterioration in DM function after treatment was statistically significant in vivax malaria but not in uncomplicated falciparum malaria. Oxygen saturation deteriorated after treatment in vivax but improved in falciparum malaria. Conclusions. The baseline reduction in VC volume but not in DM function suggests encroachment on VC volume by parasitized erythrocytes and suggests that P. vivax-infected erythrocytes may sequester within the pulmonary microvasculature. Progressive alveolar-capillary dysfunction after treatment of vivax malaria is consistent with a greater inflammatory response to a given parasite burden in P. vivax relative to that in P. falciparum.
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DOI: 10.1086/510756
Affiliations:
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Pain</name></author><author><name sortKey="Kenangalem, Enny" sort="Kenangalem, Enny" uniqKey="Kenangalem E" first="Enny" last="Kenangalem">Enny Kenangalem</name></author><author><name sortKey="Tjitra, Emiliana" sort="Tjitra, Emiliana" uniqKey="Tjitra E" first="Emiliana" last="Tjitra">Emiliana Tjitra</name></author><author><name sortKey="Price, Ric N" sort="Price, Ric N" uniqKey="Price R" first="Ric N." last="Price">Ric N. Price</name></author><author><name sortKey="Maguire, Graeme P" sort="Maguire, Graeme P" uniqKey="Maguire G" first="Graeme P." last="Maguire">Graeme P. 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Anstey</name><affiliation></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Australie</country></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Australie</country><wicri:regionArea>Reprints or correspondence: Dr. Nicholas M. Anstey, Menzies School of Health Research, PO Box 41096, Casuarina, Darwin NT 0811</wicri:regionArea><wicri:noRegion>Darwin NT 0811</wicri:noRegion></affiliation></author><author><name sortKey="Handojo, Tjandra" sort="Handojo, Tjandra" uniqKey="Handojo T" first="Tjandra" last="Handojo">Tjandra Handojo</name><affiliation><wicri:noCountry code="subField">Hospital</wicri:noCountry></affiliation></author><author><name sortKey="Pain, Michael C F" sort="Pain, Michael C F" uniqKey="Pain M" first="Michael C. F." last="Pain">Michael C. F. Pain</name><affiliation wicri:level="3"><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><wicri:orgArea>Department of Respiratory Medicine, Royal Melbourne Hospital and University of Melbourne</wicri:orgArea></affiliation></author><author><name sortKey="Kenangalem, Enny" sort="Kenangalem, Enny" uniqKey="Kenangalem E" first="Enny" last="Kenangalem">Enny Kenangalem</name><affiliation wicri:level="3"><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><wicri:orgArea>Department of Respiratory Medicine, Royal Melbourne Hospital and University of Melbourne</wicri:orgArea></affiliation><affiliation><wicri:noCountry code="subField">Papua</wicri:noCountry></affiliation></author><author><name sortKey="Tjitra, Emiliana" sort="Tjitra, Emiliana" uniqKey="Tjitra E" first="Emiliana" last="Tjitra">Emiliana Tjitra</name><affiliation wicri:level="1"><country xml:lang="fr">Indonésie</country><wicri:regionArea>National Institute of Health Research and Development, Ministry of Health, Jakarta</wicri:regionArea><wicri:noRegion>Jakarta</wicri:noRegion></affiliation></author><author><name sortKey="Price, Ric N" sort="Price, Ric N" uniqKey="Price R" first="Ric N." last="Price">Ric N. Price</name><affiliation></affiliation><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Vaccinology and Tropical Medicine, Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Maguire, Graeme P" sort="Maguire, Graeme P" uniqKey="Maguire G" first="Graeme P." last="Maguire">Graeme P. Maguire</name><affiliation></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Australie</country><wicri:regionArea>Western Australia Country Health Service-Kimberley, Broome</wicri:regionArea><wicri:noRegion>Broome</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">The Journal of Infectious Diseases</title><title level="j" type="abbrev">The Journal of Infectious Diseases</title><idno type="ISSN">0022-1899</idno><idno type="eISSN">1537-6613</idno><imprint><publisher>The University of Chicago Press</publisher><date when="2007-02-15">2007</date><biblScope unit="vol">195</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="589">589</biblScope><biblScope unit="page" to="596">596</biblScope></imprint><idno type="ISSN">0022-1899</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-1899</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Background. The mechanisms underlying lung injury in vivax malaria are not well understood. Inflammatory responses to Plasmodium falciparum and P. vivax, to our knowledge, have not previously been compared at an organ level. Methods. Respiratory symptoms and physiological aspects were measured longitudinally in Indonesian adults with uncomplicated vivax (n=50) and falciparum (n=50) malaria. Normal values were derived from 109 control subjects. Gas transfer was partitioned into its alveolar-capillary membrane (DM) and pulmonary capillary vascular (VC) components, to characterize the site and timing of impaired gas transfer. Results. Mean baseline VC volume was significantly reduced in vivax and falciparum malaria, improving with treatment in each species. Baseline DM function was not impaired in either species. The progressive deterioration in DM function after treatment was statistically significant in vivax malaria but not in uncomplicated falciparum malaria. Oxygen saturation deteriorated after treatment in vivax but improved in falciparum malaria. Conclusions. The baseline reduction in VC volume but not in DM function suggests encroachment on VC volume by parasitized erythrocytes and suggests that P. vivax-infected erythrocytes may sequester within the pulmonary microvasculature. Progressive alveolar-capillary dysfunction after treatment of vivax malaria is consistent with a greater inflammatory response to a given parasite burden in P. vivax relative to that in P. falciparum.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Indonésie</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Oxfordshire</li><li>Victoria (État)</li></region><settlement><li>Melbourne</li><li>Oxford</li></settlement></list><tree><noCountry><name sortKey="Handojo, Tjandra" sort="Handojo, Tjandra" uniqKey="Handojo T" first="Tjandra" last="Handojo">Tjandra Handojo</name></noCountry><country name="Australie"><noRegion><name sortKey="Anstey, Nicholas M" sort="Anstey, Nicholas M" uniqKey="Anstey N" first="Nicholas M." last="Anstey">Nicholas M. Anstey</name></noRegion><name sortKey="Anstey, Nicholas M" sort="Anstey, Nicholas M" uniqKey="Anstey N" first="Nicholas M." last="Anstey">Nicholas M. Anstey</name><name sortKey="Kenangalem, Enny" sort="Kenangalem, Enny" uniqKey="Kenangalem E" first="Enny" last="Kenangalem">Enny Kenangalem</name><name sortKey="Maguire, Graeme P" sort="Maguire, Graeme P" uniqKey="Maguire G" first="Graeme P." last="Maguire">Graeme P. Maguire</name><name sortKey="Pain, Michael C F" sort="Pain, Michael C F" uniqKey="Pain M" first="Michael C. F." last="Pain">Michael C. F. Pain</name></country><country name="Indonésie"><noRegion><name sortKey="Tjitra, Emiliana" sort="Tjitra, Emiliana" uniqKey="Tjitra E" first="Emiliana" last="Tjitra">Emiliana Tjitra</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Price, Ric N" sort="Price, Ric N" uniqKey="Price R" first="Ric N." last="Price">Ric N. Price</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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