Determinants of brain swelling in pediatric and adult cerebral malaria.
JCI Insight
; 6(18)2021 09 22.
Article
en En
| MEDLINE
| ID: mdl-34549725
ABSTRACT
Cerebral malaria (CM) affects children and adults, but brain swelling is more severe in children. To investigate features associated with brain swelling in malaria, we performed blood profiling and brain MRI in a cohort of pediatric and adult patients with CM in Rourkela, India, and compared them with an African pediatric CM cohort in Malawi. We determined that higher plasma Plasmodium falciparum histidine rich protein 2 (PfHRP2) levels and elevated var transcripts that encode for binding to endothelial protein C receptor (EPCR) were linked to CM at both sites. Machine learning models trained on the African pediatric cohort could classify brain swelling in Indian children CM cases but had weaker performance for adult classification, due to overall lower parasite var transcript levels in this age group and more severe thrombocytopenia in Rourkela adults. Subgrouping of patients with CM revealed higher parasite biomass linked to severe thrombocytopenia and higher Group A-EPCR var transcripts in mild thrombocytopenia. Overall, these findings provide evidence that higher parasite biomass and a subset of Group A-EPCR binding variants are common features in children and adult CM cases, despite age differences in brain swelling.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
/
3_ND
/
4_TD
Problema de salud:
2_enfermedades_transmissibles
/
3_malaria
/
3_neglected_diseases
/
3_zoonosis
/
4_meningitis
Asunto principal:
Trombocitopenia
/
Edema Encefálico
/
Proteínas Protozoarias
/
Malaria Cerebral
/
Carga de Parásitos
/
Antígenos de Protozoos
Tipo de estudio:
Prognostic_studies
Aspecto:
Patient_preference
Límite:
Adolescent
/
Adult
/
Aged
/
Child
/
Child, preschool
/
Humans
/
Middle aged
País/Región como asunto:
Africa
/
Asia
Idioma:
En
Revista:
JCI Insight
Año:
2021
Tipo del documento:
Article
País de afiliación:
India