Differential differentiation of B cell lymphopoiesis in lethal and non-lethal murine malaria models.

B cells in protection against malaria and need of experiencing many episodes in humans to achieve a state of immunity is largely unknown. The cellular basis of such defects in terms of B cell generation, maturation and trafficking was studied by taking Plasmodium chabaudi, a non-lethal and Plasmodium berghei, a lethal murine model. A flow cytometry (FCF) based evaluation was used to study alterations in generation and maintenance of B cells in patients with Plasmodium falciparum malaria as well as in murine malaria models. A significant accumulation of mature B cells in bone marrow and immature B cells in circulation was a feature observed only in lethal malaria. At peak parasitaemia, both the models induce a significant decrease in T2 (transitional) B cells with expansion of T1B cells. Studies in patients with acute Pf malaria showed a significant expansion of memory B cells and TB cells with a concomitant decrease in naive2 B cells as compared with healthy controls. This study clearly demonstrates that acute malarial infection induces major disturbances in B cell development in lymphoid organs and trafficking in periphery.

Management of aging skin: A questionnaire-based study among Indian dermatologists.

INTRODUCTION: With increased life expectancy, the desire to look younger has increased. Hence, many patients approach dermatologists for antiaging treatment. However, data regarding management of skin aging in India are scarce. AIMS: To understand management patterns for skin aging among dermatologists in India. METHODS: Overall, 147 Indian dermatologists were administered a questionnaire-based survey about patient characteristics, signs of skin aging, treatment options, and cost. RESULTS: Among all the patients coming for dermatologists' consultation, 10%-40% were for antiaging treatment. About 70% dermatologists opined that majority of patients aged 30-40 years consulted for antiaging treatment, and the male to female ratio was 3:7. Approximately 46% of dermatologists felt that antiaging treatment should be initiated by the age of 30. Common signs of aging were wrinkles, pigmentation, dull skin or complexion, and dry skin. Based on patient's age and sex, dermatologists prescribed a combination of 2-4 products, which included antioxidants, retinoids, growth factors, and moisturizers. Improvement was assessed by photographic and clinical evaluation, and by patients' satisfaction (55%). Effect of the antiaging products was evident within 4-6 months. Earliest improvement was noted in dry skin and dull complexion. Average extent of improvement noted by 6 months was approximately 20%-30%. The average monthly expenditure on antiaging treatments was 2000-4000 INR. CONCLUSION: Both men and women seek clinical treatment for skin aging in India. Dermatologists prescribe a combination of 2-4 products, including antioxidants, retinoids, growth factors, and moisturizers. Available antiaging therapies show an average improvement of up to 30% by 6 months.

Decreased prevalence of sepsis but not mild or severe P. falciparum malaria is associated with pre-existing filarial infection.

BACKGROUND: Enhanced inflammatory host responses have been attributed as the cellular basis for development of severe malaria as well as sepsis. In contrast to this, filarial infections have been consistently reported to be associated with an immunological hypo-responsive phenotype. This suggests that successful control of filariasis by employing mass drug administration, could potentially contribute to an increase in incidence of sepsis and cerebral malaria in human communities. A case control study was undertaken to address this critical and urgent issue. METHODS: Eighty-nine patients with sepsis and one hundred and ninety-six patients with P. falciparum malaria all originating from Odisha, were tested for prevalence of circulating filarial antigens - a quantitative marker of active filarial infection. Antibodies to four stage specific malarial recombinant proteins were measured by solid phase immunoassays and circulating CD4+CD25high T-cells were quantified by flow cytometry with an objective to study if pre-existing filarial infections influence antibody responses to malarial antigens or the levels of circulating T-regulatory cells in P. falciparum infected patients. RESULTS: Prevalence of filarial antigenemia was significantly less in sepsis patients as compared to controls suggesting that pre-existing filariasis could influence development of sepsis. On the other hand, levels of circulating filarial antigen were comparable in severe malaria cases and healthy controls suggesting that development of severe malaria is independent of pre-existing W. bancrofti infections. Plasma TNF-a, RANTES and antibodies to recombinant malarial proteins as well as levels of circulating CD4+ CD25high cells were comparable in malaria patients with or without filarial infections. CONCLUSIONS: These observations imply that successful control of filariasis could have adverse consequences on public health by increasing the incidence of sepsis, while the incidence of severe malaria may not adversely increase as a consequence of elimination of filariasis.

Complement receptor 1 variants confer protection from severe malaria in Odisha, India.

BACKGROUND: In Plasmodium falciparum infection, complement receptor-1 (CR1) on erythrocyte's surface and ABO blood group play important roles in formation of rosettes which are presumed to be contributory in the pathogenesis of severe malaria. Although several studies have attempted to determine the association of CR1 polymorphisms with severe malaria, observations remain inconsistent. Therefore, a case control study and meta-analysis was performed to address this issue. METHODS: Common CR1 polymorphisms (intron 27 and exon 22) and blood group were typed in 353 cases of severe malaria (SM) [97 cerebral malaria (CM), 129 multi-organ dysfunction (MOD), 127 non-cerebral severe malaria (NCSM)], 141 un-complicated malaria and 100 healthy controls from an endemic region of Odisha, India. Relevant publications for meta-analysis were searched from the database. RESULTS: The homozygous polymorphisms of CR1 intron 27 and exon 22 (TT and GG) and alleles (T and G) that are associated with low expression of CR1 on red blood cells, conferred significant protection against CM, MOD and malaria deaths. Combined analysis showed significant association of blood group B/intron 27-AA/exon 22-AA with susceptibility to SM (CM and MOD). Meta-analysis revealed that the CR1 exon 22 low expression polymorphism is significantly associated with protection against severe malaria. CONCLUSIONS: The results of the present study demonstrate that common CR1 variants significantly protect against severe malaria in an endemic area.