Loscertales María-Paz, Owens Stephen, O'Donnell James, Bunn James, Bosch-Capblanch Xavier, Brabin Bernard J
Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Liverpool L3 5QA, United Kingdom.
Adv Parasitol. 2007;65:1-50. doi: 10.1016/S0065-308X(07)65001-5.
Host susceptibility to Plasmodium falciparum infection is central for improved understanding of malaria in human populations. Red blood cell (RBC) polymorphisms have been proposed as factors associated with malaria infection or its severity, although no systematic appraisal of ABO phenotypes and malaria risk has been undertaken. This analysis summarises epidemiological, clinical and immunological evidence on the nature of ABO histo-blood antigens and their interaction with malaria in terms of population genetics, infection risk, severe malaria and placental malaria. In non-pregnant subjects, a meta-analysis showed no conclusive evidence associating ABO phenotypes with risk of uncomplicated malaria. There was stronger evidence that ABO phenotype modulates severity of P. falciparum malaria, with group A associated with severe disease and blood group O with milder disease. Among pregnant subjects, group O was associated with increased risk of placental malaria in primigravidae and reduced risk in multigravidae. The biological basis for ABO-related susceptibility to malaria is reviewed. Several mechanisms relate to these associations including affinity for Anopheles gambiae; shared ABO antigens with P. falciparum; impairment of merozoite penetration of RBCs; and cytoadherence, endothelial activation and rosetting. ABO phenotypic associations with malaria are related to its pathogenesis and improved understanding of these interactions is required for understanding the glycobiology of malaria infection.
宿主对恶性疟原虫感染的易感性对于深入了解人类疟疾至关重要。红细胞（RBC）多态性被认为是与疟疾感染或其严重程度相关的因素，尽管尚未对ABO血型表型与疟疾风险进行系统评估。本分析总结了关于ABO组织血型抗原的性质及其在群体遗传学、感染风险、重症疟疾和胎盘疟疾方面与疟疾相互作用的流行病学、临床和免疫学证据。在非孕妇中，一项荟萃分析显示没有确凿证据表明ABO血型表型与非重症疟疾风险相关。有更强的证据表明ABO血型表型可调节恶性疟原虫疟疾的严重程度，其中A型血与严重疾病相关，O型血与较轻疾病相关。在孕妇中，O型血与初产妇胎盘疟疾风险增加以及经产妇风险降低相关。本文综述了ABO血型相关疟疾易感性的生物学基础。几种机制与这些关联有关，包括对冈比亚按蚊的亲和力；与恶性疟原虫共享的ABO抗原；裂殖子穿透红细胞的受损；以及细胞黏附、内皮激活和红细胞凝聚。ABO血型表型与疟疾的关联与其发病机制有关，为了解疟疾感染的糖生物学，需要对这些相互作用有更深入的认识。
