Department of Public Health and Infectious Diseases Istituto Pasteur-Fondazione Cenci Bolognetti, Sapienza University of Rome, Italy.
Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso.
J Infect Dis. 2015 Aug 15;212(4):626-34. doi: 10.1093/infdis/jiv098. Epub 2015 Feb 23.
Although hemoglobin S (HbS) and hemoglobin C (HbC) are well known to protect against severe Plasmodium falciparum malaria, conclusive evidence on their role against infection has not yet been obtained. Here we show, in 2 populations from Burkina Faso (2007-2008), that HbS is associated with a 70% reduction of harboring P. falciparum parasitemia at the heterozygous state (odds ratio [OR] for AS vs AA, 0.27; 95% confidence interval [CI], .11-.66; P = .004). There is no evidence of protection for HbC in the heterozygous state (OR for AC vs AA, 1.49; 95% CI, .69-3.21; P = .31), whereas protection even higher than that observed with AS is observed in the homozygous and double heterozygous states (OR for CC + SC vs AA, 0.04; 95% CI, .01-.29; P = .002). The abnormal display of parasite-adhesive molecules on the surface of HbS and HbC infected erythrocytes, disrupting the pathogenic process of sequestration, might displace the parasite from the deep to the peripheral circulation, promoting its elimination at the spleen level.
尽管血红蛋白 S（HbS）和血红蛋白 C（HbC）已被证实可预防严重的恶性疟原虫疟疾，但它们在感染方面的作用仍缺乏确凿的证据。在这里，我们在来自布基纳法索的 2 个人群（2007-2008 年）中显示，HbS 在杂合状态下与携带恶性疟原虫寄生虫血症的风险降低 70%相关（AS 与 AA 的比值比 [OR]，0.27；95%置信区间 [CI]，0.11-0.66；P=0.004）。HbC 在杂合状态下没有保护作用（AC 与 AA 的比值比 [OR]，1.49；95% CI，0.69-3.21；P=0.31），而在纯合和双重杂合状态下观察到的保护作用甚至高于 AS（CC+SC 与 AA 的比值比 [OR]，0.04；95% CI，0.01-0.29；P=0.002）。感染 HbS 和 HbC 的红细胞表面异常展示寄生虫黏附分子，破坏了疟疾原虫的寄生过程，可能将寄生虫从深部推向外周循环，促进其在脾脏水平的清除。
