Department of Pharmacological and Molecular Sciences, Università degli Studi di Milano, Milan, Italy.
Rega Institute for Medical Research, KU Leuven-University of Leuven, Louvain, Belgium.
Malar J. 2018 Jan 9;17(1):18. doi: 10.1186/s12936-017-2159-3.
Cerebral malaria and severe anaemia are the most common deadly complications of malaria, and are often associated, both in paediatric and adult patients, with hepatopathy, whose pathogenesis is not well characterized, and sometimes also with acute respiratory distress syndrome (ARDS). Here, two species of murine malaria, the lethal Plasmodium berghei strain NK65 and self-healing Plasmodium chabaudi strain AS which differ in their ability to cause hepatopathy and/or ARDS were used to investigate the lipid alterations, oxidative damage and host immune response during the infection in relation to parasite load and accumulation of parasite products, such as haemozoin.
Plasma and livers of C57BL/6J mice injected with PbNK65 or PcAS infected erythrocytes were collected at different times and tested for parasitaemia, content of haemozoin and expression of tumour necrosis factor (TNF). Hepatic enzymes, antioxidant defenses and lipids content and composition were also evaluated.
In the livers of P. berghei NK65 infected mice both parasites and haemozoin accumulated to a greater extent than in livers of P. chabaudi AS infected mice although in the latter hepatomegaly was more prominent. Hepatic enzymes and TNF were increased in both models. Moreover, in P. berghei NK65 infected mice, increased lipid peroxidation, accumulation of triglycerides, impairment of anti-oxidant enzymes and higher collagen deposition were detected. On the contrary, in P. chabaudi AS infected mice the antioxidant enzymes and the lipid content and composition were normal or even lower than uninfected controls.
This study demonstrates that in C57BL/6J mice, depending on the parasite species, malaria-induced liver pathology results in different manifestations, which may contribute to the different outcomes. In P. berghei NK65 infected mice, which concomitantly develop lethal acute respiratory distress syndrome, the liver tissue is characterized by an excess oxidative stress response and reduced antioxidant defenses while in P. chabaudi AS infected mice hepatopathy does not lead to lipid alterations or reduction of antioxidant enzymes, but rather to inflammation and cytokine burst, as shown earlier, that may favour parasite killing and clearance of the infection. These results may help understanding the different clinical profiles described in human malaria hepatopathy.
脑型疟疾和严重贫血是疟疾最常见的致命并发症,在儿科和成人患者中常与肝病相关,其发病机制尚未得到很好的描述,有时还与急性呼吸窘迫综合征(ARDS)相关。在这里,使用两种鼠疟原虫,致死性疟原虫 NK65 株和自愈性疟原虫 AS 株,来研究感染过程中的脂质改变、氧化损伤和宿主免疫反应与寄生虫载量和寄生虫产物(如疟原血红素)的积累之间的关系。
用 PbNK65 或 PcAS 感染的红细胞注射 C57BL/6J 小鼠后,不同时间收集血浆和肝脏,检测疟原虫载量、疟原血红素含量和肿瘤坏死因子(TNF)的表达。还评估了肝酶、抗氧化防御和脂质含量及组成。
在 P. berghei NK65 感染小鼠的肝脏中,寄生虫和疟原血红素的积累程度大于 P. chabaudi AS 感染小鼠的肝脏,尽管后者肝肿大更为明显。两种模型中肝酶和 TNF 均升高。此外,在 P. berghei NK65 感染小鼠中,检测到脂质过氧化增加、甘油三酯积累、抗氧化酶受损和胶原沉积增加。相反,在 P. chabaudi AS 感染小鼠中,抗氧化酶和脂质含量及组成正常或甚至低于未感染对照组。
本研究表明,在 C57BL/6J 小鼠中,根据寄生虫种类的不同,疟疾引起的肝病理表现不同,这可能导致不同的结果。在同时发生致命性急性呼吸窘迫综合征的 P. berghei NK65 感染小鼠中,肝脏组织的特征是过度氧化应激反应和抗氧化防御减少,而在 P. chabaudi AS 感染小鼠中,肝病变不会导致脂质改变或抗氧化酶减少,而是导致炎症和细胞因子爆发,如之前所示,这可能有利于寄生虫的杀伤和清除感染。这些结果可能有助于理解人类疟疾肝病变描述的不同临床特征。