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严重疟疾中的肾脑致病轴。

The kidney-brain pathogenic axis in severe falciparum malaria.

机构信息

Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA.

University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, University of Bern, Bern, Switzerland.

出版信息

Trends Parasitol. 2023 Mar;39(3):191-199. doi: 10.1016/j.pt.2023.01.005. Epub 2023 Feb 2.

Abstract

Severe falciparum malaria is a medical emergency and a leading cause of death and neurodisability in endemic areas. Common complications include acute kidney injury (AKI) and cerebral malaria, and recent studies have suggested links between kidney and brain dysfunction in Plasmodium falciparum infection. Here, we review these new findings and present the hypothesis of a pivotal pathogenic crosstalk between the kidneys and the brain in severe falciparum malaria. We highlight the evidence of a role for distant organ involvement in the development of cerebral malaria and subsequent neurocognitive impairment post-recovery, describe the challenges associated with current diagnostic shortcomings for both AKI and brain involvement in severe falciparum malaria, and explore novel potential therapeutic strategies.

摘要

严重的恶性疟疾是一种医学急症,也是流行地区死亡和神经残疾的主要原因。常见的并发症包括急性肾损伤(AKI)和脑型疟疾,最近的研究表明恶性疟原虫感染中肾脏和大脑功能障碍之间存在关联。在这里,我们回顾了这些新发现,并提出了严重恶性疟疾中肾脏和大脑之间关键致病串扰的假说。我们强调了远处器官受累在脑型疟疾发展和随后康复后神经认知障碍中的作用的证据,描述了目前 AKI 和严重恶性疟疾中大脑受累的诊断缺陷相关的挑战,并探讨了新的潜在治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03c3/11071448/acfb0329baed/nihms-1987579-f0001.jpg

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