Brasseur P, Agrapart M, Ballet J J, Druilhe P, Warrell M J, Tharavanij S
Clin Immunol Immunopathol. 1983 Apr;27(1):38-50. doi: 10.1016/0090-1229(83)90054-5.
Several cell-mediated functions were studied in vivo and in vitro in 63 Thai patients with acute falciparum malaria, including 21 cases with cerebral manifestations and 10 cases with initial parasitemia over 10%. Initial delayed cutaneous reactions to phytohemagglutinin and soluble protein antigens were negative in most cerebral malaria cases. In other patients, skin reactions were impaired or abolished as a direct function of parasitemia. No major alteration in the numbers of blood T and B lymphocytes was found. In lymphocyte cultures, proliferative responses to lectins were generally found within normal ranges; in contrast, proliferative responses to candidin were suppressed in parallel with delayed cutaneous responses to the same antigen. From these data, it can be concluded that the alteration of specific cell-mediated responses are predominantly detectable in acute cases with major parasite invasion, i.e., high parasitemia and/or cerebral manifestations. A direct role of Plasmodium falciparum was further suggested by the rapid restoration of cell-mediated functions observed in several cases under successful antimalarial therapy. These results do not support any evidence in favor of a preexisting cellular immune deficiency in relation with the occurrence of cerebral or high-parasitemia acute malaria in these patients.
对63例泰国急性恶性疟患者的多种细胞介导功能进行了体内和体外研究，其中包括21例有脑部表现的患者和10例初始寄生虫血症超过10%的患者。大多数脑型疟病例对植物血凝素和可溶性蛋白抗原的初始延迟皮肤反应为阴性。在其他患者中，皮肤反应作为寄生虫血症的直接函数而受损或消失。未发现血液中T淋巴细胞和B淋巴细胞数量有重大改变。在淋巴细胞培养中，对凝集素的增殖反应一般在正常范围内；相反，对念珠菌素的增殖反应与对相同抗原的延迟皮肤反应同时受到抑制。从这些数据可以得出结论，特异性细胞介导反应的改变主要在寄生虫大量入侵的急性病例中可检测到，即高寄生虫血症和/或脑部表现。在成功的抗疟治疗下，几例患者观察到细胞介导功能迅速恢复，这进一步提示了恶性疟原虫的直接作用。这些结果不支持任何证据表明这些患者发生脑型或高寄生虫血症急性疟疾与预先存在的细胞免疫缺陷有关。
