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Chambrion C, Depond M, Angella L, Mouri O, Kendjo E, Fricot-Monsinjon A, Roussel C, Biligui S, Tantaoui I, Taieb A, Argy N, Houzé S, Piarroux R, Siriez JY, Jaureguiberry S, Larréché S, Théllier M, Cenac N, Buffet P, Ndour PA. Altered Subpopulations of Red Blood Cells and Post-treatment Anemia in Malaria. Front Physiol 2022; 13:875189. [PMID: 35480048 PMCID: PMC9037233 DOI: 10.3389/fphys.2022.875189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
In acute malaria, the bulk of erythrocyte loss occurs after therapy, with a nadir of hemoglobin generally observed 3–7 days after treatment. The fine mechanisms leading to this early post-treatment anemia are still elusive. We explored pathological changes in RBC subpopulations by quantifying biochemical and mechanical alterations during severe malaria treated with artemisinin derivatives, a drug family that induce “pitting” in the spleen. In this study, the hemoglobin concentration dropped by 1.93 G/dl during therapy. During the same period, iRBC accounting for 6.12% of all RBC before therapy (BT) were replaced by pitted-RBC, accounting for 5.33% of RBC after therapy (AT). RBC loss was thus of 15.9%, of which only a minor part was due to the loss of iRBC or pitted-RBC. When comparing RBC BT and AT to normal controls, lipidomics revealed an increase in the cholesterol/phosphatidylethanolamine ratio (0.17 versus 0.24, p < 0.001) and cholesterol/phosphatidylinositol ratio (0.36 versus 0.67, p = 0.001). Using ektacytometry, we observed a reduced deformability of circulating RBC, similar BT and AT, compared to health control donors. The mean Elongation Index at 1.69Pa was 0.24 BT and 0.23 AT vs. 0.28 in controls (p < 0.0001). At 30Pa EI was 0.56 BT and 0.56 AT vs. 0.60 in controls (p < 0.001). The retention rate (rr) of RBC subpopulations in spleen-mimetic microsphere layers was higher for iRBC (rr = 20% p = 0.0033) and pitted-RBC (rr = 19%, p = 0.0031) than for healthy RBC (0.12%). Somewhat surprisingly, the post-treatment anemia in malaria results from the elimination of RBC that were never infected.
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Affiliation(s)
- Charlotte Chambrion
- Biologie Intégrée du Globule Rouge, Université de Paris, Université des Antilles, Paris, France
| | - Mallorie Depond
- Biologie Intégrée du Globule Rouge, Université de Paris, Université des Antilles, Paris, France
| | - Lucia Angella
- Biologie Intégrée du Globule Rouge, Université de Paris, Université des Antilles, Paris, France
| | - Oussama Mouri
- Centre National de Référence du Paludisme, Hôpital Pitié Salpêtrière, Paris, France
| | - Eric Kendjo
- Centre National de Référence du Paludisme, Hôpital Pitié Salpêtrière, Paris, France
| | | | - Camille Roussel
- Biologie Intégrée du Globule Rouge, Université de Paris, Université des Antilles, Paris, France
- Laboratoire d'Hématologie, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Sylvestre Biligui
- Centre National de Référence du Paludisme, Hôpital Pitié Salpêtrière, Paris, France
| | - Ilhame Tantaoui
- Centre National de Référence du Paludisme, Hôpital Pitié Salpêtrière, Paris, France
| | - Aida Taieb
- Centre National de Référence du Paludisme, Hôpital Pitié Salpêtrière, Paris, France
| | - Nicolas Argy
- Centre National de Référence du Paludisme, Laboratoire de Parasitologie-Mycologie, Hôpital Bichat-Claude Bernard, Paris, France
| | - Sandrine Houzé
- Centre National de Référence du Paludisme, Laboratoire de Parasitologie-Mycologie, Hôpital Bichat-Claude Bernard, Paris, France
| | - Renaud Piarroux
- Sorbonne Université, Centre National de Référence du Paludisme, Hôpital Pitié-Salpêtriére, Paris, France
| | - Jean-Yves Siriez
- Service d'accueil des Urgences Pédiatriques, Hôpital Robert Debré, Paris, France
| | | | - Sébastien Larréché
- Département de Biologie Médicale, Hôpital d’Instruction Des Armées Bégin, Saint-Mandé, France
| | - Marc Théllier
- Sorbonne Université, Centre National de Référence du Paludisme, Hôpital Pitié-Salpêtriére, Paris, France
| | - Nicolas Cenac
- IRSD, INSERM, INRA, INPENVT, Université de Toulouse, Toulouse, France
| | - Pierre Buffet
- Biologie Intégrée du Globule Rouge, Université de Paris, Université des Antilles, Paris, France
| | - Papa Alioune Ndour
- Biologie Intégrée du Globule Rouge, Université de Paris, Université des Antilles, Paris, France
- *Correspondence: Papa Alioune Ndour,
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Abstract
Despite a 30% decline in mortality since 2000, malaria still affected 219 million subjects and caused 435,000 deaths in 2017. Red blood cells (RBC) host Plasmodium parasites that cause malaria, of which Plasmodium falciparum is the most pathogenic. The deformability of RBC is markedly modified by invasion and development of P. falciparum. Surface membrane area is potentially impacted by parasite entry and development, the cytoskeleton is modified by parasite proteins and cytosol viscosity is altered by parasite metabolism. RBC hosting mature parasites (second half of the asexual erythrocytic cycle) are abnormally stiff but the main reason for their absence from the circulation is their adherence to endothelial cells, mediated by parasite proteins exposed at the infected-RBC surface. By contrast, the circulation of non-adherent rings and gametocytes, depends predominantly on deformability. Altered deformability of rings and of uninfected-RBC altered by malaria infection is an important determinant of malaria pathogenesis. It also impacts the response to antimalarial therapy. Unlike conventional antimalarials that target mature stages, currently recommended first-line artemisinin derivatives and the emerging spiroindolones act on circulating rings. Methods to investigate the deformability of RBC are therefore critical to understand the clearance of infected- and uninfected-RBC in malaria. Herein, we review the main methods to assess the deformability of P. falciparum infected-RBC, and their contribution to the understanding of how P. falciparum infection causes disease, how the parasite is transmitted and how antimalarial drugs induce parasite clearance.
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Affiliation(s)
- Mallorie Depond
- UMR_S1134, BIGR, Inserm, Universit de Paris, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Benoit Henry
- UMR_S1134, BIGR, Inserm, Universit de Paris, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Pierre Buffet
- UMR_S1134, BIGR, Inserm, Universit de Paris, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Papa Alioune Ndour
- UMR_S1134, BIGR, Inserm, Universit de Paris, Paris, France.,Institut National de la Transfusion Sanguine, Paris, France.,Laboratory of Excellence GR-Ex, Paris, France
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Roussel C, Marin M, Michaël D, Fricot A, Chambrion C, Henry B, Volle G, Depond M, Rougé S, Dokmak S, Paye F, Sauvanet A, Hermine O, Kim CLV, Colin Y, Ndour PA, Amireault P, Buffet P. Clairance post-transfusionnelle des globules rouges stockés : analyse dans un modèle de rate humaine isolée-perfusée. Transfus Clin Biol 2019. [DOI: 10.1016/j.tracli.2019.06.221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gayral-Taminh M, Bravi C, Depond M, Pourre F, Maffre T, Raynaud JP, Grandjean H. [Self-evaluation of the quality of life of children aged 6 to 12 years old: analysis of the concept and development of a prototype tool]. Sante Publique 2005; 17:35-45. [PMID: 15835214 DOI: 10.3917/spub.051.0035] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The objective of this work was to assess the quality of life of children aged 6 to 12 years old. The authors present the different conceptual and operational steps which lead to the construction of a prototype tool. It was a generic tool composed of 63 items which covered the classically described areas of life. Its originality was due to the method of construction used which included children's involvement, to the pictorial representation of real-life situations for children, and to its adaptation for gender. The evaluation of this tool showed a good level of acceptability but statistical analysis revealed some metrological inadequacies leading to the reconsideration of the initial concepts and their methods of exploration. Therefore a new tool was constructed whose validation is presented in a second article in the next issue.
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Affiliation(s)
- M Gayral-Taminh
- Inserm U558, Faculté de Médecine, 37, Allée Jules-Guesde, 31073 Toulouse cedex, France
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