Anemia Offers Stronger Protection Than Sickle Cell Trait Against the Erythrocytic Stage of Falciparum Malaria and This Protection Is Reversed by Iron Supplementation

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• 作者：M.M. Goheen^a ; ^{morgan_goheen@med.unc.edu} ; R. Wegmü ; ller^b ; ; A. Bah^b ; B. Darboe^b ; E. Danso^b ; M. Affara^b ; D. Gardner^c ; J.C. Patel^d ; A.M. Prentice^b ; ^e ; C. Cerami^b
• 关键词：AA ; normal β-globin genotype ; AC ; heterozygous hemoglobin C β-globin genotype ; AS ; heterozygous sickle-cell trait β-globin genotype ; CI ; confidence interval ; CRP ; C reactive protein ; G6PD ; glucose-6-phosphate dehydrogenase ; GPA ; glycophorin A ; GR ; growth rate ; Hgb ; hemoglobin ; IDA ; iron deficiency anemia ; MCH ; mean corpuscular hemoglobin ; MCHC ; mean corpuscular hemoglobin concentration ; MCV ; mean corpuscular volume ; MFI ; mean fluorescent intensity ; MPV ; mean platelet volume ; Pf ; Plasmodium falci
• 刊名：EBioMedicine
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：14
• 期：Complete
• 页码：123-130
• 全文大小：569 K
• 卷排序：14

文摘

P. falciparum laboratory and field strains invade and grow less efficiently in RBCs from anemic children. Deficits in invasion and growth for erythrocytic stage P. falciparum are reversed when RBCs are used from anemic children receiving iron supplementation for 49 and 84 days. The population level impact of protection against malaria from anemia was greater than that for sickle-cell trait.The long-term consequences of anemia are severe, and it is easily treatable. However, concerns remain about the safety of iron supplements, particularly for children in malaria-endemic countries lacking adequate access to health services. We used RBCs from Gambian children before, during, and after 12 weeks of daily iron supplementation for in vitro P. falciparum assays. P. falciparum invasion and growth was decreased in anemic RBCs and increased after 49 days of iron supplementation relative to baseline (p < 0.001), paralleling increases in young RBCs, which the parasite prefers. The parasite growth protection from anemia was substantial, providing greater population level impact than sickle-cell trait.