Combined measurement of soluble and cellular ICAM-1 among children with Plasmodium falciparum malaria in Uganda

Malaria Journal

Research

Christine M Cserti-Gazdewich¹  Walter H Dzik²  Isaac Ssewanyana³  Charles Musoke⁴  Aggrey Dhabangi⁴  Kevin C Kain⁵  Laura Erdman⁵ 

[1] Department of Laboratory Medicine & Pathobiology, University Health Network/University of Toronto, Toronto, Canada;Department of Pathology, Massachusetts General Hospital, Boston, MA, USA;Joint Clinical Research Centre, Kampala, Uganda;Makerere University, Kampala, Uganda;McLaughlin-Rotman Centre for Global Health, University Health Network/University of Toronto, Toronto, Canada;

关键词: Malaria;    Severe Malaria;    Cerebral Malaria;    Uncomplicated Malaria;    Plasmodium Falciparum Malaria;   

DOI  :  10.1186/1475-2875-9-233

 received in 2010-06-14, accepted in 2010-08-16,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundIntercellular adhesion molecule-1 (ICAM-1) is a cytoadhesion molecule implicated in the pathogenesis of Plasmodium falciparum malaria. Elevated levels of soluble ICAM-1 (sICAM-1) have previously been reported with increased malaria disease severity. However, studies have not yet examined both sICAM-1 concentrations and monocyte ICAM-1 expression in the same cohort of patients. To better understand the relationship of soluble and cellular ICAM-1 measurements in malaria, both monocyte ICAM-1 expression and sICAM-1 concentration were measured in children with P. falciparum infection exhibiting a spectrum of clinical severity.MethodsSamples were analysed from 160 children, aged 0.5 to 10.8 years, with documented P. falciparum malaria in Kampala, Uganda. The patients belonged to one of three pre-study defined groups: uncomplicated malaria (UM), severe non-fatal malaria (SM-s), and fatal malaria (SM-f). Subset analysis was done on those with cerebral malaria (CM) or severe malaria anaemia (SMA). Monocyte ICAM-1 was measured by flow cytometry. sICAM-1 was measured by enzyme immunoassay.ResultsBoth sICAM-1 and monocyte cell-surface ICAM-1 followed a log-normal distribution. Median sICAM-1 concentrations increased with greater severity-of-illness: 279 ng/mL (UM), 462 ng/mL (SM-s), and 586 ng/mL (SM-f), p < 0.0001. sICAM-1 levels were not statistically different among children with CM compared to SMA. Monocyte ICAM-1 expression was significantly higher in cases of UM compared with SM-s or SM-f (p < 0.001) and was higher among the subset of patients with CM compared with SMA, p < 0.0014. The combination of sICAM-1 and cellular ICAM-1 identified distinct categories of patients (UM with low sICAM-1 and higher monocyte ICAM-1, CM with both sICAM-1 and monocyte ICAM-1 high, and SMA with sICAM-1 high but monocyte ICAM-1 low).ConclusionIn this cohort of children with P. falciparum malaria, sICAM-1 levels were associated with severity-of-illness. Patients with UM had higher monocyte ICAM-1 expression consistent with a role for monocyte ICAM-1 in immune clearance during non-severe malaria. Among the subsets of patients with either SMA or CM, monocyte ICAM-1 levels were higher in CM, consistent with the role of ICAM-1 as a marker of cytoadhesion. Categories of disease in pediatric malaria may exhibit specific combinations of soluble and cellular ICAM-1 expression.

【 授权许可】

CC BY   
© Cserti-Gazdewich et al; licensee BioMed Central Ltd. 2010