Abstract
Background: The role of the circulating platelet has until in relatively recent times, been mainly considered in terms of cellular mediators of thrombo-haemorrhagic activities. It has most recently also been shown to play important role in modulating host immune response to infections such as malaria infection, both in the early and later phases of the infection. Data on the role that platelets play in early malaria infection is relatively scanty. This review highlights changes in platelet characteristics and function that have been reported in acute malaria infection.
Methods: Literature from Pubmed (MEDLINE), Google Scholar, Google search, textbooks and Cochrane Library were reviewed covering the period
Results: It is observed that Thrombocytopenia which had hitherto been considered as the hallmark of the complication of acute malaria infection, occurs in 40-80% of human acute malaria infection and in 100% of murine models. It results from platelet activation mechanism. The evidence in support of this view includes associated findings of elevated plasma concentrations of Beta-thromboglobulin (BTG) and Platelet Factor 4 (PF4) as well as enhanced production of Thromboxane A2 (TXA2 ) and 6-keto prostaglandin F1α (6-KPF1α). There is also loss of total platelet sialic acid associated with reduction of platelet life span. A more recent finding of platelet killing of the parasite inside the infected red cell has revealed a hitherto little known potential which shows that early interaction between circulating platelets and the malaria parasite in the course of infection may result in reduction of parasitaemia thus mediating host survival to malaria infection. The mechanism(s) of platelet protective activity in early acute malaria is/are yet to be fully clarified in order to provide better understanding of the phenomenon. Clinically, it has also been reported that in acute malaria infection, the severity of clinical manifestations correlates closely with the parasite load.
Conclusion: Reported changes of platelet/malaria parasite interactions highlighted in this review bring to the fore the need for more research activities to be undertaken in this area.
Keywords: Acute malaria; platelet function; thrombocytopenia
Résumé
Contexte: Le rôle de la tablette circulante a, jusqu’à une époque relativement récente, été principalement considéré en termes de médiateurs cellulaires des activités thrombo-hémorragique. Elle a, aussi plus récemment, été montré à jouer un rôle important dans la modulation de réponse immunitaire de l’hôte aux infections telles que l’infection du paludisme, tout à la fois dans les périodes précoces et plus tardive de l’infection. Les données sur le rôle que les tablettes jouent au début de l’infection du paludisme sont relativement rares. Cette revue souligne les changements des caractéristiques et fonction de la tablette qui ont été signalés dans l’infection du paludisme aigu.
Méthodes: Les littératures recueillies du Pubmed (MEDLINE), Google Scolaire, recherche du Google, des manuels et la Librairie de Cochrane ont été examinés pendant la période
Résultats: Il est observé que la Thrombo-cytopénie qui jusque là avait été considérée comme la marque la complication de l’infection du paludisme aigu, survient dans 40 à 80% des infections du paludisme aigu humaine et dans 100% des modèles murins. Elle en résulte des mécanismes d’activation de la tablette. La preuve à l’appui de ce point de vue comprend les résultats associés aux concentrations plasmatiques élevées de bêta-thrombo-globuline (BTG) et facteur de tablette 4 (PF4) ainsi que la production accrue de thromboxane A2 (TXA2) et 6-celto prostaglandine F1α (6-KPF1α). Il ya aussi la perte de l’acide sialique de la tablette associée à une réduction totale de durée de vie de la tablette. Un constat plus récent du carnage des tablettes du parasite à l’intérieur du globule rouge infecté a révélé jusqu’ici un potentiel peu connu qui montre que l’interaction précoce entre les tablettes circulantes et le parasite du paludisme dans le cours de l’infection peut entraîner une réduction de parasitémie ainsi donc servant de médiation pour la survie de l’hôte à l’infection du paludisme. Le(s) mécanisme(s) d’activité protective de la tablette au début du paludisme aigu n’est/sont pas encore totalement clarifiée afin de fournir une meilleure compréhension du phénomène. Cliniquement, il a également été rapporté que, dans l’infection paludéenne aiguë, la gravité des manifestations cliniques est en étroite corrélation avec la charge parasitaire.
Conclusion: Les changements rapportés d’interactions parasite de la tablette / paludisme soulignés dans cette revue mettent en avant la nécessité àentreprendre plus activités de recherche dans ce domaine.
Mots-clés: le paludisme aiguë; fonction de tablette; thrombo-cytopénie
Correspondence: Prof. Etim M. Essien, Department of Haematology, University of Uyo, Akwa Ibom State, Nigeria. Email: emessien@yahoo.co.uk
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