Dysfunction of CD169 + macrophages and blockage of erythrocyte maturation as a mechanism of anemia in Plasmodium yoelii infection

Author:

Tumas Keyla C.1,Xu Fangzheng1,Wu Jian1ORCID,Hernandez Maricarmen1,Pattaradilokrat Sittiporn12ORCID,Xia Lu13ORCID,Peng Yu-chih1,Lavali Angela Musu1,He Xiao1,Singh Brajesh K.1,Zhang Cui1,Percopo Caroline1,Qi Chen-Feng4,Huang Suming56,Long Carole A.1,Su Xin-zhuan1ORCID

Affiliation:

1. Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Disease, NIH, Rockville, MD 20852

2. Department of Biology, Faculty of Science, Chulalongkorn University, Bangkok 10330, Thailand

3. Center for Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan 410033, China

4. Pathology Core, Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, NIH, Rockville, MD 20852

5. Department of Pediatrics, Division of Pediatric Hematology and Oncology, Penn State Cancer Institute, Hershey, PA 17033

6. Department of Pharmacology, Division of Pediatric Hematology and Oncology, Penn State Cancer Institute, Hershey, PA 17033

Abstract

Plasmodium parasites cause malaria with disease outcomes ranging from mild illness to deadly complications such as severe malarial anemia (SMA), pulmonary edema, acute renal failure, and cerebral malaria. In young children, SMA often requires blood transfusion and is a major cause of hospitalization. Malaria parasite infection leads to the destruction of infected and noninfected erythrocytes as well as dyserythropoiesis; however, the mechanism of dyserythropoiesis accompanied by splenomegaly is not completely understood. Using Plasmodium yoelii yoelii 17XNL as a model, we show that both a defect in erythroblastic island (EBI) macrophages in supporting red blood cell (RBC) maturation and the destruction of reticulocytes/RBCs by the parasites contribute to SMA and splenomegaly. After malaria parasite infection, the destruction of both infected and noninfected RBCs stimulates extramedullary erythropoiesis in mice. The continuous decline of RBCs stimulates active erythropoiesis and drives the expansion of EBIs in the spleen, contributing to splenomegaly. Phagocytosis of malaria parasites by macrophages in the bone marrow and spleen may alter their functional properties and abilities to support erythropoiesis, including reduced expression of the adherence molecule CD169 and inability to support erythroblast differentiation, particularly RBC maturation in vitro and in vivo. Therefore, macrophage dysfunction is a key mechanism contributing to SMA. Mitigating and/or alleviating the inhibition of RBC maturation may provide a treatment strategy for SMA.

Funder

HHS | National Institutes of Health

HHS | NIH | Office of Extramural Research, National Institutes of Health

Publisher

Proceedings of the National Academy of Sciences

Subject

Multidisciplinary

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