4/6/2023 0 Comments Mal de diogenesThis persistence is due to some unique biological features complicating treatment and elimination, including low peripheral parasitaemia and presence of dormant liver stages (hypnozoites) which relapse weeks or months after blood infection has been cleared. vivax than for Plasmodium falciparum, with the elimination of the former presenting a major challenge in areas that successfully reduced P. falciparum as the current measures for malaria control are less effective for P. vivax elimination will be significantly more difficult than P. In 2018, Plasmodium vivax infection accounted for 41% of all malaria cases outside of Sub-Saharan Africa, with a total of 6.5 million cases and more than 2 billion people in 90 countries at risk ( World Malaria Reports, 2019). ![]() Malaria remains a heavy burden across endemic regions worldwide. vivax tissue reservoir, particularly in the haematopoietic niche of bone marrow and spleen. This supports the emerging paradigm of a P. vivax patients than peripheral parasitaemia. Altogether, our data show that total parasite biomass is a better predictor of perturbations in host homeostasis in P. Finally, machine learning models defined a combination of host parameters measured in the circulation that could predict the extent of parasite infection outside of circulation. When patients’ signatures were combined, high association of total parasite biomass with a subset of markers of EC activation, thrombocytopenia, and lymphopenia severity was observed. Vivax high patients presented more severe thrombocytopenia and lymphopenia, along with enrichment of neutrophils in the peripheral blood and increased neutrophil-to-lymphocyte ratio (NLCR). Overall Vivax low patients clustered with healthy donors and Vivax high patients showed more profound alterations in haematological parameters, endothelial cell (EC) activation, and glycocalyx breakdown and levels of cytokines regulating different haematopoiesis pathways compared to Vivax low. These patient subgroups were defined based on differences in total parasite biomass but not peripheral parasitaemia. Further data deconvolution revealed two patient clusters, here termed Vivax low and Vivax high. Patterns of clinical features, parasite burden, and host signatures measured in plasma across the patient cohort were highly heterogenous. ![]() We analysed parasite and host signatures in a cohort of uncomplicated vivax malaria patients from Manaus, Brazil, combining clinical and parasite parameters, multiplexed analysis of host responses, and ex vivo assays. In this study, we investigate associations between both peripheral and total parasite biomass and host response in vivax malaria. vivax biomass based on circulating markers indicates existence of a predominant parasite population outside of circulation. vivax infection can lead to poor clinical outcomes, despite low peripheral parasitaemia, remains a matter of intense debate. Plasmodium vivax is the major cause of human malaria in the Americas. ![]()
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