Year: 2023
Type: preprint
Abstract: Background: The interaction between iron deficiency and malaria is incompletely understood. We evaluated longitudinal changes in iron homeostasis in volunteers enrolled in malaria volunteer infection studies (VIS) and in Malaysian patients with falciparum and vivax malaria. Methods: We retrieved samples and associated data from 55 participants enrolled in malaria VIS, and 171 malaria patients and 30 healthy controls enrolled in clinical studies in Malaysia. Ferritin, hepcidin, erythropoietin, and soluble transferrin receptor (sTfR) were measured by ELISA. Results: In the VIS, participants' parasitaemia was correlated with baseline mean corpuscular volume (MCV), but not iron status (ferritin, hepcidin or sTfR). Ferritin, hepcidin and sTfR all increased during the VIS. Ferritin and hepcidin normalised by day 28, while sTfR remained elevated. In VIS participants, baseline iron status (ferritin) was associated with post-treatment increases in liver transaminase levels. In Malaysian malaria patients, hepcidin and ferritin were elevated on admission compared to healthy controls, while sTfR increased following admission. Hepcidin normalised by day 28; however, ferritin and sTfR both remained elevated 4 weeks following admission. Conclusion: Our findings demonstrate that parasitaemia is associated with an individual's MCV rather than iron status. The persistent elevation in sTfR 4 weeks post-infection in both malaria VIS and clinical malaria may reflect a causal link between malaria and iron deficiency.
Source: medRxiv
Institutions: Liverpool School of Tropical Medicine, QIMR Berghofer Medical Research Institute, Royal Centre for Defence Medicine, Charles Darwin University, Menzies School of Health Research, The University of Queensland, Queen Elizabeth II Hospital, Queen Elizabeth Hospital, Queen Elizabeth Hospital, Subang Jaya Medical Centre, Medicines for Malaria Venture, The University of Melbourne, Peter Doherty Institute, Royal Brisbane and Women's Hospital
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Addressing the threat of emerging zoonotic malaria in our region, Malaria volunteer infection studies for the advancement of antimalarial therapeutics, Translational studies in infectious diseases, Comparative incidence and clinical spectrum of Plasmodium knowlesi malaria, a longitudinal study in Sabah, Malaysia, QIMR Berghofer Medical Research Institute - to establish dose/concentration-response of single doses of tafenoquine in induced blood-stage malaria infections to facilitate dose-selection of t..., Tropical Disease - immunity, pathogenesis and vaccine development: global translation, Targeting acute kidney injury in knowlesi malaria, Comparative pathophysiology of severe knowlesi and falciparum malaria
OpenAlex ID: W4390080562