Intravenous whole blood transfusion results in faster recovery of vascular integrity and increased survival in experimental cerebral malaria.

IF 2.5 4区 医学 Q2 PARASITOLOGY Memorias do Instituto Oswaldo Cruz Pub Date : 2023-01-01 DOI:10.1590/0074-02760220184
Saba Gul, Hans C Ackerman, Cláudio Tadeu Daniel-Ribeiro, Leonardo Jm Carvalho
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Abstract

Background: Cerebral malaria is a lethal complication of Plasmodium falciparum infections in need of better therapies. Previous work in murine experimental cerebral malaria (ECM) indicated that the combination of artemether plus intraperitoneal whole blood improved vascular integrity and increased survival compared to artemether alone. However, the effects of blood or plasma transfusion administered via the intravenous route have not previously been evaluated in ECM.

Objectives: To evaluate the effects of intravenous whole blood compared to intravenous plasma on hematological parameters, vascular integrity, and survival in artemether-treated ECM.

Methods: Mice with late-stage ECM received artemether alone or in combination with whole blood or plasma administered via the jugular vein. The outcome measures were hematocrit and platelets; plasma angiopoietin 1, angiopoietin 2, and haptoglobin; blood-brain barrier permeability; and survival.

Findings: Survival increased from 54% with artemether alone to 90% with the combination of artemether and intravenous whole blood. Intravenous plasma lowered survival to 18%. Intravenous transfusion provided fast and pronounced recoveries of hematocrit, platelets, angiopoietins levels and blood brain barrier integrity.

Main conclusions: The outcome of artemether-treated ECM was improved by intravenous whole blood but worsened by intravenous plasma. Compared to prior studies of transfusion via the intraperitoneal route, intravenous administration was more efficacious.

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静脉全血输注可使实验性脑型疟疾患者血管完整性恢复更快,生存率提高。
背景:脑型疟疾是恶性疟原虫感染的致命并发症,需要更好的治疗方法。先前在小鼠实验性脑疟疾(ECM)中的研究表明,与单独使用蒿甲醚相比,蒿甲醚联合腹腔全血可改善血管完整性并提高生存率。然而,通过静脉途径输注血液或血浆对ECM的影响以前没有被评估过。目的:评价静脉全血与静脉血浆对蒿甲醚治疗ECM患者血液学参数、血管完整性和生存的影响。方法:晚期ECM小鼠单独或联合全血或血浆经颈静脉给药。结果指标为血细胞比容和血小板;血浆血管生成素1、血管生成素2和触珠蛋白;血脑屏障通透性;和生存。结果:生存率从单独使用蒿甲醚的54%提高到静脉全血联合使用蒿甲醚的90%。静脉注射血浆使存活率降低到18%。静脉输血提供了快速和明显的恢复红细胞压积,血小板,血管生成素水平和血脑屏障的完整性。主要结论:静脉全血治疗蒿甲醚治疗的ECM疗效改善,血浆治疗的疗效恶化。与先前的研究相比,通过腹腔途径输血,静脉给药更有效。
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来源期刊
CiteScore
5.00
自引率
3.60%
发文量
91
审稿时长
3-8 weeks
期刊介绍: Memórias do Instituto Oswaldo Cruz is a journal specialized in microbes & their vectors causing human infections. This means that we accept manuscripts covering multidisciplinary approaches and findings in the basic aspects of infectious diseases, e.g. basic in research in prokariotes, eukaryotes, and/or virus. Articles must clearly show what is the main question to be answered, the hypothesis raised, and the contribution given by the study. Priority is given to manuscripts reporting novel mechanisms and general findings concerning the biology of human infectious prokariotes, eukariotes or virus. Papers reporting innovative methods for diagnostics or that advance the basic research with these infectious agents are also welcome. It is important to mention what we do not publish: veterinary infectious agents research, taxonomic analysis and re-description of species, epidemiological studies or surveys or case reports and data re-analysis. Manuscripts that fall in these cases or that are considered of low priority by the journal editorial board, will be returned to the author(s) for submission to another journal.
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