Evidence of endothelial activation in asymptomatic Plasmodium falciparum parasitemia and effect of blood group on levels of von Willebrand factor in Malaria

Gregory S. Park, Kathleen F. Ireland, Robert O. Opoka, Chandy John

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Endothelial activation may contribute to development of severe disease from Plasmodium falciparum infection, but optimal markers of endothelial activation in severe malaria, the extent of endothelial activation in asymptomatic infection, and the effect of blood group O on endothelial activation have not been defined. Methods: Serum levels of 3 markers of endothelial activation-von Willebrand factor (VWF), soluble intercellular adhesion molecule-1 (sICAM-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1)-were assessed in Ugandan children with cerebral malaria (CM) (n = 86), children with uncomplicated malaria (UM) (n = 81), and community children (CC) (n = 90). Results: Serum VWF, sICAM-1, and sVCAM-1 levels were all elevated in asymptomatic community children with microscopy-confirmed parasitemia when compared with children without parasitemia by microscopy or polymerase chain reaction (all, P ≤.05). Levels of VWF, sICAM-1, and sVCAM-1 were higher in children with UM than in CC (all, P <0.001), but only VWF levels effectively distinguished CM from UM (P <0.001), a finding confirmed by receiver operating characteristic analyses (area under the curve = 0.67; 95% confidence interval,.58-.75). Von Willebrand factor levels were lower in children with blood group O versus non-O blood groups across the disease spectrum, but VWF levels remained higher in CM versus UM, even after controlling for blood group. Conclusions: Endothelial activation, as assessed by serum levels of VWF, sICAM-1, and sVCAM-1, occurs even in subclinical P. falciparum parasitemia. Von Willebrand factor levels increase with greater malaria disease severity. Blood group O is associated with lower VWF levels, but presence of blood group O alone does not explain the higher VWF levels seen in children with CM.

Original languageEnglish (US)
Article numberpis010
Pages (from-to)16-25
Number of pages10
JournalJournal of the Pediatric Infectious Diseases Society
Volume1
Issue number1
DOIs
StatePublished - 2012
Externally publishedYes

Fingerprint

Parasitemia
von Willebrand Factor
Plasmodium falciparum
Blood Group Antigens
Malaria
Cerebral Malaria
Vascular Cell Adhesion Molecule-1
Intercellular Adhesion Molecule-1
Microscopy
Serum
Asymptomatic Infections
ROC Curve
Area Under Curve
Confidence Intervals
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Infectious Diseases
  • Pediatrics, Perinatology, and Child Health

Cite this

Evidence of endothelial activation in asymptomatic Plasmodium falciparum parasitemia and effect of blood group on levels of von Willebrand factor in Malaria. / Park, Gregory S.; Ireland, Kathleen F.; Opoka, Robert O.; John, Chandy.

In: Journal of the Pediatric Infectious Diseases Society, Vol. 1, No. 1, pis010, 2012, p. 16-25.

Research output: Contribution to journalArticle

@article{0bc7b3d899df4fe48fed356391153ff0,
title = "Evidence of endothelial activation in asymptomatic Plasmodium falciparum parasitemia and effect of blood group on levels of von Willebrand factor in Malaria",
abstract = "Background: Endothelial activation may contribute to development of severe disease from Plasmodium falciparum infection, but optimal markers of endothelial activation in severe malaria, the extent of endothelial activation in asymptomatic infection, and the effect of blood group O on endothelial activation have not been defined. Methods: Serum levels of 3 markers of endothelial activation-von Willebrand factor (VWF), soluble intercellular adhesion molecule-1 (sICAM-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1)-were assessed in Ugandan children with cerebral malaria (CM) (n = 86), children with uncomplicated malaria (UM) (n = 81), and community children (CC) (n = 90). Results: Serum VWF, sICAM-1, and sVCAM-1 levels were all elevated in asymptomatic community children with microscopy-confirmed parasitemia when compared with children without parasitemia by microscopy or polymerase chain reaction (all, P ≤.05). Levels of VWF, sICAM-1, and sVCAM-1 were higher in children with UM than in CC (all, P <0.001), but only VWF levels effectively distinguished CM from UM (P <0.001), a finding confirmed by receiver operating characteristic analyses (area under the curve = 0.67; 95{\%} confidence interval,.58-.75). Von Willebrand factor levels were lower in children with blood group O versus non-O blood groups across the disease spectrum, but VWF levels remained higher in CM versus UM, even after controlling for blood group. Conclusions: Endothelial activation, as assessed by serum levels of VWF, sICAM-1, and sVCAM-1, occurs even in subclinical P. falciparum parasitemia. Von Willebrand factor levels increase with greater malaria disease severity. Blood group O is associated with lower VWF levels, but presence of blood group O alone does not explain the higher VWF levels seen in children with CM.",
author = "Park, {Gregory S.} and Ireland, {Kathleen F.} and Opoka, {Robert O.} and Chandy John",
year = "2012",
doi = "10.1093/jpids/pis010",
language = "English (US)",
volume = "1",
pages = "16--25",
journal = "Journal of the Pediatric Infectious Diseases Society",
issn = "2048-7207",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Evidence of endothelial activation in asymptomatic Plasmodium falciparum parasitemia and effect of blood group on levels of von Willebrand factor in Malaria

AU - Park, Gregory S.

AU - Ireland, Kathleen F.

AU - Opoka, Robert O.

AU - John, Chandy

PY - 2012

Y1 - 2012

N2 - Background: Endothelial activation may contribute to development of severe disease from Plasmodium falciparum infection, but optimal markers of endothelial activation in severe malaria, the extent of endothelial activation in asymptomatic infection, and the effect of blood group O on endothelial activation have not been defined. Methods: Serum levels of 3 markers of endothelial activation-von Willebrand factor (VWF), soluble intercellular adhesion molecule-1 (sICAM-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1)-were assessed in Ugandan children with cerebral malaria (CM) (n = 86), children with uncomplicated malaria (UM) (n = 81), and community children (CC) (n = 90). Results: Serum VWF, sICAM-1, and sVCAM-1 levels were all elevated in asymptomatic community children with microscopy-confirmed parasitemia when compared with children without parasitemia by microscopy or polymerase chain reaction (all, P ≤.05). Levels of VWF, sICAM-1, and sVCAM-1 were higher in children with UM than in CC (all, P <0.001), but only VWF levels effectively distinguished CM from UM (P <0.001), a finding confirmed by receiver operating characteristic analyses (area under the curve = 0.67; 95% confidence interval,.58-.75). Von Willebrand factor levels were lower in children with blood group O versus non-O blood groups across the disease spectrum, but VWF levels remained higher in CM versus UM, even after controlling for blood group. Conclusions: Endothelial activation, as assessed by serum levels of VWF, sICAM-1, and sVCAM-1, occurs even in subclinical P. falciparum parasitemia. Von Willebrand factor levels increase with greater malaria disease severity. Blood group O is associated with lower VWF levels, but presence of blood group O alone does not explain the higher VWF levels seen in children with CM.

AB - Background: Endothelial activation may contribute to development of severe disease from Plasmodium falciparum infection, but optimal markers of endothelial activation in severe malaria, the extent of endothelial activation in asymptomatic infection, and the effect of blood group O on endothelial activation have not been defined. Methods: Serum levels of 3 markers of endothelial activation-von Willebrand factor (VWF), soluble intercellular adhesion molecule-1 (sICAM-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1)-were assessed in Ugandan children with cerebral malaria (CM) (n = 86), children with uncomplicated malaria (UM) (n = 81), and community children (CC) (n = 90). Results: Serum VWF, sICAM-1, and sVCAM-1 levels were all elevated in asymptomatic community children with microscopy-confirmed parasitemia when compared with children without parasitemia by microscopy or polymerase chain reaction (all, P ≤.05). Levels of VWF, sICAM-1, and sVCAM-1 were higher in children with UM than in CC (all, P <0.001), but only VWF levels effectively distinguished CM from UM (P <0.001), a finding confirmed by receiver operating characteristic analyses (area under the curve = 0.67; 95% confidence interval,.58-.75). Von Willebrand factor levels were lower in children with blood group O versus non-O blood groups across the disease spectrum, but VWF levels remained higher in CM versus UM, even after controlling for blood group. Conclusions: Endothelial activation, as assessed by serum levels of VWF, sICAM-1, and sVCAM-1, occurs even in subclinical P. falciparum parasitemia. Von Willebrand factor levels increase with greater malaria disease severity. Blood group O is associated with lower VWF levels, but presence of blood group O alone does not explain the higher VWF levels seen in children with CM.

UR - http://www.scopus.com/inward/record.url?scp=84907737213&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84907737213&partnerID=8YFLogxK

U2 - 10.1093/jpids/pis010

DO - 10.1093/jpids/pis010

M3 - Article

AN - SCOPUS:84907737213

VL - 1

SP - 16

EP - 25

JO - Journal of the Pediatric Infectious Diseases Society

JF - Journal of the Pediatric Infectious Diseases Society

SN - 2048-7207

IS - 1

M1 - pis010

ER -