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Cytoadherence and its association with clinical disease in Plasmodium falciparum infections in Sri Lanka


S.L. Pathirana ,

Malaria Research Unit, Department of Parasitology, Faculty of Medicine, University of Colombo, Kynsey Road, Colombo 08, LK
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K. Ekanayake,

Avon Pharmo Chem (Pvt) Ltd., No 64 B ½. 2nd Floor, Jambugasmulla Road, Nugegoda., LK
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R.J. Howard,

Department of Molecular Biology, DNAX Research Institute, Palo Alto, California, U.S.A., US
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K.N. Mendis,

Roll Back Malaria Initiative, World Health Organization, Geneva, Switzerland, CH
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S.M. Handunnetti

Institute of Biochemistry, Molecular Biology and Biotechnology, 90, Kumaratunga Munidasa Mawatha, University of Colombo, Colombo 03, LK
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Abstract: Cytoadherence properties of two categories of Plasmodium falciparum isolates from Sri Lanka were assessed using CHO-CD36 and CHO-ICAM-1 stable transfected cell lines, and the association with the clinical disease in patients, from whom the parasites were obtained was also analyzed. In the 40 uncomplicated malaria isolates (UM) studied, infected erythrocyte (IE) adherence to CHO-CD36 cells (25.8±2.1) was comparable to that of the 12 severe malaria (SM) isolates (35.0±6.4). IE adherence to CHO-ICAM-1 cells of the SM isolates (14.9±2.3) were significantly higher (p=0.006) compared to that of UM isolates (5.7±0.7). The percentage of isolates forming rosettes in the two clinical categories, UM and SM, were 69% and 42% respectively. However, the mean rosetting values were not statistically different (10.5±2.9 and 2.9±1.7). Expression of surface antigens was studied using assays for surface immunofluorescence and antibody mediated agglutination. All 40 UM isolates were positive for expression of surface antigens. In the UM group, the intensity of clinical symptoms, as expressed by a clinical score, was significantly and positively correlated to IE adherence to CHO-ICAM-1 (r=0.54; p=0.003) but not to CHO-CD36 cells or rosetting. The intensity of clinical symptoms was also significantly correlated with peripheral blood parasitaemia of these patients (r=0.39; p=0.037). However, the association between adherence to ICAM-1 and intensity of clinical symptoms was independent of the peripheral blood parasitaemia of the patients (multiple regression analysis controlling for parasitaemia; p=0.016). These results show that IE adherence to ICAM-1 may have implications for the intensity of clinical symptoms and the severity of infection in falciparum malaria.

Keywords: Cytoadherence, pathogenesis, Plasmodium falciparum, Sri Lanka, surface antigens.

Doi: 10.4038/jnsfsr.v38i4.2650

J.Natn.Sci.Foundation Sri Lanka 2010 38 (4):233-240

How to Cite: Pathirana, S.L., Ekanayake, K., Howard, R.J., Mendis, K.N. and Handunnetti, S.M., 2010. Cytoadherence and its association with clinical disease in Plasmodium falciparum infections in Sri Lanka. Journal of the National Science Foundation of Sri Lanka, 38(4), pp.233–240. DOI:
Published on 30 Dec 2010.
Peer Reviewed


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