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Woolley, Stephen, Grigg, Matthew J., Marquart, Louise, Gower, Jeremy S.E., Piera, Kim, Nair, Arya Sheela, Amante, Fiona M., Rajahram, Giri S., William, Timothy, Frazer, David M., Chalon, Stephan, McCarthy, James S., Anstey, Nicholas M. and Barber, Bridget E. (2024) 'Longitudinal changes in iron homeostasis in human experimental and clinical malaria'. EBioMedicine, Vol 105, e105189.
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Abstract
Background
The interaction between iron status 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 data and samples from 55 participants (19 female) enrolled in malaria VIS, and 171 patients (45 female) with malaria and 30 healthy controls (13 female) enrolled in clinical studies in Malaysia. Ferritin, hepcidin, erythropoietin, and soluble transferrin receptor (sTfR) were measured by ELISA.
Findings
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 ferritin was associated with post-treatment increases in liver transaminase levels. In Malaysian patients with malaria, hepcidin and ferritin were elevated on admission compared to healthy controls, while sTfR increased following admission. By day 28, hepcidin had normalised; however, ferritin and sTfR both remained elevated.
Interpretation
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.
| Item Type: | Article |
|---|---|
| Subjects: | QV Pharmacology > Hematologic Agents > QV 183 Iron. Iron compounds WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1016/j.ebiom.2024.105189 |
| SWORD Depositor: | JISC Pubrouter |
| Depositing User: | JISC Pubrouter |
| Date Deposited: | 20 Jun 2024 09:51 |
| Last Modified: | 20 Jun 2024 09:51 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/24736 |
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