1. Longitudinal changes in iron homeostasis in human experimental and clinical malaria.
- Author
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Woolley SD, Grigg MJ, Marquart L, Gower JSE, Piera K, Nair AS, Amante FM, Rajahram GS, William T, Frazer DM, Chalon S, McCarthy JS, Anstey NM, and Barber BE
- Subjects
- Humans, Female, Male, Adult, Receptors, Transferrin metabolism, Receptors, Transferrin blood, Middle Aged, Malaysia epidemiology, Young Adult, Longitudinal Studies, Malaria, Falciparum parasitology, Malaria, Falciparum blood, Malaria, Falciparum metabolism, Erythropoietin metabolism, Erythropoietin blood, Biomarkers, Parasitemia blood, Iron metabolism, Iron blood, Homeostasis, Hepcidins blood, Hepcidins metabolism, Malaria blood, Malaria parasitology, Malaria metabolism, Ferritins blood
- 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., Funding: National Health and Medical Research Council (Program Grant 1037304, Project Grants 1045156 and 1156809; Investigator Grants 2016792 to BEB, 2016396 to JCM, 2017436 to MJG); US National Institute of Health (R01-AI116472-03); Malaysian Ministry of Health (BP00500420)., Competing Interests: Declaration of interests None of the authors have conflicts of interests to declare., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2024
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