Plasmodium berghei: correlation of in vitro erythrophagocytosis with the dynamics of early-onset anemia and reticulocytosis in mice.

Infection of BALB/c mice with Plasmodium berghei results in an anemia which is excessive to that which can be accounted for solely by direct destruction of infected erythrocytes by the mature schizonts at the time of merozoite release. Mice infected with 10⁴ infected erythrocytes exhibited a progressive anemia beginning on Day 7. Significant reticulocytosis was first observed on Day 9 and parasitemia tended to parallel reticulocytosis with a lag of about 1 day. In studies of erythrophagocytosis, washed erythrocytes from randomly selected mice infected with 10⁵ infected red blood cells were phagocytized by peritoneal macrophages in vitro to a significantly greater extent on Days 3–5 postinfection than were erythrocytes taken from normal controls. The degree of erythrophagocytosis reached a peak on Day 4 and returned to control levels on Days 6 and 7. Erythrocytes taken from infected animals on Day 7 and incubated in normal plasma were phagocytized to a significantly greater extent than were normal erythrocytes incubated in normal plasma or erythrocytes from infected mice incubated in plasma from infected animals. The enhanced in vitro erythrophagocytosis observed on Days 3–5, which preceded and coincided with the beginning of the early-onset anemia on Day 5, may correlate with in vivo phenomena which may contribute to the developing anemia. Furthermore, the restoration of enhanced erythrophagocytosis by normal plasma seems to indicate that some component(s) of normal plasma may be depleted during the early stages of P. berghei infection.     

Erythrocyte Lysis and Xenopus laevis Oocyte Rupture by Recombinant Plasmodium falciparum Hemolysin III

Malaria kills more than 1 million people per year worldwide, with severe malaria anemia accounting for the majority of the deaths. Malaria anemia is multifactorial in etiology, including infected erythrocyte destruction and decrease in erythrocyte production, as well as destruction or clearance of noninfected erythrocytes. We identified a panspecies Plasmodium hemolysin type III related to bacterial hemolysins. The identification of a hemolysin III homologue in Plasmodium suggests a potential role in host erythrocyte lysis. Here, we report the first characterization of Plasmodium falciparum hemolysin III, showing that the soluble recombinant P. falciparum hemolysin III is a pore-forming protein capable of lysing human erythrocytes in a dose-, time-, and temperature-dependent fashion. The recombinant P. falciparum hemolysin III-induced hemolysis was partially inhibited by glibenclamide, a known channel antagonist. Studies with polyethylene glycol molecules of different molecular weights indicated a pore size of approximately 3.2 nm. Heterologous expression of recombinant P. falciparum hemolysin III in Xenopus oocytes demonstrated early hypotonic lysis similar to that of the pore-forming aquaporin control. Live fluorescence microscopy localized transfected recombinant green fluorescent protein (GFP)-tagged P. falciparum hemolysin III to the essential digestive vacuole of the P. falciparum parasite. These transfected trophozoites also possessed a swollen digestive vacuole phenotype. Native Plasmodium hemolysin III in the digestive vacuole may contribute to lysis of the parasitophorous vacuole membrane derived from the host erythrocyte. After merozoite egress from infected erythrocytes, remnant P. falciparum hemolysin III released from digestive vacuoles could potentially contribute to lysis of uninfected erythrocytes to contribute to severe life-threatening anemia.     

Alterations in the permeability of mouse erythrocytes infected with the malaria parasite, Plasmodium berghei

Alterations in the permeability of erythrocytes from mice infected with the malaria parasite Plasmodium berghei were demonstrated with l-¹⁴C-glucose. This sugar rapidly entered erythrocytes from infected mice but not those from normal mice. The results obtained were not due to contamination either by white cells, which were removed beforehand, or by immature cells, as judged by comparable investigations on blood from phenylhydrazine treated mice. Uptake was proportional to the concentration in the suspending medium, and was affected neither by relatively high concentrations of d-glucose nor by N-ethyl maleimide, and this suggests that the rapid uptake was due to an increased rate of diffusion through the membrane of the erythrocytes.     

Babesia microti: Biochemistry and function of hamster erythrocytes infected from a human source

Babesia microti, a protozoan parasite of mammalian erythrocytes was obtained from the blood of an infected human and maintained in golden hamsters, in which a parasitemia of 70% was obtained regularly. The hamsters' response—a subacute, hemolytic anemia—was studied with regard to oxygen affinity and red cell organic phosphate content. In addition, the reduced glutathione status of infected erythrocytes was observed because of the possible importance of this metabolite to parasite growth and red cell integrity. Infected animals developed a severe anemia with reticulocytosis; there occurred a 4-mm decrease in whole blood oxygen affinity without any change in erythrocytes' 2,3-diphosphoglycerate levels. The glutathione content of the infected animals' erythrocytes increased twofold during the course of the infection. In uninfected animals, in which anemia and reticulocytosis had been produced by bleeding, all changes seen in infected animals were reproduced. It was concluded that the changes in the infected animals were due to the anemia and reticulocytosis alone, and that the parasite played no role in these changes apart from being a cause of anemia and reticulocytosis.     

Immunological studies of the mechanism of anaemia in experimental Trypanosama evansi infection in rats

Pathological changes in the blood of rats acutely infected with Trypanosoma evansi and the probable mechanism of the accompanying anaemia, were investigated. A severe anaemia, together with rreticulocytosis and hepato-splenomegaly, were regularly observed. Histological examination of the liver, spleen and bone-marrow confirmed the increasedin erythropoietic activity that the observed anaemia was due to increasedextravascular destruction of erythrocytes rather than by inhibition of haemopoietic activity. All the infected rats showed significant immune responses to the infecting trypanosome peak agglutinin titres occurring 10–12 days after injection, coincidentally with maximun destruction of erythrocytes. Serological examination of sera and erythrocytes from all infected and control rats did not reveal the presence of either circulating or adsorbed erythrocyte auto--antibodies. Furthermore, there was no in vivo trypanosomal antigen coating of the erythrocytes from either infected or multiple antigen-injected rats. Repeated intraveoous injections into rats of more than 100 μg per g body weight of soluble T. evansi antigen resulted in moderately severe, probably antibody-mediated, haemolytic anaemia. It is considered that an immunologically-mediated mechanism may be responsible for the development of the anaemia accompanying T. evansi infection.     

Effects of IgG and IgM autoantibodies on non-infected erythrocytes is related to ABO blood group in Plasmodium vivax malaria and is associated with anemia

Autoantibodies play an important role in the destruction of non-infected red blood cells (nRBCs) during malaria. However, the relationship between this clearance and ABO blood groups is yet to be fully enlightened, especially for Plasmodium vivax infections. Here we show that anti-RBC IgG and IgM are increased in anemic patients with acute vivax malaria. Furthermore, both antibodies are able to decrease the deformability of nRBCs, but only IgG can induce in vitro erythrophagocytosis. Such effects are enhanced in type O erythrocytes, suggesting that individuals from this blood group infected with P. vivax malaria may be more susceptible to develop anemia.     

Plasmodium berghei: the influence of blood volume changes on the malaria-induced anemia in Balb/C mice

Malaria-induced anemia exceeds that attributable to direct parasite destruction of erythrocytes. Since spleen and liver weights increase significantly, hemodilution may account for part of this excessive anemia. To determine the role of hemodilution in the etiology of anemia, vascular volumes were measured with Evans blue and isotope dilution techniques. The Evans blue dilution technique showed that blood volume increased 20%, in infected Balb/C mice. However, when blood volume was measured with Evans blue bound to protein prior to injection or with iodinated albumin and chromium-labelled red blood cells no significant change was detected. Evidently the permeability of the vasculature and/or erythrocytes of infected mice was increased so that injected Evans blue occupied a space larger than the vascular volume before becoming bound to plasma proteins. We conclude that hemodilution is not involved in the excessive anemia of Plasmodium berghei-infected Balb/C mice.     

Trypanosoma brucei: attenuation by cortcosteroids of the anemia of infected mice

BALBc/J mice infected with pleomorphic stabilate of Trypanosoma brucei develop a severe anemia. The anemia is initially normoblastic and normocytic but becomes macrocytic due to brisk and sustained reticulocytosis. Red blood cells from uninfected animals are destroyed when transfused into infected animals. Neither extensive intravascular hemolysis nor red cell agglutinins were detected in infected animals, but spherocytes were common in the peripheral circulation. Treatment of mice with either dexamethasone or hydrocortisone greatly retarded the development of the anemia. Comparison of the course of infection in these treated mice to that in normal mice suggests that these corticosteroids attenuate the anemia through their immunosuppressive action.     

Studies on immune responses to parasite antigens in mice: VII. Cells secreting antibodies to modified mouse erythrocytes in Babesia rodhaini-infected mice

Increased numbers of plaque-forming cells (PFC) secreting antibodies to bromelain-treated mouse erythrocytes were detected in the spleens of BALB/c·nu/+ mice heavily infected with Babesia rodhaini but not in the spleens of infected hypothymic BALB/ c·nu/nu mice. Whether the products of these cells, antierythrocyte autoantibodies, play any role in the destruction of intact erythrocytes in parasitized mice is unknown, but it is noteworthy that only low numbers of PFC were detected, and the modification of mouse erythrocytes was obligatory for detection of PFC.     

Oesophagostomum radiatum in calves: intestinal hemorrhage associated with larval emergence

Intestinal blood loss in calves infected with various numbers of Oesophagostomum radiatum was measured using ⁵¹Cr-labeled erythrocytes, and compared with the subsequent changes in the packed cell volume of jugular blood. Emergence of histotropic fourth-stage larvae from the submucosal cysts was associated with intestinal hemorrhage in all infected calves but only in the calves given a near lethal dose of larvae was the bleeding sufficient to cause anemia. At the lower infection rates the hemorrhage caused by larvae was considerably less than that produced by the ensuing adult population. The proportion of adult worms recovered from the infecting dose diminished as the dose increased.     

Plasmodium gallinaceum: mechanisms of anemia in infected chickens

Erythrocyte labeling by random and cohort techniques was used to study erythrocyte survival in normal chickens and chickens infected with Plasmodium gallinaceum. Occurrence of erythrocyte destruction during the prepatent period was apparent in infected chickens by both techniques. Treatment with the antimalarials chloroquine and quinacrine not only cleared the circulation of parasites promptly but brought about an equally prompt cessation of disease-related erythrocyte destruction. Plasmodium gallinaceum infection caused a transitory decrease in blood volume at the time of rapid decrease in packed cell volume. The blood volume returned to preinfection values before the packed cell volume returned to normal. Parasitized erythrocytes were present in capillaries of the spleen, liver, and bone marrow during the entire prepatent period of the infection, thus providing a reasonable explanation for erythrocyte destruction observed in the absence of parasitemia during the prepatent period.     

Cytopathological observations and epizootiology of frog erythrocytic virus in bullfrogs (Rana catesbeiana).

A 5 yr survey (1985 to 1989) revealed that the prevalence of frog erythrocytic virus (FEV) was significantly higher in juveniles than in adult bullfrogs (Rana catesbeiana) in Algonquin Park, Ontario (Canada). The prevalence of infection in juveniles declined during May and June and increased in early August, persisting until late September. Tadpoles were not infected naturally with FEV, but were susceptible to experimental infection. Experimental data indicate that FEV is neither waterborne, nor transmitted by the oral route, nor by the leech Desserobdella picta. The virus may be transmitted mechanically by the mosquito Culex territans, or the midge Forcipomyia (Lasiohelea) fairfaxensis. Nine percent recapture of marked uninfected frogs versus 4% recapture of infected animals suggests that FEV contributes to mortality of juvenile bullfrogs. Infected erythrocytes were transformed from ellipsoidal to spheroidal cells, some of which contained flattened elongate, trapezoidal inclusions. There was no evidence of denatured hemoglobin or significant change in the hemoglobin content of infected cells. Anemia recorded in heavily infected animals was not attributable to an increased osmotic fragility of infected erythrocytes.     

ABO Blood Groups Influence Macrophage-mediated Phagocytosis of Plasmodium falciparum-infected Erythrocytes

Erythrocyte polymorphisms associated with a survival advantage to Plasmodium falciparum infection have undergone positive selection. There is a predominance of blood group O in malaria-endemic regions, and several lines of evidence suggest that ABO blood groups may influence the outcome of P. falciparum infection. Based on the hypothesis that enhanced innate clearance of infected polymorphic erythrocytes is associated with protection from severe malaria, we investigated whether P. falciparum-infected O erythrocytes are more efficiently cleared by macrophages than infected A and B erythrocytes. We show that human macrophages in vitro and mouse monocytes in vivo phagocytose P. falciparum-infected O erythrocytes more avidly than infected A and B erythrocytes and that uptake is associated with increased hemichrome deposition and high molecular weight band 3 aggregates in infected O erythrocytes. Using infected A₁, A₂, and O erythrocytes, we demonstrate an inverse association of phagocytic capacity with the amount of A antigen on the surface of infected erythrocytes. Finally, we report that enzymatic conversion of B erythrocytes to type as O before infection significantly enhances their uptake by macrophages to observed level comparable to that with infected O wild-type erythrocytes. These data provide the first evidence that ABO blood group antigens influence macrophage clearance of P. falciparum-infected erythrocytes and suggest an additional mechanism by which blood group O may confer resistance to severe malaria.     

Babesia and plasmodia increase host erythrocyte permeability through distinct mechanisms

Human erythrocytes infected with Plasmodium falciparum have markedly increased permeability to diverse solutes, many of which may be mediated by an unusual small conductance ion channel, the plasmodial surface anion channel (PSAC). Because these increases may be essential for parasite survival in the bloodstream, an important question is whether other intraerythrocytic parasites induce similar ion channels. Here, we examined this question using human erythrocytes infected with Babesia divergens, a distantly related apicomplexan parasite that can cause severe disease in immunocompromised humans. Osmotic lysis experiments after enrichment of infected erythrocytes with a new method revealed that these parasites also increase host permeability to various organic solutes. These permeability changes differed significantly from those induced by P. falciparum in transport rates, selectivity profiles and temperature dependence. Cell-attached and whole-cell patch-clamp experiments confirmed and extended these differences because neither PSAC-like channels nor significant increases in whole-cell anion conductance were seen after B. divergens infection. While both babesia and plasmodia increase host erythrocyte permeability to a diverse collection of organic solutes, they utilize fundamentally different mechanisms.     

Autoimmunity to phosphatidylserine and anemia in African Trypanosome infections

Anemia caused by trypanosome infection is poorly understood. Autoimmunity during Trypanosoma brucei infection was proposed to have a role during anemia, but the mechanisms involved during this pathology have not been elucidated. In mouse models and human patients infected with malaria parasites, atypical B-cells promote anemia through the secretion of autoimmune anti-phosphatidylserine (anti-PS) antibodies that bind to uninfected erythrocytes and facilitate their clearance. Using mouse models of two trypanosome infections, Trypanosoma brucei and Trypanosoma cruzi, we assessed levels of autoantibodies and anemia. Our results indicate that acute T. brucei infection, but not T. cruzi, leads to early increased levels of plasma autoantibodies against different auto antigens tested (PS, DNA and erythrocyte lysate) and expansion of atypical B cells (ABCs) that secrete these autoantibodies. In vitro studies confirmed that a lysate of T. brucei, but not T. cruzi, could directly promote the expansion of these ABCs. PS exposure on erythrocyte plasma membrane seems to be an important contributor to anemia by delaying erythrocyte recovery since treatment with an agent that prevents binding to it (Annexin V) ameliorated anemia in T. brucei-infected mice. Analysis of the plasma of patients with human African trypanosomiasis (HAT) revealed high levels of anti-PS antibodies that correlated with anemia. Altogether these results suggest a relation between autoimmunity against PS and anemia in both mice and patients infected with T. brucei.     

The role of hapten-reactive T lymphocytes in the induction of autoimmunity in mice. II. Termination of self-tolerance to erythrocytes by immunization with hapten-isologous erythrocytes.

When mice which had been primed with hapten-isologous protein conjugate (PAG-MGG) were challenged with PAB-conjugated isologous mouse erythrocytes (MRBC), they developed Coombs positivity and anemia. However, when mice primed with hapten-heterologous protein conjugate (PAG-HGG) were challenged with PAB-MRBC, neither Coombs positivity nor anemia developed.Since it was demonstrated that PAB-reactive helper T cells were generated by immunization with PAB-MGG but not with PAB-HGG, PAB-reactive helper T cells were considered to play a very crucial role in the induction of autoantibody. These results, as a model for autoantibody production in mice, were discussed on the basis of cellular cooperation mediated by a hapten-mechanism, and are consistent with the hypothesis proposed by Weigle for the mechanism of termination of self-tolerance.     

A Unique Feature of Iron Loss via Close Adhesion of Helicobacter pylori to Host Erythrocytes

Iron deficiency anemia is an extra-stomach disease experienced in H. pylori carriers. Individuals with type A blood are more prone to suffering from H. pylori infection than other individuals. To clarify the molecular mechanisms underlying H. pylori-associated anemia, we collected erythrocytes from A, B, O, and AB blood donors and analyzed morphology, the number of erythrocytes with H. pylori colonies attached to them, and iron contents in erythrocytes and H. pylori (NCTC11637 and SS1 strains) by means of optical microscopy, scanning electron microscopy, and synchrotron radiation soft X-ray imaging. The number of type A erythrocytes with H. pylori attached to them was significantly higher than that of other erythrocytes (P<0.05). Far more iron distribution was observed in H. pylori bacteria using dual energy analysis near the iron L2, 3 edges by soft X-ray imaging. Iron content was significantly reduced in host erythrocytes after 4 hours of exposure to H. pylori. H. pylori are able to adhere more strongly to type A erythrocytes, and this is related to iron shift from the host to the bacteria. This may explain the reasons for refractory iron deficiency anemia and elevated susceptibility to H. pylori infection in individuals with type A blood.     

The P2 Protein of Rice Dwarf Phytoreovirus Is Required for Adsorption of the Virus to Cells of the Insect Vector

Intact particles of rice dwarf phytoreovirus adsorbed to and entered monolayer-cultured cells of the insect vector Nephotettix cincticeps and multiplied within the cells. Particles that lacked the P2 protein neither attached to nor infected such cells. Furthermore, P2-free particles obtained from a transmission-competent isolate of the virus were unable to infect insect vectors that had been allowed to feed on these virus particles through a membrane. However, when such virus particles were injected into insects via a glass capillary tube they successfully infected the insects, which became able to transmit the virus. These results support the hypothesis that, while P2-free particles can neither interact with nor infect cells in the intestinal tract of the insect vector, they do retain the ability to infect such cells when physically introduced into the hemolymph by injection.     

Plasmodium berghei: modification of sialic acid on red cells from infected mouse blood

The surface membrane glycoproteins of normal mouse erythrocytes can be labeled by oxidation with either periodate or galactose oxidase in the presence of neuraminidase, followed by reduction with NaB³H₄. Without neuraminidase there is little galactose oxidase-catalyzed labeling of protein. Analysis of labeled proteins by SDS-polyacrylamide gel electrophoresis showed that both methods labeled the same set of glycoproteins. Plasmodium berghei infection dramatically reduced the sialoglycoprotein labeling of red blood cells from infected blood using the periodate/NaB³H₄ method. Provided neuraminidase was present, labeling by the galactose oxidase method gave identical results to normal erythrocytes. We conclude that the glycoprotein sialic acid of uninfected as well as infected red cells is modified during infection such that it is refractory to periodate oxidation. Acylation of the exocyclic hydroxyls of sialic acid is suggested to account for this. Lectin binding and cell agglutination experiments using Limulin, soybean and wheatgerm lectins, and concanavalin A confirmed and extended these observations. The possible implications of these results with regard to anemia induced by malaria are briefly discussed.     

Hemagglutination and Erythrophagocytosis Associated with the Anemia of Plasmodium berghei Infections of Rats*

SYNOPSIS. The presence of anemia that often seems excessive for the amount of parasitemia in Plasmodium berghei infections had led to the suggestion that autoimmunity might be in part responsible for the anemia. In another erythrocytic infection, Anaplasma marginale of cattle, the association of erythrophagocytosis, autohemagglutination and anemia with infection has led to the suggestion that autoimmunization may occur in anaplasmosis. The possibility that similar findings might be present in P. berghei infections of rats has been investigated. Groups of rats infected with P. berghei were examined at 2–3 day intervals during the course of infection. Red blood cell counts, hematocrit values and percentages of parasitized erythrocytes were determined. The rats were bled at intervals and the sera tested for agglutinins for trypsinized rat erythrocytes. Other infected rats were killed, and their spleens and bone marrow were examined for evidence of erythrophagocytosis. Parasitemia reached a peak on the 9th day of infection and became subpatent by the 14th. The greatest depression in erythrocyte numbers occurred on the 11th day, and the counts remained below normal until the 23rd day. Phagocytized erythrocytes, predominantly uninfected, were found in the phagocytes of the spleen and bone marrow from the 5th through the 21st day. Agglutinins for trypsinized normal rat erythrocytes were present in the sera of the rats in titers as high as 1:64 from the 5th through 14th day of infection. Lower agglutinin titers (1:8) were found from time to time in sera of rats made anemic by repeated bleedings. It is not clear whether these agglutinins are responsible for erythrophagocytosis; however, the fact that predominantly uninfected erythrocytes were phagocytized suggests that the erythrocytes might have been opsonized by an autoantibody associated with the P. berghei infections.