Acute Phase Responses Vary Between Children of HbAS and HbAA Genotypes During Plasmodium falciparum Infection
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Dovepress
Abstract
Purpose: Haemoglobin genotype S is known to offer protection against Plasmodium
falciparum infections but the mechanism underlying this protection is not completely under stood. Associated changes in acute phase proteins (APPs) during Plasmodium falciparum
infections between Haemoglobin AA (HbAA) and Haemoglobin AS (HbAS) individuals also
remain unclear. This study aimed to evaluate changes in three APPs and full blood count
(FBC) indices of HbAA and HbAS children during Plasmodium falciparum infection.
Methods: Venous blood was collected from three hundred and twenty children (6 months to
15 years) in Begoro in Fanteakwa District of Ghana during a cross-sectional study. Full blood
count (FBC) indices were measured and levels of previously investigated APPs in malaria
patients; C-reactive protein (CRP), ferritin and transferrin measured using Enzyme-Linked
Immunosorbent Assays.
Results: Among the HbAA and HbAS children, levels of CRP and ferritin were higher in
malaria positive children as compared to those who did not have malaria. The mean CRP
levels were significantly higher among HbAA children (p=0.2e-08) as compared to the
HbAS children (p=0.43). Levels of transferrin reduced in both HbAA and HbAS children
with malaria, but the difference was only significant among HbAA children (p=0.0038), as
compared to the HbAS children. No significant differences were observed in ferritin levels
between HbAA and HbAS children in both malaria negative (p=0.76) and positive (p=0.26)
children. Of the full blood count indices measured, red blood cell count (p=0.044) and
haemoglobin (Hb) levels (p=0.017) differed between HbAA and HbAS in those without
malaria, with higher RBC counts and lower Hb levels found in HbAS children. In contrast,
during malaria, lymphocyte and platelet counts were elevated, whilst granulocytes and Mean
Cell Haematocrit counts were reduced among children of the HbAS genotypes.
Conclusion: Significant changes in APPs were found in HbAA children during malaria as
compared to HbAS children, possibly due to differences in malaria-induced inflammation
levels. This suggests that the HbAS genotype is associated with better control of
P. falciparum infection-induced inflammatory response than HbAA genotype.
Description
Research Article
Keywords
acute phase response, APR, acute phase proteins, APP, Plasmodium falciparum, C-reactive protein, ferritin, transferrin