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In falciparum malaria, the deformability of the entire erythrocyte population is reduced in proportion to disease severity, and this compromises microcirculatory blood flow through vessels partially obstructed by cytoadherent parasitized erythrocytes. The cause of rigidity of uninfected erythrocytes in not known but could be mediated by malaria heme products. In this study, we show that red blood cell deformability (RBC-D), measured by laser-assisted optical rotational cell analyzer, decreased in a dose-dependent manner after incubation with hemin and hydrogen peroxide but not with hemoglobin or beta-hematin. Hemin also reduced mean red cell volume. Albumin decreased and N-acetylcysteine (NAC) both prevented and reversed rigidity induced by hemin. Hemin-induced oxidative damage of the membrane seems to be a more important contributor to pathology than cell shrinkage because the antioxidant NAC restored RBC-D but not red blood cell volume. The findings suggest novel approaches to the treatment of potentially lethal malaria.

Original publication

DOI

10.4269/ajtmh.2007.77.617

Type

Journal article

Journal

The American journal of tropical medicine and hygiene

Publication Date

10/2007

Volume

77

Pages

617 - 622

Addresses

Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Keywords

Erythrocytes, Humans, Malaria, Falciparum, Anemia, Hydrogen Peroxide, Hemin, Acetylcysteine, Glutathione, Albumins, Hemoglobins, Hemeproteins, Antioxidants, Erythrocyte Deformability