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. 2009 Apr;80(4):541-6.

Cerebral malaria is associated with low levels of circulating endothelial progenitor cells in African children

Ben Gyan  1 , Bamenla Quarm Goka, George O Adjei, John K A Tetteh, Kwadwo Asamoah Kusi, Anastasia Aikins, Daniel Dodoo, Martin L Lesser, Cristina P Sison, Sanchita Das, Marion E Howard, Elizabeth Milbank, Kimberly Fischer, Shahin Rafii, David Jin, Linnie M Golightly
Affiliations

Cerebral malaria is associated with low levels of circulating endothelial progenitor cells in African children

Ben Gyan et al. Am J Trop Med Hyg. 2009 Apr.

Abstract

Damage to the cerebral microvasculature is a feature of cerebral malaria. Circulating endothelial progenitor cells are needed for microvascular repair. Based on this knowledge, we hypothesized that the failure to mobilize sufficient circulating endothelial progenitor cells to the cerebral microvasculature is a pathophysiologic feature of cerebral malaria. To test this hypothesis, we compared peripheral blood levels of CD34 (+)/VEGFR2(+) and CD34 (+)/CD133(+) cells and plasma levels of the chemokine stromal cell-derived growth factor 1 (SDF-1) in 214 children in Accra, Ghana. Children with cerebral malaria had lower levels of CD34 (+)/VEGFR2(+) and CD34 (+)/CD133(+) cells compared with those with uncomplicated malaria, asymptomatic parasitemia, or healthy controls. SDF-1 levels were higher in children with acute malaria compared with healthy controls. Together, these results uncover a potentially novel role for endothelial progenitor cell mobilization in the pathophysiology of cerebral malaria.

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Figures

Figure 1
Figure 1
Percentage of circulating endothelial progenitor cells in each study group. A, Flow cytometry of CD34+/VEGFR2+ cells. CM: N = 31, geometric mean = 0.72; UM: N = 46, geometric mean = 1.24; AP: N = 39, geometric mean = 1.42; HC: N = 57, geometric mean = 1.28; SA: N = 14, geometric mean = 1.42 (P < 0.0001) B, Flow cytometry of CD34+/CD133+ cells. CM: N = 21, geometric mean = 0.37; UM: N = 31, geometric mean = 0.64; AP: N = 38, geometric mean = 0.77; HC: N = 57 geometric mean = 0.76 (P < 0.002). Geometric means and 95% confidence limits are presented. All means are adjusted for age, hemoglobin, parasite density, and study year. Because of the volume of blood available from young children, not all antibody combinations could be tested on each patient sample and therefore the number of patients (N) varies.
Figure 2
Figure 2
SDF-1 plasma levels in each study group. CM: N = 33, geometric mean = 1,959; UM: N = 33, geometric mean = 2,031; AP: N = 44, geometric mean = 1,645; HC: N = 60, geometric mean = 1,476 (P < 0.001). SDF-1 concentrations given are in pg/mL. All means are adjusted for age, hemoglobin, parasitic density, and study year.
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