Malaria has exerted a major selective pressure for red blood cell (RBC) polymorphisms that confer protection to severe disease. There is a predominance of blood type O in malaria endemic regions, and several lines of evidence suggest that the outcome of Plasmodium falciparum infection may be influenced by ABO blood type antigens. Based on observations that enhanced phagocytosis of infected polymorphic RBCs is associated with protection to malaria in other red cell disorders, we hypothesized that infected type O RBCs may be more efficiently cleared by the innate immune system than infected type A and B RBCs. The present work demonstrates human macrophages in vitro and murine monocytes in vivo phagocytosed P. falciparum infected O RBCs more avidly than infected A and B RBCs independent of macrophage donor blood type. This difference in clearance may confer relative resistance to severe malaria in individuals with blood type O.

Typescript. / Thesis (Ph. D.)--University of Hawaii at Manoa, 1985. / Bibliography: leaves 301-319. / Photocopy. / xxii, 319 leaves, bound ill., maps 29 cm

Thesis (Ph. D.)--University of Hawaii at Manoa, 1994. / Includes bibliographical references (leaves 166-191). / Microfiche. / xiii, 191 leaves, bound ill. 29 cm

Thesis (Ph. D.)--University of Hawaii at Manoa, 1990. / Includes bibliographical references (leaves 134-152) / Microfiche. / xvi, 152 leaves, bound ill. 29 cm

Cerebral malaria (CM) is a severe complication of Plasmodium falciparum infection, predominantly experienced by children in sub-Saharan Africa. Patients with CM are comatose and often convulse, develop retinal haemorrhages and motor abnormalities. Recent histological studies on brain tissue obtained from patients who have died from CM have identified heterogeneity in brain pathology. As a result, CM is considered to be a complex disease that may be comprised of a number of syndromes. Patients admitted to hospital with CM are treated with anti-malaria drugs; however, even in the best equipped hospitals, a large number of CM patients die within the first 24-hours following hospital admission before the anti-malarial treatment can have an effect. For this reason, it is critical that the mechanisms leading to CM are elucidated in order to develop effective adjunct therapies. Experimental cerebral malaria (ECM) caused by P. berghei ANKA (PbA) infection of susceptible mice displays many features of human CM. A key feature of this model is the pivotal role of the host immune response in pathogenesis, particularly the involvement of T cells. Evidence, predominantly from ECM studies, suggests that tumour necrosis factor (TNF) superfamily (TNFSF) members play critical roles in the immunopathology associated with CM. The first hypothesis investigated in this thesis was that key immune response pathways contribute to the development of CM and, despite the heterogeneity observed between CM patients, common pathways exist that may be targeted to prevent CM. The second hypothesis tested was that members of the TNF superfamily modulate the immune response to infection and are involved in the development of pathology observed in severe malaria (SM). In order to investigate the above hypotheses, three projects were carried out. First, we examined the great heterogeneity in brain expression profiles between ECM-susceptible CBA/CaH (CBA) and C57BL/6 (B6) mice at the peak of disease, as well as the significant differences in circulating cytokine expression and expansion of microglia in brain tissue. We found that, despite these differences, common therapeutic and preventative strategies existed to disrupt the development of ECM in the two ECM-susceptible mouse strains. Second, studies in ECM mice have identified T cells and TNFSF members, TNF and lymphotoxin (LT)-a, as critical mediators of ECM pathology. We extend these studies to examine the role of the TNFSF member LIGHT in ECM. Specific blockade of LIGHT signalling through its receptor, LTβR, in PbA-infected B6 mice abrogated the hallmark features of ECM brain pathology and improved the control of parasite growth. Importantly, specific blockade of LIGHT-LTβR signalling caused the expansion of splenic monocytes and an overall enhanced capacity to remove and process antigen during infection. Together, this study discovered a novel pathogenic role for LIGHT and LTβR in ECM and identified this TNF family receptor-ligand interaction as a potential target for therapeutic intervention in SM. Finally, we investigated the role of LTa in human SM and, more specifically, CM. We tested whether the polymorphisms within the gene encoding LTa (LTA) were associated with susceptibility to SM in Papuan Highland children and adults who had migrated from an area without malaria pressure to a region where malaria is endemic. Despite a lack of association between single nucleotide polymorphisms (SNPs) in the LTA/TNF locus and susceptibility to SM in Papuan Highland children and adults, we found a significant association between a SNP in the LTa-related gene encoding galactin-2 (LGALS2) and susceptibility to CM in children, but not adults in this study population. Interestingly, no association was found between this SNP and susceptibility to CM in Tanzanian children originating from and living in a malaria endemic region. These results suggest that there may be differences in the mechanisms leading to CM in adults and children, as well as between individuals from malaria endemic and non-endemic areas. Together, the findings outlined in this thesis are important to both the understanding of the underlying mechanisms leading to CM and to the development of improved interventions and adjunct therapies.

I investigated parasitic infection and immunocompetence in populations of introduced bird species in New Zealand (NZ) that had experienced a range of population bottlenecks (11-808 individuals), and compared these parameters to non-bottlenecked conspecifics in the United Kingdom (UK). My aims were two-fold; firstly to assess if population bottlenecks are linked to increased parasite loads and/or decreased immunocompetence, and secondly, to assess at what severity of bottleneck these effects become evident. I found that ectoparasite load (chewing lice, Order: Phthiraptera, Sub-Orders: Amblycera & Ischnocera) was significantly higher in the more severely bottlenecked species in NZ than in the UK, whilst this difference became non-significant at more moderate bottlenecks. The difference was mainly driven by the Sub-Order Amblycera. The prevalence of avian malaria (Plasmodium spp.) was significantly negatively correlated to bottleneck size within NZ, after controlling for body mass. Total leucocyte and differential lymphocyte counts were elevated in the less bottlenecked species that were infected with malaria, whilst the populations at the more severe end of the bottleneck spectrum did not exhibit such a response. Furthermore, heterophil/lymphocyte (HL) ratio (a parameter used as an indicator of environmental and/or immunological stress), was significantly raised in the more bottlenecked species when compared to their UK counterparts, and this difference was correlated with the size of the bottleneck. Immunocompetence was further assessed by the experimental challenge of six introduced birds species in NZ with the mitogen phytohaemagglutinin (PHA). Immune response to PHA was significantly correlated to bottleneck size, but in the opposite direction to that predicted; immune response was greater in the more bottlenecked species. However, this may be an indication of increased investment in immunity, due to increased parasite and pathogen pressure or differential investment in varying components of the immune system. Finally, the immune response to PHA was compared in nestlings of two species that had experienced very different bottlenecks (70 vs. 653). After controlling for ectoparasitic infestation, I found no difference between the two species; however, this finding may be confounded by interspecific competition. Overall, my findings suggest that more severe population bottlenecks may result in increased susceptibility to pathogens, and impact on the immune system. This has a number of implications for the development of conservation protocols, and future avenues of research are suggested.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

Diss. (sammanfattning) Uppsala : Univ., 2004. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2005. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 4 uppsatser.