Abstract
There is considerable debate as to the nature of the primary parasite-derived moieties that activate innate pro-inflammatory responses during malaria infection. Microparticles (MPs), which are produced by numerous cell types following vesiculation of the cellular membrane as a consequence of cell death or immune-activation, exert strong pro-inflammatory activity in other disease states. Here we demonstrate that MPs, derived from the plasma of malaria infected mice, but not naive mice, induce potent activation of macrophages in vitro as measured by CD40 up-regulation and TNF production. In vitro, these MPs induced significantly higher levels of macrophage activation than intact infected red blood cells. Immunofluorescence staining revealed that MPs contained significant amounts of parasite material indicating that they are derived primarily from infected red blood cells rather than platelets or endothelial cells. MP driven macrophage activation was completely abolished in the absence of MyD88 and TLR-4 signalling. Similar levels of immunogenic MPs were produced in WT and in TNF−/−, IFN-γ−/−, IL-12−/− and RAG-1−/− malaria-infected mice, but were not produced in mice injected with LPS, showing that inflammation is not required for the production of MPs during malaria infection. This study therefore establishes parasitized red blood cell-derived MPs as a major inducer of systemic inflammation during malaria infection, raising important questions about their role in severe disease and in the generation of adaptive immune responses.
Highlights
Severe malaria in humans is a leading cause of morbidity and mortality, especially in sub-Saharan Africa [1]
In this study we demonstrate that sub micron particles are produced by malaria infected red blood cells during malaria infection, and we show that these microparticles can promote strong inflammatory responses by activating macrophages
We have examined the receptors and signalling pathways required for macrophage activation by microparticles, and we show that the pathway of microparticle-induced activation is distinct from other previously reported pathways
Summary
Severe malaria in humans is a leading cause of morbidity and mortality, especially in sub-Saharan Africa [1]. Whilst it is clear that early innate and T cell proinflammatory immune responses are essential for the control of malaria infection [2,3], excessive production of pro-inflammatory cytokines, including IL-6, TNF and IFN-c, may directly contribute to severe disease, such as severe anaemia, cerebral malaria (CM) and organ damage [3,4]. Activation of macrophages is a key event in the pathogenesis of severe malaria in both humans [5] and in experimental models of malaria [6]. P. berghei ANKA (PbA) infection of C57BL/6 mice, which is the best available model of CM, is characterized by the development of strong pro-inflammatory immune responses, including macrophage activation and the production of TNF, IL12, IL-1b, IL-6, ROI and NO [2,3]. Splenic and liver macrophage populations have been shown to be required for optimal parasite control [7,8], excessive macrophage responses in these organs has been directly correlated with malarial anaemia and liver damage [9]
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