Open AccessEnhanced virulence of Plasmodium falciparum in blood of diabetic patients
Author(s) -
Jun-Hong Ch’ng,
Kirsten Moll,
Katja Wyss,
Ulf Hammar,
Mikael Rydén,
Olle Kämpe,
Anna Färnert,
Mats Wahlgren
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0249666
Subject(s) - malaria , diabetes mellitus , plasmodium falciparum , type 2 diabetes , glycated hemoglobin , medicine , immunology , glycemic , erythrocyte sedimentation rate , type 2 diabetes mellitus , body mass index , insulin resistance , biology , endocrinology
Rising prevalence of diabetes in sub-Saharan Africa, coupled with continued malaria transmission, has resulted more patients dealing with both communicable and non-communicable diseases. We previously reported that travelers with type 2 diabetes mellitus (T2DM) infected with Plasmodium falciparum were three times more likely to develop severe malaria than non-diabetics. Here we explore the biological basis for this by testing blood from uninfected subjects with type 1 and type 2 diabetes, ex vivo, for their effects on parasite growth and rosetting (binding of infected erythrocytes to uninfected erythrocytes). Rosetting was associated with type 2 diabetes, blood glucose and erythrocyte sedimentation rate (ESR), while parasite growth was positively associated with blood glucose, glycated hemoglobin (HbA1c), body mass index (BMI), fibrinogen and triglycerides. This study establishes a link between diabetes and malaria virulence assays, potentially explaining the protective effect of good glycemic control against severe malaria in subjects with diabetes.