Severe Plasmodium falciparum Malaria Is Associated with Circulating Ultra-Large von Willebrand Multimers and ADAMTS13 Inhibition
2009

Severe Malaria Linked to von Willebrand Factor and ADAMTS13 Inhibition

Sample size: 33 publication 10 minutes Evidence: high

Author Information

Author(s): Larkin Deirdre, de Laat Bas, Jenkins P. Vince, Bunn James, Craig Alister G., Terraube Virginie, Preston Roger J. S., Donkor Cynthia, Grau George E., van Mourik Jan A., O'Donnell James S.

Primary Institution: Haemostasis Research Group, Trinity Centre for Health Sciences, Trinity College Dublin, Dublin, Ireland

Hypothesis

Is severe Plasmodium falciparum malaria associated with increased von Willebrand factor and reduced ADAMTS13 activity?

Conclusion

The study found that severe malaria is associated with increased levels of ultra-large von Willebrand factor multimers and reduced ADAMTS13 activity.

Supporting Evidence

  • Increased plasma von Willebrand factor antigen levels were observed in children with severe malaria.
  • Patients with cerebral malaria showed significantly higher von Willebrand factor collagen binding activity.
  • ADAMTS13 activity was reduced to approximately 55% of normal levels in severe malaria patients.
  • Mixing studies indicated persistent inhibition of ADAMTS13 function in malarial plasma.
  • Ultra-large von Willebrand factor multimers were present in the plasma of children with severe malaria.

Takeaway

Kids with severe malaria have a lot of a sticky protein in their blood that helps with clotting, but they also have less of a protein that usually helps break it down.

Methodology

The study involved a prospective analysis of plasma samples from children with severe malaria, measuring levels of von Willebrand factor and ADAMTS13.

Potential Biases

Potential biases may arise from the selection of participants and the specific setting of the study.

Limitations

The study was limited to a specific cohort of children in Ghana, which may not be representative of all populations affected by malaria.

Participant Demographics

Children aged 6 months to 6 years from Ghana.

Statistical Information

P-Value

p<0.005

Statistical Significance

p<0.005

Digital Object Identifier (DOI)

10.1371/journal.ppat.1000349

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