Biochemical and immunological mechanisms by which sickle cell trait protects against malaria
Open accessAbstract
Sickle cell trait (HbAS) is the best-characterized genetic polymorphism known to protect against falciparum malaria. Although the protective effect of HbAS against malaria is well known, the mechanism(s) of protection remain unclear. A number of biochemical and immune-mediated mechanisms have been proposed, and it is likely that multiple complex mechanisms are responsible for the observed protection. Increased evidence for an immune component of protection as well as novel mechanisms, such as enhanced tolerance to disease mediated by HO-1 and reduced parasitic growth due to translocation of host micro-RNA into the parasite, have recently been described. A better understanding of relevant mechanisms will provide valuable insight into the host-parasite relationship, including the role of the host immune system in protection against malaria.
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In sickle cell hemoglobin, the balance between damaging prooxidative molecules such as free heme or iron and antioxidative factors such as carbon monoxide and bilirubin is shifted towards cytoprotection.
“As a consequence, the balance between damaging prooxidative molecules such as free heme or iron and antioxidative factors such as carbon monoxide (CO) and bilirubin is shifted towards cytoprotection (Cholera et al., 2008;Ferreira et al., 2011;Gong et al., 2013;Jeney et al., 2014).”
From Iron in infection and immunity (2020) · cites this paper as Gong et al., 2013
The Background section (‘Modulation of immunopathogenesis’; page not provided) reports that sickle haemoglobin may induce HO-1, reducing cytotoxic free haem and tissue damage in a mouse model of cerebral malaria. The Conclusions likewise describe HO-1–mediated tolerance as a possibility. Our copy does not state that carbon monoxide and bilirubin shift a balance against free haem or iron toward cytoprotection, and the cited mechanism is more tentative than the claim suggests. (LLM, conf=0.86)
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- Authors
- Gong, L., Parikh, S., Rosenthal, P. J., & Greenhouse, B.
- Affiliations
- University of California, San Francisco (US)
- Yale University (US)
- Corresponding author
- Greenhouse, Bryan
- Venue
- Malaria Journal
- Published
- 2013-09-11
- Volume
- 12
- Issue
- 1
- Pages
- 317-317
- ISSN
- 1475-2875 (ISSN-L)
- PMC
- PMC3847285
- OpenAlex
- W2156643348
- Cited by
- 105
- References
- 108
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 4 · 2023: 10 · 2022: 9 · 2021: 8 · 2020: 7 · 2019: 9 · 2018: 12 · 2017: 7 · 2016: 6 · 2015: 12 · 2014: 6
- FWCI
- 1.14
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Malaria Journal (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Funders
- Doris Duke Charitable Foundation (2011043)
- National Institutes of Health
- U.S. Public Health Service (U19 A1089674)
- National Institute of Allergy and Infectious Diseases (K23AI076614, U19AI089674)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
- Health Sciences › Medicine › Hematology › Blood groups and transfusion
- Keywords
- sickle cell trait, falciparum malaria, malaria prevention, host-parasite interactions, host immune response, heme oxygenase-1, host genetic polymorphisms
- MeSH terms
- Humans, Sickle Cell Trait, Malaria, Falciparum, Host-Pathogen Interactions
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