CONFERENCE REPORT: Transfusion‐transmitted babesiosis in the United States: summary of a workshop

Gubernot, Diane M.; Nakhasi, Hira L.; Mied, Paul; Asher, David M.; Epstein, Jay S.; Kumar, Sanjai

doi:10.1111/j.1537-2995.2009.02429.x

Cited by 80 publications

(104 citation statements)

References 28 publications

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“…Their effects on malaria can be both beneficial and pathological, depending on the amount and place of production (15,16). Their importance as babesiacidal agents has been demonstrated in vitro, in which Babesia replication was inhibited, inducing degeneration of the parasites that display crisis forms inside the erythrocytes (15,23,33).…”

Section: Discussionmentioning

confidence: 99%

“…Babesiosis causes huge economic losses in the livestock industry. Recently, the disease has become an important emerging zoonosis, with Babesia microti being the most important cause of human babesiosis in America, Europe, and Asia (23,26,27,35,55). Most of the human cases are either from tainted blood transfusions or from bites of infected Ixodes scapularis nymphs, which inject sporozoites into the bloodstream of the host during their feeding.…”

mentioning

confidence: 99%

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Macrophages Are Critical for Cross-Protective Immunity Conferred by Babesia microti against Babesia rodhaini Infection in Mice

Terkawi

Nishikawa

et al. 2012

Infect Immun

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Although primary infection of mice with Babesia microti has been shown to protect mice against subsequent lethal infection by Babesia rodhaini, the mechanism behind the cross-protection is unknown. To unravel this mechanism, we investigated the influence of primary infection of mice with nonlethal B. microti using different time courses on the outcome of subsequent lethal B. rodhaini infection. Simultaneous infections of mice with these parasites resulted in rapid increases in parasitemia, with 100% mortality in BALB/c mice, as observed with control mice infected with B. rodhaini alone. In contrast, mice with acute, resolving, and chronic-phase B. microti infections were completely protected against B. rodhaini, resulting in low parasitemia and no mor-

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Macrophages Are Critical for Cross-Protective Immunity Conferred by Babesia microti against Babesia rodhaini Infection in Mice

Terkawi

Nishikawa

et al. 2012

Infect Immun

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“…This well-documented increase in the number of transmission cases has elevated TTB to a key policy issue for blood collection organizations, test manufacturers, and the FDA. To this end, the FDA recently sponsored a workshop addressing TTB in the United States (42). Despite the current recognition that B. microti poses a growing blood safety risk, existing options for preventing the transmission of this parasite by blood transfusion are untenable.…”

Section: Introductionmentioning

confidence: 99%

Transfusion-TransmittedBabesiaspp.: Bull's-Eye onBabesia microti

2011

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SUMMARY Babesia spp. are intraerythrocytic protozoan parasites of animals and humans that cause babesiosis, a zoonotic disease transmitted primarily by tick vectors. Although a variety of species or types of Babesia have been described in the literature as causing infection in humans, the rodent parasite Babesia microti has emerged as the focal point of human disease, especially in the United States. Not only has B. microti become established as a public health concern, this agent is increasingly being transmitted by blood transfusion: estimates suggest that between 70 and 100 cases of transfusion-transmitted Babesia (TTB) have occurred over the last 30 years. A recent upsurge in TTB cases attributable to B. microti , coupled with at least 12 fatalities in transfusion recipients diagnosed with babesiosis, has elevated TTB to a key policy issue in transfusion medicine. Despite clarity on a need to mitigate transmission risk, few options are currently available to prevent the transmission of B. microti by blood transfusion. Future mitigation efforts may stress serological screening of blood donors in regionalized areas of endemicity, with adjunct nucleic acid testing during the summer months, when acute infections are prevalent. However, several hurdles remain, including the absence of a licensed blood screening assay and a thorough cost-benefit analysis of proposed interventions. Despite current obstacles, continued discussion of TTB without proactive intervention is no longer a viable alternative.

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“…Infection usually is asymptomatic or causes mild malaria-like symptoms. However, severe infections have been documented in immunocompromised people, who may suffer from respiratory failure, organ dysfunction, or coma (3)(4)(5). The rapid emergence of B. microti infection worldwide as a potential threat to public health has spurred an urgent search for effective preventive strategies.…”

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confidence: 99%

Macrophages Are the Determinant of Resistance to and Outcome of Nonlethal Babesia microti Infection in Mice

et al. 2015

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cIn the present study, we examined the contributions of macrophages to the outcome of infection with Babesia microti, the etiological agent of human and rodent babesiosis, in BALB/c mice. Mice were treated with clodronate liposome at different times during the course of B. microti infection in order to deplete the macrophages. Notably, a depletion of host macrophages at the early and acute phases of infection caused a significant elevation of parasitemia associated with remarkable mortality in the mice. The depletion of macrophages at the resolving and latent phases of infection resulted in an immediate and temporal exacerbation of parasitemia coupled with mortality in mice. Reconstituting clodronate liposome-treated mice at the acute phase of infection with macrophages from naive mice resulted in a slight reduction in parasitemia with improved survival compared to that of mice that received the drug alone. These results indicate that macrophages play a crucial role in the control of and resistance to B. microti infection in mice. Moreover, analyses of host immune responses revealed that macrophage-depleted mice diminished their production of Th1 cell cytokines, including gamma interferon (IFN-␥) and tumor necrosis factor alpha (TNF-␣). Furthermore, depletion of macrophages at different times exaggerated the pathogenesis of the infection in deficient IFN-␥ ؊/؊ and severe combined immunodeficiency (SCID) mice. Collectively, our data provide important clues about the role of macrophages in the resistance and control of B. microti and imply that the severity of the infection in immunocompromised patients might be due to impairment of macrophage function.

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CONFERENCE REPORT: Transfusion‐transmitted babesiosis in the United States: summary of a workshop

Cited by 80 publications

References 28 publications

Macrophages Are Critical for Cross-Protective Immunity Conferred by Babesia microti against Babesia rodhaini Infection in Mice

Macrophages Are Critical for Cross-Protective Immunity Conferred by Babesia microti against Babesia rodhaini Infection in Mice

Transfusion-TransmittedBabesiaspp.: Bull's-Eye onBabesia microti

Macrophages Are the Determinant of Resistance to and Outcome of Nonlethal Babesia microti Infection in Mice

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