2014
DOI: 10.1182/blood-2013-09-521005
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Plasmodium falciparum picks (on) EPCR

Abstract: Of all the outcomes of Plasmodium falciparum infection, the coma of cerebral malaria (CM) is particularly deadly. Malariologists have long wondered how some patients develop this organ-specific syndrome. Data from two recent publications support a novel mechanism of CM pathogenesis in which infected erythrocytes (IEs) express specific virulence proteins that mediate IE binding to the endothelial protein C receptor (EPCR). Malaria-associated depletion of EPCR, with subsequent impairment of the protein C system … Show more

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Cited by 40 publications
(41 citation statements)
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“…6 Recently, additional hemostatic abnormalities have been identified including a reduction of VWF-cleaving protease, ADAMTS13, 7 in plasma and a loss of endothelial protein C receptor (EPCR) in the cerebral vessels in patients with cerebral malaria. 8 One other historical observation is of interest: severe P falciparum cerebral malaria is less common in blood group O individuals, 9 and this finding holds up even with more recent genome-wide association studies. In addition, VWF levels are 25% to 30% higher in non-O blood groups, 10 which might suggest an association for VWF levels in the pathogenesis of cerebral malaria.…”
mentioning
confidence: 86%
See 1 more Smart Citation
“…6 Recently, additional hemostatic abnormalities have been identified including a reduction of VWF-cleaving protease, ADAMTS13, 7 in plasma and a loss of endothelial protein C receptor (EPCR) in the cerebral vessels in patients with cerebral malaria. 8 One other historical observation is of interest: severe P falciparum cerebral malaria is less common in blood group O individuals, 9 and this finding holds up even with more recent genome-wide association studies. In addition, VWF levels are 25% to 30% higher in non-O blood groups, 10 which might suggest an association for VWF levels in the pathogenesis of cerebral malaria.…”
mentioning
confidence: 86%
“…The latter assumption does not necessarily preclude them from mediating biological effects outside of platelets. Indeed, circRNAs may still play a role in other cells, as shown previously for mRNAs and miRNAs, 8 provided that they are expelled within exosomes or larger microparticles, under basal conditions or upon activation, which remains to be seen. Because exon-intron circRNAs regulate transcription in nucleated cells, 9 it is tempting to speculate that circRNAs that accumulate in platelets may end up regulating gene expression and function of other recipient cells of the circulatory system.…”
mentioning
confidence: 92%
“…They also provide a rationale for the development of novel therapeutic strategies based on soluble EPCR and EPCR ligands (refer to the original articles and subsequent comment/review articles for further discussion on this [92][93][94] ). The addition of soluble EPCR at levels between 15 and 300 ng/mL was shown to progressively inhibit the binding between DC8-expressing parasites and endothelial cells.…”
Section: Org Frommentioning
confidence: 99%
“…During the symptomatic phase of malaria several clinical complications can occur and are defined as severe malaria. These complications are anemia, cerebral malaria, placental malaria, and acute lung injury/acute respiratory distress syndrome (ALI/ARDS) [3]. The ALI/ARDS has been diagnosed in patients suffering from malaria caused by all the species that cause disease in humans, including P. knowlesi [4]; however it is more common in P. falciparum and P. vivax malaria [5].…”
Section: Introductionmentioning
confidence: 99%