Severe<i>Babesia microti</i>infection presenting as multiorgan failure in an immunocompetent host

Ripoll, Juan G.; Rizvi, Mahrukh; King, Rebecca; Daniels, Craig

doi:10.1136/bcr-2018-224647

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…Both our platforms detected an upregulation of miR-4454, which has been associated with severe thrombocytopenia in P. vivaxinfected human plasma (Santos et al, 2021). Like malaria, babesiosis is also associated with a steep drop in platelets (Akel and Mobarakai, 2017;Ripoll et al, 2018). Furthermore, in our microarray platform, we also found an almost 3.5-fold increase in miR-4497 in iRBC-derived EVs.…”

Section: Discussionsupporting

confidence: 50%

Identification and characterization of extracellular vesicles from red cells infected with Babesia divergens and Babesia microti

Beri

Rodriguez²,

Singh³

et al. 2022

Front. Cell. Infect. Microbiol.

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Babesiosis is a zoonosis and an important blood-borne human parasitic infection that has gained attention because of its growing infection rate in humans by transfer from animal reservoirs. Babesia represents a potential threat to the blood supply because asymptomatic infections in man are common, and blood from such donors can cause severe disease in certain recipients. Extracellular vesicles (EVs) are vesicles released by cells that contain a complex mixture of proteins, lipids, glycans, and genetic information that have been shown to play important roles in disease pathogenesis and susceptibility, as well as cell–cell communication and immune responses. In this article, we report on the identification and characterization of EVs released from red blood cells (RBCs) infected by two major human Babesia species—Babesia divergens from in vitro culture and those from an in vivo B. microti mouse infection. Using nanoparticle tracking analysis, we show that there is a range of vesicle sizes from 30 to 1,000 nm, emanating from the Babesia-infected RBC. The study of these EVs in the context of hemoparasite infection is complicated by the fact that both the parasite and the host RBC make and release vesicles into the extracellular environment. However, the EV frequency is 2- to 10-fold higher in Babesia-infected RBCs than uninfected RBCs, depending on levels of parasitemia. Using parasite-specific markers, we were able to show that ~50%–60% of all EVs contained parasite-specific markers on their surface and thus may represent the specific proportion of EVs released by infected RBCs within the EV population. Western blot analysis on purified EVs from both in vivo and in vitro infections revealed several parasite proteins that were targets of the host immune response. In addition, microRNA analysis showed that infected RBC EVs have different microRNA signature from uninfected RBC EVs, indicating a potential role as disease biomarkers. Finally, EVs were internalized by other RBCs in culture, implicating a potential role for these vesicles in cellular communication. Overall, our study points to the multiple functional implications of EVs in Babesia–host interactions and support the potential that EVs have as agents in disease pathogenesis.

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Section: Discussionsupporting

confidence: 50%

Identification and characterization of extracellular vesicles from red cells infected with Babesia divergens and Babesia microti

Beri

Rodriguez²,

Singh³

et al. 2022

Front. Cell. Infect. Microbiol.

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“…In addition, this review discovered the following less commonly reported sequela or associated conditions: acute lung injury, pulmonary edema, warm autoimmune hemolytic anemia (WAHA) [11], thrombocytopenia [12], reactive hemophagocytosis or hemophagocytic lymphohistiocytosis (HLH) [13], hepatitis [14][15][16], hepatomegaly [14], splenomegaly [14], pancytopenia [17], septic shock [18], multiorgan failure, and even death [12][13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…Curiously, there is also a report of a patient whose chronic hepatitis C resolved after co-infection with Babesia, Borrelia burgdorferi, and Ehrlichia (human granulocytic ehrlichiosis) [15]. There was also only one report in which Babesia was involved in septic shock, with other etiologies present [12]. Similarly, the cases involving multiorgan failure involved multiple comorbidities and complicated hospital courses.…”

Section: Multiorganmentioning

confidence: 99%

Babesiosis: Appreciating the Pathophysiology and Diverse Sequela of the Infection

Ortíz¹,

Millhouse²,

Cox³

et al. 2020

Cureus

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Babesiosis is a blood-borne disease found mainly in the United States caused by a parasitic piroplasm. While most infections are mild to moderate in immunocompetent hosts, life-threatening complications can occur in those with significant comorbidities like congestive heart failure (CHF) or chronic obstructive pulmonary disease (COPD). There is sparse literature discussing the complications of Babesia microti infection or the pathophysiology and management thereof. A literature review was conducted to consolidate the current knowledge about the disease, pathophysiology, and proposed management of all potential complications based on risk factors and other clinical information. A MeSH cross-references strategy was employed in PubMed using the search terms "babesia" and "babesiosis" and the established associated conditions, and the search expanded to increase capture. Only papers written in the English language and discussing human subjects in the North American patient population were included. The initial search yielded 315 papers and, after applying the inclusion/exclusion criteria, a final number of 18 was reviewed. The various complications and pathophysiology thereof are then discussed according to organ system. Babesia is a subversive parasite associated with a variety of conditions. We hope a better appreciation of all potential presentations and complications will help clinicians manage this increasingly common zoonosis and reduce adverse effects. More research is recommended into the pathophysiology and prevention of complications following this and other tick-borne illnesses.

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“…Importantly, the severity of babesiosis is highly dependent on the babesia species (Cooke et al, 2005). For example, babesiosis caused by Babesia microti, B. bovis, B. Lengua, and B. canis is associated with the development of severe syndromes such as brain babesiosis and multi-organ failure due to the sequestration of IEs in the organ's microvasculature (Wright et al, 1979;Aikawa et al, 1992;Bosman et al, 2013;Sondgeroth et al, 2013;Ripoll et al, 2018;Schetters, 2019).…”

Section: Adhesion Of Babesia To the Placentamentioning

confidence: 99%

Congenital Transmission of Apicomplexan Parasites: A Review

et al. 2021

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Apicomplexans are a group of pathogenic protists that cause various diseases in humans and animals that cause economic losses worldwide. These unicellular eukaryotes are characterized by having a complex life cycle and the ability to evade the immune system of their host organism. Infections caused by some of these parasites affect millions of pregnant women worldwide, leading to various adverse maternal and fetal/placental effects. Unfortunately, the exact pathogenesis of congenital apicomplexan diseases is far from being understood, including the mechanisms of how they cross the placental barrier. In this review, we highlight important aspects of the diseases caused by species of Plasmodium, Babesia, Toxoplasma, and Neospora, their infection during pregnancy, emphasizing the possible role played by the placenta in the host-pathogen interaction.

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SevereBabesia microtiinfection presenting as multiorgan failure in an immunocompetent host

Cited by 6 publications

References 14 publications

Identification and characterization of extracellular vesicles from red cells infected with Babesia divergens and Babesia microti

Identification and characterization of extracellular vesicles from red cells infected with Babesia divergens and Babesia microti

Babesiosis: Appreciating the Pathophysiology and Diverse Sequela of the Infection

Congenital Transmission of Apicomplexan Parasites: A Review

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