Absence of Erythrocyte Sequestration and Lack of Multicopy Gene Family Expression in Plasmodium falciparum from a Splenectomized Malaria Patient

BACKGROUND:To avoid spleen-dependent killing mechanisms parasite-infected erythrocytes (IE) of Plasmodium falciparum malaria patients have the capacity to bind to endothelial receptors. This binding also known as sequestration, is mediated by parasite proteins, which are targeted to the erythrocyte surface. Candidate proteins are those encoded by P. falciparum multicopy gene families, such as var, rif, stevor or PfMC-2TM. However, a direct in vivo proof of IE sequestration and expression of multicopy gene families is still lacking. Here, we report on the analysis of IE from a black African immigrant, who received the diagnosis of a malignant lymphoproliferative disorder and subsequently underwent splenectomy. Three weeks after surgery, the patient experienced clinical falciparum malaria with high parasitemia and circulating developmental parasite stages usually sequestered to the vascular endothelium such as late trophozoites, schizonts or immature gametocytes. METHODOLOGY/PRINCIPAL FINDINGS:Initially, when isolated from the patient, the infected erythrocytes were incapable to bind to various endothelial receptors in vitro. Moreover, the parasites failed to express the multicopy gene families var, A-type rif and stevor but expression of B-type rif and PfMC-2TM genes were detected. In the course of in vitro cultivation, the parasites started to express all investigated multicopy gene families and concomitantly developed the ability to adhere to endothelial receptors such as CD36 and ICAM-1, respectively. CONCLUSION/SIGNIFICANCE:This case strongly supports the hypothesis that parasite surface proteins such as PfEMP1, A-type RIFIN or STEVOR are involved in interactions of infected erythrocytes with endothelial receptors mediating sequestration of mature asexual and immature sexual stages of P. falciparum. In contrast, multicopy gene families coding for B-type RIFIN and PfMC-2TM proteins may not be involved in sequestration, as these genes were transcribed in infected but not sequestered erythrocytes

Insights into needs of business travelers to China from calls to a medical assistance provider

Background: Although 17.5% of German travelers were business travelers in the years 2011–2013, little is known about their pathologies. Recent publications indicate that infections are the primary health issue in general travelers. Our aim was to investigate whether business travelers from Germany to China also primarily suffer from infections. Methods: From 2011 to 2013, 587 calls for service of German business travelers to China were collected by a medical assistance provider. 482 of these calls were evaluated regarding demographics, reported diseases and conditions and the type of service provided by the medical assistance company. Results: The most common reasons for calls for service were “factors influencing health status and contact with health service” (18.8%), “injury and poisoning” (16.0%) as well as “symptoms, signs, and ill-defined conditions” (13.7%). Most patients asked for “medical advice” (37.8%), referral to “outpatient care” (25.1%) or “inpatient care” (16.6%). “Evacuation and/or repatriation” was required mainly due to “injury and poisoning” (n = 12), “diseases of the circulatory system” (n = 5) or “mental disorders” (n = 3). Conclusion: German business travelers to China are seeking primarily administrative support from a medical assistance provider and are mostly affected by non-infectious diseases. Pre-travel preparation of such travelers need to place more emphasis on non-communicable health risks and prevention

LiS ClassCast : 9434 Booktalks, Part 1 of 5

Webcast file name: esser1_dec6_2005Date: December 6, 2005Booktalks by Dr. Esser's 9434 Teen Lit Class. These booktalks are by Nicole, Michaela, Addie, and Sally & group

Religionen im Vorderen Orient (RVO)

Benz M, Bukovec P, Esser M, Lippke F, Sporer J, eds. Religionen im Vorderen Orient (RVO). Vol ab Bd. 2. Hamburg: Verlag Dr. Kovač; 2014