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Journal article : Review

Intestinal injury and the gut microbiota in patients with Plasmodium falciparum malaria

Abstract:

The pathophysiology of severe falciparum malaria involves a complex interaction between the host, parasite, and gut microbes. In this review, we focus on understanding parasite-induced intestinal injury and changes in the human intestinal microbiota composition in patients with Plasmodium falciparum malaria. During the blood stage of Pfalciparum infection, infected red blood cells adhere to the vascular endothelium, leading to widespread microcirculatory obstruction in critical tissues, including the splanchnic vasculature. This process may cause intestinal injury and gut leakage. Epidemiological studies indicate higher rates of concurrent bacteraemia in severe malaria cases. Furthermore, severe malaria patients exhibit alterations in the composition and diversity of the intestinal microbiota, although the exact contribution to pathophysiology remains unclear. Mouse studies have demonstrated that the gut microbiota composition can impact susceptibility to Plasmodium infections. In patients with severe malaria, the microbiota shows an enrichment of pathobionts, including pathogens that are known to cause concomitant bloodstream infections. Microbial metabolites have also been detected in the plasma of severe malaria patients, potentially contributing to metabolic acidosis and other clinical complications. However, establishing causal relationships requires intervention studies targeting the gut microbiota.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1371/journal.ppat.1011661

Authors


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Role:
Author
ORCID:
0000-0003-0721-2113
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Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
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Role:
Author
ORCID:
0000-0003-3707-7979


Publisher:
Public Library of Science
Journal:
PLoS Pathogens More from this journal
Volume:
19
Issue:
10
Article number:
e1011661
Publication date:
2023-10-19
Acceptance date:
2023-10-01
DOI:
EISSN:
1553-7374
ISSN:
1553-7366
Pmid:
37856470


Language:
English
Keywords:
Subtype:
Review
Pubs id:
1548147
Local pid:
pubs:1548147
Deposit date:
2024-03-26

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