Plasmodium berghei-Hamster Cheek Pouch Model for the Study of Severe Malaria

摘要

Severe malaria in man, caused by Plasmodium falciparum, is typically characterized by drowsiness, disorientation, incoherence, and severe headache. Untreated, coma and death often follow; mortality may be as high as 25% to 50%. The syndrome is often called cerebral malaria because of its most common clinical signs and typical postmortem cerebral lesions; however, it involves multiple organ systems, and results in far-ranging pathologic change. Systemic changes include an adult respiratory distress-like syndrome, acute renal tubular necrosis, hypoglycemia, thrombocytopenia, dyserythropoiesis and hemolysis, gastro-intestinal abnormalities, and liver damage. Simple invasion of erythrocytes (RBCs) by protozoa cannot explain all the lesions described. Several hypotheses have been advanced to try to explain the observed lesions- increased permeability of the blood brain barrier, disseminated intravascular coagulation, immunologically mediated disease, and systemic toxemia-yet, the pathogenesis of severe malaria remains unknown. Yoeli, noting that the human vascular lesion can only be observed on postmortem, challenged malariologists to develop an in-vivo model in which one might observe and record the changes in the microcirculation during active infection. The classical hamster cheek-pouch model has now been combined with a previously described Plasmodium berghei-infected golden hamster model. (aw)