Malaria Parasitemia Effect on Human Platelets Thesis

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What is most certain is that malaria can be directly linked to the reduction of platelet count in humans. The severity of malaria, however, does not seem to have an underlying impact on the platelet count.

Relationship Between Platelet Aggregate Flag and Platelet-Count

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Platelet clumping has been found to exist in malaria infection cases and has been described as the most vital platelet abnormality observed in most studies. There have been a large number of small platelets that have been seen to be mixing up or clamping with a few giant platelets. This could be due to cytokine interference of megakaryopoiesis (Maina et al., 2010, p. 8). The peripheral blood smears from samples obtained have shown that samples with platelet aggregate flag indicated small platelet aggregates mixed with giant platelet. This could explain the reason why there is a low platelet count. The combination of large and small platelets results in the reduction in the number of platelets counted and this could explain why in some of the cases there have been reports that patients have low platelet count. According to Maina et al. (2010, p. 8) The platelet clumps are mostly made up of groups of three to twelve platelets and this would falsely be counted as a single platelet by most analyzers. In essence and to a trained one could be able to differentiate the clumping and instead count the platelets as individual platelets clumped together instead of assuming, they are one. Pseudo-thrombocytopenia is what results from the clumping of platelets and the resultant miscounting. What this means is that while there is a likelihood that patients with malaria are likely to develop thrombocytopenia, having a reduced platelet count for some patients could be attributed to pseudo-thrombocytopenia. This could also explain the lack of bleeding. Thrombocytopenia is linked to bleeding and for most patients, there has to be uncontrollable bleeding. However, in the case of malaria, bleeding has not been observed in all patients. This has led to most scientists questioning the reason for a reduced platelet count in patients.

Thesis on Malaria Parasitemia Effect on Human Platelets Assignment

There is another counter-argument for pseudo-thrombocytopenia in that a patient with giant platelets and increased mean platelet volume (MPV) indicates that pseudo-thrombocytopenia might not be the cause of thrombocytopenia in a patient infected with malaria. Not all samples will have microscopically detectable platelet aggregates even if they have thrombocytopenia. Increased MPV and giant platelets could be an indicator of premature release of platelets from the bone marrow and this will be in line with how true thrombocytopenia occurs.

Platelet Hypersensitivity

It has been noted that patients suffering from malaria their platelets become hypersensitive. The hypersensitivity is caused by the addition of ADP between 1.0 and 5.0 micro M. Having hypersensitive platelets does enhance hemostatic responses and this could be the reason why patients with malaria rarely have bleeding episodes even though there is a clear indication of the presence of thrombocytopenia (Maina et al., 2010, p. 8). When platelets are hypersensitive, they tend to react to the slightest triggers. This increased hypersensitivity increases the number of platelets produced and circulating in the bloodstream, which also increases the platelet removal by splenic pooling. An increase in platelet removal results in a reduction of platelet and this leads to thrombocytopenia. The immune system could also be destructing circulating platelets and this can be a leading cause of thrombocytopenia as seen in malaria. Hypersensitive platelets respond much faster than would be normal and this could be triggered by the malaria parasites during erythrocytes (del Portillo et al., 2012, p. 347). With the continued destruction of red blood cells, there is also a likelihood that platelets are destroyed and this would increase their production to restore the decreased platelets in the blood. However, this increment could be counterproductive since the platelet is destroyed by the splenic process.

Causes of Thrombocytopenia in Malaria Infection

Antibody-Mediated Platelet Destruction

Antibody-mediated platelet destruction occurs when there is a dysfunctional proliferation of autoreactive T cells. These T cells will induce uncontrollable development of autoantibody producing B cells that leads to the continued anti-platelet autoimmunity. The autoimmune response will result in the increased destruction of platelets (Wassmer et al., 2008, p. 73). The destruction will be taking place at a much faster rate thus exceeding the compensatory capacity of bone marrow. If the bone marrow is not able to produce platelets at the same rate as they are being destroyed, then there is going to be a reduced platelet count and this continued reduction will result in the development of thrombocytopenia. The malaria causing parasites are assumed to cause the dysfunction.

Splenic Sequestration

Infections caused by malaria parasites will cause dramatic and abnormal splenic responses that are characterized by splenomegaly. The size of the spleen has been used to determine how intense malaria transmission is within the endemic regions of Nigeria. The spleen is the main organ that is charged with the development of immune responses and the elimination of parasite RBC during the erythrocytic stage of malaria infection (del Portillo et al., 2012, p. 347). However, it has been established that the parasites have formulated a method for counteracting by building chronic infections by evading ad modulating the immune responses, which results in the remodeling of the spleen that will at times provoke abnormal immune responses. These abnormal immune responses result in the elimination of vital platelet as the body is fighting the infection, which results in the reduction in platelet count leading to thrombocytopenia.

Oxidative Stress

Oxidative stress is defined as an imbalance in the body of free radicals and antioxidants. As a response to the malaria infection that is caused by the Plasmodium falciparum parasite, the body's natural defense mechanism will be activated with the involvement of phagocytes (Postma, Zuidema, Mommérs, & Eling, 1996, p. 122). Percário et al. (2012, p. 16347) state that these will, in turn, generate large amounts of reactive oxygen species (ROS) and reactive nitrogen species (RNS) that will cause an imbalance between the establishment of oxidizing species and antioxidants activity. The imbalance created is what triggers oxidative stress. Oxidative stress is a vital mechanism of human hosts as a response to infections (Ebrahim, 2018, p. 25). In the case of malaria, this response can result in the death of the parasites. Oxidative… [END OF PREVIEW] . . . READ MORE

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