Pathological features observed in both human and experimental
cerebral malaria (ECM) are endothelial dysfunction and changes in blood components.
Blood transfusion has been routinely used in patients with severe malarial
anemia and can also benefit
comatose and acidotic
malaria patients. In the present study Plasmodium berghei-infected mice were transfused intraperitoneally with 200 μL of whole blood along with 20 mg/kg of
artemether. ECM mice showed severe
thrombocytopenia and decreases in hematocrit.
Artemether treatment markedly aggravated
anemia within 24 h. Whole blood administration significantly prevented further drop in hematocrit and partially restored the platelet count. Increased levels of plasma
angiopoietin-2 (Ang-2) remained high 24 h after
artemether treatment but returned to normal levels 24 h after
blood transfusion, indicating reversal to quiescence. Ang-1 was depleted in ECM mice and levels were not restored by any treatment.
Blood transfusion prevented the aggravation of the breakdown of blood brain barrier after
artemether treatment and decreased spleen congestion without affecting splenic lymphocyte populations. Critically,
blood transfusion resulted in markedly improved survival of mice with ECM (75.9% compared to 50.9% receiving
artemether only). These findings indicate that whole
blood transfusion can be an effective adjuvant
therapy for
cerebral malaria.