- 20 February 2020
1:00 pm - 2:00 pm
THURSDAY 20 FEBRUARY 1.00 PM
Auditorium, Level 6, Bancroft Building
Microvascular pathology in severe knowlesi malaria
Associate Professor Bridget Barber
Clinical Tropical Medicine
QIMR Berghofer Medical Research Institute
The zoonotic parasite Plasmodium knowlesi is the most common cause of malaria in Malaysia, with over 4000 cases reported in 2018. Like severe falciparum malaria, severe knowlesi malaria can cause jaundice, shock, respiratory distress and acute kidney injury. However, cerebral malaria does not occur, suggesting key differences in pathogenic mechanisms. In Malaysian patients with knowlesi malaria, we have investigated key mechanisms of microvascular pathology, with the aim of identifying potential targets for therapeutic intervention. We have demonstrated that as with falciparum malaria, endothelial activation, impaired microvascular function, reduced red blood cell deformability, and degradation of the endothelial glycocalyx are all features of severe knowlesi malaria and contribute to adverse outcomes. We have also shown that intravascular haemolysis is more prominent in knowlesi than in falciparum malaria, and is associated with acute kidney injury; these findings informed the development of a randomised controlled trial, in which we demonstrated that regularly dosed paracetamol attenuated haemolysis-associated acute kidney injury in patients with severe knowlesi malaria.
Associate Professor Bridget Barber is an Infectious Diseases Physician, Team Head of Malaria Pathophysiology at QIMR Berghofer Medical Research Institute, and Principal Research Fellow at Menzies School of Health Research. She has spent 10 year working with collaborators in Sabah, Malaysia, to study the emergence of zoonotic knowlesi malaria as Malaysia approaches elimination of the human-only malaria species. In addition, she is investigating pathophysiological mechanisms of disease in severe falciparum, vivax and knowlesi malaria, with a focus on microvascular pathology and with the aim of identifying targets for adjunctive treatment.