Loss of complement regulatory proteins on uninfected erythrocytes in vivax and falciparum malaria anemia

Red blood cells destruction through loss of complement regulatory proteins (CRPs) is an immunopathogenic mechanism that contributes to malaria anaemia in Plasmodium falciparum. However, its role in P. vivax malaria is unknown. Our study showed CR1 and CD55 were reduced in severe anaemia in both falciparum and vivax malaria. The loss of CRPs however, was only restricted to uninfected RBCs, with infected RBCs having higher expressions. This study highlights the likely critical role of reduced CRPs expression on uninfected RBCs in falciparum and vivax malaria anaemia, and demonstrated that higher CRPs expression on infected RBCs may suggest parasite’s invasion and immune evasion strategy.