mesЭкстремальная биомедицинаExtreme Medicine3033-89643033-8972Centre for Strategic Planning of the Federal Medical and Biological Agency10.47183/mes.2024.034mes-73Research ArticleОРИГИНАЛЬНОЕ ИССЛЕДОВАНИЕORIGINAL RESEARCHЭлектронная микроскопия трофозоитов Plasmodium falciparum и инфицированных ими тканей при тяжелой форме тропической малярииElectron microscopy of the Plasmodium falciparum trophozoites and the tissues these have infected in severe tropical malariaСоловьевА. И.SolovevA. I.

ул. Академика Лебедева, д. 6, г. Санкт-Петербург, 194044

Akademika Lebedeva, 6, Saint-Petersburg, 194044

КапацинаВ. А.KapacinaV. A.

ул. Академика Лебедева, д. 6, г. Санкт-Петербург, 194044

Akademika Lebedeva, 6, Saint-Petersburg, 194044

СоколоваМ. О.SokolovaM. O.

ул. Академика Лебедева, д. 6, г. Санкт-Петербург, 194044

Akademika Lebedeva, 6, Saint-Petersburg, 194044

АрюковА. Р.AriukovA. R.

Артем Русланович Арюков

ул. Академика Лебедева, д. 6, г. Санкт-Петербург, 194044

Artem R. Ariukov

Akademika Lebedeva, 6, Saint-Petersburg, 194044

КоваленкоА. Н.KovalenkoA. N.

ул. Академика Лебедева, д. 6, г. Санкт-Петербург, 194044

Akademika Lebedeva, 6, Saint-Petersburg, 194044

УсковА. Н.UskovA. N.

ул. Академика Лебедева, д. 6, г. Санкт-Петербург, 194044

Akademika Lebedeva, 6, Saint-Petersburg, 194044

РоманенкоВ. А.RomanenkoV. A.

ул. Академика Лебедева, д. 6, г. Санкт-Петербург, 194044

Akademika Lebedeva, 6, Saint-Petersburg, 194044

Военно-медицинская академия имени С. М. КироваРоссияKirov Military Medical AcademyRussian FederationКлиническая инфекционная больница имени С. П. БоткинаРоссияBotkin Clinical Infectious Diseases HospitalRussian FederationДетский научно-клинический центр инфекционных болезней Федерального медико-биологического агентстваРоссияChildren's Research and Clinical Center for Infectious Diseases of the Federal Medical Biological AgencyRussian Federation202423102024262133139Copyright © Соловьев А.И., Капацина В.А., Соколова М.О., Арюков А.Р., Коваленко А.Н., Усков А.Н., Романенко В.А., 20242024Соловьев А.И., Капацина В.А., Соколова М.О., Арюков А.Р., Коваленко А.Н., Усков А.Н., Романенко В.А.Solovev A.I., Kapacina V.A., Sokolova M.O., Ariukov A.R., Kovalenko A.N., Uskov A.N., Romanenko V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.extrememedicine.ru/jour/article/view/73

Представлены результаты комплексного электронно-микроскопического исследования образцов венозной крови и тканей внутренних органов, полученных при изучении летального случая завозной тропической малярии. Целью работы было изучить ультраструктуру эритроцитарных стадий развития Plasmodium falciparum и изменений пораженных ими тканей при тяжелой форме тропической малярии. Образцы венозной крови, тканей коры головного мозга и миокарда исследовали с помощью световой, а также электронной (сканирующей и трансмиссионной) микроскопии. В крови были выявлены многочисленные трофозоиты Plasmodium falciparum. В цитоплазме инфицированных эритроцитов обнаружены множественные расщелины Маурера. Между инфицированными и непораженными эритроцитами выявлены патологические межклеточные контакты, что приводит к их слипанию и формированию розеток (эритроцитарный розеттинг). При исследовании тканей коры головного мозга и миокарда в просвете капилляров отмечена фиксация пораженных эритроцитов на эндотелии (эритроцитарная адгезия). Розеттинг и адгезия эритроцитов приводят к тромбированию капилляров, нарушению микроциркуляции и возникновению секвестров в тканях жизненно важных органов (паразитарная секвестрация). Выявленные морфологические особенности возбудителей тропической малярии и поряженных ими тканей определяют способность паразитов менять свойства клеточных мембран инфицированных эритроцитов, что приводит к формированию патологических межклеточных контактов и служит одним из основных механизмов вирулентности Plasmodium falciparum.

The paper provides the results of the comprehensive electron microscopic examination of the venous blood and internal organ tissue samples obtained when studying the imported case of tropical malaria. The study was aimed to assess the fine structure of the erythrocytic stages of Plasmodium falciparum and alterations of the affected tissues in severe tropical malaria. The venous blood, cerebral cortical tissue and myocardial samples were examined by light microscopy and electron (scanning and transmission) microscopy. Numerous Plasmodium falciparum trophozoites were found in blood. Multiple Maurer's clefts were found in the cytoplasm of the infected erythrocytes. Abnormal intercellular contacts between the infected and unaffected erythrocytes were revealed, which resulted in their adhesion and rosette formation (erythrocyte rosetting/e-rosetting). When studying cortical tissue and myocardial samples, fixation of the affected erythrocytes on the endothelium (erythrocyte adhesion) was noted in the capillary lumen. Rosetting and erythrocyte adhesion lead to capillary thrombosis, disruption of microcirculation and sequestration of tissues in vital organs (parasite sequestration). The identified morphological features of the pathogens causing tropical malaria and the affected tissues determine the parasites’ capability of changing properties of the infected erythrocytes’ cell membranes, which leads to formation of abnormal intercellular contacts and constitutes one of the main mechanisms underlying the Plasmodium falciparum virulence.

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The authors declare that there are no conflicts of interest present.