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Abstract
Malaria is an enormous burden on global health that caused 409,000 deaths in 2019. Severe malaria can manifest in the lungs, an illness known as acute respiratory distress syndrome (ARDS). Not much is known about the development of malaria-associated ARDS (MA-ARDS), especially regarding cell death in the lungs. We had previously established a murine model that mimics various human ARDS aspects, such as pulmonary edema, hemorrhages, pleural effusion, and hypoxemia, using DBA/2 mice infected with Plasmodium berghei ANKA. Here, we explored the mechanisms and the involvement of apoptosis in this syndrome. We found that apoptosis contributes to the pathogenesis of MA-ARDS, primarily as facilitators of the alveolar-capillary barrier breakdown. The protection of pulmonary endothelium by inhibiting caspase activation could be a promising therapeutic strategy to prevent the pathogenicity of MA-ARDS. Therefore, intervention in the programmed death cell mechanism could help patients not to develop severe malaria.
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1 Universidade de São Paulo, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, São Paulo, Brazil (GRID:grid.11899.38) (ISNI:0000 0004 1937 0722)
2 Universidade de São Paulo, Departamento de Imunologia, Instituto de Ciências Biomédicas, São Paulo, Brazil (GRID:grid.11899.38) (ISNI:0000 0004 1937 0722); Seattle Children’s Research Institute, Center for Global Infectious Disease, Seattle, USA (GRID:grid.240741.4) (ISNI:0000 0000 9026 4165)
3 Universidade Federal do ABC, Centro de Ciências Naturais e Humanas, São Paulo, Brazil (GRID:grid.412368.a) (ISNI:0000 0004 0643 8839)
4 Universidade de São Paulo, Departamento de Imunologia, Instituto de Ciências Biomédicas, São Paulo, Brazil (GRID:grid.11899.38) (ISNI:0000 0004 1937 0722)
5 Universidade de São Paulo, Departamento de Imunologia, Instituto de Ciências Biomédicas, São Paulo, Brazil (GRID:grid.11899.38) (ISNI:0000 0004 1937 0722); Instituto Nacional de Ciência e Tecnologia (INCT-iii), Instituto de Investigação em Imunologia, São Paulo, Brazil (GRID:grid.11899.38) (ISNI:0000 0004 1937 0722)
6 Universidade de São Paulo, Departamento de Parasitologia, Instituto de Ciências Biomédicas, São Paulo, Brazil (GRID:grid.11899.38) (ISNI:0000 0004 1937 0722)