Cytoadherence characteristics of Plasmodium falciparum isolates in Thailand using an in vitro human lung endothelial cells model

Using an in vitro model of human lung endothelial cells, we studied differe nt characteristics of Plasmodium falciparum isolates as potential factors f or malaria severity in 2 Thai patient groups: 27 with complicated malaria a nd 42 with uncomplicated malaria. In regard to binding properties, no assoc iation existed between cytoadherence and rosette phenotypes (P = 0.1) and h ypothrombocytemia increased the cytoadherence level (P = 0.007). Cytoadhere nce was significantly associated with malaria severity (P = 0.05) in contra st to rosette formation (P = 0.9). Intercellular adhesion molecule-1 and ch ondroitin-4-sulfate were major receptors of cytoadherence in those with com plicated malaria compared with those with uncomplicated malaria (P < 10(-4) ). Chondroitin-4-sulfate could act as a putative receptor for malaria compl ications in non-pregnant women. CD36 was the main receptor in patients with uncomplicated malaria (P < 10(-3)). Vascular cell adhesion molecule-1 and E-selectin played a minor role in 2 groups (P = 0.6). Qinghaosu derivatives were more efficient than other antimalarial drugs, but a positive correlat ion was observed between the 50% inhibitory concentrations of halofantrine and quinine and the number of adhesive parasitized red blood cells, suggest ing their influence on cytoadherence.