Autoantibody levels are associated with acute kidney injury, anemia and post-discharge morbidity and mortality in Ugandan children with severe malaria

Juan Rivera-Correa, Andrea L. Conroy, Robert O. Opoka, Anthony Batte, Ruth Namazzi, Benson Ouma, Paul Bangirana, Richard Idro, Andrew L. Schwaderer, Chandy C. John, Ana Rodriguez

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Autoantibodies targeting host antigens contribute to autoimmune disorders, frequently occur during and after infections and have been proposed to contribute to malaria-induced anemia. We measured anti-phosphatidylserine (PS) and anti-DNA antibody levels in 382 Ugandan children prospectively recruited in a study of severe malaria (SM). High antibody levels were defined as antibody levels greater than the mean plus 3 standard deviations of community children (CC). We observed increases in median levels of anti-PS and anti-DNA antibodies in children with SM compared to CC (p < 0.0001 for both). Children with severe malarial anemia were more likely to have high anti-PS antibodies than children with cerebral malaria (16.4% vs. 7.4%), p = 0.02. Increases in anti-PS and anti-DNA antibodies were associated with decreased hemoglobin (p < 0.05). A one-unit increase in anti-DNA antibodies was associated with a 2.99 (95% CI, 1.68, 5.31) increase odds of acute kidney injury (AKI) (p < 0.0001). Elevated anti-PS and anti-DNA antibodies were associated with post-discharge mortality (p = 0.031 and p = 0.042, respectively). Children with high anti-PS antibodies were more likely to have multiple hospital readmissions compared to children with normal anti-PS antibody levels (p < 0.05). SM is associated with increased autoantibodies against PS and DNA. Autoantibodies were associated with anemia, AKI, post-discharge mortality, and hospital readmission.

Original languageEnglish (US)
Article number14940
JournalScientific reports
Volume9
Issue number1
DOIs
StatePublished - Dec 1 2019

Bibliographical note

Funding Information:
We would like to thank the study participants and their families for participating in the study, and the study team for their dedication. We thank David Narum, David Lanar, Michael Theisen for provision of recombinant antigens used in the testing. Funding from National Institutes of Health–NINDS R01 NS055349 to C.C.J. and the Training Grant T32 AI007180 to J.R.C.

Publisher Copyright:
© 2019, The Author(s).

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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