Elevated Levels of Procoagulant Microvesicles and Tissue-Factor Bearing Microvesicles in Malaria Patients

Aymen M Madkhali,1 Abdullah A Mobarki,1 Ahmad H Ghzwani,2 Hesham M Al-Mekhlafi,2 Ahmed Zhranei,1 Abdulrahman Osais,1 Ahmed Sohel,1 Basim Othman,3 Gasim Dobie,1 Hassan A Hamali1 1Department of Medical Laboratory Technology, College of Applied Medical Sciences, Jazan University, Gizan, Saudi Arabia; 2Medical Research Center, Jazan University, Gizan, Saudi Arabia; 3Department of Public Health, Faculty of Applied Medical Sciences, Albaha University, Albaha, Saudi ArabiaCorrespondence: Hassan A Hamali, Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, P.O. Box 1906, Gizan, 45142, Saudi Arabia, Email hhamali@jazanu.edu.saBackground: Procoagulant microvesicles (MVs) are submicron membrane fragments released from activated cells and cells undergoing apoptosis. The procoagulant activity of MVs is enhanced in the presence of tissue factor (TF). MVs and TF are active mediators that induce pro-inflammatory response and prothrombotic tendency and have been linked to the severity of several disorders, including malaria infection. The current study aimed to measure the levels of circulating procoagulant MVs and TF-bearing MVs in malaria patients and correlate these levels with other hematological parameters and parasitemia.Materials and Methods: Levels of MVs and TF-bearing MVs in the plasma of children and adult patients infected with Plasmodium falciparum were measured alongside matched healthy controls.Results: Patients with Plasmodium falciparum infection had ~3.8 times MVs (p < 0.0001) and ~13.0 times TF-bearing MVs compared to the matched healthy controls. MVs showed inverse significant correlation with platelet count (p = 0.0055), hemoglobin (p = 0.0004) and parasitemia.Conclusion: Elevated levels of MVs and TF-bearing MVs could be useful biomarkers to evaluate the procoagulant activity, inflammatory response and parasitemia levels in malaria infection, aiding in better management of the disease.Keywords: procoagulant, microvesicles, tissue factor, malaria, prothrombotic inflammation