Blood transfusion alters the course and outcome of Plasmodium chabaudi AS infection in mice

The importance of severe anemia in the mortality of susceptible A/J mice during blood-stage Plasmodium chabaudi AS infection was assessed. Blood transfusion during and 2 to 3 days after peak parasitemia rescued 90% of susceptible mice from severe anemia and death and allowed these mice to clear the infection and acquire immunity to reinfection. However, blood transfusion prolonged the patency of the infection for up to 5 days after peak parasitemia. Blood transfusions in resistant C57BL/6 mice produced an identical effect, that is, prolongation of the patency of parasitemia. In addition, blood transfusion increased the numbers of gametocytes in both mouse strains. In both strains of mice, the rapid reduction in parasitemia, which occurs during crisis, was associated with the development of moderate levels of anemia. The possible mechanisms for the modulation of parasitemia by blood transfusion and the implications of the present observations for our understanding of the events which occur during crisis are discussed. It is proposed that parasitologic crisis is induced and/or maintained by physiological alterations associated with anemia.