Malaria infection may result in bone loss as a result of chronic inflammation induced by accumulated by-products in the bone marrow left by the parasite that causes the disease, say researchers.
Malaria caused by Plasmodium parasites is a life-threatening infectious disease that kills at least half a million people annually while causing over 200 million new infections.
In some cases, complications can quickly develop such as cerebral malaria, respiratory distress and severe anemia, often leading to death.
The majority of patients recover from the disease; however, there is increasing evidence to suggest that survivors experience long-term 'hidden' pathologies due to infection that are as yet poorly defined.
The new research uses mouse malaria models to show that robust immune activation and invasion of parasite by-products into the bone marrow during and after malaria infection lead to bone loss.
"Even after a one time malaria infection (it does not matter if the disease is completely cured or chronic low level infection continues), substantial chronic bone loss occurs," said Cevayir Coban, Professor at Osaka University in Japan and corresponding author of the study.
One may think that the infection has been completely cured by anti-malarial treatment, and be feeling fully recovered, however, sustained long-term accumulation of parasite by-products leaves the bone in a state of chronic inflammation, leading to long term bone loss, according to the study published in the journal Science Immunology.
"We found that Plasmodium products continuously accumulate in the bone marrow niche which turns the bone noticeably black in colour, and results in it being 'eaten-up' by bone resorbing cells known as osteoclasts, eventually disrupting bone homeostasis," first author of the study Michelle Lee from Osaka University said.
"Although chronic inflammatory conditions are known to facilitate bone disorders, our study -for the first time- shows that malaria can do the same thing, with hallmark 'signatures' left in the bone tissue, a very unique feature of malaria infection," Coban explained.
The findings suggest that anti-malarial treatment coupled with bone therapy may be beneficial in improving bone health in malaria-infected individuals.