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Inactivation of Plasmodium falciparum in whole blood by riboflavin plus irradiation

Authors

  • Mira El Chaar,

    1. Department of Haematology, University of Cambridge, Cambridge, United Kingdom
    2. Department of Immunology & Infection, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
    3. HPA Malaria Reference Laboratory, London School of Hygiene & Tropical Medicine, London, United Kingdom
    4. Faculty of Health Sciences, University of Balamand, Beirut, Lebanon
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  • Sharan Atwal,

    1. Department of Haematology, University of Cambridge, Cambridge, United Kingdom
    2. Department of Immunology & Infection, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
    3. HPA Malaria Reference Laboratory, London School of Hygiene & Tropical Medicine, London, United Kingdom
    4. Faculty of Health Sciences, University of Balamand, Beirut, Lebanon
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  • Graham L. Freimanis,

    1. Department of Haematology, University of Cambridge, Cambridge, United Kingdom
    2. Department of Immunology & Infection, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
    3. HPA Malaria Reference Laboratory, London School of Hygiene & Tropical Medicine, London, United Kingdom
    4. Faculty of Health Sciences, University of Balamand, Beirut, Lebanon
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  • Bismarck Dinko,

    1. Department of Haematology, University of Cambridge, Cambridge, United Kingdom
    2. Department of Immunology & Infection, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
    3. HPA Malaria Reference Laboratory, London School of Hygiene & Tropical Medicine, London, United Kingdom
    4. Faculty of Health Sciences, University of Balamand, Beirut, Lebanon
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  • Colin J. Sutherland,

    1. Department of Haematology, University of Cambridge, Cambridge, United Kingdom
    2. Department of Immunology & Infection, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
    3. HPA Malaria Reference Laboratory, London School of Hygiene & Tropical Medicine, London, United Kingdom
    4. Faculty of Health Sciences, University of Balamand, Beirut, Lebanon
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  • Jean-Pierre Allain

    Corresponding author
    1. Department of Haematology, University of Cambridge, Cambridge, United Kingdom
    2. Department of Immunology & Infection, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
    3. HPA Malaria Reference Laboratory, London School of Hygiene & Tropical Medicine, London, United Kingdom
    4. Faculty of Health Sciences, University of Balamand, Beirut, Lebanon
    • Address reprint requests to: Jean-Pierre Allain, Cambridge Blood Centre, Long Road, Cambridge CB2 2PT, UK; e-mail: jpa1000@cam.ac.uk

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  • This work was supported by a grant from TerumoBCT to CS and JPA.

Abstract

Background

Malaria parasites are frequently transmitted by unscreened blood transfusions in Africa. Pathogen reduction methods in whole blood would thus greatly improve blood safety. We aimed to determine the efficacy of riboflavin plus irradiation for treatment of whole blood infected with Plasmodium falciparum.

Study Design and Methods

Blood was inoculated with 104 or 105 parasites/mL and riboflavin treated with or without ultraviolet (UV) irradiation (40-160 J/mL red blood cells [mLRBCs]). Parasite genome integrity was assessed by quantitative amplification inhibition assays, and P. falciparum viability was monitored in vitro.

Results

Riboflavin alone did not affect parasite genome integrity or parasite viability. Application of UV after riboflavin treatment disrupted parasite genome integrity, reducing polymerase-dependent amplification by up to 2 logs (99%). At 80 J/mLRBCs, riboflavin plus irradiation prevented recovery of viable parasites in vitro for 2 weeks, whereas untreated controls typically recovered to approximately 2% parasitemia after 4 days of in vitro culture. Exposure of blood to 160 J/mLRBCs was not associated with significant hemolysis.

Conclusions

Riboflavin plus irradiation treatment of whole blood damages parasite genomes and drastically reduces P. falciparum viability in vitro. In the absence of suitable malaria screening assays, parasite inactivation should be investigated for prevention of transfusion-transmitted malaria in highly endemic areas.

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