Evidence mapPaperPMID 41115249Full record

ArticleBlood advances2026

Heme and hemozoin induce platelet cell death through UPR-induced apoptosis and ferroptosis in vivax malaria.

Milena Tavares Gomes, Isabel M Medeiros-de-Moraes, Adriana Vieira-de-Abreu, Isaclaudia G de Azevedo-Quintanilha, Thayane M Fontes, Alan de Brito Carneiro, Pedro Azambuja, Neal D Tolley, Jesse W Rowley, Barbara Albuquerque Carpinter and 13 more

Abstract read
In one paragraph

Article in Blood advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Milena Tavares GomesLaboratory of Immunothrombosis, Department of Biochemistry, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
Isabel M Medeiros-de-MoraesLaboratory of Immunopharmacology, Oswald Cruz Institute, Oswald Cruz Foundation, Rio de Janeiro, Brazil.
Adriana Vieira-de-AbreuLaboratory of Immunopharmacology, Oswald Cruz Institute, Oswald Cruz Foundation, Rio de Janeiro, Brazil.
Isaclaudia G de Azevedo-QuintanilhaLaboratory of Immunopharmacology, Oswald Cruz Institute, Oswald Cruz Foundation, Rio de Janeiro, Brazil.
Thayane M FontesLaboratory of Immunothrombosis, Department of Biochemistry, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
Alan de Brito CarneiroLaboratory of Immunopharmacology, Oswald Cruz Institute, Oswald Cruz Foundation, Rio de Janeiro, Brazil.
Pedro AzambujaLaboratory of Clinical Research in Intensive Care Medicine, National Institute of Infectious Diseases Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil.ORCID 0000-0002-2834-0061
Neal D TolleyDepartment of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, UT.
Jesse W RowleyDepartment of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, UT.
Barbara Albuquerque CarpinterPrograma de Pós-graduação em Ciências Biológicas, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Brazil.ORCID 0000-0001-8672-4461
Marcelo U FerreiraDepartment of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.ORCID 0000-0002-5293-9090
Raquel Muller GonçalvesDepartment of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
Vinicius Novaes RochaLaboratory of Veterinary Pathology and Histology, Department of Veterinary Medicine, Faculty of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
Ana Lúcia Rosa NascimentoLaboratory of Ultrastructure and Tissue, Department of Histology and Embryology, State University of Rio de Janeiro, Rio de Janeiro, Brazil.ORCID 0000-0002-9273-7362
Wanessa Araújo CarvalhoLaboratory of Animal Health, Embrapa Gado de Leite, Juiz de Fora, Brazil.ORCID 0000-0002-1346-5240
Kézia K G ScopelDepartment of Parasitology, Microbiology and Immunology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Brazil.ORCID 0000-0003-1394-6156
Robert A CampbellDepartment of Emergency Medicine, Washington University, St Louis, MO.
Patrícia T BozzaPrograma de Pós-graduação em Ciências Biológicas, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Brazil.ORCID 0000-0001-8349-9529
Andrew S WeyrichDepartment of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, UT.
Guy A ZimmermanDepartment of Internal Medicine and Molecular Medicine Program, University of Utah, Salt Lake City, UT.
Marcus Vinícius G LacerdaFundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil.ORCID 0000-0003-3374-9985
Hugo C Castro-Faria-NetoLaboratory of Immunopharmacology, Oswald Cruz Institute, Oswald Cruz Foundation, Rio de Janeiro, Brazil.ORCID 0000-0002-0763-3578
Eugenio D HottzLaboratory of Immunothrombosis, Department of Biochemistry, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Brazil.ORCID 0000-0002-2201-1742

Funding

Mitochondrial fusion protein MFN2 prevents platelet death and dysfunctionR01HL144957 · NHLBI · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2021 to 2025
$1.8M
NHLBI NIH HHS R01 HL144957
6 · The paper itself

Abstract

abstractMalaria is a highly prevalent infectious disease caused by Plasmodium parasites. Plasmodium intraerythrocytic replication leads to hemolysis-driven intermittent febrile crises in patients. In addition, the lysis of unparasitized red blood cells contributes to anemia and endotoxemia. Because thrombocytopenia is an important feature of vivax and severe falciparum malaria, we hypothesized that increased hemolysis in malaria contributes to severe thrombocytopenia by releasing endogenous and parasite toxins (ie, heme and hemozoin) capable of inducing programmed cell death in platelets. Using complementary biochemical, ultrastructural, pharmacological, and molecular approaches, we examined response to stress and cell death pathways that were elevated in the transcriptome of platelets during vivax malaria and evaluated markers of hemolysis that correlated with thrombocytopenia. We found that heme in plasma from thrombocytopenic vivax malaria, but not nonthrombocytopenic vivax or falciparum malaria, induced platelet cell death ex vivo. Platelet stimulation with heme and hemozoin induced apoptotic and necrotic cell death features, with stronger necrosis triggered by hemozoin. Heme and hemozoin activated apoptotic caspases, but only heme induced calpain-dependent BcL-xL degradation, which was not required for platelet apoptosis. We unmasked a caspase-independent intrinsic apoptosis program mechanism depending on the endoplasmic reticulum stress sensor and unfolded protein response trigger IRE1α. Regarding necrosis, we observed inflammasome activation but not pyroptosis. Instead, we distinguished a necrotic cell death feature consistent with ferroptosis, dependent on lipid peroxidation and regulated by DGAT1/2 enzymes, which was the main pathway for hemozoin-induced thrombocytopenia in vitro. Our results identify novel pathways of regulated cell death in platelets that were associated with thrombocytopenia in malaria and may have potential implications for other hemolytic disorders.

Indexed as

ApoptosisBlood PlateletsFerroptosisHemeHemeproteinsMalaria, VivaxUnfolded Protein ResponseCell DeathHumansThrombocytopeniaHemeHemeproteinshemozoin

Identifiers

PMID41115249
PMCPMC12865578

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.