{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T09:45:39Z","timestamp":1790070339924,"version":"4.0.1"},"reference-count":35,"publisher":"National Academy of Sciences","issue":"44","content-domain":{"domain":["www.pnas.org"],"crossmark-restriction":true},"short-container-title":["Proc. Natl. Acad. Sci. U.S.A."],"published-print":{"date-parts":[[2009,11,3]]},"abstract":"<jats:p>\n                    In many Asian populations, the commonest form of severe thalassemia results from the coinheritance of HbE and \u03b2 thalassemia. The management of this disease is particularly difficult because of its extreme clinical diversity; although some genetic and adaptive factors have been identified as phenotypic modifiers, the reasons remain unclear. Because the role of the environment in the course of severe thalassemia has been neglected completely and because malaria due to both\n                    <jats:italic>Plasmodium falciparum<\/jats:italic>\n                    and\n                    <jats:italic>Plasmodium vivax<\/jats:italic>\n                    has been prevalent in Sri Lanka, we carried out a pilot study of patients with HbE \u03b2 thalassemia that showed high frequencies of antibodies to both parasite species and that 28.6% of the children had DNA-based evidence of current infection with\n                    <jats:italic>P. vivax<\/jats:italic>\n                    . Malarial antibodies then were assessed in patients with HbE \u03b2 thalassemia compared with those in age-matched controls. There was a significant increase in the frequency of antibodies in the thalassemic patients, particularly against\n                    <jats:italic>P. vivax<\/jats:italic>\n                    and in young children. There was also a higher frequency in those who had been splenectomized compared with those with intact spleens, although in the latter it was still higher than that in the controls. The thalassemic patients showed significant correlations between malaria antibody status and phenotype. Patients with HbE \u03b2 thalassemia may be more prone to malaria, particularly\n                    <jats:italic>P. vivax<\/jats:italic>\n                    , which is reflected in their clinical severity. Because\n                    <jats:italic>P. vivax<\/jats:italic>\n                    malaria is widespread in Asia, further studies of its interaction with HbE \u03b2 thalassemia and related diseases are required urgently as a part of ongoing thalassemia control programs.\n                  <\/jats:p>","DOI":"10.1073\/pnas.0910142106","type":"journal-article","created":{"date-parts":[[2009,10,19]],"date-time":"2009-10-19T21:44:12Z","timestamp":1255988652000},"page":"18716-18721","update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":45,"title":["Interaction of malaria with a common form of severe thalassemia in an Asian population"],"prefix":"10.1073","volume":"106","author":[{"given":"A.","family":"O'Donnell","sequence":"first","affiliation":[{"name":"Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Headington, Oxford OX3 9DS, United Kingdom;"},{"name":"Clinical School, University of Wales, Swansea SA2 8PP, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Premawardhena","sequence":"additional","affiliation":[{"name":"University of Kelaniya, Colombo, Sri Lanka;"},{"name":"National Thalassaemia Centre, District Hospital, Kurunegala, Sri Lanka;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Arambepola","sequence":"additional","affiliation":[{"name":"National Thalassaemia Centre, District Hospital, Kurunegala, Sri Lanka;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Samaranayake","sequence":"additional","affiliation":[{"name":"National Thalassaemia Centre, District Hospital, Kurunegala, Sri Lanka;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. J.","family":"Allen","sequence":"additional","affiliation":[{"name":"Clinical School, University of Wales, Swansea SA2 8PP, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. E. A.","family":"Peto","sequence":"additional","affiliation":[{"name":"Clinical School, University of Wales, Swansea SA2 8PP, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. A.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Clinical School, University of Wales, Swansea SA2 8PP, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London WC1 7HT, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. H.","family":"Corran","sequence":"additional","affiliation":[{"name":"Department of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London WC1 7HT, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy F.","family":"Olivieri","sequence":"additional","affiliation":[{"name":"Hemoglobinopathy Research, University Health Network, 200 Elizabeth Street, Toronto, ON, Canada M5G 2C4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. J.","family":"Weatherall","sequence":"additional","affiliation":[{"name":"Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Headington, Oxford OX3 9DS, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"341","published-online":{"date-parts":[[2009,11,3]]},"reference":[{"key":"e_1_3_3_1_2","volume-title":"March of Dimes Global Report on Birth Defects","author":"Christianson A","year":"2006","unstructured":"A Christianson, CP Howson, B Modell March of Dimes Global Report on Birth Defects (March of Dimes Birth Defects Foundation, White Plains, NY, 2006)."},{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/9780470696705"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/300768a0"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3109\/03630269709000664"},{"key":"e_1_3_3_5_2","first-page":"1","article-title":"Prevalence of beta thalassemia trait and Hb E trait in Bangladeshi school children and health burden of thalassemia in our population","volume":"21","author":"Khan WA","year":"2005","unstructured":"WA Khan, et al., Prevalence of beta thalassemia trait and Hb E trait in Bangladeshi school children and health burden of thalassemia in our population. Dhaku Shishu (Children) Hospital Journal 21, 1\u20137 (2005).","journal-title":"Dhaku Shishu (Children) Hospital Journal"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2003.04346.x"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07126.x"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67396-5"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.2174\/156652408786241410"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-007-0407-2"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-4-8"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1990.42.298"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2001.64.97"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0050136"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01732885"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0408725102"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-9-69"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0092-8674(92)90642-P"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0264-410X(01)00472-8"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/383522a0"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.94.26.14736"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1998.00971.x"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1980.tb07148.x"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)91678-5"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1128\/iai.40.3.985-994.1983"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1086\/340213"},{"key":"e_1_3_3_27_2","first-page":"183","volume-title":"The Role of the Spleen in the Immunology of Parasitic Diseases","author":"Wyler DJ","year":"1979","unstructured":"DJ Wyler, CN Oster, TC Quinn The Role of the Spleen in the Immunology of Parasitic Diseases, ed G Torrigiani (Schwabe, Basel), pp. 183\u2013204 (1979)."},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/clind\/16.3.361"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07085.x"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.220267997"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1996.55.2.TM0550020144"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.72.3.1557-1567.2004"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/0166-6851(93)90077-B"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2001.tb03891.x"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.molbiopara.2007.01.015"}],"container-title":["Proceedings of the National Academy of Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/pnas.org\/doi\/pdf\/10.1073\/pnas.0910142106","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T19:09:05Z","timestamp":1649790545000},"score":1,"resource":{"primary":{"URL":"https:\/\/pnas.org\/doi\/full\/10.1073\/pnas.0910142106"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,11,3]]},"references-count":35,"journal-issue":{"issue":"44","published-print":{"date-parts":[[2009,11,3]]}},"alternative-id":["10.1073\/pnas.0910142106"],"URL":"https:\/\/doi.org\/10.1073\/pnas.0910142106","relation":{},"ISSN":["0027-8424","1091-6490"],"issn-type":[{"value":"0027-8424","type":"print"},{"value":"1091-6490","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,11,3]]},"assertion":[{"value":"2009-07-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2009-11-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}