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Complement activation and reduced expression of complement regulatory proteins (CRPs) on RBCs are an important pathogenic mechanism in severe malarial anaemia in both<jats:italic>Plasmodium falciparum<\/jats:italic>and<jats:italic>Plasmodium vivax<\/jats:italic>infection. However, little is known about loss of CRPs on RBCs during mild malarial anaemia and in low-density infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The expression of CRP CR1, CD55, CD59, and the phagocytic regulator CD47, on uninfected normocytes and reticulocytes were assessed in individuals from two study populations: (1)<jats:italic>P. falciparum<\/jats:italic>and<jats:italic>P. vivax<\/jats:italic>-infected patients from a low transmission setting in Sabah, Malaysia; and, (2) malaria-na\u00efve volunteers undergoing<jats:italic>P. falciparum<\/jats:italic>induced blood-stage malaria (IBSM). For clinical infections, individuals were categorized into anaemia severity categories based on haemoglobin levels. For IBSM, associations between CRPs and haemoglobin level were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CRP expression on RBC was lower in Malaysian individuals with<jats:italic>P. falciparum<\/jats:italic>and<jats:italic>P. vivax<\/jats:italic>mild malarial anaemia compared to healthy controls. CRP expression was also reduced on RBCs from volunteers during IBSM. Reduction occurred on normocytes and reticulocytes. However, there was no significant association between reduced CRPs and haemoglobin during IBSM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Removal of CRPs occurs on both RBCs and reticulocytes during<jats:italic>Plasmodium<\/jats:italic>infection even in mild malarial anaemia and at low levels of parasitaemia.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12936-019-2962-0","type":"journal-article","created":{"date-parts":[[2019,9,18]],"date-time":"2019-09-18T10:03:22Z","timestamp":1568801002000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Loss of complement regulatory proteins on red blood cells in mild malarial anaemia and in Plasmodium falciparum induced blood-stage infection"],"prefix":"10.1186","volume":"18","author":[{"given":"Damian A.","family":"Oyong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica R.","family":"Loughland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arya","family":"SheelaNair","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dean","family":"Andrew","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabian D. 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For clinical cohorts, sample collection was approved by the Human Ethics Committee of NT Department of Health and Menzies School of Health Research, Darwin (HREC 10\/1431), Australia and from Malaysian Ministry of Health (NMRR 10 754 6684). The IBSM sub-study was approved by QIMR Berghofer Ethics Committee, Brisbane, Australia (P1479).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"312"}}