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Immunogenetic Mechanisms of Black Water Fever: Article Review

Joseph M. Bodi, Célestin N. Nsibu, Kenji Hirayama

The authors systematically reviewed the literature on mechanisms of Black Water Fever ‘BWF) on immunology and genetics point of view to determine whether immunity and genetics are involved in the occurrence of Acute Intravascular haemolysis in malaria, leading to BWF.. All original reports of BWF were retrieved from Embase, Medline from 1935 to December 2018. Information extracted from each article included study design, definitions of BWF, pathogeny and risk factors of the disease. Descriptive, Prospective cohort, cross sectional, and case-control studies were assessed. Malaria IgG1 antibodies were measured. MBL2 gene were amplified and sequenced. BWF was associated to high level of malaria IgG1 antibodies. The geometric mean of antibodies in patients with BWF was high [1,95mg/l (IC95% :1,55-2,44) compared to [ 1,19 mg/l (IC95%: 0,98–1,43) ] in children with uncomplicated malaria. High malaria IgG1 were statistically significantly associated with increased risk to develop BWF Children with MBL2 gene variants were less susceptible to develop BWF compared to children with normal MBL2 gene. Genotypes MBL2 AB&AC (AO) were more frequent in the control children group compared to the BWF cases: [OR: 0,21 (0,06-0,78) avec p=0,019] suggesting a protection conferred by gene mutations. Because of high level of MBL protein in MBL2AA genotypes patients; complement activation do to this protein can increase risk to acute intravascular hemolysis, the major mechanism of BWF Malaria .High level IgG1 and the MBL2 AA genotypes seem to the risk factors incriminated in the occurrence of BWF.