The EPCR rs867186 gene polymorphism is associated with increased level of soluble EPCR and high risk of severe malaria and fatality in Beninese children.

The EPCR-rs867186-G allele has been linked to high plasma level of soluble-EPCR and controversially associated with either susceptibility or resistance to severe and cerebral malaria. In this study, quantitative-ELISA and sequencing were used to assess sEPCR levels and EPCR-rs867186 polymorphism in blood samples from Beninese children with different clinical presentations of malaria. Our findings show that sEPCR levels were higher at admission to hospital than during convalescence and that EPCR-rs867186-G-allele was associated with increased sEPCR plasma levels, severe malaria and mortality (p-values < .0001,  = .03 and = .04, respectively), suggesting a role of sEPCR in the pathogenesis of severe malaria.