Journal article
Cerebrospinal fluid studies in Kenyan children with severe falciparum malaria
- Abstract:
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The pathogenesis of the neurological complications of Plasmodium falciparum malaria is unclear. We measured proteins and amino acids in paired plasma and cerebrospinal fluid (CSF) samples in children with severe falciparum malaria, to assess the integrity of the blood brain barrier (BBB), and look for evidence of intrathecal synthesis of immunoglobulins, excitotoxins and brain damage.
Methods: Proteins of different molecular sizes and immunoglobulins were measured in paired CSF and plasma samples in children with falciparum malaria and either impaired consciousness, prostrate, or seizures.
Results: The ratio of CSF to plasma albumin (Qalb) exceeded the reference values in 42 (51%) children. The CSF concentrations of the excitotoxic amino acid aspartate and many non-polar amino acids, except alanine, were above the reference value, despite normal plasma concentrations. IgM concentrations were elevated in 21 (46%) and the IgM index was raised in 22 (52%). Identical IgG oligoclonal bands were found in 9 (35%), but only one patient had an increase in the CSF IgG without a concomitant increase in plasma indicating intrathecal synthesis of IgG.
Conclusions: This study indicates that the BBB is mildly impaired in some children with severe falciparum malaria, and this impairment is not confined to cerebral malaria, but also occurs in children with prostrate malaria and to a lesser extent the children with malaria and seizures. There is evidence of intrathecal synthesis of immunoglobulins in children with malaria, but this requires further investigation. This finding, together with raised level of excitotoxic amino acid aspartate could contribute to the pathogenesis of neurological complications in malaria.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 537.9KB, Terms of use)
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- Publisher copy:
- 10.2174/1874315300801010056
Authors
- Funder identifier:
- https://ror.org/029chgv08
- Grant:
- 070114/Z/02/Z
- G9818340B
- Publisher:
- Bentham Open
- Journal:
- Open Journal of Tropical Medicine More from this journal
- Volume:
- 1
- Pages:
- 56-62
- Publication date:
- 2008-09-05
- Acceptance date:
- 2008-07-21
- DOI:
- ISSN:
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1874-3153
- Language:
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English
- Pubs id:
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pubs:120582
- UUID:
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uuid:86c0151d-f088-405d-b574-4d84669d99ae
- Local pid:
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pubs:120582
- Source identifiers:
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120582
- Deposit date:
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2012-12-19
Terms of use
- Copyright holder:
- Mturi et al.
- Copyright date:
- 2008
- Rights statement:
- © Mturi et al.; Licensee Bentham Open. This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
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