Malaria Parasite Infection is associated with Inflammatory and Endothelial Dysregulation in Preeclampsia

Abstract

Abstract Introduction/Objective Previous Studies have associated Preeclampsia with alterations in inflammation and endothelial dysfunction . However the relationship between the pathway of this alteration and the Malaria infection in pregnancy remains underexplored, especially in malaria endemic regions like Nigeria where there is high incidence of preeclampsia. Methods/Case Report A comparative cross-sectional study was carried out among 260 pregnant women at term (18-45 years); comprising 100 preeclamptic with Malaria (PEM), 80 preeclamptic without Malaria (PE2) and 80 Normotensive, Non Malaria (Control), at Federal Medical Center Owerri, Nigeria. The groups were matched for maternal age, gestational age, gravidity and body mass index. Fasting serum lipids were analyzed by Enzymatic colorimetric method. Some Inflammatory and anti-angiogenic markers; Vascular Endothelial growth factor (VEGF), Plasminogen Activator inhibitor 1, Intracellular adhesion molecule, CRP. IL 6 and IL 8 were tested by Magnetic multiplex ELISA. Results (if a Case Study enter NA) There were significantly higher levels of Total Cholesterol, LDL and triglyceride among the 2 pre-eclamptic groups (PEM,PE2) compared to the normotensive nonmalaria group; P< 0.001, p=0.001, p=0.003 respectively, while HDL was decreased in the pre-eclamptic groups against the normotensive nonmalaria group (P = 0.024). PAI-1 and VEGF expressed significantly higher levels in the pre- eclamptic groups (PEM,PE2) compared to the normotensive nonmalaria group (P < 0.0001, P=0.000). Based on Malaria exposure, PAI-1, and IL8 were significantly elevated in PEM group (P < 0.0001) compared to the PE2 and normotensive nonmalaria group. There was no significant difference in the CRP and ICAM-I between the 2 preeclamptic groups (PEM and PE2). Conclusion These findings demonstrated that Malaria is associated with dysregulated inflammation and endothelia function, which may enhance the pathogenesis of Preeclampsia. Further studies on the predictive role of PAI-I in the pathophysiology and diagnosis of Malaria and preeclampsia is hence suggested.