Abstract
BackgroundCerebral malaria is a clinical manifestation of Plasmodium falciparum infection. Although brain damage is the predominant pathophysiological complication of cerebral malaria (CM), respiratory distress, acute lung injury, hydrothorax/pleural effusion are also observed in several cases. Immunological parameters have been assessed in pleural fluid in murine models; however there are no reports of characterization of metabolites present in pleural effusion.Methods1H NMR of the sera and the pleural effusion of cerebral malaria infected mice were analyzed using principal component analysis, orthogonal partial least square analysis, multiway principal component analysis, and multivariate curve resolution.ResultsIt has been observed that there was 100% occurrence of pleural effusion (PE) in the mice affected with CM, as opposed to those are non-cerebral and succumbing to hyperparasitaemia (NCM/HP). An analysis of 1H NMR and SDS-PAGE profile of PE and serum samples of each of the CM mice exhibited a similar profile in terms of constituents. Multivariate analysis on these two classes of biofluids was performed and significant differences were detected in concentrations of metabolites. Glucose, creatine and glutamine contents were high in the PE and lipids being high in the sera. Multivariate curve resolution between sera and pleural effusion showed that changes in PE co-varied with that of serum in CM mice. The increase of glucose in PE is negatively correlated to the glucose in serum in CM as obtained from the result of multiway principal component analysis.ConclusionsThis study reports for the first time, the characterization of metabolites in pleural effusion formed during murine cerebral malaria. The study indicates that the origin of PE metabolites in murine CM may be the serum. The loss of the components like glucose, glutamine and creatine into the PE may worsen the situation of patients, in conjunction with the enhanced glycolysis, glutaminolysis and increased activity of creatine phophokinase which are already reported characteristic pathophysiological features of malaria.
Highlights
Cerebral malaria is a clinical manifestation of Plasmodium falciparum infection
Some of the clinical and pathologic aspects are known for these complications; like increased vascular permeability [16], vasodilatation that might lead to cardiac insufficiency [17]
The increase in the vascular permeability and decrease in osmotic pressure of serum colloid play a crucial role in circulatory shock in cerebral malaria [18]
Summary
Cerebral malaria is a clinical manifestation of Plasmodium falciparum infection. One of the major complications of the disease is cerebral malaria, caused in humans by the unicellular protozoan Plasmodium and pleural effusion [14]. While pulmonary involvement is a recognized complication of malaria infection, little is currently known about its pathogenesis [15]. Some of the clinical and pathologic aspects are known for these complications; like increased vascular permeability [16], vasodilatation that might lead to cardiac insufficiency [17]. The increase in the vascular permeability and decrease in osmotic pressure of serum colloid play a crucial role in circulatory shock in cerebral malaria [18]. Circulatory shock is known as septic shock and is characterized by vasodilatation, decrease in arterial pressure and changes in the vascular permeability [19]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
