title: Cerebrospinal fluid levels of markers of brain parenchymal damage in Vietnamese adults with severe malaria.
abstract: A retrospective study of cerebrospinal fluid (CSF) markers of brain parenchymal damage was conducted in Vietnamese adults with severe malaria. Three markers were analysed by immunoassays: the microtubule-associated protein tau, for degenerated axons; neuron-specific enolase (NSE), for neurons; and S100B for astrocytes. The mean concentration of tau proteins in the CSF was significantly raised in patients with severe malaria compared with controls (P=0.0003) as reported for other central nervous system diseases. By contrast, the mean concentration of NSE and S100B remained within the normal range. Tau levels were associated with duration of coma (P=0.004) and S100B was associated with convulsions (P=0.006). Concentrations of axonal and astrocyte degeneration markers also were associated with vital organ dysfunction. No association was found between the level of markers of brain parenchymal damage on admission and a fatal outcome. On admission to hospital, patients with severe malaria had biochemical evidence of brain parenchymal damage predominantly affecting axons.
authors.affiliation: Nuffield Department of Clinical Laboratory Sciences, University of Oxford, Academic block, Level 4, John Radcliffe Hospital Headington, Oxford OX3 9DU, UK. isabelle.medana@ndcls.ox.ac.uk
authors.forename: Isabelle M
authors.initials: IM
authors.lastname: Medana
authors.forename: Ralf-Björn
authors.initials: RB
authors.lastname: Lindert
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wurster
authors.forename: Tran Tinh
authors.initials: TT
authors.lastname: Hien
authors.forename: Nicholas P J
authors.initials: NP
authors.lastname: Day
authors.forename: Nguyen Hoan
authors.initials: NH
authors.lastname: Phu
authors.forename: Nguyen Thi Hoang
authors.initials: NT
authors.lastname: Mai
authors.forename: Ly Van
authors.initials: LV
authors.lastname: Chuong
authors.forename: Tran Thi Hong
authors.initials: TT
authors.lastname: Chau
authors.forename: Gareth D H
authors.initials: GD
authors.lastname: Turner
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Farrar
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: White
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000134:cerebrospinal fluid; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D016779:Malaria, Cerebral / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000134:cerebrospinal fluid; D010751:Phosphopyruvate Hydratase / Q000134:cerebrospinal fluid; D011379:Prognosis; D012189:Retrospective Studies; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000134:cerebrospinal fluid; D016875:tau Proteins / Q000134:cerebrospinal fluid
chemical_list: D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human; D016875:tau Proteins; D010751:Phosphopyruvate Hydratase