Stronger host response per parasitized erythrocyte in Plasmodium vivax or ovale than in Plasmodium falciparum malaria.
OBJECTIVE
Fever tends to start at a lower level of parasitemia in Plasmodium vivax or ovale than in P. falciparum malaria, but hyperparasitemia and complications are more likely to occur in P. falciparum malaria. Therefore, we compared the relationship between parasitemia and host response parameters before therapy in 97 patients with P. faciparum malaria (18 with complications), and 28 with P. vivax or ovale malaria.


RESULTS
In both types of malaria, parasitemia correlated with blood levels of tumour necrosis factor alpha (TNF-alpha), lactate dehydrogenase (LDH), Thrombin-antithrombin III (TAT) and elastase, and these parameters were higher in P. falciparum malaria than in P. vivax or ovale malaria. In contrast, the ratios of TNF-alpha, TAT, elastase, and LDH per parasitized erythrocyte were higher in P. vivax or ovale malaria than in uncomplicated P. falciparum malaria. They were lowest in complicated disease. Multivariate regression analysis confirmed that parasitemia did not affect these differences.


CONCLUSIONS
The host response may reach full strength at lower parasitemia in Plasmodium vivax or ovale, than in P. falciparum malaria. With hyperparasitemia in P. falciparum malaria, the host response seems to be unable to control parasite multiplication.
Hemmer
Christoph Josef
CJ
Department of Tropical Medicine and Infectious Diseases, University of Rostock, Rostock, Germany. christoph_hemmer@med.uni-rostock.de
Holst
Friedrich Georg Ernst
FG
Kern
Peter
P
Chiwakata
Collins Batsirai
CB
Dietrich
Manfred
M
Reisinger
Emil Christian
EC
D000818:Animals; D000990:Antithrombin III; D004912:Erythrocytes / Q000469:parasitology*; D006790:Host-Parasite Interactions; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008288:Malaria / Q000097:blood* / Q000503:physiopathology; D016778:Malaria, Falciparum / Q000097:blood / Q000503:physiopathology; D016780:Malaria, Vivax / Q000097:blood / Q000503:physiopathology; D010196:Pancreatic Elastase / Q000097:blood; D018512:Parasitemia / Q000097:blood / Q000469:parasitology; D010447:Peptide Hydrolases / Q000097:blood; D010963:Plasmodium falciparum / Q000502:physiology; D041122:Plasmodium ovale / Q000502:physiology; D010966:Plasmodium vivax / Q000502:physiology; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D014409:Tumor Necrosis Factor-alpha; C046193:antithrombin III-protease complex; D000990:Antithrombin III; D007770:L-Lactate Dehydrogenase; D010447:Peptide Hydrolases; D010196:Pancreatic Elastase