title: Some aspects of the behavior of the hypothalamus-pituitary-adrenal axis in patients with uncomplicated Plasmodium falciparum malaria: Cortisol and dehydroepiandrosterone levels.
abstract: We studied the behavior of cortisol and dehydroepiandrosterone (DHEA) in 24 patients with uncomplicated Plasmodium falciparum malaria of the Evandro Chagas Institute, Belém, Pará, Brazil. The patients were evaluated before treatment (Day 0), 24h after the beginning of medication (Day 1) and on Day 8 of follow-up (Day 7). Steroid levels were correlated with parasitemia, temperature and time of the disease. The levels of these hormones were found to be significantly higher on Day 0 than on Day 7, showing no correlation with parasitemia or temperature, but temperature had a positive effect on the correlation between cortisol and dehydroepiandrosterone. Cortisol was not correlated with the time of disease, but a significant negative correlation was observed between DHEA and time of disease on Day 7, suggesting a decline in the adrenal reserve of this steroid. In conclusion, an increase in cortisol and dehydroepiandrosterone is observed in patients with falciparum malaria, with these levels declining with decreasing parasitemia. The finding that temperature interfered with the correlation between cortisol and dehydroepiandrosterone suggests a common mechanism for the activation of these hormones in malaria.
authors.affiliation: Núcleo de Medicina Tropical, Universidade Federal do Pará, Av. Generalíssimo Deodoro 92, Umarizal, Belém, PA 66055-420, Brazil. rlibonati@globo.com
authors.forename: Rosana Maria Feio
authors.initials: RM
authors.lastname: Libonati
authors.forename: Berenice Bilharinho
authors.initials: BB
authors.lastname: de Mendonça
authors.forename: José Antônio
authors.initials: JA
authors.lastname: Maués
authors.forename: Juarez Antonio Simões
authors.initials: JA
authors.lastname: Quaresma
authors.forename: José Maria
authors.initials: JM
authors.lastname: de Souza
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D003687:Dehydroepiandrosterone / Q000097:blood*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D016778:Malaria, Falciparum / Q000097:blood* / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000502:physiology*; D010963:Plasmodium falciparum / Q000302:isolation & purification
chemical_list: D003687:Dehydroepiandrosterone; D006854:Hydrocortisone