Axonal and astrocyte injury markers in the cerebrospinal fluid of Kenyan children with severe malaria.
A retrospective study of cerebrospinal fluid (CSF) levels of markers of brain parenchymal damage was conducted in Kenyan children with severe falciparum malaria. Two markers were analysed by immunoassays: the microtubule-associated protein tau for degenerated axons and S-100B for astrocytes. The level of tau proteins in the CSF was significantly elevated in children with cerebral malaria compared with either malaria with prostration or malaria with seizures but normal consciousness (p<0.001). Elevated tau was also found to be associated with impaired delivery of oxygen (severe anaemia), severe metabolic acidosis manifesting as respiratory distress (increased respiratory rate and deep acidotic breathing) and at higher parasite densities. Elevated S-100B in children was associated with an increased risk of repeated seizures. This study provides evidence that axonal injury is associated with malaria coma and identifies the potential role of severe anaemia, acidosis and hyperparasitaemia to causing brain parenchymal damage in children with malaria.
Medana
Isabelle M
IM
Nuffield Department of Clinical Laboratory Sciences, Academic block, level 4, The John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom. isabelle.medana@ndcls.ox.ac.uk
Idro
Richard
R
Newton
Charles R J C
CR
D000138:Acidosis / Q000150:complications; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000150:complications; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D008288:Malaria / Q000134:cerebrospinal fluid* / Q000145:classification / Q000453:epidemiology*; D008297:Male; D009414:Nerve Growth Factors / Q000134:cerebrospinal fluid*; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000134:cerebrospinal fluid*; D012720:Severity of Illness Index; D016875:tau Proteins / Q000134:cerebrospinal fluid*
D006454:Hemoglobins; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D016875:tau Proteins