title: Is human malarial coma caused, or merely deepened, by sequestration?
abstract: Much research into falciparum malaria coma assumes the primary event to be vascular obstruction by parasitized red blood cells. Recent evidence that vivax malaria, caused by a parasite traditionally thought not to block blood flow, seems to alter brain function to the same degree as falciparum malaria has seriously questioned this. These data are a timely call to reassess whether vascular obstruction should still be considered the primary cause of the coma of falciparum disease. They add to a growing literature that suggests that enhancement of brain-origin cytokines, such as tumour necrosis factor, by non-brain systemic inflammation and an appreciation of the degree to which neuronal homeostasis depends on them provide a more fruitful research direction.
authors.affiliation: School of Biochemistry and Molecular Biology, Australian National University, Canberra, ACT 0200, Australia. ian.clark@anu.edu.au
authors.forename: Ian A
authors.initials: IA
authors.lastname: Clark
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Alleva
mesh_terms: D001921:Brain / Q000098:blood supply; D002448:Cell Adhesion; D003128:Coma / Q000150:complications / Q000453:epidemiology / Q000469:parasitology*; D016207:Cytokines / Q000378:metabolism; D006801:Humans; D007194:India / Q000453:epidemiology; D016779:Malaria, Cerebral / Q000150:complications*; D016780:Malaria, Vivax / Q000150:complications* / Q000453:epidemiology; D008295:Malawi / Q000453:epidemiology; D009512:New Guinea / Q000453:epidemiology
chemical_list: D016207:Cytokines