title: Lipid peroxidation and antioxidant enzymes activity in Plasmodium vivax malaria patients evolving with cholestatic jaundice.
abstract: BACKGROUND
  Plasmodium vivax infection has been considered a benign and self-limiting disease, however, recent studies highlight the association between vivax malaria and life-threatening manifestations. Increase in reactive oxygen species has already been described in vivax malaria, as a result of the increased metabolic rate triggered by the multiplying parasite, and large quantities of toxic redox-active byproducts generated. The present study aimed to study the oxidative stress responses in patients infected with P. vivax, who developed jaundice (hyperbilirubinaemia) in the course of the disease, a common clinical complication related to this species.
  
  
  METHODS
  An evaluation of the lipid peroxidation and antioxidant enzymes profile was performed in 28 healthy individuals and compared with P. vivax infected patients with jaundice, i.e., bilirubin < 51.3 μmol/L (8 patients) or without jaundice (34 patients), on day 1 (D1) and day 14 (D14) after anti-malarial therapy.
  
  
  RESULTS
  Hyperbilirubinaemia was more frequent among women and patients experiencing their first malarial infection, and lower haemoglobin and higher lactate dehydrogenase levels were observed in this group. Malondialdehyde levels and activity of celuroplasmin and glutathione reductase were increased in the plasma from patients with P. vivax with jaundice compared to the control group on D1. However, the activity of thioredoxin reductase was decreased. The enzymes glutathione reductase, thioredoxin reductase, thiols and malondialdehyde also differed between jaundiced versus non-jaundiced patients. On D14 jaundice and parasitaemia had resolved and oxidative stress biomarkers were very similar to the control group.
  
  
  CONCLUSIONS
  Cholestatic hyperbilirubinaemia in vivax malaria cannot be totally disassociated from malaria-related haemolysis. However, significant increase of lipid peroxidation markers and changes in antioxidant enzymes in patients with P. vivax-related jaundice was observed. These results suggest oxidative processes contributing to malaria pathogenesis, what may be useful information for future anti-oxidant therapeutical interventions in these patients.
authors.affiliation: Fundação de Medicina Tropical Dr, Heitor Vieira Dourado, Manaus, AM 69040-000, Brazil. marcuslacerda.br@gmail.com.
authors.forename: Camila
authors.initials: C
authors.lastname: Fabbri
authors.forename: Rita
authors.initials: R
authors.lastname: de Cássia Mascarenhas-Netto
authors.forename: Pritesh
authors.initials: P
authors.lastname: Lalwani
authors.forename: Gisely C
authors.initials: GC
authors.lastname: Melo
authors.forename: Belisa M L
authors.initials: BM
authors.lastname: Magalhães
authors.forename: Márcia A A
authors.initials: MA
authors.lastname: Alexandre
authors.forename: Marcus V G
authors.initials: MV
authors.lastname: Lacerda
authors.forename: Emerson S
authors.initials: ES
authors.lastname: Lima
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000378:metabolism*; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000473:pathology*; D015227:Lipid Peroxidation; D016780:Malaria, Vivax / Q000150:complications* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000975:Antioxidants
references.citation: PLoS Med. 2008 Jun 17;5(6):e128
references.pmid: 18563962
references.citation: Arch Biochem Biophys. 1959 May;82(1):70-7
references.pmid: 13650640
references.citation: PLoS One. 2012;7(4):e35406
references.pmid: 22523591
references.citation: Emerg Infect Dis. 2007 Oct;13(10):1597-600
references.pmid: 18258018
references.citation: Methods Enzymol. 1995;252:199-208
references.pmid: 7476354
references.citation: Parasitol Int. 2008 Mar;57(1):1-7
references.pmid: 17890140
references.citation: Free Radic Biol Med. 2001 Dec 1;31(11):1287-312
references.pmid: 11728801
references.citation: Clin Chem. 1974 Dec;20(12):1556-63
references.pmid: 4214636
references.citation: Malar J. 2010 Apr 30;9:115
references.pmid: 20433744
references.citation: Bull World Health Organ. 1960;22:633-40
references.pmid: 13804322
references.citation: Clin Biochem. 1997 Dec;30(8):631-9
references.pmid: 9455617
references.citation: Rev Esp Enferm Dig. 2010 Jun;102(6):352-6
references.pmid: 20575594
references.citation: Free Radic Biol Med. 2008 Feb 15;44(4):602-13
references.pmid: 18070610
references.citation: Anal Biochem. 2009 Nov 15;394(2):147-58
references.pmid: 19664585
references.citation: Braz J Infect Dis. 2010 Jul-Aug;14(4):410-2
references.pmid: 20963329
references.citation: Am J Trop Med Hyg. 2009 Feb;80(2):194-8
references.pmid: 19190212
references.citation: Biochimie. 2010 Aug;92(8):927-32
references.pmid: 20302905
references.citation: J Gastroenterol Hepatol. 2005 Sep;20(9):1322-32
references.pmid: 16105116
references.citation: Int J Parasitol. 2004 Feb;34(2):163-89
references.pmid: 15037104
references.citation: Clin Biochem. 2007 Mar;40(5-6):377-82
references.pmid: 17307156
references.citation: FASEB J. 2006 Jun;20(8):1224-6
references.pmid: 16603602
references.citation: Am J Trop Med Hyg. 1993 Dec;49(6):720-5
references.pmid: 8279640
references.citation: Clin Infect Dis. 2004 Nov 1;39(9):1336-45
references.pmid: 15494911
references.citation: Trans R Soc Trop Med Hyg. 2000 Apr;94 Suppl 1:S1-90
references.pmid: 11103309
references.citation: Free Radic Biol Med. 2010 Dec 1;49(11):1746-54
references.pmid: 20840864
references.citation: Emerg Infect Dis. 2010 Oct;16(10):1611-4
references.pmid: 20875292
references.citation: J Pharmacol Exp Ther. 2002 Oct;303(1):141-8
references.pmid: 12235244
references.citation: J Clin Invest. 1994 Apr;93(4):1493-501
references.pmid: 8163654
references.citation: Brain Res. 2004 Nov 5;1026(1):33-43
references.pmid: 15476695
references.citation: Emerg Infect Dis. 2005 Jan;11(1):132-4
references.pmid: 15705338
references.citation: Klin Med (Mosk). 2011;89(3):57-63
references.pmid: 21861407
references.citation: PLoS Negl Trop Dis. 2012;6(9):e1814
references.pmid: 22970336
references.citation: Free Radic Biol Med. 2009 Jan 15;46(2):271-81
references.pmid: 19015023
references.citation: Trop Parasitol. 2013 Jan;3(1):53-7
references.pmid: 23961442
references.citation: Mem Inst Oswaldo Cruz. 2008 Sep;103(6):517-21
references.pmid: 18949318
references.citation: Clin Biochem. 2003 Feb;36(1):71-8
references.pmid: 12554064
references.citation: Mol Biochem Parasitol. 1993 Oct;61(2):315-20
references.pmid: 8264734
references.citation: Methods Enzymol. 1990;186:407-21
references.pmid: 2233308
references.citation: Clin Infect Dis. 2012 Oct;55(8):e67-74
references.pmid: 22772803
references.citation: Methods Enzymol. 1994;233:380-5
references.pmid: 8015473
references.citation: Braz J Infect Dis. 2005 Oct;9(5):425-30
references.pmid: 16410895
references.citation: Korean J Parasitol. 2009 Dec;47(4):421-4
references.pmid: 19967095
references.citation: Biochim Biophys Acta. 2009 Nov;1790(11):1478-85
references.pmid: 19268692
references.citation: J Trop Pediatr. 2012 Apr;58(2):147-50
references.pmid: 21602230