| Summary: | <p>Abstract</p> <p>Background</p> <p>Molecular mechanisms involved in the pathogenesis of severe <it>Plasmodium falciparum </it>malaria (SM), are not yet fully understood. Both endothelin-1 (ET-1) and C-type natriuretic peptide (CNP) are produced by vascular endothelium and act locally as paracrine regulators of vascular tone, ET-1 being a potent vasoconstrictor and CNP having strong vasorelaxant properties.</p> <p>Methods</p> <p>Plasma levels of ET-1 and N-terminal fragments of CNP (NT-proCNP) were studied on admission and after 24 hours of treatment, using enzyme-linked-immunosorbent-assay (ELISA) technique, in Gabonese children with severe falciparum malaria (SM, <it>n </it>= 50), with uncomplicated malaria (UM, <it>n </it>= 39) and healthy controls (HC, <it>n </it>= 25).</p> <p>Results</p> <p>Compared to HC, malaria patients had significantly higher plasma levels of ET-1 and significantly lower levels of NT-proCNP (<it>p </it>< 0.001 and <it>p </it>< 0.024 respectively). Plasma levels of NT-proCNP were additionally decreased in SM patients compared to HC (<it>p </it>= 0.034), whereas UM was not significantly different to HC. In the SM group we found a trend towards lower ET-1 levels compared to UM (<it>p </it>= 0.085).</p> <p>Conclusion</p> <p>In the present study, an imbalance between the vasoconstricitve and vasorelaxant endothelium-derived substances ET-1 and CNP in the plasma of children with falciparum malaria is demonstrated, presumably in favor of vasoconstrictive and pro-inflammatory effects. These results may indicate involvement of ET-1 and CNP in malaria pathogenesis. Furthermore, results of lower ET-1 and CNP levels in SM may reflect endothelial cell damage.</p>
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