Amino acid derangements in adults with severe falciparum malaria

Amino acid derangements are common in severe falciparum malaria and have been associated with endothelial dysfunction (L-arginine), metabolic acidosis (alanine and lactate), and disease severity (phenylalanine and tryptophan metabolites). Whether these amino acid perturbations reflect isolated patho...

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Main Authors: Leopold, S, Apinan, S, Ghose, A, Kingston, H, Plewes, K, Hossain, A, Dutta, A, Paul, S, Barua, A, Sattar, A, Day, N, Tarning, J, Winterberg, M, White, N, Dondorp, A
Format: Journal article
Language:English
Published: Nature Research 2019
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author Leopold, S
Apinan, S
Ghose, A
Kingston, H
Plewes, K
Hossain, A
Dutta, A
Paul, S
Barua, A
Sattar, A
Day, N
Tarning, J
Winterberg, M
White, N
Dondorp, A
author_facet Leopold, S
Apinan, S
Ghose, A
Kingston, H
Plewes, K
Hossain, A
Dutta, A
Paul, S
Barua, A
Sattar, A
Day, N
Tarning, J
Winterberg, M
White, N
Dondorp, A
author_sort Leopold, S
collection OXFORD
description Amino acid derangements are common in severe falciparum malaria and have been associated with endothelial dysfunction (L-arginine), metabolic acidosis (alanine and lactate), and disease severity (phenylalanine and tryptophan metabolites). Whether these amino acid perturbations reflect isolated pathogenic mechanisms or if they are part of overall changes in amino acid metabolism is unclear. To investigate this, we prospectively simultaneously quantified a broad range of plasma free amino acids (PFAA) using HPLC-MRM-Mass spectrometry in relation to presenting symptoms in adults with severe malaria (n = 88), septicaemia (n = 88), uncomplicated malaria (n = 71), and healthy controls (n = 48) from Bangladesh. The total plasma concentration of measured amino acids was significantly reduced in each of the patient groups when compared to normal levels observed in healthy local controls: uncomplicated malaria -54%, severe malaria -23%, and sepsis -32%, (p = <0.001). Inspection of amino acid profiles revealed that in each group the majority of amino acids were below normal levels, except for phenylalanine. Among patients with severe malaria, L-lactate was strongly associated with an increase of the total amino acid concentration, likely because this reflects tissue hypoxia. Our data confirm previously described amino acid abnormalities, likely resulting from overall changes in the concentration of PFAA.
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spelling oxford-uuid:0e3517dd-5d6c-46af-8968-1cef86026eac2022-03-26T09:44:50ZAmino acid derangements in adults with severe falciparum malariaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0e3517dd-5d6c-46af-8968-1cef86026eacEnglishSymplectic Elements at OxfordNature Research2019Leopold, SApinan, SGhose, AKingston, HPlewes, KHossain, ADutta, APaul, SBarua, ASattar, ADay, NTarning, JWinterberg, MWhite, NDondorp, AAmino acid derangements are common in severe falciparum malaria and have been associated with endothelial dysfunction (L-arginine), metabolic acidosis (alanine and lactate), and disease severity (phenylalanine and tryptophan metabolites). Whether these amino acid perturbations reflect isolated pathogenic mechanisms or if they are part of overall changes in amino acid metabolism is unclear. To investigate this, we prospectively simultaneously quantified a broad range of plasma free amino acids (PFAA) using HPLC-MRM-Mass spectrometry in relation to presenting symptoms in adults with severe malaria (n = 88), septicaemia (n = 88), uncomplicated malaria (n = 71), and healthy controls (n = 48) from Bangladesh. The total plasma concentration of measured amino acids was significantly reduced in each of the patient groups when compared to normal levels observed in healthy local controls: uncomplicated malaria -54%, severe malaria -23%, and sepsis -32%, (p = <0.001). Inspection of amino acid profiles revealed that in each group the majority of amino acids were below normal levels, except for phenylalanine. Among patients with severe malaria, L-lactate was strongly associated with an increase of the total amino acid concentration, likely because this reflects tissue hypoxia. Our data confirm previously described amino acid abnormalities, likely resulting from overall changes in the concentration of PFAA.
spellingShingle Leopold, S
Apinan, S
Ghose, A
Kingston, H
Plewes, K
Hossain, A
Dutta, A
Paul, S
Barua, A
Sattar, A
Day, N
Tarning, J
Winterberg, M
White, N
Dondorp, A
Amino acid derangements in adults with severe falciparum malaria
title Amino acid derangements in adults with severe falciparum malaria
title_full Amino acid derangements in adults with severe falciparum malaria
title_fullStr Amino acid derangements in adults with severe falciparum malaria
title_full_unstemmed Amino acid derangements in adults with severe falciparum malaria
title_short Amino acid derangements in adults with severe falciparum malaria
title_sort amino acid derangements in adults with severe falciparum malaria
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