Identifying the components of acidosis in patients with severe plasmodium falciparum malaria Using metabolomics

<h4>Background</h4> <p>Acidosis in severe Plasmodium falciparum malaria is associated with high mortality yet the pathogenesis remains incompletely understood. The aim of this study was to determine the nature and source of metabolic acids contributing to acidosis in patients with...

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Main Authors: Leopold, S, Ghose, A, Allman, E, Kingston, H, Hossain, A, Dutta, A, Plewes, K, Chotivanich, K, Day, N, Tarning, J, Winterberg, M, White, N, Llinás, M, Dondorp, A
Format: Journal article
Language:English
Published: Oxford University Press 2018
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author Leopold, S
Ghose, A
Allman, E
Kingston, H
Hossain, A
Dutta, A
Plewes, K
Chotivanich, K
Day, N
Tarning, J
Winterberg, M
White, N
Llinás, M
Dondorp, A
author_facet Leopold, S
Ghose, A
Allman, E
Kingston, H
Hossain, A
Dutta, A
Plewes, K
Chotivanich, K
Day, N
Tarning, J
Winterberg, M
White, N
Llinás, M
Dondorp, A
author_sort Leopold, S
collection OXFORD
description <h4>Background</h4> <p>Acidosis in severe Plasmodium falciparum malaria is associated with high mortality yet the pathogenesis remains incompletely understood. The aim of this study was to determine the nature and source of metabolic acids contributing to acidosis in patients with severe falciparum malaria.</p> <h4>Methods</h4> <p>A prospective observational study was conducted to characterise circulating acids in adults with P. falciparum malaria (n=107) and healthy controls (n=45) from Bangladesh using high-resolution LC-MS metabolomics. Additional in vitro P. falciparum culture studies were performed to determine if parasites release the acids detected in plasma from patients with severe malaria acidosis.</p> <h4>Results</h4> <p>We identified previously unmeasured plasma acids strongly associated with acidosis in severe malaria. Metabolomic analysis of P. falciparum parasites in vitro showed no evidence that these acids are released by the parasite during its life-cycle. Instead ten of the plasma acids could be mapped to a gut microbial origin. Patients with malaria had low L-citrulline levels, a plasma marker indicating reduced gut barrier integrity. Longitudinal data showed the clearance of these newly identified acids was delayed in fatal cases.</p> <h4>Discussion</h4> <p>These data suggest that a compromise in intestinal barrier function may contribute significantly to the pathogenesis of life-threatening acidosis in severe falciparum malaria.</p>
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spelling oxford-uuid:d695b5f6-50f4-40fc-8e83-29e86dbf2be62022-03-27T08:34:35ZIdentifying the components of acidosis in patients with severe plasmodium falciparum malaria Using metabolomicsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:d695b5f6-50f4-40fc-8e83-29e86dbf2be6EnglishSymplectic Elements at OxfordOxford University Press2018Leopold, SGhose, AAllman, EKingston, HHossain, ADutta, APlewes, KChotivanich, KDay, NTarning, JWinterberg, MWhite, NLlinás, MDondorp, A <h4>Background</h4> <p>Acidosis in severe Plasmodium falciparum malaria is associated with high mortality yet the pathogenesis remains incompletely understood. The aim of this study was to determine the nature and source of metabolic acids contributing to acidosis in patients with severe falciparum malaria.</p> <h4>Methods</h4> <p>A prospective observational study was conducted to characterise circulating acids in adults with P. falciparum malaria (n=107) and healthy controls (n=45) from Bangladesh using high-resolution LC-MS metabolomics. Additional in vitro P. falciparum culture studies were performed to determine if parasites release the acids detected in plasma from patients with severe malaria acidosis.</p> <h4>Results</h4> <p>We identified previously unmeasured plasma acids strongly associated with acidosis in severe malaria. Metabolomic analysis of P. falciparum parasites in vitro showed no evidence that these acids are released by the parasite during its life-cycle. Instead ten of the plasma acids could be mapped to a gut microbial origin. Patients with malaria had low L-citrulline levels, a plasma marker indicating reduced gut barrier integrity. Longitudinal data showed the clearance of these newly identified acids was delayed in fatal cases.</p> <h4>Discussion</h4> <p>These data suggest that a compromise in intestinal barrier function may contribute significantly to the pathogenesis of life-threatening acidosis in severe falciparum malaria.</p>
spellingShingle Leopold, S
Ghose, A
Allman, E
Kingston, H
Hossain, A
Dutta, A
Plewes, K
Chotivanich, K
Day, N
Tarning, J
Winterberg, M
White, N
Llinás, M
Dondorp, A
Identifying the components of acidosis in patients with severe plasmodium falciparum malaria Using metabolomics
title Identifying the components of acidosis in patients with severe plasmodium falciparum malaria Using metabolomics
title_full Identifying the components of acidosis in patients with severe plasmodium falciparum malaria Using metabolomics
title_fullStr Identifying the components of acidosis in patients with severe plasmodium falciparum malaria Using metabolomics
title_full_unstemmed Identifying the components of acidosis in patients with severe plasmodium falciparum malaria Using metabolomics
title_short Identifying the components of acidosis in patients with severe plasmodium falciparum malaria Using metabolomics
title_sort identifying the components of acidosis in patients with severe plasmodium falciparum malaria using metabolomics
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