Hyperhomocysteinemia in acute Plasmodium falciparum malaria: an effect of host–parasite interaction

Background: Plasmodium falciparum utilises the polyamine pathway, essential in proliferation and differentiation, and imposes an oxidative stress on host cell, enhancing the loss of glutathione. Methods: Standard hematological parameters were determined in 40 black African subjects with acute P. fal...

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Bibliographic Details
Published in:Clinica chimica acta 2004-10, Vol.348 (1), p.113-120
Main Authors: Chillemi, R., Zappacosta, B., Simporè, J., Persichilli, S., Musumeci, M., Musumeci, S.
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Age Factors
Animals
Child
Child, Preschool
Chromatography, High Pressure Liquid
Cysteine - blood
Dipeptides - blood
Female
Glutathione - blood
Homocysteine - blood
Host-Parasite Interactions
Humans
Hyperhomocysteinemia
Hyperhomocysteinemia - blood
Hyperhomocysteinemia - complications
Infant
Malaria, Falciparum - complications
Malaria, Falciparum - parasitology
Male
Plasmodium falciparum - physiology
Plasmodium falciparum malaria
Severity of Illness Index
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Summary:Background: Plasmodium falciparum utilises the polyamine pathway, essential in proliferation and differentiation, and imposes an oxidative stress on host cell, enhancing the loss of glutathione. Methods: Standard hematological parameters were determined in 40 black African subjects with acute P. falciparum malaria, 30 aged 5–24 months, 5 aged 4–10 years and 5 aged 19–35 years. Plasma homocysteine, cysteine, glutathione and cysteinylglycine levels were measured by HPLC method. Twenty-eight healthy black children (15 aged 6–24 months and 13 aged 3–10 years) and 20 healthy black adults (aged 20–40 years) were also included as controls. Results: Plasma homocysteine levels were higher in all subjects with P. falciparum malaria and correlated positively with the disease severity and number of parasites, but negatively with Hb levels and patient ages. Cysteine level was found higher in all patients and markedly higher in 4–10 year old patients. Cysteinylglycine level was found lower particularly in 19–35 year old patients. Glutathione level was significantly lower in all patients. Conclusions: The elevated level of homocysteine during acute P. falciparum infection suggests an imbalance in the folate cycle, which could be a consequence of the reduced availability of NADPH and Vit B 12, caused by increased oxidative stress. This may suggest a selection for the C677T MTHFR allele, driven by P. falciparum in sub-Saharan regions. Hence Hcy level could be useful as a predictive parameter of severity, as well as of treatment efficacy.
ISSN:0009-8981
1873-3492
DOI:10.1016/j.cccn.2004.05.007