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Cerebral malaria: Approaching a diagnostic test
May 04, 2007Scientists at CNRS and the Pasteur Institute, collaborating with physicians in Gabon, have just undertaken a study on cerebral malaria in children living in an endemic region. This study, which was published in PLoS ONE, should allow us to better understand this severe form of malaria which affects 20 to 40 percent of people infected by the Plasmodium falciparum parasite, and is fatal in 30 to 50 percent of cases. The study also provides a lead on how to perfect a diagnostic test, which should allow for better patient care.
Cerebral malaria presents with a high fever and convulsions followed by coma. The high mortality rate from this form of malaria is also linked to a problem of patient care because, despite the availability of effective treatment, patients often arrive at hospital too late. The availability of predictive tests would therefore be useful in improving patient care. It is this hope that has been raised by the study undertaken by Sylviane Pied and her team. Pied, a scientist at CNRS, leads the malaria immunophysiology group* at the Pasteur Institute, which collaborated on the study with Maryvonne Kombila of the Science and Health University of Libreville, the Libreville Hospital Center, and with the Owendo Pediatric Hospital (Gabon).
The study concentrated on the particular immunological phenomenon observed in people infected by Plasmodium falciparum. The B-lymphocytes, the main antibody - producing cells, increase their secretion of a range of antibodies, notably those directed against various components of the organism (DNA, red blood cells, etc.). Today we still don't know if these "auto-antibodies" are the result of pathological mechanisms associated with the infection or if they contribute to the events leading to the severe forms of the illness.
The French and Gabonese teams sought to understand if some of these auto-antibodies were directed against the molecules in the brain. In order to do this, they worked on the blood samples of some 350 children aged between 6 months and 5 years who had been treated in Gabonese hospitals. The cohort was divided into 5 groups: control patients (without parasites in the blood), asymptomatic patients, patients developing simple malaria, patients suffering from serious, non-cerebral malaria (notably severe anaemia), and finally patients suffering from neurological infection. The results of the study show that, in 90% of children suffering from cerebral malaria, the antibodies specifically recognize a protein in the brain, cerebral alpha-spectrin.
"Our hope today is that this discovery will allow for the development of a diagnostic test for cerebral malaria," explains Pied. "Our hypothesis is that the production of auto-antibodies against alpha-spectrin is a predisposition to the development of cerebral malaria, and our current research aims to verify this. If, in the field, we had a test which allowed us to tell whether or not a person is susceptible to developing cerebral malaria it would enable us to considerably improve their treatment".
This study also opens a new sector of malaria research; understanding the role of auto-antibodies directed against cerebral antigens in the development of the illness.
CNRS
The French and Gabonese teams sought to understand if some of these auto-antibodies were directed against the molecules in the brain. In order to do this, they worked on the blood samples of some 350 children aged between 6 months and 5 years who had been treated in Gabonese hospitals. The cohort was divided into 5 groups: control patients (without parasites in the blood), asymptomatic patients, patients developing simple malaria, patients suffering from serious, non-cerebral malaria (notably severe anaemia), and finally patients suffering from neurological infection. The results of the study show that, in 90% of children suffering from cerebral malaria, the antibodies specifically recognize a protein in the brain, cerebral alpha-spectrin.
"Our hope today is that this discovery will allow for the development of a diagnostic test for cerebral malaria," explains Pied. "Our hypothesis is that the production of auto-antibodies against alpha-spectrin is a predisposition to the development of cerebral malaria, and our current research aims to verify this. If, in the field, we had a test which allowed us to tell whether or not a person is susceptible to developing cerebral malaria it would enable us to considerably improve their treatment".
This study also opens a new sector of malaria research; understanding the role of auto-antibodies directed against cerebral antigens in the development of the illness.
CNRS
Cerebral Malaria Current Events and Cerebral Malaria News RSSBiomarkers in blood could aid diagnosis of crippling, often fatal forms of malaria
Canadian researchers have identified protein biomarkers that shed new light on the development of two severe and debilitating forms of malaria.
Johns Hopkins scientists discover what drives the development of a fatal form of malaria
Platelets - those tiny, unassuming cells that cause blood to clot and scabs to form when you cut yourself - play an important early role in promoting cerebral malaria, an often lethal complication that occurs mostly in children.
U of M researchers find cerebral malaria may be a major cause of brain injury in African children
Researchers at the University of Minnesota have found that cerebral malaria is related to long-term cognitive impairment in one of four child survivors. The research is published in the current issue of the journal Pediatrics.
MSU researcher helps develop computer game for Ugandan children recovering from cerebral malaria
The computer program Captain's Log - originally used with individuals diagnosed with attention deficit hyperactivity disorder, brain injuries or learning disabilities - is being adapted to rehabilitate Ugandan children who are survivors of cerebral malaria.
Eye-opening research provides important diagnostic tool for major childhood killer
The eye can provide a very reliable way of diagnosing cerebral malaria, researchers in Malawi have shown.
Possible new compound for treatment of cerebral malaria
In a paper published online in PLoS Medicine researchers from Marseille describe the effects of a new compound that may be a future treatment for patients with cerebral malaria.
Brain Wave Monitor Could Replace Lumbar Puncture
Scientists in Southampton have developed non-invasive technology to measure the fluid pressure in the brain safely and painlessly which they hope will eventually reduce the need for a lumbar puncture. Collaborators in London now believe it could be a major advance in the diagnosis and treatment of conditions such as meningitis, head injury and sleeping disorders. It could even be used by astronauts in space.
Malaria : Plasmodium togetherness a strategy for breeding success
Malaria, which infects 600 million people in the world and leads annually to 2 million deaths, is the most widespread of infectious diseases. The pathological agent is a microscopic parasite of the Plasmodium genus which develops inside the host's erythrocytes. Plasmodia go through a series of asexual reproduction cycles before a transition takes place from asexual stages to production of sexual cells, the gametocytes or pre-gametes, in the host blood. The females of Anopheles, the mosquito vector, ingest blood and gametocytes during a nocturnal feed on human skin. The meal reaches the mosquito's stomach where Plasmodium sexual reproduction takes place. An encounter and subsequent binding be
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