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Title: Complement activation in severe Plasmodium falciparum malaria
Authors: Christoph Wenisch
Susanne Spitzauer
Ken Florris-Linau
Helmut Rumpold
Suparp Vannaphan
Bernhard Parschalk
Wolfgang Graninger
Sornchai Looareesuwan
Internal Medicine I
Medizinische Universitat Wien
Mahidol University
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Jan-1997
Citation: Clinical Immunology and Immunopathology. Vol.85, No.2 (1997), 166-171
Abstract: We determined indices of plasma complement activation (C3, C4, Bb, C4d, iC3b, and SC5b-9), levels of tumor necrosis factor (TNF) and interleukin-6, and the APACHE H score in 23 patients with complicated Plasmodium falciparum malaria. On admission, plasma concentrations of Bb, SC5b-9, and C4d were markedly increased compared to healthy control subjects (n = 24) (4.5 ± 1.9 vs 1.5 ± 0.6 mg/L; 1125.7 ± 496.9 vs 183.2 ± 76.5 μg/L; and 15.7 ± 5.7 vs 7.2 ± 1.4 mg/L, P < 0.01 for all). In contrast C3 and iC3b concentrations were decreased (631.4 ± 247 vs 947.3 ± 243.2 and 105 ± 17.9 vs 151.3 ± 14.5 mg/L; P < 0.01 for both). Plasma C4 concentrations in malaria were not different from normal controls. Plasma Bb, C3, and iC3b levels normalized on day 7 of treatment, whereas SC5b-9 and C4d levels remained elevated. A significant correlation between elevated TNF levels and Bb (r = 0.507) and SC5b-9 (r = 0.448, P < 0.01 for both) and a negative correlation between iC3b and SC5b-9 and TNF levels existed (r = -0.537 and r = -0.466, P < 0.01 for both). In addition, a significant correlation between C3 and iC3b (r = 0.689) and C4 and C4d (r = 0.737) existed. However, no relation between clinical disease severity and complement fragments existed. The results demonstrate that both the classical and the alternative pathways of the complement system are profoundly activated in complicated malaria.
ISSN: 00901229
Appears in Collections:Scopus 1991-2000

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