Preliminary assessment of serum endocan as a biomarker of disease severity in Plasmodium falciparum and Plasmodium vivax malaria
Issued Date
2025-12-01
Resource Type
eISSN
14752875
Scopus ID
2-s2.0-105011048139
Journal Title
Malaria Journal
Volume
24
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Malaria Journal Vol.24 No.1 (2025)
Suggested Citation
Nantavisai K., Puttikamonkul S., Viriyavejakul P. Preliminary assessment of serum endocan as a biomarker of disease severity in Plasmodium falciparum and Plasmodium vivax malaria. Malaria Journal Vol.24 No.1 (2025). doi:10.1186/s12936-025-05483-7 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/111432
Title
Preliminary assessment of serum endocan as a biomarker of disease severity in Plasmodium falciparum and Plasmodium vivax malaria
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Corresponding Author(s)
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Abstract
Background: Endocan, a component of endothelial glycocalyx, is a recognized biomarker of endothelial dysfunction in various inflammatory and infectious diseases. Malaria, characterized by marked endothelial activation and microvascular pathology, may involve endocan, but its role remains unclear. This study aimed to assess serum endocan levels in various clinical presentations of malaria and evaluate its correlation with laboratory parameters of disease severity. Methods: Leftover serum samples from 99 participants were categorized into four groups: healthy controls (n = 20), Plasmodium vivax malaria (n = 36), uncomplicated Plasmodium falciparum malaria (n = 30), and severe P. falciparum malaria (n = 13). Serum endocan concentrations were measured via enzyme-linked immunosorbent assay on day 0 (pre-treatment) and day 7 (post-treatment). Correlation analyses examined associations between endocan levels and laboratory parameters, including parasite density, white blood cell count, haemoglobin, and platelet count. Results: All malaria groups showed significantly higher serum endocan levels compared to healthy controls (p < 0.0001). Levels were highest in severe P. falciparum (median 4.67 [IQR 2.85–7.93] ng/ml), followed by uncomplicated P. falciparum (median 3.27 [IQR 2.24–4.33] ng/ml), and P. vivax malaria (median 1.85 [IQR 1.44–3.23] ng/ml). Endocan correlated positively with parasite density in P. vivax (r<inf>s</inf> = 0.4632, p = 0.0066) and severe P. falciparum malaria (r<inf>s</inf> = 0.6264, p = 0.0251) and negatively with platelet count in P. vivax infections (r<inf>s</inf> = − 0.5523, p = 0.001). Conclusion: Serum endocan is elevated in malaria in a severity-dependent manner—highest in severe P. falciparum malaria—and correlates with circulating parasite density and thrombocytopenia, highlighting its potential as a biomarker of endothelial injury in malaria.