Serum dehydroepiandrosterone sulfate profile, hemoglobin concentrations and parasite density in falciparum malaria patients

Abstract

It has been proposed that severe malarial anemia, a major cause of morbidity and mortality in endemic areas, is multifactor. Dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEAS), which are the most abundant hormones secreted by the adrenal cortex may be one of those factors. We examined the relationship between Plasmodium falciparum parasitemia, hemoglobin (Hb) concentrations and serum DHEAS in Thai patients living along the Thai-Myanmar border. During 28 days of treatment, serum DHEAS and Hb levels were analyzed on days 0, 7, 14, 21 and 28 for monitoring the association. We found that, DHEAS levels were not significantly associated with decreased parasite density, and also not significantly associated with hemoglobin levels through 4 week of follow up, even after adjustment for other determinants of hemoglobin level. These findings not support the hypothesis that DHEAS, an adrenal androgen which is low in childhood and rises with the development of secondary sexual characteristics, is necessary for resistance to malarial infection. Although the physiological hormone DHEAS is a potent inhibitor of G6PD activity, and G6PD deficiency is known to exert antimalarial protection via enhanced opsonization and phagocytosis of rings, the early forms of the parasite. This study suggests that DHEAS should not be used as adjuvant to stimulate red blood cell production in severe falciparum malaria patients.