Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10556
Title: Nitric Oxide-Dependent Endothelial Dysfunction and Reduced Arginine Bioavailability in Plasmodium vivax Malaria but No Greater Increase in Intravascular Hemolysis in Severe Disease.
Authors: Barber, Bridget E
William, Timothy
Grigg, Matthew J
Piera, Kim A
Chen, Youwei
Wang, Hao
Weinberg, J Brice
Yeo, Tsin W
Anstey, Nicholas M
Affiliation: Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University.. Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit..
Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit.. Jesselton Medical Center, Kota Kinabalu, Malaysia..
Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University.. Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit..
Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University..
Duke University Medical Center.. VA Medical Center, Durham, North Carolina..
Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University..
Duke University Medical Center.. VA Medical Center, Durham, North Carolina..
Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University.. Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit.. Lee Kong Chian School of Medicine, Nanyang Technological University.. Institute of Infectious Disease and Epidemiology, Tan Tock Seng Hospital, Singapore..
Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University.. Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Australia.. Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit..
Issue Date: 15-Nov-2016
Citation: The Journal of infectious diseases 2016-11-15; 214(10): 1557-1564
Abstract:  Pathogenesis of severe Plasmodium vivax malaria is poorly understood. Endothelial dysfunction and reduced nitric oxide (NO) bioavailability characterize severe falciparum malaria, but have not been assessed in severe vivax malaria.  In patients with severe vivax malaria (n = 9), patients with nonsevere vivax malaria (n = 58), and healthy controls (n = 79), we measured NO-dependent endothelial function by using reactive hyperemia-peripheral arterial tonometry (RH-PAT) and assessed associations with arginine, asymmetric dimethylarginine (ADMA), and hemolysis.  The L-arginine level and the L-arginine to ADMA ratio (a measure of L-arginine bioavailability) were reduced in patients with severe vivax malaria and those with nonsevere vivax malaria, compared with healthy controls (median L-arginine level, 65, 66, and 98 µmol/mL, respectively [P = .0001]; median L-arginine to ADMA ratio, 115, 125, and 187, respectively [P = .0001]). Endothelial function was impaired in proportion to disease severity (median RH-PAT index, 1.49, 1.73, and 1.97 in patients with severe vivax malaria, those with nonsevere vivax malaria, and healthy controls, respectively; P = .018) and was associated with the L-arginine to ADMA ratio. While the posttreatment fall in hemoglobin level was greater in severe vivax malaria as compared to nonsevere vivax malaria (2.5 vs 1 g/dL; P = .0001), markers of intravascular hemolysis were not higher in severe disease.  Endothelial function is impaired in nonsevere and severe vivax malaria, is associated with reduced L-arginine bioavailability, and may contribute to microvascular pathogenesis. Severe disease appears to be more associated with extravascular hemolysis than with intravascular hemolysis.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10556
DOI: 10.1093/infdis/jiw427
Type: Journal Article
Subjects: Plasmodium vivax
arginine
asymmetric dimethylarginine
endothelial function
hemolysis
malaria
nitric oxide
Adolescent
Adult
Aged
Arginine
Biological Availability
Endothelial Cells
Epidemiologic Studies
Female
Humans
Malaria, Vivax
Male
Middle Aged
Nitric Oxide
Prospective Studies
Young Adult
Hemolysis
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