Relationships between Inflammation and Immunopathology of Malaria
Mary M. Stevenson in Malaria: Host Responses to Infection, 2017
The most striking contrast in monkeys and human beings experiencing malaria for the first time is that monkeys remain alert, and eat and drink, until relatively large numbers of erythrocytes are parasitized. As noted earlier, people are very different since they can become quite ill when parasites are rare enough to be difficult to find even on thick smears. This contrast is not because monkey parasites are innocuous — it also occurs when Aotus sp. are infected with Plasmodium falciparum of human origin.13,15 Once these monkeys do become ill, however, they can suffer the same erythrophagocytosis of unparasitized red cells,13 thrombocytopenia,14 hypoglycemia,14 and pulmonary edema15 as their human counterparts. Furthermore, knob-bearing red cells adhere to vessel walls as effectively in Aotus sp. as they do in human patients, but in monkeys this adherence is not associated with any particular pathology.13,16 In particular, there is no predilection for the cerebral vasculature,17,13 which presumably accounts for the absence of cerebral malaria in these animals.
Vegetables
Christopher Cumo in Ancestral Diets and Nutrition, 2020
A previous paragraph introduced anemia in the form of thalassemia as defense against malaria. About forty species of Anopheles mosquitoes transmit Plasmodium parasites, with Plasmodium falciparum afflicting southern Italy.128 Warm temperatures aid mosquitoes’ development. Females lay eggs in water, preferring clean, still, small pools. Temporary bodies of water are best because they do not accumulate fish that eat eggs and larvae. These requirements favored mosquitoes and malaria from Rome south through the peninsula, especially as the region became marshier over time. Mosquitoes’ proliferation during summers and autumns weakened laborers for the harvest, retarding southern Italy’s economy and worsening food scarcity.129 The resulting undernutrition diminished vitality.
Causality and induction
R. Paul Thompson, Ross E.G. Upshur in Philosophy of Medicine, 2017
In medicine, we are occasionally fortunate enough to find a single relevant cause (the presence of pneumococcal bacterium, Plasmodium falciparum (malaria parasite) or arsenic, for example). Identifying these causes allows an uncluttered explanation of the symptoms of the disease. In the case of pneumococcal bacterium, the symptoms include fever, fluid in the lungs, painful breathing and coughing. In the case of Plasmodium falciparum, the symptoms include anaemia (low blood oxygen resulting in weakness, dizziness, headaches and spots before the eyes), jaundice (yellowing of the skin) and fever. In the case of arsenic poisoning, symptoms include constriction of the throat, burning gastro-intestinal pain, vomiting, diarrhoea and dysphagia. The cause explains these symptoms in relevant cases. Since many of these collections of symptoms are also found in other diseases, differential diagnosis is still required. Once, however, a diagnosis is made (today often with the aid of blood tests, x-rays and so on), the cause of the symptoms, or test results, is claimed to be known. If available, an intervention can be employed. In each of these three examples, successful interventions are available. “Successful” requires qualification because not all those with a disease respond well to the standard intervention and for a few the intervention has unwanted side-effects that undermine further the health of the patient.
Plasma mEV levels in Ghanain malaria patients with low parasitaemia are higher than those of healthy controls, raising the potential for parasite markers in mEVs as diagnostic targets
Published in Journal of Extracellular Vesicles, 2020
Samuel Antwi-Baffour, Memory Malibha-Pinchbeck, Dan Stratton, Samireh Jorfi, Sigrun Lange, Jameel Inal
The clinical data and a summary of the main haematological profile of the patients with falciparum malaria (median age 27.3 years), in this study that met all the inclusion criteria as well as that for the uninfected controls, are presented in Table 1. Over the course of the study, samples that fell within the exclusion criteria were not included. Data collected over 1 year, of patients infected with Plasmodium falciparum was grouped into those of low parasitaemia (20–50 and 51–500 parasites µL−1), intermediate parasitaemia (501–8,000 parasites µL−1) and high parasitaemia (8,001–40,000 parasites µL−1). Analysis revealed that 62% of the 434 patients who suffered a ≥ 4d “patient delay” (PD) (period from the onset of symptoms to seeking medical care, also known as period of acute illness [50–52]) had increased levels of parasitaemia (501–40,000) (Table 2 and supplementary Figure S1).
Delayed diagnosis of severe falciparum malaria in a patient presenting with acute gastroenteritis in West Texas
Published in Baylor University Medical Center Proceedings, 2022
Busara Songtanin, Nicole Welch, Sabrina Siddiqui, Kenneth Nugent, Sarath Nath
The patient was started on ceftriaxone and ampicillin for empiric meningitis coverage and atovaquone-proguanil for empiric malaria therapy while a malaria smear was pending. Within 12 hours of admission, her mental status declined; she was delirious and demonstrated worsening neck stiffness. A computed tomography scan of the head without contrast showed no intracranial pathology. Lumbar puncture was performed, and the cerebrospinal fluid analysis was unremarkable. A malarial blood smear was positive for Plasmodium falciparum with >60% parasite burden (Figure 1). The Centers for Disease Control and Prevention was contacted and artesunate was requested. The patient’s mental status improved after two doses of artesunate. However, she developed a fever of 101.2°F, as well as hypoxemia (oxygen saturation 95% on nonrebreather 10 L/min), tachycardia (heart rate 115 beats/min), and pulmonary edema with bilateral pleural effusion and required intubation despite a decrease in her malarial parasitemia. She was successfully extubated after 24 hours, was switched to an oral artemisinin course which she completed, and was discharged on oral primaquine to take for 14 days to avoid relapsing in case she had co-infection with P. vivax or P. ovale.
Application of hot melt extrusion for improving bioavailability of artemisinin a thermolabile drug
Published in Drug Development and Industrial Pharmacy, 2018
C. Kulkarni, A. L. Kelly, T. Gough, V. Jadhav, K. K. Singh, A. Paradkar
Artemisinin, a keystone of malaria treatment, is effective against Plasmodium falciparum infection and cerebral malaria [12]. Artemisinin has low bioavailability and poor water solubility; its molecular structure is displayed in Figure 1. Due to its thermolabile nature, artemisinin poses significant processing challenges to forming solid dispersions [13]. Several studies have described attempts to improve the solubility of artemisinin, such as micronization using supercritical fluid technology, solid dispersions prepared using a solvent evaporation method [14] and complexation [15,16]. However, these methods are complex, difficult to scale-up, and yielded relatively poor improvements in drug release properties. Here, an amphiphilic graft copolymer, Soluplus® (polyvinyl caprolactum polyvinyl acetate polyethylene glycol) was used to form solid dispersions with artemisinin using HME, as it has the ability to enhance the solubility of poorly water soluble drugs and is suitable for melt extrusion below 120 °C, without the need for incorporation of additional plasticizer [17,18].
Related Knowledge Centers
- Anopheles
- Burkitt Lymphoma
- Malaria
- Parasitism
- Plasmodium
- Liver
- Red Blood Cell
- Mosquito
- Iarc Group 2A
- Apicomplexan Life Cycle