Falciparum malaria infection is associated with significant destruction of erythrocytes. This leads to the release of toxic metabolic products, including oxidant compounds. We measured the serum concentration of the antioxidant, ascorbic acid, in 129 patients presenting with acute falciparum malaria infection and in 65 healthy individuals. None of the study subjects administered any form of ascorbic acid supplementation within one week prior to participation in this study. The mean serum ascorbate concentration in infected adult males (n = 49, age range 18-50 years) was found to be 2.02 +/- 0.20 mg/dL, and it was 2.03 +/- 0.24 mg/dL in infected adult females (n = 56, age range 18-50 years). These values were significantly greater than the serum ascorbate levels (1.54 +/- 0.10 mg/dL) in healthy adult males (n = 28) and females (n = 28) (p < 0.05). In children (age range 3 to 5 years), the serum ascorbate concentration was significantly lower (1.95 +/- 0.20 mg/dL) during infection (n = 25) than in their healthy counterparts (2.9 +/- 0.24 mg/dL, n = 9) (p < 0.05). It is evident therefore that ascorbic acid plays a significant role in the pathogenesis of acute falciparum malaria in adults. Infected children also need to be given supplemental doses of ascorbate in view of the weakness of their immune system.
Serum magnesium concentration was measured in 80 adult patients (age range: 18-40 yr) presenting with acute, uncomplicated falciparum malaria infection and a control group of 20 age-matched, healthy individuals. The mean serum magnesium concentration in the patients was 1950.0 +/- 10.0 microg/dL. The control serum magnesium was 640.0 +/- 40.0 microg/dL. This represents an over threefold increase in serum magnesium levels above normal value, p < 0.01. The key pathogenic event in acute falciparum malaria infection is the hemolysis of both infected and uninfected red blood cells. Therefore, the increased serum magnesium concentration might occur because of the hemolysis arising from erythrocytic merogony because red blood cells contain high amounts of magnesium. In conclusion, the increased serum magnesium has potential application as a biomarker of acute falciparum malaria infection in adults.
The activities of total serum acid phosphatase (E.C. 3.1.3.2) and of two of its isoenzymes, tartrate-resistant acid phosphatase and erythrocyte-specific acid phosphatase were measured in 109 adult male and female patients presenting acute falciparum malaria infection, and a normal, healthy control group comprised of 82 subjects. All the three forms of acid phosphatase were found to be significantly (p < 0.05) higher during infection as compared to their activity in the control group. This result suggests that the measurement of acid phosphatase, particularly the erythrocyte isoenzyme, in serum could be potentially used as a biomarker of acute falciparum malaria infection.
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