Antioxidant Status of Bilirubin and Uric Acid in Patients Diagnosed with Plasmodium falciparum Malaria in Douala

Abstract

Oxidative stress and changes in antioxidant status have been implicated in the pathogenesis of malaria. To assess the antioxidant level ofbilirubin and uric acid associated with falciparum malaria infection, 60 untreated patients (30 men and 30 women) in Douala, Cameroon were screened for the study. Sixty five healthy individuals (29 men and 36 women) were used as controls. Total and conjugated bilirubin were calculated using Jendrassik-Grof method while uric acid was determined using Barham-Trinder method. It was observed that total and conjugated bilirubins were significantly (p < 0.001) higher in malaria patients (10.722 +/- 4.043 and 3.627 +/- 1.571 mg L(-1), respectively) when compared to control (6.830 +/- 2.436 and 1.777 +/- 0.729 mg L(-1)) and these bilirubin levels increased significantly with parasite count (p < 0.050). There was also significant increased (p = 0.021) of uric acid in malaria patients (56.262 +/- 13.963 mg L(-1)) compared to controls (49.838 +/- 15.419 mg L(-1)). No significant differences based on sex were observed on uric acid, parasite count, total and conjugated bilirubins in malaria patients. Positive correlations were obtained between parasite count and total bilirubin (r = 0.320, p < 0.050), conjugated bilirubin (r = 0.477, p < 0.001), uric acid (r = 0.060, p > 0.050) and between total and conjugated bilirubin (r = 0.729, p < 0.001). From this study, it has been hypothesized that the augmentation of plasma level ofbilirubin and uric acid could provide more protection against oxidative stress induced by malaria.

Plasma Uric Acid Levels Correlate with Inflammation and Disease Severity in Malian Children with Plasmodium falciparum Malaria

“…Bertrand et al . [33] describe a weak correlation (r = 0.06, p>0.05) in a group of 60 Cameroonian adults with UM. In comparing groups of Nigerian children with asymptomatic parasitemia, UM and severe malaria, Iwalokun et al [35] showed that the association between UA levels and parasite density gets stronger with disease severity; however, this correlation (r = 0.61, p<0.05) was significant only in the group of severe cases.…”

“…Before making these correlations, we confirmed that the cytokines we measured increase with disease severity, thus implicating them in the pathogenesis of severe malaria in our Malian study population. Previous studies that measured UA levels in patients with malaria tested the hypothesis that UA is an indirect marker of oxidative stress [33]–[35]. This is because the formation of UA from hypoxanthine and xanthine generates ROS.…”

Plasmodium falciparum-Derived Uric Acid Precipitates Induce Maturation of Dendritic Cells

“…The absence of plasma uricase activity may therefore contribute to malaria inflammation, as humans would have difficulty eliminating highly inflammatory uric acid precipitates released by ruptured Plasmodium -infected erythrocytes. Indeed, elevated plasma urate levels were found in Plasmodium infections in mice [55] and in humans, which correlate with disease severity in P. falciparum [25]–[27] and with parasitemia in P. vivax [28]. In addition, a correlation between uric acid plasma levels and inflammatory cytokines in children infected with P. falciparum in Mali was found [56].…”

Antioxidant-oxidant status in patients with hydatid cyst

“…Oxidative stress results from increased production of oxidants, reduced level of antioxidants or a combination of both [15]. Several studies have demonstrated that the issue of oxidative stress and antioxidants is involved in the pathogenesis of various parasitic diseases and inflammatory events [25,26]. Malondialdehyde (MDA), a marker of lipid peroxidation; a non-enzymatic antioxidant, glutathione, and enzymatic antioxidants glutathione peroxidase and superoxide dismutase have been determined in patients with hydatid cyst.…”