Status of Blood Levels of Superoxide Dismutase in Patients with Malaria: A Systematic Review and Meta-Analysis

Kotepui, Kwuntida Uthaisar; Mueangson, Onchuma; Mala, Wanida; Mahittikorn, Aongart; Wangdi, Kinley; Kotepui, Manas

doi:10.1089/ars.2023.0273

Cited by 4 publications

(7 citation statements)

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“…In addition to GPx, which plays a role against oxidative stress-related Plasmodium infections, other antioxidants such as SOD, CAT, peroxiredoxin 2 (PRDX2), GSH, ascorbic acid, lipoic acid, α-tocopherol, and β-carotene are necessary to maintain the redox balance 46 . In our previous meta-analysis, levels of SOD in malaria patients were significantly lower compared to uninfected cases 43 . Our previous meta-analysis and this study suggest a possible positive correlation between GPx and SOD.…”

Section: Discussionmentioning

confidence: 76%

“…Babalola et al demonstrated that GPx was higher during P. falciparum infections 20 . Increased levels of MDA and decreased levels of antioxidant enzymes such as SOD, CAT, and GPx indicate that antioxidant levels are equally increased to combat the generation of oxidative stress products 42 , 43 .…”

Section: Discussionmentioning

confidence: 99%

“…The relationship between oxidative stress and antioxidant levels is an essential host-related factor as depletion of antioxidants, such as reduced glutathione (GSH), antioxidant vitamins (A, C, and E), and superoxide dismutase (SOD), leads to increased severity of malaria 10 – 14 . Glutathione peroxidase (GPx) is a member of the oxidoreductase family that catalyzes the conversion of hydrogen peroxide and organic hydroperoxides into water or related alcohols 15 .…”

Section: Introductionmentioning

confidence: 99%

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Impact of malaria on glutathione peroxidase levels: a systematic review and meta-analysis

Kotepui,

Mahittikorn,

Anabire

et al. 2023

Sci Rep

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The primary antioxidant, glutathione peroxidase (GPx), is hypothesized to contribute to the pathophysiology of malaria. This current study conducted a meta-analysis to examine variations in GPx blood levels in malaria patients. Seven electronic databases—ProQuest, Scopus, Embase, MEDLINE, PubMed, Ovid, and Google Scholar—were searched for relevant studies with no limitations to publication language or publication date. The Joanna Briggs Institute critical appraisal tools were used to appraise the risk of bias among the included studies critically. The meta-analysis was conducted by pooling the effect estimates and Hedges’s g using a random-effects model. Search results returned 1253 articles, of which 16 studies were used for syntheses. Results of the meta-analysis indicated that malaria patients had decreased blood levels of GPx compared to uninfected individuals (P < 0.01, Hedges’ g: − 4.06, 95% CI − 5.49–(− 2.63), I2: 99.07%, 1278 malaria patients/627 uninfected individuals, 15 studies). Subgroup analyses indicated that peripheral levels of GPx were significantly diminished in patients with P. falciparum malaria compared to uninfected controls (P < 0.01, Hedges’ g: − 3.06, 95% CI − 4.46–(− 1.65), I2: 98.39%, 9 studies) but not in patients with P. vivax malaria (P = 0.15, Hedges’ g: − 2.05, 95% CI − 4.83–0.74), I2: 98.64%, 2 studies) Overall, malaria is associated with declined levels of GPx, particularly in patients with P. falciparum malaria. The finding provides valuable insights that prompt the need to investigate the role of GPx depletion in malaria pathogenesis.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of malaria on glutathione peroxidase levels: a systematic review and meta-analysis

Kotepui,

Mahittikorn,

Anabire

et al. 2023

Sci Rep

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“…Oxidative stress markers, such as malondialdehyde (MDA) have been reported to be positively correlated with malaria parasite density; meanwhile, negative correlations have been observed between parasite density and antioxidant enzymes, such as GSH, SOD, ascorbic acid, and CAT 42 , 53 . These results indicate that not only are CAT levels affected by Plasmodium infection but also other antioxidants tend to be lower.…”

Section: Discussionmentioning

confidence: 99%

Differences in catalase levels between malaria-infected individuals and uninfected controls: a systematic review and meta-analysis

Kotepui,

Mahittikorn,

Masangkay

et al. 2023

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Inconsistent catalase (CAT) research necessitates a comprehensive review of CAT levels among patients with malaria to achieve better therapeutic strategies. This study aimed to systematically review and meta-analyze available literature on CAT levels in nonpregnant and pregnant individuals with malaria compared with those in uninfected controls, with the goal of providing a robust evidence base for future research and potential interventions. Following PRISMA guidelines, a systematic literature search across six databases was conducted to examine CAT levels in patients with malaria. Data was extracted independently by two reviewers, and study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. The standardized mean difference of CAT levels was calculated with heterogeneity assessment. Subgroup and sensitivity analyses were conducted to explore heterogeneity and assess the robustness of the findings. Publication bias was visually and statistically assessed and corrected, if necessary. Statistical analyses were performed using Stata software, with a significance level set at P < 0.05. Nineteen studies were included in the review. These studies, published from before 2000 to 2023, primarily from Africa and Asia, focused on different Plasmodium species and age groups. Results of qualitative synthesis among nonpregnant individuals consistently showed lower CAT levels in malaria-infected individuals, although some studies reported higher levels. No significant differences in CAT levels were found between malaria-infected and uninfected individuals, as demonstrated by a meta-analysis overall (P = 0.05, Hedges’ g: − 0.78, 95% confidence interval (CI): (− 1.56)–0.01, I2: 98.47, 15 studies), but subgroup analyses showed significant differences in CAT levels in studies conducted in Africa (P = 0.02, Hedges’ g: − 0.57, 95% CI: − 1.02–(0.11), I2: 91.81, 7 studies), and in studies that specifically focused on children (P = 0.03, Hedges’ g: − 0.57, 95% CI: − 1.07–(− 0.07), I2: 87.52, 4 studies). Pregnant women showed variations in CAT levels across trimesters. This study provides valuable insights into the association between malaria infection and CAT enzyme levels, particularly in nonpregnant individuals. Furthermore, well-designed studies are essential to decoding the intricacies of this relationship, which could have significant implications for understanding disease processes and improving patient care.

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“…It consists of enzymatic and nonenzymatic antioxidants that work together to neutralize and scavenge ROS, thereby protecting cells and tissues from oxidative damage [ 61 , 62 ]. Several studies investigating the relationship between MDA and the antioxidant system in the context of malaria showed that the activities of various antioxidant enzymes, such as superoxide dismutase (SOD), glutathione peroxidase, and catalase, were decreased during malaria [ 17 , 63 , 64 ]. A longitudinal birth cohort study reported that several polymorphisms in antioxidant enzymes, including glutathione reductase, glutamylcysteine synthetase, glutathione S-transferase P1, haem oxygenase 1, and SOD2, were associated with the oxidative stress status of children [ 65 ].…”

Section: Discussionmentioning

confidence: 99%

Increased Blood Concentrations of Malondialdehyde in Plasmodium Infection: A Systematic Review and Meta-Analysis

et al. 2023

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Several studies have evaluated the relationship between malondialdehyde (MDA) concentrations and Plasmodium infections; however, the findings remain inconclusive. This study synthesized differences in MDA concentrations among patients with different levels of clinical severity, uninfected controls, and different Plasmodium species. The research protocol was registered in PROSPERO (CRD42023393540). Systematic literature searches for relevant studies were performed using the Embase, MEDLINE, Ovid, ProQuest, PubMed, Scopus, and Google Scholar databases. Qualitative and quantitative syntheses (meta-analyses) of distinct MDA concentrations between the disease groups were performed. Twenty-three studies met the eligibility criteria and were included in the systematic review. Overall, MDA concentrations were significantly elevated in participants with malaria relative to uninfected controls (p < 0.01, Cohen d: 2.51, 95% confidence interval (CI): 1.88–3.14, I2: 96.22%, 14 studies). Increased MDA concentrations in participants with malaria compared with uninfected controls were found in studies that enrolled patients with P. falciparum malaria (p < 0.01, Cohen d: 2.50, 95% CI: 1.90–3.10, I2: 89.7%, 7 studies) and P. vivax malaria (p < 0.01, Cohen d: 3.70, 95% CI: 2.48–4.92, I2: 90.11%, 3 studies). Our findings confirm that MDA concentrations increase during Plasmodium infection, indicating a rise in oxidative stress and lipid peroxidation. Thus, MDA levels can be a valuable biomarker for evaluating these processes in individuals with malaria. However, further research is necessary to fully elucidate the intricate relationship between malaria, antioxidants, oxidative stress, and the specific role of MDA in the progression of malaria.

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Status of Blood Levels of Superoxide Dismutase in Patients with Malaria: A Systematic Review and Meta-Analysis

Cited by 4 publications

References 53 publications

Impact of malaria on glutathione peroxidase levels: a systematic review and meta-analysis

Impact of malaria on glutathione peroxidase levels: a systematic review and meta-analysis

Differences in catalase levels between malaria-infected individuals and uninfected controls: a systematic review and meta-analysis

Increased Blood Concentrations of Malondialdehyde in Plasmodium Infection: A Systematic Review and Meta-Analysis

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