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Possible central role of nitric oxide in conditions clinically similar to cerebral malaria

The changes in mental status during cerebral malaria, heat stroke, and recovery from major surgery are clinically similar, and are associated with high circulating concentrations of cytokines that can induce nitric oxide generation in vascular walls. This vascular nitric oxide could diffuse across t...

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Published in:The Lancet (British edition) 1992-10, Vol.340 (8824), p.894-896
Main Authors: Clark, I.A, Rockett, K.A, Cowden, W.B
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cited_by cdi_FETCH-LOGICAL-c507t-2ff904bedde056489ba60443e3625d680a403e26754e5d894d1dca95386fe5293
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container_title The Lancet (British edition)
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creator Clark, I.A
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description The changes in mental status during cerebral malaria, heat stroke, and recovery from major surgery are clinically similar, and are associated with high circulating concentrations of cytokines that can induce nitric oxide generation in vascular walls. This vascular nitric oxide could diffuse across the bloodbrain barrier, causing functional changes that include inhibition of glutamate-induced calcium entry, reduced activity of the calcium-dependent nitric oxide synthase, and thus reduced nitric oxide formation, in post-synaptic neurons. Certain general anaesthetics and ethanol reduce glutamate-induced calcium entry into post-synaptic cells, and so would also reduce the rate of formation of neuronal nitric oxide. In view of the apparent importance of glutamate-induced nitric oxide in excitatory neurotransmission, a reduction in neuronal nitric oxide could help explain why these otherwise unrelated influences alter central nervous system function in a similar manner. In particular, this reduction could rationalise why heat stroke, ethanol excess, morphine poisoning, and conditions with high blood ammonia concentrations are easily confused clinically with cerebral malaria.
doi_str_mv 10.1016/0140-6736(92)93295-X
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subjects Amino Acid Oxidoreductases - metabolism
Ammonia
Ammonia - pharmacology
Anatomy & physiology
Anesthesia, General
Anesthetics
Biological and medical sciences
Brain
Brain - drug effects
Calcium
Calcium - metabolism
Calcium oxide
Central nervous system
Cytokines
Cytokines - metabolism
Ethanol
Ethanol - pharmacology
Heat Exhaustion - metabolism
Heat Exhaustion - physiopathology
Heat recovery
Heat stroke
Heatstroke
Human protozoal diseases
Humans
Immunotherapy
Infectious diseases
Lime
Malaria
Malaria, Cerebral - metabolism
Malaria, Cerebral - physiopathology
Medical research
Medical sciences
Morphine
Morphine - pharmacology
Nervous system
Neurotransmission
Nitric oxide
Nitric Oxide - metabolism
Nitric Oxide Synthase
Parasitic diseases
Protozoal diseases
Receptors, N-Methyl-D-Aspartate - metabolism
Reduction
Stroke
Surgery
Vector-borne diseases
title Possible central role of nitric oxide in conditions clinically similar to cerebral malaria
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