Low plasma arginine concentrations in children with cerebral malaria and decreased nitric oxide production

• Published in: The Lancet (British edition) 2003-02, Vol.361 (9358), p.676-678
• Main Authors: Lopansri, Bert K, Anstey, Nicholas M, Weinberg, J Brice, Stoddard, Gregory J, Hobbs, Maurine R, Levesque, Marc C, Mwaikambo, Esther D, Granger, Donald L
• Format: Article
• Language: English
• Subjects: Arginine; Arginine - blood; Biological and medical sciences; Biosynthesis; Blood; Brain; Case-Control Studies; Child, Preschool; Children; Children & youth; Cryopreservation; Cytokines; Fatalities; Female; Human protozoal diseases; Humans; Infectious diseases; Logistic Models; Malaria; Malaria, Cerebral - blood; Male; Medical sciences; Multivariate analysis; Nitric oxide; Nitric Oxide - biosynthesis; Nitric-oxide synthase; Oxidative stress; Parasites; Parasitic diseases; Plasma; Plasmodium falciparum; Proteins; Protozoal diseases; Regression analysis; Sickle cell disease; Substrates; Tanzania; Tropical medicine; Vector-borne diseases
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(03)12564-0

Nitric oxide (NO) production and mononuclear cell NO synthase 2 (NOS2) expression are high in healthy Tanzanian children but low in those with cerebral malaria. Factors that downregulate NOS2 also diminish factors involved in cellular uptake and biosynthesis of L-arginine, the substrate for NO synthesis. We therefore postulated that L-arginine concentrations would be low in individuals with cerebral malaria. We measured concentrations of L-arginine in cryopreserved plasma samples from Tanzanian children with and without malaria. L-arginine concentrations were low in individuals with cerebral malaria (mean 46 μmol/L, SD 14), intermediate in those with uncomplicated malaria (70 μmol/L, 20), and within the normal range in healthy controls (122 μmol/L, 22; p