Lactate levels in severe malarial anaemia are associated with haemozoin-containing neutrophils and low levels of IL-12

• Main Authors: Williams Thomas N, English Mike, Lowe Brett, Kai Oscar, Casals-Pascual Climent, Maitland Kathryn, Newton Charles RCJ, Peshu Norbert, Roberts David J
• Format: Article
• Language: English
• Published: BMC 2006-11-01
• Series: Malaria Journal
• Online Access: http://www.malariajournal.com/content/5/1/101

<p>Abstract</p> <p>Background</p> <p>Hyperlactataemia is often associated with a poor outcome in severe malaria in African children. To unravel the complex pathophysiology of this condition the relationship between plasma lactate levels, parasite density, pro- and anti-inflammatory cytokines, and haemozoin-containing leucocytes was studied in children with severe falciparum malarial anaemia.</p> <p>Methods</p> <p>Twenty-six children with a primary diagnosis of severe malarial anaemia with any asexual <it>Plasmodium falciparum </it>parasite density and Hb < 5 g/dL were studied and the association of plasma lactate levels and haemozoin-containing leucocytes, parasite density, pro- and anti-inflammatory cytokines was measured. The same associations were measured in non-severe malaria controls (N = 60).</p> <p>Results</p> <p>Parasite density was associated with lactate levels on admission (<it>r </it>= 0.56, <it>P </it>< 0.005). Moreover, haemozoin-containing neutrophils and IL-12 were strongly associated with plasma lactate levels, independently of parasite density (<it>r </it>= 0.60, <it>P </it>= 0.003 and <it>r </it>= -0.46, <it>P </it>= 0.02, respectively). These associations were not found in controls with uncomplicated malarial anaemia.</p> <p>Conclusion</p> <p>These data suggest that blood stage parasites, haemozoin and low levels of IL-12 may be associated with the development of hyperlactataemia in severe malarial anaemia.</p>