Abstract
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<0·0001). Analysis by logistic regression showed that hypoargininaemia was significantly associated with cerebral malaria case-fatality. Hypoargininaemia may contribute to limited NO production in children with cerebral malaria and to severe disease.
Original language | English |
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Pages (from-to) | 676-678 |
Number of pages | 3 |
Journal | Lancet |
Volume | 361 |
Issue number | 9358 |
DOIs | |
Publication status | Published - 22 Feb 2003 |