[PDF][PDF] Blood-brain barrier function in cerebral malaria in Malawian children.

H Brown, S Rogerson, T Taylor, M Tembo… - The American journal …, 2001 - researchgate.net
H Brown, S Rogerson, T Taylor, M Tembo, J Mwenechanya, M Molyneux, G Turner
The American journal of tropical medicine and hygiene, 2001researchgate.net
Cerebral malaria (CM) is a serious complication of Plasmodium falciparum infection. Binding
of parasitized erythrocytes to cerebral endothelium plays a key role in disease
pathogenesis. Central nervous system signs and symptoms (coma, seizures, raised
intracranial pressure) predominate in African children, whereas in adults, multiorgan system
failure is more common. In this study we investigated whether changes in blood-brain barrier
(BBB) structure and function are compatible with the signs and symptoms observed in …
Abstract
Cerebral malaria (CM) is a serious complication of Plasmodium falciparum infection. Binding of parasitized erythrocytes to cerebral endothelium plays a key role in disease pathogenesis. Central nervous system signs and symptoms (coma, seizures, raised intracranial pressure) predominate in African children, whereas in adults, multiorgan system failure is more common. In this study we investigated whether changes in blood-brain barrier (BBB) structure and function are compatible with the signs and symptoms observed in Malawian children with CM. Immunohistochemistry on autopsy brain tissues from eight cases of CM showed activation of endothelial cells and macrophages, and disruption of endothelial intercellular junctions in vessels containing sequestered parasitized erythrocytes, but no gross leakage of plasma proteins. Examination of the partition of albumin between circulating plasma and the cerebrospinal fluid from 72 cases of CM showed subtle but measurable changes compatible with impaired BBB function in malaria. These findings suggest that BBB breakdown occurs in areas of parasite sequestration in CM in African children.
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