Cerebral Malaria Treatment With Nitric Oxide

Malaria is a Parasitic Disease

Malaria symptoms include high fevers, chills, flu-like symptoms, and anemia. It is caused by a parasite that is transmitted from one human to another by the bite of an infected mosquito. These parasites multiply in our body's red blood cells which rupture within 48 to 72 hours, infecting even more red blood cells. The first symptoms usually appear 10 days to 4 weeks after infection, although in some cases they can take as long as a year after infection to manifest.

Cerebral Malaria occurs when blood cells filled with parasites block the small blood vessels to your brain. This can create swelling of your brain or brain damage. Symptoms of cerebral malaria include convulsions or, in some cases, a coma. About 20% of those who suffer from this disease die, while another 20% suffer from permanent brain injuries.

Malaria Statistics

In 2008, the disease caused nearly one million deaths, mostly among African children. In the country, the disease accounts for 20% of all childhood deaths. It is most predominant in sub-Saharan Africa, but it is also a problem in Asia, Latin America, the Middle East, and parts of Europe.

Malaria can cause a significant economic burden on countries with high prevalence of the disease. For these countries, gross domestic product (GDP) can decrease as much as 1.3%. It disproportionately affects poor people who cannot afford treatment or have limited access to health care.

 Nitric Oxide Treatment

The big problem with cerebral malaria is determining the 2% of people who are susceptible to the disease and figuring out how to treat it. A study led by Dr. Kevin Kain may hold the answer to both problems. Those with cerebral malaria tend to have lower-than-normal levels of nitric oxide (NO).

In a study done by Dr. Kain and his fellow researchers, mice afflicted with cerebral malaria were split into two groups - one group was given the standard drugs to treat the malaria while the other was given both the drug and nitric oxide. The mice that had the nitric oxide treatment showed improved survival rate.

Dr. Kain believes that increasing NO levels can prevent the release of angiopoietin-2 (Ang-2), a blood protein that encourages the breakdown of blood vessels and puts the patient at risk for severe and fatal malaria. This would protect the blood vessels in the brain, decreasing the effects of malaria. Ang-2 also presents a possible key for screening people with cerebral malaria. A simple blood test will reveal elevated Ang-2 levels in the body, and then aggressive treatment involving nitric oxide can take place.

The Study

Although this is not the first time NO's role in malaria treatment has been investigated, Kain's study may be the closest nitric oxide has gotten to practical application. His current study will provide 180 children between the ages of one and 10 with antimalarial drugs to treat the infection. 90 of those children will also be administered inhaled nitric oxide. The hope is that nitric oxide will provide humans the same survivability that it provided to mice. If his study is successful, nitric oxide may become available as a cost-effective malaria treatment!

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