Pharmacy World and Science

, Volume 18, Issue 4, pp 121–129 | Cite as

Oxidative stress in malaria; implications for prevention and therapy

  • Postma N S 
  • Zuidema J 
  • Mommérs E C 
  • Eling W M C 
Review

Abstract

Malaria affects world-wide more than 200 million people, of which 1–2 million die every year. New drugs and treatment strategies are needed to face the rapidly increasing problems of drug resistance.

During a malaria infection, both host and parasite are under oxidative stress. Increased production levels of reactive oxygen species (ROS, e.g. superoxide anion and the hydroxyl radical) are produced by activated neutrophils in the host and during degradation of haemoglobin in the parasite.

The effects of ROS in malaria can be both beneficial and pathological, depending on the amount and place of production. Enhanced ROS production after the administration of pro-oxidants, which is directed against the intra-erythrocytic parasite, inhibits the infection bothin vitro andin vivo. However, ROS are also involved in pathological changes in host tissue like damage of the vascular endothelial lining during a malaria infection (cerebral malaria).

Pro-oxidants support the host defense against the parasite when working in or near the infected cell but potentially cause vascular damage when working on or near the vascular lining. Examples of pro-oxidants are found among xenobiotics and food components. Important new drugs belonging to the class of pro-oxidants are artemisinin and its derivatives. Anti-oxidants potentially counteract these agents.

Treatment with anti-oxidants or chelators of metals to prevent their catalytic function in the generation of ROS may prevent vascular pathology. In addition, the iron chelator desferrioxamine, exhibits an antiparasitic activity, because iron is also essential for the proliferation of the parasite.

Cytokines play an important role in ROS-related pathology of malaria, though their mechanism of action is not completely elucidated. This field might bring up new treatment concepts and drugs.

Drugs which prevent host pathology, such as the cerebral complications might be life saving.

Keywords

Oxidative stress Reactive oxygen species Malaria Cerebral malaria Cytokines Pro-oxidants Anti-oxidants Artemisinin Desferrioxamine 

List of abbreviations and symbols

BCNU

1,3-bis(2-chloroethyl)-1-nitrosourea (a GSH-R inhibitor)

BHA

butylated hydroxyanisole (a radical scavenger)

CM

cerebral malaria

CD36

cluster of difference 36 (integral membrane glycoprotein)

DFO

desferrioxamine, deferoxamine, desferal (a chelator)

ELAM-1

endothelial leukocyte adhesion molecule-1

G6PD

glucose-6-phosphate dehydrogenase

GSH

glutathione (reduced)

GSH-P

glutathione peroxidase

GSH-R

glutathione reductase

GSSG

glutathione (oxidised)

HeCNU

1-(2-chloroethyl)-3-(2-hydroxyethyl)-1-nitrosourea (a GSH-R inhibitor)

HMS

hexose monophosphate shunt

HRP

histidine-rich proteins

ICAM-1

intercellular adhesion molecule-1

IFN-g

interceron-gamma (a cytokine)

Il-j

interleukine-1 (a cytokine)

IRBC

infected red blood cells

NADPH

nicotinamide-adenine-dinucleotide phosphate (reduced)

O2

superoxide radical

OH

hydroxyl radical

P

Plasmodium

PE

parasitised erythrocytes

PEG

polyethylene glycol

PTEMP1

Plasmodium falciparum erythrocyte major protein 1

PMN's

polymorphonuclear cells

R

secondary radical

ROS

reactive oxygen species

SOD

superoxide dismutase

TNF

tumour necrosis factor (a cytokine)

VCAM-1

vascular adhesion molecule-1

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© Kluwer Academic Publishers 1996

Authors and Affiliations

  • Postma N S 
    • 1
  • Zuidema J 
    • 1
  • Mommérs E C 
    • 2
  • Eling W M C 
    • 2
  1. 1.Department of PharmaceuticsUniversity of UtrechThe Netherlands
  2. 2.Department of Medical MicrobiologyUniversity Hospital NijmegenThe Netherlands

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