Abstract
Anti-phosphatidyl choline antibodies (αPC) have been measured in adult patients from Orissa, India with Plasmodium falciparum infection of varying clinical severity. Significantly raised levels of αPC were observed in infected individuals in comparison with controls. The IgG αPC were found to be generally more than IgM αPC in most cases. The IgG αPC levels were significantly more in those cases of cerebral malaria who recovered fully after quinine administration in comparison with fatal cases not responding to quinine therapy, indicating a role for αPC in prognosis of adult cerebral malaria. There was no significant difference in levels of αPC IgG between non-cerebral and fatal cerebral malaria patients, indicating an absence of a direct protective role in the development of cerebral manifestations. Subgroup typing of IgG with αPC activity indicated IgG3 to be the predominant type, followed by IgG2. IgG1 and IgG4. A significant inverse relationship between serum tumour necrosis factor-alpha (TNF-α) levels and IgG1 antibodies with αPC activity was found, emphasizing the importance of αPC in modifying disease severity. These observations appear to give credence to recent reports in the literature indicating that toxic malarial antigens consist of phospholipids and that antibodies to phospholipids (αPL) inhibit such antigens in experimental systems.
Keywords: cerebral malaria, phosphatidyl choline antibodies, Plasmodium falciparum prognosis, tumour necrosis factor-alpha
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