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. 2009 Mar 20;5(3):e1000349. doi: 10.1371/journal.ppat.1000349

Figure 5. Severe P. falciparum malaria and plasma ADAMTS13 inhibitor levels.

Figure 5

(A&B) In children with CM or SM, plasma IL-6 levels (means±SEM) were significantly increased compared to those in normal controls. However the absolute concentrations of IL-6 did not reach that previously described as being required to inhibit ADAMTS proteolysis of VWF, and in spiking experiments we found no inhibitory effect of IL-6 (final concentration range 0.01–10 µg/ml) on ADAMTS13 activity in pooled normal plasma (FRETS-VEF73 assay). (C) Reduced plasma FVIII levels have recently been reported to inhibit ADAMTS13 activity but plasma FVIII∶C levels (means±SEM) were significantly increased in children with severe P. falciparum malaria. (D) Although, intravascular haemolysis is a recognised complication of malarial infection, and free plasma haemoglobin has been shown to inhibit ADAMTS13 activity, only minor increased plasma haemoglobin concentrations were observed in children with CM or SM, well below that previously described to significantly inhibit ADAMTS13 activity. (* p<0.05; ** p<0.005; *** p<0.0005).