Fig. 10.

Adrenal hormones confer tolerance to malarial disease. Blood glucose levels decrease slightly, hepatic glycogen is consumed and the expression of a main gluconeogenic enzyme, glucose-6-phosphatase is lowered in murine malaria models without affecting survival. However, when adrenal hormone production is abolished, glycogen stores become exhausted and glycemia declines further until lethal glycemia levels are reached. This hypoglycemia is accompanied by increased circulatory and cerebral cytokine levels and can be prevented by supplementing dexamethasone. These effects are independent of the parasite load, indicating that adrenal hormones are crucial in mediating tolerance to malarial disease