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Title: Challenges in the determination of early predictors of cerebral malaria: lessons from the human disease and the experimental murine models
Authors: Martins, Yuri Chaves
Carvalho, Leonardo José de Moura
Daniel-Ribeiro, Cláudio Tadeu
Affilliation: Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Malária. Rio de Janeiro, RJ. Brasil.
La Jolla Bioengineering Institute. La Jolla, California, USA.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Pesquisa em Malária. Rio de Janeiro, RJ. Brasil.
Abstract: Cerebral malaria (CM) is a life-threatening complication of malaria caused by Plasmodium falciparum, and it claims around two million lives a year, mainly those of children in sub-Saharan Africa. A number of works, particularly in murine models of CM, showed that several mediators are involved in the development of the disease, including monocytes, T lymphocytes, cytokines, chemokines, platelets, nitric oxide scavengers and heme, among others, but a comprehensive understanding of the pathogenesis of this complication is still lacking. This overview critically analyzes and discusses the definition, clinical features, neurocognitive outcomes and pathogenesis of human CM. We focused on the relationship between clinical and laboratory features and the diagnosis and prognosis of the complication showing indicators of poor prognosis and emphasizing the need of establishing predictive scores to estimate, on admission, the likelihood of any malarial patient to develop neurological complications. The potential development of a mathematical model for early prediction of CM through neurological assessment using the SHIRPA protocol in Plasmodium berghei ANKA-infected susceptible mice is shown. High positive predictive values (>89%) on days 5 and 6 of infection, observed for some generated SHIRPA scores, indicate the possibility of early detection of mice with a high probability of developing CM.
Keywords: cerebral malaria
Plasmodium berghei ANKA
Murine models
keywords: Malária cerebral
modelos murinos
Plasmodium berghei
Issue Date: 2009
Publisher: Karger Publishers
Citation: MARTINS, Yury Chaves. CARVALHO, Leonardo José de Moura; DANIEL-RIBEIRO, Cláudio Tadeu. Challenges in the Determination of Early Predictors of Cerebral Malaria: Lessons from the Human Disease and the Experimental Murine Models. Neuroimmunomodulation, v.16, p.134–145, Feb. 2009.
DOI: 10.1159/000180268
ISSN: 1021-7401
Copyright: restricted access
Appears in Collections:IOC - Artigos de Periódicos

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