Longitudinal associations of plasma amino acid levels with recovery from malarial coma

Abstract Background Disordered amino acid metabolism is observed in cerebral malaria (CM). This study sought to determine whether abnormal amino acid concentrations were associated with level of consciousness in children recovering from coma. Twenty-one amino acids and coma scores were quantified lo...

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Bibliographic Details
Published in:Malaria Journal
Main Authors: Donald L. Granger, Daniel Ansong, Tsiri Agbenyega, Melinda S. Liddle, Benjamin A. Brinton, Devon C. Hale, Bert K. Lopansri, Richard Reithinger, Donal Bisanzio
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2024
Subjects:
Cerebral malaria
Blantyre coma score
Amino acids
Generalized linear mixed-effects model
Tetrahydrobiopterin
Glyceryl lipid ethers
Arctic medicine. Tropical medicine
RC955-962
Infectious and parasitic diseases
RC109-216
Arctic
Online Access:https://doi.org/10.1186/s12936-024-05077-9
https://doaj.org/article/e283d499619144efb6f12c60a5d547d3
Description
Summary:Abstract Background Disordered amino acid metabolism is observed in cerebral malaria (CM). This study sought to determine whether abnormal amino acid concentrations were associated with level of consciousness in children recovering from coma. Twenty-one amino acids and coma scores were quantified longitudinally and the data were analysed for associations. Methods In a prospective observational study, 42 children with CM were enrolled. Amino acid levels were measured at entry and at frequent intervals thereafter and consciousness was assessed by Blantyre Coma Scores (BCS). Thirty-six healthy children served as controls for in-country normal amino acid ranges. Logistic regression was employed using a generalized linear mixed-effects model to assess associations between out-of-range amino acid levels and BCS. Results At entry 16/21 amino acid levels were out-of-range. Longitudinal analysis revealed 10/21 out-of-range amino acids were significantly associated with BCS. Elevated phenylalanine levels showed the highest association with low BCS. This finding held when out-of-normal-range data were analysed at each sampling time. Conclusion Longitudinal data is provided for associations between abnormal amino acid levels and recovery from CM. Of 10 amino acids significantly associated with BCS, elevated phenylalanine may be a surrogate for impaired clearance of ether lipid mediators of inflammation and may contribute to CM pathogenesis.

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