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

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...

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Bibliographic Details
Published in:	Malaria journal Vol. 23; no. 1; pp. 253 - 11
Main Authors:	Granger, Donald L, Ansong, Daniel, Agbenyega, Tsiri, Liddle, Melinda S, Brinton, Benjamin A, Hale, Devon C, Lopansri, Bert K, Reithinger, Richard, Bisanzio, Donal
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 23-08-2024 BMC
Subjects:	Amino acids Amino Acids - blood Blantyre coma score Cerebral malaria Child Child, Preschool Coma Coma - blood Complications and side effects Female Generalized linear mixed-effects model Glyceryl lipid ethers Health aspects Humans Infant Longitudinal Studies Malaria Malaria, Cerebral - blood Malaria, Cerebral - complications Male Medical research Medicine, Experimental Patient outcomes Physiological aspects Prospective Studies Risk factors Tetrahydrobiopterin United States Cerebral malaria Glyceryl lipid ethers Amino acids Generalized linear mixed-effects model Blantyre coma score Tetrahydrobiopterin
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Summary:	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. 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. 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. 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	1475-2875 1475-2875
DOI:	10.1186/s12936-024-05077-9