Cerebrospinal fluid and plasma β-endorphin levels in children with cerebral malaria

ObjectivesCerebral malaria (CM) is the most lethal form of malaria, yet its pathogenesis is not fully understood. Cytoadherence, sequestration, alterations in cytokine expression, inflammation, and microvascular obstruction are all hypothesized to be important in the aetio-pathogenesis of coma which characterizes cerebral malaria and the death which sometimes result. Beta ()-endorphin has been postulated to be involved in the pathogenetic processes of inflammation and cytokine expression, although the exact role is unknown. The aim of this study was to determine the levels of -endorphin in cerebrospinal fluid (CSF) and plasma of children with CM and compare the levels of -endorphin in the plasma of children with CM with that of apparently healthy age- and sex-matched controls at Ile-Ife, Nigeria. Materials and MethodsAdditional to the standard investigation for CM, CSF and venous blood samples were obtained from the subjects for the determination of -endorphin levels. ResultsForty children with CM were studied along with forty age- and sex-matched controls. The mean CSF -endorphin ( SD) level for the children with CM was 1.8 +/- 0.9pmol/L. The mean plasma -endorphin levels at admission (3.1 +/- 2.0pmol/L) and discharge (4.1 +/- 3.3pmol/L) were higher in children with CM than in the control subjects (2.7 +/- 0.7pmol/L). However, only the mean plasma -endorphin levels at discharge was significantly higher than that of controls (p=.012). ConclusionChildren with CM had higher mean plasma -endorphin levels compared to the controls and there was increased production of -endorphins in children with CM during the course of the illness.