Clinicopathological study of potential biomarkers of Plasmodium falciparum malaria severity and complications.

18 Oct 2019
Bhardwaj N, Ahmed MZ, Sharma S, Srivastava B, Pande V, Anvikar AR


Early diagnosis, risk stratification and evaluation of possible biomarkers are much in demand nowadays, as the routine laboratory markers do not always predict severity of disease. The prevention of malaria caused by Plasmodium falciparum which when in severe form may lead to life threatening complications like acute kidney failure, heart disease, and respiratory altered etc. may be facilitated by these biomarkers. The present study was designed to evaluate the potential diagnostic biomarkers of P. falciparum malaria in complications.


Samples of P. falciparum (n = 74) and healthy control (n = 22) were collected from Dhalai district hospital, Dhalai, Tripura, India during September 2016 to October 2017 to study the potential biomarkers of the P. falciparum malaria severity and complications. 19 potential biomarkers of malaria complications and cellular signaling proteins were assessed using Enzyme Linked Immuno Sorbent assays (ELISA) and biochemical analyses for selected proteins. Mann -Whitney U test and chi square test were used to compare the malaria case versus healthy control group and uncomplicated malaria versus severe malaria group. The prognostic performance for all parameters was assessed using ROC (receiver operating characteristic) analysis.


The demographic, clinical and laboratory parameters were significantly altered in case group compared to healthy controls, p-value <.05 except gender, cholesterol, triglycerides, Gamma-GT and cytochrome-C. The respiratory rate, CK-MB, uric acid, CKD-EPI eGFR, total bilirubin, caveolin1 and pLDH were significantly altered in the severe malaria group as compared to the uncomplicated malaria group (p-value<.05).


Interestingly, the known markers of heart ailment CK-MB and PGC1α, kidney dysfunction marker CKD-EPI eGFR and other cellular signaling markers, DAPK1, p53 and beclin1 were significantly altered in uncomplicated malaria than healthy controls. These findings may pave path for unfolding of disease pathogenesis and complexity in malaria infection.