Circulating receptors implicated in the cyto-adherence occurring in severePlasmodium falciparum malaria in Thailand

The kinetic profiles of soluble chondroitin-sulphate A (CSA), intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1) a nd E-selectin were investigated in 17 patients hospitalized with Plasmodium falciparum malaria. The aim was to see if these circulating adhesion molec ules could be considered as markers for the severity of P. falciparum malar ia. The levels of all the adhesion molecules were found to be higher in the sera from all the malaria cases, both severe and uncomplicated, than in th ose from uninfected controls. The elevation in plasma CSA, reported for the first time, was statistically very significant (P = 0.00001). However, whe n severe cases were compared with the uncomplicated, there were no signific ant differences in the level of any of the receptors except ICAM-1, which w as highest in those with the severe disease (P = 0.01). The absence of any significant correlation between the plasma concentration of CSA and malaria severity indicates that this adhesion molecule could not be used to predic t the severity of malaria, although its role in sequestration of the parasi tes in pregnant women is well established.