Oxidative stress and erythrocyte damage in Kenyan children with severe Plasmodium falciparum malaria

Anaemia causes significant morbidity in children with Plasmodium falciparum malaria, but the mechanism(s) are unclear. During malarial infection, incr eased reactive oxygen species (ROS) are generated that may contribute to er ythrocyte damage and anaemia. This study measured the concentrations of alp ha -tocopherol in plasma and erythrocyte membranes, and the percentage poly unsaturated fatty acid composition (%PUFA) (an indirect marker of ROS damag e) in erythrocyte membranes in children with severe P. falciparum malaria f rom Kilifi, Kenya, and asymptomatic children from the same district. Malari al subjects were stratified Into complicated malaria and malaria anaemia. R esults demonstrated significant reductions in erythrocyte membrane cli-toco pherol concentration (1.63 +/- 0.16 versus 3.38 +/- 0.18 mu mol/mg protein; P<0.001) and total %PUFA (30.7 +/- 0.49 versus 32.8 +/- 0.44% P < 0.005) f or the malarial subjects (non-stratified) compared with controls. Malarial subjects showed a significant positive correlation between membrane alpha - tocopherol and haemoglobin concentrations (P < 0.005 r = 0.63 complicated m alaria group; P < 0.05 r = 0.36 non-stratified data). There were no signifi cant differences in plasma alpha -tocopherol concentration between malaria patients and controls. In conclusion, malarial infection may be associated with oxidative damage and reduced alpha -tocopherol reserve in the erythroc yte membrane, suggesting that local antioxidant depletion may contribute to erythrocyte loss in severe malaria. Erythrocyte membrane alpha -tocopherol appeared a better indicator of ROS exposure than plasma.