Brain-derived Neurotrophic Factor Is Associated With Disease Severity and Clinical Outcome in Ugandan Children Admitted to Hospital With Severe Malaria.

Abstract

BACKGROUND:

Malaria remains a leading cause of childhood death and neurologic disability in sub-Saharan Africa. Here, we test the hypothesis that malaria-induced alterations to circulating brain-derived neurotrophic factor (BDNF) are associated with poor clinical outcomes in children with severe malaria.

METHODS:

We quantified BDNF (by enzyme-linked immunosorbent assay) in plasma samples collected [at presentation (day 1), day 3 and day 14], during a prospective study of Ugandan children admitted to hospital with severe malaria (n = 179).

RESULTS:

BDNF concentration at presentation (day 1) was lower in children with cerebral malaria (P < 0.01), coma (P < 0.01), Lambaréné Organ Dysfunction Score >1 (P < 0.05) and respiratory distress (P < 0.01). Higher BDNF concentration at presentation was associated with shorter time to coma recovery [hazard ratio = 1.655 (1.194-2.293); P = 0.002] and a reduced odds ratio of disability [0.50 (0.27-0.94); P = 0.047] and death [0.45 (0.22-0.92); P = 0.035]. BDNF concentration was lower on day 1 and increased in children surviving severe malaria (day 14; P < 0.0001).

CONCLUSIONS:

Our findings provide the new evidence linking circulating BDNF with disease severity, coma recovery and clinical outcome in children with severe malaria.

• Authors: Chloe R McDonald, Andrea L Conroy, Michael Hawkes, Robyn E Elphinstone, Joel L Gamble, Kyla Hayford, Sophie Namasopo, Robert O Opoka, W Conrad Liles, Kevin C Kain
• Journal: The Pediatric infectious disease journal (Pediatr Infect Dis J) Vol. 36 Issue 2 Pg. 146-150 (02 2017) ISSN: 1532-0987 [Electronic] United States
• PMID: 27798544 (Publication Type: Journal Article)

Chemical References

• Brain-Derived Neurotrophic Factor
• BDNF protein, human

Topics

• Brain-Derived Neurotrophic Factor (blood)
• Child, Preschool
• Coma
• Female
• Hospitalization
• Humans
• Infant
• Malaria, Cerebral (blood, epidemiology)
• Malaria, Falciparum (blood, epidemiology)
• Male
• Plasmodium falciparum
• Prospective Studies
• Randomized Controlled Trials as Topic
• Severity of Illness Index
• Treatment Outcome
• Uganda (epidemiology)