Cargando…

Variation in Glucose-6-Phosphate Dehydrogenase activity following acute malaria

Primaquine and tafenoquine are the only licensed drugs with activity against Plasmodium vivax hypnozoites but cause haemolysis in patients with glucose–6–phosphate dehydrogenase (G6PD) deficiency. Malaria also causes haemolysis, leading to the replacement of older erythrocytes with low G6PD activity...

Descripción completa

Detalles Bibliográficos
Autores principales: Ley, Benedikt, Alam, Mohammad Shafiul, Satyagraha, Ari Winasti, Phru, Ching Swe, Thriemer, Kamala, Tadesse, Dagimawie, Shibiru, Tamiru, Hailu, Asrat, Kibria, Mohammad Golam, Hossain, Mohammad Sharif, Rahmat, Hisni, Poespoprodjo, Jeanne R., Khan, Wasif Ali, Simpson, Julie A., Price, Ric N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9094517/
https://www.ncbi.nlm.nih.gov/pubmed/35544453
http://dx.doi.org/10.1371/journal.pntd.0010406
_version_ 1784705555123666944
author Ley, Benedikt
Alam, Mohammad Shafiul
Satyagraha, Ari Winasti
Phru, Ching Swe
Thriemer, Kamala
Tadesse, Dagimawie
Shibiru, Tamiru
Hailu, Asrat
Kibria, Mohammad Golam
Hossain, Mohammad Sharif
Rahmat, Hisni
Poespoprodjo, Jeanne R.
Khan, Wasif Ali
Simpson, Julie A.
Price, Ric N.
author_facet Ley, Benedikt
Alam, Mohammad Shafiul
Satyagraha, Ari Winasti
Phru, Ching Swe
Thriemer, Kamala
Tadesse, Dagimawie
Shibiru, Tamiru
Hailu, Asrat
Kibria, Mohammad Golam
Hossain, Mohammad Sharif
Rahmat, Hisni
Poespoprodjo, Jeanne R.
Khan, Wasif Ali
Simpson, Julie A.
Price, Ric N.
author_sort Ley, Benedikt
collection PubMed
description Primaquine and tafenoquine are the only licensed drugs with activity against Plasmodium vivax hypnozoites but cause haemolysis in patients with glucose–6–phosphate dehydrogenase (G6PD) deficiency. Malaria also causes haemolysis, leading to the replacement of older erythrocytes with low G6PD activity by reticulocytes and young erythrocytes with higher activity. Aim of this study was to assess the impact of acute malaria on G6PD activity. Selected patients with uncomplicated malaria were recruited in Bangladesh (n = 87), Indonesia (n = 75), and Ethiopia (n = 173); G6PD activity was measured at the initial presentation with malaria and a median of 176 days later (range 140 to 998) in the absence of malaria. Among selected participants (deficient participants preferentially enrolled in Bangladesh but not at other sites) G6PD activity fell between malaria and follow up by 79.1% (95%CI: 40.4 to 117.8) in 6 participants classified as deficient (<30% activity), 43.7% (95%CI: 34.2 to 53.1) in 39 individuals with intermediate activity (30% to <70%), and by 4.5% (95%CI: 1.4 to 7.6) in 290 G6PD normal (≥70%) participants. In Bangladesh and Indonesia G6PD activity was significantly higher during acute malaria than when the same individuals were retested during follow up (40.9% (95%CI: 33.4–48.1) and 7.4% (95%CI: 0.2 to 14.6) respectively), whereas in Ethiopia G6PD activity was 3.6% (95%CI: -1.0 to -6.1) lower during acute malaria. The change in G6PD activity was apparent in patients presenting with either P. vivax or P. falciparum infection. Overall, 66.7% (4/6) severely deficient participants and 87.2% (34/39) with intermediate deficiency had normal activities when presenting with malaria. These findings suggest that G6PD activity rises significantly and at clinically relevant levels during acute malaria. Prospective case-control studies are warranted to confirm the degree to which the predicted population attributable risks of drug induced haemolysis is lower than would be predicted from cross sectional surveys.
format Online
Article
Text
id pubmed-9094517
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-90945172022-05-12 Variation in Glucose-6-Phosphate Dehydrogenase activity following acute malaria Ley, Benedikt Alam, Mohammad Shafiul Satyagraha, Ari Winasti Phru, Ching Swe Thriemer, Kamala Tadesse, Dagimawie Shibiru, Tamiru Hailu, Asrat Kibria, Mohammad Golam Hossain, Mohammad Sharif Rahmat, Hisni Poespoprodjo, Jeanne R. Khan, Wasif Ali Simpson, Julie A. Price, Ric N. PLoS Negl Trop Dis Research Article Primaquine and tafenoquine are the only licensed drugs with activity against Plasmodium vivax hypnozoites but cause haemolysis in patients with glucose–6–phosphate dehydrogenase (G6PD) deficiency. Malaria also causes haemolysis, leading to the replacement of older erythrocytes with low G6PD activity by reticulocytes and young erythrocytes with higher activity. Aim of this study was to assess the impact of acute malaria on G6PD activity. Selected patients with uncomplicated malaria were recruited in Bangladesh (n = 87), Indonesia (n = 75), and Ethiopia (n = 173); G6PD activity was measured at the initial presentation with malaria and a median of 176 days later (range 140 to 998) in the absence of malaria. Among selected participants (deficient participants preferentially enrolled in Bangladesh but not at other sites) G6PD activity fell between malaria and follow up by 79.1% (95%CI: 40.4 to 117.8) in 6 participants classified as deficient (<30% activity), 43.7% (95%CI: 34.2 to 53.1) in 39 individuals with intermediate activity (30% to <70%), and by 4.5% (95%CI: 1.4 to 7.6) in 290 G6PD normal (≥70%) participants. In Bangladesh and Indonesia G6PD activity was significantly higher during acute malaria than when the same individuals were retested during follow up (40.9% (95%CI: 33.4–48.1) and 7.4% (95%CI: 0.2 to 14.6) respectively), whereas in Ethiopia G6PD activity was 3.6% (95%CI: -1.0 to -6.1) lower during acute malaria. The change in G6PD activity was apparent in patients presenting with either P. vivax or P. falciparum infection. Overall, 66.7% (4/6) severely deficient participants and 87.2% (34/39) with intermediate deficiency had normal activities when presenting with malaria. These findings suggest that G6PD activity rises significantly and at clinically relevant levels during acute malaria. Prospective case-control studies are warranted to confirm the degree to which the predicted population attributable risks of drug induced haemolysis is lower than would be predicted from cross sectional surveys. Public Library of Science 2022-05-11 /pmc/articles/PMC9094517/ /pubmed/35544453 http://dx.doi.org/10.1371/journal.pntd.0010406 Text en © 2022 Ley et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Ley, Benedikt
Alam, Mohammad Shafiul
Satyagraha, Ari Winasti
Phru, Ching Swe
Thriemer, Kamala
Tadesse, Dagimawie
Shibiru, Tamiru
Hailu, Asrat
Kibria, Mohammad Golam
Hossain, Mohammad Sharif
Rahmat, Hisni
Poespoprodjo, Jeanne R.
Khan, Wasif Ali
Simpson, Julie A.
Price, Ric N.
Variation in Glucose-6-Phosphate Dehydrogenase activity following acute malaria
title Variation in Glucose-6-Phosphate Dehydrogenase activity following acute malaria
title_full Variation in Glucose-6-Phosphate Dehydrogenase activity following acute malaria
title_fullStr Variation in Glucose-6-Phosphate Dehydrogenase activity following acute malaria
title_full_unstemmed Variation in Glucose-6-Phosphate Dehydrogenase activity following acute malaria
title_short Variation in Glucose-6-Phosphate Dehydrogenase activity following acute malaria
title_sort variation in glucose-6-phosphate dehydrogenase activity following acute malaria
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9094517/
https://www.ncbi.nlm.nih.gov/pubmed/35544453
http://dx.doi.org/10.1371/journal.pntd.0010406
work_keys_str_mv AT leybenedikt variationinglucose6phosphatedehydrogenaseactivityfollowingacutemalaria
AT alammohammadshafiul variationinglucose6phosphatedehydrogenaseactivityfollowingacutemalaria
AT satyagrahaariwinasti variationinglucose6phosphatedehydrogenaseactivityfollowingacutemalaria
AT phruchingswe variationinglucose6phosphatedehydrogenaseactivityfollowingacutemalaria
AT thriemerkamala variationinglucose6phosphatedehydrogenaseactivityfollowingacutemalaria
AT tadessedagimawie variationinglucose6phosphatedehydrogenaseactivityfollowingacutemalaria
AT shibirutamiru variationinglucose6phosphatedehydrogenaseactivityfollowingacutemalaria
AT hailuasrat variationinglucose6phosphatedehydrogenaseactivityfollowingacutemalaria
AT kibriamohammadgolam variationinglucose6phosphatedehydrogenaseactivityfollowingacutemalaria
AT hossainmohammadsharif variationinglucose6phosphatedehydrogenaseactivityfollowingacutemalaria
AT rahmathisni variationinglucose6phosphatedehydrogenaseactivityfollowingacutemalaria
AT poespoprodjojeanner variationinglucose6phosphatedehydrogenaseactivityfollowingacutemalaria
AT khanwasifali variationinglucose6phosphatedehydrogenaseactivityfollowingacutemalaria
AT simpsonjuliea variationinglucose6phosphatedehydrogenaseactivityfollowingacutemalaria
AT pricericn variationinglucose6phosphatedehydrogenaseactivityfollowingacutemalaria