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This article is part of the supplement: Infectious diseases of the nervous system: pathogenesis and worldwide impact

Open Access Poster presentation

Opposed plasma levels of endothelin-1 and C-type natriuretic peptide in children with Plasmodium falciparum malaria

Anelia Dietmann13*, Peter Lackner1, Raimund Helbok13, Katharina Spora13, Bertrand Lell23, Saadou Issifou2, Markus Reindl1, Peter Kremsner23 and Erich Schmutzhard1

Author Affiliations

1 Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria

2 Department of Parasitology, Institute of Tropical Medicine, University of Tübingen, Germany

3 Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon

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BMC Proceedings 2008, 2(Suppl 1):P16  doi:

The electronic version of this article is the complete one and can be found online at:

Published:23 September 2008

© 2008 Dietmann et al; licensee BioMed Central Ltd.


Molecular mechanisms involved in the pathogenesis of severe Plasmodium falciparum (Pf) malaria (SM), are not yet fully understood. Both endothelin-1 (ET-1) and C-type natriuretic peptide (CNP) are produced by vascular endothelium and act locally as paracrine regulators of vascular tone, ET-1 being a potent vasoconstrictor and CNP having strong vasorelaxant properties.


We studied plasma levels of ET-1 and N-terminal fragments of CNP (NT-proCNP) on admission and after 24 hours of treatment, using enzyme-linked-immunosorbent-assay (ELISA) technique, in Gabonese children with severe Pf malaria (SM, n = 50), with uncomplicated Pf malaria (UM, n = 39) and healthy controls (HC, n = 25).


Plasma levels of ET-1 were significantly higher in malaria patients compared to HC (p < 0.001) and levels were significantly higher in UM patients compared to HC (p < 0.001) and a trend towards higher levels than SM (p = 0.085). Plasma levels of NT-proCNP were significantly lower in SM malaria patients compared to HC (p = 0.034), whereas no significant difference was found for UM patients compared to HC.


We could show an imbalance between the vasoconstricitve and vasorelaxant endothelium-derived substances ET-1 and CNP in the plasma of children with Pf malaria, probably in favor of vasoconstrictive and pro-inflammatory effects. Our results may reflect endothelial cell damage. We provide evidence for a critical involvement of ET-1 and CNP in SM pathogenesis and would like to point to the importance of further investigation of the vascular entity, in particular endothelial cells, and their way of contributing to the development of severe malaria with its devastating multi-organ complications.