AJTMH Transactions of the Royal Society of Tropical Medicine and Hygiene
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Am. J. Trop. Med. Hyg., 71(5), 2004, pp. 542-545
Copyright © 2004 by The American Society of Tropical Medicine and Hygiene

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CEREBRAL METABOLIC REDUCTION IN SEVERE MALARIA: FLUORODEOXYGLUCOSE-POSITRON EMISSION TOMOGRAPHY IMAGING IN A PRIMATE MODEL OF SEVERE HUMAN MALARIA WITH CEREBRAL INVOLVEMENT

MUNEHIRO SUGIYAMA, EIJI IKEDA, SATORU KAWAI, TETSUYA HIGUCHI, HONG ZHANG, NASIM KHAN, KATSUMI TOMIYOSHI, TOMIO INOUE, HARUYASU YAMAGUCHI, KEN KATAKURA, KEIGO ENDO, AND MAMORU SUZUKI
Department of Parasitology and Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan; Department of Tropical Medicine and Parasitology, Dokkyo University School of Medicine, Mibu, Tochigi, Japan; Nishidai Clinic Diagnostic Imaging Center, Takashimadaira, Tokyo, Japan; Department of Radiology, Yokohama City University School of Medicine, Yokohama, Japan; Gunma University Graduate School of Health Sciences, Maebashi, Japan

Cerebral metabolic changes in Japanese macaques (Macaca fuscata) infected with Plasmodium coatneyi, a primate model of severe human malaria with cerebral involvement, were directly evaluated by fluorodeoxyglucose-positron emission tomography (FDG-PET). We observed diffuse and heterogeneous reduction of metabolism in the cerebral cortex in the acute phase of malaria infection. Neuropathologic examination showed preferential sequestration of parasitized red blood cells in the cerebral microvasculature. However, hemorrhagic change or necrosis was not observed in hematoxylin and eosin-stained and Nissl-stained brain tissues. This suggests that reduction of cerebral metabolism occurs before parenchymal changes appear in the brain. This may be one reason why more than half of the patients with cerebral malaria have no neurologic sequelae after recovery.

Received April 13, 2004. Accepted for publication June 14, 2004.

Acknowledgments: We thank Professor Fumio Goto and Dr. Hideaki Obata for their instruction on anesthesia, Dr. Jun Matsumoto, Dr. Akihiro Ichikawa, Erika Misaki, and Nao Taguchi for their help with the experiments, and Dr. Noboru Oriuchi and Dr. Hiroshi Kageyama for their valuable advice.

Financial support: This work was supported by Grants-in-Aid for Scientific Research (A) (11307004) and (C) (12670239) from the Ministry of Education, Science, Sports and Culture, Japan and a grant for Research on Emerging and Re-emerging Infectious Diseases (H12-Shinkou-17).

Authors’ addresses: Munehiro Sugiyama, Eiji Ikeda, Ken Katakura, and Mamoru Suzuki, Department of Parasitology, Gunma University Graduate School of Medicine, Maebashi, 371-8511 Japan, Fax: 81-27-220-8025, E-mails: musugijp{at}yahoo.co.jp, eulophidaejp{at}yahoo.co.jp, kenkata{at}vetmed.hokudai.ac.jp, and suzuki{at}med.gunma-u.ac.jp. Satoru Kawai, Department of Tropical Medicine and Parasitology, Dokkyo University School of Medicine, Mibu, Tochigi, 321-0293 Japan, Telephone: 81-282-87, Fax: 81-282-86-6431, E-mail: skawai{at}dokkyomed.ac.jp. Tetsuya Higuchi, Hong Zhang, Nasim Khan, and Keigo Endo, Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, 371-8511 Japan, Fax: 81-27-220-8025, E-mails: tetsuyah{at}showa.gunma-u.ac.jp, zhang{at}med.gunma-u.ac.jp, nasim{at}med.gunma-u.ac.jp, and endo{at}pop.med.gunma-u.ac.jp. Katsumi Tomiyoshi, Nishidai Clinic Diagnostic Imaging Center, 1-83-8 Takashimadaira, Tokyo, 175-0082 Japan. Fax: 81-282-86-6431, E-mail: tomiyoshi{at}ncdic.org. Tomio Inoue, Department of Radiology, Yokohama City University School of Medicine, Yokohama, Kanagawa, 236-0004 Japan, Fax: 81-282-86-6431, E-mail: tomioi{at}med.yokohama-cu.ac.jp. Haruyasu Yamaguchi, Gunma University Graduate School of Health Sciences, Maebashi, 371-8511 Japan, Fax: 81-27-220-8999, E-mail: yamaguti{at}health.gunma-u.ac.jp.

Reprint requests: Satoru Kawai, Department of Tropical Medicine and Parasitology, Dokkyo University School of Medicine, Mibu, Tochigi, 321-0293 Japan.




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S. KAWAI, E. IKEDA, M. SUGIYAMA, J. MATSUMOTO, T. HIGUCHI, H. ZHANG, N. KHAN, K. TOMIYOSHI, T. INOUE, H. YAMAGUCHI, et al.
ENHANCEMENT OF SPLENIC GLUCOSE METABOLISM DURING ACUTE MALARIAL INFECTION: CORRELATION OF FINDINGS OF FDG-PET IMAGING WITH PATHOLOGICAL CHANGES IN A PRIMATE MODEL OF SEVERE HUMAN MALARIA.
Am J Trop Med Hyg, March 1, 2006; 74(3): 353 - 360.
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