Research Group Heussler (Malaria I) - Bernhard-Nocht-Institut für ...

More documents

Recommendations

Info

Clinical Department Cardiac impairment in falciparum malaria Zusammenfassung Eine Herzbeteiligung bei Malaria tropica wurde bisher als äusserst selten beschrieben. Eine Fall-Kontroll-Studie bei Europäern mit komplizierter und unkomplizierter Malaria tropica sollte diese Annahme verifizieren. Es wurden Serumkonzentrationen sensitiver und spezifischer Herzparameter wie das aminoterminale pro-brain natriuretic peptide (NT-proBNP) sowie das heart-type fatty acid-binding protein (H- FABP) neben Routineparametern für Myokardschädigung bestimmt. Es konnte gezeigt werden, dass es bei komplizierter Malaria, nicht aber bei unkomplizierter Malaria häufig zu einer Herzmuskelschädigung kommt, die sich durch erhöhte Serumkonzentrationen sensitiver Marker ausdrückt. Summary Cardiac impairment is thought to be rare in Plasmodium falciparum malaria. A case-control study in European travelers with uncomplicated and complicated falciparum malaria was conducted. Sensitive and specific markers for myocardial impairment like serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), heart-type fatty acid-binding protein (H-FABP), myoglobin, troponin T and CK-MB were compared. Elevated levels of NT-proBNP and H-FABP indicated substantial myocardial damage in complicated but not in uncomplicated falciparum malaria. 102 Project Description and Results Myocardial impairment in Plasmodium falciparum malaria is thought to be rare. Pulmonary edema is thought to be noncardiogenic in nature. In a case control study on severe malaria in children in northern Ghana it was felt that myocardial impairment might occur more often than expected. We conducted an unmatched case-control study in 63 patients with uncomplicated (n=52) and complicated (n=11) falciparum malaria. We measured the serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) as a sensitive marker of impaired left ventricular (LV) function, and heart-type fatty acid-binding protein (H-FABP) as a sensitive and specific marker of acute myocardial injury. Additionally we assessed myoglobin, creatine kinase muscle-brain (CK-MB), and troponin T (TnT) as established markers of myocardial injury. Cardiac impairment, as defined by elevated levels of cardiac specific markers, was found to be common in complicated but not in uncomplicated falciparum malaria. Our first results are to be verified in differernt ways. The pathogenesis of cardiac impairment is to be examined. Possible contributing factors include ischemia, acidosis, direct toxic effects of substances like glycosylphosphatidyl-inositol (GPI), or apoptosis. The latter is currently assessed in a murine model. Our results are also verified in a endemic population. Therefore, 200 serum samples of Ghanaian children with uncomplicated and 200 serum samples of children
with complicated falciparum malaria are currently analyzed. Furthermore, the clinical relevance of the obtained results will be assessed using techniques like echocardiography, magnetic resonance imaging and more invasive procedures like the transpulmonary double indicator dilution. We expect relevant insights into pathophysiology of the disease which might have impact on fluid management as well as on transfusion criteria. Selected Publications • Günther A, Grobusch MP, Slevogt H, Abel W, Burchard GD. Myocardial damage in falciparum malaria detectable by cardiac troponin T is rare. Trop Med Int Health 2003; 8: 30-32. • Ehrhardt S, Mockenhaupt FP, Agana-Nsiire P, Mathieu A, Anemana SD, Stark K, Otchwemah RN, Bienzle U. Efficacy of chloroquine in the treatment of uncomplicated, Plasmodium falciparum malaria in northern Ghana. Ann Trop Med Parasitol. 2002; 96:239-47. • Ehrhardt S, Mockenhaupt FP, Eggelte TA, Agana-Nsiire A, Stollberg C, Anemana SD, Otchwemah R, Bienzle U. Chloroquine blood concentrations and molecular markers of chloroquine-resistant Plasmodium falciparum in febrile children in northern Ghana. Trans R Soc Trop Med Hyg. 2003; 97, in press Cooperating Partners • PD Dr. Norbert W. Brattig, Department of Tropical Medicine, BNI • Dr. Christoph J. Hemmer, Department of Tropical Medicine and Infectious Diseases, University of Rostock Medical School, Rostock, Germany Investigators • Stephan Ehrhardt • Dominic Wichmann • Gerd D. Burchard 103 Clinical Department
Page 1 and 2:
BERNHARD NOCHT INSTITUTE FOR TROPIC
Page 3 and 4:
Human genetic variants influencing
Page 5 and 6:
Research Funding / Haushaltsmittel
Page 7 and 8:
Introduction The appearance of SARS
Page 9 and 10:
tive project with the Faculty of Me
Page 11 and 12:
since this group headed by Dr. Chri
Page 13 and 14:
Vorwort Das Erscheinen der schweren
Page 15 and 16:
AIDS-Forschung hat eine lange zurü
Page 17 and 18:
europäisches Konsortium mit 8 Part
Page 19 and 20:
Parasitology Section Selected Scien
Page 21 and 22:
Zusammenfassung des Sprechers Die S
Page 23 and 24:
Research Group Clos (Leishmaniasis
Page 25 and 26:
Figure 2: Incidence of ALA in Hué
Page 27 and 28:
jects were assigned to receive dilo
Page 29 and 30:
is increased in the first 24 h of h
Page 31 and 32:
the populations from the endemic ar
Page 33 and 34:
CQR Dd2. In order to determine whet
Page 35 and 36:
Project Description and Results A g
Page 37 and 38:
Project Description and Results Ado
Page 39 and 40:
39 Parasitology Section Figure 2: S
Page 41 and 42:
The paraflagellar rod, a crosshatch
Page 43:
Figure 1: Suggested in vivo develop
Page 46 and 47:
Medical Microbiology Section Chairm
Page 48 and 49:
Medical Microbiology Section Zusamm
Page 50 and 51: Medical Microbiology Section Medica
Page 52 and 53: Medical Microbiology Section Zusamm
Page 54 and 55: Medical Microbiology Section Murine
Page 56 and 57: Medical Microbiology Section The ro
Page 58 and 59: Medical Microbiology Section Zusamm
Page 60 and 61: Medical Microbiology Section Immunp
Page 62 and 63: Medical Microbiology Section Role o
Page 64 and 65: Medical Microbiology Section Elimin
Page 66 and 67: Medical Microbiology Section Charac
Page 68 and 69: Medical Microbiology Section Identi
Page 70 and 71: Medical Microbiology Section A dry-
Page 73 and 74: Tropical Medicine Section Selected
Page 75 and 76: Zusammenfassung des Sektionsspreche
Page 77 and 78: Kumasi Centre for Collaborative Res
Page 79 and 80: Data of twin studies and evidence f
Page 81 and 82: Figure 1: Changing patterns of mala
Page 83 and 84: Zusammenfassung In einer Studie an
Page 85 and 86: low level chronic replication of th
Page 87 and 88: The KCCR Team and the main laborato
Page 89 and 90: Kooperierende Institutionen • Kwa
Page 91: Figure 2: Study sites in and around
Page 94 and 95: Clinical Department Department Head
Page 96 and 97: Clinical Department Bericht des Abt
Page 98 and 99: Clinical Department Staff Clinical
Page 102 and 103: Clinical Department Persistence and
Page 104 and 105: 106
Page 106 and 107: Administration and Public Relations
Page 108 and 109: Administration and Public Relations
Page 110 and 111: 112
Page 112 and 113: Education and Teaching Diploma Thes
Page 114 and 115: Education and Teaching Parasitology
Page 116 and 117: Education and Teaching Lars Volkman
Page 118 and 119: Education and Teaching The objectiv
Page 120 and 121: Education and Teaching Ziel des Kur
Page 122 and 123: Education and Teaching Institute Fa
Page 124 and 125: Education and Teaching Lectures and
Page 126 and 127: Education and Teaching Training for
Page 128 and 129: Seminar Programme 2002 Prof. Aileen
Page 130 and 131: Seminar Programme Dr. Stefan Martin
Page 132 and 133: Symposia and Meetings 2002 Symposia
Page 134 and 135: Symposia and Meetings 2003 May 13 t
Page 136 and 137: 138
Page 138 and 139: Staff Activities Staff Activities A
Page 140 and 141: Staff Activities PD Dr. Joachim Clo
Page 142 and 143: Staff Activities Editorial Activiti
Page 144 and 145: Staff Activities Prof. Dr. Rolf Hor
Page 146 and 147: Staff Activities Prof. Dr. Christia
Page 148 and 149: Staff Activities Prof. Dr. Egbert T
Page 150 and 151:
152
Page 152 and 153:
Publications Book chapters and Mono
Page 154 and 155:
Publications Herbst R, Ott C, Jacob
Page 156 and 157:
Publications Supali T, Wibowo H, Ru
Page 158 and 159:
Publications Scholze H and Tannich
Page 160 and 161:
Publications Graefe SE, Meyer BS, M
Page 162 and 163:
Publications Schulz A, Mellenthin K
Page 164 and 165:
166
Page 166 and 167:
Appendix 01. Januar 2002 Das BNI wi
Page 168 and 169:
Appendix 01. Oktober 2002 Gemeinsam
Page 170 and 171:
Appendix 01. April 2003 Ergebnis de
Page 172 and 173:
Appendix 01. Juni 2003 Fernsehrepor
Page 174 and 175:
Appendix November 2003 Inauguration
Page 176 and 177:
Appendix red by solar energy could
Page 178 and 179:
Appendix Ansprache von Dr. Thomas F
Page 180 and 181:
Diary 2004/2005 12.-14. November 20
show all

Research Group Heussler (Malaria I) - Bernhard-Nocht-Institut für ...

Create successful ePaper yourself

Delete template?

Save as template?