P-glycoprotein expression in human cerebral malaria: a preliminary study

Background: P-glycoprotein is an efflux protein, which is expressed on several cell types, including vascular endothelial cells lining brain capillaries. The expression and activity of P-glycoprotein can be modulated under conditions, including inflammatory process. Cerebral malaria (CM), a complication caused by infections of Plasmodium falciparum, is considered an inflammatory disease.

Objective: We determined P-glycoprotein expression at protein levels in human CM brain capillaries.

Methods: Four brains, three CM and one control, were subjected to a postmortem study. The brain capillaries were isolated from cerebellum, cerebral cortex, striatum, and brainstem and analyzed for expression of P-glycoprotein using SDS-PAGE and western blot techniques. The expression levels in CM brain capillaries were assessed by comparing with that in control brain capillaries.

Results: P-glycoprotein decreased in all CM brain capillaries isolated from striatum, while two of three cerebellums showed the reduction, compared with the control. For cerebral cortex and brainstem brain capillaries, the expression decreased only in one of three CM subjects.

Conclusion: P-glycoprotein expression levels were modulated in CM brain capillaries, suggesting an involvement of P-glycoprotein in CM.