Publications des scientifiques de l'IRD

Mwanga-Amumpaire J., Carroll R. W., Baudin E., Kemigisha E., Nampijja D., Mworozi K., Santorino D., Nyehangane D., Nathan D. I., Beaudrap de Pierre, Etard Jean-François, Feelisch M., Fernandez B. O., Berssenbrugge A., Bangsberg D., Bloch K. D., Boum Y., Zapol W. M. (2015). Inhaled nitric oxide as an adjunctive treatment for cerebral malaria in children : a phase II randomized open-label clinical trial. Open Forum Infectious Diseases, 2 (3), p. [9 p.]. ISSN 2328-8957.

Titre du document
Inhaled nitric oxide as an adjunctive treatment for cerebral malaria in children : a phase II randomized open-label clinical trial
Année de publication
2015
Type de document
Article référencé dans le Web of Science WOS:000365786500027
Auteurs
Mwanga-Amumpaire J., Carroll R. W., Baudin E., Kemigisha E., Nampijja D., Mworozi K., Santorino D., Nyehangane D., Nathan D. I., Beaudrap de Pierre, Etard Jean-François, Feelisch M., Fernandez B. O., Berssenbrugge A., Bangsberg D., Bloch K. D., Boum Y., Zapol W. M.
Source
Open Forum Infectious Diseases, 2015, 2 (3), p. [9 p.] ISSN 2328-8957
Background. Children with cerebral malaria (CM) have high rates of mortality and neurologic sequelae. Nitric oxide (NO) metabolite levels in plasma and urine are reduced in CM. Methods. This randomized trial assessed the efficacy of inhaled NO versus nitrogen (N-2) as an adjunctive treatment for CM patients receiving intravenous artesunate. We hypothesized that patients treated with NO would have a greater increase of the malaria biomarker, plasma angiopoietin-1 (Ang-1) after 48 hours of treatment. Results. Ninety-two children with CM were randomized to receive either inhaled 80 part per million NO or N-2 for 48 or more hours. Plasma Ang-1 levels increased in both treatment groups, but there was no difference between the groups at 48 hours (P = not significant [NS]). Plasma Ang-2 and cytokine levels (tumor necrosis factor-alpha, interferon-., interleukin [IL]-1 beta, IL-6, IL-10, and monocyte chemoattractant protein-1) decreased between inclusion and 48 hours in both treatment groups, but there was no difference between the groups (P = NS). Nitric oxide metabolite levels-blood methemoglobin and plasma nitrate-increased in patients treated with NO (both P<.05). Seven patients in the N-2 group and 4 patients in the NO group died. Five patients in the N-2 group and 6 in the NO group had neurological sequelae at hospital discharge. Conclusions. Breathing NO as an adjunctive treatment for CM for a minimum of 48 hours was safe, increased blood methemoglobin and plasma nitrate levels, but did not result in a greater increase of plasma Ang-1 levels at 48 hours.
Plan de classement
Santé : généralités [050] ; Entomologie médicale / Parasitologie / Virologie [052]
Description Géographique
OUGANDA
Localisation
Fonds IRD [F B010068854]
Identifiant IRD
fdi:010068854
Contact