Malaria immunosuppression

Varicella-zoster virus is a member of the Herpesviridae femily. The viral contagion is transmitted via aerosolized water droplets or close physical contact with infected lesions. The primary infection results in varicella or chickenpox. The varicella infection can have potentially devastating ocular sequelae the most common is anterior uveitis followed by SPK. After the primary infection, latent infection occurs in multiple ganglia throughout the body. Herpes zoster is the resultant reactivation of the latent varicella-zoster virus and most often occurs in elderly and immunocompromised patients. Factors such as physical and emotional trauma, immunosuppressive medications, irradiation, cancer, tuberculosis, malaria, and syphilis are known to reactivate the virus. 

Enzymes that are addressed by major drugs have been studied in particular detail. Thus, well above one hundred stmctures have been reported for dihydrofolate reductases from a variety of organisms, including major pathogens such as Mycobacterium tuberculosis, which is the causative agent of tuberculosis, and of Plasmodium falciparum, which is the most important of the Plasmodium spp. that causes malaria. The interaction of mammalian dihydrofolate reductases with inhibitors that are used as cytostatic agents and/or immunosuppressants is also documented extensively by X-ray stmctures. 

Transfusion-induced malaria may be a life-threatening complication, especially in patients who have been repeatedly transfused, treated with immunosuppressive drugs, or splenectomized (190). The disease is readily transmitted from asymptomatic donors with latent infection. Means of preventing and treating transfusion-transmitted malaria are well defined in current literature (191,192). To prevent malaria transmission, donors from malaria-endemic areas are now only accepted after spending 3 years in a malaria-free area this interval may well be too short. 

The Indianapolis-Ibadan Dementia Project also demonstrated the reverse side of the coin, and this too was passed off with little comment the mortality rate in the African cohort was nearly double that of the American cohort, despite their better cardiovascular health. What they died of is not stated. I imagine many must have died from infections or cancers. Studies in Tanzania, where malaria is also endemic, showed that the death rate fell substantially in regions where malaria had been controlled by draining swamps. The scale of this effect was larger than could be attributed directly to malaria, and prompted research into the hidden morbidity of malaria. This research has confirmed the suspicions immuno-suppression in areas where malaria is endemic perpetuates opportunistic infections, leading to the spread of diseases such as tuberculosis. In addition, cancers such as Burkitt s lymphoma (a malignant cancer of B cells) are common and linked with malarial immunosuppression, probably... 

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