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. 2024 Mar 22:12:e17084.
doi: 10.7717/peerj.17084. eCollection 2024.

Malaria: biochemical, physiological, diagnostic, and therapeutic updates

Enas El Saftawy  1   2 , Mohamed F Farag  3 , Hossam H Gebreil  4 , Mohamed Abdelfatah  3 , Basma Emad Aboulhoda  5 , Mansour Alghamdi  6   7 , Emad A Albadawi  8 , Marwa Ali Abd Elkhalek  4   9
Affiliations

Malaria: biochemical, physiological, diagnostic, and therapeutic updates

Enas El Saftawy et al. PeerJ. .

Abstract

Background: Malaria has been appraised as a significant vector-borne parasitic disease with grave morbidity and high-rate mortality. Several challenges have been confronting the efficient diagnosis and treatment of malaria.

Method: Google Scholar, PubMed, Web of Science, and the Egyptian Knowledge Bank (EKB) were all used to gather articles.

Results: Diverse biochemical and physiological indices can mirror complicated malaria e.g., hypoglycemia, dyslipidemia, elevated renal and hepatic functions in addition to the lower antioxidant capacity that does not only destroy the parasite but also induces endothelial damage. Multiple trials have been conducted to improve recent points of care in malaria involving biosensors, lap on-chip, and microdevices technology. Regarding recent therapeutic trials, chemical falcipain inhibitors and plant extracts with anti-plasmodial activities are presented. Moreover, antimalaria nano-medicine and the emergence of nanocarrier (either active or passive) in drug transportation are promising. The combination therapeutic trials e.g., amodiaquine + artemether + lumefantrine are presented to safely counterbalance the emerging drug resistance in addition to the Tafenoquine as a new anti-relapse therapy.

Conclusion: Recognizing the pathophysiology indices potentiate diagnosis of malaria. The new points of care can smartly manipulate the biochemical and hematological alterations for a more sensitive and specific diagnosis of malaria. Nano-medicine appeared promising. Chemical and plant extracts remain points of research.

Keywords: Biochemical; Combination treatment; Malaria; Nanomedicine; Physiological; Plant extract; Point of care.

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Conflict of interest statement

The authors declare there are no competing interests.

Figures

Figure 1
Figure 1. Paradigm showing pathogenesis of malaria.
(A) Liver. (B) Kidney. (C) Oxidative stress.
Figure 2
Figure 2. A general paradigm for biosensors.
Figure 3
Figure 3. Paradigm of optical biosensors.
(A) SPR biosensors. Target analyte reacted with immobilized bioreceptors. Excitation of electrons in the metal film by inclined photons. Dissemination of electrons parallel to the metal surface (plasmon wave). Shifting in the refractive index (RI). (B) Surface-enhanced Raman spectroscopy. (1) Silicon (Si) substrate, (2) coating of Si substrates by polydi-allyl-dimethyl ammonium (PDDA), (3) assemblage of AuNps on PDDA, (4) formation of the poly-di-methylsiloxane (PDMS) layer, (5) embedding of Au Nps on PDMS, (6) hematin detection by Raman laser. (C) Fluorescence biosensors. The target analyte binds the bottom immobilized bioreceptor layer. Then a “Top bioreceptor layer” is detected by either (1) Abs- fluorescently-labeled Abs, (2) a double layer of antibodies (Abs)- fluorescently-labeled Abs, (3) or a monolayer of fluorescently-labeled aptamers.
Figure 4
Figure 4. Lab-on-a-chip and microfluidic system designs.
(A) Infected RBCs are displaced to the margins of the micro-channel wall (RBCs margination) whereas healthy RBCs migrate to the axial center due to gradients in the flow velocity. (B) Faster margination of infected RBCs was achieved by an externally applied magnetic field.
See this image and copyright information in PMC

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