Inhibition of Plasmodium falciparum Field Isolates-Mediated Endothelial Cell Apoptosis by Fasudil: Therapeutic Implications for Severe Malaria

Plasmodium falciparum infection can abruptly progress to severe malaria, a life-threatening complication resulting from sequestration of parasitized red blood cells (PRBC) in the microvasculature of various organs such as the brain and lungs. PRBC adhesion can induce endothelial cell (EC) activation and apoptosis, thereby disrupting the blood-brain barrier. Moreover, hemozoin, the malarial pigment, induces the erythroid precursor apoptosis. Despite the current efficiency of antimalarial drugs in killing parasites, severe malaria still causes up to one million deaths every year. A new strategy targeting both parasite elimination and EC protection is urgently needed in the field. Recently, a rho-kinase inhibitior Fasudil, a drug already in clinical use in humans for cardio- and neuro-vascular diseases, was successfully tested on laboratory strains of P. falciparum to protect and to reverse damages of the endothelium. We therefore assessed herein whether Fasudil would have a similar efficiency on P. falciparum taken directly from malaria patients using contact and non-contact experiments. Seven (23.3%) of 30 PRBC preparations from different patients were apoptogenic, four (13.3%) acting by cytoadherence and three (10%) via soluble factors. None of the apoptogenic PRBC preparations used both mechanisms indicating a possible mutual exclusion of signal transduction ligand. Three PRBC preparations (42.9%) induced EC apoptosis by cytoadherence after 4 h of coculture (“rapid transducers”), and four (57.1%) after a minimum of 24 h (“slow transducers”). The intensity of apoptosis increased with time. Interestingly, Fasudil inhibited EC apoptosis mediated both by cell-cell contact and by soluble factors but did not affect PRBC cytoadherence. Fasudil was found to be able to prevent endothelium apoptosis from all the P. falciparum isolates tested. Our data provide evidence of the strong anti-apoptogenic effect of Fasudil and show that endothelial cell-P. falciparum interactions are more complicated than previously thought. These findings may warrant clinical trials of Fasudil in severe malaria management

In vitro antiplasmodial activity and cytotoxicity of extracts and fractions of Vitex madiensis, medicinal plant of Gabon.

International audienceVitex madiensis Oliv. (Lamiaceae) is traditionally used to treat malaria symptoms in Haut-Ogooué, Gabon. Leaves and stem barks extracts were obtained using dichloromethane (CH(2)Cl(2)), ethyl acetate (EtOAc) and methanol (MeOH) as extraction solvents and fractionated on silica gel column. The in vitro antiplasmodial activity of CH(2)Cl(2), EtOAc and MeOH extracts and fractions was evaluated against the chloroquine-resistant FCB strain and field isolates of Plasmodium falciparum using the DELI test. The cytotoxicity of the extracts was tested on MRC-5 and THP1 cells using the tetrazolium salt MTT colorimetric assay, and the selectivity index (SI) of each extract was calculated. CH(2)Cl(2) extract, the EA1 fraction from EtOAc extract of stem barks and cyclohexane (L(cycl)), dichloromethane (L(DM)) and butanol (L(but)) fractions from MeOH/H(2)O extract of leaves exhibited the highest in vitro antiplasmodial activity on FCB strain and field isolates (IC(50) from 0.53 to 4.87 μg/ml) with high selectivity index (of 20.15-1800). These data support the use of V. madiensis in malaria treatment along with continued investigations within traditional medicines in the search of new antimalarial agents. The EA1, C(6)H(12) and CH(2)Cl(2) fractions could be selected for future investigation or/and for the treatment of malaria symptoms after standardization