Abstract:
The reduction of red cell deformability in infected and uninfected red blood cells
was observed in malaria patients. It was hypothesized that reduction of red cell
deformability may be caused by free radical damage from oxidative stress. The parasite’s
hemoglobin degradation was the source of oxidative stress. This process produced free
radical, oxidizing agents and pro-oxidizing agents when the schizonts ruptured. These free
radicals and oxidizing agents attack the red cell membrane it lead to a loss of
deformability. In this study, normal red blood cells were incubated with the reagents
hemin, hemoglobin, ß-hematin and hydrogen peroxide. Red cell deformability was
determined by Laser Optical Rotational Cell Analyser (LORCA). Red cell deformability
was reduced significantly when incubated with hemin and hydrogen peroxide (P<0.01)
but not with hemoglobin and ß-hematin (P>0.05). The effect of N- acetylcysteine was
studied by simultaneously adding hemin and normal red blood cells. The results showed
that N-acetyslcysteine significantly affected inhibition of reduction in red cell
deformability (P<0.01). Moreover, N-acetylcysteine can also reverse the reduction of
RCD (P<0.01). These studies showed that reduction of red cell deformability in malaria
can occur by free radicals generated from oxidative stress. The source of oxidative stress
was the process of hemoglobin degradation. The effect of N-acetylcysteine as an
antioxidant could prevent and reverse the reduction of red cell deformability. Thus, Nacetylcysteine
might be of benefit as an adjunctive therapy in severe falciparum malaria