Australasian Science: Australia's authority on science since 1938

New Treatment for Cerebral Malaria

By Stephen Luntz

A new class of anti-inflammatory drugs has saved mice infected with cerebral malaria, offering hope for patients who have been failed by existing lines of defence.

“The most severe forms of malaria, such as cerebral malaria, which causes brain damage, are actually the result of the immune system trying to fight infection and causing collateral damage,” says Dr Ariel Achtman. Anti-inflammatory drugs could act as peacekeepers in the body’s struggle, protecting the most vulnerable victims of the conflict.

“Cerebral malaria can be thought of like the tiny veins in the brain filling up with pus,” Achtman says. Applied sufficiently early, anti-malarial drugs can usually prevent such situations occurring, but by the time symptoms of severe clinical malaria develop these drugs are ineffective in one case in four.

Achtman and Dr Sandra Pilat-Carotta, both of the Walter and Eliza Hall Institute, revealed in Science Translational Medicine their use of innate defence regulators (IDR), a new class of anti-inflammatory peptides, in mice infected with Plasmodium berghei. “In this study, we showed IDRs could prevent inflammation in the brains of mice with malaria and improve their survival. This is an example of a ‘host-directed’ therapy – a treatment intended to act on the host, not the parasite,” Pilat-Carotta says.

The inflammatory response is the body’s way to fight the malaria parasite’s presence, but Achtman says the use of IDRs will not allow the parasite to flourish because “you would never give them on their own”. Accompanied by traditional anti-malarial drugs it should be possible to control the parasite while also preventing damage from the inflammatory response.

Concentrated among the world’s poorest, malaria often affects those without access to health care. Achtman agrees that, as a result, many victims of malaria may never get to benefit from IDRs. Even those arriving at a hospital in a coma may be beyond assistance.

However, Achtman says that IDRs are cheap and easy to administer. With the annual death toll from malaria in excess of a million people, a treatment that saves even a small proportion could offer huge benefits.

IDR peptides are a very new class of drugs that guide where cells travel in the body, in the process bolstering the initial immune response while reducing subsequent inflammation. Achtman says they have shown promise against cystic fibrosis and antibiotic-resistant bacteria, particularly since they also have a direct antimicrobial effect.