IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 17, Issue 2 Ver. 6 February. (2018), PP 69-72 www.iosrjournals.org DOI: 10.9790/0853-1702066972 www.iosrjournals.org 69 | Page Does Artesunate Treatment normalize Depressed Immunological Parameters Following Plasmodium falciparum Infection? Teddy Charles Adias 1 , Diweni Pere Dick 2 , Vera Achuonye 2 , Joseph Ogwo 2 1 (Department of Microbiology, Faculty of Science/ Federal University Otuoke, Nigeria) 2 (Bayelsa State College of Health Technology/Bayelsa State, Nigeria) Corresponding author: * Teddy Charles Adias Abstract : Plasmodium falciparum is the predominant cause of malaria infection and death in Nigeria and Africa. It perturbs the normal process of immune cells, of which CD 4 + T cells have a crucial relevance for anti- malarial immunity. The study aims at determining the effect of artesunate treatment on immunological parameters following Plasmodium falciparum malaria. A randomized non-block experimental design was conducted for the study at Bayelsa State College of Health Technology, Otuogidi-Ogbia, Bayelsa State, Nigeria, between February 2015 and April 2017. Out of 90 subjects enrolled into the study, data collected from 80 subjects (38 males, 42 females, and age range 18-59 years) were analyzed. 40 of the subjects had P. falciparum malaria and the other 40 were negative and were used as controls. 3 ml of blood was collected from the antecubital vein of each enrollee without stasis using a disposable plastic syringe and dispensed into K-EDTA bottles. Immuno-phenotyping was done using the AuRICA system. 20 of the malaria subjects had lymphopenia at presentation. The white cell count was also reduced (P = .05) among the malaria subjects compared with the controls. There was a significant increase in WBC count on completion of the 5-day treatment with the drug (P = .05). Although an increase in the CD4 count after treatment was observed, the mean CD4 count of 1008.1/μl for normal subjects was significantly higher (P = .05) than 889.76/μl for the malaria patients. We conclude that Plasmodium falciparum infection is associated with strong decrease in CD4+ cell activation and depletion of WBC counts. Artesunate in addition to other effects possess immune reconstituting properties. Keywords: Antimalarial Treatment, Artesunate, CD4 Count, Immunophenotying, and Malaria --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 02-02-2018 Date of acceptance: 17-02-2018 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Malaria is caused by the intracellular protozoan Plasmodium. Currently, there are five known species: P. falciparum, P. malariae, P. ovale, P. vivax and P. Knowlesi [1]. However, P. falciparum is the cause of about 80% of infections and 91% of deaths [2]. According to the WHO, malaria causes about 596,000 deaths annually in Africa [2]. Malaria parasites are known to perturb the normal profile of immune cells. Immunity against malaria can be acquired after infection and its protective efficacy depends on host characteristics, place of stay, number of infections suffered etc. This acquired immunity has been graded as anti-disease immunity (that protects against clinical disease), anti-parasite immunity (protects against high parasitemia), and sterilizing immunity (protects against new infections by maintaining a low-grade, asymptomatic parasitemia). The acquired anti-malaria immunity has been demonstrated to be strain and stage specific, with cross reactivity [3]. Cells concerned with anti-malarial immune response comprise neutrophils, activated macrophages, Natural Killer (NK) cells, dendritic cells, and T-cells. CD4 + T cells (of both the T H 1 and T H 2 subtypes) have a crucial relevance for anti-malarial immune protection against asexual blood stage infections [4]. The naturally acquired immunity against P. falciparum takes years to develop, at least partly due to a very effective immune evasion strategy mediated by naturally occurring variants of the same antigen epitopes which are capable of inhibiting memory T cells [5]. It can also be explained by the fact that the parasite actively modulates the immune system of the host, preventing the development of specific immune responses [6]. In the absence of re-infection for a long period, this acquired immunity can be lost. Thus, malaria infection does not induce long-term immunity, and antimalarial drug treatment is expedient. Artesunate is the most rapidly acting and potent antimalarial drug [7]. It is a semi-synthetic derivative of Artemisinin which is the principal active constituent of the plant Artemisia annua. In addition to their activity against multi-drug resistant P. falciparum, artemisinin and its derivatives possess antiviral [8], antifungal [9] and anti-inflammatory effects [10]. They can be administered once every day and are safer and easier than quinine. Artesunate or artemether given orally are an essential component of the combination treatment of uncomplicated falciparum malaria, which is now accepted as the treatment of choice [11]. We therefore aimed at determining the effect of artesunate treatment on depressed immunological parameters following Plasmodium falciparum malaria.