Research ArticleMalaria

Malaria in pregnancy alters l-arginine bioavailability and placental vascular development

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Science Translational Medicine  07 Mar 2018:
Vol. 10, Issue 431, eaan6007
DOI: 10.1126/scitranslmed.aan6007

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Malaria relief, one amino acid at a time

Malaria infection during pregnancy can disrupt placental vasculature and cause complications during the pregnancy and delivery. Nitric oxide plays a key role in placental vascular function, and its synthesis requires l-arginine. Knowing that l-arginine and nitric oxide are both depleted during malaria-induced hemolysis and that many people in malaria-endemic areas lack sufficient l-arginine in their diets, McDonald et al. examined the effects of dietary l-arginine supplementation. The authors first studied a cohort of pregnant women in Malawi and showed that the blood of patients with malaria had less l-arginine and that this was associated with worse pregnancy outcomes. Conversely, l-arginine supplementation in a mouse model of malaria in pregnancy improved fetal weight and viability, indicating the potential value of this intervention.