Angiogenic proteins in brains of patients who died with cerebral malaria

J Neuroimmunol. 2003 Sep;142(1-2):101-11. doi: 10.1016/s0165-5728(03)00250-9.


In cerebral malaria (CM), microvascular activation accompanies blood-brain barrier dysfunction which in turn represents the pathophysiological basis of neurological impairments in affected patients. To dissect the molecular basis of this process, we analyzed localization of proangiogenic vascular endothelial growth factor (VEGF), its receptor vascular endothelial growth factor receptor-1 (VEGFR-1, Flt-1), of downstream VEGF effectors matrix-metalloproteinase-1 (MMP-1) and connective tissue growth factor (CTGF), and of VEGF-interacting antiangiogenic thrombospondin-1 and -independent angiostatin in brains of patients who died with CM and controls by immunohistochemistry and Western blotting experiments. Most prominently, we detected more VEGF(+) astrocytes in CM patients and deposition of Flt-1 in Dürck's granulomas. MMP-1 and thrombospondin-1 accumulated in macrophages/microglial cells in Dürck's granulomas. In one CM patient, massive amounts of CTGF were detected as perivascular paracellular deposits. Angiostatin was observed in the serum of 2/7 control but in no CM patients. These data demonstrate the activation of the proangiogenic VEGF signaling cascade in patients with CM, probably reflecting compensatory mechanisms of general and focal brain hypoxia observed in these patients.

Publication types

  • Comparative Study

MeSH terms

  • Angiogenic Proteins / analysis*
  • Angiostatins / analysis
  • Blotting, Western
  • Brain Chemistry*
  • Connective Tissue Growth Factor
  • Fluorescent Antibody Technique
  • Humans
  • Immediate-Early Proteins / analysis
  • Immunohistochemistry
  • Intercellular Signaling Peptides and Proteins / analysis
  • Malaria, Cerebral / enzymology
  • Malaria, Cerebral / metabolism*
  • Malaria, Cerebral / mortality
  • Malaria, Cerebral / pathology
  • Matrix Metalloproteinase 1 / analysis
  • Thrombospondin 1 / analysis
  • Vascular Endothelial Growth Factor A / analysis
  • Vascular Endothelial Growth Factor Receptor-1 / analysis


  • Angiogenic Proteins
  • CCN2 protein, human
  • Immediate-Early Proteins
  • Intercellular Signaling Peptides and Proteins
  • Thrombospondin 1
  • Vascular Endothelial Growth Factor A
  • Connective Tissue Growth Factor
  • Angiostatins
  • Vascular Endothelial Growth Factor Receptor-1
  • Matrix Metalloproteinase 1