iNOS promoter variants and severe malaria in Ghanaian children

Trop Med Int Health. 2004 Oct;9(10):1074-80. doi: 10.1111/j.1365-3156.2004.01312.x.


Nitric oxide is an important mediator in the host defence against Plasmodium falciparum malaria. It has antiparasitic effects in vitro. However, its role in clinical disease remains controversial. Polymorphisms in the inducible nitric oxide synthase promoter (iNOS; -954G-->C, -1173C-->T, -2.6 kb CCTTT(n) microsatellite) may influence susceptibility to and severity of malaria. We tested this hypothesis in a case-control study among Ghanaian children with severe malaria (SM) and asymptomatic parasitaemia, respectively, and in healthy controls. In this study, the respective frequencies of iNOS-954G-->C and -1173C-->T did not differ between groups but > or =13 microsatellite copies were associated with SM. -954G-->C and -1173C-->T were in linkage disequilibrium with CCTTT(8) and CCTTT(13), respectively. -954G-->C/CCTTT(8) protected against hyperparasitaemia whereas -1173C-->T/CCTTT(13) increased fatality. These findings suggest that iNOS promoter haplotypes rather than single nucleotide polymorphisms are associated with malaria in Ghanaian children.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Child
  • Child, Preschool
  • Female
  • Gene Frequency
  • Genetic Predisposition to Disease*
  • Genotype
  • Haplotypes
  • Humans
  • Infant
  • Linkage Disequilibrium
  • Malaria / genetics*
  • Male
  • Microsatellite Repeats
  • Nitric Oxide Synthase / genetics*
  • Nitric Oxide Synthase Type II
  • Polymorphism, Single Nucleotide
  • Promoter Regions, Genetic / genetics*


  • NOS2 protein, human
  • Nitric Oxide Synthase
  • Nitric Oxide Synthase Type II