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Background <p>Endocan, a component of endothelial glycocalyx, is a recognized biomarker of endothelial dysfunction in various inflammatory and infectious diseases. Malaria, characterized by marked endothelial activation and microvascular pathology, may&#xa0;involve&#xa0;endocan, but&#xa0;its&#xa0;role&#xa0;remains&#xa0;unclear. This study aimed to assess serum endocan levels in various clinical presentations of malaria and evaluate its correlation with laboratory parameters of disease severity.</p> Methods <p>Leftover serum samples from 99 participants were categorized into four groups: healthy controls (n = 20),&#xa0;<i>Plasmodium vivax</i>&#xa0;malaria (n = 36), uncomplicated&#xa0;<i>Plasmodium falciparum</i>&#xa0;malaria (n = 30), and severe&#xa0;<i>P. falciparum</i>&#xa0;malaria (n = 13). Serum endocan concentrations were measured via enzyme-linked immunosorbent assay on day 0 (pre-treatment) and day 7 (post-treatment). Correlation analyses examined associations between endocan levels and laboratory parameters, including parasite density, white blood cell count, haemoglobin, and platelet count.</p> Results <p>All malaria groups showed significantly higher serum endocan levels compared to healthy controls (p &lt; 0.0001). Levels were highest in severe&#xa0;<i>P. falciparum</i>&#xa0;(median 4.67 [IQR 2.85–7.93] ng/ml), followed by uncomplicated&#xa0;<i>P. falciparum</i>&#xa0;(median 3.27 [IQR 2.24–4.33] ng/ml), and&#xa0;<i>P. vivax</i>&#xa0;malaria (median 1.85 [IQR 1.44–3.23] ng/ml). Endocan correlated positively with parasite density in&#xa0;<i>P. vivax</i>&#xa0;(<i>r</i><sub><i>s</i></sub> = 0.4632, <i>p</i> = 0.0066) and severe&#xa0;<i>P. falciparum</i>&#xa0;malaria (<i>r</i><sub><i>s</i></sub> = 0.6264, <i>p</i> = 0.0251) and negatively with platelet count in&#xa0;<i>P. vivax</i>&#xa0;infections (<i>r</i><sub><i>s</i></sub> = −&#xa0;0.5523, <i>p</i> = 0.001).</p> Conclusion <p>Serum endocan is elevated in malaria in a severity-dependent manner—highest in severe&#xa0;<i>P. falciparum</i> malaria—and correlates with circulating parasite density and thrombocytopenia, highlighting its potential as a biomarker of endothelial injury in malaria.</p>

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Preliminary assessment of serum endocan as a biomarker of disease severity in Plasmodium falciparum and Plasmodium vivax malaria

  • 期刊论文

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  • 发表日期：

    2025年7月18日

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  • Kwannan Nantavisai,
  • Srisombat Puttikamonkul,
  • Parnpen Viriyavejakul

摘要

Background

Endocan, a component of endothelial glycocalyx, is a recognized biomarker of endothelial dysfunction in various inflammatory and infectious diseases. Malaria, characterized by marked endothelial activation and microvascular pathology, may involve endocan, but its role remains unclear. This study aimed to assess serum endocan levels in various clinical presentations of malaria and evaluate its correlation with laboratory parameters of disease severity.

Methods

Leftover serum samples from 99 participants were categorized into four groups: healthy controls (n = 20), Plasmodium vivax malaria (n = 36), uncomplicated Plasmodium falciparum malaria (n = 30), and severe P. falciparum malaria (n = 13). Serum endocan concentrations were measured via enzyme-linked immunosorbent assay on day 0 (pre-treatment) and day 7 (post-treatment). Correlation analyses examined associations between endocan levels and laboratory parameters, including parasite density, white blood cell count, haemoglobin, and platelet count.

Results

All malaria groups showed significantly higher serum endocan levels compared to healthy controls (p < 0.0001). Levels were highest in severe P. falciparum (median 4.67 [IQR 2.85–7.93] ng/ml), followed by uncomplicated P. falciparum (median 3.27 [IQR 2.24–4.33] ng/ml), and P. vivax malaria (median 1.85 [IQR 1.44–3.23] ng/ml). Endocan correlated positively with parasite density in P. vivax (rs = 0.4632, p = 0.0066) and severe P. falciparum malaria (rs = 0.6264, p = 0.0251) and negatively with platelet count in P. vivax infections (rs = − 0.5523, p = 0.001).

Conclusion

Serum endocan is elevated in malaria in a severity-dependent manner—highest in severe P. falciparum malaria—and correlates with circulating parasite density and thrombocytopenia, highlighting its potential as a biomarker of endothelial injury in malaria.