Iron Chelation as a Chemotherapeutic Strategy for Falciparum Malaria

Victor R. Gordeuk MetroHealth Medical Center, Case Western Reserve University, Hershey Medical Center, Pennsylvania State University, Macha Mission Hospital, Choma, Zambia, Ciba-Geigy Limited, Institute of Pathology, Case Western Reserve University, Cleveland, Ohio, Switzerland

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Philip E. Thuma MetroHealth Medical Center, Case Western Reserve University, Hershey Medical Center, Pennsylvania State University, Macha Mission Hospital, Choma, Zambia, Ciba-Geigy Limited, Institute of Pathology, Case Western Reserve University, Cleveland, Ohio, Switzerland

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Gary M. Brittenham MetroHealth Medical Center, Case Western Reserve University, Hershey Medical Center, Pennsylvania State University, Macha Mission Hospital, Choma, Zambia, Ciba-Geigy Limited, Institute of Pathology, Case Western Reserve University, Cleveland, Ohio, Switzerland

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Godfrey Biemba MetroHealth Medical Center, Case Western Reserve University, Hershey Medical Center, Pennsylvania State University, Macha Mission Hospital, Choma, Zambia, Ciba-Geigy Limited, Institute of Pathology, Case Western Reserve University, Cleveland, Ohio, Switzerland

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Stenford Zulu MetroHealth Medical Center, Case Western Reserve University, Hershey Medical Center, Pennsylvania State University, Macha Mission Hospital, Choma, Zambia, Ciba-Geigy Limited, Institute of Pathology, Case Western Reserve University, Cleveland, Ohio, Switzerland

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Gracious Simwanza MetroHealth Medical Center, Case Western Reserve University, Hershey Medical Center, Pennsylvania State University, Macha Mission Hospital, Choma, Zambia, Ciba-Geigy Limited, Institute of Pathology, Case Western Reserve University, Cleveland, Ohio, Switzerland

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Peter Kalense MetroHealth Medical Center, Case Western Reserve University, Hershey Medical Center, Pennsylvania State University, Macha Mission Hospital, Choma, Zambia, Ciba-Geigy Limited, Institute of Pathology, Case Western Reserve University, Cleveland, Ohio, Switzerland

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Abraham M'Hango MetroHealth Medical Center, Case Western Reserve University, Hershey Medical Center, Pennsylvania State University, Macha Mission Hospital, Choma, Zambia, Ciba-Geigy Limited, Institute of Pathology, Case Western Reserve University, Cleveland, Ohio, Switzerland

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Dean Parry MetroHealth Medical Center, Case Western Reserve University, Hershey Medical Center, Pennsylvania State University, Macha Mission Hospital, Choma, Zambia, Ciba-Geigy Limited, Institute of Pathology, Case Western Reserve University, Cleveland, Ohio, Switzerland

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A. A. Poltera MetroHealth Medical Center, Case Western Reserve University, Hershey Medical Center, Pennsylvania State University, Macha Mission Hospital, Choma, Zambia, Ciba-Geigy Limited, Institute of Pathology, Case Western Reserve University, Cleveland, Ohio, Switzerland

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Masamichi Aikawa MetroHealth Medical Center, Case Western Reserve University, Hershey Medical Center, Pennsylvania State University, Macha Mission Hospital, Choma, Zambia, Ciba-Geigy Limited, Institute of Pathology, Case Western Reserve University, Cleveland, Ohio, Switzerland

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To examine the effect of iron chelation against human malaria, 37 Zambians with asymptomatic Plasmodium falciparum infections were randomly assigned to 72-hr infusions of desferrioxamine B or placebo. Mean concentrations of ring forms decreased significantly with desferoxamine B (P < 0.001) but not with a placebo. Over seven days of observation, mean parasite concentrations remained at the initial levels in six individuals originally given placebo, but decreased promptly with administration of desferrioxamine B (P = 0.001). Mean parasitemia was significantly lower for up to four weeks in 16 subjects treated with desferrioxamine B when compared with the eight who had received placebo only (P = 0.027). We conclude that iron chelation has antiplasmodial activity and may offer a new therapeutic strategy for falciparum malaria.

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