EFFECT OF PLASMODIUM-FALCIPARUM MALARIA INFECTION ON THE PLASMA-CONCENTRATION OF ALPHA-1-ACID GLYCOPROTEIN AND THE BINDING OF QUININE IN MALAWIAN CHILDREN

1 We have measured plasma concentrations of alpha-1-acid glycoprotein (AGP) in 18 healthy children and 85 children with falciparum malaria in Malawi. In addition, we determined the degree of protein binding of quinine (QN) in the plasma of 52 of the patients and each of the healthy controls. 2 The mean plasma AGP concentration was higher in patients than in controls (P < 0.0001) and remained elevated 3 weeks after complete resolution of malaria infection. 3 The mean unbound QN fraction was significantly less (P < 0.00001) in patients with malaria (0.128 +/- 0.037) than in controls (0.193 +/- 0.051) and significantly higher (P = 0.02) in convalescence (0.153 +/- 0.067) than during acute illness. 4 There were highly significant negative correlations between plasma AGP concentration and the free QN fraction in spiked plasma samples (r = -0.534, P < 0.0001, n = 93) and in clinical samples (r = -0.484, P < 0.00001, n = 225). There was a significant positive correlation between plasma concentrations of AGP and another acute phase reactant, C reactive protein (P < 0.001).