Biochemical role of zinc in vivax malaria

Introduction and Aim: Zinc is a micronutrient that has a significant immune modulatory function, its deficiency is known to increase the risk of plasmodium infection in humans Although inflammatory processes contribute to the elimination of plasmodium, persistent inflammation is the underlying cause of malaria pathology. Cholinesterases are carboxypeptidases that are zinc dependent and are the indicators of low-grade inflammation. Plasma butyryl cholinesterase, is a biomarker of dietary status of zinc. Matrix metalloproteinases (MMP) are endopeptidases that contain zinc which take part in inflammatory reactions. They participate in remodeling of extracellular matrix and aid tissue repair. The current investigation aims to study the association of these metalloproteins with zinc in patients with vivax malaria. Materials and methods: Plasma zinc, butyrylcholinesterase (BChE) and erythrocyte acetylcholinesterase (AChE) were estimated spectrophotometrically in 100 vivax malaria patients and 50 healthy subjects. MMP9 was determined using ELISA. Results: Plasma zinc was markedly lower in malaria patients compared to healthy controls (p<0.05). Both BChE and AChE decreased significantly in malaria (p<0.00) compared to healthy subjects. There was an elevation of MMP9 in malaria, although the increase was statistically insignificant. Cholinesterases correlated positively with zinc in controls and malaria. MMP9 showed a significant positive correlation with zinc in malaria patients (r=0.405, p=0.05). Conclusion: The study highlights the role of zinc in the pathology of malaria as it is essential for the maintenance of several enzyme activities. Further, prompt administration of micronutrients like zinc may reduce the inflammation related morbidity in malaria.