Plasma levels of hsa‐miR‐3158‐3p microRNA on admission correlate with MRI findings and predict outcome in cerebral malaria

Severe Plasmodium falciparum malaria (SM) remains a leading cause of mortality worldwide and is characterized by a combination of unregulated inflammatory processes and sequestration of infected erythrocytes (IE) within microvessels. Recent reports identified age-specific magnetic resonance imaging (MRI) features on admission associated with CM fatality, namely brain swelling in children and decreased apparent diffusion coefficient (ADC) values indicative of global hypoxia in adults.2,3 Because neuroimaging facilities are rarely accessible in malaria-endemic countries, we investigated the potential of miRNAs, which are rapidly released upon organ damage, as biomarkers of such MRI features across different age groups in a cohort of Indian patients. [...]elevated circulating levels of hsa-miR-3158-3p were reported in patients recovering from ischemic stroke.8 Its expression was also found significantly increased in an in vitro model of neurodegenerative disorders in response to oxidative stress.9 Hypoxic conditions trigger the production of reactive oxygen species and favor oxidative stress,10 potentially further contributing to the high plasma levels of hsa-miR-3158-3p observed in fatal CM patients. [...]hsa-miR-3158-3p represents a promising biomarker candidate for CM prognosis across age groups that may be considered instead of neuroimaging to monitor disease progression and, potentially, inform clinical management in the future by helping the selection of adjunctive treatment targeting brain swelling and/or hypoxic injury.