Alcohol and malaria

Full text

Submit Manuscript | http://medcraveonline.com
tropical countries.1,2 During gametocytogenenesis malaria parasites
hide in the bone marrow. Ethanol has an effect on bone marrow.
Biopsies from 30 alcohol-dependent individuals were investigated.
The ndings took the form of heightened ineffective erythropoiesis in
bone marrow associated with impaired iron utilization. Both may be
detrimental to the survival of the gametocytes.3 The effect of ethanol
on the in vitro growth of the malaria parasite Plasmodium falciparum
was investigated during six days of incubation. A signicant growth
inhibition for ethanol concentrations was observed on each day.
Malarial parasites are strongly inhibited by ethanol concentrations.4,5
Fever is accompanied by glycogen destruction. This was already
discovered more than 100 years ago. Glycogen disappears from the
liver during tetanus, diphtheria and pneumonia. A natural way of our
body to ght parasites and diseases. It makes thus complete nonsense
to ght fever in the early stages of a malaria infection.6,7 Alcohol
also removes glycogen from the liver.8 Chronic ethanol consumption
also results in a dramatic decrease in liver glycogen concentrations,
which could be related to either a depressed rate of synthesis or an
increased rate of breakdown.9 Macrophages, including Kupffer cells,
appear to increase their production of cytokines in patients with
alcoholic liver disease. Precursors of macrophages, i.e. monocytes
with alcohol induced hepatitis produce greater amounts of TNF-α and
reactive oxygen species. These data have been conrmed in animals.
Malaria parasites are destroyed by oxidative species, like NO, H2O2
or artemisinin peroxides.10‒12 Wine is efcient against other pathogens.
An in vitro study was undertaken to determine the potential for
survival of enteric pathogens in common drinking beverages. Three
carbonated soft drinks, two alcoholic beverages, skim milk, and
water were inoculated with Salmonella, Shigella, and enterotoxigenic
Escherichia coli and quantitative counts were performed over 2 days.
The study showed poorest survival of all three organisms in wine, and
greatest growth in milk and water.
Long-term intake of alcohol affects the immune system. Serum
levels of immunoglobulins (total IgE, IgG, IgM, and IgA) therefore,
were analyzed in adult chronic alcoholics in Indian population and
were correlated with different epidemiological and alcohol-related
parameters. The results showed that 98% of alcoholics had abnormal
immunoglobulin levels and 92% showed high or very high total serum
IgE levels compared to 24% of the control group. Several other studies
have shown that that total serum IgE concentrations are increased in
moderate alcohol consumers with respect to abstainers. This increase
is independent of cofounders such as age, sex, liver disease, cigarette
smoking.13‒16 In a recent paper we have shown how IgE contributes to
malaria prophylaxis.17 Alcohol can increase the solubility of poorly
soluble drugs and hence increase their bioavailability. And increases
the intestinal permeability to indigested macromolecules.18,19
Palm wines
A study from Niger showed that palm wine consumption may
deplete the body’s antioxidants against free radical attacks and render
the body in a state of oxidative stress.20 In Nigeria a face-to-face ethno-
medical survey on 1000 randomly selected families in conrmed the
use of palm wines as antimicrobial agents and prophylactic agents
against malaria. The hypothesized mechanism is that the ethanol
content of the palm wines may increase membrane uidity, altering
ion channels and K⁺ content of the infected erythrocytes thereby
impairing motor performance of Plasmodia.21,22 Medicinal herbs can
be infused in palm wine. Palm wine is added to the decoctions of
bitter herbs to increase their palatability. Palm wine is very rich in
potassium, sodium is only present in traces, a situation very similar to
that of Artemisia annua.23 Many palm wines are rich in anthocyanins
concentrated in the pericarp. Anthocyanins have a strong effect on
hemozoin inhibition like in black or red grapes or in pomegranate.24,25
Conclusion
It is hard to outline a conclusion. Heavy alcohol drinking certainly
never should be recommended. Alcoholism is a health problem. Lets
rather listen to the French” Boire du vin rouge modérément est bon
pour la santé”.
Acknowledgements
None.
Conict of interest
The author declares that there is no Conict of interest.
References
1. Jerome M, Lucile CV, Michel I. Artemisia annua and Artemisia afra tea
infusions were equal to or better than artesunate-amodiaquine (ACT) in
treating Plasmodium falciparum malaria in a large scale, double blind,
randomized clinical trial; 2018.
2. Chrostek L, Jelski W, Szmitkowski M, et al. Gender-related differences
in hepatic activity of alcohol dehydrogenase isoenzymes and aldehyde
dehydrogenase in humans. J Clin Lab Anal. 2003;17(3):93–96.
Pharm Pharmacol Int J. 2018;6(4):310‒311. 310
© 2018 Lutgen. This is an open access article distributed under the terms of the Creative Commons Attribution License, which
permits unrestricted use, distribution, and build upon your work non-commercially.
Alcohol and malaria
Volume 6 Issue 4 - 2018
Pierre Lutgen
IFBV-BELHERB, Luxembourg
Correspondence: Pierre Lutgen, IFBV-BELHERB, BP 98
L-6905, Niederanven, Luxembourg, Email lutgenp@gms.lu
Received: July 18, 2018 | Published: August 08, 2018
Pharmacy & Pharmacology International Journal
Opinion Open Access
Opinion
In a large scale clinical trial with malaria infected patients in
RDCongo comparing ACTs with Artemisia infusion we observed
a gender difference. Whilst both genders responded equally well
to Artemisia, in the ACT-treated arm there was signicantly more
gametocyte carriage in females than males for days 14-28. Having
no valid explanation for this observation, one may wonder if it due to
differences in enzyme between males and females, like those which are
responsible for a lower susceptibility of males to alcohol consumption.
It is well known on the other hand that alcohol consumption,
especially palm wine, is much higher for males than for females in

Alcohol and malaria 311
Copyright:
©2018 Lutgen
Citation: Lutgen P. Alcohol and malaria. Pharm Pharmacol Int J. 2018;6(4):310‒311. DOI: 10.15406/ppij.2018.06.00193
3. Michot F, Gut J. Alcohol-induced bone marrow damage. A bone marrow
study in alcohol-dependent individuals. Acta Haematol. 1987;78(4):252–
257.
4. Lell B, Binh VQ, Kremsner PG. Effect of alcohol on growth of
Plasmodium falciparum. Wien Klin Wochenschr. 2000;112(10):451–452.
5. Milan NF, Kacsoh BZ, Schlenke TA. Alcohol consumption as self-
medication against blood-borne parasites in the fruit y. Curr Biol.
2012;22(6):488–493.
6. Graham G, Poulton EP. The Inuence of High Temperature on Protein
Metabolism with reference to Fever. Int J Med. 1912;6(1):82–124.
7. Colla A. Archiv Ital de Biologie. 1896;26:120.
8. Salant W. The Inuence of Alcohol on the Metabolism of Hepatic
Glycogen. Proceedings of the Society for Experimental Biology and
Medicine, Newyork: Columbia University; 1905. 17 p.
9. Van Horn CG, Ivester P, Cunningham CC. Chronic ethanol consumption
and liver glycogen synthesis. Arch Biochem Biophys. 2001;392(1):145–
152.
10. Wheeler MD. Endotoxin and Kupffer cell activation in alcoholic liver
disease. Alcohol Res Health. 2003;27(4):300–306.
11. Honchel R, Ray MB, Marsano L, et al. Tumor necrosis factor in alcohol
enhanced endotoxin liver injury. Alcohol Clin Exp Res. 1992;16(4):665–
669.
12. Sheth NK, Wisniewski TR, Franson TR. Survival of enteric pathogens
in common beverages: an in vitro study. Am J Gastroenterol.
1988;83(6):658–660.
13. Kumar Y, Lakshmi PVM, Minz RW, et al. Evaluation of Serum
Immunoglobulins IgG, IgA, IgM and Total IgE in Chronic Alcoholics:
A Community-based Study. Immunochem Immunopathol. 2015;1:102.
14. Lomholt FK, Nielsen SF, Nordestgaard BG. High alcohol consumption
causes high IgE levels but not high risk of allergic disease. J Allergy Clin
Immunol. 2016;138(5):1404–1413.
15. Vidal C, Armisén M, Domínguez-Santalla MJ, et al. Inuence of alcohol
consumption on serum IgE levels. Alcohol Clin Exp Res. 2002;26(1):59–
64.
16. Gonzalez-Quintela A, Vidal C, Gude F. Alcohol-induced alterations
in serum immunoglobulin IgE levels in human subjects. Front Biosci.
2002;7:e234–244.
17. Pierre Lutgen. Antibodies, Prophylaxis, Transmission. Pharm Pharmacol
Int J. 2018;6(2):00155.
18. Jonas HF, Erik S, Christel AS Bergström. Concomitant intake of alcohol
may increase the absorption of poorly soluble drugs. European Journal
of Pharmaceutical Sciences. 2015;67:12–20.
19. Worthington BS, Meserole L, Syrotuck JA. Effect of daily ethanol
ingestion on intestinal permeability to macromolecules. Am J Dig Dis.
1978;23(1):23–32.
20. Ogunro PS, Ologunagba PO. The effect of palm wine on lipid
peroxidation and antioxidant status of rural dwellers in South West
Nigeria. Niger Postgrad Med J. 2011;18(3):186–190.
21. Ibegbulem CO, Alisi CS. Medicinal values of Elaeis guineensis and Ra-
phia hookeri wines. Journal of Research in Biology. 2012; 2(6):589–595.
22. Chi LM, Wu WG. Mechanism of hemolysis of red blood cell mediated
by ethanol. Biochim Biophys Acta. 1991;1062(1):46–50.
23. Iwegbue CM, Ojelum AL, Bassey FI. A survey of metal proles in
some traditional alcoholic beverages in Nigeria. Food Sci Nutr. 2014;
2(6):724–733.
24. Singh R, Low ET, Ooi LC. The oil palm VIRESCENS gene controls fruit
colour and encodes a R2R3-MYB. Nat Commun. 2014;5:4106.
25. Akkawi M, Abu-La S, Abu-Remeleh Q, et al. HPLC separation of
phenolic phytochemicals from grape peels and seeds water extrac-
ts and their in vitro antimalarial activities. Pharm Pharmacol Int J.
2018;6(4):253‒259.