Annona muricata Associated with Reduced Macrophage Phagocytic Index of Swiss Mice During Cerebral Malaria Phase

Background: Cerebral malaria (CM) is mostly fatal case. Anti-plasmodial and immunomodulatory effects of Annona muricata-leaf extract (AME) might avoid CM. Immunomodulatory treatment which increased macrophage-phagocytic index (PI) and macrophage nitric oxide (NO) production, related to the increase survival of experimental (E)CM. The objectives were to determine whether ethanolic-AME influenced PI, NO-production, and correlate PI and NO-production with parasitemia during CM-phase. Method: A post-test only control group design-study was done. Thirty swiss-mice were randomly divided into 6 groups, PbA-inoculated and healthy mice grouped in C(+) and C(−); healthy mice treated with A. muricata 100 and 150 mg/Kg BW/day named as X ₁ and X ₂; PbA-inoculated and treated either dose mentioned above grouped as X ₃ and X ₄. Light microscope was used to observe parasitemia and PI. NO was measured using elisa. One-Way Anova and Benfereoni-post-hoc test were performed for normally-distributed data. Pearson test was done for analyzing correlation between variables. Results: Parasitemia-percentage and NO production were not different among PbA-inoculated groups (p = 0.916 and p = 1.000). NO produced in each of C(+), X ₃ and X ₄ group was significantly lower than C(−) (p < 0.0001). PI of X ₃ was significantly lower than C(−) group (p = 0.022). Activated-macrophage NO production correlated strongly with parasitemia-percentage in X ₃ group (r = 0.852, p = 0.015). Conclusion: The conclusions were AME treatment at any dose studied might not improve NO-production and decrease parasitemia-percentage of swiss mice during CM phase. Dose of 100 mg/kg BW/day AME might reduce PI below normal during CM-phase. This dose might contribute to a strong correlation between NO production and parasitemia percentage.