Angiotensin Receptor Blocker (ARB): Is it Effective to Prevent Cerebral Malaria?

Cerebral malaria is a severe complication of plasmodium falciparum infection with 15-25% mortality rates. Sequestration of infected red blood cells disrupts the blood brain barried leading to irreversible brain damage, impacting quality of life. Recent studies suggest angiotensin receptor blocker may offer neuroprotective by modulating the angiotensin II pathway. This research indicates that cerebral malaria disrupts the blood-brain barrier via activating β-catenin and hypertension worsens endothelial dysfunction in cerebral malaria due to increased angiotensin II activity. This correlation underscores the importance of the modulation renin-angiotensin system in cerebral malaria. Angiotensin receptor blockers show potential in cerebral malaria by inhibiting angiotensin II type 1 receptor and angiotensin II type 2 receptor. With those effects, angiotensin receptor blocker reduces endothelial damage, limits oxidative stress and neuroinflammation. Angiotensin receptor blockers offer promising potential as adjunctive therapy in cerebral malaria by targeting the dual effect of angiotensin II with improved survival and reduced cerebral edema in preclinical studies.