Increased Levels of Inflammatory Mediators in Children with Severe Plasmodium falciparum Malaria with Respiratory Distress
GA Awandare, B Goka, P Boeuf… - The Journal of …, 2006 - academic.oup.com
GA Awandare, B Goka, P Boeuf, JKA Tetteh, JAL Kurtzhals, C Behr, BD Akanmori
The Journal of infectious diseases, 2006•academic.oup.comBackground Respiratory distress (RD), a symptom of underlying metabolic acidosis, has
been identified as a major risk factor for mortality in children with severe malaria in Africa, yet
the molecular mediators involved in the pathogenesis of RD have not been identified
Methods We studied circulating levels of mediators of inflammation—including the cytokines
tumor necrosis factor (TNF)–α and interleukin (IL)–10; the chemokines macrophage
inflammatory protein (MIP)–1α, MIP-1β, and IL-8; and the immune activation marker …
been identified as a major risk factor for mortality in children with severe malaria in Africa, yet
the molecular mediators involved in the pathogenesis of RD have not been identified
Methods We studied circulating levels of mediators of inflammation—including the cytokines
tumor necrosis factor (TNF)–α and interleukin (IL)–10; the chemokines macrophage
inflammatory protein (MIP)–1α, MIP-1β, and IL-8; and the immune activation marker …
Abstract
BackgroundRespiratory distress (RD), a symptom of underlying metabolic acidosis, has been identified as a major risk factor for mortality in children with severe malaria in Africa, yet the molecular mediators involved in the pathogenesis of RD have not been identified
MethodsWe studied circulating levels of mediators of inflammation—including the cytokines tumor necrosis factor (TNF)–α and interleukin (IL)–10; the chemokines macrophage inflammatory protein (MIP)–1α, MIP-1β, and IL-8; and the immune activation marker neopterin—in children with RD, severe malarial anemia (SMA), cerebral malaria (CM), and uncomplicated malaria (UM)
ResultsChildren with RD had significantly higher plasma levels of TNF-α, IL-10, and neopterin and a significantly higher TNF-α:IL-10 ratio than those without RD. In addition, the results demonstrated that, relative to UM, CM was associated with increased levels of TNF-α and decreased levels of MIP-1α, whereas SMA was associated with decreased levels of IL-10. Circulating levels of neopterin were inversely correlated with hemoglobin, whereas levels of MIP-1β were positively correlated with parasitemia
ConclusionsWe conclude that distinct clinical presentations of severe malaria are associated with specific patterns of inflammatory mediators. In particular, we show, to our knowledge for the first time, that patients with malaria and RD have a strong and unbalanced proinflammatory response that may be involved in the pathogenesis of the underlying metabolic acidosis
Oxford University Press