Patterns of inflammatory responses and parasite tolerance vary with malaria transmission intensity
Patterns of inflammatory responses and parasite tolerance vary with malaria transmission intensity
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DOI：
10.1186/s12936-017-1796-x
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发表时间：
2017-04-11
期刊：
影响因子：
3
通讯作者：
Awandare, Gordon A.
中科院分区：
文献类型：
--
作者：
Ademolue, Temitope W.;Aniweh, Yaw;Awandare, Gordon A.
背景资料：在生活在疟疾流行地区的个人中，出现临床症状的寄生虫病阈值随传播强度而变化。然而，调节这种关系的机制尚不清楚。由于寄生虫感染的炎症反应有助于疟疾的临床表现，本研究调查了不同传播强度（从低到高）的地区疟疾儿童的炎症细胞因子反应。方法：从三个不同传播强度的地区的社区医院确诊疟疾的儿童中获得血液样本。使用基于Luminex（R）的磁珠阵列系统评估细胞因子水平，并使用适当的统计学检验比较不同部位的水平。年龄，性别，寄生虫血症和传播强度对细胞因子水平的相对贡献进行了调查，采用多元回归analysis.Results：寄生虫密度的增加，在儿童出现症状的疟疾到医院的传播强度增加，表明临床疟疾的寄生虫血症阈值增加，随着传播强度的增加。此外，促炎性细胞因子水平，包括肿瘤坏死因子α（TNF-α），干扰素-γ（IFN-γ），白细胞介素（IL）-1 β，IL-2，IL-6，IL-8和IL-12，随着传播强度的增加而下降，并与低传播区域的寄生虫血症水平显著相关，但在高传播区域则不相关。同样，抗炎细胞因子，包括IL-4，IL-7，IL-10和IL-13的水平随着传播强度的增加而下降，IL-10与低传播区的寄生虫血症水平有很强的相关性。多元线性回归分析显示，传输强度是一个更强的预测因子水平比年龄，性别和parasitaims.Conclusion：两者合计，数据表明，流行的传输强度，parasitaims水平和临床疟疾引起的炎症反应的幅度之间的强有力的关系。
Background: In individuals living in malaria-endemic regions, parasitaemia thresholds for the onset of clinical symptoms vary with transmission intensity. The mechanisms that mediate this relationship are however, unclear. Since inflammatory responses to parasite infection contribute to the clinical manifestation of malaria, this study investigated inflammatory cytokine responses in children with malaria from areas of different transmission intensities (ranging from low to high).Methods: Blood samples were obtained from children confirmed with malaria at community hospitals in three areas with differing transmission intensities. Cytokine levels were assessed using the-Luminex (R)-based magnetic bead array system, and levels were compared across sites using appropriate statistical tests. The relative contributions of age, gender, parasitaemia and transmission intensity on cytokine levels were investigated using multivariate regression analysis.Results: Parasite density increased with increasing transmission intensity in children presenting to hospital with symptomatic malaria, indicating that the parasitaemia threshold for clinical malaria increases with increasing transmission intensity. Furthermore, levels of pro-inflammatory cytokines, including tumour necrosis factor alpha (TNF-alpha), interferon-gamma ( IFN-gamma), interleukin ( IL)-1 beta, IL-2, IL-6, IL-8, and IL-12, decreased with increasing transmission intensity, and correlated significantly with parasitaemia levels in the low transmission area but not in high transmission areas. Similarly, levels of anti-inflammatory cytokines, including IL-4, IL-7, IL-10 and IL-13, decreased with increasing transmission intensity, with IL-10 showing strong correlation with parasitaemia levels in the low transmission area. Multiple linear regression analyses revealed that transmission intensity was a stronger predictor of cytokine levels than age, gender and parasitaemia.Conclusion: Taken together, the data demonstrate a strong relationship between the prevailing transmission intensity, parasitaemia levels and the magnitude of inflammatory responses induced during clinical malaria.