A Low Interleukin-10 Tumor Necrosis Factor-α Ratio Is Associated with Malaria Anemia in Children Residing in a Holoendemic Malaria Region in Western Kenya

• Published in: The Journal of infectious diseases Vol. 179; no. 1; pp. 279 - 282
• Main Authors: Othoro, Caroline, Lal, Altaf A., Nahlen, Bernard, Koech, Davy, Orago, Alloys S. S., Udhayakumar, Venkatachalam
• Format: Journal Article
• Language: English
• Published: Chicago, IL University Chicago Press 01-01-1999; University of Chicago Press
• Subjects: Anemia; Anemia - blood; Anemia - etiology; Anemia - immunology; Biological and medical sciences; Blood plasma; Case-Control Studies; Cerebral malaria; Child; Child, Preschool; Concise Communications; Cross-Sectional Studies; Cytokines; Down-Regulation; Human protozoal diseases; Humans; Infections; Infectious diseases; Interleukin-10 - blood; Kenya; Malaria; Malaria, Falciparum - blood; Malaria, Falciparum - complications; Malaria, Falciparum - immunology; Medical sciences; Models, Biological; Parasitemia; Parasitic diseases; Parasitism; Protozoal diseases; Symptoms; Tumor Necrosis Factor-alpha - metabolism; Tumor necrosis factors; Kenya; Human; Protozoa; Apicomplexa; Protozoal disease; Prognosis; Malaria; Anemia; Pathogenesis; Cytokine; Helper cell; Hemopathy; Parasitosis; Infection; Plasmodium falciparum; T-Lymphocyte; Interleukin 10; Child; Tumor necrosis factor α; Quantitative analysis
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/314548

The balance between Th1 cytokines (tumor necrosis factor [TNF]-α, interferon [IFN]-γ) and Th2 cytokines (interleukin [IL]-10, -4) may be critical in the development of severe falciparum malaria. Therefore, plasma concentrations of these cytokines were determined in children with various manifestations of malaria. Plasma levels of IFN-γ and IL-4 were undetectable in most children. However, TNF-α and IL-10 were significantly elevated in children with high-density parasitemia and malaria anemia compared with children in control groups. In children with mild malaria, IL-10, but not TNF-α, was significantly elevated. While the highest concentrations of TNF-α were found in children with malaria anemia, IL-10 levels were highest in children with high-density uncomplicated malaria. The mean ratio of IL-10 to TNF-α was significantly higher in children with mild and high-density parasitemia (4.64, P <.005) than in children with malaria anemia (1.77). Thus, higher levels of IL-10 over TNF-α may prevent development of malaria anemia by controlling the excessive inflammatory activities of TNF-α.