Severe Plasmodium vivax malaria exhibits marked inflammatory imbalance

Malaria Journal

Research

Antonio Reis-Filho¹  Jorge Clarêncio¹  Sebastião M Souza-Neto¹  Bruno B Andrade¹  Manoel Barral-Netto²  Aldina Barral²  Luis MA Camargo³ 

[1] Centro de Pesquisas Gonçalo Moniz (CPqGM), Fundação Oswaldo Cruz (FIOCRUZ), Bahia, Salvador, Brazil;Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Bahia, Salvador, Brazil;Centro de Pesquisas Gonçalo Moniz (CPqGM), Fundação Oswaldo Cruz (FIOCRUZ), Bahia, Salvador, Brazil;Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Bahia, Salvador, Brazil;Instituto de Investigação em Imunologia (iii), Instituto Nacional de Ciência e Tecnologia (INCT), São Paulo, Brazil;Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade de São Paulo, Brazil;Faculdade de Medicina, Faculdade São Lucas, Rondônia, Brazil;

关键词: Malaria;    Malaria Case;    Visceral Leishmaniasis;    Malaria Infection;    Cerebral Malaria;   

DOI  :  10.1186/1475-2875-9-13

 received in 2009-10-16, accepted in 2010-01-13,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundDespite clinical descriptions of severe vivax malaria cases having been reported, data regarding immunological and inflammatory patterns are scarce. In this report, the inflammatory and immunological status of both mild and severe vivax malaria cases are compared in order to explore immunopathological events in this disease.Methods and ResultsActive and passive malaria case detections were performed during 2007 in Buritis, Rondônia, in the Brazilian Amazon. A total of 219 participants enrolled the study. Study individuals were classified according to the presence of Plasmodium vivax infection within four groups: non-infected (n = 90), asymptomatic (n = 60), mild (n = 50) and severe vivax infection (n = 19). A diagnosis of malaria was made by microscopy and molecular assays. Since at present no clear criteria define severe vivax malaria, this study adapted the consensual criteria from falciparum malaria. Patients with severe P. vivax infection were younger, had lived for shorter time in the endemic area, and recalled having experienced less previous malaria episodes than individuals with no malaria infection and with mild or asymptomatic infection. Strong linear trends were identified regarding increasing plasma levels of C reactive protein (CRP), serum creatinine, bilirubins and the graduation of disease severity. Plasma levels of tumour necrosis factor (TNF), interferon-gamma(IFN-gamma) and also IFN-gamma/interleukin-10 ratios were increased and exhibited a linear trend with gradual augmentation of disease severity. Both laboratory parameters of organ dysfunction and inflammatory cytokines were reduced during anti-parasite therapy in those patients with severe disease.ConclusionDifferent clinical presentations of vivax malaria infection present strong association with activation of pro-inflammatory responses and cytokine imbalance. These findings are of utmost importance to improve current knowledge about physiopathological concepts of this serious widespread disease.

【 授权许可】

Unknown   
© Andrade et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.