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Obeagu EI. Role of cytokines in immunomodulation during malaria clearance. Ann Med Surg (Lond) 2024; 86:2873-2882. [PMID: 38694310 PMCID: PMC11060309 DOI: 10.1097/ms9.0000000000002019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/22/2024] [Indexed: 05/04/2024] Open
Abstract
Malaria remains a significant global health challenge, demanding a deeper understanding of host immune responses for effective clearance of the parasitic infection. Cytokines, as crucial mediators of the immune system, orchestrate a complex interplay during the various stages of malaria infection. Throughout the course of the disease, an intricate balance of pro-inflammatory and anti-inflammatory cytokines dictate the immune response's outcome, influencing parasitic clearance and disease severity. During the initial stages, interleukins such as interleukin-12 (IL-12), interferon-gamma (IFN-γ), and tumour necrosis factor-alpha (TNF-α) play pivotal roles in activating innate immune cells, initiating the anti-parasitic response. Simultaneously, regulatory cytokines like interleukin-10 (IL-10) and transforming growth factor-beta (TGF-β) modulate this immune activation, preventing excessive inflammation and tissue damage. As the infection progresses, a delicate shift occurs, characterized by a transition to adaptive immunity, guided by cytokines like interleukin-4 (IL-4), interleukin-5 (IL-5), and interleukin-13 (IL-13), promoting antibody production and T-cell responses. Notably, the resolution of malaria infection crucially relies on a fine-tuned balance of cytokine networks. Dysregulation or imbalances in these mediators often result in immune hyperactivation, contributing to severe manifestations and prolonged infection. Understanding the multi-faceted roles of cytokines in malaria clearance offers promising avenues for therapeutic interventions. Targeting cytokine pathways to restore immune equilibrium or bolster protective responses could potentially enhance treatment strategies and vaccine development. In conclusion, the pivotal role of cytokines in immunomodulation during malaria clearance underscores their significance as potential targets for therapeutic interventions, offering promising prospects in the global fight against this infectious disease.
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Kotepui M, Duangchan T, Mahittikorn A, Mekhora C, Anabire NG, Kotepui KU. Interleukin-5 levels in relation to malaria severity: a systematic review. Malar J 2023; 22:226. [PMID: 37537570 PMCID: PMC10401852 DOI: 10.1186/s12936-023-04659-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 07/25/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND The role of cytokines such as interleukin-5 (IL-5) in the pathogenesis of malaria remains unclear. This systematic review sought to synthesize variations in IL-5 levels between severe and uncomplicated malaria, as well as between malaria and controls not afflicted with the disease. METHODS This systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022368773). Searches for studies that reported IL-5 levels in patients with malaria (any severity) and/or uninfected individuals were performed in Web of Science, PubMed, EMBASE, Scopus, CENTRAL, and MEDLINE, between 1st and 10th October, 2022. The risk of bias among all included studies was minimized using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for reporting observational studies. The differences in IL-5 levels between malaria and uninfected controls, and between severe and uncomplicated malaria were synthesized by narrative synthesis. RESULTS Among 1177 articles identified in the databases, 23 matched the eligibility criteria and were included in this systematic review. Qualitative syntheses showed the heterogeneity of IL-5 levels between different severities of clinical malaria and uninfected controls. The majority of the included studies (12/15 studies, 80%) found no change in IL-5 levels between malaria cases and uninfected controls. Similarly, most studies found no difference in IL-5 levels between severe (regardless of complications) and uncomplicated malaria (4/8 studies, 50%). The qualitative syntheses revealed that most studies found no difference in IL-5 levels between severe and non-severe malaria. CONCLUSIONS The comprehensive review suggests that IL-5 levels are unchanged in patients with different levels of clinical severity of malaria and uninfected controls. Given the limited number of published studies on IL-5 levels in malaria, there is a need for additional research to determine the function of this cytokine in the pathogenesis of malaria.
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Affiliation(s)
- Manas Kotepui
- Medical Technology Program, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
| | - Thitinat Duangchan
- Medical Technology Program, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Aongart Mahittikorn
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Chusana Mekhora
- Department of Nutrition and Health, Institute of Food Research and Product Development, Kasetsart University, Bangkok, Thailand
| | - Nsoh Godwin Anabire
- Department of Biochemistry & Molecular Medicine, School of Medicine, University for Development Studies, Tamale, Ghana
- Department of Biochemistry, Cell & Molecular Biology, West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana
| | - Kwuntida Uthaisar Kotepui
- Medical Technology Program, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
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Sornsenee P, Wilairatana P, Kotepui KU, Masangkay FR, Romyasamit C, Kotepui M. Relation between Increased IL-10 Levels and Malaria Severity: A Systematic Review and Meta-Analysis. Trop Med Infect Dis 2023; 8:35. [PMID: 36668942 PMCID: PMC9865813 DOI: 10.3390/tropicalmed8010035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 01/06/2023] Open
Abstract
The roles of anti-inflammatory cytokines in the pathogenesis of severe malaria have been widely studied, and the role of IL-10 in the pathogenesis of severe malaria remains unclear. Therefore, we performed a systematic review and meta-analysis to determine the difference in IL-10 levels between patients with severe malaria and those with non-severe malaria. The search for relevant studies was performed using PubMed, Scopus, and Embase from 1 February 2022 to 12 February 2022. The quality of the included studies was assessed according to the guidelines of the Strengthening the Reporting of Observational Studies in Epidemiology. The random-effects model was used to estimate the pooled effect. In all, 1215 studies were identified, and 19 were included in the quantitative syntheses. The results showed that patients with severe malaria had a higher IL-10 level than those with non-severe malaria (p = 0.03, pooled standardized mean difference: 0.74, 95% CI: 0.08-1.40, I2: 97.22%, 19 studies/21 sub studies). The meta-analysis results demonstrated increased IL-10 levels in patients with severe malaria compared with those with non-severe malaria. However, with the heterogeneity of the meta-analysis results, further studies are required to confirm the changes in the IL-10 levels according to the severity of malaria and to investigate whether a combination of other severity parameters with IL-10 levels could be an alternative marker for severe malaria.
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Affiliation(s)
- Phoomjai Sornsenee
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand
| | | | - Chonticha Romyasamit
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand
| | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand
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Mahittikorn A, Mala W, Masangkay FR, Kotepui KU, Wilairatana P, Kotepui M. Increased interferon-γ levels and risk of severe malaria: a meta-analysis. Sci Rep 2022; 12:18917. [PMID: 36344583 PMCID: PMC9640646 DOI: 10.1038/s41598-022-21965-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 10/06/2022] [Indexed: 11/09/2022] Open
Abstract
Interferon (IFN)-γ contributes to the pathogenesis of severe malaria; however, its mechanism remains unclear. Herein, differences in IFN-γ levels between patients with severe and uncomplicated malaria were evaluated using qualitative and quantitative (meta-analysis) approaches. The systematic review protocol was registered at PROSPERO (ID: CRD42022315213). The searches for relevant studies were performed in five databases, including PubMed, Scopus, Embase, MEDLINE and Web of Science, between 1 January and 10 July 2022. A meta-analysis was conducted to pool the mean difference (MD) of IFN-γ levels between patients with severe malaria and those with uncomplicated malaria using a random-effects model (DerSimonian and Laird method). Overall, qualitative synthesis indicated that most studies (14, 58.3%) reported no statistically significant difference in IFN-γ levels between patients with severe malaria and those with uncomplicated malaria. Meanwhile, remaining studies (9, 37.5%) reported that IFN-γ levels were significantly higher in patients with severe malaria than those in patients with uncomplicated malaria. Only one study (4.17%) reported that IFN-γ levels were significantly lower in patients with severe malaria than those in patients with uncomplicated malaria. The meta-analysis results indicated that patients with severe malaria had higher mean IFN-γ levels than those with uncomplicated malaria (p < 0.001, MD: 13.63 pg/mL, 95% confidence interval: 6.98-20.29 pg/mL, I2: 99.02%, 14 studies/15 study sites, 652 severe cases/1096 uncomplicated cases). In summary, patients with severe malaria exhibited higher IFN-γ levels than those with uncomplicated malaria, although the heterogeneity of the outcomes is yet to be elucidated. To confirm whether alteration in IFN-γ levels of patients with malaria may indicate disease severity and/or poor prognosis, further studies are warranted.
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Affiliation(s)
- Aongart Mahittikorn
- grid.10223.320000 0004 1937 0490Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Wanida Mala
- grid.412867.e0000 0001 0043 6347Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Frederick Ramirez Masangkay
- grid.412775.20000 0004 1937 1119Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines
| | - Kwuntida Uthaisar Kotepui
- grid.412867.e0000 0001 0043 6347Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Polrat Wilairatana
- grid.10223.320000 0004 1937 0490Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Manas Kotepui
- grid.412867.e0000 0001 0043 6347Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
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Kotepui KU, Thirarattanasunthon P, Rattaprasert P, Kotepui M. A systematic review and meta-analysis of blood interleukin-4 levels concerning malaria infection and severity. Malar J 2022; 21:217. [PMID: 35820892 PMCID: PMC9277793 DOI: 10.1186/s12936-022-04237-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/30/2022] [Indexed: 11/16/2022] Open
Abstract
Background Interleukin (IL)-4 had been linked to malaria severity, but the findings are controversial, and the evidence is inconsistent and imprecise. In the current investigation, data on IL-4 levels in patients with severe and uncomplicated malaria were compiled. Methods The systematic review was registered at PROSPERO (CRD42022323387). Searches for relevant articles on IL-4 levels in patients with severe malaria and studies that examined IL-4 levels in both uncomplicated malaria and healthy controls were performed in PubMed, Embase, and Scopus using the search strategy without limitation to publication years or language. The quality of all included studies was evaluated using The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: standards for reporting observational studies. Qualitative and quantitative data syntheses were performed. The random-effects model, which weights each study according to its between- and within-study variance, was used to pool the mean difference (MD) of individual studies. The degree of heterogeneity was determined using Cochran's Q and I2 statistics. Additionally, meta-regression and subgroup analyses were perfomed to investigate possible sources of heterogeneity. The outliers were identified using the leave-one-out method and assessed publication bias using funnel plots, Egger’s test, and a contour-enhanced funnel plot. Results A total of 2300 studies were identified through database searches, and 36 were included for analyses. The meta-analysis results showed lower mean IL-4 levels in severe malaria (434 cases) than in uncomplicated malaria (611 cases) (P = 0.01, pooled MD: −3.36 pg/mL, 95% confidence intervals CI −5.55 to −1.16 pg/mL, I2: 98.15%, 11 studies). The meta-analysis results showed no difference in mean IL-4 levels between cerebral malaria (96 cases) and noncerebral severe malaria (108 cases) (P = 0.71, pooled MD: 0.86 pg/mL, 95% CI −3.60 to 5.32 pg/mL, I2 92.13%, four studies). Finally, no difference was found in mean IL-4 levels between uncomplicated malaria (635 cases) and healthy controls (674 cases) (P = 0.57, pooled MD: 0.79 pg/mL, 95% CI −1.92 to 3.50 pg/mL, I2: 99.89%, 11 studies). Conclusion The meta-analysis revealed lower IL-4 levels in patients with severe malaria than in those with uncomplicated malaria, though a trend toward comparable IL-4 levels between both groups was more likely because several sources of heterogeneities were observed. Based on the limited number of studies included in the meta-analysis, until additional investigations have been conducted, IL-4 consideration as an alternative prognostic factor for malaria severity is not warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04237-z.
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Affiliation(s)
- Kwuntida Uthaisar Kotepui
- Medical Technology Program, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Phiman Thirarattanasunthon
- Public Health Program, School of Public Health, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Pongruj Rattaprasert
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Manas Kotepui
- Medical Technology Program, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
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Wilairatana P, Mala W, Milanez GDJ, Masangkay FR, Kotepui KU, Kotepui M. Increased interleukin-6 levels associated with malaria infection and disease severity: a systematic review and meta-analysis. Sci Rep 2022; 12:5982. [PMID: 35396564 PMCID: PMC8993930 DOI: 10.1038/s41598-022-09848-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 03/29/2022] [Indexed: 01/18/2023] Open
Abstract
Interleukin-6 (IL-6) is generated by immune cells during infection with malaria parasites and they are associated with the immunopathogenesis of malaria. The present systematic review and meta-analysis aimed to compare the differences in IL-6 levels between several groups of patients with malaria and healthy control groups. The systematic review was registered at PROSPERO with a registration number: CRD42021290753. Systematic literature searches were conducted in PubMed, Web of Science, and Scopus until November 7, 2021 to obtain studies that documented IL-6 levels in patients with malaria. The quality of the included studies was assessed using critical appraisal tools from the Joanna Briggs Institute. Differences in the mean IL-6 levels among patients with: (1) severe and non-severe malaria, (2) uncomplicated malaria and controls, (3) uncomplicated and asymptomatic malaria, (4) asymptomatic malaria and healthy controls, and (5) those that died or survived were estimated using a random-effects model. Forty-three of 1,969 studies were included in the systematic review. Results of the meta-analysis showed that patients with severe malaria had higher mean IL-6 levels than those with non-severe malaria [P = 0.04, weight mean difference (WMD) = 96.63 pg/mL, 95% confidence interval (CI) = 0.88 − 19.38 pg/mL, I2 = 99.9%, 13 studies]. Patients with uncomplicated malaria had higher mean IL-6 levels than the controls (P < 0.001, WMD = 42.86 pg/mL, 95% CI = 30.17 − 55.56 pg/mL, I2 = 100%, 17 studies). No differences in the mean levels of IL-6 were found between patients with uncomplicated malaria and those with asymptomatic malaria (P = 0.063, WMD = 42.07 pg/mL, 95% CI = − 2.23 pg/mL to − 86.37 pg/mL, I2 = 99.1%, 8 studies), or between patients with asymptomatic malaria and healthy controls (P = 0.45, WMD = 1.67 pg/mL, 95% CI = − 2.73 pg/mL to − 6.07 pg/mL, I2 = 98.1%, 2 studies). A higher mean level of IL-6 was observed in patients who died compared with the levels of those who survived (P = 0.007, WMD = 1,399.19 pg/mL, 95% CI = 384.16 − 2,414.2 pg/mL, I2 = 93.1%, 4 studies). Our meta-analysis of the pooled evidence can be used to guide future studies in which IL-6 levels are measured during malaria outbreaks to monitor malaria severity. Heterogeneity of the effect estimate among the included studies was the main limitation of this analysis. In conclusion, significantly increased levels of IL-6 were observed in patients with severe malaria compared with those in patients with non-severe malaria, which indicates that IL-6 is a candidate marker for severe malaria. Future studies should investigate the sensitivity and specificity of increased IL-6 levels to determine the effectiveness of assessments of IL-6 levels monitoring of malaria infection and severity.
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Affiliation(s)
- Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Wanida Mala
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Giovanni De Jesus Milanez
- Department of Medical Technology, Faculty of Pharmacy, University of Santo Tomas, Manila, Philippines
| | | | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
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Onohuean H, Alagbonsi AI, Usman IM, Iceland Kasozi K, Alexiou A, Badr RH, Batiha GES, Ezeonwumelu JOC. Annona muricata Linn and Khaya grandifoliola C.DC. Reduce Oxidative Stress In Vitro and Ameliorate Plasmodium berghei-Induced Parasitemia and Cytokines in BALB/c Mice. J Evid Based Integr Med 2021; 26:2515690X211036669. [PMID: 34350806 PMCID: PMC8358498 DOI: 10.1177/2515690x211036669] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background. Annona muricata and Khaya grandifoliola are ethnomedicinally used for the treatment of malaria and have been experimentally shown to have an anti-plasmodial effect, but the mechanisms involved are not fully understood. This study investigated the effect of the ethanol extracts of their leaves on parasitemia, radical scavenging and cytokines in Plasmodium berghei ANKA-infected BALB/c mice. Methods. BALB/c mice were infected with P. berghei and treated with chloroquine, A. muricata or K. grandifoliola extract for 4 days. The percentage of parasitemia and the level of cytokine expression were determined after treatment. Trace element, phytochemical and nitric oxide (NO) scavenging activity, 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging properties assays were done to study the antioxidant effects of AN and KG in vitro. Results. P. berghei consistently increased parasitemia in BALB/c mice. The tested doses (100-, 200-, and 400 mg/kg) of A. muricata and K. grandifoliola attenuated the P. berghei-induced elevation of parasitemia and cytokines (TNF-α, IL-5, and IL-6) in vivo during the experimental period, though not as much as chloroquine. Moreover, both extracts scavenged the DPPH and NO radicals, though A. muricata had more anti-oxidant effect than K. grandifoliola in-vitro. Conclusion. The ethanol extracts of A. muricata and K. grandifoliola reduce parasitemia in P. berghei-treated mice BALB/c by scavenging free radicals and reducing cytokines, though the extracts were not as effective as chloroquine.
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Affiliation(s)
- Hope Onohuean
- Biomolecules, Metagenomics, Endocrine and Tropical Disease Research Group (BMETDREG), Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda.,Biopharmaceutics Unit, Department of Pharmacology and Toxicology, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
| | - Abdullateef I Alagbonsi
- Physiology Unit, Department of Clinical Biology, School of Medicine and Pharmacy, University of Rwanda College of Medicine and Health Sciences, Huye, Republic of Rwanda
| | - Ibe M Usman
- Biomolecules, Metagenomics, Endocrine and Tropical Disease Research Group (BMETDREG), Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda.,Department of Anatomy, Faculty of Biomedical Sciences, Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda
| | | | - Athanasios Alexiou
- Novel Global Community Educational Foundation, Hebersham, New South Wales, Australia.,AFNP Med Austria, Wien, Austria
| | - Reem H Badr
- Department of Plant Physiology Botany and Microbiology, Faculty of Science, Alex University, Egypt
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, El Beheira, Egypt
| | - Joseph O C Ezeonwumelu
- Biomolecules, Metagenomics, Endocrine and Tropical Disease Research Group (BMETDREG), Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda.,Department of Clinical Pharmacy and Biopharmacy, School of Pharmacy, Kampala International University, Western Campus, Ishaka-Bushenyi, Uganda
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Chukwuagwu IU, Ukibe NR, Ogbu II, Ikimi CG, Agu VO, Kalu OA, Ukibe SN, Awalu JC. Evaluation of Serum Interleukin 6, Tumor Necrosis Factor-Alpha, and Interferon-Gamma Levels in Relation to Body Mass Index and Blood Pressure in HIV Seropositive Pregnant Women Coinfected with Malaria. Interdiscip Perspect Infect Dis 2020; 2020:2424802. [PMID: 33193759 PMCID: PMC7641722 DOI: 10.1155/2020/2424802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 07/23/2020] [Accepted: 10/15/2020] [Indexed: 11/26/2022] Open
Abstract
Malaria and HIV are leading causes of morbidity and mortality, particularly in sub-Saharan Africa. Both diseases are highly endemic and have a wide geographic overlap with severe impact on pregnancy. This was a case-control study designed to evaluate the levels of interleukin -6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ) and their relationship with some anthropometric indices such as body mass index (BMI) and blood pressure in HIV-malaria coinfected women attending antenatal clinic at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria. 122 pregnant women and 30 nonpregnant women (control) aged between 18 and 42 years were recruited for the study. Screening of HIV antibodies was done using a national algorithm. Peripheral malaria was determined using rapid detection and the Giemsa stain technique. Cytokines were assayed using the enzyme-linked immunosorbent assay technique. HIV-malaria coinfected pregnant women showed significantly higher levels of IL-6, IFN-γ, TNF-α, and blood pressure with reduced BMI value compared with HIV seronegative pregnant and nonpregnant control participants (p ≤ 0.001, respectively). The findings indicated significant cytokine imbalance which suggests an active inflammatory process and reduced cellular immunity. The increased BMI and blood pressure level observed indicate overweight and possible hypertension which could subsequently lead to preeclampsia and other adverse pregnancy outcomes.
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Affiliation(s)
- Ikechukwu Uzoma Chukwuagwu
- Department of Medical Laboratory, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, PMB 5025, Nnewi, Anambra State, Nigeria
| | - Nkiruka Rose Ukibe
- Department of Medical Laboratory, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, PMB 5025, Nnewi, Anambra State, Nigeria
| | - Innocent Ikechi Ogbu
- Department of Medical Laboratory, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, PMB 5025, Nnewi, Anambra State, Nigeria
| | - Charles German Ikimi
- Department of Biochemistry, Faculty of Science, Federal University of Otuoke, Yenagoa, Beyalsa State, Nigeria
| | - Victoria Ogechi Agu
- Department of Medical Laboratory, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, PMB 5025, Nnewi, Anambra State, Nigeria
| | - Ofia Anya Kalu
- Department of Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, PMB 5025, Nnewi, Anambra State, Nigeria
| | - Solomon Nwabueze Ukibe
- Department of Medical Microbiology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, PMB 5025, Nnewi, Anambra State, Nigeria
| | - Joseph Chimezie Awalu
- Department of Medical Laboratory, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, PMB 5025, Nnewi, Anambra State, Nigeria
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9
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Leão L, Puty B, Dolabela MF, Povoa MM, Né YGDS, Eiró LG, Fagundes NCF, Maia LC, Lima RR. Association of cerebral malaria and TNF-α levels: a systematic review. BMC Infect Dis 2020; 20:442. [PMID: 32576141 PMCID: PMC7310527 DOI: 10.1186/s12879-020-05107-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/18/2020] [Indexed: 02/06/2023] Open
Abstract
Background Cerebral malaria is the most severe form of infection with Plasmodium falciparum characterized by a highly inflammatory response. This systematic review aimed to investigate the association between TNF-α levels and cerebral malaria. Methods This review followed the Preferred Reporting of Systematic Review and Meta-analyses (PRISMA) guidelines. The search was performed at PubMed, LILACS, Scopus, Web of Science, The Cochrane Library, OpenGrey and Google Scholar. We have included studies of P. falciparum-infected humans with or without cerebral malaria and TNF-α dosage level. All studies were evaluated using a risk of bias tool and the GRADE approach. Results Our results have identified 2338 studies, and 8 articles were eligible according to this systematic review inclusion criteria. Among the eight articles, five have evaluated TNF- α plasma dosage, while two have evaluated at the blood and one at the brain (post-Morten). Among them, only five studies showed higher TNF-α levels in the cerebral malaria group compared to the severe malaria group. Methodological problems were identified regarding sample size, randomization and blindness, but no risk of bias was detected. Conclusion Although the results suggested that that TNF-α level is associated with cerebral malaria, the evidence is inconsistent and imprecise. More observational studies evaluating the average TNF-alpha are needed.
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Affiliation(s)
- Luana Leão
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, 01 Augusto Correa Street, Guama, Belem, PA, 66075-900, Brazil
| | - Bruna Puty
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, 01 Augusto Correa Street, Guama, Belem, PA, 66075-900, Brazil
| | - Maria Fâni Dolabela
- Postgraduate Program in Pharmaceutical Sciences, Institute of Health Sciences, Federal University of Pará, Belém, Brazil
| | | | - Yago Gecy De Sousa Né
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, 01 Augusto Correa Street, Guama, Belem, PA, 66075-900, Brazil
| | - Luciana Guimarães Eiró
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, 01 Augusto Correa Street, Guama, Belem, PA, 66075-900, Brazil
| | | | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, 01 Augusto Correa Street, Guama, Belem, PA, 66075-900, Brazil.
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Olaniyan SA, Amodu OK, Bakare AA, Troye-Blomberg M, Omotade OO, Rockett KA. Tumour necrosis factor alpha promoter polymorphism, TNF-238 is associated with severe clinical outcome of falciparum malaria in Ibadan southwest Nigeria. Acta Trop 2016; 161:62-7. [PMID: 27178813 DOI: 10.1016/j.actatropica.2016.05.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 05/03/2016] [Accepted: 05/09/2016] [Indexed: 01/24/2023]
Abstract
Tumour necrosis factor (TNF) - α has been shown to play an important role in the pathogenesis of falciparum malaria. Two TNF promoter polymorphisms, TNF-308 and TNF-238 have been associated with differential activity and production of TNF. In order to investigate the association between TNF-308 and TNF-238 and the clinical outcome of malaria in a Nigerian population, the two TNF polymorphisms were analysed using Sequenom iPLEX Platform. A total of 782 children; 283 children with uncomplicated malaria, 255 children with severe malaria and 244 children with asymptomatic infection (controls) were studied. The distribution of TNF-308 and TNF-238 genotypes were consistent with the Hardy-Weinberg equilibrium. Distribution of both TNF polymorphisms differed significantly across all clinical groups (TNF-308: p=0.007; TNF-238: p=0.001). Further tests for association with severe malaria using genotype models controlling for age, parasitaemia and HbAS showed a significant association of the TNF-238 polymorphism with susceptibility to severe malaria (95% CI=1.43-6.02, OR=2.94, p=0.003237) The GG genotype of TNF-238 significantly increased the risk of developing cerebral malaria from asymptomatic malaria and uncomplicated malaria (95% CI=1.99-18.17, OR=6.02, p<0.001 and 95% CI=1.78-8.23, OR=3.84, p<0.001 respectively). No significant association was found between TNF-308 and malaria outcome. These results show thegenetic association of TNF-238 in the clinical outcome of malaria in Ibadan, southwest Nigeria. These findings add support to the role of TNF in the outcome of malaria infection. Further large scale studies across multiple malaria endemic populations will be required to determine the specific roles of TNF-308 and TNF-238 in the outcome of falciparum malaria infection.
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Malaria parasite carbonic anhydrase: inhibition of aromatic/heterocyclic sulfonamides and its therapeutic potential. Asian Pac J Trop Biomed 2015; 1:233-42. [PMID: 23569766 DOI: 10.1016/s2221-1691(11)60034-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Revised: 02/16/2011] [Accepted: 03/13/2011] [Indexed: 11/20/2022] Open
Abstract
Plasmodium falciparum (P. falciparum) is responsible for the majority of life-threatening cases of human malaria, causing 1.5-2.7 million annual deaths. The global emergence of drug-resistant malaria parasites necessitates identification and characterization of novel drug targets and their potential inhibitors. We identified the carbonic anhydrase (CA) genes in P. falciparum. The pfCA gene encodes anα-carbonic anhydrase, a Zn(2+)-metalloenzme, possessing catalytic properties distinct from that of the human host CA enzyme. The amino acid sequence of the pfCA enzyme is different from the analogous protozoan and human enzymes. A library of aromatic/heterocyclic sulfonamides possessing a large diversity of scaffolds were found to be very good inhibitors for the malarial enzyme at moderate-low micromolar and submicromolar inhibitions. The structure of the groups substituting the aromatic-ureido- or aromatic-azomethine fragment of the molecule and the length of the parent sulfonamide were critical parameters for the inhibitory properties of the sulfonamides. One derivative, that is, 4- (3, 4-dichlorophenylureido)thioureido-benzenesulfonamide (compound 10) was the most effective in vitro Plasmodium falciparum CA inhibitor, and was also the most effective antimalarial compound on the in vitro P. falciparum growth inhibition. The compound 10 was also effective in vivo antimalarial agent in mice infected with Plasmodium berghei, an animal model of drug testing for human malaria infection. It is therefore concluded that the sulphonamide inhibitors targeting the parasite CA may have potential for the development of novel therapies against human malaria.
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Zerihun T, Degarege A, Erko B. Association of ABO blood group and Plasmodium falciparum malaria in Dore Bafeno Area, Southern Ethiopia. Asian Pac J Trop Biomed 2015; 1:289-94. [PMID: 23569777 DOI: 10.1016/s2221-1691(11)60045-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 03/21/2011] [Accepted: 04/10/2011] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess the distribution of ABO blood group and their relationship with Plasmodium falciparum (P. falciparum) malaria among febrile outpatients who sought medical attention at Dore Bafeno Health Center, Southern Ethiopia. METHODS A total of 269 febrile outpatients who visited Dore Bafeno Health Center, Southern Ethiopia, were examined for malaria and also tested for ABO blood groups in January 2010. The blood specimens were collected by finger pricking, stained with Geimsa, and examined microscopically. Positive cases of the parasitemia were counted. CareStart™ Malaria Pf/Pv Combo was also used to test the blood specimens for malaria. ABO blood groups were determined by agglutination test using ERYCLONE(®) antisera. Data on socio-demographic characteristics and treatment status of the participants were also collected. Chi-square and ANOVA tests were used to assess the difference between frequencies and means, respectively. RESULTS Out of a total of 269 participants, 178 (66.2%) febrile patients were found to be infected with Plasmodium parasites, among which 146 (54.3%), 28 (10.4%), and 4 (1.5%) belonged to P. falciparum, P. vivax, and mixed infections, respectively. All febrile patients were also tested for ABO blood groups and 51.3%, 23.5%, 21.9% and 3.3% were found to be blood types of O, A, B and AB, respectively. Both total malaria infection and P. falciparum infection showed significant association with blood types (P<0.05). The proportion of A or B but not O phenotypes was higher (P<0.05) in individuals with P. falciparum as compared with non-infected individuals. The chance of having P. falciparum infection in patients with blood groups A, B and AB was 2.5, 2.5 and 3.3 times more than individuals showing blood O phenotypes, respectively. The mean P. falciparum malaria parasitaemia for blood groups A, B, AB, and O were 3 744/µL, 1 805/µL, 5 331/µL, and 1 515/µL, respectively (P<0.01). CONCLUSIONS The present findings indicate that individuals of blood groups A, B and AB are more susceptible to P. falciparum infection as compared with individuals of blood group O. Nevertheless, further in depth studies are required to clearly establish the role that ABO blood group plays in P. falciparum malaria.
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Affiliation(s)
- Tewodros Zerihun
- Department of Medical Laboratory Science and Pathology, Jimma University, P. O. Box 455, Jimma, Ethiopia
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Plasmodium falciparum hyperparasitaemia in Nigerian children: epidemiology, clinical characteristics, and therapeutic responses to oral artemisinin-based combination treatments. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2011. [DOI: 10.1016/s2222-1808(11)60043-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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