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Cytokine response during non-cerebral and cerebral malaria: evidence of a failure to control inflammation as a cause of death in African adults
- Source :
- PeerJ, Vol 4, p e1965 (2016), PeerJ
- Publication Year :
- 2016
- Publisher :
- PeerJ Inc., 2016.
-
Abstract
- Background.With 214 million cases and 438,000 deaths in 2015, malaria remains one of the deadliest infectious diseases in tropical countries. Several species of the protozoanPlasmodiumcause malaria. However, almost all the fatalities are due toPlasmodium falciparum, a species responsible for the severest cases including cerebral malaria. Immune response toPlasmodiumfalciparum infection is mediated by the production of pro-inflammatory cytokines, chemokines and growth factors whose actions are crucial for the control of the parasites. Following this response, the induction of anti-inflammatory immune mediators downregulates the inflammation thus preventing its adverse effects such as damages to various organs and death.Methods.We performed a retrospective, nonprobability sampling study using clinical data and sera samples from patients, mainly adults, suffering of non-cerebral or cerebral malaria in Dakar, Sénégal. Healthy individuals residing in the same area were included as controls. We measured the serum levels of 29 biomarkers including growth factors, chemokines, inflammatory and anti-inflammatory cytokines.Results.We found an induction of both pro- and anti-inflammatory immune mediators during malaria. The levels of pro-inflammatory biomarkers were higher in the cerebral malaria than in the non-cerebral malaria patients. In contrast, the concentrations of anti-inflammatory cytokines were comparable in these two groups or lower in CM patients. Additionally, four pro-inflammatory biomarkers were significantly increased in the deceased of cerebral malaria compared to the survivors. Regarding organ damage, kidney failure was significantly associated with death in adults suffering of cerebral malaria.Conclusions.Our results suggest that a poorly controlled inflammatory response determines a bad outcome in African adults suffering of cerebral malaria.
- Subjects :
- 0301 basic medicine
Cerebral
medicine.medical_treatment
Immunology
Plasmodium falciparum
lcsh:Medicine
Inflammation
Biology
Global Health
General Biochemistry, Genetics and Molecular Biology
03 medical and health sciences
Immune system
parasitic diseases
medicine
Adverse effect
Cytokine
Cause of death
General Neuroscience
lcsh:R
General Medicine
medicine.disease
biology.organism_classification
Malaria
Infectious Diseases
030104 developmental biology
Cerebral Malaria
Parasitology
medicine.symptom
General Agricultural and Biological Sciences
Subjects
Details
- Language :
- English
- ISSN :
- 21678359
- Volume :
- 4
- Database :
- OpenAIRE
- Journal :
- PeerJ
- Accession number :
- edsair.doi.dedup.....ac4e8eac06b6bf94644c7eb39b94511f