Pro‐ and anti‐inflammatory cytokines mediate the progression of severe anemia in malaria‐infected children: A prospective study

Author:

Nkansah Charles12ORCID,Osei‐Boakye Felix23,Abbam Gabriel1,Appiah Samuel K.12,Daud Samira1,Boakye Bright4,Abdulai Samsiyatu4,Ahmed Madina4,Antwi Theophilus B.4,Boateng Birago4,Libatin Miigbat P.4,Mensah Alexander S.4,Missah Mary K.4,Duneeh Richard V.5,Haruna Ashiya4,Adda Stephany4,Abdul‐Rauf Pagnaa G.4,Ofori Zacharia A.4,Fosu George B.4ORCID,Segnitome Sandra4,Adjei Isaac46,Appiah‐Kubi Emmanuel4,Banyeh Moses4ORCID,Derigubah Charles A.27,Tanko Muniru M.4,Chukwurah Ejike F.2

Affiliation:

1. Department of Haematology, School of Allied Health Sciences University for Development Studies Tamale Ghana

2. Department of Medical Laboratory Science, Faculty of Health Sciences and Technology Ebonyi State University Abakaliki Nigeria

3. Department of Medical Laboratory Technology, Faculty of Applied Science and Technology Sunyani Technical University Sunyani Ghana

4. Department of Biomedical Laboratory Sciences, School of Allied Health Sciences University for Development Studies Tamale Ghana

5. Department of Medical Laboratory Science, School of Allied Health Sciences University of Health and Allied Sciences Ho Ghana

6. Haematology Unit, Department of Medical Laboratory Tamale Teaching Hospital Tamale Ghana

7. Department of Medical Laboratory Technology, School of Applied Science and Arts Bolgatanga Technical University Bolgatanga Ghana

Abstract

AbstractBackgroundSevere Plasmodium falciparum malarial anemia is still the principal cause of death in children in underdeveloped countries. An imbalance between proinflammatory and anti‐inflammatory cytokines is associated with malaria progression. This study evaluated circulating levels of selected inflammatory cytokines among malaria‐infected children in Ghana.MethodsThis case‐control study was conducted at Tamale Teaching Hospital, Ghana. One hundred and twenty children with malaria and 60 controls, aged 12−144 months were selected from April to July, 2023 for the study. Malaria was diagnosed through microscopy, full blood count was measured using hematology analyzer, and cytokines were measured using enzyme‐linked immunosorbent assay.ResultsMalaria‐infected children had higher tumor necrosis factor alpha (TNF‐α) (p < .001), interferon‐gamma (IFN‐ɣ) (p < .001), interleukin (IL)‐1β (p < .001), IL‐6 (p < .001), granulocyte macrophage‐colony stimulating factor (GM‐CSF) (p < .001), and IL‐10 (p < .001) levels than controls. Participants with high parasitemia had raised TNF‐α (p < .001), IFN‐ɣ (p < .001), IL‐1β (p < .001), IL‐6 (p < .001), GM‐CSF (p < .001), and IL‐10 (p < .001), but reduced IL‐3 (p < .001) and TGF‐β (p < .001) than those with low parasitemia. Severe malarial anemic children had elevated TNF‐α (p < .001), IFN‐ɣ (p < .001), IL‐1β (p < .001), IL‐6 (p < .001), GM‐CSF (p < .001), and IL‐10 (p < .001), but lower IL‐3 (p < .001) and TGF‐β (p < .001) than those with uncomplicated malaria.ConclusionParasite density was the principal predictor of the cytokine levels, as parasitemia positively associated with IL‐10, GM‐CSF, IL‐6, IL‐1β, IFN‐ɣ, and TNF‐α, but negatively associated with IL‐3 and TGF‐β. Malaria is associated with enhanced secretion of pro‐ and anti‐inflammatory cytokines in Ghanaian children. Inflammatory cytokines may be involved in the development of severe malarial anemia in children. However, IL‐3 and TGF‐β may offer protection against severe malarial anemia.

Publisher

Wiley

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