A Low interleukin-10 tumor necrosis factor-a ratio Is associated with malaria anemia in children residing in a moloendemic malaria region in Western Kenya
Lal, Altaf A.
Orago, Alloys S. S.
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The balance between Th1 cytokines (tumor necrosis factor [TNF]-α, interferon [IFN]-g) 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-g 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-a 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