title: A low interleukin-10 tumor necrosis factor-alpha ratio is associated with malaria anemia in children residing in a holoendemic malaria region in western Kenya.
abstract: The balance between Th1 cytokines (tumor necrosis factor [TNF]-alpha, interferon [IFN]-gamma) 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-gamma and IL-4 were undetectable in most children. However, TNF-alpha 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-alpha, was significantly elevated. While the highest concentrations of TNF-alpha 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-alpha 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-alpha may prevent development of malaria anemia by controlling the excessive inflammatory activities of TNF-alpha.
authors.affiliation: Vector Biology and Control Research Center, Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: C
authors.initials: C
authors.lastname: Othoro
authors.forename: A A
authors.initials: AA
authors.lastname: Lal
authors.forename: B
authors.initials: B
authors.lastname: Nahlen
authors.forename: D
authors.initials: D
authors.lastname: Koech
authors.forename: A S
authors.initials: AS
authors.lastname: Orago
authors.forename: V
authors.initials: V
authors.lastname: Udhayakumar
mesh_terms: D000740:Anemia / Q000097:blood* / Q000209:etiology / Q000276:immunology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D015536:Down-Regulation; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D007630:Kenya; D016778:Malaria, Falciparum / Q000097:blood* / Q000150:complications / Q000276:immunology*; D008954:Models, Biological; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10