Markers of inflammation in children with severe malarial anaemia.
OBJECTIVE
To investigate if severe malarial anaemia is associated with a specific immune response pattern, we determined serum levels of neopterin (a marker of activation of macrophages by interferon-gamma) and of the anti-inflammatory cytokines, interleukins 4 and 10.


METHODS
Zambian children < 6 years of age presenting to a rural hospital with cerebral malaria were studied. Twenty-one children with admission haemoglobin concentrations </= 5 g/dl were classified as having severe anaemia and 40 with haemoglobin concentrations >/= 7 g/dl served as a control group.


RESULTS
Logistic regression modelling indicated that a 10-fold rise in serum neopterin concentrations was associated with a 50-fold increase in the estimated odds of having severe anaemia (P = 0.015), while a 10-fold rise in serum interleukin 4 concentrations was associated with a 10-fold decrease in the estimated odds of having severe anaemia (P = 0.023). Increasing serum interleukin 10 concentrations, measured in less than half of the subjects, were associated with a nonsignificant reduction in the odds of having severe anaemia (P = 0.095).


CONCLUSIONS
Development of severe malarial anaemia may be directly associated with serum neopterin concentrations and inversely correlated with serum interleukin 4 levels.
Biemba
G
G
Churches Medical Association of Zambia, Lusaka, Zambia.
Gordeuk
V R
VR
Thuma
P
P
Weiss
G
G
D000740:Anemia / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006454:Hemoglobins; D006801:Humans; D007249:Inflammation / Q000097:blood*; D016753:Interleukin-10 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D016015:Logistic Models; D016779:Malaria, Cerebral / Q000097:blood* / Q000276:immunology; D016778:Malaria, Falciparum / Q000097:blood* / Q000276:immunology; D008297:Male; D019798:Neopterin / Q000097:blood*; D012189:Retrospective Studies; D012424:Rural Population; D015024:Zambia
D015415:Biomarkers; D006454:Hemoglobins; D016753:Interleukin-10; D015847:Interleukin-4; D019798:Neopterin