title: CD4+ CD25+ Foxp3+ regulatory T cells, dendritic cells, and circulating cytokines in uncomplicated malaria: do different parasite species elicit similar host responses?
abstract: Clearing blood-stage malaria parasites without inducing major host pathology requires a finely tuned balance between pro- and anti-inflammatory responses. The interplay between regulatory T (Treg) cells and dendritic cells (DCs) is one of the key determinants of this balance. Although experimental models have revealed various patterns of Treg cell expansion, DC maturation, and cytokine production according to the infecting malaria parasite species, no studies have compared all of these parameters in human infections with Plasmodium falciparum and P. vivax in the same setting of endemicity. Here we show that during uncomplicated acute malaria, both species induced a significant expansion of CD4(+) CD25(+) Foxp3(+) Treg cells expressing the key immunomodulatory molecule CTLA-4 and a significant increase in the proportion of DCs that were plasmacytoid (CD123(+)), with a decrease in the myeloid/plasmacytoid DC ratio. These changes were proportional to parasite loads but correlated neither with the intensity of clinical symptoms nor with circulating cytokine levels. One-third of P. vivax-infected patients, but no P. falciparum-infected subjects, showed impaired maturation of circulating DCs, with low surface expression of CD86. Although vivax malaria patients overall had a less inflammatory cytokine response, with a higher interleukin-10 (IL-10)/tumor necrosis factor alpha (TNF-α) ratio, this finding did not translate to milder clinical manifestations than those of falciparum malaria patients. We discuss the potential implications of these findings for species-specific pathogenesis and long-lasting protective immunity to malaria.
authors: Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
authors: Raquel M
authors: RM
authors: Gonçalves
authors: Karina C
authors: KC
authors: Salmazi
authors: Bianca A N
authors: BA
authors: Santos
authors: Melissa S
authors: MS
authors: Bastos
authors: Sandra C
authors: SC
authors: Rocha
authors: Sílvia B
authors: SB
authors: Boscardin
authors: Ariel M
authors: AM
authors: Silber
authors: Esper G
authors: EG
authors: Kallás
authors: Marcelo U
authors: MU
authors: Ferreira
authors: Kézia K G
authors: KK
authors: Scopel
mesh_terms: D000328:Adult; D000818:Animals; D015704:CD4 Antigens / Q000378:metabolism; D016207:Cytokines / Q000097:blood*; D003713:Dendritic Cells / Q000276:immunology*; D005260:Female; D051858:Forkhead Transcription Factors / Q000378:metabolism; D006790:Host-Parasite Interactions / Q000276:immunology*; D006801:Humans; D053645:Interleukin-2 Receptor alpha Subunit / Q000378:metabolism; D008213:Lymphocyte Activation; D016778:Malaria, Falciparum / Q000276:immunology / Q000469:parasitology; D016780:Malaria, Vivax / Q000276:immunology / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D010963:Plasmodium falciparum / Q000276:immunology* / Q000502:physiology; D010966:Plasmodium vivax / Q000276:immunology* / Q000502:physiology; D013045:Species Specificity; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*; D055815:Young Adult
chemical_list: D015704:CD4 Antigens; D016207:Cytokines; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; C508017:IL2RA protein, human; D053645:Interleukin-2 Receptor alpha Subunit