title: Immunoregulation in human malaria: the challenge of understanding asymptomatic infection.
abstract: Asymptomatic Plasmodium infection carriers represent a major threat to malaria control worldwide as they are silent natural reservoirs and do not seek medical care. There are no standard criteria for asymptomatic Plasmodium infection; therefore, its diagnosis relies on the presence of the parasite during a specific period of symptomless infection. The antiparasitic immune response can result in reduced Plasmodium sp. load with control of disease manifestations, which leads to asymptomatic infection. Both the innate and adaptive immune responses seem to play major roles in asymptomatic Plasmodium infection; T regulatory cell activity (through the production of interleukin-10 and transforming growth factor-β) and B-cells (with a broad antibody response) both play prominent roles. Furthermore, molecules involved in the haem detoxification pathway (such as haptoglobin and haeme oxygenase-1) and iron metabolism (ferritin and activated c-Jun N-terminal kinase) have emerged in recent years as potential biomarkers and thus are helping to unravel the immune response underlying asymptomatic Plasmodium infection. The acquisition of large data sets and the use of robust statistical tools, including network analysis, associated with well-designed malaria studies will likely help elucidate the immune mechanisms responsible for asymptomatic infection.
authors.affiliation: Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brasil.
authors.forename: Vitor R de
authors.initials: VR
authors.lastname: Mendonça
authors.affiliation: Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brasil.
authors.forename: Manoel
authors.initials: M
authors.lastname: Barral-Netto
mesh_terms: D056704:Adaptive Immunity / Q000502:physiology; D000953:Antigens, Protozoan / Q000276:immunology*; D058345:Asymptomatic Infections; D015415:Biomarkers; D002353:Carrier State / Q000276:immunology* / Q000469:parasitology; D004197:Disease Reservoirs / Q000469:parasitology; D005293:Ferritins / Q000276:immunology; D006242:Haptoglobins / Q000276:immunology; D051547:Heme Oxygenase-1 / Q000276:immunology; D006801:Humans; D007113:Immunity, Innate / Q000502:physiology; D016753:Interleukin-10 / Q000276:immunology; D048031:JNK Mitogen-Activated Protein Kinases / Q000276:immunology; D016778:Malaria, Falciparum / Q000276:immunology* / Q000517:prevention & control; D016780:Malaria, Vivax / Q000276:immunology* / Q000517:prevention & control; D018512:Parasitemia / Q000276:immunology; D010961:Plasmodium / Q000276:immunology* / Q000302:isolation & purification; D016212:Transforming Growth Factor beta / Q000276:immunology
chemical_list: D000953:Antigens, Protozoan; D015415:Biomarkers; D006242:Haptoglobins; D016212:Transforming Growth Factor beta; D016753:Interleukin-10; D005293:Ferritins; D051547:Heme Oxygenase-1; D048031:JNK Mitogen-Activated Protein Kinases