Purpose: In India, Plasmodium vivax malaria is endemic and accounts for 50-55% of the total malaria burden in the country. There has been limited sero-epidemiological data available from malaria non-endemic regions in Karnataka state. In this study, we aimed to evaluate the plasma levels of Tumor necrosis factor-α (TNF-α), Interferon- γ (IFN-γ), Interleukin-10 (IL-10), and Transforming growth factor- β (TGF-β) and correlate with malaria parasitaemia and infection type in vivax and falciparum malaria cases reported from two study centres.
Methods: This hospital-based cross sectional observational study was conducted at BLDEU SHRI B.M. Patil Medical College, Hospital and Research Centre Vijayapur, Karnataka and BGS Global Institute of Medical Sciences, Bengaluru, Karnataka during 2016 to 2019. A total number of 45 microscopy positive and molecularly confirmed malaria cases were included in the study. Plasma samples were analyzed for the concentrations of four cytokines by Enzyme-linked immunosorbent assay (ELISA). 20 uninfected healthy volunteers were used as controls. Correlation of cytokines and parasitemia was done using Pearson correlation analysis.
Results: The results show an overall significant elevation of plasma TNF-α (p<0.05), IFN-γ (p<0.005), IL-10 (p<0.001), and TGF-β (p<0.001) in malaria patients compared to healthy controls. Except TNF-α (p<0.001), there was no significant difference in infection type specific immune responses. No significant correlation was seen among all the four cytokines with parasite load. A Receiver operating curve (ROC) was generated and showed that TNF-α, IL-10, and IFN-γ were the best individual predictors of malaria.
Conclusions: We conclude that significantly elevated plasma concentrations of TNF-α-, IL-10, IFN-γ and TGF-β in both P. vivax and P. falciparum cases suggest their active involvement in mounting defensive immune response against malaria infection.
Keywords: Malaria, Plasmodium vivax malaria, TNF-α, INF-γ, IL-10, TGF-β, Karnataka
Chloroquine–Primaquine Therapeutic Efficacy, Safety, and Plasma Levels in Patients with Uncomplicated Plasmodium vivax Malaria in a Colombian Pacific Region
