Issifou Saadou, Mavoungou Elie, Borrmann Steffen, Bouyou-Akotet Marielle K, Matsiegui Pierre-Blaise, Kremsner Peter G, Ntoumi Francine
Unité de Recherches Médicales, Hôpital Albert Schweitzer, Lambaréné, Gabon.
Eur Cytokine Netw. 2003 Oct-Dec;14(4):238-41.
To investigate if severe malarial anemia is associated with specific cytokine overproduction, we evaluated serum levels of soluble Fas ligand (sFasL), tumor necrosis factor (TNF-alpha) and interleukin-10 (IL-10) from three groups of young children with Plasmodium falciparum infection (asymptomatic cases, uncomplicated malaria cases and severe malarial anemia cases), in a hyperendemic area of Gabon. In uncomplicated cases, only TNF levels were significantly (p < 0.001) increased in comparison to asymptomatic cases with P. falciparum infection. High levels of sFasL, TNF-alpha and IL-10 were associated with low hemoglobin concentrations, sFasL levels were significantly higher in children with severe malarial anemia (p < 0.001) as compared to both other groups. The parasite density was positively correlated with IL-10, TNF-alpha and sFasL levels. TNF-alpha and sFasL, but not IL-10 or parasitemia, were independent predictors of hemoglobin concentrations. These results suggest that, in malaria, a specific dysregulation of the cytokine balance may lead to complications such as severe anemia.
为了研究严重疟疾贫血是否与特定细胞因子的过度产生有关，我们评估了加蓬一个高度流行地区三组感染恶性疟原虫的幼儿（无症状病例、非复杂性疟疾病例和严重疟疾贫血病例）血清中可溶性Fas配体（sFasL）、肿瘤坏死因子（TNF-α）和白细胞介素-10（IL-10）的水平。在非复杂性疟疾病例中，与感染恶性疟原虫的无症状病例相比，仅TNF水平显著升高（p < 0.001）。高水平的sFasL、TNF-α和IL-10与低血红蛋白浓度相关，与其他两组相比，严重疟疾贫血儿童的sFasL水平显著更高（p < 0.001）。寄生虫密度与IL-10、TNF-α和sFasL水平呈正相关。TNF-α和sFasL而非IL-10或寄生虫血症是血红蛋白浓度的独立预测因素。这些结果表明，在疟疾中，细胞因子平衡的特定失调可能导致严重贫血等并发症。
