肿瘤坏死因子、白细胞介素-6和白细胞介素-10可能与巴基斯坦南部人群的间日疟原虫相关血小板减少症有关。
Tumour necrosis factor, interleukin-6 and interleukin-10 are possibly involved in Plasmodium vivax-associated thrombocytopaenia in southern Pakistani population.
作者信息
Raza Afsheen, Khan Muhammad Shahzeb, Ghanchi Najia Karim, Raheem Ahmed, Beg Mohammad A
机构信息
Department of Pathology and Microbiology, Aga Khan University, Stadium Road, PO Box 3500, Karachi 74800, Pakistan.
出版信息
Malar J. 2014 Aug 16;13:323. doi: 10.1186/1475-2875-13-323.
BACKGROUND
In Pakistan, Plasmodium vivax is endemic causing approximately 70% of the malaria cases. A number of haematological changes, especially thrombocytopaenia have been reported for P. vivax. Several host factors including cell-mediated immune cells, such as IL-1, IL-6 and IL-10 have been documented for P. vivax-induced thrombocytopaenia. However, study on correlation of cytokines and thrombocytopaenia in P. vivax, particularly in patients with severe signs and symptoms has not been reported from Pakistan.
METHODS
A case control study to correlate TNF, IL-6 and IL-10 in healthy controls and thrombocytopaenic P. vivax-infected patients (both uncomplicated and complicated cases) from southern Pakistan was carried out during January 2009 to December 2011. One Hundred and eighty two patients presenting with microscopy-confirmed asexual P. vivax mono-infection and 100 healthy controls were enrolled in the study at Aga Khan University Hospital, Karachi. Enzyme-linked immunosorbent assay (ELISA) was performed for determination of TNF, IL-6 and IL-10 levels.
RESULTS
Out of 182 cases, mild thrombocytopaenia (platelet count 100,000-150,000 mm3) was observed in ten (5.5%), moderate (50,000-100,000 mm3) in 93 (51.1%), and profound thrombocytopaenia (<50,000 mm3) was detected in 79 (43.4%) patients. IL-6 and IL-10 levels were found approximately three-fold higher in the mild cases compared to healthy controls. Two-fold increase in TNF and IL-10 (p < 0.0001) was observed in profound thrombocytopaenic when compared with moderate cases, while IL-6 was not found to be significantly elevated.
CONCLUSION
Cytokines may have a possible role in P. vivax-induced thrombocytopaenia in Pakistani population. Findings from this study give first insight from Pakistan on the role of cytokines in P.vivax-associated thrombocytopaenia. However, further studies are required to understand the relevance of cytokines in manifestations of thrombocytopaenia in P. vivax malaria.
背景
在巴基斯坦，间日疟原虫为地方性流行，约70%的疟疾病例由其引起。已有多项关于间日疟原虫导致血液学变化的报道，尤其是血小板减少。包括细胞介导免疫细胞（如白细胞介素-1、白细胞介素-6和白细胞介素-10）在内的一些宿主因素与间日疟原虫诱导的血小板减少有关。然而，巴基斯坦尚未有关于间日疟原虫，特别是重症体征和症状患者细胞因子与血小板减少相关性的研究报道。
方法
于2009年1月至2011年12月开展一项病例对照研究，以关联巴基斯坦南部健康对照者与感染间日疟原虫且血小板减少的患者（包括非复杂性和复杂性病例）体内的肿瘤坏死因子、白细胞介素-6和白细胞介素-10水平。在卡拉奇阿迦汗大学医院，182例经显微镜确诊为间日疟原虫无性体单一感染的患者及100名健康对照者纳入该研究。采用酶联免疫吸附测定法（ELISA）测定肿瘤坏死因子、白细胞介素-6和白细胞介素-10水平。
结果
182例患者中，10例（5.5%）出现轻度血小板减少（血小板计数为100,000 - 150,000/mm³），93例（51.1%）为中度血小板减少（50,000 - 100,000/mm³），79例（43.4%）为重度血小板减少（<50,000/mm³）。与健康对照者相比，轻度病例的白细胞介素-6和白细胞介素-10水平约高出三倍。与中度血小板减少病例相比，重度血小板减少病例的肿瘤坏死因子和白细胞介素-10升高两倍（p < 0.0001），而白细胞介素-6未发现显著升高。
结论
细胞因子可能在巴基斯坦人群中间日疟原虫诱导的血小板减少中发挥作用。本研究结果首次为巴基斯坦提供了关于细胞因子在间日疟原虫相关性血小板减少中作用的见解。然而，需要进一步研究以了解细胞因子在间日疟原虫疟疾血小板减少表现中的相关性。
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