Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
Sci Rep. 2022 Nov 7;12(1):18917. doi: 10.1038/s41598-022-21965-z.
Interferon (IFN)-γ contributes to the pathogenesis of severe malaria; however, its mechanism remains unclear. Herein, differences in IFN-γ levels between patients with severe and uncomplicated malaria were evaluated using qualitative and quantitative (meta-analysis) approaches. The systematic review protocol was registered at PROSPERO (ID: CRD42022315213). The searches for relevant studies were performed in five databases, including PubMed, Scopus, Embase, MEDLINE and Web of Science, between 1 January and 10 July 2022. A meta-analysis was conducted to pool the mean difference (MD) of IFN-γ levels between patients with severe malaria and those with uncomplicated malaria using a random-effects model (DerSimonian and Laird method). Overall, qualitative synthesis indicated that most studies (14, 58.3%) reported no statistically significant difference in IFN-γ levels between patients with severe malaria and those with uncomplicated malaria. Meanwhile, remaining studies (9, 37.5%) reported that IFN-γ levels were significantly higher in patients with severe malaria than those in patients with uncomplicated malaria. Only one study (4.17%) reported that IFN-γ levels were significantly lower in patients with severe malaria than those in patients with uncomplicated malaria. The meta-analysis results indicated that patients with severe malaria had higher mean IFN-γ levels than those with uncomplicated malaria (p < 0.001, MD: 13.63 pg/mL, 95% confidence interval: 6.98-20.29 pg/mL, I: 99.02%, 14 studies/15 study sites, 652 severe cases/1096 uncomplicated cases). In summary, patients with severe malaria exhibited higher IFN-γ levels than those with uncomplicated malaria, although the heterogeneity of the outcomes is yet to be elucidated. To confirm whether alteration in IFN-γ levels of patients with malaria may indicate disease severity and/or poor prognosis, further studies are warranted.
干扰素 (IFN)-γ 参与严重疟疾的发病机制;然而,其机制尚不清楚。本研究采用定性和定量(荟萃分析)方法评估严重和无并发症疟疾患者之间 IFN-γ 水平的差异。系统评价方案在 PROSPERO(ID:CRD42022315213)中注册。在 2022 年 1 月 1 日至 7 月 10 日期间,在五个数据库(PubMed、Scopus、Embase、MEDLINE 和 Web of Science)中进行了相关研究的检索。采用随机效应模型(DerSimonian 和 Laird 方法)对 IFN-γ 水平在严重疟疾患者和无并发症疟疾患者之间的均数差值(MD)进行荟萃分析。总体而言,定性综合分析表明,大多数研究(14 项,58.3%)报告严重疟疾患者和无并发症疟疾患者之间 IFN-γ 水平无统计学显著差异。同时,其余研究(9 项,37.5%)报告严重疟疾患者的 IFN-γ 水平明显高于无并发症疟疾患者。只有一项研究(4.17%)报告严重疟疾患者的 IFN-γ 水平明显低于无并发症疟疾患者。荟萃分析结果表明,严重疟疾患者的 IFN-γ 水平高于无并发症疟疾患者(p<0.001,MD:13.63 pg/mL,95%置信区间:6.98-20.29 pg/mL,I:99.02%,14 项研究/15 个研究地点,652 例严重病例/1096 例无并发症病例)。总之,与无并发症疟疾患者相比,严重疟疾患者的 IFN-γ 水平更高,尽管其结果的异质性尚待阐明。为了确认疟疾患者 IFN-γ 水平的改变是否表明疾病严重程度和/或预后不良,需要进一步的研究。