Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana.
Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana.
Malar J. 2023 Jul 31;22(1):220. doi: 10.1186/s12936-023-04652-w.
Severe malaria (SM) is a fatal multi-system disease which accounted for an estimated 619,000 deaths in 2021. Less than 30% of children presenting with SM are diagnosed and treated promptly, resulting in increased mortality and neurologic impairments in survivors. Studies have identified cytokine profiles that differentiate the various clinical manifestations of malaria (severe and uncomplicated). However, the diagnostic capability of these cytokines in differentiating between the disease states in terms of cut-off values has not yet been determined.
The plasma levels of 22 pro-inflammatory cytokines (Eotaxin/CCL 11, interferon-gamma (IFN-γ), interleukin (IL)- 2, IL-6, IL-1β, IL-12p40/p70, IL-17A, RANTES, MCP-1, IL-15, IL-5, IL-1RA, IL-2R, IFN-α, IP-10, TNF, MIG, MIP-1α, MIP-1β, IL-7, IL-8 and Granulocyte Macrophage-Colony Stimulating Factor (GM-CSF), and 3 anti-inflammatory cytokines-(IL-4, IL-13 and IL-10) in patients with SM, uncomplicated malaria (UM) and other febrile conditions, were measured and compared using the Human Cytokine Magnetic 25-Plex Panel. The receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic value of these cytokines.
The level of the pro-inflammatory cytokine, IL-17A, was significantly higher in the SM group as compared to the UM group. Levels of the anti-inflammatory cytokines however did not differ significantly among the SM and UM groups. Only IL-1β and IL-17A showed good diagnostic potential after ROC curve analysis.
The data show that levels of pro-inflammatory cytokines correlate with malaria disease severity. IL-1β and IL-17A showed good diagnostic potentials and can be considered for use in clinical practice to target treatment.
严重疟疾（SM）是一种致命的多系统疾病，据估计，2021 年有 61.9 万人因此死亡。不到 30%的出现严重疟疾的儿童能得到及时诊断和治疗，这导致死亡率增加，并使幸存者出现神经功能障碍。研究已经确定了区分疟疾（严重和不复杂）各种临床表现的细胞因子谱。然而，这些细胞因子在区分疾病状态方面的诊断能力，尚未通过截止值来确定。
使用人细胞因子磁珠 25 合 1 面板，测量并比较了严重疟疾患者、无并发症疟疾患者和其他发热患者的血浆中 22 种促炎细胞因子（嗜酸性粒细胞趋化因子/CCL11、干扰素-γ（IFN-γ）、白细胞介素（IL）-2、IL-6、IL-1β、IL-12p40/p70、IL-17A、RANTES、MCP-1、IL-15、IL-5、IL-1RA、IL-2R、IFN-α、IP-10、TNF、MIG、MIP-1α、MIP-1β、IL-7、IL-8 和粒细胞-巨噬细胞集落刺激因子（GM-CSF））和 3 种抗炎细胞因子（IL-4、IL-13 和 IL-10）的水平，并进行比较。使用接收者操作特征（ROC）曲线分析来确定这些细胞因子的诊断价值。
与无并发症疟疾组相比，严重疟疾组中促炎细胞因子 IL-17A 的水平显著升高。然而，抗炎细胞因子的水平在严重疟疾组和无并发症疟疾组之间没有显著差异。只有 IL-1β 和 IL-17A 在 ROC 曲线分析后显示出良好的诊断潜力。
数据表明，促炎细胞因子水平与疟疾疾病严重程度相关。IL-1β 和 IL-17A 显示出良好的诊断潜力，可以考虑用于临床实践以靶向治疗。
