@Article{ecn.2010.0208,
AUTHOR = {Swapnil Sinha, Tabish Qidwai, Kanika Kanchan, Ganga N. Jha, Prerna Anand, Sudhanshu S. Pati, Sanjib Mohanty, Saroj K. Mishra, Prajesh K. Tyagi, Surya K. Sharma, Shally Awasthi, Vimala Venkatesh, Saman Habib},
TITLE = {Distinct cytokine profiles define clinical immune response to <i>falciparum</i> malaria in regions of high or low disease transmission},
JOURNAL = {European Cytokine Network},
VOLUME = {21},
YEAR = {2010},
NUMBER = {4},
PAGES = {232--240},
URL = {http://www.techscience.com/ECN/v21n4/65840},
ISSN = {1952-4005},
ABSTRACT = {The immune effector response to <i>Plasmodium falciparum</i> infection involves a finely-tuned inter-play
between different cell types and cytokines. However, the processes by which they mediate the development
of clinical immunity, in areas of different endemicity, are poorly understood. We analyzed circulating levels of
pro-inflammatory (TNF, IFN-γ, IL-12, IL-16) and anti-inflammatory (IL-4, IL-10, IL-13) cytokines in control
and patient groups drawn from a <i>P. falciparum</i>-endemic and a non-endemic region of India. The endemic
region control population exhibited a lower pro- to anti-inflammatory cytokine ratio, indicating a shift towards
a high basal Th2 response. Levels of IL-10 contributed most towards the region-specific difference in basal
cytokine response. IL-10 was also the strongest predictor of disease in the endemic region, while IL-12, along
with IL-10 and IL-6, contributed most to disease outcome in the non-endemic region. A low, mean IFN-γ/IL-10
ratio was associated with disease severity in the endemic region (p < 0.0001). In contrast, a low mean
IL-12/IL-10 ratio correlated with disease outcome in the non-endemic region (p < 0.0001). In the endemic
region, IL-13 correlated negatively with IFN-γ in severe patients (Spearman’s ρ: -0.49; p : 0.013), while in the
non-endemic region, IL-13 correlated negatively with IL-6 in severe malaria patients (Spearman’s ρ: -0.485;
p : 0.001). In conclusion, levels of pro- and anti-inflammatory cytokines and the relative balance between the
Th1 and Th2 response, illustrates how populations residing in areas of varying disease endemicity may respond
to <i>P. falciparum</i>-induced immune challenge.},
DOI = {10.1684/ecn.2010.0208}
}