Anti-inflammatory cytokines (TNF-α and IL-10) in malaria-infected “AA” and “AS” subjects in Enugu metropolis, South-East Nigeria

Emeka Neboh, Anthoinette Okaka, Clarence Diribe


Malaria has remained a public health issue in Nigeria and Africa, and increasing attention is being directed towards disease prevention. Cytokines have been reported to determine the outcome of malaria and Hb polymorphism has also been implicated in protection in endemic areas. This study investigated the relationship between some anti-inflammatory cytokines (TNF-α and IL-10) in Plasmodium falciparum malaria patients of AA and AS Hb genotypes in Enugu metropolis, South-East Nigeria. A total of 207 subjects aged 20-60 years were recruited for the study and divided into 4 groups. Determination of Hb genotype was done electrophoretically, while quantitation of parasites and estimation of parasite density were done microscopically. Estimation of TNF-α and IL-10 in serum was carried out using ELISA kit (Enzo® Life Sciences, U.S.A). All data were analyzed using Graph Pad Prism version 5 and SPSS version 20 computer software at 95% confidence level and results are expressed as mean ± SEM. A comparison of the test groups showed that AA test group had significantly higher (P<0.0001) MP density (3,906 ± 436.5/µl) than AS test group (1,293 ± 179/µl). The AA test group also had significantly higher TNF-α (36.31 ± 2.34 pg/ml), compared to AS test group (22.05 ± 1.22 pg/ml). IL-10 also showed significant increase (<0.05) in AA test subjects (21.78 ± 1.09 pg/ml) compared to the AS test subjects (17.21 ± 1.53). The cytokines were generally significantly higher (P<0.05) in the test subjects compared to the control. MP density however showed a significant positive correlation (P=0.0215) with IL-10 in AA test subjects. There was significant positive correlation (r=0.439, P=0.003) between IL-10 and TNF-α in AA test subjects. The high IL-10 and TNF-α in AA test subjects is suspected to have led to progression of the disease, as evidenced by the increased parasitemia in these subjects. There was neither any correlation in AA test subjects between gender and either IL-10 (r= 0.024, P= 0.873) or TNF-α (r=-0.045, P=0.771) nor in AS subjects between gender and IL-10 (r= 0.116, P= 0.463) or TNF-α (r=-0.176, P=0.271). The present study shows that cytokines actually contribute to P. falciparum malaria outcome in AA and AS subjects in Enugu metropolis. The predisposition of AA subjects to malaria may be linked to increased TNF-α and IL-10. 

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