Skip to main content
Top
Published in: Malaria Journal 1/2011

Open Access 01-12-2011 | Research

Plasmodium berghei ANKA infection increases Foxp3, IL-10 and IL-2 in CXCL-10 deficient C57BL/6 mice

Authors: Bismark Y Sarfo, Nana O Wilson, Vincent C Bond, Jonathan K Stiles

Published in: Malaria Journal | Issue 1/2011

Login to get access

Abstract

Background

Cerebral malaria (CM) is a major cause of malaria mortality. Sequestration of infected red blood cells and leukocytes in brain vessels coupled with the production of pro-inflammatory factors contribute to CM. CXCL-10 a chemokine that is chemotactic to T cells has been linked to fatal CM. Mice deficient for CXCL-10 gene are resistant to murine CM, while antibody ablation of CXCL-10 enhanced the production of regulatory T cells (CD4+Cd25+Foxp3+) and IL-10 which regulate the immune system. Interleukin-2 (IL-2), a pro-inflammatory cytokine implicated in malaria pathogenesis has also been shown to be a key regulator of Foxp3. However the role of Foxp3 in resistant murine CM is not well understood.

Methods

The hypothesis that resistance of CXCL-10-/- mice to murine CM may be due to enhanced expression of Foxp3 in concert with IL-10 and IL-2 was tested. CXCL-10-/- and WT C57BL/6 mice were infected with Plasmodium berghei ANKA and evaluated for CM symptoms. Brain, peripheral blood mononuclear cells (PBMCs) and plasma were harvested from infected and uninfected mice at days 2, 4 and 8. Regulatory T cells (CD4+CD25+) and non-T regs (CD4+CD25-) were isolated from PBMCs and cultured with P. berghei antigens in vitro with dendritic cells as antigen presenting cells. Regulatory T cell transcription and specific factor Foxp3, was evaluated in mouse brain and PBMCs by realtime-PCR and Western blots while IL-10, and IL-2 were evaluated in plasma and cultured supernatants by ELISA.

Results

Wild type mice exhibited severe murine CM symptoms compared with CXCL-10-/- mice. Foxp3 mRNA and protein in brain and PBMC's of CXCL-10-/- mice was significantly up-regulated (p < 0.05) by day 4 post-infection (p.i) compared with WT. Plasma levels of IL-10 and IL-2 in infected CXCL-10-/- were higher than in WT mice (p < 0.05) at days 2 and 4 p.i. Ex-vivo CD4+CD25+ T cells from CXCL-10-/- re-stimulated with P. berghei antigens produced more IL-10 than WT CD4+CD25+ T cells.

Conclusion

The results indicate that in the absence of CXCL-10, the resulting up-regulation of Foxp3, IL-10 and IL-2 may be involved in attenuating fatal murine CM.
Appendix
Available only for authorised users
Literature
1.
go back to reference Finley RW, Mackey LJ, Lambert PH: Virulent P. berghei malaria: prolonged survival and decreased cerebral pathology in T cell-dependent nude mice. J Immunol. 1982, 129: 2213-2218.PubMed Finley RW, Mackey LJ, Lambert PH: Virulent P. berghei malaria: prolonged survival and decreased cerebral pathology in T cell-dependent nude mice. J Immunol. 1982, 129: 2213-2218.PubMed
2.
go back to reference Sarfo BY, Armah HB, Irune I, Adjei AA, Olver CS, Singh S, Lillard JW, Stiles JK: Plasmodium yoelii 17XL infection up-regulates RANTES, CCR1, CCR3 and CCR5 expression, and induces ultrastructural changes in the cerebellum. Malar J. 2005, 4: 63-10.1186/1475-2875-4-63.PubMedCentralCrossRefPubMed Sarfo BY, Armah HB, Irune I, Adjei AA, Olver CS, Singh S, Lillard JW, Stiles JK: Plasmodium yoelii 17XL infection up-regulates RANTES, CCR1, CCR3 and CCR5 expression, and induces ultrastructural changes in the cerebellum. Malar J. 2005, 4: 63-10.1186/1475-2875-4-63.PubMedCentralCrossRefPubMed
3.
go back to reference Hanum PS, Hayano M, Kojima S: Cytokine and chemokine responses in a cerebral malaria-susceptible or -resistant strain of mice to Plasmodium berghei ANKA infection: early chemokine expression in the brain. Int Immunol. 2003, 15: 633-640. 10.1093/intimm/dxg065.CrossRef Hanum PS, Hayano M, Kojima S: Cytokine and chemokine responses in a cerebral malaria-susceptible or -resistant strain of mice to Plasmodium berghei ANKA infection: early chemokine expression in the brain. Int Immunol. 2003, 15: 633-640. 10.1093/intimm/dxg065.CrossRef
4.
go back to reference Sarfo BY, Singh S, Lillard JW, Quarshie A, Gyasi RK, Armah H, Adjei AA, Jolly P, Stiles JK: The cerebral-malaria-associated expression of RANTES, CCR3 and CCR5 in post-mortem tissue samples. Ann Trop Med Parasitol. 2004, 98: 297-303. 10.1179/000349804225003271.CrossRefPubMed Sarfo BY, Singh S, Lillard JW, Quarshie A, Gyasi RK, Armah H, Adjei AA, Jolly P, Stiles JK: The cerebral-malaria-associated expression of RANTES, CCR3 and CCR5 in post-mortem tissue samples. Ann Trop Med Parasitol. 2004, 98: 297-303. 10.1179/000349804225003271.CrossRefPubMed
5.
go back to reference Armah HB, Wilson NO, Sarfo BY, Powell MD, Bond VC, Anderson W, Adjei AA, Gyasi RK, Tettey Y, Wiredu EK, Tongren JE, Udhayakumar V, Stiles JK: Cerebrospinal fluid and serum biomarkers of cerebral malaria mortality in Ghanaian children. Malar J. 2007, 6: 147-10.1186/1475-2875-6-147.PubMedCentralCrossRefPubMed Armah HB, Wilson NO, Sarfo BY, Powell MD, Bond VC, Anderson W, Adjei AA, Gyasi RK, Tettey Y, Wiredu EK, Tongren JE, Udhayakumar V, Stiles JK: Cerebrospinal fluid and serum biomarkers of cerebral malaria mortality in Ghanaian children. Malar J. 2007, 6: 147-10.1186/1475-2875-6-147.PubMedCentralCrossRefPubMed
6.
go back to reference Campanella GS, Tager AM, El Khoury JK, Thomas SY, Abrazinski TA, Manice LA, Colvin RA, Luster AD: Chemokine receptor CXCR3 and its ligands CXCL9 and CXCL10 are required for the development of murine cerebral malaria. Proc Natl Acad Sci. 2008, 105: 4814-4819. 10.1073/pnas.0801544105.PubMedCentralCrossRefPubMed Campanella GS, Tager AM, El Khoury JK, Thomas SY, Abrazinski TA, Manice LA, Colvin RA, Luster AD: Chemokine receptor CXCR3 and its ligands CXCL9 and CXCL10 are required for the development of murine cerebral malaria. Proc Natl Acad Sci. 2008, 105: 4814-4819. 10.1073/pnas.0801544105.PubMedCentralCrossRefPubMed
7.
go back to reference Sather BDP, Treuting N, Perdue M, Miazgowicz JD, Fontenot AY, Rudensky DJ, Campbell DJ: Altering the distribution of Foxp3+ regulatory T cells results in tissue-specific inflammatory disease. J Exp Med. 2007, 4: 1335-1347. 10.1084/jem.20070081.CrossRef Sather BDP, Treuting N, Perdue M, Miazgowicz JD, Fontenot AY, Rudensky DJ, Campbell DJ: Altering the distribution of Foxp3+ regulatory T cells results in tissue-specific inflammatory disease. J Exp Med. 2007, 4: 1335-1347. 10.1084/jem.20070081.CrossRef
8.
go back to reference Schneider MA, Meingassner JG, Lipp M, Moore HD, Rot A: CCR7 is required for the in vivo function of CD4+CD25+ regulatory T cells. J Exp Med. 2007, 204: 735-745. 10.1084/jem.20061405.PubMedCentralCrossRefPubMed Schneider MA, Meingassner JG, Lipp M, Moore HD, Rot A: CCR7 is required for the in vivo function of CD4+CD25+ regulatory T cells. J Exp Med. 2007, 204: 735-745. 10.1084/jem.20061405.PubMedCentralCrossRefPubMed
9.
go back to reference Heller EA, Liu E, Tager AM, Yuan Q, Lin AY, Ahluwalia N, Jones K, Koehn SL, Lok VM, Aikawa E, Moore KJ, Luster AD, Gerszten RE: Chemokine CXCL10 promotes atherogenesis by modulating the local balance of effector and regulatory T cells. Circulation. 2006, 113: 2301-2312. 10.1161/CIRCULATIONAHA.105.605121.CrossRefPubMed Heller EA, Liu E, Tager AM, Yuan Q, Lin AY, Ahluwalia N, Jones K, Koehn SL, Lok VM, Aikawa E, Moore KJ, Luster AD, Gerszten RE: Chemokine CXCL10 promotes atherogenesis by modulating the local balance of effector and regulatory T cells. Circulation. 2006, 113: 2301-2312. 10.1161/CIRCULATIONAHA.105.605121.CrossRefPubMed
10.
go back to reference Qin S, Sui Y, Soloff AC, Junecko BA, Kirschner DE, Murphey-Corb MA, Watkins SC, Tarwater PM, Pease JE, Barratt-Boyes SM, Reinhart TA: Chemokine and cytokine mediated loss of regulatory T cells in lymph nodes during pathogenic simian immunodeficiency virus infection. J Immunol. 2008, 180: 5530-5536.PubMedCentralCrossRefPubMed Qin S, Sui Y, Soloff AC, Junecko BA, Kirschner DE, Murphey-Corb MA, Watkins SC, Tarwater PM, Pease JE, Barratt-Boyes SM, Reinhart TA: Chemokine and cytokine mediated loss of regulatory T cells in lymph nodes during pathogenic simian immunodeficiency virus infection. J Immunol. 2008, 180: 5530-5536.PubMedCentralCrossRefPubMed
11.
go back to reference Haque A, Echchannaoui H, Seguin R, Schwartzman J, Kasper LH, Haque S: Cerebral malaria in mice: interleukin-2 treatment induces accumulation of gammadelta T cells in the brain and alters resistant mice to susceptible-like phenotype. Am J Pathol. 2001, 158: 163-172. 10.1016/S0002-9440(10)63954-5.PubMedCentralCrossRefPubMed Haque A, Echchannaoui H, Seguin R, Schwartzman J, Kasper LH, Haque S: Cerebral malaria in mice: interleukin-2 treatment induces accumulation of gammadelta T cells in the brain and alters resistant mice to susceptible-like phenotype. Am J Pathol. 2001, 158: 163-172. 10.1016/S0002-9440(10)63954-5.PubMedCentralCrossRefPubMed
12.
go back to reference Sakaguchi S: Regulatory T cells: key controllers of immunologic self-tolerance. Cell. 2000, 101: 455-458. 10.1016/S0092-8674(00)80856-9.CrossRefPubMed Sakaguchi S: Regulatory T cells: key controllers of immunologic self-tolerance. Cell. 2000, 101: 455-458. 10.1016/S0092-8674(00)80856-9.CrossRefPubMed
13.
go back to reference Sakaguchi S: Naturally arising Foxp3-expressing CD25+CD4+ regulatory T cells in immunological tolerance to self and non-self. Nat Immunol. 2005, 6: 345-352. 10.1038/ni1178.CrossRefPubMed Sakaguchi S: Naturally arising Foxp3-expressing CD25+CD4+ regulatory T cells in immunological tolerance to self and non-self. Nat Immunol. 2005, 6: 345-352. 10.1038/ni1178.CrossRefPubMed
14.
go back to reference Asseman C, Mauze S, Leach MW, Coffman RL, Powrie F: An essential role for interleukin 10 in the function of regulatory T cells that inhibit intestinal inflammation. J Exp Med. 1999, 190: 995-1004. 10.1084/jem.190.7.995.PubMedCentralCrossRefPubMed Asseman C, Mauze S, Leach MW, Coffman RL, Powrie F: An essential role for interleukin 10 in the function of regulatory T cells that inhibit intestinal inflammation. J Exp Med. 1999, 190: 995-1004. 10.1084/jem.190.7.995.PubMedCentralCrossRefPubMed
15.
go back to reference Powrie F, Read S, Mottet C, Uhlig H, Maloy K: Control of immune pathology by regulatory T cells. Norvatis Found Symp. 2003, 252: 92-98. full_text.CrossRef Powrie F, Read S, Mottet C, Uhlig H, Maloy K: Control of immune pathology by regulatory T cells. Norvatis Found Symp. 2003, 252: 92-98. full_text.CrossRef
16.
go back to reference Ocaña-Morgner C, Wong KA, Lega F, Dotor J, Borras-Cuesta F, Rodriguez A: Role of TGF-beta and PGE2 in T cell responses during Plasmodium yoelii infection. Eur J Immunol. 2007, 37: 1562-1574.CrossRefPubMed Ocaña-Morgner C, Wong KA, Lega F, Dotor J, Borras-Cuesta F, Rodriguez A: Role of TGF-beta and PGE2 in T cell responses during Plasmodium yoelii infection. Eur J Immunol. 2007, 37: 1562-1574.CrossRefPubMed
17.
go back to reference Kima PE, Srivastava IK, Long CA: Proteins with molecular masses of 25 to 40 kilodaltons elicit optimal protective responses against Plasmodium chabaudi adami infection. Infect Immun. 1992, 60: 5065-5070.PubMedCentralPubMed Kima PE, Srivastava IK, Long CA: Proteins with molecular masses of 25 to 40 kilodaltons elicit optimal protective responses against Plasmodium chabaudi adami infection. Infect Immun. 1992, 60: 5065-5070.PubMedCentralPubMed
18.
go back to reference Brown H, Hien TT, Day N, Mai NTH, Chuong LV, Chau TTH, Loc PP, Phu NH, Bethell D, Farrar J, Gatter K, White N, Turner G: Evidence of blood-brain barrier dysfunction in human cerebral malaria. Neuropathol & Appl Neurobiol. 1999, 25: 331-340.CrossRef Brown H, Hien TT, Day N, Mai NTH, Chuong LV, Chau TTH, Loc PP, Phu NH, Bethell D, Farrar J, Gatter K, White N, Turner G: Evidence of blood-brain barrier dysfunction in human cerebral malaria. Neuropathol & Appl Neurobiol. 1999, 25: 331-340.CrossRef
19.
go back to reference Sanni LA, Jarra W, Li C, Langhorne J: Cerebral edema and cerebral hemorrhages in Interleukin-10-deficient mice infected with Plasmodium chabaudi. Infect Immun. 2004, 72: 3054-3058. 10.1128/IAI.72.5.3054-3058.2004.PubMedCentralCrossRefPubMed Sanni LA, Jarra W, Li C, Langhorne J: Cerebral edema and cerebral hemorrhages in Interleukin-10-deficient mice infected with Plasmodium chabaudi. Infect Immun. 2004, 72: 3054-3058. 10.1128/IAI.72.5.3054-3058.2004.PubMedCentralCrossRefPubMed
20.
go back to reference Wiese L, Kurtzhals JAL, Penkowa M: Neuronal apoptosis, metallothionein expression and proinflammatory responses during cerebral malaria in mice. Exp Neurol. 2005, 200: 216-226.CrossRef Wiese L, Kurtzhals JAL, Penkowa M: Neuronal apoptosis, metallothionein expression and proinflammatory responses during cerebral malaria in mice. Exp Neurol. 2005, 200: 216-226.CrossRef
21.
go back to reference Jain V, Armah HB, Tongren JE, Ned RM, Wilson NO, Crawford S, Joel PK, Singh MP, Nagpal AC, Dash AP, Udhayakumar V, Singh N, Stiles JK: Plasma CXCL-10, apoptotic and angiogenic factors associated with fatal cerebral malaria in India. Malar J. 2008, 7: 83-10.1186/1475-2875-7-83.PubMedCentralCrossRefPubMed Jain V, Armah HB, Tongren JE, Ned RM, Wilson NO, Crawford S, Joel PK, Singh MP, Nagpal AC, Dash AP, Udhayakumar V, Singh N, Stiles JK: Plasma CXCL-10, apoptotic and angiogenic factors associated with fatal cerebral malaria in India. Malar J. 2008, 7: 83-10.1186/1475-2875-7-83.PubMedCentralCrossRefPubMed
22.
go back to reference Loetscher MB, Gerber P, Loetscher SA, Jones L, Piali I, Clark-Lewis M, Baggiolini , Moser B: Chemokine receptor specific for CXCL-10 and Mig: structure, function and expression in activated T lymphocytes. J Exp Med. 1996, 184: 184-963. Loetscher MB, Gerber P, Loetscher SA, Jones L, Piali I, Clark-Lewis M, Baggiolini , Moser B: Chemokine receptor specific for CXCL-10 and Mig: structure, function and expression in activated T lymphocytes. J Exp Med. 1996, 184: 184-963.
23.
go back to reference Belnoue E, Kayibanda M, Vigario AM, Deschemin JC, van Rooijen N, Viguier M, Snounou G, Rénia L: The pathogenic role of brain-sequestered alphabeta CD8+ T cells in experimental cerebral malaria. J Immunol. 2002, 169: 6369-6375.CrossRefPubMed Belnoue E, Kayibanda M, Vigario AM, Deschemin JC, van Rooijen N, Viguier M, Snounou G, Rénia L: The pathogenic role of brain-sequestered alphabeta CD8+ T cells in experimental cerebral malaria. J Immunol. 2002, 169: 6369-6375.CrossRefPubMed
24.
go back to reference Nitcheu J, Bonduelle O, Combadiere C, Tefit M, Seilhean D, Mazier D, Combadiere B: Perforin-dependent brain-infiltrating cytotoxic CD8+ T lymphocytes mediate experimental cerebral malaria pathogenesis. J Immunol. 2003, 170: 2221-2228.CrossRefPubMed Nitcheu J, Bonduelle O, Combadiere C, Tefit M, Seilhean D, Mazier D, Combadiere B: Perforin-dependent brain-infiltrating cytotoxic CD8+ T lymphocytes mediate experimental cerebral malaria pathogenesis. J Immunol. 2003, 170: 2221-2228.CrossRefPubMed
25.
go back to reference Finney OC, Nwakanma D, Conway DJ, Walther M, Riley EM: Homeostatic regulation of T effector to Treg ratios in an area of seasonal malaria transmission. Eur J Immunol. 2009, 39: 1288-1300. 10.1002/eji.200839112.CrossRefPubMed Finney OC, Nwakanma D, Conway DJ, Walther M, Riley EM: Homeostatic regulation of T effector to Treg ratios in an area of seasonal malaria transmission. Eur J Immunol. 2009, 39: 1288-1300. 10.1002/eji.200839112.CrossRefPubMed
26.
go back to reference Steeg C, Adler G, Sparwasser T, Fleischer B, Jacobs T: Limited role of CD4+Foxp3+ regulatory T Cells in the control of experimental cerebral malaria. J Immunol. 2009, 183: 7014-7022. 10.4049/jimmunol.0901422.CrossRefPubMed Steeg C, Adler G, Sparwasser T, Fleischer B, Jacobs T: Limited role of CD4+Foxp3+ regulatory T Cells in the control of experimental cerebral malaria. J Immunol. 2009, 183: 7014-7022. 10.4049/jimmunol.0901422.CrossRefPubMed
27.
go back to reference Liesz A, Suri-Payer E, Veltkamp C, Doerr H, Sommer C, Rivest S, Giese T, Veltkamp R: Regulatory T cells are key cerebroprotective immunomodulators in acute experimental stroke. Nat Med. 2009, 15: 192-199. 10.1038/nm.1927.CrossRefPubMed Liesz A, Suri-Payer E, Veltkamp C, Doerr H, Sommer C, Rivest S, Giese T, Veltkamp R: Regulatory T cells are key cerebroprotective immunomodulators in acute experimental stroke. Nat Med. 2009, 15: 192-199. 10.1038/nm.1927.CrossRefPubMed
28.
go back to reference Chen G, Liu J, Wang QH, Wu Y, Feng H, Zheng W, Guo SY, Li DM, Wang JC, Cao YM: Effects of CD4+CD25+Foxp3+regulatory T cells on early Plasmodium yoelii 17XL infection in BALB/c mice. Parasitol. 2009, 2: 1-14. Chen G, Liu J, Wang QH, Wu Y, Feng H, Zheng W, Guo SY, Li DM, Wang JC, Cao YM: Effects of CD4+CD25+Foxp3+regulatory T cells on early Plasmodium yoelii 17XL infection in BALB/c mice. Parasitol. 2009, 2: 1-14.
29.
go back to reference Vigário AM, Gorgette O, Dujardin HC, Cruz T, Cazenave PA, Six A, Bandeira A, Pied S: Regulatory CD4+ CD25+ Foxp3+ T cells expand during experimental Plasmodium infection but do not prevent cerebral malaria. Int J Parasitol. 2007, 37: 963-973.CrossRefPubMed Vigário AM, Gorgette O, Dujardin HC, Cruz T, Cazenave PA, Six A, Bandeira A, Pied S: Regulatory CD4+ CD25+ Foxp3+ T cells expand during experimental Plasmodium infection but do not prevent cerebral malaria. Int J Parasitol. 2007, 37: 963-973.CrossRefPubMed
30.
go back to reference Nie CQ, Bernard NJ, Schofield L, Hansen DS: CD4+CD25+ regulatory T cells suppress CD4+ T-cell function and inhibit the development of Plasmodium berghei-specific TH1 responses involved in cerebral malaria pathogenesis. Infect Imunnol. 2007, 75: 2275-2288. 10.1128/IAI.01783-06.CrossRef Nie CQ, Bernard NJ, Schofield L, Hansen DS: CD4+CD25+ regulatory T cells suppress CD4+ T-cell function and inhibit the development of Plasmodium berghei-specific TH1 responses involved in cerebral malaria pathogenesis. Infect Imunnol. 2007, 75: 2275-2288. 10.1128/IAI.01783-06.CrossRef
31.
go back to reference Long TT, Nakazawa S, Onizuka S, Huaman MC, Kambara H: Influence of CD4+CD25+ T cells on Plasmodium berghei NK65 infection in BALB/c mice. Int J Parasitol. 2003, 33: 175-183. 10.1016/S0020-7519(02)00261-8.CrossRefPubMed Long TT, Nakazawa S, Onizuka S, Huaman MC, Kambara H: Influence of CD4+CD25+ T cells on Plasmodium berghei NK65 infection in BALB/c mice. Int J Parasitol. 2003, 33: 175-183. 10.1016/S0020-7519(02)00261-8.CrossRefPubMed
32.
go back to reference Cambos M, Belanger B, Jacques A, Roulet A, Scorza A: Natural regulatory (CD4+CD25+FOXP+) T cells control the production of pro-inflammatory cytokines during Plasmodium chabaudi adami infection and do not contribute to immune evasion. Int J Parasitol. 2007, 38: 229-238. 10.1016/j.ijpara.2007.07.006.CrossRefPubMed Cambos M, Belanger B, Jacques A, Roulet A, Scorza A: Natural regulatory (CD4+CD25+FOXP+) T cells control the production of pro-inflammatory cytokines during Plasmodium chabaudi adami infection and do not contribute to immune evasion. Int J Parasitol. 2007, 38: 229-238. 10.1016/j.ijpara.2007.07.006.CrossRefPubMed
33.
go back to reference Murawski MR, Litherland SA, Clare-Salzler MJ, Davoodi-Semiromi A: Up regulation of Foxp3 expression in mouse and human Treg is IL-2/STAT5 dependent: implications for the NOD STAT5B mutation in diabetes pathogenesis. Ann N Y Acad Sci. 2006, 1079: 198-204. 10.1196/annals.1375.031.CrossRefPubMed Murawski MR, Litherland SA, Clare-Salzler MJ, Davoodi-Semiromi A: Up regulation of Foxp3 expression in mouse and human Treg is IL-2/STAT5 dependent: implications for the NOD STAT5B mutation in diabetes pathogenesis. Ann N Y Acad Sci. 2006, 1079: 198-204. 10.1196/annals.1375.031.CrossRefPubMed
34.
go back to reference Zorn E, Ritz J: Studying human regulatory T cells in vivo. Clin Cancer Res. 2006, 12: 5520-5525. 10.1158/1078-0432.CCR-06-1417.CrossRef Zorn E, Ritz J: Studying human regulatory T cells in vivo. Clin Cancer Res. 2006, 12: 5520-5525. 10.1158/1078-0432.CCR-06-1417.CrossRef
Metadata
Title
Plasmodium berghei ANKA infection increases Foxp3, IL-10 and IL-2 in CXCL-10 deficient C57BL/6 mice
Authors
Bismark Y Sarfo
Nana O Wilson
Vincent C Bond
Jonathan K Stiles
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2011
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-10-69

Other articles of this Issue 1/2011

Malaria Journal 1/2011 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine