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Malaria Journal
Published in: Malaria Journal 1/2016

Open Access 01-12-2016 | Research

Immune response pattern in recurrent Plasmodium vivax malaria

Authors: Yury Oliveira Chaves, Allyson Guimarães da Costa, Marcelo Luís Monteiro Pereira, Marcus Vinícius Guimarães de Lacerda, Jordana Grazziela Coelho-dos-Reis, Olindo Assis Martins-Filho, Andréa Teixeira-Carvalho, Adriana Malheiro, Wuelton Marcelo Monteiro, Patrícia Puccinelli Orlandi, Claudio Romero Farias Marinho, Paulo Afonso Nogueira

Published in: Malaria Journal | Issue 1/2016

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Abstract

Background

Plasmodium vivax is the causative agent of human malaria of large geographic distribution, with 35 million cases annually. In Brazil, it is the most prevalent species, being responsible by around 70 % of the malaria cases.

Methods

A cross-sectional study was performed in Manaus (Amazonas, Brazil), including 36 adult patients with primary malaria, 19 with recurrent malaria, and 20 endemic controls. The ex vivo phenotypic features of circulating leukocyte subsets (CD4+ T-cells, CD8+ T-cells, NK, NKT, B, B1 and Treg cells) as well as the plasmatic cytokine profile (IL-2, IL-4, IL-6, IL-10, TNF and IFN-γ) were assessed, aiming at establishing patterns of immune response characteristic of primary malaria vs recurrent malaria as compared to endemic controls.

Results

The proportion of subjects with high levels of WBC was reduced in malaria patients as compared to the endemic control. Monocytes were diminished particularly in patients with primary malaria. The proportion of subjects with high levels of all lymphocyte subsets was decreased in all malaria groups, regardless their clinical status. Decreased proportion of subjects with high levels of CD4+ and CD8+ T-cells was found especially in the group of patients with recurrent malaria. Data analysis indicated significant increase in the proportion of the subjects with high plasmatic cytokine levels in both malaria groups, characterizing a typical cytokine storm. Recurrent malaria patients displayed the highest plasmatic IL-10 levels, that correlated directly with the CD4+/CD8+ T-cells ratio and the number of malaria episodes.

Conclusion

The findings confirm that the infection by the P. vivax causes a decrease in peripheral blood lymphocyte subsets, which is intensified in the cases of “recurrent malaria”. The unbalanced CD4+/CD8+ T-cells ratio, as well as increased IL-10 levels were correlated with the number of recurrent malaria episodes. These results suggest that the gradual remodelling of the immune response is dependent on the repeated exposure to the parasite, which involves a strict control of the immune response mediated by the CD4+/CD8+ T-cell unbalance and exacerbated IL-10 secretion.
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Metadata
Title
Immune response pattern in recurrent Plasmodium vivax malaria
Authors
Yury Oliveira Chaves
Allyson Guimarães da Costa
Marcelo Luís Monteiro Pereira
Marcus Vinícius Guimarães de Lacerda
Jordana Grazziela Coelho-dos-Reis
Olindo Assis Martins-Filho
Andréa Teixeira-Carvalho
Adriana Malheiro
Wuelton Marcelo Monteiro
Patrícia Puccinelli Orlandi
Claudio Romero Farias Marinho
Paulo Afonso Nogueira
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2016
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-016-1501-5

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