Intestinal Parasites Coinfection Does Not Alter Plasma Cytokines Profile Elicited in Acute Malaria in Subjects from Endemic Area of Brazil

Abstract

In Brazil, malaria is prevalent in the Amazon region and these regions coincide with high prevalence of intestinal parasites but few studies explore the interaction between malaria and other parasites. Therefore, the present study evaluates changes in cytokine, chemokine, C-reactive protein, and nitric oxide (NO) concentrations in 264 individuals, comparing plasma from infected individuals with concurrent malaria and intestinal parasites to individuals with either malaria infection alone and uninfected. In the studied population 24% of the individuals were infected with Plasmodium and 18% coinfected with intestinal parasites. Protozoan parasites comprised the bulk of the intestinal parasites infections and subjects infected with intestinal parasites were more likely to have malaria. The use of principal component analysis and cluster analysis associated increased levels of IL-6, TNF-α, IL-10, and CRP and low levels of IL-17A predominantly with individuals with malaria alone and coinfected individuals. In contrast, low levels of almost all inflammatory mediators were associated predominantly with individuals uninfected while increased levels of IL-17A were associated predominantly with individuals with intestinal parasites only. In conclusion, our data suggest that, in our population, the infection with intestinal parasites (mainly protozoan) does not modify the pattern of cytokine production in individuals infected with P. falciparum and P. vivax.

The influence of intestinal parasites on Plasmodium vivax-specific antibody responses to MSP-119 and AMA-1 in rural populations of the Brazilian Amazon

“…Although protozoa infection was predominant in the present study, it is generally believed that in helminth infection the type 2 T helper (Th2) response induced by helminths could alter the natural immune response of the host to Plasmodium , due to the anti-inflammatory effect of cytokines induced by helminths. However, the cytokine profile of this population have been published and for malaria-infected individuals (M and CI groups) the profile showed high levels of IL-1, IL-6, TNF, IL-10, and CRP and decreased levels of IL-17A while for malaria-negative individuals (IP and N) the profile was high levels of IL-17A, NO and decreased levels of IL-10 and CRP [ 20 ]. Therefore, it seems that intestinal parasites co-infection (mainly protozoan) does not influence the plasmatic cytokine levels of acute malaria-infected individuals.…”

“…The individuals who took part in this study were part of a previous study investigating the effect of intestinal parasites on the circulating levels of cytokines and inflammatory markers [ 20 ]. The study area and population were also described in detail in this study.…”

“…In humans, studies demonstrating an effect of helminths on vaccine-induced immune responses against influenza, cholera and tetanus have been described [ 18 , 19 ]. So far, little information is available about whether and how co-infections of helminths and malaria parasites can affect specific immune response to malaria parasites and vaccine candidates [ 20 – 26 ]. In some epidemiological studies schistosomiasis co-infection favors anti-malarial protective antibody responses [ 21 , 25 ] while in others no significant association between schistosome-specific and Plasmodium -specific antibody responses was observed [ 22 , 23 ].…”

Enteroparasite and vivax malaria co-infection on the Brazil-French Guiana border: Epidemiological, haematological and immunological aspects

“…vivax malaria episodes in a population of children in the city of Manaus, Amazonas State [ 25 ]. In addition, in the municipality of Porto Velho in the State of Rondônia, co-infection with enteroparasites did not affect the immune response pattern to vivax malaria [ 26 , 27 ], but differences were observed between the haemoglobin levels of malaria patients and individuals who were not infected by enteroparasites [ 26 ].…”

High Frequency of Enteroparasitoses in the Municipality of Oiapoque, Amapá State, Brazil, on the Border With French Guiana

“…The implications of coinfections in humans evaluated in relation to the effects of intestinal helminth infections on falciparum malaria represent a temporal trend of continuity with variability and epidemiological complexity of each parasite in non - Brazilian endemic areas with conflicting results. In Brazil, studies with patients from the state of Rondônia coinfected with P. vivax and intestinal parasites did not find a direct relationship with anemia [29,30]. Although prevalent coinfection of malaria-intestinal parasites in tropical regions of the planet, little is known about this interaction and its impact on the immune response.…”