A low interleukin-10 tumor necrosis factor-α ratio is associated with malaria anemia in children residing in a holoendemic malaria region in western Kenya

Abstract

The balance between Th1 cytokines (tumor necrosis factor [TNF]-α, interferon [IFN]-γ) and Th2 cytokines (interleukin [IL]-10, -4) may be critical in the development of severe falciparum malaria. Therefore, plasma concentrations of these cytokines were determined in children with various manifestations of malaria. Plasma levels of IFN-γ and IL-4 were undetectable in most children. However, TNF-α and IL-10 were significantly elevated in children with high-density parasitemia and malaria anemia compared with children in control groups. In children with mild malaria, IL-10, but not TNF-α, was significantly elevated. While the highest concentrations of TNF- α were found in children with malaria anemia, IL-10 levels were highest in children with high-density uncomplicated malaria. The mean ratio of IL-10 to TNF-α was significantly higher in children with mild and high-density parasitemia (4.64, P